High alkaline phosphatase

[Otterfield]

I was mostly quite pleased with my blood results today and I don't need a transfusion this week. However, my liver function is not so great with the alkaline phosphatase having increased to 375 after going down at my last blood test. It was one of the haematology nurses that told me and when I was concerned, she said she would ask my consultant whether it needs looking into. In the meantime, does anyone have any thoughts on whether this might be related to my high consumption of paracetamol? I am extremely careful not to go above the recommended daily dose but I have been taking it every day, as otherwise my knee/leg pain badly affects my quality of life. I am going to ask my GP about appropriate pain relief (I am almost out of Oxycodone now, which was prescribed in hospital). Any thoughts on any of the above?

Thanks all, Jennie, post ET MF

[socrates_8]

Hey Jenny...

Glad most of your results are excellent... Completely understand, and I also understand the dilemma that is faced by us MPNers when we have to make decisions concerning whether or not to take Painkillers (PKs)

Once upon a time, my sleepless nights were only every now & then... Now, they are every night, and when I wake, I sit on the edge of my bed and debate whether I will or won't avail myself of the PKs... That can be two or three times per night...

Sadly, it seems it's a case of damned if I do or I don't... So frustrating!

Living w/out proper sleep is so hard at times...

Me, I also have liver issues, and I believe that is largely responsible for what is termed 'Restless Leg Syndrome ~ RLS' and between that and my back pain, I rarely ever sleep well anymore...

Hence, trying to maintain my anti-inflammatory diet and my intense exercise regime as they seem to help me a little...

Sorry but that's all I have and I use myself...

Best wishes Jenny...

Steve

[Otterfield in reply to socrates_8]

Thanks Steve, I'm sorry you are also suffering with this pain. It is a dilemma isn't it. Part of me wants to ask my GP for something really strong but I'm beginning to feel that we have to choose between a relatively pain free life and a healthy liver.

Jennie

[socrates_8 in reply to Otterfield]

Jenny...

Sometimes, having something really strong may be useful too... (?)

Obviously, we all have to make these decisions based upon our own individual needs & circumstances etc...

Stay safe & well...

Steve

[Wyebird]

I’m afraid I can’t help but apparently nettle tea is very good for liver x

[Otterfield in reply to Wyebird]

Thank you, that's something to try. I really don't like taste but I'm willing to drink it if it might help.

[Wyebird in reply to Otterfield]

I found that by not making it too strong and leaving it go tepid then drinking it fast is the best way to take it. I’d like to be point out that I’ve only taken it after drinking a bit too much☺️

[hunter5582]

Paracetamol (acetaminophen) is hepatoxic and does have to be used with caution. Many other meds are metabolized in the liver, including oxycodone. Not sure what else you are on, but you may also want to check for side effects of those meds and drug interactions. (Oxycodone-acetaminophen does not show with an interaction).

[Otterfield in reply to hunter5582]

Thank you. I have been taking the maximum "safe" dose of Paracetamol most days because otherwise the pain becomes unbearable, but I feel it can't be good to do that every day. I use Oxycodone as a top up when necessary. It's frustrating that Ibuprofen is a big NO as I've read that it's not quite so bad for the liver.

[Susana7]

Paracetamol is almost certainly a contributing factor. I had flu a couple of years ago and took paracetamol for 5 days, every day, maximum dose. I had a haemo appointment soon after and my liver counts were higher than ever. I stopped taking paracetamol and went for a repeat test 2 weeks after and the numbers had come down (still higher than normal, but much lower). I hardly ever take paracetamol now, which is a pain as there are not many alternatives given that I cannot take ibuprofen because of interferon. If you stop the paracetamol and repeat the test a few weeks later, hopefully the liver enzymes will have gone down. Good luck! Susana x

[Otterfield in reply to Susana7]

Thank you for sharing your experience. Unfortunately I don't feel able to stop taking it without an alternative, as the pain is too severe. I daren't take too much Oxycodone as it's an opiate (and I've nearly run out).

[Susana7]

Sorry to hear you are in so much pain... without paracetamol and ibuprofen we are a bit stuck in terms of over the counter pain relief. Worth discussing alternatives with your GP. And maybe trying some natural liver supplements to see if it helps a little - although I took milk thistle tablets for a while and did not notice any improvement. I will give nettle tea a try as Wyebird suggests above!

[Otterfield]

Thank you to everyone who has commented. I have spoken to one of the GPs at my medical centre and he said that as long as I don't exceed the recommended dose of Paracetamol it should be safe for my liver. I hope he's right. He has also prescribed codeine to take when needed so I'll see how it goes. Meanwhile, I will read up on TENS machines too.