There is a lack of scientific evidence to support the many health claims of kombucha. While some studies suggest that kombucha does possess antimicrobial, antioxidant, free radical scavenging and detoxification effects, the studies have largely been in vitro or in vivo in animal models. Consumption has led to adverse effects and death in vulnerable individuals, and should be avoided in those who are at risk of metabolic acidosis, or are sick or immunocompromised. Use should be discouraged in pregnancy and lactation. Kombucha should not be taken with disulfiram due to its alcohol content.