Announcement from Medtox Laboratories.
As of 11/01/2011, MEDTOX is expanding the confirmation for all Ethyl Glucuronide (ETG) testing to include Ethyl Sulfate (ETS) as well. Similar to ETG, ETS is also a phase II metabolite that is produced after an individual ingests alcohol, and both metabolites are useful in identifying alcohol consumption/exposure. The detected amounts of ETS are slightly lower than for ETG, so a lower reporting threshold is commonly used – the Medtox standard cutoffs for the new confirmation test are 500ng.ml for ETG and 250 ng/ml for ETS.
This change is an enhancement to the testing that will provide additional information to assist you in understanding and interpreting results of testing for these Alcohol Biomarkers. We know that interpretation of ETG results can be difficult. Incidental exposure to alcohol-containing products can lead to the presence of low levels of ETG, and there is evidence both invitro bacterial synthesis and degradations of ETG in urine samples under certain conditions.
While ETS is also produced following incidental exposure to alcohol, it appears to be resistant to the bacterial effects. Therefore, if a specimen is positive for both ETS and ETG or ETS alone, it is likely indicative of alcohol exposure and not due to the presence of glucose and bacterial synthesis in the urine sample. Thus, the addition of ETS minimizes the possibility that the metabolites are present from non-alcohol sources.
MEDTOX continues to urge caution in interpreting results in the context of the potential for unintentional alcohol exposure, inter-individual variability in the metabolism of alcohol and other relevant clinical information.