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Kombucha

Scientific Name(s): SCOBY., Symbiotic culture of bacteria and yeast.
Common Name(s): "fungus" Japonicus, Champagne of life, Combucha tea, Dr. Sklenar's kombucha mushroom infusion, Kargasok tea, Kombucha mushroom, Kombucha tea, Kwassan, Manchurian "fungus", Manchurian tea, Pellicle, Spumonto, T'chai from the sea, Teekwass, Tschambucco, Yeast/bacteria fungal symbiont, Zoogleal mat

Medically reviewed by Drugs.com. Last updated on Aug 1, 2019.

Clinical Overview

Use

Evidence does not support the pharmacologic claims for kombucha teas; case reports of severe toxicity exist.

Dosing

There is no clinical evidence to support specific dosage recommendations for kombucha.

Contraindications

Use in immune-suppressed patients, and during pregnancy and lactation is not advised.

Pregnancy/Lactation

Avoid use.

Interactions

None well documented.

Adverse Reactions

Cases of nausea and allergic responses have been reported.

Toxicology

Information is limited. Rare case reports of severe toxicity exist.

Botany

Kombucha is not a fungus or a mushroom, but rather a cellulose pellicle or mat fermented in a black tea and sugar mix.1 Pellicle is sometimes referred to as a symbiotic colony of bacteria and yeast (SCOBY),2, 3 the bacterial portion of which generally contains Gluconacetobacter xylinus (formerly known as Acetobacter xylinum), that ferments the ethanol produced by the yeast component. Kombucha tea is the resultant sour-tasting, fermented liquid broth, described as resembling sparkling apple cider. Black or green tea has been used, and a number of other beverages, teas (including fruit-based teas), Jerusalem artichoke, milk, and whey, have also been described.1, 4, 5

Kombucha should not be confused with the seaweed konbu (Japanese). See Seaweed monograph.

History

Kombucha tea has grown rapidly in popularity and has been touted as a miracle cure for a wide variety of illnesses ranging from memory loss to premenstrual syndrome.6

The name "kombucha" is derived from Japanese in that it is brewed in a seaweed (kombu) tea (cha). In Western countries, the product is typically propagated in black tea. Growing spores are floated on the surface of brewed, sweetened black tea, with the mycelium doubling in mass approximately every week. The mass is then divided, and the new portion is propagated on new tea media. In this manner, kombucha mycelium can be propagated at a rapid rate for commercial distribution.7

As the growth matures, it ferments the beverage slightly, which is then consumed for its purported medicinal properties. Consumption of fermented teas has long been popular in Eastern cultures, and the use of this particular mycelial growth may date back several centuries.

Despite extravagant claims for its pharmacologic activity, some experts believe that the tea fulfills the US Food and Drug Administration’s criteria for identifying a fraudulent product, including reference to non-US medical studies, an appeal to personal vanity, ancient origins, and alleged cures for a wide variety of ailments.6 Some of these claims include curing cancer, rheumatism, and intestinal disorders, as well as reversing the effects of aging.

Chemistry

The major bacteria in kombucha are most commonly from the genus Gluconacetobacter, with Acetobacter as the minor or trace bacterium present.5 Other bacteria such as Lactobacillus may also be present.5, 8

Zygosaccharomyces is the likely yeast, but with others such as Candida and Pichia possibly present.9 Standardization issues exist, and the many kombucha teas should be referred to in the plural rather than as kombucha tea (singular).10

The bacteria and yeast together are embedded in a cellulose pellicle, and although symbiosis between the yeast and bacteria has not been proven, a close association is evident.9, 10 The yeast produces ethanol from the sugar, which the bacteria ferments to produce acetic acid, thereby increasing the acidity of the liquid broth. Similarly, the acetic acid appears to stimulate production of ethanol by the yeast, and both ethanol and acetic acid inhibit the growth of other microorganisms.4, 9, 11

Carbon dioxide, acids (gluconic, glucuronic,11 acetic and lactic), phenolic compounds, fructose, sucrose, glucose, minerals, and vitamins (B and C) are also found in kombucha teas.1, 12 With time, the sugar content decreases, and acidity increases to a pH of approximately 2.5.9

Uses and Pharmacology

As the base liquid is generally green or black tea, some of the purported uses may be attributed to the teas themselves.11 See the Green Tea monograph.

Cancer

Animal data

Limited studies in rodents have demonstrated a protective effect against radiation-induced chromosomal aberrations.13, 14

Clinical data

Results of a systematic review did not support the use of kombucha teas for cancer prevention or for cancer treatment due to the lack of human studies to support claims and because of the potential risk of serious adverse events.15

Liver disease

Animal data

Studies in rats have demonstrated decreased liver enzymes and improved creatinine and urea indices with consumption of kombucha teas for up to 30 days. Protection against acetaminophen-, carbon tetrachloride-, and radiation-induced injury has been demonstrated. Antioxidant properties may be responsible for the observed effects.16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27

Clinical data

There are no clinical data on the use of kombucha in hepatic disease.1 Rare case reports of hepatotoxicity exist.28

Metabolic syndrome

Due to the presence of phenolic compounds, inhibition of pancreatic alpha-amylase has been postulated, sufficient to cause a net decrease in the absorption of glucose.12

Animal data

In mice and rats, limited studies have shown that kombucha teas improve lipid profiles and indices of diabetes (glycosylated hemoglobin [HbA1c] and plasma insulin), and well as increasing antioxidant capacity and cardiac markers.16, 29, 30, 31

Clinical data

There are no clinical data on the use of kombucha in treating cardiovascular disease, diabetes, or dyslipidemia. Rare case reports of severe metabolic acidosis32, 33 and cardiomyopathy34 exist.

Wound healing

Animal data

Studies in rodents have shown that intraperitoneal administration of kombucha teas decreased inflammation and adhesions in induced peritoneal wounds,35 while topical application of the kombucha pellicle resulted in wound healing in rats at a similar rate to that of nitrofurazone ointment.36

Clinical data

There are no clinical data to support the use of kombucha in wound healing, despite the suggested use of the pellicle in burns and as a temporary skin substitute.11

Other uses

Antimicrobial

Kombucha teas have demonstrated in vitro antimicrobial activity against bacterial and fungal species, including some human pathogens.4, 9, 37 Antimicrobial activity has been demonstrated even after thermal denaturation4; however, clinical studies are lacking.

Toxins

Glucuronic acid has been shown to bind to toxins.1, 11 A study in rats with silica dust–induced pulmonary lesions showed improvements with kombucha administration.38

Gastric ulceration

Indomethacin-induced gastric ulcers were healed (histological assessment) in rodents with administration of kombucha teas. Despite the acidity of kombucha tea, reduced gastric acid secretion was described.39

Dosing

There is no clinical evidence to support specific dosage recommendations for kombucha.

Pregnancy / Lactation

Avoid use.1

Interactions

Case reports are lacking. Based on chemical studies, inhibition of the angiotensin-converting enzyme may be possible.40

Adverse Reactions

Cases of nausea and allergic responses have been reported.11 Because the final pH of kombucha teas is very acidic (pH 2.5), consumption with water is advised.9 Use in immune-suppressed patients is not advised.1

Toxicology

Rare case reports of severe metabolic acidosis,32, 33 cardiomyopathy,34 and hepatotoxicity28 exist.11, 15, 33 Teas produced under sterile conditions are likely to be safe for consumption, and a food code process for their production has been published.2, 9 Studies in rodents have been conducted. In a 90-day study with oral kombucha, no hematological, biochemical, or histological changes were evident.9 Another study found no evidence of harm to nerve tissue in rats,41 while the internal organs of rats (but not mice) showed lesions in a 12-week study.9

References

1. Jayabalan R, Malbaša RV, Lončar ES, Vitas JS, Sathishkumar M. A review on kombucha tea — microbiology, composition, fermentation, beneficial effects, toxicity, and tea fungus. Compr Rev Food Sci Food Saf. 2014;13(4):538-550.
2. Nummer BA. Kombucha brewing under the Food and Drug Administration model Food Code: risk analysis and processing guidance. J Environ Health. 2013;76(4):8-11.24341155
3. Velicanski AS, Cvetkovic DD, Markov SL, Tumbas Šaponjac VT, Vulic JJ. Antioxidant and antibacterial activity of the beverage obtained by fermentation of sweetened lemon balm (Melissa officinalis L.) tea with symbiotic consortium of bacteria and yeasts. Food Technol Biotechnol. 2014;52(4):420-429.27904315
4. Sreeramulu G, Zhu Y, Knol W. Kombucha fermentation and its antimicrobial activity. J Agric Food Chem. 2000;48(6):2589-2594.10888589
5. Marsh AJ, O'Sullivan O, Hill C, Ross RP, Cotter PD. Sequence-based analysis of the bacterial and fungal compositions of multiple kombucha (tea fungus) samples. Food Microbiol. 2014;38:171-178.24290641
6. Foster RD. Kombucha: mushroom with a mission. Nat Health. 1995;March/April:52-55.
7. Marin R, Biddle NA. Trends: taking the fungal-tea plunge. Newsweek. January 9, 1995:64.
8. Vīna I, Semjonovs P, Linde R, Denina I. Current evidence on physiological activity and expected health effects of kombucha fermented beverage. J Med Food. 2014;17(2):179-188.24192111
9. Greenwalt CJ, Steinkraus KH, Ledford RA. Kombucha, the fermented tea: microbiology, composition, and claimed health effects. J Food Prot. 2000;63(7):976-981.10914673
10. Jarrell J, Cal T, Bennett JW. The kombucha consortia of yeasts and bacteria. Mycologist. 2000;14(4):166-170.
11. Dufresne C, Farnworth E. Tea, kombucha, and health: a review. Food Res Int. 2000;33(6):409-421.
12. Kallel L, Desseaux V, Hamdi M, Stocker P, Ajandouz E. Insights into the fermentation biochemistry of kombucha teas and potential impacts of kombucha drinking on starch digestion. Food Res Int. 2012;49(1):226-232.
13. Cavusoglu K, Guler P. Protective effect of kombucha mushroom (KM) tea on chromosomal aberrations induced by gamma radiation in human peripheral lymphocytes in-vitro. J Environ Biol. 2010;31(5):851-856.
14. Yapar K, Cavusoglu K, Oruc E, Yalcin E. Protective effect of kombucha mushroom (KM) tea on phenol-induced cytotoxicity in albino mice. J Environ Biol. 2010;31(5):615-621.21387911
15. Ernst E. Kombucha: a systematic review of the clinical evidence. Forsch Komplementarmed Klass Naturheilkd. 2003;10(2):85-87.12808367
16. 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;12:63.22591682
17. Abshenas J, Derakhshanfar A, Ferdosi MH, Hasanzadeh S. Protective effect of kombucha tea against acetaminophen-induced hepatotoxicity in mice: a biochemical and histopathological study. Comp Clin Pathol. 2012;21(6):1243-1248.
18. Bhattacharya S, Gachhui R, Sil PC. Effect of kombucha, a fermented black tea in attenuating oxidative stress mediated tissue damage in alloxan induced diabetic rats. Food Chem Toxicol. 2013;60:328-340.23907022
19. Bhattacharya S, Manna P, Gachhui R, Sil PC. Protective effect of kampuchea tea against tertiary butyl hydro peroxide induced cytotoxicity and cell death in murine hepatocytes. Indian J Exp Biol. 2011;49(7):511-524.21800502
20. Bhattacharya S, Gachhui R, Sil PC. Hepatoprotective properties of kombucha tea against TBHP-induced oxidative stress via suppression of mitochondria dependent apoptosis. Pathophysiology. 2011;18(3):221-234.21388793
21. Pauline T, Dipti P, Anju B, et al. Studies on toxicity, anti-stress and hepato-protective properties of kombucha tea. Biomed Environ Sci. 2001;14(3):207-213.11723720
22. Wang Y, Ji B, Wu W, et al. Hepatoprotective effects of kombucha tea: Identification of functional strains and quantification of functional components. J Sci Food Agric. 2014;94(2):265-272.23716136
23. Gharib OA. Effects of kombucha on oxidative stress induced nephrotoxicity in rats. Chin Med. 2009;4:23.19943946
24. Murugesan GS, Sathishkumar M, Jayabalan R, Binupriya AR, Swaminathan K, Yun SE. Hepatoprotective and curative properties of kombucha tea against carbon tetrachloride-induced toxicity. J Microbiol Biotechnol. 2009;19(4):397-402.19420997
25. Jayabalan R, Marimuthu S, Thangaraj P, et al. Preservation of kombucha tea-effect of temperature on tea components and free radical scavenging properties. J Agric Food Chem. 2008;56(19):9064-9071.18781766
26. Sai Ram M, Anju B, Pauline T, et al. Effect of kombucha tea on chromate(VI)-induced oxidative stress in albino rats. J Ethnopharmacol. 2000;71(1-2):235-240.10904168
27. Rashid K, Sinha K, Sil PC. An update on oxidative stress-mediated organ pathophysiology. Food Chem Toxicol. 2013;62:584-600.24084033
28. Kovacevic Z, Davidovic G, Vuckovic-Filipovic J, Janicijevic-Petrovic MA, Janicijevic K, Popovic A. A toxic hepatitis caused the kombucha tea — case report. Macedonian J Med Sci. 2014;7(1):128-131.
29. Yang ZW, Ji BP, Zhou F, et al. Hypocholesterolaemic and antioxidant effects of kombucha tea in high-cholesterol fed mice. J Sci Food Agric. 2009;89(1):150-156.
30. Srihari T, Karthikesan K, Ashokkumar N, Satyanarayana U. Antihyperglycaemic efficacy of kombucha in streptozotocin-induced rats. J Funct Foods. 2013;5(4):1794-1802.
31. Lobo RO, Shenoy CK. Myocardial potency of bio-tea against isoproterenol induced myocardial damage in rats [published online August 2, 2014]. J Food Sci Technol. doi: 10.1007/s13197-014-1492-6.
32. SungHee Kole A, Jones HD, Christensen R, Gladstein J. A case of kombucha tea toxicity. J Intensive Care Med. 2009;24(3):205-207.19460826
33. Kombucha tea. In: POISINDEX System [online]. Greenwood Village, CO: Thomson Micromedex. 4985284.
34. 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;23(4):355-357.15293100
35. Maghsoudi H, Mohammadi HB. The effect of kombucha on post-operative intra-abdominal adhesion formation in rats. Indian J Surg. 2009;71(2):73-77.23133119
36. Barati F, Javanbakht J, Adib-Hashemi F, et al. Histopathological and clinical evaluation of kombucha tea and nitrofurazone on cutaneous full-thickness wounds healing in rats: an experimental study [published online July 17, 2013]. Diagn Pathol.2386696010.1186/1746-1596-8-120
37. Battikh H, Chaieb K, Bakhrouf A, Ammar E. Antibacterial and antifungal activities of black and green kombucha teas. J Food Biochem. 2013;37(2):231-236.
38. Fu NF, Luo CH, Wu JC, et al. Clearance of free silica in rat lungs by spraying with chinese herbal kombucha [published online August 19, 2013]. Evid Based Complement Alternat Med.2402358310.1155/2013/790792
39. Banerjee D, Hassarajani SA, Maity B, Narayan G, Bandyopadhyay SK, Chattopadhyay S. Comparative healing property of kombucha tea and black tea against indomethacin-induced gastric ulceration in mice: possible mechanism of action. Food Funct. 2010;1(3):284-293.21776478
40. Hrnjez D, Vaštag Ž, Milanović S, et al. The biological activity of fermented dairy products obtained by kombucha and conventional starter cultures during storage. J Funct Foods. 2014;10:336-345.
41. Zhu C, Li F, Zhou X, Lin L, Zhang T. Kombucha-synthesized bacterial cellulose: preparation, characterization, and biocompatibility evaluation. J Biomed Mater Res A. 2014;102(5):1548-1557.23666905

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This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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