Mason Delacroix
Feeling drunk without drinking alcohol can be a sign of a serious underlying medical condition. Auto-brewery syndrome (ABS), also known as gut fermentation, is a rare condition where yeast grows in parts of the digestive tract and ferments alcohol from carbohydrate-heavy meals, causing drunkenness without alcohol consumption. Other causes of feeling drunk without drinking include middle and inner ear problems, dehydration, sleep deprivation, and stress. Experiencing these symptoms can be distressing and confusing, leading to feelings of helplessness and depression. It is important to seek medical attention to rule out dangerous causes and receive proper diagnosis and treatment.
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What You'll Learn
Auto-brewery syndrome (ABS)
The ethanol generated from these pathways is absorbed into the small intestine, causing an increase in blood alcohol concentrations that produce the effects of intoxication without the ingestion of alcohol. Symptoms that usually accompany ABS include elevated blood alcohol levels as well as symptoms consistent with alcohol intoxication, such as slurred speech, stumbling, loss of motor functions, dizziness, and belching. Mood changes and other neurological problems have also been reported.
ABS is believed to be caused by a variety of factors, including prolonged antibiotic use, poor nutrition, diets high in carbohydrates, and pre-existing conditions such as diabetes and genetic variations that result in improper liver enzyme activity. The condition can be diagnosed through serum measurement methods, where patients fast to establish baseline blood alcohol and blood glucose levels, followed by the administration of a dose of IG glucose to monitor any increase in blood alcohol and blood sugar.
Treatment for ABS typically involves addressing the immediate symptoms of alcohol intoxication, followed by the use of medications such as antifungals and probiotics to eliminate the fungi or bacteria causing gut fermentation and restore a healthy gut microbiome. Patients are also advised to maintain a low-carbohydrate diet, avoid dietary antibiotics, and abstain from alcohol consumption to prevent relapse.
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Dehydration, sleep deprivation, stress, and hormonal changes
Dehydration can occur when you lose more fluids than you take in. This can happen on a hot day if you sweat a lot, or if you are sick with a fever, diarrhoea, or vomiting. It can also occur if you do not drink enough water or if you are taking a medication that increases your urine output. Dehydration may cause dizziness, confusion, altered mental state, slurred speech, and lethargy. It can also impact your mental health by causing hormonal imbalances, impairing cognitive functioning, and robbing you of sleep. Specifically, dehydration can cause an increase in the stress hormone cortisol, and a decline in happy hormone production, such as serotonin, dopamine, and oxytocin.
Sleep deprivation can cause dehydration by disrupting the release of the hormone vasopressin, which regulates the body's water balance. Sleep-deprived people should drink more water, as insufficient sleep impairs attention and judgment, and prolonged sleep deprivation raises the risk of type 2 diabetes, high blood pressure, obesity, and respiratory disease.
Stress can also contribute to dehydration, as the body can lose fluids through sweating when under stress. Additionally, hormonal changes can impact hydration levels. For example, an increase in cortisol, a stress hormone, can lead to increased water loss through urination.
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Inner ear disorders
There are several inner ear disorders that can cause a person to feel dizzy or unbalanced, similar to the feeling of being drunk. Vertigo, for example, is a sensation of dizziness and spinning that can be caused by various inner ear conditions and inflammation. Benign paroxysmal positional vertigo (BPPV) occurs when sudden head movements result in a spinning sensation. Labyrinthitis, an inflammation of the inner ear, can cause dizziness, imbalance, and hearing loss. Vestibular neuritis is an inflammation of the vestibular nerve that connects the inner ear to the brain. Ménière’s disease, a rare condition, results from excessive fluid buildup in the ear and can cause severe dizziness, hearing loss, and ear congestion. It can also lead to tinnitus and impact a person's mental health.
Another example of an inner ear disorder is Persistent Postural-Perceptual Dizziness (PPPD), which can be accompanied by vestibular migraines. This condition can cause a person to feel dizzy and unbalanced, similar to the sensation of being drunk. In addition to medical treatments, physical therapy, and specific exercises can help alleviate the symptoms of inner ear disorders and improve balance.
It is important to note that alcohol consumption can negatively impact inner ear disorders. Alcohol is known to cause dehydration, which can lead to dizziness. Additionally, drinking alcohol can impair the nervous system, causing lightheadedness and delayed reaction times. For individuals with Ménière's disease, alcohol consumption can worsen symptoms by reducing blood supply to the inner ear. Therefore, doctors often advise against drinking alcohol for individuals experiencing vertigo or other inner ear disorders.
If you are experiencing persistent feelings of dizziness or imbalance, it is recommended to consult a doctor or specialist for proper diagnosis and treatment. They may advise lifestyle changes, dietary adjustments, or specific treatments based on your individual condition.
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Persistent Postural-Perceptual Dizziness
There are many reasons why one might feel drunk without having consumed alcohol. One possible explanation is Persistent Postural-Perceptual Dizziness (PPPD), a condition characterised by a constant dizzy and foggy feeling, as if one's surroundings are moving or rocking. PPPD is a chronic vestibular disorder, which means it interferes with one's sense of balance and spatial orientation. The condition is often triggered by a central, peripheral, or vascular insult, such as a panic attack, vestibular migraine, or fainting spell. It is important to note that PPPD is not a diagnosis of exclusion and has specific diagnostic criteria. To be diagnosed with PPPD, patients must experience vestibular symptoms for more than half of the days over a period of 90 days.
The symptoms of PPPD include feelings of floating, swaying, or rocking, which can last for long periods and affect people almost daily. These symptoms are worse when standing, when tired, or in complex visual environments such as grocery stores or crowds. People with migraine, anxiety, or depression are at a higher risk of developing PPPD, but it can occur in anyone. The exact cause of PPPD is unknown, but it is believed to be related to a change in the brain's ability to interpret space and motion. After an alarming event, the fight-or-flight system is activated, altering the brain's perception of movement and surroundings. In PPPD, this altered perception persists, resulting in a constant rocking sensation that can last for at least three months.
Treatment for PPPD aims to help the brain re-establish a better sense of perception and balance. Vestibular balance rehabilitation therapy and cognitive behavioural therapy, along with pharmaceutical management, have been shown to improve quality of life and facilitate a return to normal activities. While the condition may improve with treatment, it rarely goes away entirely. It is important to seek medical attention if one suspects they may have PPPD, as early diagnosis and treatment can improve outcomes.
It is worth noting that there are other potential causes for feeling drunk without alcohol consumption. These include Lyme disease, thyroid issues, dietary factors, and, as illustrated by Roy Whittington's story, gastrointestinal issues. In Roy's case, his gut was turning carbs and sugar into alcohol, leading to drunk-like symptoms. It is important to consult a healthcare professional to receive a proper diagnosis and treatment plan.
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Chronic medical conditions
Auto-brewery syndrome (ABS) is a rare condition in which the body turns sugary and starchy foods (carbohydrates) into alcohol. This can cause symptoms similar to drunkenness, such as slurred speech, fatigue, stumbling, dizziness, and nausea, even when no alcohol has been consumed. The condition was first identified in a Japanese study involving patients with chronic yeast infections and abnormal liver enzymes. The extra yeast, combined with the abnormal liver enzyme, led to an inability to break down alcohol quickly enough, resulting in fermentation into ethanol and causing an intoxicated feeling.
While it is a rare condition, ABS can have a significant impact on the lives of those affected. People with ABS may find themselves struggling at school or work, experiencing exhaustion from mild physical activities, and having difficulty getting up in the mornings. They may also face social challenges, such as explaining their symptoms to loved ones and dealing with the fear of public embarrassment or driving due to unexpected episodes of intoxication.
The cause of ABS is attributed to yeast overgrowth in the gut or intestines, leading to ethanol fermentation. This can be influenced by various factors, including liver problems, short bowel syndrome in toddlers and children, and a high-carbohydrate diet. In some cases, individuals with ABS may need to adapt their diets to reduce fermentation in their intestines by limiting grains, carbohydrates, and refined sugars. Antifungal medications and a paleo diet comprising meat, nuts, and seeds may also be recommended.
Diagnosing ABS can be challenging, and there are currently no specific tests available. However, doctors may perform stool tests to check for yeast overgrowth in the gut or utilize approved breathalyzers to assist with home detection during acute attacks. While ABS is rare, it has been used as a defence in drunk driving cases, although skepticism and proper testing are warranted to confirm the diagnosis.
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Frequently asked questions
Feeling drunk without consuming alcohol could be a sign of auto-brewery syndrome (ABS), a condition in which yeast grows in parts of the digestive tract and ferments carbohydrates and sugars into alcohol. Other causes could be labyrinthitis, benign positional vertigo, dehydration, sleep deprivation, or stress.
Symptoms of ABS include dizziness, nausea, fatigue, slurred speech, loss of motor coordination, and bad breath.
ABS can be treated with a course of antifungal medication and a low-carb diet.
