Elevated ALP

[Constantlyconfused]

Hi Everyone, I am new here and am just trying to get some reassurance. Here is my story:

Last November I started to not feel very good, heartburn all of the time, shaky, and started to worry something was seriously wrong! That started the long list of tests that I have been through. Finally, I had a scope to see what could be causing me so much pain in my stomach and chest. They found out I had H. Pylori and treated me right away. At the same time though, the Gastro doctor asked me if I knew I had an elevated liver Enzyme. I said no! No one ever told me, he said that he would do more tests to make sure it was not coming from my liver. I went for the blood work and worried for days waiting for a reply. I called the office, and about an hour later the doctor called me at home to tell me it looked like it was not coming from any type of liver disease, but he wanted my family doctor to keep researching! I was very happy, but then I was also confused. Why is this so high, and what could be causing it? Of course, I start to think that that have missed something. I had an abdominal ultrasound, which showed nothing wrong with anything! and I have been doing blood tests for the past 4 months to keep checking my liver functions etc. The only thing in all of my blood work that is abnormal is my ALP. I have now seen 3 different doctors who have looked at all of my blood work, and said that they are positive it is not from any type of liver disease. So they sent me for a bone scan ( I do have herniated discs in my lumbar so I thought that might be why it is happening) The bone scan was fine! No bone disease.. which again makes me worry that they are missing something with my liver. Now for the past few days my stomach has been upset again, and I seem to have a dull twinge on right side but only once in awhile. It does not seem like it is pain coming from the liver capsule but part of me cannot stop thinking they are missing something!

After 2 years with an elevated ALP enzyme, if it was something like a liver disease would other tests not be abnormal by now? I serioulsy have had so many tests done and the only thing that they see is the elevated ALP, I don't know what else could be going on.. or where I should have them look next? Does anyone have any ideas, or thoughts on what could be happening? I am scared, and my family thinks I am crazy because I have had the doctors tell me all is good but I still worry. I am only 32 years old ! Thanks in advance, and I hope to hear from you!

[L4LSarah]

Dear Constantly Confused,

Many thanks for contacting me via HealthUnlocked and for providing me with information regarding your concerns.

Gosh…’yes’, I’m not surprised you’re confused, but hopefully I’ll be able to help you in some small way.

I was pleased to learn that you’ve undertaken a bone scan and abdominal ultrasound scan, and that everything was ok.

As you know, the ALP enzyme is not only found in the liver, but in the bone and bile ducts too.

If you could let me know what your ALP result was, plus the reference range, I would find that most useful.

I just wanted to give you a little bit of an explanation regarding ALP.

ALP has a very wide reference range, so sometimes 'conditions' aren't always detected immediately, because if a patients results fall within the reference range, nothing is alerting the health professional/GP to anything abnormal......unless there are previous results to compare. For instance, it could be that the ALP result was at the lower end of the reference range a few years ago but has now increased.......but still within the reference range. Hope that makes sense!

Sometimes the ALP will rise when there are any changes to bone density, so it is possible therefore that as we get older (especially women during the menopause) that we see an increase in this enzyme (the same can happen with adolescents going through puberty, when they have growth spurts), but it's not always obvious because of the wide reference range.

In your case, as it is only the ALP that is elevated, then I would immediately think that it was bone related, and although your scan didn’t reveal anything to be concerned over, the fact is, that you have a herniated disc in your lumbar, and therefore, there is some stress in that area, which could correlate to the elevated ALP.

How much over the reference range is your ALP?

Of course, it could be that not only is the elevation due to your lumbar, but there could be some trauma within your bile ducts, which is influencing the ALP. However, if this was the case, then I would expect to see an elevation in your Gamma GT results too.

Therefore, if you could supply me with all of your LFT results and the reference ranges, that would be most helpful to me so that I may be able to elaborate on what I’ve said already.

Even though your other results may be within their reference ranges, some might be at the upper end of the range.

Is there a history of gallstone/gallbladder or cholesterol problems in the family?

Could you give me some information about your lifestyle please, e.g. whether you smoke or consume alcohol, what your diet is like, are you overweight, do you have a high cholesterol?

If you could supply me with some more information, then I would be very happy to comment further.

In the meantime,

Best wishes and kind regards,

Sarah

[ALP-LEVELS-CONCERNED in reply to L4LSarah]

Hi I saw your response to Remember by the name of severely confused regarding her elevated ALP levels And I wanted to know if you remember I’m going through exactly the same thing I had a herniated disc operated on in 2014 I have lumbar issues still going on probably for the rest of my life I have a vitamin D deficiency and I have a fatty liver this is how it all started I started taking we’re going to get blood work done and my ALP levels are slightly elevated the range for LabCorp is up to 117 mine was 121 and 127 a few weeks later the fraction ice test shows that it’s not coming from my liver but the elevation is coming from the bone which I am super super scared!!!! I’m not a drinker maybe socially I don’t smoke I’ve lost 25 pounds I’m still a little bit overweight I have chronic acid reflux but I am horrified that this Can I have to do something with my bones I’ve read on Google which I shouldn’t have but it can be something like osteoporosis or even bone cancer I don’t think that I have anything serious my levels are within the range but the last two years my ALP levels have gone up from 89 to 121 and 127 since 2019 can you please give me some insight I’m really concerned

[AlexandriaUK]

Hi do you exercise heavily or take medication of any form on a regular basis.