MCV

• A mean cell volume > 98fl has been reported in up to a third of heavy drinkers but up to 5% of normal drinkers have increased MCV in the absence of known causes.
• Alcohol and its metabolic derivative acetaldehyde exert toxic effects on the bone marrow affecting erythropoiesis.
• Elevated mean cell volume in heavy drinkers is not related to B12 or folate deficiency (a problem which may also occur in some heavy drinkers).
• Changes in MCV values with reduction in alcohol consumption occur slowly reflecting the long degradation period for red cells and the relatively prolonged phase of new red cell development.

Uric acid

• Uric acid is helpful in this case to support the diagnosis of gout and to use as a marker which may improve with reduction in alcohol use. There is however no direct relationship in general between alcohol consumption and uric acid levels.

Electrolytes

• It is unlikely that measuring electrolytes would be of value in this patent in relationship to alcohol use.

Other measures

• A number of other biochemical measurements have been shown to be useful as markers of alcohol consumption e.g. carbohydrate-deficient transferrin, urine and serum B-hexosaminodase, but these are not readily available for clinical practice.

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