The DVLA Medical test, CDT and an individual case study

white43

Well-known member
#1
Individual Test
I am male, 41. Largely sedentary, clinically obese. Previous history of alcohol abuse and recent consumption of alcohol in the range of 22-24 UK alcohol units a day (179g), about six nights a week.
I have diabetes type 2, but diet controlled. Suffer from gout, but controlled by gout medication (Allopurinol). I smoke a couple of rollups a day, but will attempt to stop during this period because smoking may raise CDT levels.(see below)

I had been led to believe that CDT would take 2-4 weeks to correct itself, but further reading(on this forum) revealed contradictory evidence with other researchers claiming 12 weeks was necessary dependent on amount drank and period. I decided to try to give myself as long as possible in abstinence and have decided to purchase private CDT tests to give some guidance to myself and hopefully others.

I take the following supplements: Mega dose vitamins, Magnesium, Taurine, Milk Thistle, Zinc, Omega 3 and an iron supplement to avoid any iron deficiency that may cause CDT levels to be elevated. (See below)

Conflicting arguments
Different independent studies have indicated a half life of CDT being anywhere between 7 and 17 days; this has resulted in some studies claiming that CDT levels return to normal 2 to 4 weeks and others indicating a longer time of 1-2 months. Some speculate it could take as long as 12 weeks or 3 months to return to normal.

Some studies indicate binge drinking once a week will can elevate CDT levels. Others indicate not. Likewise, it has been argued that smoking can elevate CDT levels.

Several studies have indicated that iron can play a role in CDT levels. Low levels of iron can raise CDT levels, conversely high levels can cause a low level reading.

Obesity and high cholesterol has been argued to produce lower level CDT readings as it appears to reduce the sensitivity of the test. Medications may also reduce CDT levels. Women who abuse alcohol may have higher CDT levels, but the test appears to be more accurate in males.

20/02/2016
I received application form from DVLA, exactly three months to the end of my ban.

At this stage, I was still drinking regularly (at levels indicated above) and began abstinence from this date. Decided to hold off submitting application for 4 weeks, to gain a month’s abstinence and test CDT levels before and after this. Based on the result of the 2[SUP]nd[/SUP] test, I will determine hopefully in what part of the DVLA six week window I would book an appointment for the DVLA test for.

23/02/2016
First blood test submitted to find a baseline CDT level. Takes 5 working days (Medichecks)
RESULT: 0.9% 29/02/2016*

21/03/2016
Second blood test submitted to see a result after 4 weeks.
RESULT:

* So I wasn't expecting this result merely days after I was consuming large amounts of alcohol. If this result is correct, some factors that may influence it are potentially, being obese, having high cholesterol(this makes the test . Unknown factors - supplementation, see above. I have no idea if this is influencing the result. I'd get a test done with someone else, but it's kinda pricey! I didn't start taking iron until the day of the test.

Of course, the test could be completely wrong!
 
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white43

Well-known member
#3
0.9%? Wow!! That's interesting and unexpected..Will you continue to abstain until the next test? Interested to see what reading you get in three weeks time.
As I'm not sure I 100% trust that figure and I don't have the money for more tests, I will still abstain for the next three weeks to the 2nd test.
 
#4
Yes, without being sure of the reliability of the lab and their procedures, it would be best to abstain. It's just a shame about the expense if the results are inaccurate. Or you might be a medical anomaly! Keep us posted.
 

white43

Well-known member
#5
Another update.

After two weeks of sobriety (and a 0.9% CDT result), I had a particularly difficult week at work and I did drink in the region of 24 units of a Friday night(4th March). Yes, silly. :(But I somehow justified this to myself by saying I had a 0.9% result and one binge could not knock this up too high! :confused:

By the Sunday night(6th March), I was panicking that the first result could have been wrong and I could have just set myself back.

I decided to get a blood test through 'privatebloodtests' the next day, which arranges for you to visit a Nuffield hospital, get the blood drawn venously and sent off professionally. This test cost £141. It's not cheap. This is significantly more expensive than the pin prick method offered by 'Medichecks'(£79), who I sent the first sample off to myself via special delivery.

The result came back today(14/03/2016) as a 1%.(one week to get results)

So, as you can see, the Medichecks pinprick* test was as accurate as a venously drawn sample by a Nuffield hospital nurse. The difference between 0.9% and 1% is nothing. Perhaps the rise of 0.01% is attributable to the binge I had three days before.

*(The pinprick is not simply a blob of blood, your finger is lanced and you 'massage out' a significant amount of blood into a blood sample tube.)

Unfortunately, it doesn't explain my low results. The first result of 0.9% is the most baffling, as I was definitely drinking large amounts of alcohol(around 22-24 units), daily, before this. The second result follows two weeks of abstinence and one binge, so it's possible.

I'm beginning to wonder if I am exhibiting false negatives for some reason. I can only reiterate what I said before, I supplement with : Mega dose vitamins, Magnesium(400-800mg), Taurine(4g), Milk Thistle(x3 daily), Zinc and Omega 3 (1g EPA). My milk thistle is advertised as 5700MG. I have no idea if this helps or not. I did start taking Iron, but it's clear I don't need to. I've been taking statins for 2/3 weeks and this hasn't changed the result.

With this second result under my belt, I am no longer delaying and have sent my application off today(14/03/2016), with a cheque, as I refuse to pay £11 for the privilege of a postal order! So I'm expecting some sort of response in three weeks from DVLA.

I don't think the blood test will be the problem, it's me answering 'Yes' to a couple of the questions that I found on the DVLA Medical questionnaire here.....:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/320711/DR1V_.pdf
 
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Mclanelli

Well-known member
#6
Another update.

After two weeks of sobriety (and a 0.9% CDT result), I had a particularly difficult week at work and I did drink in the region of 24 units of a Friday night(4th March). Yes, silly. :(But I somehow justified this to myself by saying I had a 0.9% result and one binge could not knock this up too high! :confused:

By the Sunday night(6th March), I was panicking that the first result could have been wrong and I could have just set myself back.

I decided to get a blood test through 'privatebloodtests' the next day, which arranges for you to visit a Nuffield hospital, get the blood drawn venously and sent off professionally. This test cost £141. It's not cheap. This is significantly more expensive than the pin prick method offered by 'Medichecks'(£79), who I sent the first sample off to myself via special delivery.

The result came back today(14/03/2016) as a 1%.(one week to get results)

So, as you can see, the Medichecks pinprick* test was as accurate as a venously drawn sample by a Nuffield hospital nurse. The difference between 0.9% and 1% is nothing. Perhaps the rise of 0.01% is attributable to the binge I had three days before.

*(The pinprick is not simply a blob of blood, your finger is lanced and you 'massage out' a significant amount of blood into a blood sample tube.)

Unfortunately, it doesn't explain my low results. The first result of 0.9% is the most baffling, as I was definitely drinking large amounts of alcohol(around 22-24 units), daily, before this. The second result follows two weeks of abstinence and one binge, so it's possible.

I'm beginning to wonder if I am exhibiting false negatives for some reason. I can only reiterate what I said before, I supplement with : Mega dose vitamins, Magnesium(400-800mg), Taurine(4g), Milk Thistle(x3 daily), Zinc and Omega 3 (1g EPA). My milk thistle is advertised as 5700MG. I have no idea if this helps or not. I did start taking Iron, but it's clear I don't need to. I've been taking statins for 2/3 weeks and this hasn't changed the result.

With this second result under my belt, I am no longer delaying and have sent my application off today(14/03/2016), with a cheque, as I refuse to pay £11 for the privilege of a postal order! So I'm expecting some sort of response in three weeks from DVLA.

I don't think the blood test will be the problem, it's me answering 'Yes' to a couple of the questions that I found on the DVLA Medical questionnaire here.....:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/320711/DR1V_.pdf
From what I understand and have read, your CD level can take 7 to 10 days to increase from alcohol consumption. So on that basis it could be possible to take the same test again latter and see an increased CDT level; despite no further alcohol consumption.

I doubt it would be high enough to cause a problem even if there was an increase.

I've read that a lot of people don't respond to the CDT test. Alcoholics by all accounts have been known to score really low on the scale.

With regards to sending the cheque; it doesn't delay the process at all. In fact there are suggestions that a postal order can take longer due to DVLA internal processes. People have received the DVLA doctor letter with a date mark inside the seven day cheque clearing period. So they send out confirmation of you medical once the cheque is received; not once it has been cashed.

Regards
M
 

white43

Well-known member
#7
From what I understand and have read, your CD level can take 7 to 10 days to increase from alcohol consumption. So on that basis it could be possible to take the same test again latter and see an increased CDT level; despite no further alcohol consumption.

I doubt it would be high enough to cause a problem even if there was an increase.

I've read that a lot of people don't respond to the CDT test. Alcoholics by all accounts have been known to score really low on the scale.

With regards to sending the cheque; it doesn't delay the process at all. In fact there are suggestions that a postal order can take longer due to DVLA internal processes. People have received the DVLA doctor letter with a date mark inside the seven day cheque clearing period. So they send out confirmation of you medical once the cheque is received; not once it has been cashed.

Regards
M
I do wonder whether I don't respond to CDT. I had been drinking longer than 10 days prior to my first test and then it was over 14 days to my second test and there was no rise. My first test should have showed sustained and heavy drinking but did not. CDT is elevated after at least 2 weeks of at least 50-100g alcohol daily to get to a 3%. Even if we supposed that when I ceased drinking, a further 7-10 days would show an increase, it didn't - but CDT falls immediately from cessation of alcohol drinking.

That's somewhat of a relief to hear that they won't wait for the cheque to clear. I'd like to get on with this now.
 

white43

Well-known member
#8
I received my letter from the DVLA today (26th March) dated the 22nd March. Presumably it would have arrived yesterday if not for the bank holiday weekend!

This looks like it's taking them a week to process and reply as they had my application on the 15th March. The cheque has not cleared yet, so this does not delay.

The letter states to wait 4 working dates from receipt to book an appointment with the DVLA appointed GP. The GP is not in my town, although mine is quite small with about 4/5 practices.

I shall make appointment this week. Will try Tuesday which is sooner than they advise as above but will try.
 
#9
Hi white43.

I called the GP surgery the day I received my letter and there was no problem, they knew who I was. I read it as the date of the actual medical exam being more than 4 days from receipt of the letter. As I understand it, this is to ensure that the medical 'kit' specifically for you has arrived at the surgery but a moot point anyway, what with the bank holiday in the way. I think they're erratic when it comes to waiting for cheques to clear, I'm sure they sent my letter after my cheque cleared.

I do feel it is quite wrong that they tell you which surgery to attend. The 'nearest' surgery to me was in a town that is only 13 miles away but definitely not the easiest to get to as it involves a 56 minute train journey and a 20 minute walk. If you're given a list of franchise surgeries, it would be possible to at least choose one near to your place of work meaning that you only need to take a half day off work. I think it's deliberate to make things as difficult as possible but that's by the bye... I found that the surgery that I was assigned to only hold the DD medical clinic on one morning each week so you may not be able to pick and choose an appointment time. Keep us posted..
 

Mclanelli

Well-known member
#10
If you have trouble contacting the surgery you can phone the DVLA medical team and they will give you alternative surgeries; but they wont be as close to the original allocation, as this will be the nearest based on your post code location.

Often the DVLA doctor will travel regionally on set dates to different surgery locations to complete the medicals. So that's why you are usually given set dates and times on when you can attend.

In terms of the medical there is no "kit" sent in anticipation of your arrival. You will be asked a series of questions, all based on the last three years. You will then be asked to sign the questionnaire and sign the disclosure form for your GP; should the DVLA need to use it. You will also need your GP's name and surgery address.

You will then have your blood pressure taken.

Next you will have a basic eye test, and your height and weight checked and recorded. From this the doctor works out your BMI.

When you arrive at reception you will be given a pot to pee in; and you will be told to do this in the public toilets and keep hold of your sample. At this point in the medical the doctor will ask you for that pee sample and carry out several strip tests for drugs, glucose, and micro blood. If glucose or blood is present; depending on the amount, the doctor will advise you of what to do next. Basically you would be told to make an appointment with your GP to get this checked further. If illegal drugs are present the doctor wont tell you.

Then you will have your blood taken.

Then you will pay the doctor. £96.00 or £96.00 plus VAT, which they round up to £118.00. This will only apply if the doctor is VAT registered. In either case you will then be given a receipt.

The doctor will be allowed 2 weeks grace before the DVLA chase him/her for the questionnaire. Your blood work is picked up by a medical courier usually the next day; and it takes approximately one week for the results to be forwarded on to the DVLA's medical team. If the DVLA need to write to your GP then they allow 4 weeks grace before they chase them for the questionnaire. In each case you can phone and speed this process up.

M
 
#11
The fee for the medical is £98.50 and if the Dr. is VAT registered, 20% (£19.70) will be added.
A urine test is not always required but when you book your appointment you can ask about this and they will tell you if one is required in your case or not. Height, weight, and blood pressure are not necessarily measured nor is an eye test always required, again the receptionist can advise you specifically when you book your appointment.
Depending on the arrangements at the surgery (day/time of day that the medical takes place and locality) the blood samples are often taken/sent to the lab on the same day. The doctor I saw writes the reports for DVLA on same day too..it is possible, barring further inquiries, that your license may be issued 7 days later.
 

Mclanelli

Well-known member
#12
For clarification, the process that I have described is the complete version of the medical.

You will always have your blood taken, but the rest are subject to each doctors process.

There is no report as such from the doctor, just a signed declaration from the doctor that he/she believes you to be fit and well. This declaration is contained on the medical questionnaire which can be faxed/scanned emailed across to the DVLA, however they seem to require the original document. So this needs to be posted over to the DVLA. If the doctor is carrying out several medicals in one surgery over a calendar week then they will probably send multiples in one go on the Friday. So if your medical was on a Monday there is potentially a delay there.

One thing I forgot to mention was that the doctor will ask you if you want to be updated by email or letter. Email will save time.

What you need to ask during your medical is; when/how will the doctor be sending your signed questionnaire over to the DVLA's medical team.

M
 
#13
For clarification, I have only ever described my personal experience. My medical exam was on a Monday morning. I asked when my blood sample would be sent and was told it would be couriered on Monday afternoon, the same day. I was told, without prompting, that the paperwork would be completed and sent to DVLA that afternoon. By 'report' I mean the completed questionnaire and any further information that the doctor gleaned from our appointment, essentially a 'report' as to whether you appear to be fit, healthy and cognizant (primarily, not drunk). I was not asked whether I would like any kind of update, email or otherwise. There is a section on the DVLA form that asks if you would like your blood test results, or any anomalies shown by your blood test, forwarded to your GP. You can check yes or no to this. There is no part of the questionnaire that asks how you would like an update, whether by email or letter. If you want to check on the status of your application, post medical, you need to call DVLA medical group on the number supplied on your medical request letter.
 

white43

Well-known member
#14
Thank you for the information, I will report back my experiences.

My appointment is not until the 26th April, 4 weeks from now, which is a little disappointing. I was hoping for something sooner.
 

Mclanelli

Well-known member
#15
Here is an update and some information that might be of benefit to some of you.

I work in the Maritime Security sector, and a colleague and good friend has just been through his DVLA HRO medical; which in fact I did describe earlier in this feed, but without this individuals reference.

His medical was on the 21/03 at 16:30 in London.

The following took place:

Questionnaire - regarding alcohol use over the last three years, and a signed declaration of any prescribed medication or counselling.
Blood pressure
Eye test
Height and weight check along BMI calculation
Basic examination around kidney area
Urine sample stick test for drugs, glucose and blood.
Blood test for CDT levels.

His blood pressure was slightly high, but so was his pulse rate. So nerves were credited for this. He was advised to get this checked by a GP.
He had a small amount of glucose showing in his urine and some blood. This was confirmed during the examination. He was told to get this checked by a GP and have further tests.

He did book further tests for his glucose and blood, through our agency doctor. (we undergo many medicals in our profession so we have in house team people) He also booked a test with a NHS GP.

His glucose came back negative, and his blood was okay. knocks and an athletic lifestyle can contribute towards this; so this is standard for us and anyone in our profession so he expected that to be okay. Still, its good that this doctor checked it over don't you think?

So here is the time line:

His medical was on the 21/03 at 16:30 - so he lost that day in terms of his blood sample being collected and his questionnaire being dispatched. The clock really started on the 22/03. There was the bank holiday on the Friday 25/03 and on the Monday 28/03.

The DVLA received his blood results and questionnaire on Tuesday 29/03.
His licence was dispatched on Thursday 31/03 at 10:30

So that's six working days excluding the two bank holiday days and weekends.

We figured his glucose reading could spark further enquiries. It didn't, but it wouldn't have mattered anyway. That ain't too shabby regarding timescales and process.

He asked the doc why some people got a urine test and eye test, and why others didn't; the doc said he had a professional duty of care to sign a declaration and pass him medically fit to drive. The doc said that his duty of care should go beyond what the DVLA require as a minimum standard. Professionally this doctor wanted to check him out for his own piece of mind and for that of the patient involved. That's aces in my book. This doctor was a good guy. This explains why some do this and some don't.

That basic urine test which takes 30 seconds to complete is a great pre screen for type 2 diabetes; of which one in three people are undiagnosed in the UK. Back in the States its even higher. If you have glucose in your pee, even a small amount, then you need to get some blood tests done to rule out being type 2.

When you think about it; its almost criminal that some of these doctors aren't bothering with this simple basic test and potentially allowing people to walk out of a medical with a potentially serious condition that could be identified. Type 2 is a condition that if left untreated, will eventually cause you serious problems later down the line.

I know White43 is clued on this last subject; but I just wanted to highlight it for the benefit of others.

The medical cost £118 in VAT. It lasted 15 minutes.

By the way he stayed off alcohol completely from Jan 04 to the day of the medical.

I hope this helps.

M
 

white43

Well-known member
#16
Medical is due Tuesday 26th April. You might be interested to know I had a third CDT test this last month and scored a 0.7%.

Aside.

If one scores a complete GREEN on the CDT test and answers 'NO' to all the questions on the medical questionnaire....should there be any reason for DVLA to follow up with a GP referral?

Might there be reason to follow up with the GP if this is the second time I've been banned - the first was in 2003?

Do DVLA randomly follow up medicals despite clean results and 'No' answered questionnaires??
 
#17
Medical is due Tuesday 26th April. You might be interested to know I had a third CDT test this last month and scored a 0.7%.

Aside.

If one scores a complete GREEN on the CDT test and answers 'NO' to all the questions on the medical questionnaire....should there be any reason for DVLA to follow up with a GP referral?

Might there be reason to follow up with the GP if this is the second time I've been banned - the first was in 2003?

Do DVLA randomly follow up medicals despite clean results and 'No' answered questionnaires??

Hey white, your CDT reading is consistently low, have you maintained abstinence/no hiccoughs?

I don't think that DVLA contact your GP if your medical examination was all clear with no answers to all the questions and you score in the 'green zone'. I have read older posts where GPs have been contacted when bloods have come back ok but you don't know what the DVLA doctor has written in those instances. There may have been something that they've observed and noted that flagged up. More recent posts seem to indicate much less GP contact.
Didn't you say that you were prescribed chlorodiazepoxide within the last three years though? Are you going to tell them?

Price might be able to help with the question as to whether a second offense is likely to trigger GP enquiries..
 

white43

Well-known member
#19
I was prescribed yes, but I've always assumed that was for anxiety at the time??

That was some 19 months ago now. I don't feel I need to give DVLA a rod to beat me with. I've served my ban, did my community service and did the alcohol awarenesss course. I'm doing the medical. I am not drinking.

This guy was in the same boat : http://www.forum.drinkdriving.org/general-discussion/64936.htm

He answered 'No' to everything and wound up getting his license back, no questions asked.
 

Mclanelli

Well-known member
#20
"I'm doing the medical. I am not drinking"

Then why have you spent close to £300 in the last 12 weeks on 3 private CDT tests to make sure you are under the required level?

That is not inductive of someone who is not abstaining prior to a medical.

M
 
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