Home Blogs Dr Karl: Need to Know Drunk from the inside: Dr Karl explains rare auto-brewery syndrome

Drunk from the inside: Dr Karl explains rare auto-brewery syndrome

Contributor

Dr Karl Kruszelnicki

Contributor

Dr Karl Kruszelnicki

Dr Karl is a prolific broadcaster, author and Julius Sumner Miller fellow in the School of Physics at the University of Sydney. His latest book, Vital Science is published by Pan MacMillan. Follow him on Twitter at @DoctorKarl

This man might be suffering from auto-brewery syndrome – a condition that converts carbohydrates into alcohol – but is more likely to be the victim of a boozy stint in town. Image credit: Alamy

Fairly accurately, it’s called auto-brewery syndrome. There are only a few dozen cases worldwide. The media love it because it’s so weird. Lawyers love it too – invoking this syndrome may get their clients off drink-driving charges. 

But how does it work? Normally, your body converts carbohydrates into CO₂, water and lots of energy. But the fungus Saccharomyces cerevisiae does something very different: it turns carbohydrates into CO₂, alcohol and other stuff. We have used this fungus to brew beer for at least 7000 years. 

The auto-brewery syndrome occurs when this fungus (or a few other fungi and bacteria) multiplies to huge numbers and takes over the normal microbiome, or flora, in the gut.

Your normal flora are some 40 trillion cells (mostly bacteria) that invaded you shortly after birth. They are much smaller than your regular cells – around 37 trillion cells that came from your parents. You need these several hundred grams of healthy bacteria, and the like. Without them, you would eat twice as much, be about two-thirds of your current weight and be sickly. 

Related: Dr Karl explains the ‘Wobbling Scale’ of animal drunkenness

One case of auto-brewery syndrome developed in a 44-year-old male after a rather nasty infection, which was successfully treated with the antibiotics clavulanic acid and amoxicillin. 

The antibiotics did their job, but unfortunately killed much of his “regular” healthy microbiome, allowing his gut to be taken over by Saccharomyces cerevisiae and Candida albicans. Suddenly he had astronomically high blood-alcohol levels, without drinking any alcohol at all. 

Besides antibiotics, these fungi (and bacteria) can rise to abnormal levels as a result of poor nutrition or an unbalanced diet; metabolic or medical conditions such as Crohn’s disease or diabetes; genetic variations; liver enzymes not working correctly; short bowel syndrome – which occasionally results from part of the small intestine being surgically removed – and other causes. Auto-brewery syndrome can sometimes be treated with a change in diet, different antibiotics and antifungal drugs. 

So apparently it’s possible to get drunk from the inside.

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