Hro medical and cdt levels

[C JONES]

Just to clarify all past threads etc regarding abstaining from alcohol prior to the HRO medical ; If you are a heavy drinker eg. Averaging say 5 pints a night ie. 35 pints a week , and stop all alcohol consumption 8-10 weeks before the HRO medical , will your CDT levels be low enough to get you through ?

 

[Mclanelli]

Just to clarify all past threads etc regarding abstaining from alcohol prior to the HRO medical ; If you are a heavy drinker eg. Averaging say 5 pints a night ie. 35 pints a week , and stop all alcohol consumption 8-10 weeks before the HRO medical , will your CDT levels be low enough to get you through ?

CDT or Carbohydrate Deficient Transferrin has a half life of between two to three weeks. This means that it will take between four to six weeks for your CDT levels to start returning to normal from the moment you stop drinking, with complete abstinence from alcohol during that period. Therefore it is advised that an individual abstains from alcohol completely for a minimum period of 12 weeks in order to ensure CDT levels drop to below 2.2.

Five strong (5%) pints, five days per week over two weeks, is considered to be sufficient to raise CDT levels above 3.0

So you need to give it a full 12 weeks to be safe. Anything less is considered a risk.

Regardless to what you drank prior, 12 full weeks of abstinence seems to be considered by the medical profession as a safe cut off point.

M

 

[C JONES]

Thanks M for the continued advice . Will be applying for licence mid March and , taking into account posting of letters between all parties , I can probably expect my medical mid April ? I will be stopping all alcohol consumption , therefore , very soon .

Green Tea , Water , Milk Thistle all recommended , but can you advise any more cleansing remedies ?

 

[Mclanelli]

Thanks M for the continued advice . Will be applying for licence mid March and , taking into account posting of letters between all parties , I can probably expect my medical mid April ? I will be stopping all alcohol consumption , therefore , very soon .

Green Tea , Water , Milk Thistle all recommended , but can you advise any more cleansing remedies ?

All of the remedies mentioned are good, especially Milk Thistle tablets. You can pick up 60 Milk Thistle tablets for around £8 on amazon which is the cheapest source. You only need the standard 100/150mg tablets. Avoid the super strength versions and save your money. Your body can only absorb so much, and the rest is flushed out, so there is no point purchasing the higher strength versions. The same applies to all vitamin supplements. Save your money.

Nothing speeds up the reduction of CDT in your body, and the biomarker is in your blood. So short of having a full blood transfusion before your blood test, you are out of luck. Only time will reduce your levels. 12 weeks to be sure.

From the time your D1 application is received by the DVLA, to the time they write to you with a list of GP's for your medical is approximately four weeks. The time it takes to arrange your medical from that point can be a matter of days. So in theory you can have you medical booked and completed, within six weeks of your D1 being received by the DVLA. Postal orders are advised as opposed to cheques as they clear immediately, and this speeds up the process.

Once you have received your GP list from the DVLA you have a time limit of six weeks to book and complete the medical. This is not well documented and most people only find this out when they receive the list. So be mindful of this if your are planning any trips abroad. If you don't complete the medical within six weeks then it is classed as "none compliance" by the DVLA and they will revoke your licence, even though you are already banned. (its hard to keep a straight face over that I know) I think what happens is they restart the whole process and it probably will cost you another £100.00.

Good luck.

M

 

[price1367]

I think Mclanelli is right in your case about abstaining for 12 weeks. You seem to indicate (at 5% Abv for your pints) that you are consuming over 100 units of alcohol a week. Whils 5 pints in a night occasionally may not be too harmfull,, doing that every night certainly is.that is twice the level at which it is viewed as being likely to cause 'significant harm.'
some people swear by milk thistle, I remain unconvinced but it certainly will not harm only correction I would make is that the DVLA approved doctor will not be a GP, as in your out doctor, it will be one at a clinic or hospital and they no longer send out a list for you to chose from, they tell you THE doctor (locally) that you have to see, within 6 weeks of being notified.

 

[chatjacker]

I think Mclanelli is right in your case about abstaining for 12 weeks. You seem to indicate (at 5% Abv for your pints) that you are consuming over 100 units of alcohol a week. Whils 5 pints in a night occasionally may not be too harmfull,, doing that every night certainly is.that is twice the level at which it is viewed as being likely to cause 'significant harm.'
some people swear by milk thistle, I remain unconvinced but it certainly will not harm only correction I would make is that the DVLA approved doctor will not be a GP, as in your out doctor, it will be one at a clinic or hospital and they no longer send out a list for you to chose from, they tell you THE doctor (locally) that you have to see, within 6 weeks of being notified.

M has absolutely no evidence to back up the 12 week timescale. For scientifically researched timescales of all biomarkers please refer to the NIAAA AND ITS GLOBAL TEAM OF SCIENTISTS. They are the worlds largest funders of alcohol research in the world and will provide proven info regarding CDT levels. Scientists from the U.S and Sweden (where CDT testing was originally developed) have given proven timescales based on actual scientific research. Be very wary of timescales posted in forums that have no scientific foundation. http://pubs.niaaa.nih.gov/publications/AssessingAlcohol/biomarkers.htm

Also check out THE U.S NATIONAL LIBRARY OF MEDICINE NATIONAL INSTUTUTES OF HEALTH to see if you think your smoking may affect your CDT results.

 

[Mclanelli]

There is plenty of evidence regarding the 12 week rule. Medical professionals in abundance talk about it on various sources across the net. With notes - be that actual PA minutes taken from review meetings. In fact there are notes (minutes) taken from the DVLAs own medical review board from 2014 where there is a detailed discussion regarding abstinence periods; notably the 12 week period.

There is plenty of information out there. Some people have more time on their hands than others, and as such they can spend more time searching the web. I like to keep my information accurate and to the point, by writing in my own words; which has more benefit to the layman.


Remember, if you want to be sure you go with the 12 week period. Proven fact, backed up by every GP, Biochemist, specialist and even the good old DVLA.

I will leave you all to do your own searching.

Regards
M

 

[chatjacker]

There is plenty of evidence regarding the 12 week rule. Medical professionals in abundance talk about it on various sources across the net. With notes - be that actual PA minutes taken from review meetings. In fact there are notes (minutes) taken from the DVLAs own medical review board from 2014 where there is a detailed discussion regarding abstinence periods; notably the 12 week period.

There is plenty of information out there. Some people have more time on their hands than others, and as such they can spend more time searching the web. I like to keep my information accurate and to the point, by writing in my own words; which has more benefit to the layman.


Remember, if you want to be sure you go with the 12 week period. Proven fact, backed up by every GP, Biochemist, specialist and even the good old DVLA.

I will leave you all to do your own searching.

Regards
M

So still no evidence from specialist scientists that are experts in the field of alcohol biomarkers?? Not even a quote from a gp, biochemist etc?? "Every GP, BIOCHEMIST" but none that you can find or point people to because the worlds leading alcohol biomarker scientists say 2-4 weeks.
I wont bother commenting any further as you could have the Swedish scientist that devised the test sat right in front of you and you still wouldnt listen.
Yes you will pass if you abstain for 12 weeks... because alcohol biomarkers return to normal after 2-4 weeks lol..

 

[Mclanelli]

So still no evidence from specialist scientists that are experts in the field of alcohol biomarkers?? Not even a quote from a gp, biochemist etc?? "Every GP, BIOCHEMIST" but none that you can find or point people to because the worlds leading alcohol biomarker scientists say 2-4 weeks.
I wont bother commenting any further as you could have the Swedish scientist that devised the test sat right in front of you and you still wouldnt listen.
Yes you will pass if you abstain for 12 weeks... because alcohol biomarkers return to normal after 2-4 weeks lol..

Absolutely, you are correct; if you abstain for twelve weeks you will pass. So that's a no brainer. Anybody wishing for the safe return of their licence after the medical, would be a fool not to apply this timescale and logic.

In contrast, there are people, active on this site, who abstained for only four weeks and failed the test. Some passed after four weeks. So in conclusion, if you want to be safe, and sure, and stress free, then you go with the longer period.

People can research the sources for themselves if they wish to. It is not and never will be, my intention to bore the hell out of people with random cut and paste articles. I don't need to. Grammar comes easily to me Phil.

I'm glad you have finally come to reason with regards to the 12 week rule.

Anyway, I'm off out now in the 4x4 to pick up some pizza. I will drive safe and well.

Happy hunting Phil James.

Regards
M

 

[price1367]

M has absolutely no evidence to back up the 12 week timescale. For scientifically researched timescales of all biomarkers please refer to the NIAAA AND ITS GLOBAL TEAM OF SCIENTISTS. They are the worlds largest funders of alcohol research in the world and will provide proven info regarding CDT levels. Scientists from the U.S and Sweden (where CDT testing was originally developed) have given proven timescales based on actual scientific research. Be very wary of timescales posted in forums that have no scientific foundation. http://pubs.niaaa.nih.gov/publications/AssessingAlcohol/biomarkers.htm

Also check out THE U.S NATIONAL LIBRARY OF MEDICINE NATIONAL INSTUTUTES OF HEALTH to see if you think your smoking may affect your CDT results.

Sorry Mclanelly for this, but I am going to cut and paste despite what you say, because Chatjacker is incorrect when he says there is no evidence to back up the 12 week timescale, but he is correct that the National Institutes of Health confirm that smoking could affect CDT results. See here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074194/

Many other factors may influence CDT testing accuracy. Rare genetic mutations in amino acid sequences affect the ability to separate isoforms, reducing the test accuracy.3 Age has been shown to reduce accuracy in some studies, and yet have no effect in others. Elevated body mass index (BMI) might blunt ethanol-dose CDT-response curves. Diastolic blood pressure (BP) greater than 90 might amplify the dose-response curve. Smoking may potentiate elevated CDT levels due to increased liver damage. Drinking patterns also affect CDT. For all of these markers listed, more research is necessary to determine significance.3 However, recent research has not indicated a need to adjust CDT values for any of the listed factors.6

so they say that the changes to the readings from these factors, including smoking, are not viewed as being at all significant.

Below is a quote on a project working with alcoholics where their CDT levels were monitored over a 12 week period, you will see that their levels reduced by 30%. This is good, but it does not say what their base level was. If it was 4.2%, then a 30% reduction would have taken their reading down to 2.95% - still enough to be a fail, even after 12 weeks. This reflects the extreme end of alcohol consumption, which will not apply to most people coming here, but it does show that to say that 2-4 weeks abstenance WILL reduce your CDT to acceptable limits is flawed.
The link to the quote is below and you will see that it was funded by an organisation that has been widely recommended by someone on this site...... The NIAAA !!

http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.1996.tb05261.x/abstract

quote:

Biological markers of alcohol consumption have been used in both clinical and research settings to aid in the identification of relapse drinking. Although carbohydrate-deficient transferrin (CDT) has been shown to be a sensitive and specific marker for the identification of heavy drinkers, little data are available as to its utility as a marker for relapse drinking during treatment, particularly in comparison with the more widely used serum γ-glutamyltransferase (GGT). CDT and GGT were measured in 35 male alcoholics before entering, and every 4 weeks during, a 12-week outpatient treatment trial combining pharmacotherapy and cognitive behavioral therapy. CDT and GGT were again measured 14 weeks after completion of treatment. During the 12-week treatment period, CDT showed a significant difference in those individuals who abstained from drinking (30% decrease), compared with those who relapsed (10% increase).

People drinking in the order of 14-21 units per week probably don't need to abstain at all before their medical. People drinking more than that may well be OK after a few weeks abstenance but for someone who is a chronic drinker then even 12 weeks abstenance may not be enough.
I have previously advised people that 5 or 6 weeks sensible drinking should be sufficient to pass the test, but that has been based on the relatively low amounts of alcohol they say they have been drinking. I have to recognise that people are notoriously bad at adding up when it comes to alcohol......

 

[C JONES]

Apologies for being slow on the uptake but using this as an extreme example ; If you drank an average of 5 pints , of say Stella , per day every day for a year , then stopped all alcohol consumption for 12 weeks , would your CDT level be low enough to pass the HRO medical ?

 

[price1367]

The answer to that is...... Probably! It would depend on if you had done it for long enough to damage your liver, if so, even after 12 weeks your CDT might be raised, but only enough to be in the 'Amber' range (2.3 to 2.9) which would prompt further investigation. In fact, if you disclosed that level of drinking anyway, it would be likely to prompt further investigation after the medical exam.

 

[Ritchie1957]

If I've abstained from alcohol for a year but then drank quite a lot of wine over Christmas do you think cdt results will normalise in 6 weeks?

 

[Xeronema]

If I've abstained from alcohol for a year but then drank quite a lot of wine over Christmas do you think cdt results will normalise in 6 weeks?

Going off what other people have stated in similar postings, you should be fine. The only reason I can't say you'll be 100% fine is because my CDT levels were 0.9% and I'd been sober for several years before taking the medical (no alcoholic bevages prior to the medical for several years either).

Just out of interest, what is a 'lot of wine'?

Edit: See, for me, a lot of wine would be 21 - 28 bottles (3 - 4 bottles a day) in the space of a week.

 

[Xeronema]

"I've probably had about 8 bottles wine over 2 week period." - message from Ritchie1957, they were not able to reply for some reason.

As mentioned privately, you'll be fine.