Chandler man developed liver toxicity from green tea extract

PHOENIX — A healthy 47-year-old Chandler man developed liver toxicity from over-the-counter green tea extract capsules, prompting Banner Health experts to urge caution around the supplement’s potentially harmful impacts.

Michael Sisco thought he was taking a harmless amount of energy supplements containing vitamins and caffeine for over ten years, unaware the capsules he’d been consuming also included green tea extracts, according to health experts.

On days where Sisco’s energy ran low, he started taking two additional “immunotherapy support” supplements and three to four packets of green tea energy booster supplements, all purchased from a retail store containing large amounts of green tea extract.

“Because the writing’s so small on some of these products, we didn’t catch that it was in there, at first,” Sisco, the father of twin 13-year-old boys, said in a press release. “One Friday night, I sat down to eat and felt like someone had punched me in the abdomen a bunch of times.”

His condition worsened to include jaundice, severe nausea and flu-like symptoms.

That led to Dr. Chilukuri, a gastroenterologist at Banner Ocotillo Medical Center, to order blood tests, imagining studies and IV treatment for Sisco. A liver biopsy ultimately helped the medical team determine the cause.

“He’s getting better and should recover completely, but it was serious enough that he could have needed a liver transplant and faced life-threatening issues,” Dr. Abdul Nadir, gastroenterologist and transplant hepatologist at Banner Ocotillo Medical Center, said.

About 15-20% of cases of drug-induced liver injury could be attributed to herbal and dietary supplements, according to a medical report based on U.S. Drug-Induced Liver Injury Network research.

There are no precise estimates, likely because people often don’t report the use of herbal products to their doctors.

The FDA doesn’t regulate the multi-billion-dollar industry of herbal and alternative medicine.

According to Dr. Nadir, since these products are mainly derived from trees and herbs, the public largely believes they’re harmless.

“For some reason, similar cases of liver injury seem to be unique to taking green tea extract pills or capsules, and not to drinking green tea,” Bryan Kuhn, a pharmacist at Banner’s Poison and Drug Information Center, said.

“There’s no standard for what green tea extract contains,” Kuhn noted. “You’re talking about a plant product that has dozens, if not hundreds of components that make up the plant, and each company might use different parts for its ‘proprietary blend.’”

This doesn’t mean products with green tea extract are unsafe to take in moderation, but people also shouldn’t assume they’re safe and effective because they contain natural ingredients, Kuhn added.

Some products, especially those which are imported, could be contaminated or mislabeled in ways that misrepresent ingredients, the release said.

Medical reports vary on whether adverse effects are caused by large doses or whether reactions are unpredictable and even caused by small doses.

Banner Health experts are encouraging patients to let their physician know about any non-pharmaceutical products they’re taking, to avoid risks of drug interactions and to identify possible side effects that could be indicative of a bigger medical issue.

“The main thing I’ve been telling people is, don’t use supplements to try to power through when you’re not feeling good,” Sisco said. “It didn’t really dawn on me that I was powering through when I should have just taken a break and laid down instead.”

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