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    Are ALP levels of 489 and high globulin levels a cause for concern?

Posted on Fri, 13 May 2016 in Liver and Gall Bladder
Question: I am 30yrs old and have been regularly drinking from last 6 years, two months ago I get morning sickness after nite drinking and from there I nearly stopped drinking, 3 weeks ago I took LFT test, I found that Ast, Alt, bilirubin are under normal range but the Alp is very high 489 against the normal adult 258 range, and globulin is also high, is this very serious problem whom should I consult, at now I am taking ureso & sillymarin 150mg & 70mg respectively with lecithin
Answered by Dr. BR Hudda 9 hours later
Brief Answer:
Electrophoresis and bone marrow biopsy if need be

Detailed Answer:
Welcome to health care magic, thanks for posting your query.

ALP is generally present in all the cells all over body but mainly present in liver, bones, bile duct, intestinal lining (mucosa), kidney.

High ALP in backdrop of normal bilirubin, AST and ALT might be related to number of conditions such as:-
-Biliary duct obstruction or gall bladder stone
-Hyper parathyroidisn
-Bone condition
-Intestinal disease like coeliac disease.
-Certain blood cancer like lymphoma or leukemia
-Thyroid disease

In your case, ALP is not so high(489) along with high globulin, so you need not to worry much, I would advise you to go for further evaluation to find out underlying cause.

For further investigation I would advise you for CBC, electrophoresis, thyroid function test, serum calcium, ultrasound abdomen and pelvis to look for liver, gall bladder, billiary tree and kidney and if need be Bone marrow biopsy.

Meanwhile continue with present medicines you are taking Silymarin, urseo and lecithin.
Complete avoidance of alcohol and smoking is advisable.

Hope I could answer your question, Please feel free to ask for further assistance, I will be happy to help you.
Best wishes
Above answer was peer-reviewed by : Dr. Sonia Raina
Follow up: Dr. BR Hudda 2 hours later
as i earlier told being very alcoholic from last 6 years, for the first time i experienced hepatitis like situation 5 years ago and few months later experienced kidney stone pain(2 month) in my kidney but which was passed out during urination, now 2 months ago i experienced hepatitis like situation again, the first doc (general physician)advise me stop alcohol forever and declare me prone to PBC, later i consult local medical surgeon which also advised to stop alcohol but with my Lft test he reported no sign of major disease related with liver.
below is my LFT report for your convenience
SGOT - 26.9 IU/L
SGPT - 19.0 IU/L
Bilrubin Total - 0.71 mg/dl
Bilrubin Direct - 0.20 mg/dl
Bilrubin Indirect- 0.51 mg/dl
Alkaline Pho.4 - 489 IU/L
Total Protein - 8.1 gm/dl
Albumin - 3.3 gm/dl
Globulin - 4.8 gm/dl

Am i prone to any major liver disease ???, please suggest..

Last year (feb/2015) i underwent varicocele surgery which surprised me and my doc as varicocele advanced to leve II stage without showing any body sympotms (during varicocele surgey my appendicitis was removed on its excess swelling images), and thats the main worry for me as my body shows any sympotoms very late and later get diagnosed for major.

at now i am advised to take ureso & sillymarin 150mg & 70mg respectively with lecithin Twice a day for next 2-3 month, should i contiune with medicine or should seek advice to any specialist
i heard that sillymarin intake gets used to the body so it should be taken for 2 weeks only later give gap of 2 weeks and so on.

i am staying very far from urban places and maintaing myself away from alchol from last 2 months, i totally stopped smoking 2 years ago, at present chewing tobacco with betelnuts, does intake of tobbaco affect/damage liver function
Answered by Dr. BR Hudda 21 minutes later
Brief Answer:
Electrophoresis and ultrasound abdomen is advisable to start with.

Detailed Answer:
Welcome again and thanks for all the details.

Since globulin level is also high with elevated level of ALP so I would advise you to go for all the tests (mainly electrophoresis and ultrasound abdomen), I have advised you in previous reply to rule out/early diagnosis of any other related condition.

Silymarin is a herbal product which has antioxidants and anti inflammatory properties, so you can take it which will help by improving efficiency of liver function.
it's not addictive but it's better to avoid high doses and you can take it regularly.

Since you used to smoke and drink so high ALP might be related to residual liver damage, However I would advise you to go for electrophoresis and ultrasound abdomen for further evaluation.

Hope I could answer your question, Please feel free to ask for further clarification, I will happily answer you.
Best wishes
Above answer was peer-reviewed by : Dr. Sonia Raina
Follow up: Dr. BR Hudda 19 hours later
Thanking for response. after the both test to whom I should meet which type of specialist. how many years it will take to remove and improve from residual damage of liver,
what I had done in past had surely damaged the liver cell I hope I can recover it by medication and proper food diet avoiding harmful habits & substance,
Awaited for your suggestions
Answered by Dr. BR Hudda 6 hours later
Brief Answer:
it may take 6 months to a year

Detailed Answer:
welcome again
when you go for this reports, you can see your family physician or haematologist according to your convenience.

Residual damge could be permanent or reversible which can be assessed by ultrasound and further investigation

Reversible damage can be corrected by life style modification and quitting smoking and alcohol, it may take 6 months to a year to get back to normal or decrease the severity of damage.

Hope I could answer your question, Please feel free to ask if you have any more queries.I will gladly answer you.
wishing you good health.

Above answer was peer-reviewed by : Dr. Prasad
Answered by
Dr. BR Hudda

General & Family Physician

Practicing since :2009

Answered : 2994 Questions


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