Green Tea: Supplements 101

Kamila-kamelia

LEAH 0:00

did you know that, the Camelia flower that. Some of us have in our gardens is from the same family as Camelia sinensis, which is where tea comes from.

Tina 0:13

You mean green tea

LEAH 0:14

Al tea.

Tina 0:15

Al Tea.

LEAH 0:16

Alt tea comes from Camelia, sinensis

Tina 0:18

You mean green tea, black tea

LEAH 0:20

and white tea.

Tina 0:21

and white tea?

LEAH 0:22

Yeah, it just depends on, I guess, how it's been prepared.

Tina 0:25

I'm pretty sure I've always mispronounced the one in the yard. Then

LEAH 0:28

I've always pronounced the one in a cup. The when you drink, I always call that Camilla,

Tina 0:33

yeah, I called the one in the yard, Camilla and I called Green Tea Camilia, if I even called it anything other than green tea. Now I know,

LEAH 0:43

and so do I.

Tina 0:46

and this is what happens with the podcast. We get to learn ourselves.

LEAH 0:50

That we've been saying things wrong for decades.

Tina 0:53

Potato, potato, Camilla Camilia.

LEAH 0:55

Tomato. Tomato.

Tina 0:57

I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one

LEAH 1:01

and I'm Dr Leah Sherman and on the cancer inside

Tina 1:05

And we're two naturopathic doctors who practice integrative cancer care

LEAH 1:09

But we're not your doctors

Tina 1:11

This is for education entertainment and informational purposes only

LEAH 1:15

do not apply any of this information without first speaking to your doctor

Tina 1:20

The views and opinions expressed on this podcast by the hosts and their guests are solely their own

LEAH 1:26

Welcome to the cancer pod

Introduction

LEAH 1:44

Good morning, Tina.

Tina 1:45

Hey, Leah?

LEAH 1:46

We're talking about tea.

Tina 1:47

Yeah.

LEAH 1:48

the tea?

Tina 1:49

What's the tea? Some people call me tea.

LEAH 1:51

A video.

Tina 1:51

Yeah.

LEAH 1:52

I could see that being.

Tina 1:53

Since my name is Tina. Yes.

LEAH 1:55

We're talking tea today and green tea specifically?

Tina 1:59

Yeah, and that is one of the most, I don't know. I wanna say there's a lot of medical literature on green tea in cancer care.

LEAH 2:06

Yeah. I think a lot of it probably came from observational studies. People in certain countries who drink a lot of green tea don't get a lot of certain in certain name of cancer.

Tina 2:17

Yeah, the earliest I can remember the kickoff in my career was a study outta Japan that saw that people who drink. In excess of eight cups of green tea. And this is high quality green tea in Japan had less breast cancer. And actually there was a study that showed that outcomes were better in women who actually already had breast cancer. And that's the one that really got my attention. Of course, I was, that was the start of my career. So I guess suppose the timing was right.

LEAH 2:42

There is a lot of conflicting information. Out

Tina 2:46

Yeah.

LEAH 2:46

I saw a study that said that, green tea may actually increase the risk of breast cancer in certain postmenopausal women, And there was a decreased risk in some premenopausal women, so it's like, what do you, what do you, what do you go by

Tina 3:04

Yeah. So that's what we're gonna talk about today. I mean, what can people do? Do you dig deep and learn how to love green tea If you don't like it already, do you take a supplement in a capsule or,

LEAH 3:14

or avoid it altogether.

Tina 3:16

or avoid it all together? And so what does the, what does the research say at this point? And you and I did a little cursory review of the research. We, we know it pretty well already, but as always, in figuring out how to pronounce Camelia, we find out what we don't know what, before we do these podcasts too, we're like, oh,

LEAH 3:33

And I'm sure there's still a lot of stuff that we don't know.

Tina 3:36

we just avoid it though. We don't talk unless we know and if we don't know, we don't say

LEAH 3:41

We don't say anything. We don't, we don't talk about it. We don't talk the T about the T. Um, so yeah, so we're gonna talk about, you know, what is the difference between green tea and E G C G? We're gonna talk about green tea and its effect on cancer, cancer treatment. And then, As always, I will talk about cautions, contraindications, and interactions. And interactions Doesn't always mean a bad thing, so make sure you stick around for that. I.

Tina 4:07

That's a good point just for the interactions aren't always a bad thing. Sometimes you can. Potentiate a treatment or drug, but this is, interactions has a negative connotation.

LEAH 4:17

Right. But sometimes, yeah, it can act synergistically with, with certain medications.

Green teas- types & tips on preparing

LEAH 4:22

So, we touched on the fact that green tea, black tea and white tea all come from the same plant. Camelia, ensis,

Tina 4:29

Mm-hmm.

LEAH 4:29

and I. Of green tea. It's not like there's just one type of green tea. there are many types of, of green tea. Um, some of them are easier to find than others. I think matcha probably is the one most people have heard about because you can get matcha lattes and um, it's a popular thing these days. But the one that I prefer is Ensa.

Tina 4:50

I like sensa. If it's not steeped too long, it can get pretty bitter. I think sensa is probably, well, it's not my favorite type of tea. I like Jasmine tea to. Have in the middle of the day. But um, yeah, I think that a high quality Senta can be enjoyable.

LEAH 5:06

Well, I think the thing, what I learned about green tea is you don't. Use hot, like rolling boiling water when you make it, and you also don't steep it very long. So when I talk to patients who are like, oh, I don't like green tea, it's really bitter. I talk to them about, make sure your water isn't a rolling boil. I have to say that slowly a roiling boil. Make sure, make sure that your tea isn't like, you know, rapidly boiling. And also, Don't steep it more than three or four minutes because that's what starts to bring out the bitter and what you can do. Also, what I learned when I was a resident is you can take out the teabag after three to four minutes and then when you make your second cup of tea, use the same teabag. Are you smiling? 'cause you know who taught me this?

Tina 5:48

I do know who taught you this.

LEAH 5:50

I know I've remembered this ever since. So, yeah. And then you continue to get all of the beneficial antioxidants. From the tea and you get less caffeine and it doesn't really have that much caffeine. Matcha actually has the most caffeine.

Tina 6:04

Oh, okay. Well, not as, I mean as far as the green teas go.

LEAH 6:07

I was looking up to see how much caffeine is in the different green teas and some matcha, and I think it's just how much you put in it, but some matcha has more caffeine than a cup of coffee.

Tina 6:19

Oh wow.

LEAH 6:20

Yeah.

Tina 6:21

Yeah. 'cause I know in my mind I think of green tea having the least amount naturally, and then oolong having a good amount, and then black tea having the most caffeine. But it probably, it's all about processing.

LEAH 6:32

So Essentia is the one that I don't mind having a little later in the day because it does have a little bit of caffeine, but it's kind of like you don't feel jittery. I don't feel jittery. I'm gonna just speak for myself. I don't feel jittery. I think it's kind of a mild because of the theanine content.

Tina 6:47

was just gonna say, because green tea also contains theanine, which is calming.

LEAH 6:52

L-theanine, which we love.

Tina 6:54

Yeah. And I have never looked into the chemistry of this, but steeping the same leaves over I. My understanding is that the theanine content goes up while the caffeine content goes down, so it becomes more relaxing as you drink your second or third cup from the same leaves. I also learned that you must. Have clean leaves because the other thing is if there are contaminants of any kind on the green tea, like it's grown somewhere, that they have an over spray of that glyphosate, which is also called Roundup. Um, yes, the same Roundup people use in their yards is sprayed on plants and sometimes it may not be on this plant, but it can drift over that kind of thing. But whatever's on it will also continue to be pulled out. So you have to just make sure you have a super clean leaves and I think organic is a must.

LEAH 7:40

That's good information. Another particularly tasty type of green tea is made with roasted rice, which kind of takes out the bitterness, and it's called gen macha, G E N M A I C H A, for those taken notes.

Tina 7:55

Yeah. The only time I find that I drink that one is if I'm at a Japanese restaurant and I go, oh yeah, that tea exists. I always forget about it until I see it on a menu.

LEAH 8:04

It's hard to find. It's not something you can just find in like a regular grocery store. sometimes you can even find it like the loose leaf kind or loose leaf with rice kind. But yeah, it is, it's a lot more mellow.

Tina 8:15

Yes. I like that one.

LEAH 8:17

It's so tasty.

Tina 8:19

Yeah, it has a little bit more body to it, like it's more substantial.

LEAH 8:23

it's a pleasant tea.

Tina 8:24

Yeah, that one's even for people who don't like, like you just said, don't like green tea. I mean, it tastes completely different. If someone served me that and they asked me, are you drinking green tea? And I didn't know any better. I probably would say, no, I'm not. I'm not drinking green tea.

LEAH 8:38

Yeah. It's, it's like, like a. Like a woodsier taste, A fuller, I don't know. Not woodsy. It's not woodsy. I don't know what the flavor is.

Tina 8:44

Toasted.

LEAH 8:45

It's a toasted flavor. It's toasted. Okay.

Benefits of green tea

LEAH 8:48

So, um, green tea has been shown to reduce the risk of certain cancers. It's also been shown to be supportive to cardiovascular health. Um, what else?

Tina 9:01

Well, because it's high in antioxidants, the green tea, Ctech, kins, um, I mean, these are leaves we're talking about. So of course there's a lot of different. Plant-based chemical compounds, which we call phytonutrients that are helpful as antioxidants. So I know there's some data for the use in, at least in the T form and not the supplement, but the T in people who had cardiovascular risk history, lowering the risk of death from cardiovascular disease, So overall the tea itself is a nice antioxidant to keep in the diet, especially if you enjoy it.

LEAH 9:32

One little hot tip about drinking green tea is if you do drink it, don't drink it with dairy creamer. Don't put any dairy in it because that can lessen the effect of the antioxidants.

Tina 9:45

Aha. Good to know. I actually haven't heard that.

LEAH 9:48

That was something I learned a long time ago. Um, and then the other thing about it is something that I learned in my residency is you add a little bit of lemon and then that enhances the antioxidants. 'cause from the vitamin C, I'm assuming in the lemon.

Tina 10:00

Hmm.

LEAH 10:00

So we've got cooking tips or we've got, got all kinds of tips for you with green tea. But then that bums me out because that means green tea, ice cream just really doesn't have any antioxidant benefit.

Tina 10:10

Oh, there goes that. Well, and It can be consumed hot or cold. We should mention too, because sometimes people don't like hot teas, but they do like iced teas, and so now that you mentioned lemon, it reminds me that, oh, that would make a lovely iced tea.

LEAH 10:23

And it does. And for people that don't think that they like the green tea or haven't had the green tea, iced tea. You can also mix the black and the green together and then it can kind of mask the flavor. You just don't, I would think you wouldn't wanna steep the tea bags too long. Like, I don't know if you could really do a, maybe you could do a sun tea, but you know you're gonna bring out that bitterness. Otherwise, I have another fun fact. 12.5% of the US population drinks green tea.

Tina 10:50

12.5.

LEAH 10:51

Yeah, it doesn't sound like that much, does it?

Tina 10:53

No, I, that's more than I thought. I thought there'd be less than that.

LEAH 10:56

I thought it'd be more, 'cause I thought that people would drink probably like those bottled green tea, and there really isn't any antioxidant benefit if you're drinking one of those like, I don't know, name brand, is it Arizona Iced tea? I don't know, lip tin or whoever makes those bottled iced teas. Even if it's unsweetened, it really doesn't have that much of the health benefit.

Tina 11:16

Hmm.

LEAH 11:17

Because it's probably lost the antioxidant, value.

Tina 11:21

Okay. Yeah, and I know those Arizona iced teas a lot of the prepared teas, that you buy in a store outta the refrigerated section They have a lot of sugar in them. Like a lot of sugar.

LEAH 11:32

Yeah. Those in particular. Yeah. But you can find Lipton unsweetened, green tea.

Tina 11:37

Yes. But you gotta search, you gotta find it on the shelf. It's like the one,

LEAH 11:42

Oh yeah. It's not the, it's not like the upfront.

Tina 11:44

no. There'll be like 25 different iced teas.

LEAH 11:48

There'll be like the nacho cheese flavored flaming green tea drink before you can find the unsweetened one.

Tina 11:53

Exactly.

LEAH 11:54

Okay. Speaking of nacho cheese, flaming green tea, let's talk about green tea and cancer. Um, maybe we'll talk about it after the break. I.

Tina 12:03

Sounds good.

tina_interlude_gte_part1_2023-aug-14-0532pm_tina_& leah only 12:08

Hey Leia,

Track 2 12:08

Hey, Tina.

tina_interlude_gte_part1_2023-aug-14-0532pm_tina_& leah only 12:09

we had a new review.

Track 2 12:10

Oh, we did? I haven't seen that one.

tina_interlude_gte_part1_2023-aug-14-0532pm_tina_& leah only 12:12

Lemme read it to you. This is from Courtney who said, wish I found this sooner. My mom has been fighting stage four ovarian cancer for five years now, and I've been sharing integrative insights with her since reading how to Starve Cancer years ago. To no avail. It's really hard to convince a patient to expand their thinking beyond their oncologist alone. you all make these topics so easy to understand. You come off incredibly knowledgeable and unbiased at a time where my mom needs more hope than ever. I'm using information and stories from your podcast and she's finally listening. You've even inspired me to look into ND as a career change. We need more nds in the Midwest Thank you and please keep doing what you're doing.

Track 2 12:47

That's awesome.

tina_interlude_gte_part1_2023-aug-14-0532pm_tina_& leah only 12:48

that keeps us going.

12:49

I wish the best to Courtney and her mom. Thanks for writing in.

Tea versus capsules

LEAH 12:55

So Tina, is there a big difference between somebody drinking a few cups of green tea and taking capsules?

Tina 13:03

Yeah. that is, I think why we have so much conflicting information in the medical literature is the dose makes the difference. In other words, the action of the compound in green tea that we mostly study, which is that E G C G, the amount we can put in a capsule is way more than we can drink.

LEAH 13:22

And as we mentioned, the studies. That showed benefit of populations that drank green tea and their reduced risk of certain cancers. Those were observational studies, and I think it's important to understand that when they talk about somebody drank seven to eight cups, you know, on average a day of tea, they're not talking about a standard US measure. Eight ounce cup. So it's not like someone's drinking 64 ounces of green tea a day. They're drinking a Japanese tea Cup size.

Tina 13:56

Good point. Yes. That's an important point. A Japanese cup is not the equivalent of an American eight ounce cup.

LEAH 14:03

Yeah, like, the most, like what? Four ounces?

Tina 14:06

yes, four ounces would be the maximum size of a Japanese teacup, so something less than half of what we consider a cup. I.

LEAH 14:12

Yeah, so don't go drinking 64 ounces of green tea. Interestingly, with the studies that they did on the supplement on the E G C G. Doses over 800 milligrams were shown to have more risks like liver toxicity and other issues.

Tina 14:32

Yes. 800 milligrams of E G C G can only be gotten from a supplement though. We should point that out. I don't think you could possibly, I don't believe you could possibly do the volume of, even if you made super strong tea, you couldn't do that volume to get that

Effects on various cancers

Tina 14:47

high.

LEAH 14:47

And we mentioned breast cancer as being one where it was seen. In observational studies to have reduced incidents of cancer in women in Asian countries.

Tina 14:58

Mm-hmm.

LEAH 14:58

Other cancers were, um, lung cancer. There was a decreased risk of lung cancer, with prostate cancer. There was a Japanese study that showed drinking five or more cups a day. Of green tea. Again, these would not be those eight ounce cups, um, but five or more cups, a day of green tea was shown to reduce the risk of prostate cancer.

Tina 15:20

and four. Prostate cancer. There was also a short trial, like a six month study where they mixed it up with some other good for you, things like broccoli and pomegranate, and had men who had prostate cancer and they had a treatment for it already. Um, they took a supplement with the green tea, broccoli, pomegranate, I think curcumin was in there. And, the rate of p s a increase was reduced. So that's a good thing.

LEAH 15:47

So that's in somebody who has an established cancer or an established diagnosis.

Tina 15:52

Yes.

LEAH 15:53

There are some animal studies that showed that green tea can be protective against bladder cancer.

Tina 16:00

Not surprising.

LEAH 16:01

And there also are studies looking at colon cancer.

Tina 16:05

I believe the studies with colon cancer, one of the studies. Was green tea and curcumin. And there's actually supplements out there that mix the two, they're anti-cancer or they prevent the evolution of cancer in cells, in different ways And so I have given green tea in people with a history of colorectal cancer.

LEAH 16:27

The supplement.

Tina 16:28

As a supplement. Yeah. Yeah. I usually resort to the supplement. People don't wanna drink it, or there's evidence for a really high dose working in particular type of cancer. The evidence for high doses having a net beneficial effect is really limited the cancers I think of are our chronic lymphocytic leukemia. And myelodysplastic syndrome, which are two blood dyscrasias or bloodborne cancers. and they have to take a pretty high dose in order to get the effect that was gotten in the studies. And it has worked. It just requires dedication to quite a few capsules a day. And we're talking like eight capsules of 50% E G C G in the case of C L L. So it was a, a high dose for extended periods. So there's. Both the cost and the inconvenience of that treatment that may limit its use, But generally, I don't reach for the supplement often. I usually have people drinking it because the low doses are definitely antioxidative and definitely more anti-inflammatory. Safer, more like food.

LEAH 17:29

Food first.

Tina 17:31

Yeah. Yeah. then we're gonna talk about interactions. But those are happening, you know, when people are taking capsules. Not when they're drinking tea.

LEAH 17:38

Right? Another sort of preventive, I'm gonna use the word prevention. I usually don't, but, um, So there are a number of cancers where H P V human Papillomavirus is implicated as the cause. What's kind of cool is there actually is a pharmaceutical medication that is a topical application of green tea that that is used on external genital and perianal warts, which are caused by. H P v, which has been implicated in numerous cancers, including cervical cancer, anal cancer, and, you know, certain head and neck cancers. So that's kind of cool that there is enough evidence out there that a pharmaceutical cream, a topical cream was created.

Tina 18:27

I had a patient who would get a lot of squamous cell carcinomas on her skin. And we had a green tea cream that we would use, and she, I mean, we're talking like 30 a year, like this is some predisposition to squamous cell carcinomas of the skin. And at some point I suggested she take good green tea, and make a giant, uh, tea bag out of it and take a bath in it. Once a week. So I had her actually bathe it in green tea just to get her entire body immersed in it. And again, she was having either pre-cancerous or cancers like 30 a year on average taken off of her body. So it was worth the trouble and the effort among other things that we did. So did that help reduce the number or was it, you know, the 15 other things that we did together? Um, I don't know, but. In all, she had a huge reduction in the number of squamous cell carcinomas and pre-cancerous squamous cell lesions that had to be taken off every year. She was, she saw a dermatologist every six months.

LEAH 19:22

So that's interesting because just in terms of the topical use of green tea, One of our radiation oncologists just forwarded an article about the use of green tea topically to help reduce the risk of radiation side effects, radiation dermatitis, so using green tea applications.

Tina 19:40

Like in a cream on the area that's getting the radiation.

LEAH 19:44

I don't think it was a cream, I think it was just applying green tea.

Tina 19:47

Oh, okay. Nice. Yeah. 'cause there was also a study on radiation esophagitis, so the inflammation of the esophagus from radiation and using green tea to lower the risk of that as well.

LEAH 19:58

I know green tea has been used just like if you get a burn and you have some not hot green tea laying around. Or you could probably dampen like a green tea bag and then apply that as like a little compress, um, for like a burn in the kitchen. So, It is something that probably because of the antioxidants that is, helpful in soothing to burns. So that's kind of a little bit of, useful information. I think in the past I recommended, 'cause we usually recommend calendula compresses or topical applications for people going through radiation. And I think for. I have on occasion recommended green tea, but that was a long time ago. And then I don't remember when the study came out, but I think it was pretty recent. But that's kind of neat to know that it's been looked at. other things that green tea and their polyphenols have been looked at in terms of health benefits are it possibly may help with lowering cholesterol. A lot of the things you read in the studies is there's always this risk of like hepatotoxicity liver toxicity. so they don't advise it. But I think if somebody were just to drink a few cups of green tea a day, you know, swap that out for something that you normally drink, it might be helpful. The other one is type two diabetes. An observational study in Japan showed that drinking six or more cups daily, uh, people had less diabetes.

Tina 21:16

Ah,

LEAH 21:17

Type diabetes. So lots of good things with that green tea.

Tina 21:21

Yeah, and I know that the cutoff for those liver enzymes, there have been a couple studies in humans where they used ultra high doses of encapsulated. E G C G, And so this becomes the risk benefit discussions with someone with C l l, like, is it worth it? Yes. We'll watch your liver enzymes if this is something they wanna do or need to do to keep their, their white count in check. In the case of C L L, um, 800 milligrams seems to be the cutoff and certainly anything above that risks liver enzyme increases. Liver enzymes are on your routine metabolic panels, so you can look for that if you're using higher doses of E G C G for any reason.

LEAH 22:01

So let's take a break and then, come back and we'll talk about. Interactions, contraindications and cautions around green tea.

Cautions & Interactions (positive & negative)

LEAH 22:17

So you're talking about how. Certain people had the elevated liver enzymes or the hepatotoxicity. I just wonder if it has to do with how people metabolize the green tea.

Tina 22:30

Yeah.

LEAH 22:31

And this is a completely different rabbit hole that we're not gonna go down into, but there is information about this comped gene that if people have a certain.

Tina 22:42

C O M T.

LEAH 22:43

C O M T. It's a methylation thing. So there are some people have a certain variant on this gene and it's involved in methylation, and so I un, I don't understand all of it. I'm not gonna go into it, but I just know that green tea may slow down. The same way that we talk about these liver enzyme pathways. There may be some slowing down of how people process different medications, hormones and whatnot. again, that's a different rabbit hole we need to bring an expert in to talk about that. But that is something if maybe somebody drinks green tea and they don't feel well when they drink it or whatever, then just don't drink it. Don't force yourself to drink it or don't take the capsules.

Tina 23:21

Yeah, that's a good point. 'cause everyone has a different biochemistry, so we all break down things differently and so yeah. If something doesn't feel good, there's there. That's a good overall point. If something doesn't feel good, then maybe rethink that, especially if it's a natural agent. 'cause they should be non-toxic. You shouldn't be having any side effects or unto effects.

LEAH 23:39

And I, the thing that I hear the most when people drink, Green tea or take the capsules and it doesn't agree with them. It's mostly gastrointestinal type. It causes stomach upset, especially on an empty stomach. so kind of take that into consideration too. And honestly, I don't know that if somebody has this comped snip that is the variant that is not, advised to have things like green tea, I don't know if they're gonna actually have a physical. Reaction to it. I'm just saying like, if it doesn't agree with you, then don't make anyone force you to take it.

Tina 24:09

Yeah. And again, this is, this has to do, when, when you're talking about these interactions, seem to be happening at higher doses of green tea,

LEAH 24:16

Some of the interactions actually would be with drinking the green tea. Um, if you drink green tea while you're eating certain foods, you're. Gonna decrease the absorption of things like folic acid and iron. And so that's not necessarily just the higher doses, and they weren't really specific on the sources that I looked at, whether it was drinking or not. I know that are rat studies showing a beneficial. Interaction with green tea and tamoxifen, that it can increase the oral bioavailability of Tamoxifen and it showed in rats to be protective against liver injury that may be caused by tamoxifen. 'cause tamoxifen can increase, liver enzymes in some people. It also was shown to be synergistic with the chemotherapy Paclitaxel. Oh, the other thing that, E G C G has been shown to be synergistic with the, the drug Tarceva which is used in certain lung cancers. So those are some of the positive interactions and some of the negative interactions would be with another drug for non-small cell lung cancer called Afatinib. Um, the big one that. Most of us working in oncology think about is a drug used in multiple myeloma known as Bortezomib. Um, when combined with a strong, CYP three A four inducer, it has been shown to interact with Afinitor. Also known as everolimus. Um, lisinopril, that's the one that was kind of surprising because a lot of people take lisinopril for their blood pressure. Warfarin is another interaction, which it's because of the vitamin K content in green tea. 'cause it's green. It's a green tea. So because of that, it's contraindicated with warfarin and.

Tina 26:08

Everything interacts with warfarin. Have you ever seen the list?

LEAH 26:11

know. I know. It's just what, yeah. When in doubt, just don't take it.

Tina 26:14

Warfarin. If you look at it, you know a little funny, you have an interaction with it, you take it with your left hand instead of your right hand.

LEAH 26:20

A lot of the interactions because it also showed in mice to decrease the bioavailability of palbociclib, which is Ibrance, and it also inhibits Irinotecan, which is also inhibited by St. John's Wart, and they both have the same mechanism of this inhibition. It's because of this P glycoprotein, which it's a transporter found in the liver, but it's also found in the gut, which I think people forget that that's another route for interactions.

Tina 26:51

Yeah, that p glycoprotein is one of those drug transporters that in the case of chemo resistance, it is one of those mechanisms that the cell uses to pump drugs out of its interior and become resistant to a chemo. So I wonder if sometimes the green tea, if it's affecting that It's keeping the pump from pumping the drug out. I have the ASCO post up and I'll just tell you what it says. It says E G C G was reported to inhibit transport of irinotecan and its metabolite into biliary elimination, resulting in their enhanced half-life.

LEAH 27:26

so because that looks like there are so many different interactions, but. Unless it was somebody taking Velcade for multiple myeloma or warfarin for blood thinning, I really don't restrict them from drinking green tea. I probably would just be like, you know, limit how much you're drinking because it is a lot less of an effect with the drink than a supplement. 'cause I'm not really prescribing. Green tea capsules to patients.

Tina 27:57

Right, and, and often, you know, your cautionary and my cautionary don't match because I'm seeing patients as outpatients. You're in a hospital setting I have a lot of people post-treatment during treatment. Yes. But post-treatment, and then you're seeing folks who are. Definitely in the midst of treatment, and a hospital setting is always gonna be more conservative in a general sense than an outpatient setting.

LEAH 28:20

And I have a lot of patients who are taking multiple medications outside of. Cancer treatment. And so that just in itself increases the risk of interactions. And so if somebody is drinking a lot of a substance, whether it is a green tea or anything like that, um, it's definitely gonna come into question. If there are interactions, if there is an elevation of liver enzymes, they're gonna look most likely at what are you getting from the naturopathic doctor? More so than what are we giving them?

Tina 28:51

Absolutely.

LEAH 28:52

And that happens all the time. Patients are taken off of supplements and other things that they might be doing, you know, as complimentary, to their conventional treatment. They have elevated liver enzymes and anything that they're doing that isn't part of their treatment regimen gets stopped

Tina 29:10

Yes.

LEAH 29:10

until it's determined. If it is truly. The chemotherapy or whatever treatment that they're getting is causing those elevations, and then they'll do dose reductions. But that is kind of a tangent. Um, I'm trying to think if there's anything else that we have about green tea. Any other tips and tricks? Oh, surgery. Surgery is, the other thing is it is recommended to, if you are taking a green tea supplement to stop that about, oh, probably a week before. getting any sort of surgery.

Tina 29:41

Yeah, I mean, I think that is the take home. If you're taking a capsule with green tea and it's concentrated E G C G, which it usually is, that's the purpose of a capsule, then treat that as a more likely interaction with drugs, anesthesia for surgery, that kind of thing. So be more cautious with that than you would for a teabag at noon.

LEAH 30:01

Okay. So I think that's kind of everything that we covered. we're gonna take a break and when we come back I'm gonna talk about a moment of Woo. We have not seen one of those in a while.

Tina 30:09

We haven't done a moment in Woo forever.

LEAH 30:11

I know. And we're doing one next.

A Moment of Woo

LEAH 30:19

And now it's time for a moment of Woo. For those who have just tuned in, A moment of Woo is where we look at something that is considered alternative. Perhaps, and we try to find the truth behind why, why this substance is being promoted, why this ritual, whatever it is. We're we, we're trying to find a little bit of truth, see where something came from and is it truly woo or is there science behind it?

Tina 30:49

Yeah, we mean like that's a bunch of woo woo.

LEAH 30:52

A moment of woo woo didn't quite catch on. So we're a moment of woo. I often have patients ask me if they can take green tea for weight loss. That was a big thing for a while. Every once in a while it still pops up. where does that come from? Does it really help with weight loss

Tina 31:10

I wonder if that's an extension of some of the blood sugar regulation,

LEAH 31:14

Possibly?

Tina 31:14

it helps with blood sugar regulation.

LEAH 31:16

Absolutely. catechins. In the green tea have an effect on blood sugar metabolism. So that could possibly be part of it. Another one is the thought that the catechins and the caffeine also increase energy metabolism, but there's not really that much caffeine in there. So, there was a review that looked at, over a dozen weight loss studies and some of them actually looked at weight maintenance using. any form of green tea, When they looked back at those studies, the weight loss was not statistically significant. there was a very small, number seen, but it probably wasn't important clinically, and there was no effect on weight maintenance. When looking back at these studies,

Tina 32:01

Mm. Okay.

LEAH 32:02

when green tea is promoted for weight loss, it's often combined with, um, garcinia cambogia. Do you remember that? Like that and is another one. Garnia was like huge for a while for weight loss. So that may be like where it came from, but I think it is more supposed to be increasing your metabolism. interestingly, I do remember when Garnia was really big that there were studies showing that that can actually, um, increase liver enzymes.

Tina 32:33

Hmm.

LEAH 32:34

With that said, did find the meta-analysis from, I think it was from 2002, and it looked at 26 studies that. Only used green tea extract in relation to weight loss. And they had certain parameters they were looking at, they were looking at B M i, body weight and waist circumference. Um, they took into account the type of extract, the dosage and how long it was taken. And the conclusion was that, Participants taking 800 milligrams a day or less of green tea extract for, I think it was, they looked at 12 weeks or less. they had significant reductions in body weight the participant was obese or overweight, There was this one study that was an outlier and that kind of skewed the information where they basically found that around 500, I think it was 500 milligrams a day for 12 weeks was like kind of the sweet spot for having a reduction in body weight. The outlier study was really interesting. they looked at a proprietary formula of green tea that was using a green tea phyto zone. So it had bioavailability than a regular green tea extract. called Monos Select Camelia, there were two groups of participants. Both were on a hypocaloric diet, so they ate less calories than. recommended than normal. So the men were eating 1,850 calories a day, and the women ate 1,350 calories a day

Tina 34:15

So basically breakfast and lunch for me

LEAH 34:19

or breakfast. For me, you should see how I make my oatmeal in the morning. So the, so both groups had this lower than normal calorie diet, and the group B also took 150 milligrams of this monos select Chameleon. Uh, I must, I don't remember if it was once or twice a day. And there was a significant difference in weight loss between groups. they both lost weight. Both groups lost weight on a. Less than average calorie diet. That's not really a surprise. But group B did have an even greater reduction in weight.

Tina 34:56

Okay, so the people eating less and taking some green tea extract loss, more weight than the other group.

LEAH 35:03

They did,

Tina 35:04

Okay.

LEAH 35:05

yeah. And just because, I don't remember if we mentioned it before, just uh, a cup of green tea can have between. Because obviously this green tea extract that they're looking at is the E G C G and a cup of green tea can have anywhere from 100 to, 300 milligrams of E G C G in it. So you could drink green tea,

Tina 35:27

Yeah,

LEAH 35:28

a couple glasses of, you know, of, of green tea.

Tina 35:31

this whole thing reminds me of a phone call, a random phone call we got at my office and the receptionist, I happened to be up front when she got the call, and so she put the person on hold and asked quickly a question. She said, someone's calling and they wanna know if raspberry ketones, which they just heard on like Dr. Oz or something, will raspberry ketones help them lose weight? And I said, well, tell them the answer is yes, but only if it's done alongside lowering calories and some exercise. And so basically, My answer to that was like, if you lower your calories and add exercise, you're basically in a caloric deficit at the end of the day, So anyways, it kind of reminds me of that whole scenario, which, you know, ultimately we still have to do the hard work doesn't replace the hard work,

LEAH 36:19

Right, and these studies didn't look at anything beyond 12 weeks anyways, so if you want something that's longer lasting, it involves lifestyle change.

Tina 36:28

Exactly. In other words, it still comes down to lifestyle when it comes to losing weight properly and.

LEAH 36:34

And And weight maintenance. Yeah. Yeah.

Tina 36:36

Body composition, weight maintenance. Yeah. Yeah. And it's always composition. I don't, I, you know, we're getting away from the word weight because composition is key. You know, muscle mass underneath counts. And so the scale can say one thing, but it doesn't give you an idea of fat versus muscle and, but So, It's a funny thing that we even use a scale still. We should all use body comp analysis things. Even at home they're like 50 or $70. They're not, they're not a huge amount of money. So anyways, in the grand scheme of weight loss, we should say body composition revamp. That's a lot of words.

LEAH 37:09

So I'm gonna say green tea. The beverage can be part of a healthy, body composition

Tina 37:16

Revamp.

LEAH 37:17

revamp plan.

Tina 37:19

That's it. The body composition revamp plan.

LEAH 37:23

Trademark.

Wrap up

LEAH 37:24

Okay, so that was our moment of Woo. Um, we're coming up with a theme song for moment of Woo. hopefully we'll have that sometime soon. And that's it. That's our episode. Woo. We did it.

Tina 37:36

I hope some, some of you are enjoying a cup of green tea while you listen to this episode.

LEAH 37:40

I think you and I needed to be enjoying a cup of green tea, um, during this episode 'cause I feel a little tired.

Tina 37:49

Yeah. Yes, it's hot, it's humid, it's early. Yes. There's a lot of reasons. We're a little draggy today, so.

LEAH 37:56

Hopefully we kept you some somewhat, you know, engaged. And if you enjoyed this episode, remember to share it with a friend and leave a review. Leave us a a rating, subscribe and follow. Just click that little plus or whatever it is On your streaming app and you could buy us a coffee and we might use that money to buy some green tea. No, we use, um, anything that we get through by me, a coffee helps us to, to, you know, behind the scenes, keep this thing going. We're quickly approaching the start of our third year of doing this, so, and we got a lot of ideas, a lot of ideas.

Tina 38:35

Yeah, so stick with us 'cause. It's only gonna get better.

LEAH 38:38

On that note, I'm Dr. Leah Sherman,

Tina 38:41

And I'm Dr. Tina Kaczor

LEAH 38:42

this is the Cancer Pod. I.

Tina 38:43

Until next time.

38:44

Thanks for listening to the cancer pod. Remember to subscribe, review and rate us wherever you get your podcasts. Follow us on social media for updates, and as always, this is not medical advice. These are our opinions. Talk to your doctor before changing anything related to your treatment plan. The cancer pod is hosted by me, Dr. Lea Sherman. And by Dr. Tina Caer music is by Kevin McLeod. See you next time.

LEAH 39:32

I think we both need some green tea.

Tina 39:34

I know, right?