Health, Wellness, and Safety Aspects of the Consumption of Kombucha

Abstract

Functional foods have been identified as whole foods and fortified, enriched, or enhanced products which have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. As consumer awareness on functional food escalates, the interest towards conducting scientific studies in this field has also proportionately increased. Many of the traditional food products are known to possess bioactive components, thus qualifying as functional food. Kombucha tea is produced by fermenting sugared black tea with a mixed culture of yeast and bacteria. Kombucha tea has gained immense popularity in recent times due to many associated health benefits. The therapeutic effects of this beverage are thought to be derived from the chemical composition of this beverage, mainly the polyphenols and secondary metabolites which are produced during fermentation. However, the safety aspects of the beverage also need to be taken into account when qualifying the beverage as a functional food. Nevertheless, Kombucha tea could be easily recognized as a beverage which is able to replace the consumption of carbonated beverages due to its possession of health benefits and therapeutic properties.

Full text

Review Article
Health, Wellness, and Safety Aspects of
the Consumption of Kombucha
Mindani I. Watawana, Nilakshi Jayawardena,
Chaminie B. Gunawardhana, and Viduranga Y. Waisundara
Functional Food Product Development Project, National Institute of Fundamental Studies, Hantane Road, 20000 Kandy, Sri Lanka
Correspondence should be addressed to Viduranga Y. Waisundara; viduranga@gmail.com
Received  September ; Revised  November ; Accepted  December 
Academic Editor: Tzortzis Nomikos
Copyright ©  Mindani I. Watawana et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Functional foods have been identied as whole foods and fortied, enriched, or enhanced products which have a potentially
benecial eect on health when consumed as part of a varied diet on a regular basis, at eective levels. As consumer awareness
on functional food escalates, the interest towards conducting scientic studies in this eld has also proportionately increased.
Many of the traditional food products are known to possess bioactive components, thus qualifying as functional food. Kombucha
tea is produced by fermenting sugared black tea with a mixed culture of yeast and bacteria. Kombucha tea has gained immense
popularity in recent times due to many associated health benets. e therapeutic eects of this beverage are thought to be derived
from the chemical composition of this beverage, mainly the polyphenols and secondary metabolites which are produced during
fermentation. However, the safety aspects of the beverage also need to be taken into account when qualifying the beverage as a
functional food. Nevertheless, Kombucha tea could be easily recognized as a beverage which is able to replace the consumption of
carbonated beverages due to its possession of health benets and therapeutic properties.
1. Kombucha: Preparation and
Fermentation Process
Kombucha tea is known under dierent names throughout
theworldsuchasredteafungus,Champignondelongue
vie, Ling zhi, kocha kinoko, Chainii grib, and Chainii kvass
[]. It is traditionally prepared by fermenting sugared black
tea with a symbiotic culture of yeast and bacteria. is
beverageisthoughttohaveoriginatedinChinaover
years ago [], while there are many historical reports of
this beverage being consumed in countries such as Russia,
Germany, and the Middle East as well []. In many countries
this beverage is produced in large-scale for commercial use
as well as in domestic conditions. Despite being a fermented
beverage, the avor of Kombucha tea is considered to be
satisfactory and nonacrimonious, though mildly acidic and
mildly alcoholic, similar in taste to apple cider []. As the
fermentation progresses, the taste of Kombucha tea changes
from a pleasantly fruity, sour, lightly, and sparkling avor
to a mild vinegar-like taste, thus increasing the consumer
acceptabilityoftheavorandothersensoryaspectsofthe
beverage [, ]. e microbial composition of the Kombucha
teacultureisknowntovaryfromoneculturetoanother
depending on factors such as geographic location, climate,
the local species of bacteria and yeast, and the source of
the inoculum []. In some studies it has been proven that
the use of dierent Kombucha starter cultures can cause a
development of dierent antioxidant activity pathways even
though the same substrate has been used [, ].
e yeast and bacteria involved in this microbial fer-
mentation form a mat-like pellicle known as a “tea fungus.”
e yeast component of this culture commonly consists
of osmophilic yeast species, while the bacterial component
includes acetic acid bacteria. In many studies it has been
found that the dominant acetic acid bacterial species found in
the microbial cultures are Acetobacter xylinum, A. xylinoides,
A. aceti, A. pausterianus, and Bacterium gluconicum [].
e dominant yeast strains were found out to be Kloeckera
Hindawi Publishing Corporation
Journal of Chemistry
Volume 2015, Article ID 591869, 11 pages
http://dx.doi.org/10.1155/2015/591869

 Journal of Chemistry
e tea leaves and ltered and allowed to cool to room
temperature
e cooled tea is added to a sterile glass jar and inoculated
with the freshly grown Kombucha starter culture
e fermentation is allowed to be carried out
e pellicle which is formed is removed and the liquid
portion is strained away for consumption
Approximately 5 g of tea leaves are added to the mixture and
allowed to infuse for 5 min
water
Approximately 50 g of white sugar is dissolved in 1 liter of boiling
F : e typical method of preparation of the Kombucha
beverages using sugared black tea.
spp., Schizosaccharomyces pombe, Saccharomyces ludwigii, S.
cerevisiae, Torulaspora spp., Zygosaccharomyces bailii, and
Pichia spp.,[].efungal-likestructureisformedbythe
presence of these microbes in a zoogleal mat. is mat is
produced due to the formation of a thin layer of oating
cellulosetowhichthecellmassofbacteriaandyeastis
attached []. e cellulose is produced by the bacterial com-
ponent of the microbial consortium. A. xylinum is primarily
knowntoberesponsibleforthecelluloseproductionand
this cellulose network enhances the association between the
bacteria and the fungi []. It has been reported that the
caeineandrelatedxanthinesfoundinteahavetheability
to stimulate the synthesis of this cellulose production by
the bacteria []. is powerful symbiotic association and its
byproducts have the ability to inhibit the growth of potential
contaminating bacteria []. e bacterial cell and yeast cell
numbers are generally thought to reach 
4
–
6
cfu mL
−1
in
aKombuchaculturewhichhasbeenallowedtofermentfor
a span of approximately  days []. Many scientic studies
have proven that yeast outnumbers the bacterial count [,
]. As the fermentation progresses, the acidity of the broth
increases due to the production of organic acids. Due to
high acidity-induced oxygen starvation, the number of viable
microbial cells present in Kombucha tea decreases as well
[]. e number of yeast and bacterial cells in the broth
hasbeenreportedtobemorethanthecellnumberinthe
cellulosic pellicle [].
In terms of the traditional preparation, the starter culture
is added to a sugared black tea infusion and the fermentation
is allowed to happen for a period of  to  days under
ambient temperature []. A ow-chart containing the general
preparation method is shown in Figure . Nevertheless, under
domestic conditions of preparation, the amount of tea used
for the fermentation process and the method of preparation
dier according to personal preferences. e avor and
concentration of the compounds found in this beverage also
dier with the starter culture, amount of starter culture used,
typeoftea,andtypeofsugar[].Eventhoughtraditionally
black tea is being used as the substrate, Kombucha prepared
by other substrates such as green tea and oolong tea are
commonly available. Green tea has shown to have a better
stimulation eect on the Kombucha fermentation compared
with black tea fermentation and this leads to formation of
the product in a shorter period of time [, ]. In some
rare instances this beverage has been prepared by lemon
balm tea, mulberry tea, jasmine tea, and peppermint tea
[, , ]. e resulting broth is ltered out and the liquid
portion is consumed. e tea fungus which is initially added
to the tea is called the “mother tea fungus,” where during
the fermentation the development of a “daughter tea fungus”
takes place. e cellulosic pellet rests on top of the tea broth
andproducesafreshthinlayerofthedaughtermatwhich
isavailableasanewlayerabovetheoldKombuchaculture
mat. is new daughter mat is formed with each successful
fermentation step, and it is used to reinoculate a new batch
of tea. At the beginning of the fermentation, a small portion
of previously prepared Kombucha broth may be added to
the new tea to decrease the pH in order to stop the growth
of undesired microorganisms []. As the fermentation pro-
gresses the appearance of gas bubbles will occur due to
carbonic acid produced during the fermentation.
2. Composition of Kombucha Tea and How It
Differs from Black Tea
e microbes in this culture are able to ferment the sugared
black tea and produce a complex cocktail of molecules. At the
end of the fermentation process, the resulting beverage would
consistofsugars,polyphenolssuchascatechins,organicfood
acids, lysine, ber, ethanol, amino acids, essential elements
suchasNa,K,Ca,Cu,Fe,Mn,Ni,andZn,water-solublevita-
mins such as vitamin C, vitamin B, and vitamin B
2
,catalase,
carbon dioxide, substances which act as antibiotic substances,
and some hydrolytic enzymes [, ]. e chemical structures
of the commonly produced acids are shown in Figure . As
the fermentation progresses, the yeast component of this
mixed culture is able to break down sucrose to produce
glucose, fructose, and carbon dioxide which gives o the
eervescence and the sparkling appearance. e acetic acid
bacteria have the ability to convert glucose to gluconic acid
andfructoseintoaceticacid.Also,theyeastcomponentis
able to produce ethanol which is then oxidized into acetalde-
hyde by the bacterial counterpart of this colony []. e yeast
prefers fructose as the substrate when producing ethanol [].
e acetic acid produced by the acetic acid bacteria has the
ability to stimulate the production of ethanol by yeast, and
ethanol in turn can facilitate the acetic acid bacteria to grow
and produce acetic acid. e ethanol and acetic acid present
in the Kombucha broth have been reported to be involved
in the antimicrobial activity of the broth against pathogenic
bacteria, thus providing a protection against contamination
of the tea fungus []. It has been reported that even if the
byproducts of the fermentation process decrease, the pH

Journal of Chemistry 
O
O
O
O
O
O
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
OH
O
HO
HO
HO
HO
HOHO
O
O
O
O
CH
3
Glucuronic acid
Gluconic acid Malic acid
Oxalic acid L-lactic acid Citric acid
F : e most abundant organic acids found in Kombucha tea as a result of the fermentation process.
value of this beverage has a buering capacity. is buering
capacity is due to carbon dioxide dissociation, and when this
process happens, production of amphiprotic hydrocarbonate
anion (HCO
3
−
) occurs. is anion has the ability to react with
hydrogen ions (H
+
) from organic acids and inhibit further
change of H
+
concentration in the broth and thus contribute
to formation of buer in the system [].
Even though Kombucha is based on the preparation
of black tea, other than the fermentation process, it is
considered dierent due to the chemical contents themselves.
Tea (Camellia sinensis), in general, is one of the most popular
beverages used worldwide and it has been consumed by
many, for centuries. ere are three major types of teas,
namely,black,green,andoolong.Outofthesethreetypes,
black tea is the most popular and it accounts for nearly %
of the tea consumed worldwide []. is form of tea is
prepared by the infusion of dried leaves of Camellia sinensis
in hot water. e tea leaves, aer picking, are air dried
thencrushedtoreleasetheenzymesandthenallowedfor
enzymatic fermentation. en, they are dried again to obtain
the nal product. Some of the main components of tea are
purine alkaloids such as caeine, theaavins, gallotannins,
triterpene, saponins, avonoids, mineral compounds, car-
bohydrates, and vitamins [, ]. Black tea is known to
possess a higher radical scavenging property and the major
contributor of this property is known to be polyphenols [].
Depending on the geographical location, climate, season, soil
fertility, and plantation method, a variation can be seen in
this particular property []. Kombucha tea diers from its
parental food by the antioxidant content, starch hydrolase
inhibitory activity, anionic mineral composition, and acid
content. Kumar et al. [] have demonstrated the presence
of the anionic minerals such as uoride, chloride, bromide,
iodide, phosphate, sulphate, and nitrate in both black and
Kombucha tea. Table  shows a comparison of anionic min-
eral concentration of Kombucha tea and Black tea. ey have
further revealed that the anionic mineral compositions of
Kombucha and black tea are signicantly dierent from each
T : Comparison of anionic mineral concentration of Kom-
bucha tea and Black tea [].
Anion Kombucha tea (mg/g) Black tea (mg/g)
F
−
. ± . . ± .
Cl
−
. ± . . ± .
Br
−
. ± . . ± .
NO
3
−
. ± . . ± .
HPO
4
2−
. ± . . ± .
SO
4
2−
. ± . . ± .
I
−
. ± . . ± .
other []. Kombucha tea is known to exhibit an increase
in the radical scavenging properties during the fermentation
possess, showing a higher antioxidant capacity than black tea
[].
3. Health Benefits Associated with
Consumption of Kombucha
e American Diabetic Association has dened functional
food to be products including whole foods and fortied,
enriched, or enhanced foods, which have a potentially bene-
cial eect on health when consumed as part of a varied diet
on a regular basis, at eective levels []. Kombucha beverage
is known to possess many prophylactic and therapeutic
benets; it is believed to help in digestion, give relief against
arthritis, act as a laxative, prevent microbial infections,
combat stress and cancer, provide relief against hemorrhoids,
impartapositiveinuenceonthecholesterollevels,and
facilitate excretion of toxin as well as blood cleansing [,
, ]. is beverage is also associated with inuencing the
gastrointestinal microbial ora in humans by acting as a
probiotic drink and helping in balancing the intestinal ora,
thus facilitating the normalization of intestinal activities to
a certain extent [, , ]. It is also known to have the

 Journal of Chemistry
T : Some constituents of Kombucha related to health claims and their recommended values for consumption.
Chemical constituent
Amount present in
Kombucha green tea
(g/L)
Amount present in
Kombucha black tea
(g/L)
Recommended maximum level as per
standard guidelines
LD
50
value in rats via
oral route (mg/kg of
body weight)
Acetic acid
. ± . (on day )
[]
. ± . (on day )
[]
. g per day []  []
Glucuronic acid
. ± . (on day )
[]
. ± . (on day )
[]
Not available Not available
Lactic acid
. ± .(onday)
[]
. ± . (on day )
[]
FDA requirement substance added
directly to the human food armed as
generally recognized as safe (GRAS)
[]
 []
Citric acid
Not available Not available  mg/kg per day []  []
Oxalic acid
. (on day ) [] . (on day ) []
. mg/kg per day (the scientic basis
forthisconclusionisnotavailableand
therefore no safe dietary dose for
oxalic acid can be established) []
 []
Acetaldehyde
Not available Not available –. mg/kg per day []  []
abilitytoimprovethehealthofhair,skin,andnails,reduce
stress and nervous disturbances, reduce insomnia, relieve
headaches, reduce the craving for alcohol of an alcoholic
person, and prevent the formation of bladder infections
[, ]. Reducing the kidney calcication is also known to
be a benecial eect of this beverage []. Reduction of
menstrual disorders and menopausal hot ashes, improving
eye sight, cellular regeneration, stimulation of glandular
systemsinthebody,relievingbronchitisandasthmaand
the enhancement of general metabolism are a few more of
the health benets which have been claimed to be associated
with consumption of the Kombucha broth []. e benecial
eects of this beverage are known to be attributed to the
presence of the metabolic products released into the broth
during the fermentation, although most of the health benets
arehypothesizedtobeduetoitsradicalscavengingpotential.
e microbial community has the ability to enhance the
radical scavenging activity of black tea by the fermentation
process[].Also,thepresenceofglucuronicacidimparts
benecial properties to this drink []. Glucuronic acid is
normally produced by a healthy liver and is a highly water
soluble carboxylic acid. is acid can be converted into
glucosamine and chondroitin-sulfate which are associated
with collagen and also the uid that acts as lubricate in
the joints []. Butyric acid produced by the microbial
consortium in the fermentation process is known to protect
human cellular membranes. In combination with glucuronic
acid, this complex has the ability to strengthen the walls of gut
and give protection against parasites []. Table  shows some
of the constituents of Kombucha related to health claims and
their recommended values for consumption. Although it may
appear that many reports which are available on Kombucha
are based on personal experiences and testimonials, in recent
times, scientists have provided scientic evidence elucidating
the therapeutic eects of the beverage from in vitro as well as
in vivo studies. Table  shows the bioactivities of Kombucha
and the mode of studies which have been carried out.
However, in contrast to the number of studies done on other
fermented products such as fermented milk, the amount of
studies done on this beverage is very low. Nevertheless, the
subsequent sections of this review summarize the purported
health benets of Kombucha based on available scientic
evidence and reports. In addition, given the fermentation
process involved in producing the beverage, the review also
summarizes the safety issues and aspects of caution which
need to be borne in mind when consuming the beverage.
3.1. Antimicrobial Activity. Kombucha tea is known to show
a remarkable antimicrobial activity against a broad range
of microorganisms. Many scientic studies have been done
on this subject and the Kombucha broth has demonstrated
inhibitory activity against many pathogenic microorganisms
of both Gram positive and Gram negative origin []. Kom-
bucha tea has demonstrated the ability to inhibit the growth of
pathogens such as Helicobacter pylori (the causative organism
of peptic ulcers), Escherichia coli (the causative organism
of common diarrhea), Entamoeba cloacae, Pseudomonas
aeruginosa, Staphylococcus aureus, Staphylococcus epider-
mis, Agrobacterium tumefaciens, Bacillus cereus, Aeromonas
hydrophila, Salmonella typhimurium, Salmonella enteritidis,
Shigella sonnei, Leuconostoc monocytogenes, Yersinia entero -
colitica, Campylobacter jejuni, and Candida albicans [, ,
]. is antimicrobial activity of the broth is attributed
tothelowpHvalueofthisbeverage,especiallyowing
tothepresenceofaceticacidinparticularandarange
of other organic acids and catechins which are shown in
Figureaswellasmanylargeproteinswhichareproduced
during the fermentation [, ]. Acetic acid and catechins
are specially known to inhibit a range of Gram positive
and Gram negative microorganisms []. It has also been
demonstratedthatthebrothmaycontainantibioticsub-
stances which give the antimicrobial property [, ]. Some
studies have demonstrated that Kombucha tea shows not
only antibacterial activity but also antifungal activity [].
e antifungal activity is attributed to the production and

Journal of Chemistry 
T : Bioactivities of Kombucha and mode of studies which have been carried out.
Bioactivities References
Antihypercholesterolemic eect In vitro studies on rats []
Antioxidant activity against chromate In vivo studies on rats []
Antioxidant activity against lead In vivo studies on rats []
Antistress activity against cold and hypoxia In vivo studies on rats []
Cytogenetic activity
In vitro studies on human peripheral blood
lymphocytes []
Healing activity against indomethacin-induced acute
gastric ulceration
In vivo studies on mice []
Hypoglycaemic eect In vivo studies on mice [, ]
Inhibitory activity towards CCl
4
induced hepatic injury In vivo studies on rats []
Longevity In vivo studies on mice []
Paracetamol induced hepatotoxicity In vivo studies on mice []
Prevention of weight loss in diabetes In vivo studies on rats []
Protective eect on chromosomal aberrations induced by
gamma radiation in human peripheral lymphocytes
In vitro studies on human peripheral lymphocytes []
presence of acetic acid in this beverage. In recent times,
theimmergenceofresistantstrainsofpathogensassociated
with human diseases has been widely seen, and the use
of Kombucha tea as an antimicrobial product can be used
to overcome this problem []. In this aspect, it has been
demonstrated that the antimicrobial activity of Kombucha
tea prepared form green tea shows a higher activity than
Kombucha tea prepared traditionally from black tea [].
3.2. Probiotic Eects. Probiotics are known to be living
microorganisms; when administrated in adequate amounts,
they are able to result in health benets. Most oen, the
bacterial component of a probiotic mixture comes from
Lactobacillus or Bidobacterium or a cocktail of these two
strains. In support of these lines, there can be a few common
yeast types such as Saccharomyces boulardii and S. cerevisiae
in this mixture as well []. Probiotic microbes are known to
play a vital role in the wellness of human health. Probiotic
microorganisms provide a balance in intestinal microbiota,
normalizing processes in gut and boosting the immune
system. In addition, they help in improving digestion, ghting
against harmful bacterial overgrowths, and achieving mental
clarity and mood stability and against psychological con-
ditions such as anxiety and depression. Many studies have
claimed that this beverage not only is a probiotic but also
acts as a symbiotic, a combination of prebiotics and probiotics
[,].Aprebioticselectivelyhelpsthegrowthandactivityof
the consortium of benecial microbes present in the human
gut []. e bacteria and yeast present in this beverage act
as probiotics and the microcellulose which is present can
help in the growth of the benecial microbes present in the
intestine []. e popularity of this beverage as a probiotic
and a synbiotic has increased in recent times as scientists have
found that this beverage can be used to give the required
nutrition and help maintain health and wellness in humans
who work under unhealthy environments, such as workers
in mines and polar expeditors []. When the human body
is exposed to such conditions for a prolonged period of time,
the normal microbial consortium of microbes in the intestine
changes due to the unnatural conditions, psychoemotional
discomfort, and drastic change in the diet. is may lead
to the disappearance of the protective gut microbes and the
immergence of harmful secondary infections by opportunis-
tic microbes. is shi in the gut microbiota can lead to many
health issues such as allergies, autoimmune diseases, multiple
sclerosis, and transplant infectious disease. e change in the
gut microbiota can be corrected to some extent with the help
of Kombucha tea. In light of these mentioned possibilities,
scientists have started to consider this beverage to be used by
astronauts as a supplement to their diet in outer space [].
3.3. Anticancer Properties. Dietary phytochemicals have been
identied as eective anticancer agents. us, there is a recent
trend of consuming food rich in these bioactive compounds.
Scientic studies have claimed that Kombucha has anticancer
eects as well []. e Central Oncological Research Unit in
Russia and the Russian Academy of Sciences in Moscow have
conducted population studies on this fermented beverage
andhavefoundthatthedailyconsumptionofKombucha
broth has a correlation with an extremely high resistance
to cancer []. Scientists have come up with many possible
mechanisms for the anticancer ability of this beverage. For
instance, it has been reported that the ability of this fermented
beverage to act as an anticancer agent is due to the presence
of tea polyphenols and the secondary metabolites produced
during the fermentation process [, ]. Many studies have
shown that the ability of the tea polyphenols present in this
fermented beverage to inhibit gene mutations, inhibit the
proliferation of cancer cells, and induce cancer cell apoptosis
and the ability to terminate metastasis have been highlighted

 Journal of Chemistry
as possible mechanisms for the anticancer properties [–
]. It has also been noted that the consumption of Kom-
bucha tea can help cancer patients to reequilibrate blood
pH which usually increases more than . in the course
of the illness. Additionally, cancer patients lack L-lactic
acid in their connective tissues; this can also be corrected
by the consumption of Kombucha, where the fermentation
process produces lactic acid as a byproduct []. Many of the
compounds which were identied to be present in Kombucha
tea such as polyphenols, gluconic acid, glucuronic acid, lactic
acid, and vitamin C are known to have the ability to reduce
the occurrence of stomach cancer. It has also been found out
that Kombucha contains D-saccharic acid-,-lactone (DSL)
which is known to inhibit the activity of glucuronidase, an
enzyme which is thought to be indirectly related to cancer
[]. Glucuronidase has the ability to hydrolyze glucuronide
and produce cancer-causing aglycones []. It was reported
that the polyphenols present in the Kombucha tea pos-
sess antitumor properties, thus acting as a cancer-blocking
agent []. Another study reports presence of dimethyl-
(-hydroxy--methoxypropylidene) malonate and vitexin in
the ethyl acetate fraction of Kombucha tea which has shown
cytotoxic eects at a concentration of  𝜇g/mL [].
3.4. Detoxication. Detoxication is the complex process
of removal of toxic substances from the body of a living
organism. is process can be physiological or medicinal. In
the human body, this process is carried out mainly by the
liver. Detoxication helps in the maintenance of a healthy
liverandisalsoknowntoplayapartincancerprevention.e
enzymes, bacterial acids, and other secondary metabolites
produced by the microbes during the fermentation process
done in the preparation of Kombucha tea have displayed
the ability to detoxify body []. In addition, most of the
enzymes and bacterial acids found in Kombucha tea are
very similar to the chemicals produced by the body for the
purpose of the detoxifying process. us, incorporation of
Kombucha tea into one’s diet may result in the reduction of
the detoxication load pressured on the liver. Many scientic
studieshavereportedthatthisabilityismainlyduetothe
capacity of glucuronic acid to bind with toxic molecules
which enter the body and also the ability to increase excretion
of these molecules from the physiology by the help of kidneys
and intestines []. e process of strong binding between
the glucuronic acid molecules and the toxin is known as
glucuronidation []. Glucuronic acid is produced due to
the oxidation process of glucose during the fermentation
process []. is acid is the most signicant detoxier
in human body; thus, it has the ability to bind to the
toxins in the liver and encourage them to ush out of the
body []. Similar to glucuronic acid, malic acid is also a
byproduct of the fermentation which helps in detoxifying
the liver []. Other than supporting the detoxication of the
liver, consumption of Kombucha tea is also known to help
excrete heavy metal substances and environmental pollutants
from the human body through the kidneys []. It is also
benecial in the biotransformation of indigenous metabolites
such as bilirubin and excess of steroid hormones []. e
toxin removal action of Kombucha tea is known to help in
obtaining relief from gout, rheumatism, arthritis, and kidney
stones which are conditions associated with the accumulation
of toxic substances in the body [].
3.5. Antioxidant Activity. e popular denition of an antiox-
idant is any substance, when present at low concentrations
compared with that of an oxidizable substrate, that signi-
cantly delays or inhibits oxidation of the substrate []. is
bioactivity could be broadly presented in the form of ()
scavenging properties of molecules, () binding of prooxidant
metals, and () inhibition of prooxidant enzymes. Many
studies have proven the eect of these antioxidant properties
on many human diseases such as cancer and diabetes []. e
primary mechanism of the action of antioxidants in these
disease conditions is to remove free radical intermediates,
and these free radicals are generated in oxidation reactions
which happen across the human body. Free radicals have the
ability to start multiple chain reactions which will eventually
lead to cell damage or the death of the aected cell [].
When an antioxidant comes in contact with free radicals,
they have the ability to oxidize themselves and inhibit other
oxidation reactions which lead to harmful chain reactions.
eoxidativestresscausedbyfreeradicalsplaysanimportant
role in many of the commonly prevalent human diseases such
as Parkinson’s disease, coronary heart disease, and cancer, the
reasons being the lack of appropriate nutrition and exercise,
air pollution in the environment, and smoking []. In order to
counterbalance this oxidative stress caused by free radicals, it
is important to incorporate antioxidant containing food stu
to the daily diet [].
During the Kombucha fermentation, many compounds
with radical scavenging properties are released from the
tea leaves themselves []. Polyphenols and catechins are the
main group of compounds which are found in tea belonging
to avanol group [, , ]. Polyphenols are considered
as having high levels of broad antioxidant properties since
they have the ability to scavenge free radicals and reactive
oxygen species (ROS) []. Polyphenols are about % of
the total dry weight of fresh tea leaves and epigallocatechin,
epigallocatechin--gallate, epicatechin--gallate, and epicat-
echin are the most prominent types of polyphenols found
in tea leaves []. Kombucha tea when prepared using green
tea, black tea, and tea waste material has been shown to have
a high radical scavenging activity []. When the complex
phenolic compounds are present in an acidic environment or
when enzymes liberated by bacteria and yeasts in tea fungus
are present, degradation of complex molecules to small
molecules happens and this causes an increase in the total
phenolic compounds available in the Kombucha tea broth
[]. erefore, when the fermentation happens, the total
phenolic content increases []. e production of compounds
possessing radical scavenging properties depends on the
culture period and starter origins where they decide which
metabolites are to be produced []. However, prolonged
fermentation is not suitable as accumulation of organic acids
can cause a harmful eect when Kombucha tea is directly
consumed [].

Journal of Chemistry 
3.6. Hepatoprotective Eects. Hepatoprotection is the ability
to prevent the damage occurring to the liver by toxic
substances [, ]. Many studies carried out on cell lines
andanimalmodelshaveshownthatKombuchabrothshows
hepatoprotective activity against various environmental pol-
lutants []. Many of the environmental pollutants have the
ability to induce hepatotoxicity and damage the liver. Many
scientic studies were carried out to assess the ability of this
tea broth to eectively attenuate the physiological changes
which are caused by many of the hepatotoxicity-causing
agents such as aatoxin B [], cadmium chloride [],
tert-butyl hydroxyperoxide [], and acetaminophen [, ].
Carbon tetrachloride (CCl
4
) is a xenobiotic that induces the
lipid peroxidation and it forms a free radical CCl
3
−
,and
this involves accumulating lipid derived oxidants which leads
to liver injury []. Kombucha tea consumption has been
demonstratedtoinhibittheactivityofCCl
4
and prevent
liver injury in rats []. In vivo studies have suggested
that Kombucha tea is capable of preventing paracetamol
induced hepatotoxicity []. Studies have been carried out
to investigate how Kombucha tea can induce oxidative stress
in Albino rats by chromate (VI) []. Studies have also
been carried out to nd protective eects of Kombucha
tea against thioacetamide-induced hepatotoxicity and the
results have shown that the antioxidant activity of polyphenol
substances of Kombucha tea is responsible for this function
[]. ese studies have further explained that Kombucha
tea prevents the apoptotic cell death of the hepatocytes
which is triggered from the exposure of the liver to the
environmental toxins []. Histological analyses of alloxan-
induced diabetes rats given a diet containing Kombucha tea
have revealed protective liver-kidney functions []. is
is supported by the reduction in the activity of aspartate
transaminase, alanine transaminase, and gamma-glutamyl
transpeptidase in the plasma, as well as in the creatinine urea
concentrations []. Pathophysiological evidences are also
available for hepatoprotective eects of Kombucha tea in rat
models [, ].
3.7. Other erapeutic Eects. ere are many allegations of
health benets and uses related to this beverage, some of
which are not discussed in this review in further detail. For
instance, the microbial mat produced in the fermentation
had been used to produce articial skin in Nossa Senhora
da Conceic¸
˜
ao Hospital from Lagarto, SE, Brazil []. Some
researchers have used this skin to accelerate the healing
process and also as an antiseptic by adhering it to open
injuries, the so-called Bioskin []. e bacterial cellulose
which is produced during the Kombucha tea fermentation
process has many potential applications in elds such as food
and biopharmaceuticals. e ability and trend to use bacterial
cellulose in these elds are due to the high purity and the
unique physicochemical properties which are present in the
fermented beverage. In addition, this bacterial cellulose is
preferred in instances where plant based cellulose cannot be
used []. In the food industry bacteria-based cellulose is used
as food matrices, thickeners, dietary bers, stabilizes, and
binders []. Lactic acid is one of the organic acids produced
during the Kombucha tea fermentation. It is able to enhance
the blood circulation and helps prevent constipation [].
Oxalic acid, which is also produced as a byproduct, can be
useful in the production of adenosine triphosphate (ATP)
[]. Bacteria found in the Kombucha mat produce gluconic
acid by breakdown of caprylic acid which can prevent certain
types of yeast-based infections and candidiasis []. Butyric
acid is a production of yeast available in the Kombucha mat
and helps in protecting the human cellular membrane, where
it combines with gluconic acid and strengthens the gut walls
in conditions such as candidiasis []. Moreover, healing of
gastric ulcers in rats due to Kombucha tea has been evident
as per histopathological and biochemical studies []. e
usage of this beverage to eliminate the growth of gray hair
andtheusageintheimprovementofeyesightareafewof
the health benets which have been claimed as well [].
Oral supply of Kombucha tea at a dose of  mg/kg of body
weight in alloxan-induced diabetes rats has depicted better
inhibition on 𝛼-amylaseandlipaseenzymeactivityinthe
plasma and pancreas and also better suppression of increased
blood glucose levels []. us, Kombucha tea has potential
hypoglycemic and antilipidemic activity as well.
4. Safety Issues and Controlling Potential
Hazards of Kombucha
SinceKombuchaisacomplexmixtureofmicroorganisms,
it is essential to discuss the safety of Kombucha tea for
consumption. As mentioned previously, bacteria and fungi
in the Kombucha zoogleal mat are capable of forming a
powerful symbiosis which can inhibit the growth of contam-
inating bacteria [, ]. Nevertheless, pathogenic microor-
ganisms can contaminate the Kombucha tea throughout the
preparation. Due to fermentation, the pH reaches ≤ ..
However,untilthisisachieved,thereisahighpossibility
for contaminations to occur []. Mold contamination can
occur on Kombucha cultures, especially with Penicillium
and Aspergillus, when the Kombucha tea is home-made.
Aspergillus species are known to cause carcinogenic and
toxigenic eects []. erefore, it is important to be cau-
tious when administering infected beverages by immune-
compromised individuals. It is essential to concern that that
the ecacy of Kombucha tea as a therapeutic beverage is
hardly proven by clinical trials involving human subjects [].
Beside, even though consumption of Kombucha claims to
havenoadversesideeects,therehavebeenafewexceptions
over past years. Few case reports and case series question
the safety of Kombucha tea with suspected liver damage,
metabolic acidosis, and cutaneous anthrax infections [].
Allergic reactions and an uncomfortable stomach are a result
of consuming Kombucha tea by people with acid sensitivities
and renal insuciencies []. Several studies have conrmed
that Kombucha can cause nausea, shortness of breath, throat
tightness, headache, dizziness, and jaundice [, ]. One case
revealed that two persons had developed allergic reactions,
a third person developed jaundice, and another developed
nausea,vomiting,andheadandneckpain.ecasereports
an etiological association of all four patients since all of them

 Journal of Chemistry
had consumed Kombucha tea in proximity to the onset of
symptoms and their subsequent disappearance aer cessation
of drinking the beverage []. Some individuals have reported
that they felt dizziness and nausea aer consumption of
Kombucha tea []. However, it was not explained whether
these symptoms are a result of unusual toxins developed in a
particular batch of Kombucha tea.
Overfermentation can increase the availability of high
acetic acid concentrations, and this might lead to the leeching
of some chemical contaminants from the fermentation vessel
or packaging materials. ere is evidence that severe lead
poisoning can be caused by regular use of Kombucha tea
which was brewed in a ceramic pot [, ]. is might
have occurred due to Kombucha tea being acidic and the
resulting reactions caused by some ceramics. Most of the
ceramics contain very low levels of lead which would not be
of any danger when brewing Kombucha tea. Nevertheless,
if the Kombucha is steeped in them for a long time, then
high amounts of lead can dissolve in the tea [, ]. It
is important to use glass containers for the preparation
and storage of Kombucha tea to prevent leaching of toxic
elements such as lead into the beverage. In addition to acetic
acid, Kombucha tea contains several organic acids [, ].
Some of these metabolites have the potential to damage
liver and kidney at high concentrations, as evident by few
case reports [, , ]. Kombucha tea is contraindicated
in pregnant and lactating women []. Studies have also
reported the presence of Bacillus anthrax in Kombucha tea
fermented under unhygienic conditions []. e source of
B. anthrax was found to be cows and anthrax was passed
to an individual who rubbed it on his skin to alleviate the
pain.
Due to the detoxication eects of Kombucha tea, toxic
materials are forced to be excreted from the body. However,
if the kidneys are not working properly, these individuals may
not be able to successfully discharge the toxic materials. us,
it is recommended to drink plenty of water to facilitate the
elimination of toxins to overcome this problem []. From
this aspect, it is essential to give attention to the abnormal
odour or colour development in Kombucha tea to overcome
any adverse side eects. Domestic cultivation of Kombucha is
one of the most possible ways of contamination by pathogenic
bacteriaandyeasts.Sincethisteafungusisbeinggrown
under aseptic conditions and it is propagated from one
house to another, the transfer of contaminations is high
[, ]. A study reported that consumption of Kombucha
mightalsobeahealthriskforHIV-positivepatients[].
It was discovered that acute renal failure may occur with
lactic acidosis and hyperthermia due to consumption of this
beverage. e possibility of getting infected by toxins is higher
when Kombucha tea is consumed in large quantities. Another
report states that one individual died due to perforations
of the intestinal tract and severe acidosis, who consumed
home-made Kombucha tea  oz per day for two months [].
Another individual who consumed Kombucha tea coming
from the same initial zoogleal mat had suered from cardiac
arrest and severe acidosis []. Despite these reports, most
of these studies are limited to a very small number of
individuals. Hence, further studies should be carried out to
form a substantial conclusion about the safety aspects in the
consumption of Kombucha tea.
Using clean and sanitized utensils during preparation of
Kombucha tea helps in preventing any contamination. It is
better to keep the preparation and fermentation areas clean
to control growth of any microorganisms since tea must be
cooled to about 
∘
C within two hours prior to adding the
Kombucha culture into the tea. It is also important to control
the pH during the fermentation process since overproduction
of acetic acid can be hazardous. According to the British
Columbia Center for disease control, the fermentation should
be terminated at the pH . []. Overproduction of alcohols
andcarbondioxidecanalsobepreventedbypasteurizing
the nished product []. Adding .% sodium benzoate and
.% potassium sorbate to the nished product, followed
by refrigeration, can also be carried out for safety purposes
[]. Refrigeration of the nal product is the most common
method followed by the commercial producers of Kombucha
tea [].
5. Conclusions
e chemical composition of the Kombucha tea depends on
type of tea leaf variety, amount of sugar, and fermentation
and composition of tea fungus. However, there are a very
few studies focused on the safety of consuming Kombucha
tea. Most of the health properties of Kombucha are related
to the acidic composition of the beverage and acetic acid,
which is the major acidic component to inhibit the fungal
growth.Overproductionofacidscanbecontrolledduring
the fermentation duration as well as the packaging of the
nal product. Yet, the importance of studying the safety of
Kombucha tea consumption is important as there are only a
very few such studies been carried out throughout the years.
Since this a popular beverage around the world, investigating
the advantages and disadvantages of consuming this beverage
in similar capacities can be extremely meaningful. According
to literature, there is no evidence about systematic human
trials being done using Kombucha tea. is could be an area
in which future research could be focused in establishing this
beverage as a functional food. Since studies carried out to
assess qualitative and quantitative properties of constituents
of Kombucha are scattered, scientic research should be
carried out to clarify the health benecial claims and safety
aspects, which might help in promoting this beverage among
consumers. Despite the scattered safety issues, production
and consumption of this beverage in a safe manner can
be used to substantiate the stand of this beverage as a
replacement for carbonated beverages. Attention of relevant
authorities should be focused on establishing national and
international policies and regulations regarding the safety
of Kombucha consumption and mass production of this
beverage as a readily available commercial beverage.
Conflict of Interests
e authors declare that there is no conict of interests
regarding the publication of this paper.

Journal of Chemistry 
Acknowledgments
e authors wish to acknowledge the nancial support
rendered by the National Institute of Fundamental Studies,
Hantane Road, Kandy, Sri Lanka. Funding provided for Mrs.
Chaminie B. Gunawardhana as a research student through
National Research Council of Sri Lanka, Grant no. -, is
also acknowledged.
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