Red Bush Tea
Scientific Name(s): Aspalathus linearis (Burm. f.) R. Dahlgr.
Common Name(s): Red bush tea, Rooibos tea, Rooibosch
Limited clinical studies exist to recommend red bush tea for any indication. Due to the plant’s potential for improving oxidative stress, it may have a role in diabetes and cardiovascular disease.
The traditional dosage of the tea is 1 to 4 teaspoons of dry leaf tea per cup taken up to 3 times per day. Limited studies have used 6 cups of rooibos tea daily for 6 weeks.
Contraindications have not been identified.
Information regarding safety and efficacy in pregnancy and lactation is lacking.
In a study using human serum, rooibos acted as an angiotensin-converting enzyme (ACE) inhibitor in a manner similar to that of enalaprilat.
Information regarding adverse effects is lacking. A study of human volunteers receiving 6 cups of tea daily for 6 weeks noted increased serum levels of creatinine, as well as ALT and AST enzymes.
Long-term, high-dose use may impair kidney and liver function, but few case reports exist.
Rooibos ("red bush") grows as a low shrub, reaching a height of 1.2 to 1.5 m. It has long, needle-like leaves and small yellow flowers. The plant is native to South Africa and is cultivated extensively for its commercial value as a substitute for common tea. The leaves and twigs are collected, washed, bruised, fermented, dried, cut, and packaged for use as teas. During this process, the leaves change from green to brick red due to the release of a red pigment found in the leaves and stems.1 Synonyms are Borbonia pinifolia Marloth or Aspalathus contaminata (Thunb.) Druce.
"Bush teas" are common throughout Africa and are frequently used as substitutes for common tea. Red bush tea has been popular in South Africa for decades, and commercial preparations are sometimes found in Europe and the United States. In 1994, an American company registered the name "Rooibos" with the United States Patent and Trademark Office. However, the American Herbal Products Association and a number of import companies successfully petitioned to defeat the trademark in 2005, returning the name to the public domain.2 In 2013, the South African Department of Trade and Industry issued geographic indicator trade restrictions on the name rooibos in that country.3
The tea’s lack of caffeine and tannin make it popular as a fragrant and bittersweet, nonstimulating beverage. It has also been used to treat asthma, colic, eczema, headache, nausea, and mild depression.1, 3, 4, 5
Chemical constituents detailed for red bush tea primarily consist of flavonoids (ie, catechin, quercetin, rutin, vitexin, dihydrochalcones aspalathin, nothofagin) and phenolic acids (ie, caffeic, p-coumaric, ferulic, vanillic acids).5, 6, 7, 8, 9 Aspalathin, a dihydrochalcone C-glucoside, was identified in 1965,10 with green (unfermented) rooibos possibly containing more aspalathin than the commercial fermented rooibos tea.11 An enolic phenylpyruvic acid glucoside has also been identified.12
Phenolic content of extracts varies by season and production methods.13
Red bush tea contains no caffeine or pyrrolizidine alkaloids and low amounts of tannins (less than 5%), as determined by spectrophotometry and gas chromatography.14 The tea contains a relatively high level of vitamin C, as well as some sodium, potassium, magnesium, calcium, and zinc.5, 6
Uses and Pharmacology
Antioxidant activity has been demonstrated in laboratory experiments and in cellular systems, and in vivo studies have been conducted in rodents and quails.9, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26 Reported total antioxidant activity varies depending on the assay method and on fermentation and processing methods.27
A small, single-dose study among healthy human volunteers did not detect any change in total antioxidant capacity using the oxygen radical absorbance capacity assay,28 while another study found small increases.29 Following consumption of 6 cups of rooibos tea daily for 6 weeks, improved antioxidant status and lipid profiles (decreased low-density lipoprotein [LDL] and triacylglycerol, increased high-density lipoprotein [HDL]) were reported among adults with risk markers for cardiovascular disease.30
Suppression of mutagenic activity has been demonstrated in rodents, including studies of liver and skin tumorigenesis,27, 31, 32, 33, 34 with rooibos tea lowering activity to a greater extent than green tea in at least 1 study.31
No clinical data exist regarding the use of rooibos in cancer.
In hyperlipidemic mice, aqueous rooibos extract reduced serum cholesterol, triglyceride, and free fatty acid concentrations, and decreased adipocyte size and number.35 An in vitro study demonstrated inhibition of adipogenesis following treatment with hot water–soluble solids from fermented rooibos.36 Anticoagulant activity has been described for aspalathin and nothofagin in human umbilical endothelial cells and in mice.37 These 2 chemical constituents have also shown activity in inhibiting various mechanisms involved in vascular inflammation.6, 38, 39 In mice, hypotensive effects were demonstrated, possibly via potassium channel modulation.40
Following daily consumption of 6 cups of rooibos tea for 6 weeks, improved antioxidant status and lipid profiles (decreased LDL and triacylglycerol, increased HDL) were reported among adults with risk markers for cardiovascular disease.30 In a study using human serum, rooibos acted as an ACE inhibitor in a manner similar to that of enalaprilat.41
Experiments in rodents suggest that extracts of rooibos may have antidiabetic effects, with suppressed increases in fasting blood glucose levels demonstrated. Increased glucose uptake and insulin secretion, as well as reduced insulin resistance, are possible mechanisms of action. Green rooibos,11, 42 aspalathin alone,43 and in combination with rutin,44 and an enolic phenylpyruvic acid glucoside have all been studied.12, 44
There are no clinical data regarding the use of rooibos in diabetes.
Anti-inflammatory effects of rooibos and of the constituents aspalathin and nothofagin have been studied in models of colitis and vascular inflammation. Suppression of tumor necrosis factor-alpha and interleukin has been demonstrated.16, 39, 45
There are no clinical data regarding the use of rooibos as an anti-inflammatory agent.
The effect of rooibos, aspalathin, and nothofagin on steroid hormone biosynthesis has been investigated.46, 47 Rooibos consumption increased cortisone plasma levels in males and reduced cortisol to cortisone ratios in both males and females.48
Aspalathin was shown to inhibit xanthine oxidase activity and reduce plasma uric acid levels in mice.49
Bronchodilator and antispasmodic effects were demonstrated in mice, possibly via potassium channel modulation.40
Rooibos extracts may possess antibacterial activity, as demonstrated in limited experiments.25, 50
The traditional dosage of the tea is 1 to 4 teaspoons of dry leaf tea per cup taken up to 3 times per day.5
Limited studies have used doses of 6 cups of rooibos tea per day for 6 weeks.30, 48 Urinary excretion of rooibos metabolites when taken as a tea has been investigated.51
Pregnancy / Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking. Phytoestrogenic effects have been suggested.52, 53, 54 Rooibos tea has been shown to interfere with steroidogenesis in vivo,53 possibly due to antioxidant properties, and to improve sperm motility in rats.17, 55
No effect on iron absorption has been reported.27 In a study using human serum, rooibos acted as an ACE inhibitor in a manner similar to that of enalaprilat.41 Anticoagulant activity has been described for aspalathin and nothofagin in human umbilical endothelial cells and in mice.37 A study on the interaction of rooibos with cimetidine was inconclusive in its findings.56
Information regarding adverse effects is lacking.27 Although microbial contaminants (including Salmonella) may be present due to the fermentation process used to derive the tea product, few reports of contamination exist.4, 57
Animal studies have shown increased creatinine levels, but no changes in kidney tissue on histology.55 A study of human volunteers receiving 6 cups of tea daily for 6 weeks noted increased serum levels of creatinine, as well as ALT and AST enzymes.30 A case of hepatotoxicity has been reported in a 37-year-old man who consumed 10 cups/day of red bush tea for more than a year. He was scheduled for an emergency appendectomy where his preoperative work-up revealed elevated liver enzymes and thrombocytopenia. All other causes for the hepatotoxicity were ruled out and the tea was deemed to be the responsible agent.60
Long-term, high-dose use may impair liver and kidney function, but few case reports exist.14, 30, 55, 58 Interference with the acrosome reaction, required for penetration into an egg, has been suggested.55
1. Watt J, Breyer-Brandwijk MG. Medicinal and Poisonous Plants of Southern and Eastern Africa
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2. American Herbal Products Association. Rooibos Trademark Abandoned. American Herbal Products Association website. http://ahpa.org/Default.aspx?tabid=145&aId=216
. Updated 2015. Accessed April 14, 2015.
3. Merchandise Marks Act, 1941 (Act 17 of 1941), Final Prohibition on the Use of Certain Words. Department of Trade and Industry, Republic of South Africa. September 6, 2013. http://www.gov.za/sites/www.gov.za/files/36807_gen911.pdf
. Accessed August 6, 2015.
4. Joubert E, de Beer D, Malherbe CJ, et al. Occurrence and sensory perception of Z-2-(beta-d-glucopyranosyloxy)-3-phenylpropenoic acid in rooibos (Aspalathus linearis
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23. Fukasawa R, Kanda A, Hara S. Anti-oxidative effects of rooibos tea extract on autoxidation and thermal oxidation of lipids. J Oleo Sci
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26. Simpson MJ, Hjelmqvist D, Lopez-Alarcon C, et al. Anti-peroxyl radical quality and antibacterial properties of rooibos infusions and their pure glycosylated polyphenolic constituents. Molecules
27. Ulicná O, Vancová O, Waczulíkova I, et al. Does rooibos tea (Aspalathus linearis
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30. Villaño D, Pecorari M, Testa MF, et al. Unfermented and fermented rooibos teas (Aspalathus linearis
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31. Marnewick JL, Rautenbach F, Venter I, et al. Effects of rooibos (Aspalathus linearis
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33. Marnewick J, Joubert E, Joseph S, Swanevelder S, Swart P, Gelderblom W. Inhibition of tumour promotion in mouse skin by extracts of rooibos (Aspalathus linearis
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36. Beltran-Debon R, Rull A, Rodriguez-Sanabria F, et al. Continuous administration of polyphenols from aqueous rooibos (Aspalathus linearis
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43. Mazibuko SE, Muller CJ, Joubert E, et al. Amelioration of palmitate-induced insulin resistance in C2C12 muscle cells by rooibos (Aspalathus linearis
44. Kawano A, Nakamura H, Hata S, Minakawa M, Miura Y, Yagasaki K. Hypoglycemic effect of aspalathin, a rooibos tea component from Aspalathus linearis
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