Rising Alkaline phosphates

[Mommyofmany]

In June of 2019 my AP was 427, normal is 45-129. I started on Ursodiol and the number started dropping. By Jan. it was 180 and has stayed about the same all year. I am tested monthly. The last few months its started rising, now it's 201. I see a Gastrointerologist PA. He says it's just because of fatty liver. Can I do something to help this go back down? Should I be concerned?

[rderezin]

Always take your drugs with food..don't be supprised if they increase you meds at 1 year..I have had disease 28 years and on drug 27 ..every three months blood ..not all my numbers ever normal early years it was up and down...when they stayed up my drugs got increased..also my work was stressful..moved several times..so got new drs...went thru menopause..weight gain and lose..suggestion..eat healthy..exercise (my favorite was pool at health club classes) and be a glass half full person ..happy we have a drug...oh..and gold bond over the counter lotion for inch is as good as anything a dr will offer ( the menthol in creme tricks the never ending in your skin to reduce urge to scratch)

You will be great

[Mommyofmany in reply to rderezin]

Thank you for your words of encouragement! It has been a very stressful time. And Covid-19 epidemic made it more stressful!

It seems every time I think my body is doing better another issue flares up. The pain in my feet was so bad yesterday I could hardly walk and my hands were killing me. I wonder is this PBC or arthritis? Then I think does it matter? I don't want to take anymore medication 😫 but the pain is better today! So, I'm going to take your advice, my cup is half full! Thank you again!

[OdinsMom]

Yes you’re correct to be concerned. Fatty liver doesn’t increase Alk Phos only, so unless your other numbers are also increasing it’s probably not fatty liver. Are you taking a correct dose of urso(13/15mg per kg)? I’d find a hep familiar with PBC. Post menopausal women normally increase Alk Phos but not that much

[ninjagirlwebb in reply to OdinsMom]

Why do post menopausal women increase in alk phos? What specifically drives that?

[OdinsMom in reply to ninjagirlwebb]

Loss of bone

[ninjagirlwebb in reply to OdinsMom]

I see. There is a blood test that breaks down alk phos into 3 components: gastric, bone, and liver. So you can actually identify the make up of the total number.

[BonnieClyde in reply to ninjagirlwebb]

What is the name of the test?

[ninjagirlwebb in reply to BonnieClyde]

Alkaline Phosphatase Isoenzymes

Test Includes

Relative percentages of liver, bone, and intestinal alkaline phosphatase isoenzymes and total alkaline phosphatase

[ninjagirlwebb]

How did the GI PA determine definitively that it is fatty liver rather than the pbc acting up?

[Mommyofmany in reply to ninjagirlwebb]

Good question! I have no idea.

[ninjagirlwebb in reply to Mommyofmany]

You should ask him.

[Mommyofmany in reply to ninjagirlwebb]

I really don't know. I don't think he has much experience. Blaming it on fatty liver is just an easy thing to say without any real proof or further testing. I am trying to find a doctor with more experience in PBC that accepts my insurance.

[ninjagirlwebb in reply to Mommyofmany]

Find a hepatologist in a major teaching hospital system.

[OdinsMom]

Find a hepatologist who knows PBC. If Alk Phos only is rising it’s not pbc