Alkaline phosphatase 142 - Advice please

[IamAli_R]

Hello Everyone,

I hope you are all well

I had a Liver Function Test last week. I was asked to take the test 2 weeks after starting Atorvastatin 40mg.

I spoke to the Cardiac Nurse today and she said my Alkaline phosphatase level is at 142 (normal range 30-130). She mentioned the last few results have been on the high side of normal (above 100), with one result of 132 in 2019.

My questions are:

Has anyone else had a raised Alkaline phosphatase after starting Atorvastatin?

If you did have raised what did your medical team suggest?

Is a levels of 142 something to worry about?

The nurse didn't seem to be bothered by my raised levels.

[Steve_G]

First the disclaimer - I’m not medically qualified. I have however spent many years working on clinical trials with medics and looking at blood results. Depending on the study and the analyte being measured, a serious red flag would be raised at two or three times the upper limit of normal. Liver function is assessed across a number of analytes - bilirubin, AST & ALT are the main ones. The medics generally are looking for a pattern of results across multiple analytes so would be looking to see an elevation above the upper limit of normal (ULN) across several results and not just alkaline phosphatase - which btw exists in several forms and can be a marker for things other than liver damage. In the world I worked in, a lone alk phos marginally above the ULN would not be any cause for concern.

Personal experience is that my bilirubin level was high when I left hospital after my bypass 4 years ago & the GP was told to monitor it. High bilirubin can be a sign of liver damage caused by alcohol - not that I drink or drank excessively. It has remained high and I was sent for liver investigations which came back negative. It’s still high but the GP now calls it normal - it’s just normal for me.

[IamAli_R in reply to Steve_G]

Hello Steve_G,

Thank you for taking the time to answer my questions. Reading your answer I feel reassured. Only Alkaline phosphatase was raised from the LFT.

[Silvertail]

My liver function tests are always abnormal. Years ago I had a liver biopsy, and the outcome was that it is normal for me. That is no liver damage. Lately the doctor has stated mild liver damage, however I am of senior years and they say it is to be expected, also mild renal failure.

[IamAli_R in reply to Silvertail]

Hello Silvertail,

Thank you for taking to the time to reply.

I have checked my past LFT results and my Alkaline phosphatase has always been on the higher end of normal. I do feel reassured having read everyone's responses.

[MichaelJH Heart Star]

As the normal range is 44 - 147 in some countries I do not think you have anything to worry about. Levels can rise after stating a statin . Mine did when they raised my dose post bypass but settled in 4 - 6 weeks. I would suggest you repeat the test in about 4 weeks.

[IamAli_R in reply to MichaelJH]

Hello MichaelJH,

Thank you for taking the time to reply.

Reading your answer is reassuring. if a lot of countries are using that scale then I guess I am within rage.

[marypw]

I’m an ex-pharma biochemist and I agree with all your comments.

Anecdotally, my GP surgery is very on the ball - I had a raised LFT after starting atorvastatin, had an ultrasound which was fine, but was switched to simvastatin, with no further issues.

In most surgeries when on long term medication, patients have an annual medical review, including blood tests, so the writer needs to ensure these get done.

[IamAli_R in reply to marypw]

Hello Marypw,

Thank you for taking the time reply.

I feel reassured having read everyone's comments. This really is a fantastic forum and the support provided is priceless.

[IamAli_R]

Hello Runforhealth96,

Thank you taking the time to reply.

I was looking for people to share their experiences and I know I need to trust my Cardiac nurse. However, I suffering form health anxiety and the temptation to look for further reassurance can be impossible to resist sometimes. Thank you for answer and I agree there is little consolation having the perfect LFC if I drip dead with a heart attack.