Alcohol Intolerance in ME/CFS – A Model

While working on a different blog post on brain fog, the light went on for a model that may explain newly developed alcohol intolerance in ME/CFS. People tolerated and enjoyed alcohol before ME/CFS so the cause is not DNA for these people, but some change caused by ME/CFS.

A major subset of people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has excessive lactic acid, typically d-lactic acid, especially with cognitive issues (see Systematic review and meta-analysis of cognitive impairment in myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). [2022])

What would consuming alcohol (known as ethanol) do to such a person? The answer is clear from the literature:

So the model is simple:

High Lactic Acid + alcohol => severe lactic acidosis

So the key issue is to reduce lactic acid levels. I have written about this many times over the years, a few examples:

Bottom Line

As a FYI, a few people using their microbiome results and my analysis site, Microbiome Prescription, has reported the ability to enjoy a glass of wine when they were intolerant before. There is hope.