1. < Mental Health

Other causes of failed PEth test for alcohol abuse?

Posted by gjones1956 @gjones1956, Nov 14, 2017

My daughter undergoes periodic peth testing for alchohol abuse. She fails regularly, although swears she drinks NOTHING. We have reason to believe she is telling the truth. Assuming she is indeed not drinking, is there a physical condition or ailment that might produce positive peth tests? She is 29, has enlarged lymph nodes, some kind of mysterious condition that gives her severe hives, etc. We are wondering if some type of autoinflammation or autoimmune condition might explain elevated levels. Our daughter is FINALLY discussing this with her regular doctor but if it is some unusual condition a specialist will be needed. The reason the peth test is required is due to a nasty custody dispute with lots of allegations of misconduct. I just want to know if there is ANYTHING other than alchohol consumption that can lead to positive test results. Any thoughts or knowledge of cases? Thanks for reading.

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Mentor
John, Volunteer Mentor | @johnbishop | Nov 4, 2020
In reply to @kkb44 "Just wondering if anyone has had any successes or found any new info since this thread..." + (show)
@kkb44

Just wondering if anyone has had any successes or found any new info since this thread has been going for a couple of years.
My husband is under a Wellness contract and has urine tested about every 10 days to 2 weeks. He also got a liver transplant about 18 months ago and has labwork done about once a month as a follow up from that. Every urine test has been clear, and while the doctor's labs don't specifically test for alcohol, biomarkers that could indicate alcohol use (GGT and MCV) have also always been in range. In October he got a low positive peTH (32) and he was retested by the same lab and got another low positive (60). He has been totally abstinent. He went to a different lab to have a voluntary hair test, and had his hospital do their own peTH and we're waiting on results. We're wracking our brains for a cause of this. Two ideas have emerged - 1. is that he's in healthcare and sanitizes his hands, using a liquid that mists, about 3 times per HOUR. When COVID started and there was a run on sanitizer his office switched suppliers and we realize now that the new one is ethanol based. It was on his skin and in the air constantly. Second thought is that I see now that his finger shouldn't touch the card. In both the test and retest he said the lab tech had him touch his finger to the card rather than let the blood drop.
I have done HOURS and HOURS of research on this topic. It's ridiculous that we could have 20+ tests that prove abstinence and one questionable test can turn lives upside down.

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Hello @kkb44, Welcome to Mayo Clinic Connect. I think you are correct about the ethanol based hand sanitizers affecting the PEth test results. @toolsd and other members in the discussion I'm sure will be able to offer suggestions. Here is some information I found from January 2020 and one from 2019 that talk about the test.

Specificity of Phosphatidylethanol as a Marker for Alcoholic Beverage Consumption: https://www.centerforprofessionalrecovery.com/specificity-of-phosphatidylethanol-as-a-marker-for-alcoholic-beverage-consumption/

“Doctor, I do not understand the results of the test, because I swear I am not drinking alcohol.” Truth or lie?: https://www.sciencedirect.com/science/article/pii/S235200781930099X
Excerpt from the above article - "Conclusion - An abnormal elevation of PEth concentration in blood was observed after using ethanolic solution for hand cleaning. Thus, ethyl alcohol disinfection have to be avoid before blood sampling for DBS. If not, a rapid formation of PEth could happen during blood sampling, involving a risk of erroneous interpretation concerning alcohol consumption."

REPLY
toolsd | @toolsd | Nov 4, 2020

I sent you a private message, give me a call.

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flyboybray | @flyboybray | Nov 4, 2020

Ethyl alcohol sanitizer absolutely causes false positive peth. My number was 28ng. Very low. Breathing it also causes peth. Stay away from it moving forward. That's what happened to me. They said that hand sanitizer was safe. It obviously isn't. I've been out of work since April cuz of this crap.

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1 reply
kkb44 | @kkb44 | Nov 5, 2020
In reply to @flyboybray "Ethyl alcohol sanitizer absolutely causes false positive peth. My number was 28ng. Very low. Breathing it..." + (show)
@flyboybray

Ethyl alcohol sanitizer absolutely causes false positive peth. My number was 28ng. Very low. Breathing it also causes peth. Stay away from it moving forward. That's what happened to me. They said that hand sanitizer was safe. It obviously isn't. I've been out of work since April cuz of this crap.

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That's what we were afraid of! My husband wasn't just rubbing the gel on his hands, he has a mister thing that you wave your hand in front of and it sprays out a mist of the stuff. And his whole office used it, so not only was it misting in his face 20+ times a day from his own use, but I'm sure he walked through it sometimes when his staff used it.

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clearofclouds1234 | @clearofclouds1234 | Nov 5, 2020

I’m sorry you have been dragged into this mess that is the PEth DBS test. Get with @toolsd as he is creating a list and we are all working together and actually doing something to fight this. My advice is to get as many subsequent tests: nail, blood (intravenous) and hair that will fall in that timeline that supports the abstinence. That’s what I did and had all come back negative. Working with lawyers and toxicologists currently and dealing with the FAA to get my medical back due to this false test.

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melanie6598 | @melanie6598 | Dec 15, 2020
In reply to @genie862017 "I am also seeking help and answers. I am a recovering alcoholic. I went thru treatment...." + (show)
@genie862017

I am also seeking help and answers. I am a recovering alcoholic. I went thru treatment. I have had a total 5 PEth tests. 2 were positive, 1 Negative hair follicle test. I am waiting to do another hair follicle test. I haven't had any alcohol since Aug 5, 2017. I need help. This test could cost me my livelihood.

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My husband is waiting to have a liver transplant. He has had nothing to drink since 2019. Has had several peth tests that were negative. Had recent transfusions with blood and plasma and used the swish and swallow mouthwash and now they are saying his peth test is positive (barely but positive). This can prevent him from getting a liver. Please send any peer reviewed articles but the doctor says there has not been a false positive peth.

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4 replies
oledocfarmer | @oledocfarmer | Dec 15, 2020

There’s a French study (from 2018 or 2019) showing that even hand sanitizers can cause false-positive PEth. I’ll look for it, but it was posted early this year on this Board.

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clearofclouds1234 | @clearofclouds1234 | Dec 15, 2020
In reply to @melanie6598 "My husband is waiting to have a liver transplant. He has had nothing to drink since..." + (show)
@melanie6598

My husband is waiting to have a liver transplant. He has had nothing to drink since 2019. Has had several peth tests that were negative. Had recent transfusions with blood and plasma and used the swish and swallow mouthwash and now they are saying his peth test is positive (barely but positive). This can prevent him from getting a liver. Please send any peer reviewed articles but the doctor says there has not been a false positive peth.

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Was it the DBS (dried blood spot method) or intravenous?

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Erika | @erikas | Dec 15, 2020
In reply to @melanie6598 "My husband is waiting to have a liver transplant. He has had nothing to drink since..." + (show)
@melanie6598

My husband is waiting to have a liver transplant. He has had nothing to drink since 2019. Has had several peth tests that were negative. Had recent transfusions with blood and plasma and used the swish and swallow mouthwash and now they are saying his peth test is positive (barely but positive). This can prevent him from getting a liver. Please send any peer reviewed articles but the doctor says there has not been a false positive peth.

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@melanie6598 Welcome to Mayo Clinic Connect.

Your husband has false positive tests and you are worried he may not be able to get the liver transplant her needs.

May I ask when you find out their decision and who makes the decision?

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