Dr. Skipper I was recently given an ETG test and it came back positive. I haven't been drinking for almost a year now, but somehow I've tested positive. The test shows that no alcohol (Ethanol) was detected. The method was EA. The cutoff 0.04 g/dl. But ethyl glucuronide was detected. Method was EIA. Cutoff was 0 ng/ml Then it says Ethyl Glucuronide was detected again. (964 ng/ml) the method was LC/MS/MS and the cutoff was 100 ng/ml. After that it says tat Ethyl Sulfate was detected (422 ng/ml) The method was LC/MS/MS/ and the cutoff was 25 ng/ml. My Creatinine result was 362.1 mg/dl and the method used was Colorimetric. The reference range was >20 mg/dl. That said I use a few products around the house that I looked up as having Phenoxyethanol such as Head and Shoulder conditioner and Aveeno Sunblock. Could this have been the cause of false Positive? Plus I eat plenty of bananas and I'm on medication due to an injury that occurred at work. Please let me know what the results mean because all I see is numbers and don't understand what they signify.

Yes many products can cause a false positive..

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Originally Posted by FalseETG

Dr. Skipper I was recently given an ETG test and it came back positive. I haven't been drinking for almost a year now, but somehow I've tested positive. The test shows that no alcohol (Ethanol) was detected. The method was EA. The cutoff 0.04 g/dl. But ethyl glucuronide was detected. Method was EIA. Cutoff was 0 ng/ml Then it says Ethyl Glucuronide was detected again. (964 ng/ml) the method was LC/MS/MS and the cutoff was 100 ng/ml. After that it says tat Ethyl Sulfate was detected (422 ng/ml) The method was LC/MS/MS/ and the cutoff was 25 ng/ml. My Creatinine result was 362.1 mg/dl and the method used was Colorimetric. The reference range was >20 mg/dl. That said I use a few products around the house that I looked up as having Phenoxyethanol such as Head and Shoulder conditioner and Aveeno Sunblock. Could this have been the cause of false Positive? Plus I eat plenty of bananas and I'm on medication due to an injury that occurred at work. Please let me know what the results mean because all I see is numbers and don't understand what they signify.

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EtG = 964 ng/mL
EtS = 422 ng/mL
Creat 362.1

The first thing that jumps out is the creatinine reading. High creatinine artificially increases EtG/EtS. Normalized to creatinine EtG/EtS reads as follows:

U100EtG = 266 ng/mL
U100EtS = 166 ng/mL
Creat 362.1

This should have been performed by the testing lab with the lower amount reported* . Whether normalized or not the reading is low. After normalization is very low and now we can come closer to determining possible low level sources that could have created EtG and EtS. This is the range where incidental, innocent sources, are most likely to be responsible.

It sounds like you have the printout in front of you. Check the time of the sample collection and also the time that the test was performed. The time interval is important.

It is unlikely that the products and food items you mention could have caused the reading, but will be considered.

Also, need to know the medications that you are taking.

*The Role of Biomarkers in the Treatment of Alcohol Use Disorders, 2012 Revision
Spring 2012, Volume 11, Issue 2, p. 7

NOTE: I am not Dr Skipper but here is a website for him.

Gregory Skipper, MD Ethylglucuronide.

Dr Skipper is a nice fellow and will probably respond but recommend that the information presented be clearly organized in advance as he functions as a paid consultant and understandably doesn't provide extensive pro bono service. I do however recommend that you contact him as he is extremely knowledgeable and will hopefully provide a brief opinion.

Dr.Bill

Thank you for your feedback. My sample was collected on 7/2/2012 and it was received on 7/6/2012 at 2:29pm. The test was reported on 7/7/2012 7:35pm. I'm currently taking Vicodin 3x daily, 3 Gabapentin 3x daily, Methocarbomol 2x daily, and 800mg Ibuprofen 2x daily. No amphetamines, barbiturates, Benzodiazepines, opiates or Alcohol were detected in my urine. An ETG and a 7 panel drug screen were ordered. So doesn't this mean that one of my prescriptions should have came up as positive as well as the supposed Ethyl that was found in my urine? Please respond, as I do need a response before I go and meet with my PO so I can go in with all the information I can gather about this. I've been researching the sensitivity of ETGs and I'm writing down everything I can to contradict the claim that I've been drinking to prove that this is a false positive. Thank you once again.

It is now been established that EtG is not stable in urine. It might degrade or multiply in the container post collection (1). Each urine sample should be refrigerated from time of collection until tested, including storage time at laboratory.(2) (That is never done). The main factor is that the amounts should have been normalized to creatinine (2) which brings it well within range where even a trace amount of alcohol could have produced the amounts of each. (3) As example, the amount of EtG and EtS, adjusted for creatinine, is consistent with alcohol content of about 1-2 g. (A standard drink contains 14 g). They tested for alcohol at .04. That would require 2-3 drinks or 28 to 42 g. So the amount of EtG/EtS in your system is entirely consistent with innocent consumption, orange juice, food, or inhalation of product containing ethanol.

Be sure to read Dr. Skipper's site above. He provides a long list of problems with the test. Also, copy the new SAMHSA advisory I provided above.

You better go fully armed because court personnel are very poorly trained in regard to this test and inclined to rely entirely on lab results. They have no idea what questions to ask in order to properly interpret results.

1) Rana & Ross, 2010
2) See previous reference to Role of Biomarkers, above
3) Thierauf, 2010