[34F] Experiencing chronic disorientation and dizziness with alcohol-like breath odor

Question

Has anybody heard of auto-brewery syndrome? Could I have that?

Patient Description

A 34-year-old female reports experiencing daily episodes of feeling disoriented, dizzy, and weak, with a breath odor resembling alcohol despite not consuming any alcohol. These symptoms have persisted for approximately five years and tend to worsen a few hours after meals, lasting 2-4 hours. The disorientation can be so severe that she almost fainted while preparing lunch recently. The dizziness feels like an inability to walk straight or stand still, with severity reaching up to 8 on a scale of 1-10. Sitting or lying down helps alleviate the dizziness. She also experiences occasional headaches and slower speech during these episodes. There have been no occurrences of chest pain, shortness of breath, changes in vision, or sweating, but she did lose consciousness once and often feels confused. Her medical history includes chronic UTIs since 2015, but she has no known allergies or adverse reactions to medications. The only medication she is currently taking is vitamin D, and she is not using any other over-the-counter medications, prescription medications, herbal supplements, or topical medications except for a facial cleanser from Neutrogena.

Arora's Assessment

What might be happening

Based on the information you've provided, several potential conditions could explain your symptoms:

Auto-Brewery Syndrome (ABS): This rare condition can cause your body to produce alcohol internally, leading to symptoms of intoxication without consuming alcohol. This could explain why your breath smells of alcohol and why you feel disoriented and dizzy, especially after meals.
- Testing and Treatment: Diagnosis typically involves blood tests to measure blood alcohol levels after consuming carbohydrates. Treatment may include dietary changes, antifungal medications, and probiotics.
Hypoglycemia: Low blood sugar levels can cause dizziness, weakness, and disorientation, especially after meals. This condition can be serious and requires medical attention.
- Testing and Treatment: Blood glucose tests can diagnose hypoglycemia. Treatment involves dietary changes to maintain stable blood sugar levels and possibly medication.
Metabolic Disorders: Conditions like diabetes or thyroid dysfunction can cause similar symptoms. These disorders affect how your body processes food and maintains energy levels.
- Testing and Treatment: Blood tests to check glucose levels, thyroid function, and other metabolic markers can help diagnose these conditions. Treatment varies depending on the specific disorder but often includes medication and lifestyle changes.
Neurological Conditions: Issues such as vestibular disorders or even certain types of migraines can cause dizziness and disorientation.
- Testing and Treatment: Neurological exams and imaging tests like MRI or CT scans can help diagnose these conditions. Treatment may include medication, physical therapy, or other interventions.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

Monitor Your Diet: Keep a food diary to track what you eat and when your symptoms occur. This information can be valuable for your doctor.
Stay Hydrated: Drink plenty of water throughout the day to help manage dizziness and weakness.
Rest: When you feel dizzy or disoriented, sit or lie down until the symptoms pass.
Avoid Triggers: If you notice certain foods or activities worsen your symptoms, try to avoid them.

What you should look out for

Seek medical attention if you experience any of the following:

Severe Symptoms: If your dizziness, disorientation, or weakness becomes severe or debilitating.
Loss of Consciousness: If you lose consciousness again or feel like you might faint.
New Symptoms: If you develop new symptoms such as chest pain, shortness of breath, or severe headaches.
Persistent Symptoms: If your symptoms do not improve or worsen over time.

Remember, while this information can help guide you, it's essential to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

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7 mo ago

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