Kombucha is a fermented tea beverage created utilizing a symbiotic colony of bacteria and yeast, commonly referred to under the acronym “SCOBY.” Although its precise origin remains unknown, some allege that kombucha originated in China and may have been named after a Korean physician named “Kombu” who used his tea (“cha”) for healing purposes. Etiological investigations reveal that kombucha was consumed as early as the 1900s in Russia and Germany, and thereafter, its popularity steadily increased throughout the rest of Europe.
It wasn’t until around the 1950s that kombucha became a reasonably popular beverage in the United States. Until the late 1990s, kombucha was most often “home-brewed” and not sold on a commercial basis, however, by the 2010s, kombucha consumption had emerged as a trendy health fad. Annual sales of kombucha beverages are prognosticated to have exceeded $400 million in the United States.
Cult-like proponents of kombucha tout the drink as a magical health elixir capable of curing or treating medical conditions such as: AIDS, autoimmunity, cancer, diabetes, hair loss, and sexual dysfunction (just to name a few). Unfortunately, not only are the myriad of health claims associated with kombucha unsubstantiated by quality research, there’s reason to believe that the drink may provoke side effects and/or serious adverse reactions in a subset of the population. If you plan on consuming kombucha, be cognizant of all potential side effects and understand the risks.
Kombucha Side Effects & Adverse Reactions (List)
It is important to understand that the side effects of kombucha are subject to variation based on the specific person consuming the kombucha, as well as the particular batch of kombucha consumed. While many people drink kombucha on a regular basis and report benefit without side effects, others may experience pronounced side effects. For this reason, it is important to avoid assuming that everyone shares similar responses to consumption of kombucha beverages.
The most common side effects associated with kombucha tend to involve the gastrointestinal tract and include: constipation, diarrhea, indigestion, nausea, and stomach aches. When considering that kombucha modulates the gut microbiome, it makes logical sense that unexpected gastrointestinal events may occur following its consumption. Included below is a comprehensive list of possible side effects and adverse reactions experienced by kombucha drinkers.
Acidosis: An adverse reaction to kombucha that has been documented in medical case reports is acidosis, referring to an increased acidity in the blood and/or other tissue. Specifically, acidosis occurs when an individual’s arterial pH drops below a level of 7.35. Common signs of acidosis include: confusion, headaches, rapid breathing, tiredness, tremor.
If undetected and left untreated, acidosis could lead to brain damage, coma, and possibly death. In 1995 the Center for Disease Control (CDC) noted that 2 women were hospitalized with acidosis after consuming home-brewed kombucha tea that they had been drinking daily for 2 months. It was mentioned that 1 of the 2 women died, whereas the other experienced cardiac arrest but managed to fully recover.
A third case report of acidosis occurred in a 22-year-old male diagnosed with HIV, who died within 15 hours of his kombucha consumption. In all three of the cases, it is reasonable to suspect that acidosis may have resulted from [inadvertent] negligence on behalf of the drinkers. In the case of the 2 hospitalized women, we could suspect that their “home brewed” batch of kombucha may have been overly acidic (with a pH lower than 2.5), contaminated (from poor brewing practices), and/or consumed in excessive quantities.
Unfortunately, the pH of their “home brewed” kombucha was not tested nor reported, but may have revealed abnormally high acidity and/or miscellaneous impurities from brewing (e.g. heavy metals, mold, pathogens). We also know that the women drank the kombucha daily for ~60 consecutive days (possibly in large amounts each day), probably making it difficult for the body’s pH to maintain healthy balance – especially if coupled with a dietary intake of highly acidic foods. Had the 2 women been drinking commercialized kombucha on a less frequent basis, perhaps acidosis would’ve never occurred.
Reflecting upon the third case, it is known that kombucha consumption is contraindicated among immunocompromised persons, and the man had HIV. It is logical to suspect that the acidosis would have never occurred had the man not been diagnosed with HIV. To avoid acidosis from kombucha consumption, it is necessary to rule out medical conditions that may increase your risk (e.g. HIV, renal impairment, etc.) and ensure that you’re not taking any medications/supplements that may interact with it.
If you consume home-brewed kombucha, ensure that it was brewed in a sanitary environment, is devoid of contaminants, and test to ensure optimal pH (between 2.5 and 3.5). Another tip for avoiding acidosis is to avoid overconsumption (e.g. daily in large quantities). All that said, most healthy individuals who drink properly-brewed kombucha are unlikely to experience acidosis – this is an extremely rare adverse reaction.
- Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/00039742.htm
Acne: Many people swear that fermented foods and beverages like kombucha are able to cure or reduce severe acne and/or the number of breakouts they experience. On the other hand, some claim that kombucha significantly worsens their acne and directly causes breakouts. If you experience more acne breakouts and/or flare-ups after drinking kombucha, know that you are not alone.
What causes the acne as a side effect of kombucha? Some suspect that it could be related to the introduction of new gut bacteria from the kombucha. As pathogenic bacteria die for the gut to accommodate new bacteria, they may excrete endotoxins which could somehow have downstream effects on biological mechanisms implicated in skin health – causing increases in sebum production (from skin glands) and inevitably, acne breakouts.
It’s also possible that acne is related to an allergy to the drink or histamine intolerance. There’s no reason to continue drinking kombucha if you suspect it’s facilitating acne breakouts. If you’re concerned about the acne caused by kombucha, seek professional dermatological help.
Allergic reactions: Although rare, a small percentage of individuals may find themselves allergic to one of the many constituents within a particular kombucha formulation. Certain types of kombucha are understood to have additives for taste enhancement, one of which may trigger an allergy. It is also possible that home-brewed, “raw” (unpasteurized) versions of kombucha end up contaminated with pathogens (e.g. toxic mold) as a result of unsanitary brewing practices and/or suboptimal storage containers (e.g. lead jars) – which leach toxins.
Furthermore, the ingestion of bacteria within kombucha may upregulate production of histamine within your gut – a compound implicated in allergic reactions. If you experience an allergic reaction to kombucha, there’s no telling what the exact effects will be. Possible signs of an allergic reaction to the drink include: chills, diarrhea, facial swelling, fever, nausea, severe gastrointestinal distress, skin rash, and/or vomiting.
Should you suspect that you’re experiencing an allergic reaction to kombucha or a component of the drink, do not hesitate to contact a medical professional. To reduce your risk of a kombucha-induced allergy, it is recommended to consume only versions of the beverage that were: pasteurized, properly packaged, and screened for impurities. Also be sure to scan the label to determine whether it contains any additives to which you may be allergic.
Anxiety: Though rarely attributed to kombucha, some have claimed that its consumption causes or exacerbates their anxiety. Someone with a history of neuropsychiatric conditions, especially anxiety disorders, may be more at risk for experiencing anxiety after drinking kombucha than the general population. The anxiety you experience as a side effect may be related to altered activity within the gut-brain axis (GBA) as a result of the SCOBY.
The newly introduced SCOBY may induce death of certain bacteria, causing them to generate endotoxins and leading to an immune response – possibly implicated in anxiety. It is also possible that the specific type of SCOBY within your kombucha changed production of neuroactive metabolites generated in your gut, which in turn altered activity in your brain. Some anxiety may be nothing more than a transient adaptation response to the neuroactive metabolites, but it also could suggest incompatibility with your neurochemistry.
Arguably the most likely cause of anxiety after kombucha consumption is the histamine content; kombucha is an extremely high source of histamine. Many people are unaware of the fact that they are sensitive to histamine, and that this sensitivity may cause anxiety. If the kombucha is making you feel more anxious than usual, you may want to cease consumption and consider a histamine-related issue.
Bloating: You may feel especially bloated or swollen with fluid and/or gas after drinking kombucha. Usually bloating is extremely uncomfortable and can lead to modest or negligible increases in water retention and weight. There may be numerous reasons as to why bloating results from consumption of kombucha including carbonation, excessive intake, and/or introduction of new bacterial species.
Those that experience bloating as a side effect may benefit from reducing their kombucha intake for awhile, drinking plenty of water, and considering adjunct administration of activated charcoal. Fortunately, in most cases, bloating is transient and will subside within a day or two of consumption. If you feel bloated every time you drink kombucha, you may want to avoid it in the future or experiment with a different source.
Blood sugar changes: There’s some evidence from animal model studies to suggest that kombucha exhibits hypoglycemic properties. Whether hypoglycemia is likely to occur in humans drinking kombucha remains unknown. That said, individuals with diabetes should understand that the drink could modulate their blood sugar levels.
Generally, the greater the intake of kombucha, the more significant the blood sugar modulation is likely to be. To determine whether kombucha is affecting your blood-glucose levels, it is recommended to use a glucometer to track changes. Signs of hypoglycemia include: mental confusion, heart palpitations, shakiness, sweating, and anxiety.
Brain fog: While some people swear that kombucha enhances mental acuity and focus, others may experience “brain fog” or clouded thinking after its consumption. Though it is unclear as to why foggy thinking may occur as a side effect of kombucha, there are many possible explanations. Some theorize that the SCOBY (symbiotic colony of bacteria and yeast) within kombucha may overtake the preexisting bacteria within your gut resulting in a bacterial “die off” analogous to the Herxheimer Reaction.
The bacterial die-off may last anywhere from several days to multiple weeks, and is associated with detoxification. Until the body has fully excreted the dead bacteria and detoxified itself, brain fog may be experienced. Once the detoxification process is complete, brain fog may cease and mental clarity may improve like was initially intended.
That said, not everyone experiences brain fog just because there’s some sort of “die off” or detoxification process. It could be that the particular SCOBY you ingested within kombucha was incompatible with your physiology and is unfavorably modulating brain activity through your gut-brain axis. Another possibility is that the newly-introduced bacteria from your kombucha may generate unfavorable metabolites (e.g. endotoxins) that cross the blood-brain-barrier and interfere with neural function.
It is also possible that the brain fog may have less to do with the SCOBY (symbiotic colony of bacteria and yeast) and more to do with additional ingredients such as sugar and alcohol, or contamination from mold. If you suspect that your brain fog is unrelated to a transient detoxification phase, you may want to cease the kombucha for awhile and see if it improves. Drinking plenty of water and taking activated charcoal (for endotoxin adsorption) may also be helpful.
Chills: Anyone that drinks too much kombucha too quickly may make themselves sick. One of the side effects that has been reported from kombucha overconsumption is “chills” characterized by feverish feelings and goose bumps across the skin. Chills may also be related to kombucha-induced gastrointestinal distress and accompanied by bouts of diarrhea, nausea, and/or vomiting.
Should you experience chills, you may want to evaluate whether you’re drinking too much kombucha. If your consumption isn’t excessive, evaluate your sourcing of kombucha and investigate as to whether it may contain contaminants and/or impurities. Due to lack of quality control, those who make raw, unpasteurized kombucha are at greater risk of ingesting pathogenic bacteria and/or mold, leading to sickness and explaining your chills.
Constipation: A major reason some people drink kombucha is to enhance gastrointestinal function and correct unwanted GI issues, however, certain individuals will end up experiencing constipation as a side effect of its consumption. The constipation may be accompanied by other issues such as aches, bloating and/or gurgling of the stomach. In many cases, constipation is transient and theorized to be related to a shift in composition of a person’s gut microbiota.
New bacteria introduced to the gut are competing with older bacterial inhabitants for survival, and in the process, some will die off. Prior to dying off, gastrointestinal abnormalities such as constipation may occur and bowel movements may become infrequent. To cope with the constipation, stay as hydrated as possible and consider upping intake of fiber and complex carbohydrates.
Ensure that you’re engaged in sufficient physical activity throughout the day to induce bowel movements. Unless recommended by a doctor, laxatives should be avoided due to the fact that they can damage intestinal flora. Eventually your gastrointestinal function should normalize and any constipation experienced as a side effect is likely to subside.
Death: Kole, Jones, Christensen, and Gladstein (2009) documented the case report of a 22-year-old male that died within 15 hours of kombucha consumption. Prior to his death, the patient experienced hyperthermia (103 degrees Fahrenheit), shortness of breath, confusion, disorientation, and engaged in combative behavior. In effort to save the patient, medical professionals administered sedative agents and utilized tracheal intubation for respiratory control, however, this proved ineffective.
The cause of death was suspected to be kombucha-induced lactic acidosis. After the patient’s death, it was concluded by authors that kombucha may pose serious health risks and consumption of the tea should be discouraged. While death may be a rare adverse effect resulting from kombucha intake, odds of death are extremely low for most healthy individuals.
It was documented that this man had been diagnosed with HIV (Human Immunodeficiency Virus), which is understood to affect a myriad of bodily functions. Furthermore, the exact quantity of kombucha consumed remains unclear, and it isn’t known as to whether the batch was devoid of contaminants and/or impurities. The combination of a serious medical condition (HIV), plus a raw batch of kombucha (possibly containing mold, lead, pathogens, etc.) may have been enough to cause death.
To avoid a kombucha-related death, it is recommended to rule out medical conditions that may be contraindicated with kombucha. It would also be smart to cease drinking kombucha if you’re taking medications and/or supplements that may interact with its alcohol content. To further minimize death risk, only consume kombucha brewed with high quality control, avoid [potentially unsanitary] home brews, and only consume small quantities.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/19460826
Diarrhea: An extremely uncomfortable side effect that a subset of kombucha consumers report is diarrhea. Diarrhea is hypothesized to be most common among those who are new to drinking kombucha and may be a result of introducing billions of new bacterial species. In attempt to colonize within your gastrointestinal tract, these new bacteria essentially compete with older bacterial inhabitants for food and real estate.
In the process, you may experience some unpredictable gastrointestinal discomfort, leading to diarrhea and loose stools. You may also want to consider that diarrhea could be related to drinking too much kombucha in a short duration, or a result of its caffeine content (which can elicit a laxative effect). The diarrhea experienced as a kombucha side effect may last between 1 day and 2 weeks post-consumption.
If you experience ongoing diarrhea, it’s probably smart to stop the kombucha for awhile and let your body readjust. Always trust your body’s reaction and realize that if you’re experiencing diarrhea, it could signify that you’re unable to tolerate kombucha (or the particular batch you consumed). Since diarrhea dehydrates the body, ensure that you’re staying hydrated and replenishing lost electrolytes. Those with persistent kombucha-induced diarrhea may want to consider dietary modifications (e.g. reducing fiber), activated charcoal, or Imodium.
Dizziness: A side effect that has been reported by a subset of kombucha drinkers is dizziness. If you feel dizzy after drinking kombucha, it may be due to the fact that you drank an excessive amount in a short duration (e.g. 2 bottles in an hour) and/or on an empty stomach. Though most kombucha doesn’t contain much alcohol, it is possible that the alcohol content in your kombucha is higher than expected (or reported on the bottle).
Even a modest amount of alcohol ingested on an empty stomach could explain dizziness, especially among children consumers. Since kombucha also contains caffeine, it’s possible that the combination of caffeine and alcohol provoked a dizzy reaction. It is also possible that kombucha may cause dizziness as a result of toxic byproducts within your beverage such as mold from home brewing and/or leaching of contaminants from storage containers.
Dizziness could be related to allergic reactions to ingredients (e.g. additives) and/or significant alterations in gut bacteria after consumption. Those with diabetes should consider that dizziness might be a sign of kombucha-induced hypoglycemia. If you’re feeling dizzy, consider stopping or lowering kombucha intake for several weeks OR trying a different brand of kombucha to see if the dizziness abates.
Dry mouth: In a small number of individuals, kombucha may induce xerostomia or dry mouth as a result of suboptimal saliva flow. It is unknown as to how kombucha could interfere with salivary flow rate, however, some suspect that its bacterial constituents might alter the microbial composition of the oral mucosa. Any transient microbial alterations may be enough to disrupt homeostatic oral functions, leading to dry mouth.
Another possible explanation is that kombucha alters activity within the gastrointestinal tract, which in turn leads to dry mouth as a complication of GI distress. If you experience dry mouth, it could be a sign of a more serious medical problem or interaction (resulting from kombucha). It is possible that the sugar contents within kombucha may be more than was suspected, triggering hyperglycemia (high blood sugar) and explaining your dry mouth.
In most cases, dry mouth will be transient and can be managed by chewing sugarless gum and consuming extra water. That said, always seek evaluation by a dental professional if the dry mouth is persistent. Untreated dry mouth can lead to the proliferation of pathogenic bacteria, plaque formation, halitosis, and tooth decay.
Flatulence: Within an hour or two of drinking kombucha, you may experience flatulence characterized as the accumulation of gas within the intestinal tract. This may lead to excessive emission of gas (i.e. farting) or discomfort throughout the stomach. The flatulence may be caused by the carbonation within kombucha beverages, but could also be related to modulation of gut microflora from bacterial constituents.
To cope with the flatulence, it is recommended to stay physically active during the day and pass gas whenever the urge arises. Ensure that you are staying well-hydrated and discontinue kombucha consumption until the flatulence improves. If the flatulence is accompanied by loose stools and/or diarrhea, you may want to consider administering activated charcoal – as this may reduce stomach gas and bind to toxins in your GI tract.
Gastrointestinal toxicity: An adverse reaction suggested to occur in a small percentage of kombucha drinkers is gastrointestinal toxicity. Gastrointestinal toxicity refers to medically-significant poisoning of the gastrointestinal tract and yields a variety of symptoms. In 1997, a report by Srinivasan, Smolinske, and Greenbaum documented 4 cases of gastrointestinal toxicity occurring after consumption of kombucha tea.
The symptoms of gastrointestinal toxicity reported in the cases included: allergy-like reactions, jaundice, nausea, vomiting, and pain throughout the head/neck region. Based on the findings that kombucha was ingested just prior to symptomatic onset, and discontinuation of kombucha consumption fully alleviated symptoms, it is reasonable to suspect that kombucha may have been culpable for GI toxicity. That said, there are numerous confounding factors in all 4 of the presented cases.
The first case involved a patient with a history of heavy alcohol consumption who was drinking alcohol along with kombucha, plus taking an antidiabetic medication. The second case involved a patient taking exogenous thyroid hormone and estrogen replacements. Although the third case involved a patient who was ingesting standalone kombucha (without other drugs), this patient exhibited an elevated white blood cell count and was thought to have an allergy to the drink.
The fourth case involved a patient who was using the amphetamine-substitute known as ephedrine while drinking kombucha. In all of the aforestated cases, it is reasonable to consider that constituents within kombucha (e.g. alcohol, caffeine, etc.) may have interacted with the medications that were simultaneously administered. Another possibility is that the kombucha increased bioavailability of the drugs that were administered, resulting in amplification of their effect.
The kombucha that was consumed by each of the four individuals was documented as having been “home brewed” rather than purchased from a commercial vendor. This means there’s a chance that the kombucha contained toxins from improper storage (e.g. in ceramic) or poor sanitization, resulting in proliferation of pathogenic bacteria and/or yeast. Though it is necessary to acknowledge a potential chance that kombucha could cause GI toxicity, most should be rightfully skeptical of causation given the myriad of confounds.
GI distress: Gastrointestinal distress is among the most common side effects kombucha. In many cases, gastrointestinal distress is related to the colonization of new bacterial species within the gut. As new bacterial species compete with preexisting bacteria throughout your gastrointestinal tract, you may notice some distress throughout your gut.
The gastrointestinal distress may be accompanied by other effects such as constipation or diarrhea. Most individuals will notice that this gastrointestinal distress [resulting from kombucha] improves within several hours to several days of its consumption. In the event that the gastrointestinal distress is prolonged, you may want to question whether the kombucha you consumed may have been rancid or laden with impurities.
Also evaluate the amount of kombucha that you consumed and whether it was ingested with food. If you consumed a lot of kombucha on an empty stomach, this may explain your gastrointestinal disturbances. To manage GI-related disturbances you could: stop or cut back on your kombucha consumption or consider switching to a different source (e.g. brand). Drinking plenty of water and using activated charcoal to mop up endotoxins may also prove therapeutic for GI distress.
Gurgling stomach: Within hours of drinking kombucha, you may notice gurgling, bubbling, or churning noises and/or sensations throughout your stomach. Gurgling sounds are most likely a result of the carbonation within your beverage. In other cases, the gurgling may have resulted from drinking an excessive quantity of the beverage in a single sitting or on an empty stomach.
Another possible explanation for gurgling sensations is that the SCOBY (symbiotic colony of bacteria and yeast) within kombucha is making significant changes to your gut microbiome and gastrointestinal function. As new bacteria from kombucha colonize within the lining of your gut, older and/or pathogenic bacteria may try to resist their colonization by putting up a fight, resulting in gurgling noises and/or churning. Once the new bacteria settle in and old bacteria are expelled, gurgling should abate.
Keep in mind that if your kombucha provoked constipation, diarrhea, or any other GI distress – this may be reason as to why your tummy continues rumbling or making strange noises. While gurgling is a completely normal side effect, some may dislike the sensation. To minimize the gurgling that you experience, consider: drinking less kombucha per day, diluting your kombucha before drinking (e.g. with water), ensuring that your kombucha is devoid of contaminants, and/or only drinking it on a full stomach.
Flu-like symptoms: Though fairly uncommon, some kombucha drinkers will experience flu-like symptoms within 24 hours of consumption. In most cases, experiencing flu-like symptoms is a sign that you’re either: drinking too much kombucha in a single sitting OR drinking kombucha laden with unexpected contaminants. Obviously if you drank a large quantity of kombucha (e.g. a gallon) in a single sitting on an empty stomach, you can suspect that you probably drank way too much for your body to handle; any substance at a high enough dose can cause sickness.
If you didn’t drink too much, yet you’re still feeling flu-like, rancidity may be to blame. Improper sanitization during brewing and/or storage practices can lead to contamination with: BPA, heavy metals, mold, pathogenic bacteria and/or fungi. Even if your kombucha wasn’t contaminated or you didn’t drink too much, if you have a compromised immune system such as from a medical condition (e.g. HIV), you may become seriously sick after kombucha consumption.
Various flu-like symptoms that have been reported include: body aches, chills, diarrhea, dizziness, stomach pain, and vomiting. Some have hypothesized that the flu-like symptoms could also be related to bacterial “die off” and part of a detoxification phase, more alcohol within the drink than expected, or interactions with a medication. In the event that you experience unremitting flu-like symptoms after drinking a batch of kombucha, consult a medical professional.
Headaches: A common side effect documented by a subset of kombucha drinkers is headaches. Among those who report headaches, it is noted that they typically emerge within 1 to 2 hours post-consumption, but may linger for up to 48 hours thereafter. Those with a history of headaches and/or migraines may be at greatest risk of kombucha-induced headaches compared to the general population.
Since kombucha contains the triad of alcohol, caffeine, and sugar – each of these substances and/or a combination of the three may be responsible for your headache induction. If you are known to have an alcohol, caffeine, or sugar sensitivity – realize that there may be a greater quantity of each within your drink than listed on the nutrition label. Another blatantly obvious potential cause of headaches is histamine.
Fermented beverages such as kombucha are extremely high in histamine. If you are histamine intolerant as a result of reduced activation of enzymes such as diamine oxidase (DAO) or histamine N-methyltransferase (HNMT) – headaches could be a normal reaction to drinking kombucha. Those that experience debilitating headaches after their kombucha consumption should consider: potential histamine sensitivity, testing a different brand of the drink, or reducing future intake.
Indigestion: A fairly common side effect of kombucha is indigestion characterized by discomfort in the stomach from altered digestive function. It may feel as if your body isn’t properly metabolizing your food. Those that experience indigestion from drinking kombucha generally experience related side effects such as stomach aches, gurgling, and constipation.
It is thought that indigestion may occur as a result of carbonation within the beverage, leading to gastric distention and modified intragastric distribution of food. Another reason as to why indigestion may occur is related to a shift in the bacterial composition of your gut. Kombucha is known to modify bacteria in your GI tract, and in the process, some GI disturbances like indigestion can occur.
Other reasons for indigestion from kombucha include histamine sensitivity/intolerance and adjustment in pH (acid vs. alkaline balance). If indigestion happens every time you consume fermented foods and/or beverages – histamine intolerability may be the reason. To minimize the indigestion from kombucha you may want to: cut back on consumption, avoid drinking on an empty stomach, and increase your water intake.
Jaundice: Yellowing of the skin or jaundice has been documented as a potential adverse reaction to kombucha. In most cases, jaundice is caused by obstruction of bile ducts, hepatic disease, or excessive breakdown of red blood cells, leading to an upregulation in the pigment known as “bilirubin.” The odds of experiencing jaundice as a reaction to kombucha are extremely low.
Case reports provide the only theoretical evidence indicating that kombucha could cause jaundice in a small percentage of individuals. The first case report of jaundice from kombucha involved a 55-year-old woman who drank 2 glasses of kombucha per day for a 2-month duration. She sought medical attention as a result of experiencing jaundice for a 6-week duration.
Medical assessments ruled out chronic liver disease and hepatitis infection, leading professionals to suspect that her kombucha intake may have been implicated in causing her jaundice. As she ceased her kombucha habit and reduced her intake of alcohol, the jaundice subsided. That said, when considering that the woman was taking the antidiabetic drug glyburide and had a history of heavy alcohol consumption, we should be skeptical as to whether jaundice was really caused by kombucha.
Lead poisoning: Anyone brewing kombucha on their own should avoid using pots containing ceramic, lead crystal, or paint. It is understood that the acidity of the tea is capable of absorbing toxic lead from the storage container and/or pot. Perhaps equally important is to avoid storing kombucha in plastic containers, as they may leak toxins (e.g. BPA) into the SCOBY – leading you to drink them and get sick.
Poisoning from lead can lead to a host of symptoms such as: abdominal pain, cognitive deficits, irritability, and fatality. More problematic is that the long-term neurological effects resulting from lead exposure are irreversible. Always take the initiative to verify that your kombucha was not brewed in containers that may have contaminated the drink with lead.
If you consumed kombucha that was stored in any container with heavy metals (or suspect that you might have), do not hesitate to seek immediate medical attention. Keep in mind that lead and heavy metal poisoning can be avoided by storing kombucha in safe, glass bottles. Kombucha sold in stores throughout the United States is unlikely to contain lead due to quality control testing, whereas home-brewed kombucha may be riskier.
Lightheadedness: It is possible that you may feel lightheaded after drinking a bottle of kombucha. The lightheadedness often goes hand-in-hand with dizziness and may occur as a result of excessive and/or rapid kombucha consumption. If you drink a large amount of any beverage too quickly (even water), especially on an empty stomach, you may end up feeling lightheaded and/or sick.
To avert lightheadedness as a side effect, it is recommended to drink smaller amounts and/or only consume the beverage after a meal. Feeling lightheaded may also be a reaction to the high histamine content of kombucha, particularly among persons with histamine sensitivities. Moreover, realize that the amount of alcohol within your kombucha may be greater than what you expected, leading to slight reductions in blood pressure and/or interactions with medications that you’re taking – causing the lightheaded feeling.
Liver problems: In rare cases, it’s possible that kombucha consumption may induce hepatotoxicity and/or exacerbate preexisting hepatic impairment. Evidence to support the idea that kombucha might cause hepatotoxicity is derived a standalone “case report.” Since, in this case report there were confounds (that may have contributed to hepatotoxicity), evidence to support the idea that kombucha causes liver damage is weak.
Still, due to the fact that a case was reported, it should be acknowledged that kombucha could cause liver damage as an extremely uncommon adverse reaction. Individuals with preexisting cirrhosis, liver dysfunction, and/or liver impairment should be cognizant of this case study and may want to consider avoiding kombucha consumption altogether. Furthermore, kombucha often contains more alcohol than listed on its nutritional label, and this alcohol could be culpable for impaired liver function.
It is also possible that using medications and/or supplements may interact with the alcohol content in the kombucha to alter your liver function. If you’re unsure as to whether you may be at risk for kombucha-induced liver complications, have your doctor evaluate your liver function prior to drinking. Assuming your liver function is healthy and you aren’t taking any drugs and/or supplements with kombucha, odds of hepatotoxicity is extremely low. In fact, there’s emerging evidence to suggest that kombucha may exert hepatoprotective effects (i.e. protect your liver) by eliminating toxins.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/26882579
Loose stools: Some individuals may experience loose stools (or looser than average stools) after drinking kombucha. In a subset of consumers, loose stools might be a good sign, possibly indicative of the fact that your body is detoxifying itself and/or that gastrointestinal tract function is normalizing. Kombucha is thought to populate the gastrointestinal tract with healthy bacteria, but in the process, pathogenic bacteria are thought to fight for survival and/or die off.
These pathogenic microbes may excrete toxins and/or attempt to resist introduction of the new microbes, resulting in temporarily altered gastrointestinal function. In most cases, as the body adapts to regular kombucha ingestion, gastrointestinal function normalizes and loose stools should decrease. That said, it is important to avoid thinking that loose stools are always a good sign of detoxification.
It is very possible that loose stools are a bad sign, possibly resulting from a contaminated batch of kombucha and/or interactions with a drug or supplement that you’re taking. A contaminated batch of kombucha may harbor pathogenic bacteria that damage the lining of your GI tract, resulting in sickness and diarrhea. Other causes of kombucha-induced diarrhea include: carbonation, caffeine content, and/or histamine sensitivity/intolerance.
Mood swings: An unpredictable kombucha side effect reported anecdotally by a subset of consumers is mood swings. Some claim that they feel extremely agitated, angry, depressed, irritable within the days and/or weeks after their kombucha drink. Many of these individuals believe their mood swings result from bacteria within the kombucha competing with (and eventually replacing) pathogenic bacteria in the gastrointestinal tract.
The pathogenic bacteria may release endotoxins before dying, and the combination of endotoxins plus dead bacteria in the gastrointestinal tract might modulate activity in the gut-brain axis (GBA). This may lead to altered concentrations of neuroactive molecules, cytokines, reactive oxygen species, etc. – ultimately causing mood swings. If pathogenic bacteria die off (and endotoxins) are culpable for mood swings, you may benefit from using activated charcoal and staying as hydrated as possible to expedite elimination.
It may also be smart to cut back on kombucha intake to avoid additional die off, as each batch contains billions of microbes looking to colonize in your gut. Those with a preexisting neuropsychiatric history and/or mental disorder may be most vulnerable to mood swings resulting from kombucha. Others dealing with mood swings after drinking kombucha should consider a reaction to histamine, constituents of kombucha (e.g. additives, alcohol, caffeine, sugar, etc.), as well as possible impurities (e.g. mold, lead, bad bacteria, etc.) – as culprits.
Muscle aches: Most people who drink kombucha are unlikely to notice that it affects their muscles and/or joints – for better or worse. There’s a chance that it may cause a stomach ache related to modulation of activity within the gastrointestinal tract, however, muscle aches are certainly not common. That said, there have been a couple of case reports suggesting that aches/pains in specific areas such as the head and neck – might occur following kombucha consumption.
In the event that kombucha is causing muscle soreness or any pains throughout the body, you’ll want to consider whether you may have an allergy to one of the ingredients. Any allergic reactions may lead to swelling, joint pain, and achiness in certain regions of the body. If you are positive that your muscle aches are caused by kombucha, there’s no need to keep drinking it – cease consumption and any kombucha-induced pain should improve.
Nausea: A relatively common side effect of kombucha consumption is nausea or feeling as though you’re on the verge of vomiting. Feeling nauseous after drinking kombucha may be more likely to occur among those who are new to the beverage (i.e. first time drinkers). The nausea could also emerge from consuming a large amount and/or ingesting the beverage on an empty stomach.
Some speculate that kombucha-induced detoxification (i.e. “healing crisis”) in which toxins (heavy metals, pathogenic bacteria, etc.) undergo mobilization prior to excretion may lead to feelings of nausea. Though there is no evidence to support such speculation, the possibility hasn’t been well-researched and shouldn’t be blindly dismissed. Dead bacteria resulting from kombucha-induced GI displacement may generate endotoxins (analogous to a Herxheimer reaction) and get attacked by the body’s immune system – leading to some nausea.
Other reasons as to why kombucha makes you feel nauseous include: allergies/sensitivities to ingredients (e.g. histamine), contamination of the batch (more likely if “home brewed”), and/or an interaction with a drug/supplement that you’re taking. If the nausea never improves with time, you may be allergic to the drink. It should be recommended to seek medical support if the nausea causes vomiting.
Skin rash: A problematic reaction that kombucha consumers may experience as a side effect is a skin rash. The skin rash may be mild and isolated to a particular region (e.g. chest), or may be severe and widespread throughout the entire body. Those who experience a skin rash often report patches of redness (flat or elevated), possibly accompanied by swelling and itchiness.
If you experience a rash, you may be confused as to why the rash occurred. In many cases, the rash will be related to an allergy to one of the constituents within kombucha, including histamine. Fermented drinks are extremely high in histamine, and if your body has any difficulty tolerating histamine, this may explain your rash and itchiness.
Another legitimate possibility is that your rash resulted from an interaction between kombucha and other substances you regularly use (e.g. drugs, supplements, etc.). If the kombucha that caused the skin rash was “home brewed,” you may want to consider that the batch may have somehow been contaminated and that contamination may be culpable for your reaction. Persons who consumed copious amounts of kombucha may experience “die off” of bacteria in their GI tracts, and theoretically, there’s a chance that this could lead to an immune-induced skin rash.
Those with a compromised immune system as a result of medical conditions (e.g. HIV) may develop a bacterial and/or fungal infection from kombucha. Furthermore, it’s possible that kombucha may trigger resurgence of various infections (e.g. herpes simplex, yeast, etc.). If your rash is deemed problematic, it is recommended to consult a dermatologist as soon as possible.
Stomach aches: Experiencing a stomach ache as a kombucha side effect is considered extremely common. Many believe that the carbonation (dissolving carbon dioxide gas) within kombucha plays a role in causing upset stomach and achiness. When the carbonation is ingested, the carbon dioxide gas can accumulate throughout the gastrointestinal tract and cause pressure, leading to aches, bloating, and cramps within the stomach.
Research also suggests that carbonated beverages like kombucha tend to prolong gastric emptying, meaning the drink (and other food) stay trapped in your gastrointestinal tract for a longer duration. Carbonation also affects intragastric distribution of food, so any food that you consume with kombucha may be distributed throughout your gastric tract, possibly causing your stomach ache. Stomach aches after drinking kombucha are thought to be most significant among persons with underlying gastrointestinal conditions such as irritable bowel disease and peptic ulcers.
Other reasons for stomach aches as a side effect of kombucha include bacterial alterations, histamine content, drink constituents (additives, alcohol, caffeine, sugar), and/or medical interactions. Another possible cause of stomach ache may be drinking too much kombucha in a short duration and/or consuming it on an empty stomach. To avoid serious stomach aches from kombucha, it is recommended to: consume small amounts of the beverage infrequently, drink only on a partially-full stomach, and/or dilute kombucha with water prior to consumption.
Sweating: A less common side effect that some experience from drinking kombucha is sweating. The sweating as a reaction to the drink is usually modest and may be accompanied by perceived temperature changes such as chills and/or hot flashes. Sweating may also result from a distinct kombucha-induced side effect such as diarrhea, nausea, and/or vomiting – rather than the kombucha itself.
It’s plausible that sweating may signify an allergic reaction to kombucha and/or interaction effect (between the drink and a medication/supplement that you’re taking). If the kombucha somehow triggers a Herxheimer reaction (as a result of its billions of microbes ousting other bacterial inhabitants from your GI tract, leading to “die off”), this may also explain your bout of sweating. Should the sweating persist and/or be accompanied by other symptoms, contact a medical doctor to rule out serious and/or life-threatening conditions.
Tiredness: Although some claim that kombucha substantially enhances their physical and/or mental energy, others may report feeling fatigued and/or tired after its consumption. It is possible that for some, the tiredness experienced as a side effect is entirely transient. First-time or novice kombucha consumers may become tired as part of an internal detoxification process in which the bacterial species within kombucha replace pathogenic microbes within the gastrointestinal tract.
Among these individuals, the tiredness may eventually fade as the body excretes the pathogenic bacteria and the endotoxins that they may generate prior to dying. That said, it is important to know that tiredness is not always a result of “bacterial die off.” It could be related to the alcohol and/or sugar content within your particular brew.
If your kombucha contains more alcohol than you suspected (especially relative to its caffeine content), the tiredness may be resulting from the depressant effect of alcohol on your CNS. If your kombucha contains high amounts of sugar, the drink may create a transient spike in energy (glucose rush) followed by a crash of lethargy (i.e. reactive hypoglycemia). Another highly probable cause of tiredness as a side effect of kombucha is its histamine content.
Those with histamine sensitivity or intolerance may extremely tired and foggy after consuming small amounts. If you know alcohol, bacterial die off, histamine, and sugar aren’t the culprits – consider that the kombucha may be interacting with a drug/supplement you’re taking. Tiredness could also stem from pathogenic constituents within unregulated “raw” home-brewed batches.
Vomiting: An adverse reaction that has been reported as a result of kombucha is vomiting. In most cases, vomiting as an adverse reaction is preceded by symptoms such as nausea, dizziness, and/or lightheadedness. While there’s a small chance that vomiting could be related to some sort of bacterial “die off” that makes you sick, the more likely reason kombucha made you vomit is because it was toxic to your body.
The vomiting may be a result of: consuming a contaminated batch of kombucha, an interaction between kombucha and a prescription medication, or drinking kombucha with a serious medical condition. You may also end up vomiting if you drink an excessive amount of kombucha, especially immediately after a large meal. Other elements of the drink that may cause you to vomit include: alcohol, caffeine, carbonation, and sugar.
Those that end up vomiting from kombucha are recommended to seek emergency medical attention. Professionals should be able to identify and/or treat toxicities and come up with strategies to reduce the vomiting. Anyone who vomits from kombucha is recommended to cease further consumption, reduce intake, and/or avoid “raw” home brews of unknown quality.
Weight changes: A side effect that many long-term kombucha drinkers claim to have experienced is change in bodyweight. Some believe that kombucha helps promote weight loss by purging pathogenic bacteria and heavy metals from their system while simultaneously reducing food cravings. Although healthier gut bacteria after kombucha consumption may promote some weight loss, another reason kombucha drinkers lose weight is related to the side effect of diarrhea.
If you lose weight from a laxative response to kombucha, you’re bound to eventually gain it back. Additionally, you should beware of the fact that losing weight from diarrhea is unhealthy and may lead to micronutrient deficiencies. Should you experience diarrhea-induced weight loss from kombucha, it’s recommended to refrain further kombucha consumption and drink water instead.
It should be noted that not everyone experiences weight loss from kombucha – some may gain weight. Given its alcohol and sugar constituents, weight gain could occur among those who drink kombucha regularly. Weight gain from kombucha may also stem from gastrointestinal reactions such as: bloating, constipation, and water retention. Though most weight changes as a side effect of kombucha are likely to be modest, if you experience unwanted weight gain or loss – quit drinking it.
Yeast infection: There’s a small chance that some individuals may experience a yeast infection after drinking kombucha tea. It is understood that kombucha can contain species of Candida including Candida albicans, Candida kefyr, and Candida krusei – each of which could be problematic. The greatest risk for a yeast infection from kombucha is among those with compromised immune function (such as from medical conditions like HIV/AIDS).
Furthermore, even if the kombucha itself contains no unfavorable Candida species, its bacteria content may potentiate the growth of a preexisting yeast infection. Despite the fact that many fermented foods are highly acidic and kill yeast, many improperly-brewed versions of kombucha lack acidity (evidenced by a high pH). The low acidity of certain batches of kombucha in combination with the ingredient of sugar – may help cultivate the perfect environment for Candida to thrive.
Risk of a yeast infection from kombucha can be minimized by ensuring that the brew is of low pH to remain acidic. Those who are immunocompromised or dealing with a yeast infection should avoid kombucha, as it may lead to rapid yeast growth. If you suspect that you’re experiencing a yeast infection, consult a medical doctor for evaluation and proper treatment.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/8559192
Note: In the event that you have questions about a specific kombucha side effect, talk to your doctor. Your doctor should be able to account for your medical history, supplement usage, lifestyle, etc. and pinpoint the problem. Additionally, do not automatically assume that you’re experiencing a “healing crisis” if you experience side effects from kombucha. You could be experiencing an allergy or might have consumed a bad batch. Moreover, it’s possible that your body just doesn’t tolerate kombucha as well as others.
Variables that influence Kombucha side effects
There are numerous variables that influence side effects associated with kombucha consumption. It is these variables that determine the number of side effects, severity of side effects, and particular side effects that a person experiences. Whenever contemplating reasons as to why you may be dealing with side effects from kombucha, consider influential variables such as: kombucha constituents (e.g. additives, carbonation, pH, etc.), amount consumed, co-administered substances, individual factors (e.g. age, medical conditions, etc.), and frequency plus cumulative duration of consumption.
Not all batches of kombucha are created equal. A home-brewed kombucha may contain different quantities of alcohol, carbonation, organic acids, sugars, and toxins – than a commercially-brewed batch. Additionally, the pH (acidity vs. alkalinity) and specifics of the SCOBY (bacterial and fungal species) could have a significant impact on the consumer, thus predicting side effects. If kombucha constituents are of reasonable quantities and no impurities/pathogens are present, side effects are less likely to occur. However, if concentrations of constituents (e.g. alcohol, sugar, etc.) are higher than expected and/or impurities/pathogens are present, adverse effects should be predicted.
- Additives: Kombucha often contains a blend of additives with the intention of enhancing flavors. Many types of kombucha add berries (e.g. blueberries, raspberries, blackberries, etc.), other fruits (e.g. apples, watermelon, etc.), juices or infused water, and herbs or spices (e.g. cinnamon, cayenne, thyme, ginger). The quality and constituents of these additives could affect whether someone experiences side effects from kombucha. For example, using a moldy additive may contaminate the entire batch of your kombucha, leading to adverse reactions upon drinking. Moreover, consider whether you or a consumer of your kombucha may be allergic to a flavor-enhancing additives in your batch. Also evaluate that certain additives (in high quantities) may induce side effects of their own – especially at high doses.
- Alcohol: To legally sell kombucha in the United States, manufacturers must ensure that their kombucha products contain less than 0.5% alcohol – the legal limit set by the FDA to distinguish alcoholic from non-alcoholic beverages. While most commercialized kombucha is theorized to contain less than 0.5% alcohol, ongoing fermentation from “raw” batches increase the alcohol content. Some kombucha products have been pulled from store shelves upon finding that alcohol content exceeded the 0.5% threshold, containing up to 3% alcohol – almost as much as a can of beer. Unregulated “raw” brews may contain much more alcohol than is expected, causing side effects of its own – especially if left unrefrigerated. Populations likely to be affected by the alcohol content of kombucha include: young children, sensitivity/low tolerance to alcohol, and those with medical conditions and/or taking medications. Overall, the greater the level of alcohol in your kombucha, the more probable the side effects.
- Caffeine: To make a gallon of kombucha, it is estimated that brewers use approximately 6 to 8 teabags. While some believe that all caffeine is eliminated throughout the brewing process, evidence suggests that around 33% of the initial caffeine content remains in kombucha upon its completion. Others believe that the caffeine content isn’t reduced at all – that it is similar to the amount that was present in the teabags. If black tea was used for the creation of kombucha, you can expect a greater quantity of caffeine than if green tea was utilized. In any regard, the greater the amount of caffeine within your kombucha, the more side effects you may experience – especially if you are caffeine-sensitive or taking medications/supplements that could interact with caffeine. Caffeine-related side effects can be ruled out if the tea was previously decaffeinated.
- Carbonation: The amount of carbonation within your kombucha may influence the severity of certain side effects. While some carbonation or “fizz” is a sign of a good batch of kombucha, excessive carbonation may lead to unwanted gastrointestinal side effects. Some kombucha brewers will amplify carbonation by modifying their starter liquid and/or adding extra tea. Since carbonation can affect intragastric food distribution, delay gastric emptying, and alter gastrointestinal activity, some side effects may be more pronounced in kombucha formulations with high carbonation.
- Organic acids: The SCOBY within kombucha is known to digest sugar, and as a result of the digestion, it produces a variety of organic acids including: glucuronic acid, gluconic acid, lactic acid, acetic acid, butyric acid, malic acid, and usnic acid. Some of these organic acids (in high quantities) could trigger unexpected side effects or serious adverse reactions. For example, usnic acid is understood to exhibit hepatotoxic effects whereby it impairs liver function. Therefore, it is reasonable to suspect that the organic acid composition of your kombucha may contribute to certain side effects that you experience.
- pH level: The pH level of your kombucha could influence whether you experience side effects. Most experts suggest that the optimal pH of kombucha is within the range of 2.5 to 3.5; some recommend an even narrower range (e.g. 2.8 to 3.2). If the pH of your kombucha is above 3.5, it could be a sign that brewing was incomplete. It also may signify contamination or the presence of pathogenic bacteria/yeast. Should the pH of your kombucha fall out of the recommended pH range, it may be unsafe for consumption, increasing likelihood that you’ll experience side effects or adverse events.
- SCOBY specifics: The specifics of the SCOBY within your kombucha may also influence side effects. In many cases, the SCOBY is comprised of Gluconacetobacter xylinus (to oxidize yeast-produced alcohols to acetic and other acids) as the bacterial component and Saccharomyces (a probiotic fungus) as the yeast component. It has been suggested that the specific SCOBY in your kombucha might vary in bacterial and yeast composition based on the specific batch and/or brewing details. Since there are different types of SCOBY, you may have an easier time tolerating one SCOBY subtype compared to another. You may also notice side effects after one kombucha batch that differ from those associated with another, possibly due to the specific SCOBY subtype. Examples of yeast cultures that could exist within your kombucha include: Saccharomyces cerevisiae, Brettanomyces bruxellensis, Candida stellata, Schizosaccharomyces pombe, and Zygosaccharomyces bailii. If brewed in unsanitary conditions, it is possible that the SCOBY may become contaminated with pathogenic bacteria (e.g. anthrax) and/or fungi (e.g. aspergillus), increasing risk of serious adverse events.
- Sugar: It is understood that kombucha is made with sugars that the SCOBY relies on to grow. Regardless of how perfectly you brew kombucha, there’s always going to be a little sugar remaining at the end of the fermentation process. The amount of sugar in your kombucha will be contingent upon the fermentation length. A shorter brewing cycle leaves considerably more sugar in the beverage than a longer cycle. Nonetheless, even if you were to run a 30-day brew cycle, there will still be some sugar in the kombucha. Since most people brew their kombucha for 1-2 weeks, it is estimated that (if brewed properly) there will be around 16 grams per 8 ounces; equivalent to 4 teaspoons. Understand that ingesting a considerable quantity of sugar from kombucha may lead to: foggy thinking, an energy spike followed by fatigue, mood swings, and upset stomach.
- Toxic contaminants: In the event that your kombucha was somehow contaminated as a result of improper brewing practices, poor sanitization, or suboptimal storage – you may experience serious adverse reactions. Toxic contaminants within a batch of kombucha may include: Bisphenol-A (from plastic storage), lead or heavy metals (from brewing in ceramic, lead, or metallic pots), and mold (from unsanitary conditions). Dirty conditions can also lead to proliferation of pathogens within the SCOBY such as anthrax (bacteria) and aspergillus (fungi), which may provoke serious adverse medical reactions if consumed. Risk of toxic exposure should be considered low if purchased by commercial vendors, and greater if attained from unregulated brewers.
Amount consumed (Large vs. Small)
Though the constituents of kombucha will play the biggest role in determining whether a consumer is likely to experience an adverse reaction, the amount of kombucha consumed also matters. Someone who manages to chug an entire gallon of kombucha in a single sitting may end up extremely sick – regardless of its constituents. On the other hand, someone who drinks a very tiny amount (e.g. takes a couple sips) may not notice any abnormal side effects in reaction to the drink.
Large quantity: If you consume a large quantity of kombucha, you are more likely to experience side effects for numerous reasons. The larger the quantity of kombucha you consume in a single sitting, the more of every ingredient your body is absorbing. If you were to drink a half-gallon within an hour or two, you’d be getting significantly more: alcohol, caffeine, carbonation, organic acids, sugar, and possibly toxins (if present in your batch).
This means that your body will need to work harder to metabolize, distribute, and excrete all of the components, possibly leading to more pharmacokinetic-related side effects. Additionally, the constituents of kombucha (especially histamines) will be exerting a more prominent effect upon your brain and body – shifting each to a greater degree away from homeostasis. This shift will trigger side effects on its own, as well as other side effects as a result of the body attempting to restore homeostatic function.
Another reason for more side effects at larger doses has to do with the increased quantities of bacteria and yeast from the SCOBY being delivered to your GI tract. Large quantities of the drink may overwhelm your microbiome by displacing current inhabitants of your GI tract, leading to “die off” (i.e. a Herxheimer-like reaction) – which will generate a host of unwanted symptoms as a result of immune activation. In short, the more kombucha you drink – the more side effects you should expect.
Small quantity: If you consume a small quantity of kombucha, you probably won’t experience as many unwanted side effects and/or adverse reactions. The less kombucha you ingest, the easier it is for your body to efficiently absorb, metabolize, and excrete its constituents – leading to fewer pharmacokinetic-related side effects. In smaller amounts, the constituents of kombucha such as: alcohol, caffeine, carbonation, organic acids, sugar, and even toxins (if your batch is contaminated) – will have less of an effect upon your brain and body, making the drink more tolerable.
A small quantity is unlikely to shift your body significantly away from homeostasis and should be easier to recover from if you inadvertently ingest a bad batch and/or have difficulty tolerating the drink. Those who suffer from histamine intolerance and/or sensitivities will experience fewer unwanted histaminergic reactions when drinking small amounts of kombucha. Most obviously is the fact that consuming an extremely low quantity of the drink won’t introduce an excessive amount of bacteria/yeast to your gut microbiome.
You’re less likely to experience an immune reaction to the new strains of bacteria and/or yeast if you consume a small amount. Smaller amounts will displace less of the current inhabitants within your gut and the “die off” probably won’t be significant enough to trigger an immune response. In short, you should expect less side effects from kombucha if you drink less of it.
If you’re taking drugs or supplements while consuming kombucha, there’s a chance you may end up experiencing an interaction effect. Kombucha contains alcohol, bacteria, caffeine, carbonation, yeast, and other additives – each of which might interact with another substance you’re using. One specific way that kombucha might cause an interaction effect is by altering the hepatic metabolism speed of the drug and/or enhancing its bioavailability, leading you to feel as though the potency of your medication increased.
Many pharmaceutical drugs interact with alcohol and might also be affected by caffeine. For example, someone taking a drug with sedative properties may notice amplification of its effect if they drank kombucha with more alcohol than expected. Another example could be someone taking a psychostimulant who feels extremely jittery due to the fact that his/her kombucha contained more caffeine than was expected, which synergized with the caffeine to potentiate psychostimulation.
It is also possible that the kombucha and other substance that you’re using interact through the gut-brain axis (GBA). Some supplements exert primarily a peripheral effect, and if the kombucha leads to increased production of neuroactive molecules within the gut, this could lead to an interaction. The most obvious interaction between kombucha and another co-administered agent is likely histaminergic.
Fermented beverages like kombucha increase histamine within the body to a significant extent. If you’re taking any substance that simultaneously increased histamine, this could lead to high histamine and unwanted effects. That said, there’s a chance that you may be taking another substance with kombucha that offsets some of its unwanted side effects. For example, if you have a strong adverse reaction to the histamine content in kombucha, yet took an antihistamine – you may notice that the antihistamine attenuates some of the unwanted reaction to the high histamine.
Another example would be individuals who drink a cup of coffee prior to having kombucha with more alcohol than they expected. If the alcohol content within your kombucha exceeds 1%, you may experience brain fog, mild drowsiness, lethargy, etc. – yet the caffeine may offset these effects, ultimately rendering them unnoticeable. Any co-administered substances that modulate the gut-brain axis such as antibiotics or even strong probiotics – could influence side effects you experience from your kombucha.
Note: It is important to keep in mind that co-administered substances (drugs, supplements, etc.) usually cause side effects on their own. For this reason, it is necessary to evaluate whether you may have mistakenly attributed a side effect to kombucha that was really caused by another substance you’re using.
Some say that kombucha gives them more energy and greater mental clarity without any side effects. Others say that kombucha gives them nothing but a massive stomach ache. Differences in tolerability and side effects are likely influenced by a myriad of individual factors such as: administration details, the person’s age, body composition, gut microbiome, histamine tolerability, medical history, and metabolism.
Administration details: Did you drink kombucha on an empty stomach, full stomach, or partially full stomach? If you had food around the time of kombucha consumption, what specific type of food did you have? What time of day did you drink your kombucha? (Morning, afternoon, or evening).
Answering these questions may give some insight as to why you are experiencing more side effects than you expected. Drinking a lot of kombucha on an empty stomach is thought to increase likelihood of side effects compared to having it on a full or partially full stomach. If you ate food prior to and/or just after kombucha consumption, the type of food may dictate side effects.
Foods significantly affect your gut microbiota composition, which the kombucha is modulating. Eating a meal with histamine-rich foods may provoke more side effects due to the fact that kombucha is also high in histamine. Consuming a meal high in coconut oil may have an entirely different effect due to the medium-chain triglyceride known as “lauric acid” (C:12) which acts as an antimicrobial agent.
The time of day at which you consume kombucha may also make a difference. If you’re consuming kombucha immediately before bed, you may have a difficult time falling asleep due to the carbonation gurgling within your stomach. The caffeine and alcohol contents in your batch of kombucha may determine whether it’s better to have the drink in the morning or evening (high caffeine would probably be a better fit for morning, whereas alcohol would probably be a better fit for the evening) due to your circadian rhythm.
Age: Unless recommended by a medical professional, it may not be a smart idea to drink much kombucha until your brain is fully developed. Infants and young children consuming kombucha will likely have a difficult time handling some of its constituents including: alcohol, caffeine, histamine, as well as the bacteria/yeast (from the SCOBY). Though some of the bacteria may modulate the gut and have a favorable effect upon neurodevelopment, there are safer ways to alter gut bacteria (e.g. probiotics) without simultaneous alcohol and caffeine ingestion.
Healthy adults probably won’t have any difficulty tolerating kombucha and will be least likely to experience side effects from its consumption. That said, elderly adults may be more prone to side effects due to age-related medical conditions and compromised organ function. Young children and elderly are more likely to exhibit unfavorable reactions to kombucha compared to healthy adults.
Body composition: Consider your body composition in terms of height, weight, body fat percentage, and muscle mass percentage. Certain constituents within kombucha (e.g. alcohol) may be stored for a shorter/longer duration within your body based on your size. A small person is likely to experience a greater number of side effects due from a cup of kombucha than a larger individual.
In other words, if you’re 4’5” tall and weigh 110 lbs. – your body size is small and will have a tougher time handling a cup of kombucha. Oppositely, if you’re 7’3” tall and weigh 300 lbs., you may not notice much from drinking a cup of kombucha. A person’s body fat and muscle mass percentage might also affect pharmacokinetics of various ingredients within kombucha.
Genetic variants: Not everyone exhibits the same genetic variants for metabolizing the ingredients within kombucha, hence the reason they may experience different side effects. Some individuals may be rapid metabolizers of caffeine (as a result of exhibiting homozygous CYP1A2*1A alleles), whereas others may be slower metabolizers of caffeine (as a result of carrying one or more CYP1A2*1C alleles). Kombucha also contains alcohol which may be metabolized differently based on coding variants in ADH1B, ADH1C, and ALDH2 genes.
As an example, some ADH1B and ADH1C alleles will encode for highly active ADH enzymes, leading to quicker conversion of alcohol to acetaldehyde. Another example might be a variation in genes coding for enzymes implicated in histamine metabolism (e.g. DAO, HNMT, etc.). Moreover, from a bigger picture perspective, the summation of your expressed genes may determine whether you experience favorable or unfavorable reactions to kombuch
Gut microbiome: Your gut microbiome prior to drinking kombucha may dictate whether you experience side effects. Someone with a large colony of pathogenic, opportunistic bacteria and/or yeast throughout their gut may experience a severe adverse reaction upon kombucha ingestion. This may be due to the fact that the pathogenic bacteria and yeast are putting up a fight with the newly introduced bacteria/yeast from the kombucha.
In the process of putting up a fight, the pathogenic bacteria/yeast excrete toxins and attempt to remain in your system. They may eventually “die off” and get replaced by favorable bacteria from your kombucha drink, however, an immune response may be activated in response to the “die off” and lead you to experience uncomfortable symptoms. That said, if your gut microbiome harbors beneficial bacteria (i.e. probiotics) prior to kombucha consumption, the reaction may be less unpleasant.
It may also be that compatibility of the bacterial species with the kombucha drink dictates the reaction. You may have healthy bacteria in your gut prior to kombucha consumption, yet these bacteria still want to avoid getting displaced by the newer microbes within your drink – possibly eliciting a similar response and “die off” reaction as some pathogens. Another possibility is that your gut microbes were depleted from antibiotics, making it easy for bacteria from the kombucha to colonize (because there’s no competition); this may yield fewer side effects because the “die off” will have already occurred.
Histamine tolerability: Understand that the kombucha itself doesn’t have “histamine” in it, but the bacteria present within the drink produces a significant amount of histamine. If you have an underlying histamine sensitivity and/or intolerability, you may struggle with serious side effects after drinking even a small amount of kombucha. Many people may assume that what they’re experiencing is some sort of bacterial “die off,” when it could be a severe reaction to histamine.
Those with a histamine sensitivity and/or intolerability tend to have lower levels of the enzyme DAO (diamine oxidase). The DAO enzyme is responsible for metabolizing histamine, but if deficient, elevated levels can trigger a host of unpleasant symptoms. If you have a histamine sensitivity and/or intolerability, kombucha is guaranteed to cause side effects.
Medical conditions: If you have a preexisting medical condition, it may be smart to avoid kombucha consumption. Certain conditions will increase your risk of serious adverse reactions and/or deleterious side effects from kombucha. Furthermore, since you may be taking a medication to treat your specific medical condition, consider that the medication may interact with ingredients in the kombucha to cause interaction effects.
- Alcoholism: It is understood that kombucha contains alcohol, often times the alcohol content is more than expected. If you are a heavy drinker, recovering from alcoholism, going through alcohol withdrawal, or dealing with alcohol-induced medical conditions (e.g. cirrhosis of the liver) – kombucha is contraindicated. Many of the most severe adverse reactions to kombucha documented in case reports occurred among persons with alcoholism. It is thought that the organic acids within kombucha may also detrimentally affect liver function, thereby exacerbating any underlying adverse effects associated with hepatic impairment.
- Diabetes: There’s some evidence suggesting that kombucha affects blood sugar regulation. It tends to reduce blood sugar by exerting a hypoglycemic response. Though keeping blood sugar low is helpful among the general population, those with diabetes (especially Type 1) could experience severe adverse reactions from an unexpected blood sugar drop. While persons with diabetes can still consume kombucha, it is recommended to be especially perceptive of blood sugar changes following consumption.
- Gastrointestinal disorders: Individuals with gastrointestinal and digestive disorders should proceed with caution if considering kombucha. While many with GI disorders benefit from the colonization of bacteria/yeast from kombucha within their gastrointestinal tract, others may experience a worsening of symptoms. If you have a condition such as: colitis, constipation, diarrhea, or irritable bowel syndrome (IBS) – keep in mind that kombucha ingestion might lead to disastrous reactions.
- Hepatic and/or renal impairment: Anyone with varying degrees of hepatic and/or renal impairment should avoid kombucha consumption for obvious reasons. The alcohol content within kombucha alone may be enough to exacerbate hepatic deficits. Furthermore, the organic acids within each kombucha batch may magnify deficits in renal clearance. Consuming kombucha with hepatic and/or renal issues (without approval from a medical professional) may be dangerous.
- Immune dysfunction: If you’ve been diagnosed with a medical condition that compromises your body’s immune function such as HIV/AIDS, hepatitis, or cancer – avoid kombucha consumption altogether. A case report documented a patient with HIV who died within 15 hours of consuming kombucha tea, possibly related to his poor immune function. The bacteria and yeast within kombucha will not be kept in check by your immune system, and if pathogenic, this may be highly problematic. Furthermore, the bacteria and fungi in kombucha could potentiate growth of other pathogens in your system (in low amounts) such as Candida albicans, leading to serious complications.
- Neuropsychiatric conditions: If you’ve been diagnosed with a neuropsychiatric disorder such as anxiety, bipolar disorder, depression, or schizophrenia – you may be highly sensitive to kombucha. Those with a history of neuropsychiatric disorders should be cautious of kombucha consumption because ingredients such as alcohol and caffeine (even in low amounts) could lead to symptomatic exacerbation. Additionally, an increase in histamine from the bacteria within kombucha may lead to flare ups of anxiety or depressive symptoms. It is necessary to noted that the new bacteria/yeast introduced to the gut after kombucha consumption may alter activity within the gut-brain axis (GBA), leading to production of different neuroactive molecules. These molecules may get shuttled to the brain and trigger worsening of symptoms for certain individuals with mental illness. Finally, it is possible that the ingredients in kombucha might interact with the medications that a person is taking to treat his/her mental illness.
- Pregnant women: Women who are pregnant and/or breastfeeding are recommended to abstain from kombucha consumption. Not only does kombucha contain alcohol and caffeine, each of which could affect neurodevelopment of the fetus and/or baby, but it contains high amounts of bacteria and yeast. The bacteria and yeast may be “healthy” but in excessive amounts may produce lots of histamine and overwhelm a newborn’s system – possibly leading to unfavorable outcomes.
- Surgery: If you are scheduled to undergo a surgery and/or are in the process of recovering from a surgery, kombucha consumption is to be avoided. Not only might it interfere with medications you’re perioperatively administered. You won’t want to experience adverse complications in recovery because you decided to drink kombucha. Nevertheless, anyone who ends up drinking kombucha during the perioperative period (before, during, and after the surgery) will be at heightened risk for unwanted side effects and reactions.
Sleep & Stress: The amount of sleep that you’re getting and your stress level may dictate how well you’re able to handle kombucha. Someone with poor sleep and high stress may have higher levels of inflammatory cytokines, reactive oxygen species, and pathogenic bacteria within their gut. Upon introduction of the kombucha, the person may experience noticeable changes (as well as unwanted side effects) resulting from modulation of his/her gut microbiome.
Getting plenty of sleep and keeping stress low by exercising or engaging in relaxation may buffer against kombucha-induced side effects. Highly stressed states may also trigger flare ups of bad bacteria and fungi (e.g. Candida albicans), which may in turn receive fuel from the kombucha drink. Be sure that you’re proactively maintaining healthy sleep habits and distressing to minimize odds of kombucha side effects.
Frequency & Duration of Intake
In addition to quantity of kombucha you ingest as an influencer of side effects, the frequency/regularity of your consumption, as well as the cumulative duration over which you’ve been drinking kombucha may determine whether you experience side effects. A person who drinks kombucha several times per day on a daily basis may be more prone to side effects than someone who drinks kombucha just once per week. Additionally, the cumulative duration over which you’ve been drinking it (e.g. weeks, months, years) may affect your side effect susceptibility.
Frequency of intake: One theory is that the more frequently a person drinks kombucha, the greater the number/severity of side effects they’re likely to experience. This is likely due to the fact that frequent consumption leads to larger overall quantities of consumption in a shorter duration. This means that the body is receiving frequent doses of: alcohol, caffeine, organic acids, sugars, plus the bacteria/yeast combo.
Another theory is that increased frequency of consumption may lead to fewer side effects as a result of an adaptation response (the body and brain adapt to expect the kombucha administration). Assess how frequently you consume your kombucha and determine whether your frequency may be too high. Some people with a lower histamine threshold may have a tougher time with frequent consumption, whereas others may find that they’re able to drink kombucha daily without problems.
Cumulative duration of consumption: Though the frequency of consumption coupled with overall intake will influence side effects, cumulative duration of consumption might as well. Assuming frequency is maintained at a hypothetical interval of once per week, someone that’s consumed kombucha for 2 weeks may experience more side effects than had they been consuming it for 6 months. Those who have consumed kombucha over an extended duration may exhibit gut microbiomes that have adapted to accommodate the bacteria/yeast within the beverage.
On the other hand, someone who’s been drinking kombucha for a short-term may be experiencing side effects related as a result of being non-adapted. Then again, long-term regular kombucha consumption could lead to essentially flooding the GI tract with too much bacteria/yeasts, inevitably causing “die off” and corresponding unwanted effects. For this reason, frequency of consumption, total intake per serving, and cumulative term of consumption should be considered simultaneously in regards to their influence upon side effects.
Kombucha: Do the benefits outweigh the side effects?
Whenever drinking kombucha, it is important to reflect upon whether the benefits resulting from its consumption outweigh any side effects or reactions that it may provoke. A majority of kombucha consumers will report minimal and/or zero side effects, possibly with subjective benefits. If you derive some sort of benefit from the drink and don’t experience any side effects, it makes logical sense to continue your rate of consumption.
On the other hand, if you’re among the subset of individuals who struggle to tolerate kombucha, you’ll probably want to cut kombucha out of your diet altogether. The intolerability issue may be related to sensitivity to histamine or a comorbid medical condition. In addition to those who benefit from the drink and those who find it intolerable (plus devoid of benefits), another portion of drinkers may experience some benefit from its consumption along with side effects.
In this case, it is up to the consumer to evaluate whether the side effects are tolerable enough to justify the attained benefit. It is also likely that a subset of kombucha drinkers will experience zero “benefit,” but might enjoy the drink and be able to tolerate it reasonably well. If you find the drink enjoyable and don’t struggle with serious GI distress after each serving, continued consumption on an irregular basis may be an alright strategy.
If you’re experimenting with kombucha for the first time, it may be help to document your experience in a journal. In journal entries you’ll want to document: exactly how much kombucha you consumed, the source, the ingredients, time of day consumed, whether it was consumed on an empty stomach, whether you were taking other substances (drugs/supplements with it), etc. Journaling is a great way to help you determine whether your side effects from kombucha improve over time or worsen over time – and gives you insight as to whether any variables can be tweaked to improve your reaction to its ingestion.
How to Reduce Kombucha Side Effects: Strategies to Consider
If you’re experiencing unwanted side effects from kombucha, there may be some ways in which you can mitigate them. Possible ways to mitigate side effects of kombucha include: reducing total intake, supplementing, consuming with food, switch to a different brand of kombucha, and/or gradually titrate your intake upwards. Prior to implementing any of these mitigation strategies (and consuming kombucha), verify safety and speculative efficacy with a medical professional. Effectiveness of these mitigation strategies will likely be subject to individual variation.
- Rule out contraindications: The first thing everyone should do before drinking kombucha is verify that it’s safe in accordance with their current medical history, medical diagnoses, as well as medication or supplement regimen. If you have a condition such as HIV/AIDS, hepatitis, or cancer, drinking kombucha is contraindicated. Also, if you’re hepatic (liver) or renal (kidney) function is somehow impaired, kombucha consumption should be avoided. Ruling out all contraindications and/or interaction possibilities should help you avoid serious adverse effects associated with kombucha.
- Reduce intake: The smartest way to combat side effects of kombucha is to cut back on your overall intake. This is an especially important tip for those who are new to kombucha and/or first-time drinkers. Whatever is causing your side effects (e.g. histamine, sugar, alcohol, caffeine, bacteria/yeast, toxins, etc.), the reactions will be amplified at higher doses. Your best bet to avoid side effects from kombucha is to consume lower amounts (e.g. a small cup) on an infrequent basis. Some sources recommend that 8 ounces of kombucha per day should be a maximum. If you’re getting any therapeutic effect from the kombucha, consume the minimal effective dose – this way you won’t go overboard enough to prompt side effects.
- Ensure quality kombucha: After you’ve ruled out all contraindications and lowered your intake, verify that the kombucha you’re drinking is high quality. You don’t want some kombucha you purchased at a town market that may contain mold, heavy metals, or pathogenic SCOBY. If you don’t know how the kombucha was brewed or weren’t a part of the brewing process yourself – skip all “raw” and/or homemade kombucha for your own safety. Adverse effects and side effects are much more likely among those who consume “raw” kombucha from unlicensed vendors. Commercial kombucha manufacturers may have a steep markup on the pricing of their kombucha, but they usually do a good job of verifying pasteurization and quality, minimizing likelihood of your side effects.
- Drink water: Another way to minimize likelihood of kombucha side effects is to increase your water intake. You may want to drink plenty of water before and/or after downing your batch of kombucha. Water consumption is thought to help flush out dead bacteria (e.g. from a “die off”) and/or byproducts associated with gastrointestinal detoxification (e.g. endotoxins). You may also want to determine whether diluting your kombucha with some water helps ease gastrointestinal side effects that you experience. The greater you dilute the kombucha, the fewer side effects you’re likely to experience.
- Modify supplements: While drinking kombucha, evaluate the supplements you’re currently taking. If you’re experiencing severe side effects and/or adverse reactions, have you considered that there may be some sort of interaction effect occurring between a component of your kombucha and a supplement? For example, if you’re taking a probiotic with billions of strains of bacteria, plus drinking kombucha – it may be too much for your GI tract to handle, ultimately causing side effects. On the other hand, if you aren’t taking any supplements and experience a side effect like fatigue from kombucha, you may want to administer a supplement to help combat your fatigue. One of the best supplements to take with kombucha may be activated charcoal (best administered a couple hours after kombucha consumption to mop up endotoxins).
- Take with food: Another administration parameter you may want to manipulate for kombucha ingestion is whether you consume it on an empty stomach or with food. If you’ve tested it on an empty stomach and feel miserable, try consuming it with a bit of food or even after a big meal. You may also want to consider that the type of food you eat may affect your reaction to kombucha. For example, consuming foods high in histamine (e.g. fermented foods like sauerkraut) may exacerbate histamine-related side effects. Other foods like coconut oil may counteract some of the microbial effects of the kombucha – which could be good if you drank too much. If you feel better drinking kombucha on an empty stomach, it may be due to the fact that the carbonation is affecting intragastric distribution of your food, creating increased pressure throughout the GI tract.
- Time of day: There’s a blend of stimulant (caffeine) and depressant (alcohol) within kombucha, not to mention the fact that the bacteria/yeast signal through the gut-brain axis to likely affect neural activity within the brain. Depending on the amounts of caffeine, alcohol, organic acids, and strains of bacteria/yeast – it may be better to consume kombucha at a particular time of day. If you feel tired after drinking it, reserve your consumption for night. Oppositely, if you find it puts a little pep in your step, try drinking it in the morning or early afternoon.
- Titration: One mistake newbies might make when consuming kombucha is drinking too much and/or too frequently. While some can handle large doses without previous kombucha exposure, it may be too much for your body to handle. Start with an extremely low amount per day, every other day, or even on a weekly basis. In other words, you may want to consume just 1 to 2 ounces for several weeks if you’ve never had kombucha before. Then slowly titrate up by 0.5 ounces per week (or every other week) and see if titrating your dose helps. You may find a “sweet spot” in dosing, such as if you exceed a certain amount, a backlash of side effects ensue. If you’ve found your sweet spot during titration, stick with the amount you can tolerate.
- Continue using: Many individuals experience some side effects when they first try kombucha. However, with continued regular consumption, the side effects often diminish in intensity and/or abate altogether. If you suspect that your body is going through some sort of adaptation to the bacteria/yeast within kombucha, continued usage may be a good option. You may be surprised that within a few weeks all initially unpleasant side effects have cleared up.
- Discontinue: If you’ve tried all of the aforementioned side effect mitigation strategies and still struggle to tolerate kombucha, trust your body and stop drinking it. There’s no reason to force yourself to feel miserable just because your friend or acquaintance reacts find to kombucha. We are all different and kombucha is certainly not a miracle substance for all consumers.
Have you experienced Kombucha side effects?
If you’ve tried kombucha and/or are a regular kombucha drinker, share whether you’ve ever experienced any unwanted side effects as a result of consumption. Document the specific side effects that you experienced and note their respective severities (e.g. modest, moderate, intense). To help others better understand the specifics of your situation, provide some additional details including: the precise amount of kombucha you drink (e.g. 8 oz), frequency of consumption (e.g. once per week), and the measurements of constituents within your particular brew (e.g. alcohol, caffeine, bacteria/yeast, flavorings, sugars, etc.).
Other details you may want to add to your comment include: the pH (acidity vs. alkalinity) of your kombucha, medications or supplements you take (that might interact with kombucha), if you have a histamine sensitivity or intolerability, and/or any medical conditions that you’ve been diagnosed with that could affect your reaction to the drink. Are there any particular brands or brews that you’ve tried that you seem to tolerate better than others? If you tolerate certain types of kombucha better than others, what do you think the reasoning is?
For those that experience some side effects from kombucha, are there any strategies that you’ve found helpful for attenuating them quickly? (If you have any tips for others that might be dealing with kombucha side effects, be sure to mention them within your comment). Understand that while a majority of kombucha drinkers will have zero problem tolerating the beverage, if you experience side effects or adverse reactions, it may be a sign that kombucha isn’t a good fit for your particular body.