High Alkaline Phosphatase

[OrangeTulip]

I’m worried.. I’ve been on Urso for 3 months, my ALT and AST came back normal but my Alkaline Phosphatase increased from 220 to 240….really confusing. Any advice or information would be appreciated.

[iagra]

You should consult with your doctor on the dosage and just give it more time. It might take another 3 months to start moving the needle in the opposite direction. 20 points is not a huge jump. ALP always fluctuates. Good luck!

[OrangeTulip in reply to iagra]

Thanks. My Gastro wanted to check bloodwork after 3 months on Urso …I was disappointed that my number went up.

[ninjagirlwebb]

Just wanted to note that urso is prescribed based on weight and not based on the alk phos levels. As iagra has noted, alk phos does fluctuate so it may go back down; 3 months is a bit too soon to make conclusions.

There is also another blood test, ALP isoenzyme test, to determine where the excess ALP is coming from whether it is the bones or liver. Your liver specialist can make that decision for you regarding the additional test. If the alk phos remains an issue, the doctor can look to adding additional meds to address like obeticholic acid (Ocaliva®).

Don't worry and consult with your doctor.

[OrangeTulip in reply to ninjagirlwebb]

I see a specialist in a month…I will ask about the ALP test.

[OrangeTulip in reply to ninjagirlwebb]

both my ALT and AST were elevated when I was diagnosed so would that point to liver?

[ninjagirlwebb in reply to OrangeTulip]

I am not qualified to answer that question. I only know that my hepatologist order that ALP isoenzyme test for me when my alk phos was higher than usual. The interesting thing was that it went back down when he did the ALP isoenzyme test so then it was fine. If you have a fatty liver that can also impact alk phos.

[rderezin]

Ask your Dr at next appt...I got PBS 27 years ago it took years for my numbers to all be normal ...like 18 ...but that number wasn't the biggie ...last to get normal an increase in dose of urso did it but I avoided it cause of more side affects with bigger doses. I lived around the country and cause the goal was control by drugs to avoid transplant all liver specialists wanted minimum drug to get normal numbers except that one ...Dr's always said if it was under 250 they were happy if it was 1300 they wouldn't be...hope that helps but discuss with your Dr

[OrangeTulip]

Can I ask how you got your numbers down when you avoided taking more Urso?

[rderezin in reply to OrangeTulip]

I watched what I ate ...avoided huge meals...got my liver tests done every 3 months like clockwork and set up chart to tract results and once a year when I met with liver specialist we would discuss and I always brought in my chart of all test results ...always discuss your concerns and all other drugs you are on with your liver Dr. ...and I would ask my primary before adding a long term drug to contact a liver specialist 1st ...hope that helps...

[Gmama2]

Were you fasting? If you have O or B blood types fasting can affect the ALP numbers. Mine went down over 30 pts when I fasted before the test. I took the tests about 3 weeks apart.

[Gmama2]

Sorry meant to add click on my profile name and you will see links to studies about blood type in my post history.

[OdinsMom]

Urso can take a good year to work fully. The fact your AST and ALT are already down is indicative of decrease in inflammation. The ALP should follow but it can take the full 6-12 months to know. Hang in there. There are always more alternatives or additions if it doesn't.

[OrangeTulip in reply to OdinsMom]

Thank you for your reassuring reply.

[JaneEyre55]

HAve your Hepatologist look into Ocaliva. It was developed specifically to reduce Alkaline Phosphatase levels. I've been on it for a while and I'm within the normal range now.

[OrangeTulip in reply to JaneEyre55]

My first visit is in a couple of weeks. I will ask. I just worry about side effects of medications. I do wonder if the statins I took help create elevated liver enzymes…

[JaneEyre55]

It is my understanding that people with liver disease should not take statin. I've had no side effects from the Ocaliva, but discuss all this with your Hepatologist.