Auto brewery syndrome is also known as gut fermentation syndrome and endogenous ethanol fermentation. It’s sometimes called “drunkenness disease.” This rare condition makes you intoxicated — drunk — without drinking alcohol.

This happens when your body turns sugary and starchy foods (carbohydrates) into alcohol. Auto brewery syndrome can be difficult to diagnose. It may also be mistaken for other conditions.

Only a few cases of auto brewery syndrome have been reported in the last several decades. However, this medical condition has been mentioned in the news several times. Most of these stories involve people who were arrested for drinking and driving.

For example, one woman was found to have the condition after she was arrested for drunk driving in New York. Her blood alcohol level was four times the legal limit. She wasn’t charged because medical tests showed that auto brewery syndrome raised her blood alcohol levels.

It’s the type of story that the media loves, but it’s not likely to repeat itself very often. Nevertheless, this is a very real condition. It’s important to be diagnosed if you feel you may have it. Let’s take a closer look.

Auto brewery syndrome can make you:

  • drunk without drinking any alcohol
  • very drunk after only drinking a small amount of alcohol (such as two beers)

Symptoms and side effects are similar to when you are slightly drunk or when you have a hangover from drinking too much:

  • red or flushed skin
  • dizziness
  • disorientation
  • headache pain
  • nausea and vomiting
  • dehydration
  • dry mouth
  • burping or belching
  • fatigue
  • memory and concentration problems
  • mood changes

Auto brewery syndrome can also lead to or worsen other health conditions such as:

In auto brewery syndrome, your body makes — “brews” — alcohol (ethanol) out of the carbohydrates you eat. This happens inside the gut or intestines. It may be caused by too much yeast in the gut. Yeast is a type of fungus.

Some kinds of yeast that might cause auto brewery syndrome are:

  • Candida albicans
  • Candida glabrata
  • Torulopsis glabrata
  • Candida krusei
  • Candida kefyr
  • Saccharomyces cerevisiae (brewer’s yeast)

Who can get it?

Adults and children can have auto brewery syndrome. Signs and symptoms are similar in both. Auto brewery syndrome is usually a complication of another disease, imbalance, or infection in the body.

You can’t be born with this rare syndrome. However, you may be born with or get another condition that triggers auto brewery syndrome. For example, in adults, too much yeast in the gut may be caused by Crohn’s disease. This can set off auto brewery syndrome.

In some people liver problems may cause auto brewery syndrome. In these cases, the liver isn’t able to clear out alcohol fast enough. Even a small amount of alcohol made by gut yeast leads to symptoms.

Toddlers and children with a condition called short bowel syndrome have a higher chance of getting auto brewery syndrome. A medical case reported that a 3-year-old girl with short bowel syndrome would get “drunk” after drinking fruit juice, which is naturally high in carbohydrates.

Other reasons you may have too much yeast in your body include:

  • poor nutrition
  • antibiotics
  • inflammatory bowel disease
  • diabetes
  • low immune system

There are no specific tests to diagnose auto brewery syndrome. This condition is still newly discovered and more research is needed. Symptoms alone are typically not enough for a diagnosis.

Your doctor will likely do a stool test to find out if you have too much yeast in your gut. This involves sending a tiny sample of a bowel movement to a lab to be tested. Another test that might be used by some doctors is the glucose challenge.

In the glucose challenge test, you’ll be given a glucose (sugar) capsule. You won’t be allowed to eat or drink anything else for a few hours before and after the test. After about an hour, your doctor will check your blood alcohol level. If you don’t have auto brewery syndrome your blood alcohol level will be zero. If you have auto brewery disease your blood alcohol level may range from 1.0 to 7.0 milligrams per deciliter.

If you suspect you have this auto brewery syndrome, you might try a similar test at home, though you shouldn’t use it to self-diagnose. Eat something sugary, like a cookie, on an empty stomach. After an hour use an at-home breathalyzer to see if your blood alcohol level has risen. Write down any symptoms.

This home test may not work because you may not have noticeable symptoms. At-home breathalyzers may also not be as accurate as the ones used by doctors and law enforcement. Regardless of what you observe, see a doctor for a diagnosis.

Auto brewery syndrome can be treated. Your doctor may recommend reducing carbohydrates in your diet. Treating an underlying condition like Crohn’s disease may help balance fungus in your gut.

Your doctor may prescribe antifungal medications. These drugs work to get rid of fungus infections that may be causing the problem in your gut. You might have to take the medications for three weeks or longer.

Antifungal drugs and other medications to help treat auto brewery syndrome include:

  • fluconazole
  • nystatin
  • oral antifungal chemotherapy
  • acidophilus tablets

You’ll need to make nutritional changes to help treat auto brewery syndrome. While you’re taking antifungal medications, follow a strict diet:

  • no sugar
  • no carbohydrates
  • no alcohol

Change your daily diet to help prevent auto brewery syndrome. A low-carbohydrate diet may help to balance fungus in your gut.

Avoid sugary foods and simple carbs like:

  • corn syrup
  • high fructose corn syrup
  • white bread and pasta
  • white rice
  • white flour
  • potato chips
  • crackers
  • sugary drinks
  • fruit juices

Also avoid table sugar and added sugars to foods:

  • glucose
  • fructose
  • dextrose
  • maltose
  • levulose

Eat plenty of complex carbohydrates that are higher in fiber:

  • whole grain bread and pastas
  • brown rice
  • fresh and cooked vegetables
  • fresh, frozen, and dried fruit
  • fresh and dried herbs
  • oats
  • barley
  • bran
  • lentils
  • quinoa
  • couscous

Although it isn’t common, auto brewery syndrome is a serious disease and can impact your life. In some cases, people with auto brewery syndrome are falsely suspected of being “closet” drinkers. Like any illness, your symptoms might differ from someone else with auto brewery syndrome.

While it’s been used as a defense against drunk driving a handful of times, auto brewery syndrome doesn’t commonly spike your blood alcohol level over the legal limit. You may feel slightly drunk while someone else may feel like they have a hangover.

If you think you have this condition, write down any symptoms you experience. Record what you ate and what time you had signs of auto brewery syndrome. Tell your doctor immediately. Ask them to check your gut yeast levels and give you other medical tests to find out what’s causing your symptoms.

Feeling “buzzed” or drunk without drinking may not sound like an important health concern. However, it can affect your well-being, safety, relationships, and job. Seek medical help urgently. Auto brewery syndrome may also be a sign of an underlying condition that is out of control.

If you’ve been diagnosed with auto brewery syndrome, ask your doctor or nutritionist about the best diet plan for you. You will need follow-up appointments to check yeast levels, even if you’ve been treated and no longer have symptoms.