Dilute Specimen
A drug test specimen with creatinine and specific gravity values below normal range, indicating excessive fluid intake before the test.
Key Facts
- Creatinine level between 2–20 mg/dL and specific gravity 1.0001–1.0029
- Can be positive-dilute or negative-dilute
- Employer may (but is not required to) order a single retest
- Creatinine below 2 mg/dL is "substituted" — treated as refusal
- Excessive fluid intake is the most common cause
A dilute specimen occurs when a drug test sample has a creatinine concentration between 2 and 20 mg/dL and a specific gravity between 1.0001 and 1.0029. This typically results from drinking excessive fluids before the test. A dilute result can be either positive-dilute (substance detected despite dilution) or negative-dilute (no substance detected). Under DOT rules, a positive-dilute is treated as a positive result. For negative-dilute results, the employer may direct the employee to take another test immediately, but only one retest is allowed. If creatinine is below 2 mg/dL, the specimen is considered "substituted" and treated as a refusal to test.
Drug Test Results & Specimen Issues Compared
Understanding the different outcomes and specimen-related issues in drug testing.
| Type | Meaning | Reported By | Next Steps | MRO Role |
|---|---|---|---|---|
| Positive | Confirmed presence above cutoff | Laboratory → MRO | MRO interview, then report to employer | Verify with donor — medical explanation? |
| Negative | No substances detected above cutoff | Laboratory → MRO | Employee cleared | Review and release result |
| Dilute | Creatinine 2–20 mg/dL & SG 1.0001–1.0029 | Laboratory → MRO | Employer may request retest (one time) | Report as negative-dilute or positive-dilute |
| Shy Bladder / Shy Lung | Unable to provide sufficient specimen | Collector | Medical evaluation within 5 days | Evaluate medical explanation |
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