Jones & Bartlett Learning Medicine Blog

    New Fads in Alternative Therapies: Why It’s Important to Question Your Patients About “Potentially Hepatotoxic Supplements”

    Posted by Lindsay White on Mar 7, 2018 8:30:00 AM

    Kombucha teaNew fads and diets are constantly surfacing in our world today, however it’s interesting to note that often a lot of the new fads are actually a resurfacing out of old traditions translated into a modern setting. For example, looking up Kombucha on leads to a wealth of articles like “What Kombucha Really is, for those of you who Drink it but Don’t really know,” “Kombucha: A Love Story,” and “7 Ways Fermented Tea Can Give You Better Skin.”  And these are only a few of the headlines surfacing online today.

    Originating around 221 BC in China during the Qin dynasty, Kombucha was used for digestion and healing. Conversely, in today’s world it feels incredibly commercialized and marketing for the product targets millennials and clean eaters. Further it has also become of interest to diabetics as it is said to help regulate blood sugar and aid to lower high blood pressure and cholesterol (Kent).

    In a case study, a 58-year-old diabetic female who reported to have a significant amount of Kombucha tea over the course of a month was discovered to have “disproportionate elevation of alkaline phosphatase with respect to aminotransferases” (Gedela). The patient then underwent a liver biopsy which suggested a drug induced liver injury. She discontinued her use of herbal until ultimately her liver enzymes normalized (Gedela). There have been other cases of hepatotoxicity in individuals who consume the tea, but the information is not a result of a medical study and cannot be conclusive of the exact health benefits. It is causal that the reason the patient got better was due to her discontinued use of the tea. 

    Kombucha is “made by fermenting sweet black tea with a round, flat gray fungus for a week or longer” (Gedela). Because there are so many different kinds of teas and variable times taken to ferment it, there is no way to measure exactly what is in Kombucha as a universal supplement and there is a lot of room for contamination due to spores from a “more pathogenic yeast” used in making the product (Gedela). Further, the fad nowadays is to “brew your own” so it can be very difficult to prepare the tea in the safest way.

    According to Tarascon products, under warnings for Kombucha Tea there is a disclaimer that “alternative therapies are regulated as dietary supplements” and not as drugs as they do not undergo the sTarascon Pocket Pharmacopoeia 2018 Classic Shirt-Pocket Editioname evaluations and marketing as those classified as drugs because they are not making specific therapeutic claims and are not required to demonstrate safety in the same way an FDA certified drug does (Hamilton). What this means is that any “health benefits” that Kombucha Tea claims to have cannot be medically substantiated. There are, however, many articles that discuss the pros and cons of this tea. Alternative therapies have their place in society but it is extremely important to know what’s going into your body to weigh the health benefits as well as risks. For this reason, a lay person should always check with their doctor before putting potentially toxic/harmful foods in their body.

    Gedela, Maheedhar. “A Case of Hepatotoxicity Related to Kombucha Tea Consumption.”,    2017,

    Hamilton, Richard J. Tarascon Pocket Pharmacopoeia: 2017 Classic Shirt-Pocket Edition. Jones & Bartlett
    Learning, 2017.

    Kent, Linda Tarr. “Kombucha & Liver Damage.” LIVESTRONG.COM, Leaf Group, 14 Aug. 2017,

    “Kombucha.” The Huffington Post,,

    “U.S. 'Kombucha': Smelly and No Kelp.” The Japan Times,

    Topics: medicine, preventive medicine

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