The cells of our bodies number about 10 trillion. The bacteria living on the inside and outside of us are about ten times that number, and this collection of cells is called the microbiome. It’s pretty amazing that there are so many more cells on us, than are in us! You might say we are outnumbered. So, we may have to be more aware of the health of the microbiome. Science suggests that things which hurt the microbiome, may also be unhealthy for us humans, like GMO foods, pesticides, and over usage of antibiotics in the commercial farming industry, all hot topics today. It makes sense intuitively. The friendly, beneficial bacteria and yeasts (and a few of the bad ones) thrive along with us, in the gut, including the small and large intestines, and inside of our mucous membranes, lining the mouth and airways, and all over us.

Scientists, and practitioners are becoming more aware of the importance of the balance between these different bacteria and yeasts. For years, the potentially harmful role of chemicals and antibiotics on this ecosystem has been downplayed or just not really recognized as significant. After all, infection is usually bad, and antibiotics are good, right? One backlash of this is the emergence of superbugs, those bacteria which are resistant to many known antibiotics. Another example of this is the use of bactericidal hand sanitizers. While “clean” is important, we depend on some of these good bacteria. There is now emerging evidence that there is a “too clean”, and that is called the hygiene hypothesis.

So, we need these beneficial bacteria and yeast to live in balance. The beneficial bacteria go by names like lactobacillus, and acidophilus, bifidus, or “probiotics”. It’s pretty much the opposite of “antibiotics”, which kill both good and bad bacteria, and can result in the overgrowth of yeast like candida. Once the numbers of bacteria are knocked down, the candida has a chance to take over with all the extra space and resources available. This can lead to a clinical syndrome. And if you keep feeding your yeast, they will grow and demand more and more sugar (sugar cravings). Anyone who has ever experienced a yeast infection after taking an antibiotic knows about that. Even if “probiotics” does not sound familiar to you, you have heard of them before, as the active ingredients of live cultured foods like yogurt, which is the most common example. They are the good bacteria that make things taste sour, like sourdough bread, sour pickles, sauerkraut, and kimchee (a Korean version of a cabbage ferment with red hot pepper and some ginger). It’s that lactic acid, a byproduct of the fermentation, which lowers the pH and makes the fermented product acidic, and the acid retards the growth of mold that would cause the food to spoil, essentially making it tasty and preserving it.

There are some very interesting stories of examples of how important these bacteria are at influencing the immune system. You may have even heard of fecal or stool transplant being done in severe cases of toxic diarrhea called clostridium difficile, where there seemed to be no hope of a cure, and the patient was in dire straits until this was tried producing almost immediate relief in some cases (please don’t try this at home, kids). There have even been studies done on mice and lab animals which show that normal mice become fat when they receive the bacteria from fat mice, and vice versa. So there is a possible role for the healthy bacteria in weight loss. There are many more scientific experiments to show these complex relationships involving the balance of bacteria in the body may exist, and therefore more research is afoot in this exciting area.

In the body, bacteria provide important functions as well. They are important in the digestive process, containing enzymes, aiding in the production of B vitamins within the intestines, and keeping overgrowth of candida albicans yeast at bay.

For centuries, people all over the world have used cultures of bacteria and yeast to produce foods with a special taste, and to provide extra health benefits in their favorite foods. Think of tea, coffee, chocolate, beer, wine, and cheeses, pickles, miso, tempeh, among others. There are many examples of traditional foods, which use the fermentation process. As the health benefits of some of these foods are being rediscovered by health enthusiasts, some of the more common ones like kombucha, kefir (a fermented dairy beverage), or water kefir, are becoming more popular in home kitchens across the country.

So, the way I like to learn about these things is by doing what my kids always tell me to do when I am struggling with technology (like trying to build a website). “Google it, Mom”. Yes, when you Google raw sauerkraut, and fermented foods, you are likely to come up with several recipes that seem very similar with a few tweaks, so you get the general idea. Like any good cook, you can read over a few recipes, and then with the general idea in mind, make it your own. (BTW, have you ever visited the YouTube show, “Munchies”? You will feel like you have taken a tour of the world, right from your laptop.)

I did find some very interesting videos on YouTube, and I watched the slicing and dicing of many buckets of cabbage (in Australia and lots of other places), making the brine, and then using anything from a mason jar, to a ceramic crock, to a 5 gallon food grade plastic bucket. Since we are doing this for health, I definitely recommend sticking with glass or lead free, mercury free ceramic. Since I don’t know the source of a lot of ceramics, I don’t trust it to be free of heavy metal. For my home fermented Kombucha, I have used a couple different glass containers, but the one which worked best for me is a two gallon heavy glass container that you can find at your local department store. If you make a larger quantity than a two-gallon bucket, then I would find a high quality food grade plastic, BPA free, with the recycling number of 1 or 2 only. You could repurpose an unused yogurt maker container, when you are not using it. It might change the flavor of the yogurt next time, if you have plans to use it again, so maybe not.

According to various sources, like “The Nourished Kitchen, farm to table recipes for the traditional foods lifestyle”, by Jennifer McGruther, you would use 5 pounds of fresh cabbage to 2 tablespoons of kosher or coarsely ground salt (not table salt, and I would not use chemically iodized salt, but rather sea salt). According to her description, the cabbage should be finely chopped and immediately massaged with salt to bring out the juice, which forms a brine (salt solution). If the cabbage dries, you will not have good brine, and that will not produce a good product. Then the chopped and salted cabbage is pressed down into a glass jar or crock until the juice rises to above the level of the cabbage. If too dry a little spring water can be added. A sterilized rock or glass weight (how about a brick, after baking in the oven to sterilize, put inside a plastic bag, placed on top of a glass plate) is used to press the cabbage down so that it stays submerged during fermentation. This means that there is an airtight water seal over the cabbage itself so that the surface of the cabbage will not become moldy during fermentation. The whole thing is then sealed tightly, where it may be left for up to 3 months, or until it reaches the desired level of sourness, to your taste. The minimum expected time is that it would need to ferment for about six weeks, depending on who you read. Again, this is to your taste.

Why go to these lengths to ferment raw cabbage? It’s a good starter vegetable, it’s cheap. If the whole thing goes bad a time or two, you haven’t lost too much. It is a great source of probiotics, and when taken daily or weekly, they will replenish the beneficial bacteria in your gut. This translates to a whole host of possible health benefits. This also means you can have a simple, inexpensive means of producing a healthful food. Another alternative is to buy your probiotics from the store in encapsulated form. It can get expensive. I have seen one YouTube demonstration of using the encapsulated probiotic as a starter, right in the cabbage. Just unscrew the capsule and put it right it. This may be beneficial since your commercially grown vegetables may have been subjected to herbicides and or pesticides, and therefore be deficient in the natural strains of bacteria and yeast that would normally be present. That’s another good reason to consider having a garden in the cooler months and growing your own, or buy organic if at all possible.

Other great sources of information about other fermented and cultured foods are available from many other health bloggers and enthusiasts, if you want to learn broadly and try some of their ideas. Like anything, you try, and perfect your techniques, just like baking bread.

In my kitchen, we have a sun porch with windows on two sides, which has been converted into a laundry room. I think the previous owners may have used it as a mud room and gardening center. Anyway, now that the weather is hot, it is the perfect place for me to make Kombucha. I learned the method my watching a digestive health course online, The Digestion Sessions, which is an online course launched in the winter of 2014. After deciding to try this out for myself, I have worked at it for about 6 months now, perfecting my method.

There is a lot to learn about the history of Kombucha and the potential health benefits which I will not go into here. I start with a batch of black tea. You can use four tea bags to three quarts. I have made batches with four green and four black tea, for a stronger brew. I am now using Lipton loose tea. I use four tablespoons for three quarts. To this you would add one cup of sugar. I brew the tea in one quart of boiling water until strong, in a mason jar. Then allow it to cool. Strain it. Stir in the sugar. Avoid use of plastic or wooden utensils. I make a double batch (six quarts) at one time, since I am using a two-gallon glass jar to ferment my Kombucha. Only after allowing the tea to cool, you add this mixture to your SCOBY (symbiotic culture of bacteria and yeast). I first purchased a SCOBY online on Amazon, and I also was able to produce one by growing one from a bottle of GT Dave’s “Original” Kombucha, by letting it grow in a mason jar for a couple of weeks. You have to be patient.

Again, after a lot of trial and error, and especially when the weather turned warmer, my Kombucha really began to turn out very successfully. I always save about 1/5 of the batch as a starter for the next batch to make sure there is enough yeast and finished Kombucha so that it is acidic enough, and my batch will not fail and grow mold. So far, I keep everything clean and this has not happened. The hardest thing for me, is to try to keep my hands out of it, until it is really ready. I emulated the taste of GT’s because my favorite is ginger blueberry. Yum.

I keep the Kombucha brew in the warmth of the laundry room, and I cover it with a clean hand towel, secured with a big rubber band, and then cover the whole thing with a piece of sheeting from an old clean sheet. I kept growing the SCOBY until it was bigger that the tea, so I finally had to peel the layers apart to leave just enough to grow the next batch. After a while, you have more than enough SCOBY to share with your friends. Some people might add to their compost, or feed to the birds. My dogs would not eat it, even though they need probiotics, too. I tried to cut it up, thinking they would chew on it.

Is Kombucha healthy? If you do a little research, there are many health claims. I would say that depends. If you have hypersensitivity to one of the ingredients, it may not be healthy for you. The taste is very addictive, but it is definitely an acquired taste. I tried it before on a trip to Earthfare, but I have to say that initially the vinegary taste is one that you sip, and sip, and eventually it grows on you. Now I enjoy it just about every day because I always have some in supply. I myself have wondered if it may be too much of a good thing. For me, this happened when I started making yogurt at home and I realized that I have an inflammatory issue with dairy, so I decided to try something cultured which did not involve dairy. I was also hoping to use this as a substitute that could help me wean off the coffee.

I do have Kefir grains in the refrigerator, and although I do not really use it that much, I was hoping to use it for my dogs, one of which has IBS symptoms. Another fermented beverage that I would like to try is water kefir. Variety is nice. Biodiversity is healthy for the gut.

What is also nice about the Kombucha is when you get it just right, it has its own natural carbonation. I let it ferment the first time until it is more sour than sweet. I use a measuring cup, and scoop out a small amount in a glass. I keep tasting it, trying to decide if it is still sweet. If so, it has to go back for another couple of days. Once it is the desired sourness, and therefore you have enough of a culture going, you bottle it in some recycled GT bottles or the flip top kind of bottle like the ones used for Grolsh beer (I don’t use these, but some do like them). Add some chopped or pureed fruit, herbs, fruit juice, and a slice of ginger, and bottle these for about five days. Burp the bottles after a day or so, to see if there is pressure building up. I have heard that bottles can explode, so you may want to store the bottles in a box or empty cooler, until you have more experience with it, just in case one explodes. When the bottle opens with a pop like champagne, then it is ready. For me this takes anywhere from one to five days depending on the weather. You have to watch it. When they are ready, you chill them in the refrigerator. This stops the fermentation. When you open it, you have a nice fizzy beverage with a foamy head on it. The brew may contain a very small amount of alcohol, but it is about the same amount found in a glass of orange juice, less the 0.5%.

So here is my recipe from top to bottom as described above.

For each 3 quart batch of sweet tea,

4 tablespoons of Lipton loose tea, OR eight tea bags, black, OR a combination of black and green tea. Keep it simple in the beginning.

One cup of sugar for every batch of 3 quarts, I would use organic evaporated cane sugar.

One SCOBY (you can use a home grown one from GT’s Kombucha, but grow it ahead of time). I have a ton to share, a literal ton.

1 ½ cups (at least) of starter finished tea (for me, 1/5 of the previous batch left in the bottom of the container).

So that you do not kill your starter, the tea must be cool. No warmer than a baby’s bottle on your wrist.

You must also rinse your vessels to remove any traces of chemical or antibacterial soap. This can kill the bacteria, and cause your ferment to fail. You must also use good clean technique, think home canning. Good hand washing, and consider rinsing your bottles out with dilute vinegar solution.

Cover your sweet tea, SCOBY is shiny side up, and put in a warm place for 2-4 weeks depending on your weather conditions. In the warmer weather you might be ready in a week. Be patient. The SCOBY might sink at first, but it doesn’t matter, it is an aerobic culture you are growing. Check after 7 days, and do your taste test. If it is still sweet on your tongue, it is not done, and will not be yeasty enough to get fizzy. You can drink it flat and sweet if that is what you like. I prefer all the sugar to be reduced by the fermentation and that means it is higher in cultures and lower in sugar. At this point you are getting ready for the second ferment, but you can drink it as is.

After your batch is ready to bottle, I add one quarter cup of Welch’s grape juice or Full Circle organic grape juice to a pint bottle, 16 ounces. I like the grape – black cherry mixture as well. Yes, it is sweet, but the sugar in the juice fuels your second ferment, which gives you fizz. I like to grate ginger, and put it right into the bottle. Then, I top it off with my Kombucha, up to the top. The second ferment is anaerobic, so you want to cap them tightly. I strain my tea with a fine mesh strainer held over a funnel, and this goes into the bottle. The straining is optional. I also strain my finished Kombucha so that you remove the new lumpy bit of SCOBY that will form on top in your bottle during the second ferment. As noted above, the time it takes for the second ferment varies.

(To be clear, after the second ferment) I chill these very well and it is a very refreshing fizzy, naturally carbonated drink. Sometimes I carry one to work with me, and sometimes I save it for the end of the day.

I hope that you have enjoyed my post, and I will take some pictures to illustrate my home culturing to share with you (one is on the website). Once you have the idea about fermented foods, the possibilities are endless, and you can get good results with many other cultured foods including vegetables, yogurt, and these are very healthy for you, as long as you do not have a hypersensitivity to the ingredients, like yeast or dairy.

Like anything, when you are modifying your diet with cultured foods, do feedback, to see if you are having any adverse effects. If you eliminate the food for several weeks and introducing it back makes a symptom reoccur, like the hives or feeling bad in some other way, you may have a hypersensivity to that food or product, and should consider removing it permanently or reserving it as a treat (cheat). This is where getting professional, one on one help may be useful, as testing for food sensitivities can be done, as well as using the food elimination method with feedback.

Due to these topics becoming very popular, and with the fact that the microbiome is receiving more attention from the scientific community, there are a wealth of authors and bloggers, nutritionists and health coaches with a lot of recipe ideas for you to try. If you have a recipe to share, please hop on over to the Facebook page share it with us.

Disclaimer: The above information is given for educational purposes only, and cannot substitute for the advice of your own health professional who is familiar with your unique medical condition. Please seek the care of a qualified health professional.

For more information on my practice at the Wellness Boutique, or to subscribe to my email list, please use the email contact box.

Wellness Boutique is my OB/GYN practice and has been in downtown Hartsville since 2012. We are located around the corner from the Center Theater on North Fifth Street and West College Avenue. If you know where the Black Creek Arts Council is, and SPC Credit Union, we are across the street. I have been a practicing OB/GYN in Hartsville, on staff at Carolina Pines Regional Medical Center since 2001. I have been in private practice since 1999. In 2000, I was featured on The Discovery Channel, A Birthday Story, in the episode called “Sickle Cell”, which was filmed at Crawford Long Hospital of Emory University, in Atlanta, Georgia where my four children were born.

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