What do I tell the patient if %dCDT is elevated?
Of course clinical judgment and other signs and symptoms should guide the response. However, a non-confrontational approach such as “it appears that the amount of alcohol you are drinking (not being accusatory of drinking too much) may be affecting how your body functions – we have evidence that alcohol may be disrupting your liver metabolism which also means it may be affecting your other symptoms (fill in the blank as necessary). So… lets see if a reduction in drinking (perhaps in conjunction with other treatments that I might prescribe) may be useful in helping with your problem. Lets make another appointment. Between now and then try to keep a diary of how much you drink each day so we can discuss it more thoroughly.” An appointment for reassessment can be made, the use of a questionnaire (like the AUDIT [see enclosed pamphlet] which takes a few minutes for the patient to file out) can be considered, and a retest of the %dCDT undertaken. If a person exhibits persistent heavy alcoho
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