rising ALP

[fattyliver2022]

Hi all!

I have a question. My ALT and AST levels are close to normalizing. ALP is still within range, but I continue to see it rising. Any thoughts as to why? I don’t exercise hard, I don’t think I’m under the weather and I do take other meds.

I have this same question into my doctor, but I wanted to see what this community thought, as well. Any feedback I would super appreciate!

Thank you, fam!

[nash2 Partner]

Hi 2022

I can't really comment much about isolated test results. I imagine that something has happened that sensitized you to these values and liver disease but diagnosis of liver issues is quite complex and blood values are of limited value by themselves. You mentioned a rising trend with ALP. It is good that you are thinking about it in that way. Trends of blood results over time can provide good clues about what is happening. Like all blood values several things can affect the level so asking your doc to clarify what that trend may suggest would be smart as it can be associated with a couple of liver diseases and some blood problems.

[fattyliver2022 in reply to nash2]

my doctor replied back to me that “it shows normal variation and is still within normal limits. He said to keep up the good work!” - per his nurse

Should I take him at his word? Sometimes I feel like I have to fight for further clarification or to be heard and to even get something more than a canned response.

Let me know what you think, please!

[fattyliver2022 in reply to fattyliver2022]

to add on I do have NASH which is slowly decreasing hence my ASTs and ALTs almost normalized. Co-morbidly diagnosed with A1AD, MZ heterozygous.

Sometimes, I wish I could just tuck the doc into the back of my pocket and ask them my questions as they come up.

[nash2 Partner in reply to fattyliver2022]

I know the feeling and there are so many questions, but it sounds like you are managing it. If you can get a Fibroscan some time it will likely help clarify your status a bit more.

[fattyliver2022 in reply to nash2]

I have had a fibroscan. My kPa is 9.6. I feel like the fibroscans aren’t very reliable since they have a tendency to overestimate, I am obese (actively working on it) and hold weight in my abdomen, so I know those points cause overestimation on fibroscans - my hepatologist has even agreed with those points.

I hate this “wait and see”. At least my alt and ast levels are better! But, I am such a fatalistic person, so this major health issue has been earth shattering for me. Anyway, I guess I need to just learn to wait in the fear. Ugh.

Thank you for taking the time to answer my question! I really appreciate it.

[nash2 Partner]

There is quite a bit of variance with Fibroscan in the lower ranges but it is a good indication that you are in a manageable range. The annoying thing is that it took us years to make our livers sick and it takes a good bit of time to deal with it. The good thing is there isn't a good reason to be overly afraid. You know the situation and understand what you need to do and if you follow through you can lead a normal life. Good luck.

Wayne