Kombucha

• How It Works

  Kombucha has not been shown to treat cancer or AIDS in humans.

  Kombucha is a beverage made by fermenting sweetened black tea (green and oolong tea are also used) with a symbiotic culture of bacteria and yeasts (SCOBY). Believed to have originated in China, kombucha has gained worldwide popularity as a functional food. It is used as an immunostimulant, and to treat diabetes, cancer and AIDS.

  The high caffeine and sugar content of the tea may account for increase in energy levels following consumption of kombucha. However, it can be easily contaminated during fermentation. Allergic reactions, jaundice, serious illness, and death have been associated following consumption of home-grown kombucha tea. It may also reduce the absorption of drugs that are sensitive to gastric pH level.

• Purported Uses
  • To treat atherosclerosis (hardening of arteries)
    Evidence is lacking to support this claim.
  • To treat cancer
    Animal studies have shown that kombucha has antioxidant effects, but human studies are lacking.
  • To treat diabetes
    Animal studies have shown that kombucha has antidiabetc effects, but human studies are lacking.
  • To treat AIDS
    Evidence is lacking to support this claim.
  • To lower blood pressure
    Evidence is lacking to support this claim.
  • To stimulate the immune system
    Animal studies demonstrate immune-stimulating activity, but human data are lacking.
• Patient Warnings
  • Growing kombucha in unsanitary conditions has resulted in contaminated product.
  • Lead poisoning has been associated with kombucha tea brewed in glazed ceramic pots.
• Do Not Take If
  • You have a suppressed immune system: Contaminated kombucha beverages can activate the immune system.
  • You are taking drugs that are sensitive to stomach pH levels: Kombucha may reduce the absorption of these drugs.
• Side Effects

  Case Reports

  Cutaneous anthrax: In 20 people following topical use of kombucha grown in unhygienic conditions.

  Consumption of oral kombucha has been reported to cause:

  • Severe illness and death
  • Lead poisoning from kombucha brewed in a lead-glazed ceramic pot
  • Hepato- and gastrointestinal toxicities including allergic reactions, jaundice and nausea, vomiting, head and neck pain
  • Yeast infections
  • Myositis associated with pleural effusions, pericardial effusion with tamponade, and ’mechanic’s hands’
  • Severe metabolic lactic acidosis in a 54-year-old asthmatic woman after she drank kombucha tea
  • Clostridium septicum sepsis due to bacteremia and hematogenous spread, resulting in encephalitis and pneumocephalus in a patient following consumption of kombucha tea and performing coffee enemas
• Clinical Summary

  Kombucha is a beverage made by fermenting sweetened black tea (green and oolong tea are also used) with a symbiotic culture of bacteria and yeasts (SCOBY). Believed to have originated in China, kombucha has gained worldwide popularity as a functional food. The SCOBY consists of several acetic acid and lactic acid bacteria. Following fermentation, kombucha’s chemical makeup includes sugars, tea polyphenols, fiber, ethanol, amino acids and water-soluble vitamins ⁽¹⁾. Health benefits attributed to kombucha include reduction of blood pressure and cholesterol along with anticancer and immunostimulatory effects.

  Preclinical studies have shown anti-inflammatory, antioxidant, immunostimulatory ⁽⁵⁾, hypolipidemic ⁽²⁰⁾, and hepatoprotective ^{(6) (18) (19) (21) (23)} effects with limited toxicity ⁽⁷⁾. In a small study involving 24 subjects with non-insulin dependent diabetes mellitus, daily intake of kombucha was associated with normalized blood sugar values ⁽²⁴⁾. Randomized studies have yet to be conducted ^(8) (1).

  Kombucha is used as an immunostimulant, and to treat diabetes, cancer and AIDS ⁽³⁾. The high caffeine and sugar content of the tea may account for increase in energy levels following its consumption ⁽⁴⁾. However, kombucha can be easily contaminated during fermentation. Allergic reactions, jaundice, serious illness, and death have been associated following consumption of home-grown kombucha ^{(9) (10) (11)}. It may also reduce the absorption of drugs that are sensitive to gastric pH level ⁽¹²⁾.

• Purported Uses
  • Atherosclerosis
  • Cancer treatment
  • Diabetes
  • AIDS
  • High blood pressure
  • Immunostimulation
• Mechanism of Action

  Kombucha demonstrated antimicrobial activity against a large number of pathogenic microorganisms at neutral pH and following denaturation, which suggests that it contains antimicrobial compounds other than acetic acid and large proteins ⁽¹³⁾.

  Fermentation increases the potential for contamination with other microorganisms. Contamination with anthrax ⁽¹⁰⁾; and Aspergillus  ⁽¹⁴⁾, a fungus that is dangerous to people with lowered immune systems, have been reported.

• Warnings
  • Growing kombucha in unsanitary conditions has resulted in contaminated product ⁽¹⁰⁾
  • Lead poisoning has been associated with kombucha tea brewed in a glazed ceramic pot ⁽¹⁵⁾
• Contraindications

  Patients with suppressed immune systems should not consume kombucha beverages produced in an uncontrolled environment ⁽²⁸⁾.

• Adverse Reactions

  Case Reports

  Cutaneous anthrax: In 20 people following topical use of kombucha grown in unhygienic conditions ⁽¹⁰⁾.

  Consumption of oral kombucha has been reported to cause:

  • Severe illness and death   ^(9) (17)
  • Lead poisoning from kombucha brewed in a lead-glazed ceramic pot ⁽¹⁵⁾
  • Hepato- and gastrointestinal toxicities including allergic reactions, jaundice and nausea, vomiting, head and neck pain ^{(2)(11) (25)}
  • Yeast infections ⁽¹²⁾
  • Myositis associated with pleural effusions, pericardial effusion with tamponade, and ’mechanic’s hands’ ⁽²²⁾
  • Severe metabolic lactic acidosis in a 54-year-old asthmatic woman after she drank kombucha tea ⁽²⁶⁾
  • Clostridium septicum sepsis due to bacteremia and hematogenous spread, resulting in encephalitis and pneumocephalus in a patient following consumption of kombucha tea and performing coffee enemas ⁽²⁷⁾
• Herb-Drug Interactions

  Kombucha tea is acidic. This may affect the bioavailability of drugs that depend on stomach pH levels for dissolution and absorption ⁽¹²⁾.

• References

  1. Kapp JM, Sumner W. Kombucha: a systematic review of the empirical evidence of human health benefit. Ann Epidemiol. 2019 Feb;30:66-70.

  2. Perron AD, Patterson JA, Yanofsky NN. Kombucha “mushroom” hepatotoxicity. Ann.Emerg.Med 1995;26:660-1.

  3. Greenwalt CJ, Steinkraus KH, Ledford RA. Kombucha, the fermented tea: microbiology, composition, and claimed health effects. J Food Prot. 2000;63:976-81.

  4. Majchrowicz M. Kombucha: a dubious “cure”. GMHC.Treat.Issues 1995;9:10.

  5. Dipti P, Yogesh B, Kain AK, Pauline T, Anju B, Sairam M et al. Lead induced oxidative stress: beneficial effects of Kombucha tea. Biomed.Environ.Sci. 2003;16:276-82.

  6. Pauline T, Dipti P, Anju B, Kavimani S, Sharma SK, Kain AK et al. Studies on toxicity, anti-stress and hepato-protective properties of Kombucha tea. Biomed.Environ.Sci. 2001;14:207-13.

  7. Vijayaraghavan R, Singh M, Rao PV, et al. Subacute (90 days) oral toxicity studies of Kombucha tea. Biomed.Environ.Sci. 2000;13:293-9.

  8. Ernst E. Kombucha: a systematic review of the clinical evidence. Forsch.Komplementarmed.Klass.Naturheilkd. 2003;10:85-7.

  9. Centers for Disease Control and Prevention. Unexplained severe illness possibly associated with consumption of Kombucha tea—Iowa, 1995. JAMA 1996;275:96-8.

  10. Sadjadi J. Cutaneous anthrax associated with the Kombucha “mushroom” in Iran. JAMA 1998;280:1567-8.

  11. Srinivasan R, Smolinske S, Greenbaum D. Probable gastrointestinal toxicity of Kombucha tea: is this beverage healthy or harmful? J Gen.Intern Med 1997;12:643-4.

  12. Kombucha—toxicity alert. Crit Path.AIDS Proj. 1994;31-2.

  13. Sreeramulu G, Zhu Y, Knol W. Kombucha fermentation and its antimicrobial activity. J Agric.Food Chem. 2000;48:2589-94.

  14. Gamundi R,.Valdivia M. [The Kombucha mushroom: two different opinions]. Sidahora. 1995;34-5.

  15. Phan TG, Estell J, Duggin G, Beer I, Smith D, Ferson MJ. Lead poisoning from drinking Kombucha tea brewed in a ceramic pot. Med J Aust. 1998;169:644-6.

  16. MICROMEDEX(R) Healthcare Series. 120. 2004. Thomson MICROMEDEX.

  17. SungHee Kole A, Jones HD, Christensen R, et al. A case of Kombucha tea toxicity. J Intensive Care Med. 2009 May-Jun;24(3):205-7.

  18. Murugesan GS, Sathishkumar M, Jayabalan R, et al. Hepatoprotective and curative properties of Kombucha tea against carbon tetrachloride-induced toxicity. J Microbiol Biotechnol. 2009 Apr;19(4):397-402.

  19. Bhattacharya S, Gachhui R, Sil PC. Hepatoprotective properties of kombucha tea against TBHP-induced oxidative stress via suppression of mitochondria dependent apoptosis. Pathophysiology. 2011 Jun;18(3):221-34.

  20. Aloulou A, Hamden K, Elloumi D, et al. Hypoglycemic and antilipidemic properties of kombucha tea in alloxan-induced diabetic rats.BMC Complement Altern Med. 2012 May 16;12:63.

  21. Bhattacharya S, Manna P, Gachhui R, Sil PC. Protective effect of kombucha tea against tertiary butyl hydroperoxide induced cytotoxicity and cell death in murine hepatocytes.Indian J Exp Biol. 2011 Jul;49(7):511-24.

  22. Derk CT, Sandorfi N, Curtis MT. A case of anti-Jo1 myositis with pleural effusions and pericardial tamponade developing after exposure to a fermented Kombucha beverage. Clin Rheumatol. 2004 Aug;23(4):355-7.

  23. Lee C, Kim J, Wang S, et al. Hepatoprotective Effect of Kombucha Tea in Rodent Model of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis. Int J Mol Sci. 2019 May 13;20(9). pii: E2369.

  24. Hiremath US, Vaidehi MP, Mushtari BJ. Effect of Fermented tea on the blood
      sugar levels of NIDDM Subjects. Indian Pract. 2002;55(7):423e5.

  25. Gedela M, Potu KC, Gali VL, Alyamany K, Jha LK. A Case of Hepatotoxicity Related to Kombucha Tea Consumption. S D Med. 2016 Jan;69(1):26-8.

  26. Holbourn A, Hurdman J. Kombucha: is a cup of tea good for you? BMJ Case Rep. 2017 Dec 2;2017. pii: bcr-2017-221702.

  27. Mirzai S, Rifai AO, Webb S, Rifai K, Reiner A. Probable Clostridium septicum pneumocephalus in a user of natural remedies with newly diagnosed diabetes mellitus type 1. IDCases. 2019 Jun 25;17:e00581.

  28. Mayser P, Fromme S, Leitzmann C, Grunder K. The yeast spectrum of the ’tea fungus Kombucha’. Mycoses 1995;38:289-95.