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Lab report showed hepatic panel in normal range. Dealing with myalgia. Steps needed to follow?

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Practicing since : 2002
Answered : 2397 Questions
I just received my lab report and the hepatic panel was all in normal range, the alkaline phosphatase however was 157. The only thing I dealing with is fibro myalgia and my Mom had mĂșltiple mylenoma. Can You share with me what steps I need to follow? I experiencia fatigue, pain in my head, (not a headache), alot of nausea no vomiting, not much of an appetite. Exercise regularly last 4 months and lost 18 lbs only exercising and drinking herbalife products.
Posted Fri, 18 Oct 2013 in Cancer
Answered by Dr. Robert Galamaga 1 hour later
Brief Answer:

Detailed Answer:
Hello and thank you for sending the question.

This is a very good question and I will work on providing you with some information and recommendations.

I completely understand your concern with the history that you have described in your mother.

There are several different possibilities regarding why alkaline phosphatase maybe elevated. one possibility would be a gallstone. even a small stone could cause a mild elevation of this laboratory results.

Other possibilities include increased bone turnover. This can happen in certain diseases including myeloma. while this is not likely in your case I believe it does need to be investigated.

Your doctor can request that the alkaline phosphatase is fractionated in the laboratory. this will help determine if the elevation is coming from liver related obstruction of bile flow or from the bones.

also it would be reasonable for you to have a comprehensive metabolic panel which might have already been performed. This would check your total protein level as well as albumin and globulin levels. if any of these is abnormal further testing might be requested.

I don't see any immediate need to worry but I do think this needs to be investigated. Every P laboratory test would be reasonable and also a fractionation might be helpful as well to determine the possible cost.

Thanks again for sending a question. Please let us know if I can be of any additional assistance.

Dr Galamaga

Above answer was peer-reviewed by
Follow-up: Lab report showed hepatic panel in normal range. Dealing with myalgia. Steps needed to follow? 3 hours later
I don't have a gallbladder so the gallstone theory would be ruled out right? I live in Mexico so what test would you recommend and in Spanish what would the names be. I don't have a doctor nor insurance.
Answered by Dr. Robert Galamaga 3 hours later
Brief Answer:
Repeat lab

Detailed Answer:
I would just have the lab repeated in 8 weeks. if still high you might ask the lab to fractionate the alk phos into liver or bone phosphatase as a source.
Above answer was peer-reviewed by
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