Support the GITP forums on Patreon
Help support GITP's forums (and ongoing server maintenance) via Patreon
Results 1 to 9 of 9
  1. - Top - End - #1
    Firbolg in the Playground
     
    Planetar

    Join Date
    Dec 2006
    Location
    Raleigh NC
    Gender
    Male

    Default The Queen Midas of Alcohol

    Seen on IFL science

    Reporting the unusual case in the Annals of Internal Medicine, the condition came to light when doctors at the University of Pittsburgh Medical Center Presbyterian Hospital were examining a 61-year-old woman for placement on the liver transplant waitlist. The woman was suffering from liver cirrhosis and diabetes, illnesses often associated with alcoholism and heavy alcohol use.

    However, she claimed to rarely touch alcohol. Doctors were, understandably, skeptical about this claim at first because her urine tests for alcohol were repeatedly positive. Multiple doctors also advised her to seek treatment for alcohol use disorder, but she continued to insist she had not had anything to drink.

    Then, some of the clinicians noted her urine test results for ethyl glucuronide and ethyl sulfate, substances produced by the break down of ethanol (alcohol), were negative. Equally, her blood tests came back negative for ethanol. This meant the alcohol was not in her bloodstream, so she didnít report feeling drunk or intoxicated.

    The strange set of circumstances eventually led the doctors to take a closer look at her pee. They discovered the womanís bladder had become colonized with a strain of yeast called Candida glabrata, a fungus that's part of the normal human flora thatís closely related to brewer's yeast (Saccharomyces cerevisiae).

    They took samples of the yeast, placed it in a petri dish under certain conditions, and watched whether it fermented. Lo and behold, the sample produced alcohol.

    It appears that the womanís bladder had effectively acted like a booze brewery. To make alcohol, whether its beer or hard liquor, you need water and sugar, paired with yeast and an absence of oxygen. The anaerobic (no oxygen) conditions make the yeast ferment the sugars into ethanol and carbon dioxide. The woman's urine contained sugar as a symptom of her poorly controlled diabetes. Paired with the yeast that had colonized her bladder, the conditions were ideal for fermentation and the production of alcohol.
    So .. King Midas turned everything he touched to gold. This woman turns anything she drinks into alcohol! Except for the whole cirrhosis of the liver thing, I should think of all kinds of interesting possibilities.

    For example, when asked the question "Who would you want to be stranded on a desert island with?" , well, a woman who can make alcohol without a still is definitely in the top five.

    Tongue-in-cheek,

    Brian P.
    "Every lie we tell incurs a debt to the truth. Sooner or later, that debt is paid."

    -Valery Legasov in Chernobyl

  2. - Top - End - #2
    Troll in the Playground
     
    BardGuy

    Join Date
    Jan 2009

    Default Re: The Queen Midas of Alcohol

    Yet if the alcohol is only in the urine, that does not make for a very satisfactory drink. I haven't read the article, but any indication of the alcohol content? I'm guessing not terribly high or else the doctors would have realized something was wrong sooner.

    Quote Originally Posted by pendell View Post
    Tongue-in-cheek,
    I wanted to explicitly note that I saw this was tongue-in-cheek, as tone can carry over poorly in written text.
    My comment is meant similarly.

    On a serious note, that is an interesting medical issue.

  3. - Top - End - #3
    Firbolg in the Playground
     
    Planetar

    Join Date
    Dec 2006
    Location
    Raleigh NC
    Gender
    Male

    Default Re: The Queen Midas of Alcohol

    Quote Originally Posted by JeenLeen View Post
    Yet if the alcohol is only in the urine, that does not make for a very satisfactory drink. I haven't read the article, but any indication of the alcohol content? I'm guessing not terribly high or else the doctors would have realized something was wrong sooner.
    In all seriousness, it was pretty high. The symptoms she was admitted for were consistent with very heavy drinking over a long period of time, and she was repeatedly told to seek alcohol abuse counselling despite the fact that she was almost totally teetotal.

    So they did some testing and noted that the normal byproducts associated with the breakdown of alcohol -- ethyl glucuronide and ethyl sulfate -- were not present in her urine. Nor was there ethanol in her blood stream.

    So there's no digestive byproducts and no alcohol in the blood stream but there is alcohol in the urine. How could that be?

    They did some more testing and found that her bladder had been colonized by bacteria very similar to baker's yeast. They took a sample, reproduced the body's normal conditions and temperature in the lab and -- presto! -- alcohol.

    That's why they were seeing alcohol in the urine but NOT alcohol digestion byproducts and NOT alcohol in the bloodstream. Her bladder was manufacturing it.

    The full report is in the Annals of Internal Medicine , where it is described as "Auto-brewery syndrome." Regrettably, it is behind a paywall so I can't see if it gives the exact numbers.

    Here's the bit I can see in the annals for free
    Quote Originally Posted by Annals Of Internal Medicine
    Background: Auto-brewery syndrome is a rare medical condition in which intoxicating quantities of ethanol are produced by specific types of yeast or bacteria through endogenous fermentation in the digestive system (1).

    Objective: To alert clinicians to the possibility of a previously unrecognized auto-brewery syndrome in which ethanol is produced through endogenous fermentation in the urinary system.

    Case Report: A 61-year-old woman with cirrhosis and poorly controlled diabetes presented to our center for placement on the liver transplant waitlist. Previously, clinicians at another hospital advised her to obtain treatment for alcohol addiction instead of placing her on their center's...
    Respectfully,

    Brian P.
    Last edited by pendell; 2020-02-26 at 03:54 PM.
    "Every lie we tell incurs a debt to the truth. Sooner or later, that debt is paid."

    -Valery Legasov in Chernobyl

  4. - Top - End - #4
    Troll in the Playground
     
    BisectedBrioche's Avatar

    Join Date
    Feb 2007
    Location
    Some rainly old island
    Gender
    Female

    Default Re: The Queen Midas of Alcohol

    That's pretty crazy, but wouldn't there have to be sugar in her urine for the yeast to convert into alcohol (we can assume it's an anaerobic environment)?

    Where did the CO2 go (the bladder isn't designed to hold gas, so it can't have gone unnoticed)?
    Hi, I'm back, I guess. ^_^
    I stream LPs of single player games on Twitch! Mon, Wed & Fri; currently playing: Pyre

  5. - Top - End - #5
    Firbolg in the Playground
     
    Planetar

    Join Date
    Dec 2006
    Location
    Raleigh NC
    Gender
    Male

    Default Re: The Queen Midas of Alcohol

    Quote Originally Posted by Bisected8 View Post
    That's pretty crazy, but wouldn't there have to be sugar in her urine for the yeast to convert into alcohol (we can assume it's an anaerobic environment)?
    She's diabetic; I suspect that means a fair amount of undigested sugar was passing through her system; I'm not a doctor, but isn't insulin necessary to process sugar, and if you don't have enough it goes straight through your system and does incalculable damage on the way?

    Where did the CO2 go (the bladder isn't designed to hold gas, so it can't have gone unnoticed)?
    An excellent question to which I don't know the answer. Regrettably, the answers are probably behind the aforementioned paywall :(.

    ETA: Layman speculation powers: ACTIVATE!
    I can only think of two vectors: Either the bloodstream or the urine itself. CO2 is a natural byproduct of cellular metabolism, isn't it? It goes into the bloodstream and thence via veins to the lungs and out to melt the planet. That's one route. The only other route I can think of is into -- and out with -- the urine. Urine changes color from deep yellow to near transparent based on the trace elements in it -- could CO2 be one of them.

    Layman speculation: DE-ACTIVATE!

    Respectfully,

    Brian P.
    Last edited by pendell; 2020-02-26 at 07:06 PM.
    "Every lie we tell incurs a debt to the truth. Sooner or later, that debt is paid."

    -Valery Legasov in Chernobyl

  6. - Top - End - #6
    Troll in the Playground
     
    Lord Torath's Avatar

    Join Date
    Aug 2011
    Location
    Sharangar's Revenge
    Gender
    Male

    Default Re: The Queen Midas of Alcohol

    Quote Originally Posted by pendell View Post
    ETA: Layman speculation powers: ACTIVATE!
    I can only think of two vectors: <snip> The only other route I can think of is into -- and out with -- the urine. Urine changes color from deep yellow to near transparent based on the trace elements in it -- could CO2 be one of them.

    Layman speculation: DE-ACTIVATE!
    CO2 is what makes soda (and champagne) fizzy. So not only is she creating alcohol, she's creating sparkling alcohol!

    You know, assuming that's the route the CO2 is taking out of her system.
    Warhammer 40,000 Campaign Skirmish Game: Warpstrike
    My Spelljammer stuff (including an orbit tracker), 2E AD&D spreadsheet, and Vault of the Drow maps are available in my Dropbox. Feel free to use or not use it as you see fit!
    Thri-Kreen Ranger/Psionicist by me, based off of Rich's A Monster for Every Season

  7. - Top - End - #7
    Titan in the Playground
     
    Yora's Avatar

    Join Date
    Apr 2009
    Location
    Germany

    Default Re: The Queen Midas of Alcohol

    It's not even an incredibly rare condition. Similar stories have been around for a very long time. Wikipedia is citing a paper from 1982.

    Having it happen in the bladder seems to be a new discovery, though. Otherwise I imagine doctors wouldn't have been that surprised by it.
    Last edited by Yora; 2020-02-27 at 02:46 PM.
    We are not standing on the shoulders of giants, but on very tall tower of other dwarves.

    Beneath the Leaves of Kaendor - Writing Sword & Sorcery
    Spriggan's Den Heroic Fantasy Roleplaying

  8. - Top - End - #8
    Titan in the Playground
     
    Brother Oni's Avatar

    Join Date
    Nov 2007
    Location
    Cippa's River Meadow
    Gender
    Male

    Default Re: The Queen Midas of Alcohol

    Quote Originally Posted by pendell View Post
    She's diabetic; I suspect that means a fair amount of undigested sugar was passing through her system; I'm not a doctor, but isn't insulin necessary to process sugar, and if you don't have enough it goes straight through your system and does incalculable damage on the way?
    Considering her age, she's most likely a Type II diabetic, that is her body isn't responding enough to insulin. Insulin tells the body to store sugar (specifically glucose) after it's been digested and absorbed out of food and the levels in blood are carefully maintained - the glucose doesn't cause damage in and of itself, but the way the body reacts to get rid of high levels of it (since the insulin isn't working) is detrimental.

    There are two main concerns for high blood sugar (hyperglycemia); one is your blood being too concentrated as it uses up all the available water to flush out the excess glucose via urine; the second is that your body doesn't have enough energy reserves and can behave as if its starving.

    As for where the CO2 went, most likely dissolved in her urine - if the concentration was enough for the CO2 to start off-gassing, then the pressure would have made her urinate. It's unlikely that it would ever reach this stage since her hyperglycemia would have been sending her to the toilet regularly anyway.


    As for blood alcohol concentrations, I've found mentioned of a man with auto-brewery syndrome in the intestine who was arrested for driving while intoxicated and had a blood alcohol level of 200 mg/dL. If he were drinking, this would have equated to a BAC of 0.05% (in the UK and nearly all states in the US, 0.08% is the limit).

  9. - Top - End - #9
    Titan in the Playground
     
    Yora's Avatar

    Join Date
    Apr 2009
    Location
    Germany

    Default Re: The Queen Midas of Alcohol

    High blood sugar also interferes with the production of chemical compounds that regulate the contraction of blood vessels. If levels remain too high for too long, blood vessels remain permanently contracted, which inhibits blood flow, which ultimately can lead to cells dying from lack of oxygen. Which also includes strokes and heart attacks.
    It's pretty nasty.
    We are not standing on the shoulders of giants, but on very tall tower of other dwarves.

    Beneath the Leaves of Kaendor - Writing Sword & Sorcery
    Spriggan's Den Heroic Fantasy Roleplaying

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •