When Your Gut Bacteria Hands You a Drink


         In functional medicine circles, I have heard many anecdotes about patients who got tipsy with sugar intake.  While not necessarily common, auto-brewery syndrome is not uncommon either.  In these patients, sugar intake appears to feed yeast in the colon which convert the sugar to alcohol.  Even conventional medicine had to recognize this entity given the multiplicity of case reports which had been tested and proven true.

            Researchers from the Capital Institute of Pediatrics, in a search for answers to non-alcoholic fatty liver disease (NAFLD), uncovered something besides yeast that could make alcohol.  They were searching for bacteria that might contribute to the development of this liver disease in patients who did not drink.  With the growing epidemic of metabolic syndrome, the numbers are growing rapidly for NAFLD.  Finding a contributor to this disease could be a game changer if they could modify it.

            In this case, they found a patient with auto-brewery syndrome who did not respond to the normal anti-yeast medications.  With further testing, they identified a bacteria, Klebsiella, which could ferment sugar into alcohol.  This strain of Klebsiella, was a much higher producer of alcohol than the average Klebsiella.  They then looked at the prevalence of this bacterial strain in NAFLD patients and the percentage with the strain were 60% versus only 6% in those without the disease.

            More research is needed, but these patients appear to have a continual source of alcohol flowing from intestines to their liver.  Ultimately, they develop fatty liver similar to those who actually drink regularly. 

            While researchers plan their next experiments to better understand these bacteria and how to manipulate them, I will be considering how to apply this in our office.  High levels of Klebsiella in patients with fatty liver may prompt me to focus attention on gut dysbiosis so our patients can live a healthier more abundant life. 

Original Article

Jing Yuan, Chen Chen, Jinghua Cui, Jing Lu, Chao Yan, Xiao Wei, Xiangna Zhao, NanNan Li, Shaoli Li, Guanhua Xue, Weiwei Cheng, Boxing Li, Huan Li, Weishi Lin, Changyu Tian, Jiangtao Zhao, Juqiang Han, Daizhi An, Qiong Zhang, Hong Wei, Minghua Zheng, Xuejun Ma, Wei Li, Xiao Chen, Zheng Zhang, Hui Zeng, Sun Ying, JianXin Wu, Ruifu Yang, Di Liu. Fatty Liver Disease Caused by High-Alcohol-Producing Klebsiella pneumoniae. Cell Metabolism, 2019; DOI: 10.1016/j.cmet.2019.08.018


Thanks to Science Daily:

Cell Press. “Alcohol-producing gut bacteria could cause liver damage even in people who don’t drink.” ScienceDaily. ScienceDaily, 19 September 2019. <www.sciencedaily.com/releases/2019/09/190919142336.htm>.


Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.

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