How the man who did not drink a drop always got drunk

A man arrested for driving under the influence of alcohol in the US state of North Carolina turned out to have no less than 0.2 percent blood alcohol: 2.5 times more than the permitted amount and the equivalent of ten drinks per hour. The man denied drinking, but nobody wanted to believe him. Until researchers in New York discovered that his intoxication had a different cause.

The 46-year-old man refused to take a breath test and was therefore taken to the hospital. A blood test showed that he had a high percentage of alcohol in his blood, but the man continued to deny. Researchers at the Richmond University Medical Center in New York eventually discovered that he was telling the truth: bacteria in his digestive system turned out to convert the carbohydrates from his diet into alcohol.

The researchers’ findings were explained in the scientific journal BMJ Open Gastroenterology. The man, whose identity was not disclosed, was a rare medical condition with ‘self-brew syndrome’.

“These patients have the same implications as alcoholism: the smell, the breath, the sleepiness, they walk differently,” says Fahad Malik, lead author of the study. “They come across as someone who is under the influence of alcohol, but the only difference here is that these patients can be treated with antifungal medication.”

The condition was caused by a course of antibiotics, which the man took after he injured his thumb. His personality began to change; he went through depressive periods, had cognitive problems, memory loss and displayed aggressive behavior that did not suit him. “He could not function, and that was mainly after the meal,” said Malik. Nobody wanted to believe he was not under the influence. The man was even treated by a psychiatrist who prescribed antidepressants and anti-anxiety drugs.


Three years later, after he was arrested for drink-driving, the man’s aunt bought a breath test to measure his alcohol level. She had heard of a similar case that had been successfully treated by a physician in Ohio and convinced him to be examined at the same center.

Doctors discovered two types of yeast in his bowel movements, including saccharomyces cerevisiae, a yeast often used in brewing beer, making wine, and baking.

The man was instructed to adhere to a carbohydrate-free diet in combination with supplements. Initially, his symptoms disappeared, but after a few weeks, they resurrected.

At one point, the man was so much under the influence that he fell and contracted a brain hemorrhage. Even in the hospital, where he stayed ten days to recover, the medical staff did not believe that he had not drunk alcohol, even though he persistently denied it.

Online self-help group

Eventually, the man came in contact with the researchers at the Richmond University Medical Center through an online self-help group. They are convinced that the antibiotics that the man had taken have altered his intestinal flora, causing fungi to grow in his digestive system.

The scientists treated the man with antifungal agents and probiotics to normalize his gut flora. He has since recovered. “About 1.5 years later, he still shows no symptoms and has resumed his original lifestyle, including eating a normal diet, while sporadically taking a breath test to test his alcohol level,” the authors write in the study.

To date, only a handful of studies have been devoted to the self-brew syndrome, says Malik. Possibly the condition is much more common than expected.

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