Liver function test

[dottyb09]

I recently had a liver function test and the Serum alkaline phosphatase level was out of range at 164 (30 - 130). The doctor suggested it could be due to being overweight (I am 75 kilos, size 16). Could it be to do with my thyroid? She said she would arrange an ultrasound to be on the safe side. I found my appointment on my NHS app, July 25th!

I take NDT and had a Monitor My Health blood test last week which came back ok, TSH .01, Free T4 19.1 and Free T3 6. Incidentally, my test was posted on Tuesday for collection at 5.15pm. The next morning I had an email to say it had been received and at 3.15pm I had the results! Less than 24 hours.

[Tina_Maria]

High T3 levels can cause ALP to rise as can very low T3 levels. However, you thyroid levels look good, especially your T3, so it is unlikely that this is the cause.

Your doctor should actually run a complete liver function test to see if your other liver enzymes are in range or also elevated. There are many causes why ALP could be high (e.g., Zinc deficiency, B12 deficiency, liver disease, bone disorder or kidney problems, also overweight) but before jumping ahead, as I have mentioned, the GP should run more liver tests. Sometimes an elevation of enzymes (up to 2x or 3x the upper limit) can be a one off, but it should still be investigated, especially if it is new.

[dottyb09 in reply to Tina_Maria]

Thank you for your reply. I had a full liver function test and that was the only one out of range. My B12 is over range so I have reduced my Igennus B Complex to one a day. I don't think I have a bone disorder or kidney problems so it is a bit of a mystery.

[Tina_Maria in reply to dottyb09]

Ah no worries. It could be that it is a transient finding, especially as the other liver enzymes are within range. Usually, if the result is not higher than 2x the upper limit (260), doctors are generally not too concerned. I would just keep an eye on it.

[helenshubby in reply to Tina_Maria]

TSH .01, Free T4 19.1 and Free T3 6 Good? TSH seems suppressed FT4 high Nornal and T3 3.6 is low normal according to most ranges I've seen (Usually something like 3.1-6.8) I suspect this lady needs T3 as she looks a poor convertor and all the T4 she's taking is doing is suppress her ash which should be around 1. Something odd here.

[Tina_Maria in reply to helenshubby]

I think you may have misread the T3 reading. This lady is taking NDT and like all patients who take NDT or T3, the TSH can be very low or suppressed (as it is in this case). The T3 value reads as 6.0, not 3.6 - otherwise you would be right that would be odd. Some people on T3 also need a decent amount of T4 to feel well, yes it might be preferable to have the T4 not too high, but it does take a while to adjust, as you cannot make too many changes at once.

[dottyb09 in reply to Tina_Maria]

Yes, I have been on NDT for about 20 years and the latest results are good for me. I self medicate, GPs don't even bother to enquire about my thyroid any more which suits me. The last GP who did query my suppressed TSH was hypothyroid himself but was just as ignorant as most others. He told me he just took one pill at breakfast and he was fine!