You might be surprised about the number of questions I get regarding liver health – it’s a very common concern! I am grateful to see most people taking a proactive approach to their health by aiming to help their body function optimally through the diet! Liver health and herbals are a common pairing, both in my professional life and also checking out what everyone is Googling. Today I’ll answer some commonly asked questions about how teas and tisanes can impact liver health. Covering...

• What is the liver and why you should want a healthy liver
• Is tea good for your liver?
• Study Review: tea's impact on liver health
• Can tea be hard on the liver? Controversial studies
• What teas should you avoid for a heathy liver?
• Is tea or coffee better for liver health?
• Is caffeine good for your liver?
• Why liver “cleanses” are NOT a good idea

Let's get stuck in!

What is the liver? Why is liver health so important?

The liver is a large organ that is a player in nearly every other organ system (Kalra, 2021). It does a lot of things, including...

• Processes waste by producing bile, which aids digestion and eliminates toxic compunds
• Processes waste also by cleaning the blood, destroying poisons, metabolizing alcohol (perhaps its most famous function), medications and more
• More generally, breaks down other potentially damaging substances not already mentioned
• Produces cholesterol and makes it into other substances, as well as making sugar (glucose) for quick energy, and making, storing and distributing fat
• Breaks down fats
• Plays a role in thyroid hormone production, as well as other hormone regulation, such as sex and adrenal hormoes
• Processes xenobiotics (medications, alcohol, non-naturally produced chemicals, etc). Generally when you take a medicine, the liver has to process it first before it can start to work
• Processes heme, which is one of the building blocks for hemoglobin in your blood (the component essential to carrying oxygen around your body)
• Produces the antioxidant glutathione - a very important constituent needed for liver function. The depletion of glutathione, which often occurs with overconsumption of alcohol, can lead to a buildup of toxic metabolites (Sacco, 2016).
• Regulates levels of minerals and vitamins
• Metabolizes and stores fat soluble vitamins

In other words, a healthy liver is essential for being healthy in general! We all know that alcohol is bad for our livers, but we don’t know that much about what’s good for them. As you can see above, the liver does so much more than just deal with alcohol, so if we do abuse the bottle, we will pay for it in a variety of ways. We don’t think about it enough, as it’s a long-suffering organ: it can still function even when 2/3 of it have been destroyed! (CLF, 2021)

So let’s start looking after our livers and jump right in with one key question:

Green tea is good! Even if pictured on the living room floor ;-)

Is Tea Good for My Liver?

First, housekeeping: always consult your doctor or medical practitioner if you have any particular disease of health concern you are thinking of treating – that is something this blog cannot do, we can only share the information and analysis we have found from our own research. We are not recommending, diagnosing nor treating any specific disease.

To give a short answer to both: yes! In general, liver studies have linked high antioxidant activity with improved liver protection and function, and within this, the antioxidant activity from Camellia sinensis (i.e. ‘true’ tea, not all herbal teas). In short, tea is good for the liver!

There are articles around the internet saying some scary things, so later in this article we will address those (just keep reading!).

Note that when I say ‘tea’ in this article, I am referring to both ‘true’ tea from the Camellia sinensis plant, and also the very broad term of herbal tea. That being said, some types of tea have been studied more than others, such as...

Green tea (in particular) and the liver

Green tea is especially considered to have liver-protective properties.

Multiple studies have shown that Epigallocatechin-3-gallate (EGCG), the main / most famous antioxidant in green tea, can both help prevent and help treat liver injuries, such as liver fibrosis.

As a quick sample of what the research says...

Green tea can help treat non-alcoholic fatty liver disease, showing “significant improvement in metabolic, chemical, inflammatory and radiological parameters” in the patients in the study (Hussain, 2017; Pezeshki, 2016)

A meta-study (a study analyzing the results of a variety of other studies) looking at green tea and liver health found that “among green tea drinkers, there was a significant reduction in the risk of liver disease ... [covering] ... a broad spectrum of liver conditions including hepatocellular carcinoma, liver steatosis, hepatitis, liver cirrhosis and chronic liver disease” (Yin, 2015). I.e. a range of liver diseases.

Additionally, many herbal teas have shown a range of liver protective properties, due to their different antioxidant makeups. “Phytochemicals such as flavonoids, alkaloids, phenols, quinones, glycosides etc....[are in plants with] anti-hepatic fibrotic properties” (a science-y way of saying plants with these antioxidants are good for the liver) (Latief, 2017). In Latief’s study, they looked at dozens of herbal teas and which ones did what to the liver. The word phytochemicals just means plant-based.

They found that “the active ingredients of each plant which fall in the category of these phytochemicals, play a key role in the treatment of hepatic fibrosis”. These plants included curcumin (in turmeric), hibiscus, moringa, ginko, green tea, blueberry, gingseng and more (Ibid). For the full list, check our Latief’s study, linked in our references below.

So, in other words, of the ‘true’ teas and herbal teas that have been studied and in general they have found them to improve liver health, thanks to their wealth of antioxidants. Good news for all of us tea drinkers! But now, let’s look at some exceptions...

 

To read about green tea supplements, check out our Mythbusting Tea for Weight Loss in 2021: Which Teas Help with Fat Metabolism?

 

 

Study Review: Tea's Impact on Liver Health

Let’s investigate some of the most researched studies:

Green Tea & Liver Studies

In one study, rats with liver damage due to tamoxifen were given green tea to see its impact (El-Beshbishy, 2005). The green tea showed protective effects via the antioxidant action by preventing oxidative damage due to the tamoxifen drug. It benefited damaged liver cells, improved enzyme antioxidant activity, and prevented lipid peroxidation! Lipid peroxidation is basically the word for lipids (such as fat) being damaged by oxidation.

Another study looked at green tea flowers and found they enhanced glutathione activity, protected the liver, and had antitumor actions (Xu, 2012).

White Tea & Liver Studies

White Peony Tea, an unoxidized white tea, contains polyphenols (a type of antioxidant) that have demonstrated liver-protective action. In a rat study, the polyphenols reduced alcohol-induced liver damage via antioxidant activity and by regulating certain anti-inflammatory factors (Zhou, 2019). The authors state that these polyphenols have effects similar to silymarin (milk thistle).

Black Tea & Liver Studies

A rat study treated rats with ethanol-damaged livers with black tea (Luczaj, 2006). The antioxidant activity protected proteins and lipids from oxidative damage due to chronic intoxication of alcohol.

Red Rooibos & Liver Studies

Because red rooibos is quite high in antioxidants, it makes sense that it can have protective effects on the liver. One promising study suggests Red Rooibos can alleviate oxidative liver-toxicity (Ajuwon, 2013). That sounds super sciency, but basically means fixing an imbalance in the liver between oxidants and antioxidants, helping to prevent damage to the proteins, lipids and DNA in the liver.

Green Rooibos & Liver Studies

Another study in rats found that green rooibos (or unfermented rooibos as they call it) increased antioxidant levels in the liver. They concluded that green rooibos can provide the liver with enhanced antioxidant capacity to reduce toxicant damage (Canda, 2014).

Specifically, “This study confirms rooibos herbal tea as good dietary antioxidant sources and, in conjunction with its many other components, offers a significantly enhanced antioxidant status of the liver in an induced oxidative stress situation” (Ibid).

Good news for green rooibos lovers!

Other Tisanes & Liver Studies

There is very little research available for the impact other types of herbal teas have on the liver. However, what liver health studies covering a wide range of antioxidants have shown repeatedly is that general antioxidant activity is responsible for liver-protective action.

Some teas such as Milk Thistle will improve liver function through antioxidant activity, anti-inflammatory activity, blocking toxins at the membrane level, improving protein synthesis, and by preventing fibroids (Mulrow, 2000). I personally often use a combination of Milk Thistle and Dandelion Root, as Dandelion root stimulates the production of liver bile (Cai, 2017).

 

Can Tea be Hard on the Liver? Controversial Studies

You’d have to drink an insane amount of most teas before they start to elevate liver enzymes and cause havoc. From a professional standpoint I can say that most teas and tisanes will not hurt your liver, in fact many will have health benefits.

But Google is showing me scary results about the dangers of tea on the liver! What’s that about? Well unfortunately, depending on the subject (green vs black vs rooibos) there are some individual studies or prominent results that were quite poorly done that showed negative impacts on liver health from tea. These consistently come up at the very top of Google Search results - despite the majority of research showing that tea is good for the liver.

I want to examine studies, debunking some, so that as you carry on with your research about tea and liver health and inevitably come across them, you’ll be able to read them critically with an educated eye. Bad science can be so dangerous!

Study 1: Green Tea & Mixed Green Tea Products

In the first poorly-carried-out, tiny study “Hepatotoxicity of green tea: an update”, the authors found concerns regarding hepatotoxicity, which is the fancy way of saying liver-damaging (Mazzanti, 2015). The study looked at herbal products containing green tea or pure green tea attempting to determine causation. Seven consumers had plain green tea while twelve consumed other green tea in combination with other herbal products. The duration of consumption was anywhere between two days to over a year.

Those who took plain green tea experienced a longer latency leading to liver concerns and resolution (a good thing!). Those who took mixed products experienced liver concerns sooner and had more complex conditions requiring hospitalization. This suggests something other than the tea was causing issues – given how widely green tea is consumed.

Eight of the 19 cases were considered to be likely causative. What we don’t know is the consumer’s previous health status. Additionally, all the ‘combination’ products differed and many included isolated vitamins, constituents, caffeine, as well as some herbs *known* to cause liver difficulty over time. Yes, you read that right ...*smacks head*.

In the end the authors stated concerns about green tea, mixed herbal products, and liver toxicity - a generalized and unfounded statement given the small size, lack of control and inconsistency of the study. There are many unaccounted-for variables such as synergistic interactions between herbs in the products, safe duration of consumption (some of the products were consumed for over a year, but included ingredients that are not recommend for long-term use), proper dosing, and alcohol-consumption status.

Additionally, the authors stated that most participants were taking the supplements for weight loss, which suggests that there may have been other underlying conditions or predispositions, let alone interactions with these supplements.

Study 2: Sweetened Black Iced Tea

In the second example, “Hepatotoxicity in an Adolescent with Black Iced Tea Overconsumption” (Hadjipanayis, 2019), similarly broad and strange conclusions were made. It is a case study of a 12-year-old boy with liver damage that corrected itself after he stopped consuming large amounts of apricot flavored iced black tea.

The authors detrmined the black tea was the cause, despite it showing liver protective effects in rat studies, because the boy's liver improved after he stopped drinking 1.5-2 liters of sweetened iced black tea a day (that’s a lot of tea, a lot of sugar, a lot of many things). Now, the tea contained ingredients, rather than tea + sugar for example, making it almost certainly a prebottled tea, which has almost no antioxidants (the authors strangely don’t specify).

The ingredients were 4.5g/100mL sugar (fructose), 0.09% black tea extract, citric acid, and 0.1% apricot flavoring (Ibid). For reference, the American Heart Association recommends adolescents have no more than 25 grams of sugar per day, or about 3 times less than this boy was consuming from his iced tea alone! Let alone what the poor boy was consuming in addition throughout the day. Too much sugar is also known to damage your liver, with “some studies show[ing] that sugar can be as damaging to the liver as alcohol]” (Khatri, 2020).

Given that most liver protective benefits appear to be due to antioxidant activity, and bottled black teas contain almost no active antioxidants (as we've researched and discussed in other posts), and the sheer quantity of sugar this boy was ingesting, this liver injury does not surprise me.

What is curious is that the researchers decided the 0.09% of black tea extract was the culprit, and not the high sugar content (some sweet teas contain as much sugar as soda). The sugar is the immediate red flag to me!

This article is not a fair representation of black tea’s impact on the liver, but is the top result when you Google "black tea and liver protection hepatoprotective" and so on, so it’s important to highlight and examine!

Study 3: The green tea health advisory from the Australian government

Australia’s Health Department states that liver harm from green tea is rare and unpredictable. I believe this comes down to bio-individuality and the variables included in lifestyle and individual health status. Furthermore, medications like acetaminophen have a riskier potential to cause liver harm (LiverTox, 2016).

According to the Department of Health Therapeutic Goods Association (Australia), only 20 cases of liver harm have been reported for green tea, and most (17) have included other suspected ingredients or been included in a mixture (TGA, 2020).

In Australia, green tea is used in low risk medications, and is included in 267 medications listed in the Australian Register of Therapeutic Goods (ARTG). Most of these include green tea concentrates (Ibid).

As with any item we consume we must go back to the increasingly forgotten adage, “The dose makes the poison.” (Grandjean, 2016) Too much of anything has potential toxicity while just about anything in the right dose can have a beneficial effect (Ibid). 

Study 4: Red Rooibos

Now, I wouldn’t be doing my job if I didn’t discuss the two case studies that are plastered all over Google about Rooibos and possible liver toxic effects due to elevated liver enzymes (Engels, 2013; Sinisalo, 2010).

In the first, a 52-year-old man who was on oral steroids and statins had liver failure. He had been drinking a mixed herbal infusion of rooibos and buchu, another type of South African plant often used in herbal medicine. When he stopped drinking this infusion, his symptoms improved.

The authors noted that “Rooibos tea consumption has reported antioxidant activity, with one study showing hepatoprotective effects in rats” while one of the traditional components of Buchu tea is pennyroyal, which is already known to be hepatotoxic (damaging to the liver) (Engels, 2013). In other words, they are thinking the pennyroyal was the culprit, rather than the rooibos.

In the second, “Possible hepatotoxic effect of rooibos tea: a case report”, the patient in the case study was not representative of the population as a whole: she was middle aged, on two medications, and had an underlying condition. She fell ill after drinking rooibos for two weeks, and improved when she stopped.

The authors state that Rooibos has an excellent record for safety (which we would agree with, given it is drunk worldwide) and it is possible that the tea she was drinking could have been contaminated with a hepatotoxic agent.

Specifically, “Although our single case suggests that rooibos tea may have adverse hepatic effects, the tea has an excellent safety record, and further study is therefore required to resolve this question. It could also be that the rooibos used by our patient was contaminated by some hepatotoxic compound, such as a pyrrolizidine alkaloid, or that she was genetically predisposed to react adversely to one of the many bioactiverooibos constituents, which include a number of flavonoids and other polyphenols as well as minerals” (Sinisalo, 2010).

Which is a long way of saying, in the eyes of the study’s authors it was unlikely to be the rooibos itself, and her tea may have been contaminated. 

Are there any teas to avoid for liver health?

I of course cannot speak for every herbal tea in existence. That generalization would be an unethical and dangerous assumption. But from our investigations the ones we have chosen for our climate-positive teashop are safe, assuming modernate consumption (there is nothing on Earth, including water, that should be consumed excessively!).

What we have found however, of other teas (which we don’t stock) is the following. When thinking about liver health, teas to avoid include:

• Certain species of comfrey (symphytum officinalis)
• Black cohosh in copious or consistent amounts
• Kava in more than normally consumed as food amounts
• Ephedra (which is illegal to include in supplements and teas in the US anyway)

This list is of course not comprehensive and there are certainly more.

 

Is Tea or Coffee Better for your Liver? What do different teas do?

As always, it’s time to look at how our two favorite caffeinated drinks stack up in terms of health benefits. I’ve also looked at the research for different types of ‘true’ teas and rooibos, so you can feel confident about what you’re drinking.

What’s interesting is that most of the liver and tea research we found has used rat studies, while there are more liver and coffee studies in people. So with that in mind, let’s look at what the research says!

Much of these effects concern free radicals causing oxidation damage and how antioxidants neutralise this effect.

 

For a quick refresher on antioxidants, free radicals, etc. and why they are important for your health, check out our "A quick summary: what are antioxidants? How do they help?" section from our very first antioxidant blog

 

Coffee & Liver Protection

Coffee also appears to protect the liver (Chen, 2014). Again, the attribution overall goes to the antioxidant action, and one study points out that coffee-drinkers with liver disease have lower risk of hepatocellular carcinoma and cirrhosis (scaring of the liver from whichever disease). In one study trying to assess whether it was caffeine or coffee that aided liver health, they even found some indications that decaf coffee was good for the liver – suggesting the high antioxidant levels are key players in both preventing and treat liver injuries, rather than say just the caffeine (Modi, 2010).

It seems that the question is not “Coffee or tea?” but rather an honest look at the antioxidant benefit of what you are ingesting, as the consensus centers around antioxidants being the mechanism of action that leads to liver protection.

Also, because different antioxidants do different things, and studies of liver health have found that a broad range of antioxidants seem to result in healthier livers, maintaining a balanced diet of antioxidant-rich food and drink is a good idea!

Some of our teas highest in antioxidants are Honeybush, Green Rooibos and Tulsi Holy Basil (we also have a cool Rooibos-Tulsi blend!).

Is Caffeine Good for Your Liver?

Yes! Multiple studies have linked caffeine consumption to lowered risk of liver disease, liver fibrosis, liver cancer, and actually slowing the progression of liver fibrosis in those patients who already had liver disease, especially alcoholic liver disease (Modi, 2010; ISIC, 2013; Kennedy, 2016; Kennedy, 2021).

The majority of these studies have focused on coffee due to its high caffeine content, to such an extent that Modi et al.’s study was specifically designed to determine if it was the coffee or the caffeine causing liver health improvements.

Modi’s study struggled to find participants who weren’t coffee drinkers (out of 177 participants, only 11% / 19 people were tea drinkers!), and only found a “non-statistically significant trend to suggest [caffeine] consumption above [61mg per day]...was associated with a lower risk of advanced fibrosis” and they suggest they could have missed “significant protective effects” from green and black tea simply due to the small numbers (Modi, 2010).

They did find clear evidence that above a certain threshold (270mg of caffeine a day), there was a clear beneficial effect on liver fibrosis (Ibid). This is a fair amount of caffeine however.

Are “Liver Cleanses” Healthy?

I am shocked by the amount of people who ask me things like, “How can I flush my liver?” and “How can I detox my liver fast?” These are the more reactionary cases that are trying to correct an imbalance in a seemingly healthy way. I.e. it feels “right” or even “trendy” rather than there is an issue they are trying to correct.

While I appreciate their good intentions, I always remind my clients that liver function decreases over time. It is a series of repeated offenses that lead to liver harm and a fast liver detox or a tea cleanse is not going to solve it overnight. In fact, it may be more damaging than not.

A gentle ‘cleanse’ meaning supporting in a healthy way, over time, can be a good thing, but it should not be used as an emergency measure to get someone out of hot water. Gentle ministrations over time will lead to an optimally functioning liver. When I say ‘cleanse’, I mean incorporating gentle herbs that support liver funcion into your diet.

The classic trendy clense is dangerously harsh, to pick an example “fast for a week, drink nothing but lemon water with cayenne”. This is a mad remedy.

Harsh cleanses are not recommended for everyone, especially not without the guidance of a qualified health professional. If you have a dietitian or naturopathic doctor who wants to guide you through a harsh cleanse because your condition indicates it, that is a specific circumstance and still should only be done until close supervision with them. There’s no point doing a liver cleanse if you cause more damage than what you started with!

Many factors play into whether a liver cleanse or detox is right for you. Factors such as your overall health, liver condition, age, underlying secondary conditions, pregnancy, medications, etc., will all be determining factors. Your practitioner can help you decide what route to take.

There are gentler ways to help the liver than flushing it with market cleanses and harsh herbals. For example, as mentioned earlier in the section on herbal teas, combining Milk Thistle, with its high antioxidant activity and anti-inflammtory action (among other benefits) and Dandelion Root, with its stimulating effect on liver bile, can be a delicious, gentle approach towards improving liver function and health (Mulrow, 2000; Cai, 2017).

 

A Note From The Herbalist...

Extremes are rarely a solution and so even the word “clense” is really not helpful, but people cannot really picture a “clense” if it’s simply eating and drinking healthier! It’s more a marketing word that anything.

So in summary: avoid harsh cleanses and antioxidant up: eat your fruits and veggies, and drink your coffee and tea. Your liver will thank you!

Questions? Thoughts? Let me know in the comments below or on our IG @MatchaAlternatives

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Disclaimer

All of the information regarding the herbs, botanicals, minerals, vitamins, etc., is information drawn from traditional use data or academic research and should be regarded as such. If you, the reader, has a health or medical concern, please consult your healthcare professional. The information found here is not meant to diagnose, treat, prescribe or cure and has not been evaluated by the FDA. This information is for educational purposes only. 

 

Tea & Liver Health References and Further Reading

Kalra A, Yetiskul E, Wehrle CJ, et al. Physiology, Liver. [Updated 2021 May 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535438/

Sacco, R., Eggenhoffner, R., & Giacomelli, L. (2016). Glutathione in the treatment of liver diseases: insights from clinical practice. Minerva gastroenterologica e dietologica, 62(4), 316–324. From https://pubmed.ncbi.nlm.nih.gov/27603810/

CLF, 2021. You may never stop to think about it, but your liver is essential to your life. Canadian Liver Foundation. https://www.liver.ca/your-liver/

Hussain M, Habib-Ur-Rehman, Akhtar L. Therapeutic benefits of green tea extract on various parameters in non-alcoholic fatty liver disease patients. Pak J Med Sci. 2017;33(4):931-936. doi:10.12669/pjms.334.12571 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648967/

Pezeshki A, Safi S, Feizi A, Askari G, Karami F. The Effect of Green Tea Extract Supplementation on Liver Enzymes in Patients with Nonalcoholic Fatty Liver Disease. Int J Prev Med. 2016;7:28. Published 2016 Feb 1. doi:10.4103/2008-7802.173051 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763469/

Yin X, Yang J, Li T, et al. The effect of green tea intake on risk of liver disease: a meta analysis. Int J Clin Exp Med. 2015;8(6):8339-8346. Published 2015 Jun 15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538013/

Latief U, Ahmad R. Herbal remedies for liver fibrosis: A review on the mode of action of fifty herbs. J Tradit Complement Med. 2017;8(3):352-360. Published 2017 Nov 22. doi:10.1016/j.jtcme.2017.07.002 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035307/

Grandjean P. (2016). Paracelsus Revisited: The Dose Concept in a Complex World. Basic & clinical pharmacology & toxicology, 119(2), 126–132. https://doi.org/10.1111/bcpt.12622 From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4942381/

TGA, 2018. Camellia sinensis (green tea) extract: Safety advisory - potential risk of harm to the liver. Therapeutic Goods Administration, Australian Government. https://www.tga.gov.au/alert/camellia-sinensis-green-tea-extract

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Acetaminophen. [Updated 2016 Jan 28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548162/

Mazzanti, G., Di Sotto, A., & Vitalone, A. (2015). Hepatotoxicity of green tea: an update. Archives of toxicology, 89(8), 1175–1191. https://doi.org/10.1007/s00204-015-1521-x From: https://link.springer.com/content/pdf/10.1007/s00204-015-1521-x.pdf

Hadjipanayis A, Efstathiou E, Papaevangelou V. Hepatotoxicity in an Adolescent with Black Iced Tea Overconsumption. Pediatr Gastroenterol Hepatol Nutr. 2019;22(4):387-391. doi:10.5223/pghn.2019.22.4.387

Khatri, M. 2020. Surprising Things That Can Damage Your Liver: Sugar. WebMD. https://www.webmd.com/hepatitis/ss/slideshow-surprising-liver-damage

El-Beshbishy, H. A. (2005). Hepatoprotective Effect of Green Tea (Camellia sinensis) Extract against Tamoxifen-induced Liver Injury in Rats. Journal Of Biochemistry And Molecular Biology, 38(5), 563-570. doi: 10.5483/bmbrep.2005.38.5.563 From https://www.koreascience.or.kr/article/JAKO200510103442661.pdf

Xu, R., Ye, H., Sun, Y., Tu, Y., & Zeng, X. (2012). Preparation, preliminary characterization, antioxidant, hepatoprotective and antitumor activities of polysaccharides from the flower of tea plant (Camellia sinensis). In Food and Chemical Toxicology (Vol. 50, Issue 7, pp. 2473–2480). Elsevier BV. https://doi.org/10.1016/j.fct.2011.10.047 From

https://www.sciencedirect.com/science/article/abs/pii/S0278691511005540

Zhou, Y., Tan, F., Li, C., Li, W., Liao, W., Li, Q., Qin, G., Liu, W., & Zhao, X. (2019). White Peony (Fermented Camellia sinensis) Polyphenols Help Prevent Alcoholic Liver Injury via Antioxidation. In Antioxidants (Vol. 8, Issue 11, p. 524). MDPI AG. https://doi.org/10.3390/antiox8110524

https://scholar.google.com/scholar_url?url=https://www.mdpi.com/2076-3921/8/11/524/pdf&hl=en&sa=X&ei=-YyiYf2pCIj4yATL6oXwCw&scisig=AAGBfm3Z_UJzEZdPKhoNhDl6fA3jNHsSQA&oi=scholarr

Luczaj, W., Siemieniuk, E., Roszkowska-Jakimiec, W., & Skrzydlewska, E. (2006). Protective effect of black tea against ethanol-induced oxidative modifications of liver proteins and lipids. Journal of studies on alcohol, 67(4), 510–518. https://doi.org/10.15288/jsa.2006.67.510

Ajuwon OR, Katengua-Thamahane E, Van Rooyen J, Oguntibeju OO, Marnewick JL. Protective Effects of Rooibos (Aspalathus linearis) and/or Red Palm Oil (Elaeis guineensis) Supplementation on tert-Butyl Hydroperoxide-Induced Oxidative Hepatotoxicity in Wistar Rats. Evid Based Complement Alternat Med. 2013; 2013:984273. doi: 10.1155/2013/984273. Epub 2013 Apr 18. PMID: 23690869; PMCID: PMC3652203. https://pubmed.ncbi.nlm.nih.gov/23690869/

Engels M, Wang C, Matoso A, Maidan E, Wands J. Tea not Tincture: Hepatotoxicity Associated with Rooibos Herbal Tea. ACG Case Rep J. 2013;1(1):58-60. Published 2013 Oct 8. doi:10.14309/crj.2013.20

Sinisalo, Marjatta & Enkovaara, Anna-Liisa & Kivistö, Kari. (2010). Possible hepatotoxic effect of rooibos tea: A case report. European journal of clinical pharmacology. 66. 427-8. 10.1007/s00228-009-0776-7. https://www.researchgate.net/publication/41014117_Possible_hepatotoxic_effect_of_rooibos_tea_A_case_report

Canda, B.D. Oguntibeju, O. O, Marnewick, J. L. "Effects of Consumption of Rooibos (Aspalathus linearis) and a Rooibos-Derived Commercial Supplement on Hepatic Tissue Injury by tert-Butyl Hydroperoxide in Wistar Rats", Oxidative Medicine and Cellular Longevity, vol. 2014, Article ID 716832, 9 pages, 2014. https://doi.org/10.1155/2014/716832

Chen, S., Teoh, N. C., Chitturi, S., & Farrell, G. C. (2014). Coffee and non-alcoholic fatty liver disease: Brewing evidence for hepatoprotection? In Journal of Gastroenterology and Hepatology (Vol. 29, Issue 3, pp. 435–441). Wiley. https://doi.org/10.1111/jgh.12422 From https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.12422

Modi AA, Feld JJ, Park Y, et al. Increased caffeine consumption is associated with reduced hepatic fibrosis. Hepatology. 2010;51(1):201-209. doi:10.1002/hep.23279 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801884/

ISIS, 2013. Coffee consumption and liver function. Institute for Scientific Information on Coffee. https://www.coffeeandhealth.org/2013/01/coffee-consumption-and-liver-function/

Kennedy, O.J., Fallowfield, J.A., Poole, R. et al. All coffee types decrease the risk of adverse clinical outcomes in chronic liver disease: a UK Biobank study. BMC Public Health 21, 970 (2021). https://doi.org/10.1186/s12889-021-10991-7

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