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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are ALP level of 145 and Albumin level of 3.9 a concern?

Answered by
Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 2764 Questions

Posted on Tue, 30 Aug 2016 in Liver and Gall Bladder
Question: I just got labs back from a life insurance check, was expecting nothing wrong .. But my ALP was 145 and Albumin was 3.9. I have been having some strange stool episodes, XXXXXXX yellow, every now and then pain to side . I had a HIDA scan 18 months ago.. Ejection was 25.. Elected not to have surgery..things were fine up until about 6 weeks ago when stool stuff started.. Now stool floats, light again ( tannish yellow).. Freaking out.. What could it be.. Also started having muscle twitching
Answered by Dr. Saddiq Ulabidin 3 hours later
Brief Answer:
Can Indicate lower gall bladder emptying as wellas pancreatic insufficiency

Detailed Answer:
Hi! Welcome to health care magic! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through.

Based on the history you have shared, it seems as if you have already been through alot. The workup and symptoms are indicating two urgent possibilities. Stool pattern and muscle twitching is indicating pancreatic insufficiency leading to defficiencies of fat soluble vitamins like Vitamin A, D etc. So you need to start replacements immediately after sending the levels of vitamin D3, calcium and B12 and start replacing all of these three. Meanwhile blood workup like amylase and lipase levels alongwith fasting lipid profile should also be sent.

As far as last HIDA scan reports and fresh ALP are suggesting, it's not that deranged to be worried about with normal bilirubin specially. Such borderline low readings and pains at that side may be due to acalculus cholecystitis and may need Ultrasound or CT abdomen for both gall bladder and pancreatic anatomy as well as liver status. Such variant can also be possible with obesity, abnormality in lipid profile as well as diabetes so these all should also be ruled out.

Meanwhile drink more amounts of water and use if antispasmodic agents like drotaverine will be helpful alongwith OTC analgesics like acetaminophen.

If fever or tenderness increases antibiotic cover may be needed but first CT or blood work up to confirm infections. If needed expert opinion with gastroentrologist should be sought. No indication of surgery so far is noted however fresh work up can guide your doctors further how to proceed.

Wishing you a speedy recovery. If you have any more questions, feel free to ask. Regards.
Above answer was peer-reviewed by : Dr. Priyanka G Raj

The User accepted the expert's answer

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