His stomach turns food into booze. 'It's horrible' and could kill him.
MATAWAN, N.J. – On Monday, Danny Giannotto ate what anyone would consider a healthy lunch: tuna fish on low-carb keto bread, with a pickle on the side and some water.
Then the 47-year-old Matawan resident blew into a breathalyzer, one of three he keeps handy to measure his blood-alcohol level after every meal. It read .04, halfway to the drunk-driving threshold in New Jersey.
It was as if he’d thrown back two beers with lunch, yet he hadn’t consumed a drop of booze.
This is life with auto-brewery syndrome, a rare condition in which one’s gut ferments food into alcohol. Giannotto’s had it since 2015.
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“It’s horrible,” he said. “You’re constantly checking the blood-alcohol meter. You never know when it’s going to flare up.”
After undergoing surgery for a deviated septum and suffering an infection, Giannotto underwent a course of antibiotics that he and his gastroenterologist believe altered the chemical composition of his digestive tract.
“Antibiotics can change the flora of your gut,” said the Staten Island-based gastroenterologist, Dr. Prasanna C. Wickremesinge. “If it kills the good guys and allows the bad guys to grow, fungi can turn carbohydrates into alcohol.”
Giannotto was Wickremesinge’s first patient with the condition; now he has a dozen hailing from all parts of the country. He recently published a paper on the subject, one that he said drew “a huge amount of interest” in the scientific community.
“It’s life-changing,” said Michelle Giannotto, Danny’s wife. “You are literally sucked into a dark underworld that you didn’t know existed. Your life completely changes beyond anything you could possibly imagine.”
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That first year, as the Giannottos tried to figure out what was wrong, Danny was hospitalized 22 times. He was pulled over for swerving and charged with driving while intoxicated, but those charges were dropped after a hospital ran tests on him and confirmed his condition.
Most maddening is this: auto-brewery syndrome comes and goes. A strong dose of carefully targeted probiotics can kill the gut yeast that causes the problem, but then the yeast can grow back and the condition flares back up. Giannotto is on a low-carb diet centered around fish, meat and green vegetables, but even a slight deviation can skyrocket his blood-alcohol level during a flare-up.
“We could go to a birthday party and the last thing you do is eat cake, right?” Michelle Giannotto said. “Even if he ate well at the party, if he has a piece of cake and starts driving, will (the intoxication) come back? It’s a crapshoot. You walk on eggshells.”
That’s why Danny had a blood-alcohol meter installed in his car.
“People make jokes, like it’s fun to have a slice of pizza and feel a buzz,” Michelle Giannotto said. “No, the levels can be lethal. A piece of cake can cause (his BAC) to jump to .422. It’s not the equivalent of one or two beers.”
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As with any rare disease, resources for research are limited. Danny has been diabetic for decades, but Wickremesinge said not all of his auto-brewery patients have diabetes. And after he’s identified specific strains of yeast and treated them with carefully targeted probiotics, Wickremesinge said, “some patients relapsed and some didn’t. One size doesn’t fit all.”
His research is ongoing. In the meantime, the Giannottos devote themselves to raising awareness. Michelle serves as vice president of the non-profit Auto-Brewery Syndrome Information and Research Inc., and helps patients through a Facebook-based auto-brewery syndrome support group that has 300 members from around the country, including some as young as 13. Their goal is to get the attention of doctors, law-enforcement official and insurance companies (Danny pays $100 a bottle for high-impact probiotics, uncovered by health insurance).
He has good days and bad days. Recently he ate some honey-roasted peanuts, went out to run errands, got back and started feeling funny. He tested his blood-alcohol content twice. The first time, it was 0.0. The second time, five minutes later, it had shot up to .20 — more than twice the legal driving limit.
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“Sometimes I feel it coming on right away, other times it can take hours,” he said.
The hardest part is explaining himself. That’s why he’s willing to blow into a breathalyzer after lunch, to let the numbers speak for themselves.
“People say, ‘No way, it can’t be,’” he said. “They don’t believe it until they see it with their own eyes.”
Follow Jerry Carino on Twitter: @NJHoopsHaven