Wait, it's possible to get drunk without drinking alcohol?

As crazy as it sounds, you can get drunk even not having consumed an alcoholic beverage. This phenomenon is called auto-brewery syndrome. It results from an overgrowth of yeast in the stomach that can cause dizziness, slurred speech, red or flushed skin, nausea or vomiting, fatigue, memory problems or loss of, dehydration, and mood changes; basically all the symptoms of a very intoxicated person.

Strawberry margarita, photo taken at Rocking Horse Cafe in 2018

First, what is yeast?

It is a fungus that can be used to make bread or beer. One called Candida resides in humans, whether it be the stomach, intestines, skin, mouth, or vagina. A little bit of yeast is good for the human body. It helps absorb vitamins and minerals, while also fighting off disease. However, too much is harmful which can lead to a yeast infection, usually characterized by bad breath, rashes, mouth sores, coating on the tongue, and diarrhea.

What is fermentation?

Fermentation, also known as anaerobic respiration, is a body's way of making ATP (energy) by breaking down glucose (sugar) without the use of oxygen. There are two types of fermentation: lactic acid and alcoholic. In this case, alcoholic fermentation occurs. 

In glycolysis, a metabolic pathway that breaks down glucose, some ATP (energy) is used to convert one glucose molecule into two pyruvate. The two pyruvate are then turned into two ethanol molecules. Yeast and bacteria can carry out this fermentation in bread, wine, and biofuels, as well as in your gut.

Challah bread, baked by me in 2020

So what causes this syndrome? 

It starts with the consumption of carbohydrates. When someone with this condition consumes sugary or starchy food, a yeast in their intestines ferments it and turns it into alcohol. Yeast such as Candida albicans, Candida glabrata, Torulopsis glabrata, Candida krusei, Candida kefyr, Saccharomyces cerevisiae can cause auto-brewery syndrome.

While the syndrome is not reported frequently, though some think that it is under-diagnosed, cases like these illustrate the dangers of this relatively unknown yet potent syndrome. In 2019, The Washington Post reported a 46-year-old man who was exhibiting the symptoms of a drunk person, yet he kept swearing to have never drunk a drop of alcohol recently. He was arrested for drunk driving. Similarly, in a 2014 case, a truck driver blamed auto-brewery syndrome when he spilled 11,000 salmon on the highway, and a 2015 case of a New York woman who was driving with blood alcohol levels more than four times the limit. Ohioan Nick Hess, who has the syndrome, described it as being in a constant state of either hungover or intoxicated. His condition caused him to drop out of college and he experiences the symptoms every day. The syndrome gets very serious when it causes blood alcohol levels to become dangerously high to the point where the person is at risk of alcohol poisoning or losing balance.

People who have short bowel syndrome, diabetes, small intestinal bacterial overgrowth (SIBO), Crohn's disease, low nutrition, and liver problems are more susceptible to yeast overgrowth. Both adults and children can get it and depending on a person's health and condition, taking antibiotics, drugs, and cutting back on carbohydrates can help lessen the symptoms.

Whether you have the syndrome or not, it's important to maintain a balanced diet. Carbohydrates are not something to avoid, they come in healthy and unhealthy food alike. Complex carbs, found in vegetables, legumes, and whole grains, contain fiber which takes a longer time to digest, therefore sugar and insulin levels remain mostly stagnant. Simple carbs, which are easy-to-digest sugars, are found naturally in fruits and dairy, but also processed baked goods, sweets, and sodas. These carbs are easily absorbed by the gut and can increase blood sugar levels. Goods with refined sugar typically lack nutrients otherwise found in foods naturally containing sugar.  Those products should be eaten less though every once in a while is perfectly fine!

Here are some of my favorite healthy carbs:

Vegetable stew, photo taken at Rocking Horse Cafe in January 2018

Roasted Cauliflower, photo taken in December 2017

Here are some of my favorite unhealthy carbs:

Dumplings, made by me in August 2020

Quesadillas, photo taken at Rocking Horse Cafe in April 2018

Mexican Wedding Cookies, photo taken at Rocking Horse Cafe in June 2018

So, if you by any chance experience extreme intoxication and have no recollection of consuming alcohol, you may just have a case of auto-brewery syndrome. Either that or you're in denial . . .