Low protein levels in blood

[J1015]

I had my annual physical with my PCP recently and got lab results back yesterday. My proteins and Alkaline phosphatase were slightly low which has never been an issue before. From what I am reading online, the two go hand in hand due to having low protein. Is this in any way CLL related or am I just not eating enough high protein foods?

[AussieNeil Administrator]

There are quite a few specific proteins measured in the metabolic panel blood tests, of which alkaline phosphatase (ALP), an enzyme protein, is just one. A bigger contributor to your total protein level, which you mentioned was low for you a month ago are your immunoglobulins. Your total protein measurement includes albumin (separately reported), immunoglobulins and carrier proteins. Have your albumin or immunoglobulins dropped significantly recently?

Immunoglobulins (antibodies) commonly drop due to CLL, a condition known as hypogammaglobulinemia. If this drop in your immunity causes sufficiently severe infections and is low enough*, your specialist may recommend IVIG or subcutaneous IgG to boost your IgG. Currently IgA and IgM can't be boosted.

* What's considered a low enough IgG depends where you live. It typically needs to be under 5/500 in the USA and under 4/400 elsewhere.

Neil

[J1015 in reply to AussieNeil]

My PCP did not order specific testing for IgG, etc as this was just my annual wellness checkup but the last appointment at MD Anderson was this past July. There wasn't any huge drop in any of my numbers. My IgG, IgA and IgM are just slightly below the healthy range. No infections or sicknesses in the ten years I have been W & W. I am still watch and wait. My white count hovers in the mid 20's. My lympocytes and neutrophils are slowly going in the direction I don't like to see but nothing to alarm the specialist yet. All the other numbers on my labs are perfect and healthy. My immunoglobulins were borderline low. I didn't realize that those numbers were part of the protein total but that could possibly be the reason it is right at the level to be considered low. I actually don't remember seeing a protein count in any of my past lab reports but I am sure it was there. Trying not to panic too much. I always get anxious when I see lab results. After a day or two, I learn to calm down and accept that "it is what it is." Thank you for reaching out.

[AussieNeil Administrator in reply to J1015]

High alkaline phosphatase (ALP) is more usually the concern, not low, as a high level shows your liver is under stress. That can be from medications, (including over the counter medications), supplements, alcohol or other potential causes.

Trends are what's important with CLL. If your M D Anderson specialist isn't alarmed, neither should you be. Sounds like your CLL is fairly stable to have those results after 10 years in watch and wait. You may never need treatment if your spleen and nodes are also behaving.

Neil

[Hotrods4me]

I have been asked this question several times before and all I can say is I have had no experience with that drug . Sorry I couldn't be of any help.