Piss whiskey and bad medicine

As you tip your glass on the holiday, here’s a little piece from the archives for you. Originally posted September 7, 2010–PalMD


Chasing around wild internet stories is a full time job, and I already have one of those, but thanks to a friend (h/t Dr. Isis), a wild story came across my desk today. Like many internet stories, this one may turn out to be difficult to verify, and the website that originated it is dead, but the story is worth some exploring independent of its veracity.  The story, reported in Wired UK and on boingboing describes a (presumably) quirky fellow who made whiskey from urine.  Many readers may find the whole idea revolting or redundant, but the idea isn’t (biochemically) insane.

Making booze relies on two basic chemical processes: fermentation and distillation.  Fermentation uses various microorganisms (usually yeasts) to convert the sugar present in foods into ethyl alcohol.  For whiskey, a mash is typically made by boiling various grains and adding yeast (unless it is naturally occurring).  The mixtures stands while the yeast feed on the sugars, excreting ethyl alcohol as a waste product.  The reaction stops either when substrate (sugar) is depleted, or when the environment becomes too toxic for the yeast.  Depending on the yeast species, fermentation can produce around 5-20% alcohol before the yeast gives up.

But if you want something more intoxicating, such as whiskey, you have to take it another step.  The alcohol mixture can be distilled, yielding up to 100% alcohol.  In vodka production, this highly concentrated alcohol is diluted with water, bottled, and consumed with great rapidity.  Whiskey goes through a much more complex process involving cask aging which gives it its rich color and some of its complex flavors. The key, though, is that just about any source of carbohydrates can be used to make booze: potatoes, barley malt, cane sugar, and perhaps even urine.

If you’re wondering how piss whiskey would taste, don’t worry—the source of the sugar is less important that what’s done with it.  Real whiskey has the complex flavors of the mash included with the sugars, so I don’t think that piss whiskey should really be called “whiskey”—it’s more of a moonshine. It appears that the producer extracts sugar from urine, ferments it, and adds real whiskey to make it palatable.  On second thought, “moonshine” might be too kind a name for this stuff.

As a physician, one thing struck me as especially troublesome (besides the idea of drinking piss whiskey): the idea that it is “normal” for diabetics to excrete glucose in their urine.  When blood enters the kidney, it heads to the nephrons, the basic operating unit of the kidneys.  It enters the nephron through the glomerulus (the kidney’s “filter”) where glucose freely enters the soon-to-be urine.  After it is filtered, glucose-rich filtrate passes through a part of the nephron where the glucose is removed and put back into the circulation, so that by the time the urine is excreted, it has no glucose in it.

Unless, that is, so much glucose is filtered that it exceeds the kidney’s ability to reabsorb it.  In diabetes, the body cannot handle glucose properly, and glucose concentrations in the blood increase, often beyond the ability of the kidney to reabsorb it.  This causes many of the classic symptoms of diabetes, such as excess thirst and frequent urination.  It also indicates diabetes that is very poorly controlled.

While in the past approximate urine glucose concentrations were used to monitor diabetes, the measurement of capillary blood glucose is now trivial.  In the early days of insulin therapy, patients had to learn some basic biochemistry lab techniques to find out how much glucose was spilling into their urine.  Now a simple finger stick can measure a reasonably accurate blood sugar in seconds, at concentrations well below those where glucose appears in the urine.

If urine is sweet enough to be used to make alcohol, then something is going wrong.  We have the ability to regulate blood glucose in diabetics very tightly.  Most diabetics following proper diet and using medications properly should not have glucose in their urine, eliminating the need to find something horrid to do with the damned stuff.


  1. stripey_cat

     /  September 7, 2010

    Two points: one is a technical niggle only. Adding extra sugar to your fermentation doesn’t produce a fortified drink. It makes a stronger/sweeter drink, but fortification specifically describes mixing a fermented product (with or without additional sugar) with distilled spirits.

    The other point is why the devil didn’t he devote that much energy into producing useful fertilizers from the urine, rather than a distilled food product no-one would ever want to drink!

    • Jon H

       /  September 8, 2010

      “why the devil didn’t he devote that much energy into producing useful fertilizers from the urine, rather than a distilled food product no-one would ever want to drink!”

      Probably because the quantity of urine available was tiny. Enough to make a limited quantity of novelty liquor, not nearly enough to be a useful agricultural product.

  2. palmd

     /  September 7, 2010

    Excellent. Research error on my part. I’ll fix that.

  3. As someone who loves both whiskey and urine, I found this tidbit horrifying. I mean, there are so many wonderful bourbons out there, why drink pee?

    Another caveat: we may soon see lots of people with diabetes spilling glucose in their urine. The latest class of drugs for blood sugar control inhibits the sodium-glucose cotransporter in the proximal tubule, allowing glucose to spill at “normal” levels of blood sugar. I expect to see these drugs hitting the market within the next year or so.
    Reviewed here: http://www.ncbi.nlm.nih.gov/pubmed/19125776

  4. palmd

     /  September 7, 2010

    Holy crap! What’s that going to do to Na/H2O balance, hydration, etc???

  5. dpryan

     /  September 7, 2010

    “The alcohol mixture can be distilled, yielding up to 100% alcohol.”

    Isn’t ethanol an azeotrope? I think you can only distill it to ~96% (absolute ethanol could then be made via dessication).

  6. palmd

     /  September 7, 2010

    Yeah, well, nearly…

    I struggled with the language here, thinking about saying “pure alcohol” or “nearly 100%”, but ended up being less accurate and more simple.

  7. Samantha

     /  September 8, 2010

    I’ve never heard of piss whiskey, although some of the bottom-shelf stuff I used to drink when I was a late-teen/early 20s sort of tasted like that.

    Guess this is right up there with the beer-smelling urine of diabetics with yeast infections.

  8. DLC

     /  September 8, 2010

    I dunno. most whiskey drinkers I’ve met couldn’t tell the difference after the first 2 or 3.

  9. Vicki

     /  September 8, 2010

    A few years ago, some Japanese researchers won an Ig Nobel prize for making vanillin from cow dung. Used in ice cream, it was indistinguishable from the shop’s usual vanilla (this was Toscanini’s in Cambridge, Mass., which makes good ice cream).

  10. ElevatedSteve

     /  September 8, 2010

    I thought that fermentation REQUIRED no (or very low) levels of oxygen.

  11. Another error. O2 isn’t required, but for many of the species of yeasts we use, O2 doesn’t inhibit fermentation.

  12. Nice post and an excellent example of why something that may be theoretically or technically plausible isn’t necessarily also practically plausible.

    Sure, you could maybe, possibly make a distilled alcohol product from urine if you found urine with enough sugar in it, but why wouldn’t you do something to lower the sugar levels in said (unhealthily produced) urine instead of using it to make liquor?

    Sure might be possibly plausible that Thimerosal could cause a neurodevelopmental disorder like autism, but even if we set aside all the studies that have failed to find credible evidence of such, since autism rates in the US have not dropped or leveled off since thimerosal was removed from all routine childhood vaccines (and old stock supplies ran out), why bother beating that dead horse any longer?

  13. …and by the way, I don’t mean to imply genuine theoretical or technical plausibility to the idea that thimerosal causes autism.

    I simply meant that even if it were theoretically or technically plausible, it’s still a failed conjecture on other practical grounds: rates have not dropped since thimerosal went bye-bye for kids in the US.

  14. I really am full of great stories lately, aren’t I???

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