Update high alkaline Phosphatase

[Oatmeal2]

Hello All,

I posted about a week ago about my husband’s blood test showing alk phospatase at 178. Doctor retested with some other liver tests and the reading was still elevated at 166, with undetectable PSA. My husband was diagnosed with Gleason 9 in July 2023 with spread to one lymph node. He had whole pelvis radiation and is getting Firmagon injections until Aug. The doctor has ordered a nm whole body scan 3 phase. We are a little worried but the doctor keeps saying the PSA is undetectable but ordering the scan to be sure.

[103532]

It is down a bit from the last test, though I know you are worried. I still think the liver is stressed as TA mentioned before. Please keep us updated. I actually have a high alkaline phosphatase caused by chronic dehydration. It could be many things. It’s good that you are right on top of things!! Good luck!

Stephanie

[tn12]

My husband's ALP has been consistently on the higher end 130-160 for the last 10yrs. They are still unable to find a cause. I read it could be familial and O+ blood types tend to have elevated ALP. Keep us posted please.

[StayingOptimistic in reply to tn12]

It’s like my CEA, has been elevated for more than 4 years and no one knows why. It’s driving me crazy.

[Oatmeal2]

Thank you for your replies

[NecessarilySo]

Could mean several things, liver- or bone- related. But it is not so high and coming down. Undetectable PSA suggests liver, mild cirrhosis? Check past bloodwork, as cirrhosis is permanent liver damage, and watch and wait. Bone density check might help.

Also, I learned that Prolia for ostopenia can lead to hyperparathyroidism, which is another possible reason for high Alk Phos. Low Vitamin D?

[j-o-h-n]

What causes Update high alkaline Phosphatase

A I - ChatGPT said:

Elevated alkaline phosphatase (ALP) levels can be caused by various conditions affecting the liver, bones, or other tissues. Here are some common causes:

1. Liver-related Causes

Liver diseases (e.g., hepatitis, cirrhosis, fatty liver)

Biliary obstruction (gallstones, bile duct blockage, or cholestasis)

Liver cancer or metastases

Primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC)

2. Bone-related Causes

Bone growth (in children/adolescents) – Normal during growth spurts

Fracture healing – Temporary increase during bone repair

Paget’s disease of bone – Excessive bone turnover

Osteomalacia (soft bones from vitamin D deficiency)

Osteoporosis or bone metastases

3. Other Causes

Pregnancy – Placental ALP increases in the third trimester

Hyperparathyroidism – Overactive parathyroid glands

Vitamin D deficiency or excess – Can affect bone metabolism

Chronic kidney disease – Can lead to secondary hyperparathyroidism

Certain medications – Antiepileptics (e.g., phenytoin), birth control, or antibiotics

What to Do Next?

If your ALP levels are high, further tests may be needed to determine the cause, such as:

Liver function tests (ALT, AST, GGT, bilirubin) – To check for liver disease

Calcium, phosphorus, and parathyroid hormone (PTH) levels – To evaluate bone disorders

Vitamin D levels – To rule out deficiency

Imaging (ultrasound, MRI, or bone scans) – If bone or liver disease is suspected

Would you like to discuss any specific symptoms or test results?

Good Luck, Good Health and Good Humor.

j-o-h-n

[Oatmeal2]

thank you for the reply

[timotur]

My ALP rose from the 60’s to the 110’s while on ADT (18mosLupron), then went back down after stopping ADT, all the while PSA was <0.02.

[dk73]

after 4 rounds of pluvicto, hubbys ALP number rose to 230. A scan showed major skeletal progression of bone Mets. I believe anything over 150 can cause concern. He’s now on cabizitaxel chemo

[tn12 in reply to dk73]

Why do you believe that?

[dk73 in reply to tn12]

On MyChart, 150 shows the top of the “normal” range for ALP

[tn12 in reply to dk73]

Oh ok, I thought you had additional insight