Nutriceuticals: trial of green tea extract in MS

Are you a green tea lover? It may enhance your energy expenditure. #MSBlog #MSResearch

“You are probably aware that there is an emerging literature that the active ingredient in green tea,  epigallocatechin-3-gallate (EGCG) may have beneficial effects on the immune system relevant to MS (although the MouseDoctor has a different view). The study below shows that EGCG may improve muscle energy metabolism during exercise in MSers. The findings were greater in men and woman. This study is small and needs to be reproduced. I would not recommend EGCG based on these results.”

“I am aware that a large number of MSers use green tea in the hope that it will have a beneficial effect on their MS. To the best of my knowledge there is no class 1 or 2 evidence (randomised controlled trials) to prove that EGCG, or green tea, is an effective disease-modifying therapy in MS. The downside of green tea is that it comes with a health warning; liver toxicity is well described with both green tea and green tea extracts. I have had one MSer under my care in a clinical trial who developed abnormal liver function tests that were probably due to excessive green tea consumption. His liver function tests improved when he stopped drinking green tea. Therefore be careful; nutriceuticals are not necessarily safe.”

Mähler et al. Metabolic response to epigallocatechin-3-gallate in relapsing-remitting multiple sclerosis: a randomized clinical trial. Am J Clin Nutr. 2015 Mar;101(3):487-95. 

BACKGROUND: Muscle weakness and fatigue are common symptoms in MS. Green tea catechins such as (-)epigallocatechin-3-gallate (EGCG) are known to improve energy metabolism at rest and during exercise.

OBJECTIVE: We tested the hypothesis that EGCG improves energy metabolism and substrate utilization in patients with MS.

DESIGN: Eighteen MSers (8 men) with relapsing-remitting MS (expanded disability status scale score <4.5, all receiving glatiramer acetate) participated in this randomized, double-blind, placebo-controlled, crossover trial at a clinical research center. All MSers received EGCG (600 mg/d) and placebo over 12 wk (4-wk washout in between). After each intervention, fasting and postprandial energy expenditure (EE), as well as fat oxidation (FAOx) and carbohydrate oxidation (CHOx) rates, were measured either at rest or during 40 min of exercise (0.5 W/kg). At rest, blood samples and microdialysates from adipose tissue and skeletal muscle were also taken.

RESULTS: At rest, postprandial EE and CHOx, as well as adipose tissue perfusion and glucose supply, were significantly lower in men but higher in women receiving EGCG compared with placebo. During exercise, postprandial EE was lower after EGCG than after placebo, indicating an increased working efficiency (men > women). After placebo, exercise EE was mainly fueled by FAOx in both men and women. After EGCG, there was a shift to a higher and more stable CHOx during exercise in men but not in women.

CONCLUSIONS: Our data indicate that EGCG given to patients with MS over 12 wk improves muscle metabolism during moderate exercise to a greater extent in men than in women, possibly because of sex-specific effects on autonomic and endocrine control.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.


  • Green tea contains caffeine, the tea bags have a higher caffeine content than the loose tea. Caffeine has been noted as being neuroprotective. Everything in moderation my mother keeps telling me. I was drinking a fair amount of mint tea each day until I found out drinking large quantities may cause possible damage to the liver and kidneys.

  • The following articles sound more sensible and balanced to me:

    There is an _enormous_ difference between drinking tea and taking a green tea extract. As a tea snob and addict, I drink practically nothing but tea, but I wouldn't go near an extract. Partly because of the common sense wisdom of the dangers of having too much of a good thing. And partly because of the potential for contaminants to be concentrated within green tea extracts.

    ***Common sense, common sense, common sense!!!***

By Prof G



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