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Section entitled "Kombucha Drops - Kombucha Extract - Information"

Kombucha drops has been merged and redirected to this article, however, the information appears to be copied and pasted verbatim from this webpage: ]. Per Misplaced Pages:Copyrights, I am removing that information. Edwardian

POV

I've added a POV tag to the "Health claims" section. The section makes no effort to be neutral and instead seems to indicate this relatively common beverage is some kind of dangerous and borderline poisonous snake oil with zero benefits. It does have nutritional value and millions of people drink it without any adverse side effects. Commercially produced kombucha is sold in grocery stores. It's lazy and incorrect to denigrate a harmless beverage simply because some new age types glommed onto it years ago. Kindzmarauli (talk) 21:39, 29 July 2014 (UTC)

And I've been reverted. The section is POV, yet I'm being told to shut up. I think that section needs to be expanded to include all health and nutritional information, otherwise it's purely negative. Kindzmarauli (talk) 21:40, 29 July 2014 (UTC)

Please read WP:MEDRS - the relevant guideline for claims regarding nutritional or health benefits. AndyTheGrump (talk) 22:59, 29 July 2014 (UTC)

I'm not arguing against including the current information, I'm trying to say that it's a POV section without including some basic information regarding the nutritional content. Surely there's nothing controversial about saying how much vitamin C (etc.) is in kombucha? It would also be nice to edit the section so that it doesn't read as some kind of slam piece, which is how it currently appears to me (and I don't even like the stuff). Kindzmarauli (talk) 17:05, 30 July 2014 (UTC)

The article already contains a section entitled 'chemical and biological properties', which states (amongst other things) that "Kombucha contains about 1.51 mg/mL of vitamin C." AndyTheGrump (talk) 18:34, 30 July 2014 (UTC)

Ok, nevermind. Kindzmarauli (talk) 18:40, 30 July 2014 (UTC)

Sorry if I'm doing this wrong. This is my first talk page post. I came here because the "Health Claims" section has nothing to do with health claims and instead talks about the dangers. I feel like the headline should be changed. Also I was disappointed to be unable to find out what the health claims are by reading this article. I just came here to learn why Kombucha is sold in my QFC! Doctrix (talk) 02:21, 15 October 2014 (UTC)

Yeah its kinda rubbish. Totally POV and lacks any impartiality. Heads up their ... Zarkme (talk) 05:45, 18 November 2014 (UTC)

It might not support your point of view, but it seems completely in line with the opinion of the American Cancer Society. Take a look at http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/dietandnutrition/kombucha-tea — Preceding unsigned comment added by 122.49.131.58 (talk) 02:01, 3 January 2015 (UTC)

It's been added by someone, but it lacks impartiality. Does POV policy apply when authoritative sources basically make statements which are misleading because the statement could apply to all? You could make the same statement for water that the ACS is making here. False equivalence argument. 76.21.107.77 (talk) 19:52, 17 March 2015 (UTC)

Kombucha Safety

Hello,

While the source for the line in the header description is legitimate, the context of it does not seem reasonable or appropriate for the page. No statistics or other corroborating information is included which would indicate health risks of a standardized, commercially produced kombucha product.

Quoted via the CDC website, "FDA has evaluated the practices of the commercial producers of the Kombucha mushroom and has found no pathogenic organisms or hygiene violations (5). However, because the tea is produced under varying conditions in individual homes, contamination with pathogenic organisms such as Aspergillus is possible."

I could find no references suggesting commercially produced kombucha associated with any health problems. The problematic issues arise from kombucha produced at home with no regulation. This should be noted in the wiki page as there are many food products (alcohol, cheese, cured meats, etc.) that are potentially dangerous when produced non-commercially and in the absence of a regulatory body, but which are perfectly safe when properly produced.

73.53.53.138 (talk) 05:36, 5 August 2014 (UTC)

That's a good point. The CDC source you're quoting is from 1995, which is pretty old by WP:MEDDATE standards, but the wide-spread commercial availability is barely even touched on in the article. If that's expanded, and it looks like it should be, then it might make sense to change the lead. Here's one source: More research is needed. Grayfell (talk) 07:06, 5 August 2014 (UTC)

References

1. http://www.cdc.gov/mmwr/preview/mmwrhtml/00039742.htm

Please fix this biased entry!

The entry on kombucha is the most biased I have ever seen on Misplaced Pages, and that bothers me greatly because I am an educator who advocates for the site as a valuable source of initial information on any topic and a superb example of a self-policing community. I have no vested interest in kombucha whatsoever; I just wanted to know what it is because someone handed me a bottle and said it was good for me. The wikipedia page taught me that it doesn't cure cancer (which is hardly surprising)and that it is dangerous (which IS surprising). There seems to be no middle ground between these two extravagant claims of Ultimate Health on one side and Death on the other side. If this is an acceptable way to present a topic, then someone should edit the article on carrots to focus primarily on dissuading readers from the belief that eating them helps you see in the dark, followed by a discussion of the dangers of allergic reactions and other carrot-related health hazards.

I can see that my critique of this article is nothing new, but the issue seems to be perpetually unresolved so I had to add my thoughts from a kombucha-neutral perspective. — Preceding unsigned comment added by 184.96.235.137 (talk) 22:16, 13 October 2014 (UTC)

Agreed Zarkme (talk) 05:48, 18 November 2014 (UTC)

I believe that the article intro should be completely rewritten. I am tempted do so myself, but need some guidance. Research referenced in the intro section seems to be misused. Statement "the claims are not supported by scientific evidence" should probably be replaced with "The research on animals does indicate health benefits but no sufficient research has been done to validate lauded human health benefits". Also, the line referencing death should be replaced with "There is no substantial evidence to confirm the toxicity of any kombucha tea or the occurrence of illness by earlier studies" which is the quote right from the referenced research paper .

That would provide more balanced picture which would be more in line with listed references. Sashalav (talk) 18:35, 12 January 2015 (UTC)

We don't pick stuff out of primary sources, but instead rely on the secondary review from the American Cancer Society. Their document is accurately reflected here. Alexbrn 19:09, 12 January 2015 (UTC)

But you did pick and choose a secondary source which doesn't have any actual statistics in their statement. The same statement could be made of water or jam. 76.21.107.77 (talk) 19:54, 17 March 2015 (UTC)

Firstly, per WP:MEDRS, we are not going to cite animal studies for claims of supposed benefits in humans. And secondly, you have cherry-picked a single sentence from a section which starts by saying that "Although kombucha tea has been reported to have curative effects, there is some evidence of toxicity associated with it...". AndyTheGrump (talk) 19:15, 12 January 2015 (UTC)

I do understand and accept that we cannot use finding about health benefits to animals but I do not agree with your statements regarding toxicity. The sentence you quoted goes on and refers to lead poisoning. There is no lead in kombucha. The poisoning was the result of fermenting in the jar containing lead. If lemonade was prepared in such jar, there would be the same risk of lead poisoning. There is no scientific evidence that kombucha itself is toxic in any way. The sentence I quoted "There is no substantial evidence to confirm the toxicity of any kombucha tea or the occurrence of illness by earlier studies" is the conclusion of the research on, among other things, kombucha toxicity. Any food prepared in unsanitary conditions, or kept in the wrong place on in the wrong conditions can become toxic. That stands for kombucha in a same way it does for chicken breasts, so I do not see why is it necessary to mention it on this page. Sashalav (talk) 04:35, 14 January 2015 (UTC)

The source we reference refers to a number of problems arising from Kombucha's brewing conditions (not just from lead vessels), and serious side effects and death linked with Kombucha drinking. It's a good source, possibly the strongest in this entire article. We need to reflect it. Failing to do so would not be neutral. Alexbrn 07:46, 14 January 2015 (UTC)

I think we are slowly getting to the point here. Sources quoted do not state that there is scientifically proven direct connection between drinking Kombucha and health benefits, so those benefits are not stated in the article intro. In a same way sources quoted do not show scientific proof that health issues linked are due to toxic properties of Kombucha but rather issues in fermentation process. As there is no scientific proof for either positive or negative effect of Kombucha to human health - neither should be highlighted in the article intro. Both are just claims but not necessarily facts and that should be noted. For an example, searching news for salmonella poisoning resulting from chicken consumption will yield many results but that is not mentioned in Misplaced Pages's Chicken article intro, and, in a same way, it should not be in the Kombucha article intro but not in the intro. I think that pointing to the lack of scientifically documented health benefits while at a same time listing possible health problems which are not scientifically documented makes for unbalanced article intro.Sashalav (talk) 17:47, 14 January 2015 (UTC)

We have an entire section on health claims, some summarizing some of it in the lede is quite in line with WP:LEDE and also satisifies our need for a WP:NPOV. We wouldn't want to airbrush all "critical" content out of the lede, now would we? Alexbrn 18:11, 14 January 2015 (UTC)

Why not? Not only that the content is NOT supported by sources in the same magnitude as showcased here, but no such content exist for any other item on Misplaced Pages. Look at pages on Kefir, Chicken, Grapes, Aspirin ... all of them can cause sickness or even death when not prepared, used or cared for properly but that is not listed right in the intro of those pages. Under 10 documented people got sick that may or may not be in some way related to consuming Kombucha (none of the sources listed claims direct connection) but that certainly is not the most important thing about it. Sashalav (talk) 22:09, 14 January 2015 (UTC)

As WP:LEDE says "explain why the topic is notable, and summarize the most important points, including any prominent controversies". We need to follow the WP:PAGs, and not try and invent rules derived from completely unrelated articles. One of the principal aspects of Kombucha in the reliable litertaure (and on many dubious web sites too) is its supposed healthful properties. Misplaced Pages faithfully reflects that as neutrality requires. Alexbrn 05:35, 15 January 2015 (UTC)

The review article cited as the source for "the claims are not supported by scientific evidence" concluded that the claims were supported by preliminary studies but that further research is necessary. This is far from saying that "the claims are not supported by scientific evidence," and an average reader may infer from the wording of the statement that the claims have been refuted, something which the review article most certainly does not claim. The sentence should be changed to be NPOV Trinu talk 05:37 23 January 2015 — Preceding undated comment added 05:39, 23 January 2015 (UTC)

To quote: "There has been no evidence published to date on the biological activities of kombucha in human trials". We are true to the source. Implying there might be benefit would be OR and not neutral. Alexbrn 05:44, 23 January 2015 (UTC)

The study did NOT conclude that there was lack of evidence; merely that the evidence was preliminary in nature. Quote: "Kombucha tea's current status as a functional food as summarized in this review, lends credibility to what has been believed by kombucha tea drinkers for a long time." We could say that there have been no human trials to this effect, or that the only trials thus far have been in animal models and cell culture, but implying that the claim has been refuted is POV and misleading, particularly when the source cited lends (limited) support to the claims. Trinu (talk) 06:09, 23 January 2015 (UTC)

Not at all: you're assuming the preliminary research has some bearing on human health effects; the "refutation" is in your mind. As regards human health we accurately reflect the source, as we should. (Add: another issue here is that this source does not appear to be published in a proper medical journal, and so is not a WP:MEDRS for health information in any case.) Alexbrn 06:43, 23 January 2015 (UTC)

Probiotic, unsourced, unrelated, chicken feed

I have moved the content below here from the article.

"Another main ingredient found in all fermented foods and beverages are probiotics which are beneficial bacteria necessary for adequate digestion and absorption of nutrients. They are viable microorganisms that improve gut microflora by secreting enzymes, organic acids, vitamins, and non-toxic anti-bacterial substances once ingested. Probiotics have also been shown to improve metabolism and to treat antibiotic-associated symptoms such as diarrhea. In a recent study, alternative diets such as probiotics, green tea extract and kombucha tea were fed to broiler chickens to measure their effects on growth and immunity. The chickens fed with kombucha showed an increase in protein digestibility. The conclusion of the study stated, "adding kombucha tea (20 % concentration) to wet wheat-based diets improved broiler performance and had a growth-promoting effect. Probiotic diets also resulted in enhanced growth and performance, but to a lesser extent.""

The first sentence is unsourced and doesn't really jibe with the article on probiotics. Specifically "necessary for adequate digestion and absorbtion" and "found in all fermented foods and beverages". The characterization as "main ingredient" is unclear, are probiotics a main ingredient of kombucha? The next sentence is sourced to a study on chickens, followed by a sentence sourced to a 2008 article that makes no mention of kombucha at all. Discussion of the general benefits of probiotics belongs in that article and would hopefully be based on much more MEDRS quality source. Then the removed content goes on to extensively discuss a study of broiler chickens. Animal studies are not appropriate for basing content on human biomedical information. If something is of use to humans it will be studied in humans and those studies reviewed. We are not talking of kombucha as chicken food so the content is undue, primary and irrelelvant. I added a reference, (Jayabalan, 2014) that is a decent review that could be used to improve the article. Jayabalan's conclusion section doesn't reflect the facts of the review but the review itself is pretty decent. Perhaps those that find the article "biased" could read that review and make a proposal or two. A good read of what the actual WP:NPOV policy says would good coupled with WP:MEDRS and WP:V and for good measure WP:RS. WP is an encyclopedia that reflects what is published in reliable sources with due weight. - - MrBill3 (talk) 12:04, 18 November 2014 (UTC)

By definition, a 'probiotic' is the main ingredient of kombucha. And if something is of use in humans, there's actually no evidence that it would be studied in humans... Someone has to pay for the study. Not all foods have had this treatment. It's not a very good presumption you've made.

However, the chicken link probably should stay on the comment page until it's gotten more specific review. 76.21.107.77 (talk) 20:12, 17 March 2015 (UTC)

References

1. http://onlinelibrary.wiley.com/doi/10.1111/1541-4337.12073/full
2. ^ Afsharmanesh, M; Sadaghi, B (May 2014). "Effects of dietary alternatives (probiotic, green tea powder, and kombucha tea) as antimicrobial growth promoters on growth, ileal nutrient digestibility, blood parameters, and immune response of broiler chickens". Comparative Clinical Pathology. 23 (3): 717–24. doi:10.1007/s00580-013-1676-x.
3. Kligler, B; Cohrssen, A (November 1, 2008). "Probiotics". American Family Physician. 78 (9): 1073–8. PMID 19007054.

Mention of possibly unrelated deaths do not belong in Lede

In this edit, I added an update to the claim of linked deaths. However, I am not convinced this deserves mention in the Lede. It would be different if the deaths were found to be caused by Kombucha drinking. That side effects have been noted seems fitting for the Lede, but 2 deaths with no causal link found after 10 years seems more like a fringe claim, and creates a Lede/article that violates WP:NPOV. petrarchan47คุก 22:27, 6 June 2015 (UTC)

Removing the otherwise well supported dead link seemed premature, per WP:LINKROT, as it still supplied enough information to find the article offline. I'm restoring the link, and moving the dead link template inside the ref tags, per Template:Dead link. Grayfell (talk) 04:41, 8 June 2015 (UTC)

Any mention of the history, especially in such cryptic terms as "remedy for immortality" should be clearly explained with solid sources in the body before it is introduced to the lead of the article, otherwise it is undue and non-neutral. (Isn't poison a remedy for immortality?) Grayfell (talk) 04:48, 8 June 2015 (UTC)

Hi GreyFall, I'm not tremendously interested in working on this article, but it does seem strange to leave all mention of history out of the Lede. Would you go ahead and add something you find appropriate? It doesn't read well to have a one line description, and then to jump right into the dire warnings. The unsubstantiated health claims are unsubstantiated because no trials have been conducted, however the current wording suggests that perhaps they have actually looked for evidence and found none. So this is misleading, and what you reverted was my attempt to fix it. Further, I did not remove the dead link from the article, only the Lede, since the claims sourced to it in the Lede were also covered in the NBC reference. Best, petrarchan47คุก 05:04, 8 June 2015 (UTC)

Yeah, I have no problem with the removal of the linked-deaths thing (although I suspect that may prompt further discussion as well). I agree it's odd to leave out the history from the article, but I'm also not all that interested in digging deep on this article, and I don't have any sources handy. I don't understand why you didn't include your source? It was a direct quote from something, no? What you added was reasonable, but without a source it was still scuttlebutt and this article already gets a lot of opinion editing and pseudoscientific blogspam and such, so the last thing it needs is more scuttlebutt. "The claims are not supported by scientific evidence" seems like a perfectly accurate way to phrase it. A lack of studies or trials is the same as a lack of support by scientific evidence. This is veering into WP:MEDRS territory, but when we have multiple sources saying that no benefits have been found, it seems reasonable to me. Grayfell (talk) 05:16, 8 June 2015 (UTC)

Never mind, I see that it's in the NBC puff piece. I'll look it over and expand the history section a little. It's very weak as a source, though. Grayfell (talk) 05:19, 8 June 2015 (UTC)

Usually if I am citing multiple claims to one source, I will link to it only at the end of all claims, rather than at the end of each one. I'm open to suggestions, though, as this has confused people before. petrarchan47คุก 06:19, 8 June 2015 (UTC)

Grayfell Thanks for expanding the history section in the article, however it was the Lede that seemed to be missing mention of the origins of the drink. It is half definition and half warnings, which doesn't reflect the article contents as it should per WP:LEDE. petrarchan47คุก 06:58, 8 June 2015 (UTC)

The NBC source was just too weak to be much use in this case, and I don't think the added content reached the threshold for inclusion in the lead. The bit about etymology (Dr. Kombu) is directly contradicted by other, more academic sources earlier in the article, and the info about its ancient origins is two sentences which are very broad, and are not supported by any other sources. Mentioning when the drink first appeared is a good idea, but there are too many ambiguities and contradictions, and I don't think a date-range should be mentioned in the lead based on this one flawed source. Otherwise saying unambiguously that its 2,000 years old seems like an appeal to tradition. These things should be properly addressed in the body first. Grayfell (talk) 19:50, 8 June 2015 (UTC)

Thank you kindly, Grayfell. This Swedish source has a good bit about the history. If I find some time, I will help with this. petrarchan47คุก 19:55, 8 June 2015 (UTC)

We should summarize the best sources. The ACS mentions death by kombucha. So we do too. Alexbrn (talk) 05:43, 8 June 2015 (UTC)

According to the CDC, Kombucha's "beneficial and/or adverse effects have not been determined scientifically". This is a much more neutral account than the WP article gives. Are there any objections to rephrasing the Lede/article in accordance with the CDC?

I don't know what ACS source you are referencing, perhaps you could leave a link, Alex? Do you consider it stronger than the CDC? petrarchan47คุก 06:19, 8 June 2015 (UTC)

Have you read this article or are you just lede bombing? We quote the ACS in the body: "Available scientific evidence does not support claims that Kombucha tea promotes good health, prevents any ailments, or works to treat cancer or any other disease. Serious side effects and occasional deaths have been linked with drinking Kombucha tea". ACS is a strong MEDRS source and does not contradict the CDC statement. Do not edit war and be aware this page is subject to discretionary sanctions. Alexbrn (talk) 06:38, 8 June 2015 (UTC)

Chill out, no one is edit warring, Alex. petrarchan47คุก 06:49, 8 June 2015 (UTC)

Here is the American Cancer Society piece, it references the CDC/FDA article I linked above. An excerpt from ACS:

"No studies have been done on humans to support any of the claims made for Kombucha tea. There have, however, been reports of some serious complications associated with the tea. In April 1995, two women who had been consuming the tea daily for two months were hospitalized with severe acidosis--an abnormal increase of the acid levels in body fluids. Both had high levels of lactic acid upon hospitalization. One woman died of cardiac arrest two days after admission. The second woman’s heart also stopped, but she was stabilized and recovered. The mushrooms used by both women came from the same "parent" mushroom. While no direct link to Kombucha tea was proven in this case, the FDA has warned consumers to use caution when making and drinking the tea."

Details on the case from the CDC:

"The mushrooms used by both women were derived from the same parent mushroom. At least 115 additional persons in the town had used or were using mushrooms from the same source as for the two ill women, but no other cases of unexplained acute illness were reported among these persons. A review of hospital emergency department records for March 1-April 10 did not detect other cases of unexplained lactic acidosis or other likely cases of tea-associated acute illness.

Samples of the mushrooms and samples of the tea consumed by both case-patients were sent to FDA for analysis. Microbiologic analysis of the tea and mushrooms identified several species of yeast and bacteria, including Saccharomyces cerevisiae and Candida valida. No known human pathogens or toxin-producing organisms were identified. The alcohol content of the tea ranged from 0.7% to 1.3%; no methanol was detected."

Having seen the ACS document, do editors feel Alexbrn's preferred version:

"Drinking kombucha has been linked, in rare cases, to serious side effects and deaths, and improper preparation can lead to contamination."

is preferable to this?

"Drinking kombucha has been linked in rare cases to serious side effects and several deaths, although no causal link to these deaths has been established. Improper preparation can lead to contamination."

Saying Kombucha is linked to death, when no causal or direct link has been established in the 10 years since this case, as opposed to noting "no direct link" is non-neutral and misleading. I'm unclear whether the ACS source meets MEDRS requirements, but Alexbrn would know more about this. The 10 year old source does not seem to adhere to MEDRS. petrarchan47คุก 06:51, 8 June 2015 (UTC)

We say what the sources say, and do not engage in editorializing and OR. Trying to discredit a good MEDRS source with a 20-year-old CDC case report (which even warns in red text at its head it may be outdated) is highly problematic. Alexbrn (talk) 06:53, 8 June 2015 (UTC)

OK. The source you prefer says:

"No studies have been done on humans to support any of the claims made for Kombucha tea. There have, however, been reports of some serious complications associated with the tea. In April 1995, two women who had been consuming the tea daily for two months were hospitalized with severe acidosis--an abnormal increase of the acid levels in body fluids. Both had high levels of lactic acid upon hospitalization. One woman died of cardiac arrest two days after admission. The second woman’s heart also stopped, but she was stabilized and recovered. The mushrooms used by both women came from the same "parent" mushroom. While no direct link to Kombucha tea was proven in this case, the FDA has warned consumers to use caution when making and drinking the tea."

And you want to summarize this as:

"Drinking kombucha has been linked, in rare cases, to serious side effects and deaths".

Your source specifically says "no direct link", and you want to quote them as saying "has been linked". I see this as highly problematic and misleading. petrarchan47คุก 07:02, 8 June 2015 (UTC)

Your comprehension is poor. The "no direct link" phrase applies to one case. As the ACS say in general (in their "Overview"): "Available scientific evidence does not support claims that Kombucha tea promotes good health, prevents any ailments, or works to treat cancer or any other disease. Serious side effects and occasional deaths have been linked with drinking Kombucha tea." We reflect that, which is NPOV. Alexbrn (talk) 07:12, 8 June 2015 (UTC)

Alex, could we discuss this sans personal attacks? IMO, this is a fringe claim and although you have one good source, does it not strike you as odd that Kombucha death is mentioned literally nowhere else? It is a strong claim to make, and it is possible that the ACS got it wrong given that they are the only source with such a claim. I would prefer to see at least one MEDRS backing this claim. petrarchan47คุก 07:26, 8 June 2015 (UTC)

The suggestion that the ACS is a source of 'fringe claims' is nonsensical. And we don't second-guess a source because a contributor thinks they might have 'got it wrong'. AndyTheGrump (talk) 07:30, 8 June 2015 (UTC)

I have made no personal attacks, merely pointed out your error. The ACS are not essaying a fringe claim and I suggest if you want to clarify that you raise it at WP:FT/N. We have a good source and will not be swapping it out for outdated primaries or your personal suppositions such as "it is possible that the ACS got it wrong". For further background see also PMID 12808367. Alexbrn (talk) 07:33, 8 June 2015 (UTC)

You pointed out their error, but in an unnecessarily harsh way. A little tact goes a long way and encourages civil discourse. TylerDurden8823 (talk) 07:50, 8 June 2015 (UTC)

I agree with petrarchan47 in regards to the text, I have answered also at original post (since there was already a response there) furthermore I will look for additional sources that dispel any link. thank you--Ozzie10aaaa (talk) 10:52, 8 June 2015 (UTC)

Ozzie, it would be better to find and summarize the best WP:MEDRS sources, we shouldn't go questing for sources to support some pre-decided POV. If there are stronger sources than the ACS (or earlier, Ernst's 2003 systematic review) then bring them forth! Alexbrn (talk) 11:18, 8 June 2015 (UTC)

actually a review 2014 is posted on the other discussion on wikiproject med. will look for more--Ozzie10aaaa (talk) 12:00, 8 June 2015 (UTC)

We already cite that - does it bear on the "death" question? I can't (currently) get access to a full text. Alexbrn (talk) 12:54, 8 June 2015 (UTC)

Sources related the the death, health, safety issue

Alexbrn has introduced this source to support this statement in the Lede (emphasis mine):

Drinking kombucha can cause liver damage and, in rare cases, death.

This is in conflict with even the originally cited ACS' wording, "linked". "Cause" is a big leap forward, and the source used does not support such a claim.

Sources that do not support death claims:

• Mayo Clinic

"There have, however, been reports of adverse effects, such as stomach upset, infections and allergic reactions in kombucha tea drinkers. Kombucha tea is often brewed in homes under nonsterile conditions, making contamination likely. If ceramic pots are used for brewing, lead poisoning might be a concern — the acids in the tea may leach lead from the ceramic glaze.

In short, there isn't good evidence that kombucha tea delivers on its health claims. At the same time, several cases of harm have been reported."

• Science Based Medicine

"The best that can be said about kombucha is that it probably won’t kill you."

• Swedish Medical Center creds

"...there are case reports, which suggest that Kombucha preparations can cause such problems as nausea, jaundice, shortness of breath, throat tightness, headache, dizziness, liver inflammation, and even unconsciousness. 4,5,6 It isn't clear whether the cause of these symptoms is an unusual reaction to a generally nontoxic substance, or a response to unusual toxins that developed in a particular batch of Kombucha.

"In addition, there is one case report of severe lead poisoning caused by regular use of Kombucha brewed in a ceramic pot. 7 When brewed or stored in some ceramics, the risk of lead poisoning results because Kombucha tea is acidic. Many ceramic glazes contain a low level of lead that would not make the pottery dangerous for ordinary use; but if an acidic solution like Kombucha is steeped in them for a long time, a dangerous amount of lead may leech into the solution.

"There is also one report of Kombucha becoming infected with anthrax and passing along the infection to an individual who rubbed it on his skin to alleviate pain. 8 Apparently, anthrax from nearby cows got into the Kombucha mixture and grew."

• NYT reports where the link began, confirming there was no real evidence of a link:

"In 1995, the Centers for Disease Control and Prevention issued a report linking kombucha to the death of an Iowa woman and the illness of another woman. Both experienced severe metabolic acidosis, excessive acid buildup in the body that health officials thought may have been related to their daily use of kombucha. Though the federal center did not definitively cite the tea as the problem, the incident put a damper on kombucha consumption."

The death claim we have in the Lede seems fringe at best. petrarchan47คุก 19:52, 8 June 2015 (UTC)

Petrarchan47 has written of the text "Drinking kombucha can cause liver damage and, in rare cases, death", “the source used does not support such a claim.” I am very surprised by this accusation since the source has "kombucha tea can cause serious hepatic damage and even fatality." In what way is our text not supported by the source? Alexbrn (talk) 08:45, 9 June 2015 (UTC)

— Additionally that same reference is referred to several times as a different reference (eg 2 and 21 are the same reference basically. It looks like there is just the one death "caused"?? by the drink, which is the AIDS guy. I haven't got access to the full paper so I am unclear if the link is actually causal, it just said he had the tea 15 hours before dying. 92.19.86.173 (talk) 10:38, 9 June 2015 (UTC)

Interesting. I was researching matcha tea and came across this discussion. Regarding the RS that alleges kombucha can cause liver damage, etc. I researched the cited source in the footnote of the source cited in the article for verifiability in accordance with WP:V. Btw, Misplaced Pages:Verifiable but not false is a great essay. The source that caused the misapprehension in the cited book is here: I found no such determination specifically stated in that journal entry. It appears the author of the source cited in this article made an assumption. It is a classic example of what can happen when we ass-u-me. I'm of the mind that the cause statement and RS used to support the assumption is inaccurate. The passage should be modified for factual accuracy and properly cited. Perhaps we should exercise as much care and concern when citing RS in these types of articles as we do in all medical and science related articles such as those involving GMF and GMOs, for example. It would certainly save time and megabytes of space on TP. --Atsme 12:10, 9 June 2015 (UTC)

“... I researched the cited source ... ” / “... I am of the mind ... ” ← yes, that's called original research and it's what we must not do. We follow reputably-published secondary sources instead of editors' non-expert views. Alexbrn (talk) 12:17, 9 June 2015 (UTC)

No, that is not considered OR.  It is considered researching for verifiability which editors are actually obligated to do because V is one of the 5 pillars.  OR, for example, is when an editor includes a passage about laboratory research or experimental results that cannot be cited by published sources.  I suggest you read WP:V and familiarize yourself with the policy.  The book that was cited to support the claim that it causes death is incorrectly stated and not supported by the book's own cited source. That is factual inaccuracy - verifiable but false.  The information has been removed, and now the onus is on those who want it included to validate why it should be.  Please keep in mind that It may be considered a violation of WP:V to revert its removal. --Atsme 16:07, 9 June 2015 (UTC)

It is the very epitome of OR. You are reintepreting the primary sourced drawn on by a secondary source to reach a different conclusion (and of course this is explicitly called out as a no-no in MEDRS). You've also been deleting secondary-sourced content and using primary sources (a case report). Also bad. Alexbrn (talk) 16:11, 9 June 2015 (UTC)

(ADD) Well, you're now edit-warring your poor content in. I have issued a warning ... Alexbrn (talk) 16:27, 9 June 2015 (UTC)

Please stop your edit warring and battleground behavior and stop the false accusations. I reverted your notice on my TP as it was an abuse of the template. It was also posted to my TP after I posted a friendly warning to you about edit warring which is exactly what you are doing. Policy clearly states that the onus is on the editor who wants to add back the disputed material, and you have not provided one ounce of evidence that supports the extraordinary claim you made in lead. I provided intext attribution from the conclusion of the report in a published, peer reviewed journal, and did not reinterpret anything. The source you are using cited that journal report with an inaccurate statement that was not supported by their cited source, therefore it failed verifiability. Per policy: extraordinary claims require extraordinary sources and that is exactly what I provided with inline text attribution. The onus is now on you to find a RS that is compliant with V and also passes the scrutiny of MEDRS. Furthermore, the simple fact that your source is a RS per MEDRS does not guarantee inclusion of the material cited. I strongly advise you to stop your battleground behavior and edit warring. Atsme 16:52, 9 June 2015 (UTC)

You are mis-stating policy, and have replaced a secondary source with a primary because you personally disagree with the secondary (which has nothing to do with WP:V, this source directly supported the cited content). You have twice inserted your preferred text. Alexbrn (talk) 17:10, 9 June 2015 (UTC)

I think perhaps the reason you believe I misstated policy may actually result from your misinterpretation of it. Exceptional claims require exceptional sources - the claim that kambucha tea causes death is an exceptional claim.  Any exceptional claim requires multiple high-quality sources.  Sorry, but the death claim was cited to a single source that was disputed for factual inaccuracy.  The source is verifiable but not true.  Red Flag.  Per policy Red flags that should prompt extra caution include: surprising or apparently important claims not covered by multiple mainstream sources;  The following also applies: claims that are contradicted by the prevailing view within the relevant community, or that would significantly alter mainstream assumptions, especially in science, medicine, history, politics, and biographies of living people. Atsme 19:02, 9 June 2015 (UTC)

Certain plants and fungi can cause illness and death; that is a commonplace and not "exceptional". Since we have high quality MEDRS sources saying so here we should use them, rather than privileging your inexpert personal opinions. Alexbrn (talk) 21:07, 9 June 2015 (UTC)

Of course plants and fungi can cause illness and death, but you need to present a source that establishes causality specifically between kombucha consumption and death. Can you do this? Has causality been firmly established? The source in the article that cites the 2009 case report does indeed say "cause", but the original case report does stop short of that: "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." and says it may be associated with life-threatening lactic acidosis. One case report saying may be associated sounds like a relatively weak case for establishing causality. More evidence is warranted to state that it can cause fatal reactions (associated with fatal reactions...sure). TylerDurden8823 (talk) 22:16, 9 June 2015 (UTC)

What Tyler said. petrarchan47คุก 23:55, 9 June 2015 (UTC)

I'd not object to "has been suspected of causing" as that is still in line with the source. Alexbrn (talk) 05:22, 10 June 2015 (UTC)

It's a fringe claim unsupported by the blurb in your book. Why would the Mayo Clinic fail to mention death if this were an established fact? We should summarize what the best sources say. No good sources are making this claim, and even the ACS was referring to an old case that was so weak the FDA merely gave a warning about the drink. The sources give a much more nuanced picture of how negative health effects arise, such as contamination during the fermentation process, and we should do the same. I think statements about death should be removed until this has been settled. Right now it's an embarrassment to host this 'information'. We should err on the safe side as Misplaced Pages has a bad reputation for misinformation regarding health content as it is. petrarchan47คุก 07:40, 10 June 2015 (UTC)

Regardless of what is included, please do not try and tie this in with Misplaced Pages's supposed reputation. What some groups may or may not think of some aspects of Misplaced Pages is extremely vague and is a terrible precedent to set for why content should be altered. If anyone is embarrassed by content someone else has put into Misplaced Pages, that's their problem. Grayfell (talk) 07:55, 10 June 2015 (UTC)

On the contrary, why would editors place questionable claims in an article that end up giving skewed information and so give fodder to such groups? The goal should be to have a reputable source of information. If an editor is embarrassed by skewed claims they need to be edited, thats the nature is WP, to improve what others have done. AlbinoFerret 11:37, 10 June 2015 (UTC)

The only people finding this "questionable" are those indulging their own prejudices. Some folks here are in effect arguing for Misplaced Pages to depart from the established pharmacological literature on this subject:

• Jean M. Wible (2005). Potentially dangerous herbal medicines. Lippincott Williams & Wilkins. p. 266. ISBN 978-0-7817-4798-1. Kombucha tea; a general cure-all; can cause acidosis and death {{cite book}}: |work= ignored (help)
• Bronwen Jean Bryant; Kathleen Mary Knights (2011). Pharmacology for Health Professionals. Elsevier Australia. p. 78. ISBN 978-0-7295-3929-6. Kombucha has been associated with illnesses and death. A tea made from Kombucha is said to be a tonic, but several people have been hospitalised and at least one woman died after taking this product.

Alexbrn (talk) 13:16, 10 June 2015 (UTC)

Alexbrn Do not to comment on other editors, its against a few policies that you should be aware of. AlbinoFerret 14:08, 10 June 2015 (UTC)

I'm trying to find what this comment is referring to, but there is nothing here. This is yet another aspersion cast against fellow editors here, insinuating that there is off-wiki communication. The Komucha cabal? It's almost as bad as this one. petrarchan47คุก

CAM (alt-med) haters systematically use exaggerated claims of side effects and death to discredit natural remedies, most of which are not scientifically supported as in this case. Maybe the benefits of kombucha are also exaggerated and scientifically unsupported but it's not our job to promote or debunk it. Our job is to write about the topic in an encyclopedic manner; i.e. neutral, informative, and sourced to RS that are Misplaced Pages:Verifiable but not false. I'm sure that's what we're all trying to accomplish, right? The kombucha review basically confirmed that for centuries there have been no reported issues linked to the consumption of kombucha tea prior to reports from the 90s forward but feel free to correct me if I misstated the dates. So what changed? It appears the fermenting process and the utensils used have had a significant influence. Lead seeping into the mix is a concern but it's not an inherent property of kombucha - it's an inherent property of the ceramic utensils. All it takes is a little common sense, a pinch of IAR, and the MEDRS approved review that was conducted last year confirming the safety of kombucha products for consumers. There are lots of books out there and most reference the same reports and articles covered in the review. The review also includes a relatively brief section on toxicity citing a small number of reports involving a small number of cases that MAY be linked to consumption of the product. We cannot state it as the cause in Wiki voice regardless of the misstatements and erroneous conclusion made by a chemist at a Texas university who cited a report that doesn't support his statement. False statements do not belong in the lead of this article. --Atsme 22:59, 10 June 2015 (UTC)

There are ownership issues, coupled with hostility, and no real, NPOV concern for the article itself. The concern here seems only to make sure the worst claims possible are front and center, and this is evidenced by the recent edit history. The Lede is in violation of WP:LEDE but I've absolutely no faith that my edits to fix this will not be immediately reverted. History of the drink does not require MEDRS sourcing. There is no reason not to mention the story of the article subject in the Lede as any other WP article would do. Editors are required to edit in a neutral manner, and those with a bias against or for the article subject should recuse themselves if that bias is drowning out the most basic WP guidelines. Because of the hostility and ownership issues, this will be my last comment here. petrarchan47คุก 20:18, 10 June 2015 (UTC)

And Atsme, who just did such an excellent job of covering the issue, might just walk away as well. Anything to do with natural healing methods has been taken over by a few biased editors and it is a waste of time to attempt to change the campaign that's been going on for some time now. Too bad for our encyclopedia, but at least for now I have no idea on how to go about changing it... Gandydancer (talk) 01:57, 11 June 2015 (UTC)

A passer-by's view: couldn't agree more with Gandydancer. This sort of bias and ownership is immensely damaging to Misplaced Pages's reputation. Although (apologies, off-topic) having read the entirety of this talk page, from a dispassionate point of view the carnage is rather entertaining. — Preceding unsigned comment added by 87.115.171.174 (talk) 11:46, 11 June 2015 (UTC)

Health benefits

• A Review on Kombucha Tea—Microbiology Composition, Fermentation, Beneficial Effects, Toxicity, and Tea Fungus Rasu Jayabalan, Radomir V. Malbaˇsa, Eva S. Lonˇcar, Jasmina S. Vitas, and Muthuswamy Sathishkumar

pg. 10

Although kombucha tea cannot be granted official health claims at this time, it can be recognized as an important part of a sound diet. Not exactly a traditional beverage, kombucha tea is now regarded as a “health” drink, a source of pharmacologically active molecules, an important member of the antioxidant food group, and a functional food with potential beneficial health properties. Research on kombucha demonstrating its beneficial effects and their mechanisms will most likely continue to increase substantially in the next few years. It is apparent that kombucha tea is a source of a wide range of bioactive components that are digested, absorbed, and metabolized by the body, and exert their effects at the cellular level.

• LWT - Food Science and Technology creds

Kombucha a fermented tea has prophylactic and therapeutic properties.

Antimicrobial activities of kombucha were studied against human pathogens.

Five new Kombucha-like drinks were investigated by fermenting herbal extracts.

New fermented beverages exhibited strong antimicrobial potentials (against Candida).

Fermented Lippia citriodora and Foeniculum vulgare may be very healthful.

Just adding newer reports that have found benefits. Our article cites older references stating that none had been found. I won't add anything as I know I will be reverted, so will just leave it here for you. petrarchan47คุก 07:49, 10 June 2015 (UTC)

The first is already cited here. I don't believe either paper has "found benefits" (in people) but rather suppose beneficial mechanisms may exist based on lab work. Have you actually read Jayabalan et.al.? (I'm finding it hard to get a full copy right now.) Alexbrn (talk) 09:35, 10 June 2015 (UTC)

A supposition that benefits may exist based on promising laboratory studies from several sources certainly warrants inclusion under phrasing such as "preliminary studies suggest ... though these benefits have not been conclusively demonstrated in human trials" or similar. Human trials are always valuable, but the laboratory indications are also important, suitably caveated. This has been repeatedly pointed out above. — Preceding unsigned comment added by 87.115.171.174 (talk) 18:55, 10 June 2015 (UTC)

@87.115.171.174: Yes, and we already say this: "Although laboratory experiments are suggestive of possible health effects, there is no evidence that kombucha consumption benefits human health." Alexbrn (talk) 05:31, 11 June 2015 (UTC)

Not the same thing. Laboratory studies constitute _preliminary_ evidence, not a lack of evidence. — Preceding unsigned comment added by 87.115.171.174 (talk) 11:49, 11 June 2015 (UTC)

The second study doesn't seem to meet WP:MEDRS standards. LWT may be reputable, but the study is a primary source. Misplaced Pages articles generally do not include WP:PRIMARY studies, especially not for medical content, and should never use such material to make generalized health claims, even obliquely. Grayfell (talk) 20:04, 10 June 2015 (UTC)

Greyfell, please explain why you think the second study "doesn't seem to meet" MEDRS standards, and then explain why you think the "death" claims do. Are you saying what was stated in a book written by a chemist at a Texas university is more reliable than a report by 4 MDs, a PharmaD plus a Journal Review which cites that same report? Perhaps I've overlooked something. --Atsme 20:57, 10 June 2015 (UTC)

Secondary sources are sources which analyze or summarize primary sources. They are, in almost all cases, preferable for use on Misplaced Pages. WP:MEDPRI spells it out pretty clearly. Because this is medical content, those secondary sources are also held to higher standards. If the study is important, it should be possible to find it explained in a reliable secondary source. The study itself is perfectly fine as a study. This isn't a comment on the credentials of any scientists, it's about neutrality and due weight, and avoiding WP:SYNTH. I have no idea why Texas would be relevant. Grayfell (talk) 21:19, 10 June 2015 (UTC)

NPOV, V and MEDRS

Agree with your comment from last year, Grayfell That reference needs to be deleted all together and the statements cited to it need to be modified to reflect current sources.  Also, per WP:MEDRS Case reports, whether in the popular press or a peer reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of reliable medical sources.  The only evidence related to illness and death regarding consumption of the tea are case reports published in a peer reviewed medical journal, all of which lack scientific evidence to confirm causality. The book that is cited to the lead statement that links consumption of the tea to death is not cited to a RS and is noncompliant with MEDRS for the following reasons: (1) the claim in the book is misstated, factually incorrect and not supported by the source cited in the book, (2) the cited source is a case report (3) the claim is only one author's opinion and it conflicts with the 2014 Journal review which cites that same case report. Policy dictates extraordinary claims require (multiple) extraordinary sources and all I've seen that link the tea to death cite the same case report which MEDRS considers to be anecdotal and below the minimum requirements. Furthermore, the inclusion of such material in this article demonstrates noncompliance with two core policies, NPOV and V.  I am asking for GF collaboration without the WP:OWN and WP:Battleground behavior we've seen demonstrated by the reverting of GF edits that correct policy noncompliance regarding the unreliable case reports and links to death.  The DS notice is now visible on this TP for all to see.  We all must abide by PAGs and MEDRS when editing this article. Atsme 13:31, 11 June 2015 (UTC) 

I'd forgotten I wrote that. The problem as I see it is that there are two angles this article needs to cover. Kombucha is a beverage which is, at least in places I've been recently, widely available in supermarkets, convenience stores, coffee-shops, etc.. From this perspective, mentioning the rare illnesses and deaths in the lead seems a bit undue, because death and illness can be found associated with virtually every consumable product, and sources are are mostly about outlying cases (right?). However, and this is a huge issue, kombucha is also a characterized by some as a health product. It may have some health benefits, but it's also been misrepresented as a treatment for a number of illnesses without any reliable sources at all. If we're talking about a commercially bottled beverage, then the health risks and benefits should be mostly ignored, because the benefits don't have any sources, and the health risks are effectively minimal (one source facetiously said something like "it probably won't kill you"). When talking about how kombucha is made, and if we're describing this as a health tonic, I don't think it's at all undue to mention the risks and to underscore the lack of scientifically studied benefits. Mentioning the death in the body seems like it may be appropriate to the extent that this is about a fringe medical practice. I would like the lead to say something like "risk of potentially fatal illness". That seems like a concise way to explain that it's a serious issue without overselling it. As I understand it, explaining potential risks and being very cautious about medical claims is the underlying rational for MEDRS. Grayfell (talk) 20:10, 11 June 2015 (UTC)

Thank you, Grayfell - I agree with you. Let's work at getting WP:UNDUE and WP:Balance fixed and the rest will self-correct. I suggest using the Journal review since it is the most reliable source we have at this point in time. There are plenty of mainstream media articles on the subject that pass the RS acid test. Mayo is another good source. I am looking forward to collaborating with you. --Atsme 20:20, 11 June 2015 (UTC)

Claim tied to primary source (case report)

This claim "Other reports of adverse reactions may be related to unsanitary fermentation conditions, leaching of compounds from the fermentation vessels, or "sickly" kombucha cultures that cannot acidify the brew." is tied to a primary source. It is unsuitable for a MEDRS claim. AlbinoFerret 19:54, 14 June 2015 (UTC)

I think part of the statement (about the leaching of compounds) is adequately referenced since it's referring to individual case reports, which is covered by the primary reference. However, the rest of the sentence is unreferenced; I'll see if I can find something that references each part. (updated) Ca2james (talk) 02:54, 15 June 2015 (UTC)

Sure, you will need to find reviews, secondary sources for all of it, including the initial claim. Case reports are the most primary form of sources and should not be used for medical claims. Per WP:MEDRS "in general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom." AlbinoFerret 12:47, 15 June 2015 (UTC)

A lot of poorly-sourced stuff there; I've trimmed (and reversed some NNPOV interim edits). Alexbrn (talk) 12:58, 15 June 2015 (UTC)

Yes, and you keep replacing it. I fixed the problem in the lead and in the body of the article using the updated journal review which is compliant with MEDRS. It replaces the old review that is 13 years old. The extraordinary claims of death and toxicity have been removed as they are antecdotal case reports which are considered below minimum requirements for inclusion per MEDRS, not to mention grossly UNDUE. I highly recommend that you stop the unwarranted reverts and your disruptive behavior. Atsme 13:08, 15 June 2015 (UTC)

What is it you think is "MEDRS" ? Please focus on content. Alexbrn (talk) 13:15, 15 June 2015 (UTC)

Please focus on the type of source used for medical claims. That is the topic of this section. Replace the primary sources or the claims need to be removed. AlbinoFerret 13:19, 15 June 2015 (UTC)

They've gone. Alexbrn (talk) 13:22, 15 June 2015 (UTC)

AlbinoFerret, WP:MEDRS doesn't say that primary sources must not be used; it says that they should not be used. In circumstances where data is limited, primary sources might be the best-available evidence. Therefore, using them isn't problematic according to the spirit of MEDRS, which is to use the highest-quality sources available. That said, the case study in question is quite old and hasn't been cited or its conclusions repeated anywhere so including it is UNDUE. Ca2james (talk) 15:01, 15 June 2015 (UTC)

Yes, and in practice the circumstances where primary sources are acceptable for health information are extremely limited. Alexbrn (talk) 15:05, 15 June 2015 (UTC)

This isnt just a primary source, but one of the lowest quality primary sources, a case report. MEDRS putts it on par with "anecdotes or conventional wisdom" and neither of those is possible to be used for medical claims. That makes the extremely rare use even harder to justify. If a high quality primary source can be found it can be discussed and possibly brought in through consensus. Any primary source should not be added without consensus. AlbinoFerret 15:43, 15 June 2015 (UTC)

Another Primary sourced claim

"Some adverse health effects may be due to the acidity of the tea; brewers have been cautioned to avoid over-fermentation." is sourced to a primary source. It needs to be a secondary source for medical claims, of which "adverse effects" is a medical claim. AlbinoFerret 13:17, 15 June 2015 (UTC)

Isn't the "Food and Drug Administration model" primary? The source is secondary to that. Alexbrn (talk) 13:20, 15 June 2015 (UTC)

No the Food and Drug Administration model is just that, it is a model, that is applied to different foods. The source is primary as it is applying the model to Kombucha and discussing that. The source is avilable at the Freelibary for those who dont have access to the print link AlbinoFerret 13:25, 15 June 2015 (UTC)

Might just want to say "To avoid excessive acidity ..." then (and move it out if the Health section)? Alexbrn (talk) 14:21, 15 June 2015 (UTC)

That sounds like a reasonable course of action. AlbinoFerret 15:46, 15 June 2015 (UTC)

CRD Summary of unsupported claims in Ernst review

I have repeatedly asked editors to stop including the poorly sourced, noncompliant extraordinary claims of toxicity and death linked to kombucha products because they are scientifically unsupported claims, and the sources used do not even meet the minimum requirements of MEDRS.  I have added DS alerts to the TPs of those editors who have not been alerted previously. I added the DS alert notice at the top of this article's TP. I have posted friendly notices on TP of those editors who have been edit warring and asked them to please stop the disruption. I have provided below the information that clearly demonstrates why the Ernst systematic review does not meet even the minimum requirements of MEDRS for inclusion of the scientifically unsupported claims of death and toxicity in this article. Reverting in order to include such claims is disruptive and noncompliant with PAGs including WP:MEDRS, UNDUE, NPOV, V but not false, and simply do not belong in this article.

See Results of 2003 Ernst review and CRD commentary. I have included them below for your convenience.

Results of the review

Three case series and two case reports of adverse events were included in the review. These included 28 patients in total.

No studies were found relating to the efficacy of Kombucha.

The reporting of the individual cases was poor, making it difficult to ascertain if Kombucha was the cause of the adverse events reported. The adverse events included suspected liver damage and metabolic acidosis from Kombucha drunk as a tea. One case series described cutaneous anthrax infection through topical application of the tea, although the Kombucha could have been contaminated due to storage in extremely unhygienic conditions.

CRD commentary

The inclusion criteria for this review were necessarily broad to allow for a full analysis of the efficacy and safety of this remedy. A wide range of information sources were searched, making it less likely that studies were missed. It was not possible to assess the validity of the evidence, nor was pooling possible due to a lack of efficacy data. Reports of adverse events were described and comments were made on the likely cause-effect relationship. It was unclear whether the review involved more than one reviewer in the study selection and data extraction processes, which could serve to minimise bias. Although the author appropriately cautions the use of an unproven remedy with potential side-effects, it is important to note that not all of the adverse events may be attributable to the remedy itself.

Please respect our PAGs. Atsme 00:51, 16 June 2015 (UTC)

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