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William Aird: What if Your Red Blood Cells Make Alcohol?
William Aird/X
Sep 14, 2026, 14:43

William Aird: What if Your Red Blood Cells Make Alcohol?

William Aird, Professor of Medicine at Harvard Medical School, shared a post on LinkedIn։

“What if your red blood cells make alcohol?

Your red cells are fermenters.

Mature RBCs have no mitochondria, so they depend on glycolysis for ATP. But glycolysis requires a continuous supply of NAD⁺.

RBCs regenerate NAD⁺ using lactate dehydrogenase:

  • pyruvate + NADH lactate + NAD⁺

Yeast take a different route, using pyruvate decarboxylase and alcohol dehydrogenase:

  • pyruvate acetaldehyde ethanol

The final step regenerates NAD⁺.

Same problem: regenerate NAD⁺.

Different fermentation product: lactate vs ethanol.

So what if our RBCs fermented glucose like yeast?

A rough calculation:

RBC glucose consumption is nearly 1.6 mmol/L RBCs/hour

RBC volume is nearly 2.25 L

  • nearly 86 mmol glucose/day

At 2 mol ethanol per mol glucose:

  • nearly 173 mmol ethanol/day
  • nearly 8 g ethanol/day

That’s a little over half a U.S. standard drink.

Made by your red cells. Every day.

Of course, they don’t.

Human RBCs lack the yeast pathway, some glucose enters other pathways, and the liver would rapidly metabolize any ethanol produced.

But the thought experiment makes an important point:

Lactate production isn’t a metabolic accident.

For a cell without mitochondria, fermentation regenerates the NAD⁺ needed to keep glycolysis, and the red cell, alive and sober.”

Other posts featuring William Aird on Hemostasis Today.

Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine 𝗿𝗲𝗱 𝗯𝗹𝗼𝗼𝗱 𝗰𝗲𝗹𝗹𝘀 William Aird
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