ALP levels in cirrhosis

[Anners6010]

Does anyone know why ALP is only sometimes elevated in ARLD and sometimes not?

[AyrshireK]

Alkaline Phosphatase (ALP) isn't solely liver related - as well as being found in the liver it's also found in kidneys, bones and digestive system. It can end up being elevated for all manner of reasons.All blood results will fluctuate with all types of liver disease, they fluctuate even within a day and can give different readings at different times depending on what stresses and strains the body is under.

High alkaline phosphatase levels may mean there is damage to your liver or that you have a type of bone disorder. Liver damage creates a different type of ALP than bone disorders do. If the test results show high alkaline phosphatase levels, your health care provider may order additional tests to find out where the extra ALP is coming from. High alkaline phosphatase levels in the liver can indicate:

Cirrhosis

Hepatitis

A blockage in the bile duct

Mononucleosis, which can sometimes cause swelling in the liver

There are several other types of blood tests that check your liver function. These include bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) tests. If these results are normal and your alkaline phosphatase levels are high, it may mean the problem is not in your liver. Instead, it can indicate a bone disorder, such as Paget's Disease of Bone, a condition that causes your bones to become abnormally large, weak, and prone to fractures.

Moderately high levels of alkaline phosphatase may indicate conditions such as Hodgkin lymphoma, heart failure, or a bacterial infection.

I know it doesn't really answer your question fully but rises and falls in all LFT's happen - as I said even within a day the results can fluctuate.

Katie

[Anners6010 in reply to AyrshireK]

Thank you for your response. So ALP is not like AST/ALT in that it will be elevated with active inflammation? It will always be elevated with liver damage regardless of if there is no longer inflammation? It is well known that liver tests can be normal even in cirrhosis….which is more easy for me to understand with the other two enzymes. ALP is a little different so I’m trying to under the science behind it I guess . Say you’re a problem drinker , does ALP rise and fall when you’re drinking / sober , or even if you’re sober but have liver damage will it remain high? Sorry if this is confusing to read , it’s hard for me to put into words what I’m trying to sayZ.

[AyrshireK in reply to Anners6010]

My hubby has cirrhosis (not due to alcohol) his ALT, AST and ALP are usually in range. His ALP, however, went more than 4 times higher than they should have been earlier this year when he had gall stones lodged in his bile duct. There are various causes why ALP might rise.

Sorry I can't explain any better either. We hardly ever get copies of hubbies bloods so never have any idea (and never worry) about what they show - we leave interpretation of bloods up to doctors and that way it doesn't cause us any stress.

Katie