High Alkaline Phosphatase

[wizzard166]

I had bloodwork recently, for a physician other than my CLL Specialist, who told me today that one of the abnormal readings was Alkaline Phosphatase. He suggested that I see a Gastroenterologist. My reading was 222.

I know it is a liver enzyme, and on a recent six month visit with my local CLL doctor she mentioned she could feel both my Spleen and my Liver. I asked what that meant, and she said they get bigger over time with CLL.

I tried to Google high Alkaline Phosphatase in conjunction with CLL, and the articles were all for physicians and a bit much to try to read. All I could get out of what I was reading was that abnormal liver function readings are not a good sign for survival rate with CLL. Maybe this has nothing to do with my CLL, maybe it does, but overall its is scaring me a bit.

Anyone with experience with this have any input for me.

Carl

[cllady01 Former Volunteer]

Carl, Sorry to hear you have this happening.

There have been reports of liver situations in connection with COVID infection---I note you had Covid some months ago. And we do have the possibility with even mild cases having some long Covid happenings in future.

Seeing the Gastroenterologist is the way to go to get some screening/testing done along with your being able to relate anything about your case of COVID and get more definitive information than mine is.

You can find med-speak dense information about Alkaline Phosphatase in relation to COVID also, and I am not able to decipher it to any satisfaction. Besides your situation may not fit any of those I have read about.

Please let us know what you fine out from the Gastro.

[AussieNeil Partner Administrator]

Elevated ALP can also be influenced by bone health. Also, is this a one off high reading, or has your ALP trended up or been high for a few tests? Good that you are having it investigated.

Neil

[wizzard166 in reply to AussieNeil]

Thanks for helping Neil. My last three readings from six-month visits to my local CLL doctor in Florida range from July 2021 to July 2022 with the middle one of the three being in January 2022. Those readings were all close together but high at 136, 130, 128 with Normal being 45 - 117. The last one was the reading of 136 on June 21, 2022. Then about seven days later I needed blood work for my four months visit with my Endocrinologist, and that reading came in at 222 (90 points higher than seven days previous). So, I've been running slightly high over normal in the 130 area for a full year.

My other Liver test numbers this past reading were AST 27 AND ALT 39, both of which are in normal range for this Quest testing center.

Other input is on this latest June 28th visit at Lynn Cancer Center in Boca Raton, my CLL doctor mentioned she could feel my Liver and Spleen. When I asked if that was a bad sign, she simply set the Liver and Spleen generally get larger as the CLL progresses.

When I went online to look into Alkaline Phosphatase high numbers and CLL it seemed that all of the articles indicated more needs to be done with respect to abnormal liver readings and progression of CLL. Many references mentioned a "Shorter Lifespan with CLL when there are abnormal Liver readings". A couple mentioned possible invasion of the CLL cancer cells into the Liver. So all of this freaked me out, but maybe this one test was skewed abnormally by the lab. Maybe the slightly above normal Alkaline Phosphatase readings since last July are not alarming to the local CLL doctor, or maybe she isn't aware enough of the relationship of those readings to escalation of CLL illness. I hope not.

Carl

[AussieNeil Partner Administrator in reply to wizzard166]

Thanks for your update. I'll add two points to keep in mind:-

1. Take note of the dates of those studies you found regarding abnormal liver function test results. Treat the conclusions with caution if the study participants included treatment histories prior to modern targeted therapies.

2. Our livers generally have an amazing capacity for regeneration - no cleansing diets or supplements are required.

Neil

[LeoPa in reply to AussieNeil]

Just the avoidance of known harmful substances I'd add.

[wizzard166 in reply to LeoPa]

I assume you mean alcohol

[LeoPa in reply to wizzard166]

I meant fructose in the first place. There are two things that often damage the liver in people who are not on any medications because as we know medications damage the liver too. As do poisons. The liver is the organ that rids the body of poisons and toxic substances. Among others alcohol and fructose. To be clear, fructose is just as bad as alcohol for the liver. Non-alcoholic fatty liver disease is a result of excess fructose consumption. Mainly high fructose corn syrup which is abundant in all sweetened beverages and processed foods, such as toast bread, cookies, chocolates, in short all sweetened junk. 45% of table sugar is fructose. 55% of honey is fructose. 60 plus percent of agave nectar is fructose. If it is sweet and is advertised as not raising blood sugar it is mainly fructose. Does a great disservice to diabetics to load them up with fructose sweetened junk ruining their livers on top of the diabetes. Once we drastically reduce our fructose and alcohol consumption we are on our way to have a well functioning healthy liver.

[wizzard166 in reply to LeoPa]

Thank you Leo

[Edalv in reply to wizzard166]

I would definitely abstain from alcohol, that would be number 1 on my list… and a redo of the metabolic panel in a few weeks… Mishandling of the blood samples should not be ruled out…

[wizzard166 in reply to Edalv]

Thank you Edalv. I wondered if mishandling of the blood by Quest had something to do with it. Since my last three readings over exactly one year were between 128 and 136, with that last one being exactly one week before the test with the large reading of 222, it seems illogical to me that I could have jumped around 90 points in the Alkaline Phosphatase reading in that short period of a week.

[Edalv in reply to wizzard166]

I would have a redo, to rule out it’s not a mistake on their part. You want to know either way… best of luck 🤞

[JigFettler Volunteer]

I would support AussieAussieNeil advice and chase this up. While CLL may cause all sorts of disequilibrium in our physiology, CLL will not be responsible for all.

Other causes for a raised Alk Phos exist. Here in the UK the next step would be to see our Family Dr who are good medical generalists. Often do ground work and efficiently direct further investigation and specialist referral.

Google is not a useful tool in this case IMHO!

Jig

[SofiaDeo]

I agree with others, Covid can possibly affect your liver, as well as various toxins in food, skin lotions, etc etc.. Looking at your profile, I wonder if the increased abdominal nodes are causing the GI problems, and if you may need treatment of the CLL to resolve the GI symptoms.

my.clevelandclinic.org/heal...

[skipro]

This "liver enzyme" can be elevated with liver disease. It is also present in bones and anything that interferes with bone metabolism like multiple myeloma or other bone tumors can cause increases.

I'd ask for a test called SPEP to check for multiple myeloma and x-rays of ALL painful bone sites.

Mike

CLL patient and orthopedic surgeon MD

[wizzard166 in reply to skipro]

Thank you and everyone with input on this new problem for me. Maybe it is a bad test result by Quest, because a 90 point increase from the 130 number to 222 seems absurd. Then again maybe something is going on with me.

I was able to get in with my Gastro this Friday, so I'm sure he will re test and also do other tests to eliminate liver disease. Oh well, just another chapter for those of us with this illness.

Carl