High ALT

[Kemba]

Does a rise in ALT (now 77) indicate bone mets in coordination with a rise in PSA ( <.1 to .1). RP 11/18. RT 4/19 and 6 mos Lupron/ casodex started 2/19. No pain or meds since treatment ended. Background : Gleason 9 with one positive lymph node in pelvis. No other mets at last scans. I'm getting confused with ALT and ALD (which is normal). I'm that crazy wife who reads too much and maybe not enough. Thank you for your thoughts

[noahware]

ALT is a liver enzyme marker, and so far as I know is not associated with bone mets. There are a number of other reasons it could be high, none of which I'm qualified to discuss! (LearnAll will probably chime in to help here.)

ALP, or alkaline phosphatase, is the marker more closely associated with bone mets (although some of that is related to liver function, too). If that marker was high, you might then look at BAP (Bone-specific Alkaline Phosphatase) to see if it is bone-related rather than liver-related.

[LearnAll]

NO... ALT has nothing to do with Bone Mets. It is an enzyme which tells how your liver is doing.

Please read NoAware's answer 2 times. He is accurate in saying that the level of Bone Alkaline Phosphatase (BALP) is a true indicator of extent of bone mets.

AST, ALT, Bilirubin and LDH are enzymes to assess health of Liver and Creatinine and Blood Urea Nitrogen (BUN) are indicators of kidney health.

[Kemba in reply to LearnAll]

Thank you

[Hidden in reply to Kemba]

Actually they do look at (1) ALT, Alanine Aminotransferase Level (standard range 7 - 55) as well as (2) Bilirubin (standard range <=1.2 mg/dL) , (3) AST, Aspartate Aminotransferase or liver enzyme level (standard range 8 - 48 U/L) , (4) Potassium (standard range 3.6 - 5.2 mmol/L), and (5) ALP, alkaline phosphatase (standard range 40 - 129 U/L). All of these have to do with the liver. This is what I was told at my last appointment. All of mine were normal but abnormal levels of any of them can be, but not necessarily are, a sign of metastasis, I believe. Why else did they check them? I asked about it and was told something to the effect that it is just to cover all bases, basically.

[Tall_Allen]

You are thinking of ALP not ALT. But there are two different kinds of ALP: one from the liver, the other from bones. Only high BONE ALP is a biomarker for bone remodeling, which may or may not be because of metastases You would need imaging to provide more info.

[Kemba in reply to Tall_Allen]

Thank you for always easing my mind!

[Gemlin_]

Lupron have potential for causing liver trouble which show up as elevated liver enzymes (ALT). Liver damage is mentioned as a rare side effect.

[Kaliber]

My ALT bounces around high .. now running 60 + .... I’m on Lupron which my oncologist says messes with it. None of my medical team seems particularly worried about it. Google says that 2X-3X the high limit is called mild elevation. As always ask your medical team if you are worried tho. Laymen’s guess is that it’s a bit elevated but not OMG anything right now. The pro’s here will advise you on the rest of it. ❤️❤️

Just say’in 😊😊😊😊

[Hidden]

Short answer to your question....no.

[monte1111]

Long answer to your question...noooooooooo. The experts have weighed in, and I learned a few more things. Prostate cancer has a long learning curve. Enjoy.

[j-o-h-n]

"I'm that crazy wife who reads too much and maybe not enough."

So what else is new?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/14/2021 9:33 PM DST