Alcohol use is called problematic as soon as it harms your health, your work or your relationships. There is no fixed number of glasses attached to it. The Dutch GP guideline uses a conversation and a questionnaire for this, and explicitly not a blood value.
That last point is striking for a company selling blood tests, so we will say it straight away. For the question of whether someone drinks problematically, a single lab value adds little according to that guideline.
Below you can read which signals GPs use, what the AUDIT questionnaire is, and in which situation objective values genuinely are the right instrument.
When is alcohol use called problematic?
Problematic alcohol use means the drinking causes harm: physical, psychological or social. It is about the consequences, not about a limit you cross. Someone drinking two glasses a day without complaints falls outside it, someone missing work at weekends possibly does not.
We deliberately avoid the word alcoholic here.
It sticks a label on a person, while this is about behaviour and consequences. That tone also helps nobody start the conversation with their GP.
Which signals are mentioned most often?
GPs look at a pattern, not at a single incident. Drinking more often or more than you intended, blackouts, cancelling arrangements and growing irritability are among the signals that recur most. Physically, tremor, sweating, stomach complaints and poor sleep can play a part.
A single signal says little on its own.
Poor sleep has dozens of causes, and so do shaking hands. What counts is the combination, and whether the picture points the same way across months.
The influence of alcohol on your night's rest is described separately in alcohol and sleep.
What is the AUDIT questionnaire?
The AUDIT is a questionnaire from the World Health Organization about how much and how often someone drinks and what the consequences are. A short version of three questions exists, the AUDIT-C. Your GP can use it to structure the conversation.
The list does not make a diagnosis.
It organises what you report yourself, so a doctor knows what to ask about next. So you discuss an outcome with your GP, not with a website.
What do blood values add here, and what not?
For establishing problematic alcohol use in general practice, lab values add little. The NHG-Standaard Problematisch alcoholgebruik states that MCV, gamma-GT, ASAT, ALAT and CDT have no added value for this, and advises against routine determination.
The reason is statistical, not a matter of principle.
Picture this: two men both have a gamma-GT of 78 U/l, well above the upper limit of about 40. One drinks fifteen glasses a week, the other drinks nothing and carries excess weight. The same value, a completely different story.
The chance that someone with problematic use shows a deviant value is limited, certainly where the use has not been heavy for years. A normal result therefore does not clear anyone. The reverse does hold: if a value was measured for another reason and turns out deviant, that can be a reason to ask about it.
| Marker | What it measures | Value for this question |
|---|---|---|
| Gamma-GT | liver enzyme, sensitive but not specific | also rises from excess weight and medicines |
| MCV | size of red blood cells | responds slowly, only after months |
| ASAT and ALAT | liver enzymes | rise from many other causes |
| CDT (%CDT) | variant of transferrin | the most specific, but only with heavy use |
When are objective values the right instrument?
There is a second situation where the point is not recognising, but proving. Think of an investigation into driving fitness, or a period in which someone wants to show they are not drinking. There a self-reported questionnaire is precisely not enough.
In that context CDT, gamma-GT and EtG do their work, and I think this is the distinction that matters most.
They describe a period behind you, independent of what someone says. How those markers relate is covered in our overview of proving alcohol use, and specifically for a monitoring period in checking your own CDT and EtG.
If you only want your CDT value measured, an alcohol CDT test can quantify that.
What can you do if you recognise this?
The first step is almost always the same: discuss it with your GP. Thuisarts.nl describes in plain language what you can expect and offers help with cutting down or stopping. The RIVM counts men drinking more than 21 glasses a week and women drinking more than 14 as excessive drinkers.
Stopping after prolonged heavy use can cause physical withdrawal that needs supervision.
So discuss that beforehand, and do not stop abruptly on your own if you drink heavily every day. What changes measurably afterwards is covered in quitting alcohol.
What strikes me most here: people often look for a test that settles it, while the answer sits in a ten-minute conversation. A number feels more objective, but here it answers a different question.
If you recognise the pattern in yourself or someone else, make an appointment with your GP and bring the AUDIT outcome if you have filled it in.
Every blood test result at Zuivertest includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
Sources
- NHG-Standaard Problematisch alcoholgebruik, Nederlands Huisartsen Genootschap (accessed July 2026).
- World Health Organization, AUDIT: the Alcohol Use Disorders Identification Test.
- RIVM, Leefstijlmonitor, alcohol use among adults, 2025 figures.
- Thuisarts.nl, "Ik drink vaak alcohol" (accessed July 2026).
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