On her 23rd birthday, Sara Lefebvre almost died. After having some drinks with friends, her friend drove Sara home. But Sara didn’t make it inside; she collapsed in sub-zero temperatures, eventually crawling inside once she regained consciousness. Sara and her friend were stumped, as she had previously seemed fine. However, these bouts of falling and becoming unconscious were not rare for Sara. It took nearly 15 years to finally receive a diagnosis: auto-brewery syndrome (ABS), an extremely rare condition that results in ethanol production in the gut, causing symptoms of intoxication. Now, Sara is hoping that she will be able to use Micafungin, an anti fungal drug, to reduce and manage her symptoms so that she can receive a liver transplant. Read the source story here.

Sara’s Story

As Sara moved through her 20s, she began experiencing more common falls and unconsciousness. By the time she turned 31, her symptoms worsened: changes in personality, slurred speech, jaundice. Her falls resulted in broken bones. Doctors were unable to come up with a diagnosis, leaving Sara, her husband Ant, and their children feeling confused and frightened.  Eventually, her symptoms became too difficult to manage, and Sara was forced to leave her job.

Two years ago, in January 2019, Sara’s doctors gave her a diagnosis: liver disease and hepatic encephalopathy. By this point, Sara no longer drank alcohol. She began taking lactulose, a sugar-based laxative, which caused her symptoms to worsen further. Unfortunately, when she attempted to pursue a liver transplant, an issue arose. Despite her lack of drinking, her blood alcohol levels were spiked. Because of this, Sara was removed from transplant lists, as doctors did not believe she was taking her condition seriously. Then, at the end of 2019, Sara collapsed again. At the hospital, her BAC was 3x the legal limit.

At this point, Ant began to wonder what could be causing his wife’s perceived drunkenness. He bought a breathalyzer and began testing Sara throughout the week. Even if he was sure she had not been drinking, Sara registered as having a high BAC. After doing some research, and hiring a helper, the couple found a Facebook group about auto-brewery syndrome. All at once, everything clicked.

Micafungin

Now that Sara, 38, finally received her diagnosis of auto-brewery syndrome, she is currently hoping to improve her health enough to qualify for a liver transplant. She has had to cut sugar and carbs out of her diet and can only eat foods like scrambled eggs, leafy greens, and meat. Sara is jaundiced and suffering from cirrhosis. But because her blood alcohol content remains high, with one test at nearly 6x the legal limit, most hospitals refuse to do the transplant.

Currently, Sara is taking Micafungin to attempt to control her condition. Previously, she was placed on a variety of antifungals, which unfortunately did not inhibit the yeast. The Micafungin is being administered directly via a catheter. Sara expresses frustration that many doctors do not view auto-brewery syndrome as an actual condition, even saying:

“If this new medication doesn’t work, I’m going to die.”

Hopefully, if the Micafungin takes effect, Sara will soon be able to get her liver transplant.

Auto-Brewery Syndrome (ABS)

According to a published article, auto-brewery syndrome (ABS):

or gut fermentation syndrome is a condition in which ethanol is produced through endogenous fermentation by fungi or bacteria in the gastrointestinal (GI) system. Patients with auto-brewery syndrome present with many of the signs and symptoms of alcohol intoxication while denying an intake of alcohol and often report a high-sugar, high-carbohydrate diet.

In short, auto-brewery syndrome occurs when yeast and other fungi feed on sugars or carbohydrates in the gut, causing ethanol to enter the bloodstream.

Only an estimated 100 people have been diagnosed with auto-brewery syndrome. However, some researchers believe that ABS is most likely under-diagnosed. The article notes that risk factors for ABS include being obese or having co-morbidities like diabetes or Crohn’s disease. This condition may also occur in others. Symptoms include:

• Nausea and vomiting
• Fatigue
• Disorientation and confusion
• Dizziness
• Dry mouth
• Frequent burping
• Depression and anxiety
• Bad breath
• Red or flushed skin
• Painful headaches
• Dehydration
• Problems with concentration
• Loss of coordination
• Irritable bowel syndrome (IBS)
• Chronic fatigue syndrome (ME/CFS)

Learn more about ABS.