War on cancer: kombucha reconsidered.
Article Type: Report
Subject: Cancer (Care and treatment)
Cancer (Prevention)
Kombucha tea (Usage)
Kombucha tea (Health aspects)
Kombucha tea (Research)
Author: Moss, Ralph
Pub Date: 11/01/2009
Publication: Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 The Townsend Letter Group ISSN: 1940-5464
Issue: Date: Nov, 2009 Source Issue: 316
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Russia Geographic Code: 4EXRU Russia
Accession Number: 210653387
Full Text: I hadn't thought about drinking kombucha tea until I saw a row of brightly colored glass bottles on a shelf in my local supermarket. For the uninitiated, kombucha is a fermented drink popular in the Eastern half of the world, and goes by many names, including "Mongolian tea." Since at least the 1960s, it has been popular in natural-food circles in the Western world as an alleged elixir. Some people claim that kombucha has been around for centuries, but it more likely developed in Russia about 100 years ago. A similar product, called kvass, is still popular in Russia and Latvia.

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It was surprising to see this odd-tasting cocktail holding its own against all the popular high-fructose corn syrup drinks in the supermarket's cooler section. Kombucha, at nearly $4 per bottle, is several times more expensive than its competitors. Breaking into the monopolistic beverage industry with a health drink cannot have been easy, and yet a young man named G. T. Dave has done just that with his GT's Kombucha and Synergy lines of beverages. Mr. Dave started his Millennium company at age 16, while still a student at Beverly Hills High School. There was Mr. Dave's brand at eye-level, right next to the full line of Lipton and Snapple products.

Mr. Dave believes that his mother's kombucha habit kept her breast cancer from metastasizing or recurring. "After a week of emotional turmoil," according to the Synergy Web site, G. T. "was relieved to find out that her breast cancer had not spread and that the pungent tasting cultured tea that she had been drinking was part of the reason why." I was amused to read his description of the Synergy kombucha manufacturing process: "Each batch is gently placed in a warm and spiritual environment where the walls are painted purple and spiritual music is played. Though it may sound silly, the most important thing that we do when making our batches is to give them LOTS of love."

So I bought a bottle of the cranberry-flavored drink and had it with my lunch. Kombucha is a fermented mixture of fungi, bacteria, black tea, and sugar. Little white strands of fungi are supposedly an integral part of the fizzy drink. There is also a small amount of alcohol. I found it all pleasant in a weird way. I liked the way it made me feel and began consuming one bottle per week. When I began investigated the actual medicinal properties of kombucha tea, I was surprised. There are a total of 38 scientific articles in PubMed on the topic of kombucha. Most of these are technical studies on the nature of the bacteria and yeast in the brew. Only a few of these are clinical. Compare this to the more than 3000 PubMed-listed articles on "Chinese" green tea!

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In the 1990s, kombucha became popular in certain circles, especially among people with HIV/AIDS. Some doctors began to express concern over this development, since they believed--without much evidence--that the bacteria or yeast in kombucha might badly affect people with compromised immune systems (Gamundi 1995). In 1995, however, the same year that the enterprising Mr. Dave founded his Millennium company, there was the first report of serious harm associated with use of this type of beverage. But it was not to be the last.

This first report appeared in the Morbidity and Mortality Weekly Report, a journal of the US government's Centers for Disease Control and Prevention (CDC). It discussed two cases of severe illness associated with the consumption of kombucha tea in a rural town in northwest Iowa. During April 1995, two cases of severe illness occurred within a week in two women who had both been drinking the same strain of kombucha daily for approximately two months.

The first woman had a strange and ill-defined sickness. On April 1, a neighbor found her 59-year old friend unconscious in her home and transported her to the local hospital. On her arrival in the emergency department, respiratory therapy was initiated with oxygen. Analysis of her arterial blood indicated "severe metabolic acidosis." In other words, the pH or acidity level of her blood was 6.9 (normal is 7.37-7.43--the lower the number, the more acidic the blood). The woman also had elevated levels of lactic acid, which, coincidentally or not, is also found in kombucha tea.

What made the case a bit complicated is that this woman also took medications for hypertension, anemia, and mild renal insufficiency. Soon after admission, she suffered cardiac arrest, and although she was resuscitated, her condition continued to deteriorate. She died on April 3. It turned out that for the previous two months, she had been drinking 4 oz. of kombucha tea per day, from a culture that had spread literally hand to hand to over 115 people in this one town alone.

I doubt whether many people would have believed there to be a connection between kombucha consumption and this woman's fatal condition had it not been for the fact that exactly one week later, on April 10, a previously healthy 48-year-old woman was also transported by ambulance to the same emergency room where the previous woman had died. On admission, the second patient was already in respiratory distress. Analysis of her arterial blood samples again indicated severe metabolic acidosis; the degree of acidity was even greater than in patient number one, with a blood pH of 6.7. She also had elevated levels of lactic acid and also suffered cardiac arrest. But, luckily, she was resuscitated and stabilized. She was discharged on April 13, 1995.

Government scientists tried, unsuccessfully, to figure out what exactly happened to these women. It is unlikely that the mere fact that they were drinking a rather acidic drink every day led to this excess acidity in the blood. Kombucha has a pH of between 2.5 and 4.5 (Stamets 1995). But cranberry juice, which no one accuses of doing harm, has an even lower pH (between 2.3 and 2.52, according to the FDA). So how does drinking an acidic drink translate into dangerously low blood pH or a build up of lactic acid? As a result of this incident, on April 10, 1995, the Iowa Department of Public Health recommended that people refrain from drinking kombucha until its role in these two cases of illness had been evaluated fully (CDC 1995).

A New Report

Then, in June 2009 came a report from Los Angeles of a similar disease in a patient taking kombucha. The lead author was Alison SungHee Kole, MD, and her three coauthors at Cedars-Sinai Medical Center in Los Angeles. It was published in the Journal of Intensive Care Medicine.

The authors wrote about a 22-year-old man, newly diagnosed with HIV, who became short of breath and feverish (103 [degree] F) within 12 hours of drinking kombucha tea. He subsequently became "combative and confused," and required both sedation and intubation for his breathing. The man also had a high lactic acid level. The authors conclude:

According to an e-mail from Dr. SungHee Kole, the patient did not mix up a brew of bacteria and yeast to create his kombucha but bought it from a local health-food store. I called the store in question, and they confirmed that they sell a full line of kombucha products. I have not yet been able to confirm the exact brand that this young man actually consumed. But the occurrence of serious symptoms in these three patients should give everyone pause.

Alleged Health Benefits?

But what about the many alleged health benefits of kombucha? They are not scientifically proven. There is, for example, an article from India stating that kombucha "has potent antioxidant and immunomodulatory properties" (Dipti 2003) and protects the liver against toxicity (Murugesan 2009). But I am unaware of any credible data linking kombucha consumption to the prevention of either recurrences or metastases. PubMed yields just two articles on the topic of kombucha and cancer, both of them negative. This is a poor basis on which to make important health decisions.

Reluctantly, therefore, I have stopped drinking kombucha tea and will seek other, less problematic elixirs. For now, I am back to drinking Chinese tea (Camella sinensis). There is about 100 times as much research on tea, especially green tea, as there is on kombucha. In addition, the cost of Chinese tea is about 4 cents per teapot compared to the $4 or so that I forked over for each bottle of kombucha.

Will Red Wine Replace Aromatase Inhibitors?

ITHACA, NY--Most of my research involves long hours on the computer or in the medical library. So it was a pleasure this summer for me to do some fieldwork in New York's Finger Lakes region. I made my annual tour of wine country, visiting some of New York State's most innovative wineries--purely for research purposes, of course. My special interest was in assessing the progress in organic wine cultivation, especially of those containing a natural compound called resveratrol. Some of the Finger Lakes wines have been found, in a Cornell University study, to have the highest resveratrol content in the world.

Resveratrol is found in the skin of grapes and in various red wines. It may be that its presence, even in minute quantities, can help explain the "French paradox," the fact that the French people have a diet much higher in saturated fats than most Americans (four times as much butter, for instance) but also less heart disease. Some scientists attribute this paradox to the resveratrol that the French imbibe with their vin ordinaire.

There is also some animal experimentation from 2008 showing that mice fed resveratrol live longer than mice that are deprived of this chemical (Pearson 2008). It may be that resveratrol triggers production of sirtuins, a class of proteins that regulate metabolism. The trouble with all these experiments is that they use a level of resveratrol that is impossible to attain in humans: you'd have to drink 35 to 100 bottles of red wine a day. But a lot of scientists are betting that they can design look-alike drugs on the model of resveratrol that can have a positive impact on health and longevity. In one of the most astonishing business deals of last year, Sirtris, a start-up company that develops drugs with effects similar to resveratrol, was sold to GlaxoSmithKline for $720 million. Sirtris is working on other drugs that can activate sirtuins.

Teetotalers needn't write in (as they did the last time I wrote in praise of wine) to remind me of all of alcohol's many downsides. I get it. If you don't drink, you shouldn't start just to boost your consumption of resveratrol. And, yes, it's also true that red or purple grape juice also contains resveratrol (about half as much as wine). But if you already do take a glass of wine now and then, and don't intend to stop, your best bet is to cultivate a taste for Pinot Noir. Because of the complicated relationships between these grapes, the fungi that attack them, and the cool temperatures in which they flourish, Pinots are particularly rich in resveratrol.

I can't leave the subject of wine and cancer without pointing to the intriguing findings of Elizabeth T. Eng and colleagues at City of Hope, Los Angeles. A few years ago they found that a Pinot Noir extract was an effective inhibitor of aromatase (Eng 2002). Aromatase is an enzyme that converts the hormone androgen to estrogen. It is generally expressed at a higher level in breast-cancer tissue than in surrounding noncancerous tissue. That is why many estrogen-receptor positive breast-cancer patients are given adjuvant doses of synthetic aromatase inhibitors. And although it is still too soon to say, perhaps some day oncologists will no longer prescribe Arimidex (anastrazole), Aromasin (exemestane), or Femara (letrozole), but a glass or two of Pinot Noir with dinner instead.

References

Dipti P et al. Lead induced oxidative stress: beneficial effects of Kombucha tea. Biomed Environ Sci. 2003;16:276-282.

Eng ET. Williams D, Mandava U, Kirma N, Tekmal RR, Chen S. Anti-aromatase chemicals in red wine. Ann N Y Acad Sci. 2002 Jun;963:239-246.

Murugesan GS, Sathishkumar Mr Jayabalan R, Binupriya AR, Swaminathan K,Yun SE. Hepatoprotective and curative properties of Kombucha tea against carbon tetrachloride-induced toxicity. J Microbiol Biotechnol. 2009;19:397-402.

Pearson KJ, Baur JA, Lewis NK, et al. Resveratrol delays age-related deterioration and mimics transcriptional aspects of dietary restriction without extending life span. Cell Metab. 2008;8:157-168.

SungHee Kole A, Jones HD, Christensen R, Gladstein J. A case of Kombucha tea toxicity. J Intensive Care Med. 2009;24:205-207.

Wade N. New hints seen that red wine may slow aging. New York Times. June 4, 2008.

by Ralph Moss, PhD

www.cancerdecisions.com
While kombucha tea is considered a healthy elixir, the limited
  evidence currently available raises considerable concern that it may
  pose serious health risks. Consumption of this tea should be
  discouraged, as it may be associated with life-threatening lactic
  acidosis (SungHee Kole 2009).
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