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Alcohol Testing
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Hair testing for direct alcohol markers
Nail testing
Blood PEth testing
Blood testing for alcohol markers CDT, LFT and MVC
Hair testing for direct alcohol markers EtG and FAEE
A hair alcohol test looks for the Etg (Ethyl Glucuronide) and FAEE (Fatty Acid Ethyl Esters) markers in hair, to measure to levels of long-term alcohol use (more than one week and up to six months)
EtG and FAEEs are both direct biomarkers of alcohol consumption, they will only be produced if the individual has consumed enough alcohol to be absorbed into the hair. Both are widely used for monitoring alcohol consumption for both clinical and forensic purposes.
An EtG test alone can be enough to accurately measure long term alcohol consumption levels. At Cansford, we can measure EtG in hair to indicate abstinence or excessive alcohol consumption.
However, because of the different effects of some cosmetic hair treatments, such as bleaching on EtG levels in hair, there is a general consensus that FAEE measurements in hair are useful in combination with EtG.
FAEEs are formed because of reactions between the ethanol in alcoholic drinks and fatty acids in the body – they are absorbed into the hair through sebum made in the sebaceous glands at the base of hair roots.
Segmentation of hair:
Hair testing is ideal for the monitoring of consumption over time as it can be cut into centimetre ‘segments’ to show use over time. Each segment represents about one month.
Nail Testing for alcohol
Because nails are made of the same fibre (keratin) as hair, nails can also be used for testing for alcohol abuse. This is useful if the donor does not have sufficient hair to test. Nail testing is only suitable as an overview test, it cannot be used to monitor consumption in a specific month.
Blood PEth testing for the direct marker Phosphatidylethanol (PEth)
PEth testing provides the highest sensitivity for the detection of current regular alcohol consumption. A single test shows levels of consumption for (up to) the previous 28 days. Regular PEth testing, can therefore easily be used to monitor alcohol abuse cases over several months.
Unlike CDT testing – which will only show chronic or not chronic, PEth provides three different cut off points, allowing for the results to show light, medium or chronic use of alcohol.
PEth can be collected as a dry blood spot (DBS) test, which simply requires a small sample from a finger prick. Dried, the sample is stable for months at ambient temperature. It’s easy to store and transport collected samples, they do not deteriorate quickly in the same way as venous blood samples can.
Blood testing for indirect alcohol markers (CDT, LFT and MVC)
CDT is a biomarker for chronic alcohol intake of more than 60 g ethanol/d and is therefore one of the most used biomarkers for monitoring alcohol use.
It is a test that should be used with caution. Elevated CDT levels are not always caused by alcohol abuse and CDT can be affected by factors such as hormonal changes and other diseases and deficiencies.
LFTs or LFs are a group of blood tests that provide information about the state of a donor’s liver. The biomarker, the Gamma glutamyl transferase (GGT) can be an indicator of an individual’s alcohol use.
However, the results may be normal in patients who suffer from serious liver disease and abnormal in patients without liver diseases, or other diseases that may interfere with results.
Another test that is less commonly ordered is the MCV test is a part of a full blood count (FBC) mainly used to identify recently ingested alcohol. This test looks at the average volume of red blood cells in the blood sample.
The MCV test can provide some indication of possible alcohol misuse, but individuals may have MCV readings outside of the normal range for a variety of reasons, such as vitamin deficiencies, medication, and previous alcohol consumption.