What Is the CDT Blood Test for Alcohol?

Table of ContentsView AllTable of ContentsTests for Alcohol UseWhat Is a CDT Test?How It WorksWhen and Why CDT Is TestedAccuracy

Table of ContentsView All

View All

Table of Contents

Tests for Alcohol Use

What Is a CDT Test?

How It Works

When and Why CDT Is Tested

Accuracy

There are a few different ways to learn about a person’s alcohol use. One is to ask them questions or use some screening questionnaire. In other cases, a blood test for alcohol can help healthcare providers learn more about currentintoxicationlevels or regular alcohol consumption. The carbohydrate-deficient transferrin (CDT) blood test can provide information about a person’s past alcohol use and help diagnose an alcohol use disorder.

At a GlanceIn order to diagnose an alcohol problem, it is important for a doctor or therapist to know more about a person’s alcohol consumption habits. Screen instruments can help, but people are not always entirely truthful. That’s where a blood alcohol test can come in handy. By using a tool such as a CDT test, health professionals can better understand the severity of a person’s drinking problem. Keep reading to learn more about how this can inform their treatment recommendations and ensure that people get the help they need to manage their alcohol use.

At a Glance

In order to diagnose an alcohol problem, it is important for a doctor or therapist to know more about a person’s alcohol consumption habits. Screen instruments can help, but people are not always entirely truthful. That’s where a blood alcohol test can come in handy. By using a tool such as a CDT test, health professionals can better understand the severity of a person’s drinking problem. Keep reading to learn more about how this can inform their treatment recommendations and ensure that people get the help they need to manage their alcohol use.

When gauging alcohol use in their patients, healthcare providers rely mainly on three methods:

The traditional brief alcohol screening isn’t as reliable as the other two methods because its accuracy depends solely on the patient being accurate and honest abouthow much they drink. While the BAC test measures the level of alcohol currently in the bloodstream, CDT testing uses biomarkers to detect a recent history of harmful levels of alcohol consumption.

The CDT test is a better indicator of binge drinking or daily heavy drinking (four or more drinks per day) than the other two tests.It can even help determine if a person with alcohol use disorder has had a relapse.

What Constitutes Heavy Drinking?The Centers for Disease Control and Prevention (CDC) defines heavy drinking as consuming at least 15 drinks/week (for men) or eight drinks/week (for women). Notably, an estimated 90% of heavy drinkers don’t meet the diagnostic criteria for moderate or severealcohol use disorder, a chronic brain disease that interferes with daily life.

What Constitutes Heavy Drinking?

The Centers for Disease Control and Prevention (CDC) defines heavy drinking as consuming at least 15 drinks/week (for men) or eight drinks/week (for women). Notably, an estimated 90% of heavy drinkers don’t meet the diagnostic criteria for moderate or severealcohol use disorder, a chronic brain disease that interferes with daily life.

What to Know About Alcohol Use Disorder

What Is a CDT Blood Test?

As the name suggests, CDT blood testing measures the level of CDT in the bloodstream. Carbohydrate-deficient transferrin (CDT) is a substance that carries iron to the bone marrow, liver, and spleen.

When someone drinks heavily, the level of CDT in their body increases to a point at which it can be measured in a blood sample. Therefore, this increase is a biomarker of excessive alcohol use.

BiomarkerA biomarker (short for “biological marker”) is a molecule in the body that signals some condition or process. Healthcare providers and researchers use biomarkers in diagnosis, treatment, and testing—for example, to check how well a cancer treatment is working or to detect high cholesterol.

Biomarker

A biomarker (short for “biological marker”) is a molecule in the body that signals some condition or process. Healthcare providers and researchers use biomarkers in diagnosis, treatment, and testing—for example, to check how well a cancer treatment is working or to detect high cholesterol.

How Long Does Alcohol Stay in Your System?

How the CDT Test Works

People who do not drink or drink only moderately have lower CDT levels in their blood than those who drink heavily. Some CDT tests use a cutoff of less than 1.7%. People who drink four or more drinks a day, at least five days a week, for two weeks before the test show significantly greater levels of CDT.

The CDT test is highly accurate in detecting heavy drinking. Similar to how an A1C test detects blood glucose levels over the previous 90 days, the CDT test detects heavy alcohol consumption over a long period. When a person stops drinking, CDT levels go back to normal after two to four weeks. Likewise, if they resume drinking, the levels once again increase after a few days.

How Much Alcohol Is Safe to Drink?

The CDT test gives a healthcare provider a far more reliable diagnostic tool than the traditional brief alcohol screening test, which relies on a patient’s honesty about their drinking habits.

People who don’t consume alcohol excessively tend to self-report accurately, but those who do are more likely to minimize their drinking levels. The greater the misuse, the more likely the person willdeny heavy alcohol consumption.

Medical Conditions

Alcohol consumption is contraindicated for many medical conditions. People with diabetes, high blood pressure, hepatitis C, or liver disease should not drink heavily.

Using the CDT test to identify patients with diabetes, hypertension, and other conditions who are drinking too much could reduce medical complications and healthcare costs significantly.

Drug Interactions

Patients who takecertain prescription and over-the-counter medicationscan experience harmful effects if they drink alcohol. Similarly, people who are being treated with opioid painkillers,sedatives, or sleep aids risk central nervous system depression should they drink alcohol heavily.

In a medical emergency, CDT testing could uncover alcohol use that’s reacting with medications and causing problems.

Recovery

CDT testing also can help healthcare providers monitor abstinence and relapse because the test is sensitive enough to detect increases and decreases in alcohol use.

Some psychotherapists and psychiatrists use the CDT test to determine a baseline level when they first begin treating a patient for alcohol use disorder. In the weeks and months that follow, they can use the CDT test to determine if the person is remaining sober or has had a relapse.

Warning Signs of a Drug or Alcohol Relapse

Accuracy of the CDT Blood Test for Alcohol

Researchers have conducted many studies on the effectiveness of using CDT testing to identify heavy alcohol consumption. Those studies find that the test is accurate but not foolproof.Research has shown, for example, that transferrin mutations can cause false positive results, which can affect the diagnostic accuracy of the test.

Confirmation methods include the use of aquestionnaire, a gamma-glutamyl transpeptidase (GGT) test, or anethyl glucuronide (EtG) test(which detects alcohol consumption in the previous 24 to 72 hours).

False Negatives

In a small percentage of people, heavy alcohol consumption does not raise levels of CDT in the blood. A healthcare provider who suspects heavy drinking despite a negative CDT test may then turn to digital DNA methylation techniques, which rely on blood or saliva samples to detect heavy alcohol consumption.

False Positives

Keep in Mind

A CDT blood test for alcohol is just one diagnostic tool that healthcare professionals may use to evaluate alcohol use and monitor treatment progress. It can provide helpful information about a person’s past alcohol use, but the test isn’t 100% accurate—it can produce false positives and false negatives in some situations.

It is crucial for your doctor or therapist to understand your alcohol consumption so they can determine which treatments may be most helpful for you. If your alcohol use is heavy and chronic,detoxingmay put you at a higher risk for seizures and other symptoms ofdelirium tremens. Knowing this, your doctor may recommend medical monitoring during the detox process and prescribe medications that can minimize withdrawal symptoms and reduce alcohol cravings.

Understanding Alcoholism and the Signs of Severe Drinking Problems

12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Solomons HD.Carbohydrate deficient transferrin and alcoholism.Germs. 2012;2(2):75-78. doi:10.11599/germs.2012.1015Liang SS, He Y, Huang ZG, Jia CY, Gan W.Evaluation of the diagnostic utility of carbohydrate-deficient transferrin in chronic alcoholism.Medicine (Baltimore). 2021;100(4):e24467. doi:10.1097/MD.0000000000024467Alcohol questions and answers. CDC.Fiorelli D, Romani L, Treglia M, et al.Carbohydrate-deficient transferrin (CDT) as a biomarker of alcohol abuse: A retrospective study of the Italian drinking trend among drivers from 2016 to 2022.Toxics. 2023;11(11):914. doi:10.3390/toxics11110914National Cancer Institute.Dictionary of cancer terms.Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol.2014;14:97. doi:10.1186/1471-230X-14-97Labcorp.Carbohydrate-deficient transferrin (CDT), adult.National Institute on Alcohol Abuse and Alcoholism(NIAAA).Harmful interactions.Zühlsdorf A, Said M, Seger C, et al.It is not always alcohol abuse—a transferrin variant impairing the CDT test.Alcohol and Alcoholism. 2016;51(2):148-153. doi:10.1093/alcalc/agv099van de Luitgaarden IAT, Schrieks IC, Kieneker LM, et al.Urinary ethyl glucuronide as measure of alcohol consumption and risk of cardiovascular disease: A population-based cohort study.J Am Heart Assoc. 2020;9(7):e014324. doi:10.1161/JAHA.119.014324Miller S, A Mills J, Long J, Philibert R.A comparison of the predictive power of DNA methylation with carbohydrate deficient transferrin for heavy alcohol consumption.Epigenetics. 2021;16(9):969-979. doi:10.1080/15592294.2020.1834918Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol. 2014;14:97. doi:10.1186/1471-230X-14-97

12 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Solomons HD.Carbohydrate deficient transferrin and alcoholism.Germs. 2012;2(2):75-78. doi:10.11599/germs.2012.1015Liang SS, He Y, Huang ZG, Jia CY, Gan W.Evaluation of the diagnostic utility of carbohydrate-deficient transferrin in chronic alcoholism.Medicine (Baltimore). 2021;100(4):e24467. doi:10.1097/MD.0000000000024467Alcohol questions and answers. CDC.Fiorelli D, Romani L, Treglia M, et al.Carbohydrate-deficient transferrin (CDT) as a biomarker of alcohol abuse: A retrospective study of the Italian drinking trend among drivers from 2016 to 2022.Toxics. 2023;11(11):914. doi:10.3390/toxics11110914National Cancer Institute.Dictionary of cancer terms.Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol.2014;14:97. doi:10.1186/1471-230X-14-97Labcorp.Carbohydrate-deficient transferrin (CDT), adult.National Institute on Alcohol Abuse and Alcoholism(NIAAA).Harmful interactions.Zühlsdorf A, Said M, Seger C, et al.It is not always alcohol abuse—a transferrin variant impairing the CDT test.Alcohol and Alcoholism. 2016;51(2):148-153. doi:10.1093/alcalc/agv099van de Luitgaarden IAT, Schrieks IC, Kieneker LM, et al.Urinary ethyl glucuronide as measure of alcohol consumption and risk of cardiovascular disease: A population-based cohort study.J Am Heart Assoc. 2020;9(7):e014324. doi:10.1161/JAHA.119.014324Miller S, A Mills J, Long J, Philibert R.A comparison of the predictive power of DNA methylation with carbohydrate deficient transferrin for heavy alcohol consumption.Epigenetics. 2021;16(9):969-979. doi:10.1080/15592294.2020.1834918Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol. 2014;14:97. doi:10.1186/1471-230X-14-97

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Solomons HD.Carbohydrate deficient transferrin and alcoholism.Germs. 2012;2(2):75-78. doi:10.11599/germs.2012.1015Liang SS, He Y, Huang ZG, Jia CY, Gan W.Evaluation of the diagnostic utility of carbohydrate-deficient transferrin in chronic alcoholism.Medicine (Baltimore). 2021;100(4):e24467. doi:10.1097/MD.0000000000024467Alcohol questions and answers. CDC.Fiorelli D, Romani L, Treglia M, et al.Carbohydrate-deficient transferrin (CDT) as a biomarker of alcohol abuse: A retrospective study of the Italian drinking trend among drivers from 2016 to 2022.Toxics. 2023;11(11):914. doi:10.3390/toxics11110914National Cancer Institute.Dictionary of cancer terms.Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol.2014;14:97. doi:10.1186/1471-230X-14-97Labcorp.Carbohydrate-deficient transferrin (CDT), adult.National Institute on Alcohol Abuse and Alcoholism(NIAAA).Harmful interactions.Zühlsdorf A, Said M, Seger C, et al.It is not always alcohol abuse—a transferrin variant impairing the CDT test.Alcohol and Alcoholism. 2016;51(2):148-153. doi:10.1093/alcalc/agv099van de Luitgaarden IAT, Schrieks IC, Kieneker LM, et al.Urinary ethyl glucuronide as measure of alcohol consumption and risk of cardiovascular disease: A population-based cohort study.J Am Heart Assoc. 2020;9(7):e014324. doi:10.1161/JAHA.119.014324Miller S, A Mills J, Long J, Philibert R.A comparison of the predictive power of DNA methylation with carbohydrate deficient transferrin for heavy alcohol consumption.Epigenetics. 2021;16(9):969-979. doi:10.1080/15592294.2020.1834918Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol. 2014;14:97. doi:10.1186/1471-230X-14-97

Solomons HD.Carbohydrate deficient transferrin and alcoholism.Germs. 2012;2(2):75-78. doi:10.11599/germs.2012.1015

Liang SS, He Y, Huang ZG, Jia CY, Gan W.Evaluation of the diagnostic utility of carbohydrate-deficient transferrin in chronic alcoholism.Medicine (Baltimore). 2021;100(4):e24467. doi:10.1097/MD.0000000000024467

Alcohol questions and answers. CDC.

Fiorelli D, Romani L, Treglia M, et al.Carbohydrate-deficient transferrin (CDT) as a biomarker of alcohol abuse: A retrospective study of the Italian drinking trend among drivers from 2016 to 2022.Toxics. 2023;11(11):914. doi:10.3390/toxics11110914

National Cancer Institute.Dictionary of cancer terms.

Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol.2014;14:97. doi:10.1186/1471-230X-14-97

Labcorp.Carbohydrate-deficient transferrin (CDT), adult.

National Institute on Alcohol Abuse and Alcoholism(NIAAA).Harmful interactions.

Zühlsdorf A, Said M, Seger C, et al.It is not always alcohol abuse—a transferrin variant impairing the CDT test.Alcohol and Alcoholism. 2016;51(2):148-153. doi:10.1093/alcalc/agv099

van de Luitgaarden IAT, Schrieks IC, Kieneker LM, et al.Urinary ethyl glucuronide as measure of alcohol consumption and risk of cardiovascular disease: A population-based cohort study.J Am Heart Assoc. 2020;9(7):e014324. doi:10.1161/JAHA.119.014324

Miller S, A Mills J, Long J, Philibert R.A comparison of the predictive power of DNA methylation with carbohydrate deficient transferrin for heavy alcohol consumption.Epigenetics. 2021;16(9):969-979. doi:10.1080/15592294.2020.1834918

Fagan KJ, Irvine KM, McWhinney BC, et al.Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.BMC Gastroenterol. 2014;14:97. doi:10.1186/1471-230X-14-97

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