Alcohol Profile Plus Blood Test

Gamma-glutamyltransferase (GGT) is a liver enzyme that becomes elevated when liver cells are stressed or damaged, particularly by alcohol, fatty liver disease, or bile duct problems. It is one of the most sensitive enzymes for detecting alcohol-related liver stress, with levels often rising within days to weeks of heavy drinking and falling again during abstinence. However, GGT is not specific to alcohol — it can also be elevated by certain medications (anticonvulsants, some antibiotics), obesity, type 2 diabetes, non-alcoholic fatty liver disease, and other liver or biliary conditions. GGT is most informative when interpreted alongside other liver enzymes and direct alcohol markers.

Alanine transferase (ALT) is an enzyme found primarily inside liver cells. When liver cells are damaged or inflamed, ALT leaks into the bloodstream, raising blood levels. It is one of the most sensitive markers of hepatocellular injury and is routinely used to detect and monitor liver conditions including viral hepatitis, fatty liver disease, alcohol-related liver damage, and drug-induced liver injury. Mild ALT elevations are common and can also result from intense exercise, certain medications, or muscle injury. Persistently raised ALT, especially together with elevated GGT or AST, warrants further investigation to identify the underlying cause.

Alkaline phosphatase (ALP) is an enzyme found mainly in the liver, bile ducts, and bones. Raised ALP can indicate problems with bile flow (cholestasis), liver disease affecting the bile ducts, or bone disorders such as Paget's disease, healing fractures, or vitamin D deficiency. In the context of alcohol monitoring, ALP is less sensitive than GGT but provides additional information about bile duct function. ALP is normally elevated during pregnancy and in growing children, and isolated mild elevations are common and not always clinically significant. Interpretation requires consideration of other liver enzymes and clinical context.

Bilirubin is a yellow pigment formed when red blood cells break down. The liver processes bilirubin and excretes it into bile, ultimately removing it from the body. Raised blood bilirubin levels can indicate liver disease (hepatitis, cirrhosis, alcohol-related damage), bile duct obstruction, or excessive red blood cell breakdown. Visible jaundice (yellowing of the skin and eyes) typically appears when bilirubin rises above approximately 40 µmol/L. Mild elevations are common in Gilbert's syndrome, a benign inherited condition affecting around 5% of the population. As with other liver markers, bilirubin is best interpreted alongside ALT, AST, ALP, and GGT to identify the cause.

Mean cell volume (MCV) is a measurement of the average size of your red blood cells, reported as part of a full blood count. In the context of alcohol monitoring, sustained heavy drinking causes red blood cells to become enlarged (macrocytosis) over a period of weeks to months, raising the MCV. Because red blood cells live for around 120 days, MCV reflects alcohol consumption over the preceding two to three months and is slow to return to normal even after abstinence. MCV is not specific to alcohol — it can also be raised by vitamin B12 or folate deficiency, hypothyroidism, certain medications, and some bone marrow disorders.

Haemoglobin is the oxygen-carrying protein inside red blood cells. Measuring blood haemoglobin assesses your overall red blood cell health and screens for anaemia (low haemoglobin) or polycythaemia (high haemoglobin). Low haemoglobin can result from iron, B12 or folate deficiency, blood loss, chronic disease, or kidney problems. Raised haemoglobin can occur with smoking, dehydration, lung disease, or rarely a bone marrow disorder. In alcohol monitoring contexts, haemoglobin is measured alongside MCV (red cell size) to provide a complete picture of red blood cell health, since sustained heavy drinking can cause anaemia or red cell abnormalities through several mechanisms including poor nutrition and direct bone marrow effects.

Carbohydrate-deficient transferrin (CDT) is a recognised marker of chronic, heavy alcohol consumption. Transferrin is an iron-transport protein normally bound to several carbohydrate chains; sustained heavy drinking interferes with this binding, raising the proportion of carbohydrate-deficient forms. CDT typically becomes elevated after consuming approximately 50–80g of alcohol per day for two weeks or more, with a detection window of around two to four weeks. It is more specific than liver enzymes for detecting heavy drinking but can be affected by rare genetic transferrin variants and severe liver disease, so is best interpreted alongside other alcohol biomarkers.