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Dr. Andrew Rynne

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What does elevated alkaline phosphatase indicate?

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Dr. Jyothi B L

Pathologist and Microbiologist

Practicing since :2003

Answered : 849 Questions

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Posted on Wed, 17 Dec 2014 in Cancer
Question: Hi, I a have had a series of blood tests 6 weeks apart.

Alkaline Phosphatase in initial testing was 106 and 127 after 6 weeks all other liver function/enzymes well within normal ranges. Initially had low Iron Serum level of 31 and after 6 weeks of Iron tablets is up to 181. Have had back pain for years now and diagnosed as celiac 5 years ago, I am taking Nexium 40mg per day for a number of years and recently been having panic attacks for no apparent reason. I am really worried that this could be bone cancer or a mestastasis of some kind. Do you think I should be worried?Sorry, I forgot to mention that my initial CRP was 21 and after 6 weeks scored 18.
Platelet count at first test was 447 and after 6 weeks 380.
MCH, MCV, MCHC are all slighty lower than normal also.
doctor
Answered by Dr. Jyothi B L 26 minutes later
Brief Answer:
No, you should not be worried.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.

Based on your query, my opinion is as follows:

1. Normal alkaline phosphatase levels are between 30-120 units/L. Yours is only mildly increased. Recent ingestion of meal can increase ALP levels and this mild is not noted in obstructive jaundice nor any liver or bone disorder. It will be 2-3 times increased.

2. Your iron levels are improving well and you need to continue the treatment.

3. Celiac disease can present with various manifestations including rarely back pain.

4. If you are worried about bone cancer or metastasis to bone, due to alkaline phosphatase, then you need not worry. It is a very mild elevation. You can check isoenzymes, if you are not sure. ALP1 is for liver and ALP2 is for bone.

5. CRP level is elevated, possibly due to celiac disease. Reducing CRP means reducing inflammation. Continue with gluten free diet for celiac disease.

6. Platelet count variation and MCH, MCV and MCHC are mild variations. If they are near normal range, not to worry.

None of the tests are significantly abnormal enough to suspect any bone cancer or any cancer or metastasis.
You can try back exercises and physiotherapy to improve back pain.
You need not worry about any of the values and continue with the treatment.

Hope it helps.
If you have any further queries, happy to help again.

Dr. Jyothi BL
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Jyothi B L 18 minutes later
Thank you for your response and detailed opinion, it has put my mind at ease.

I am still going to see the hematologist to close out the loop.

Thanks again & Regards,
XXXX
doctor
Answered by Dr. Jyothi B L 6 hours later
Brief Answer:
You are welcome

Detailed Answer:
Hi XXXXXXX
Thanks for replying.

Hope I was helpful. Do see the hematologist to ease yourself.
You are welcome.

If you do not have any further queries, you can close the discussion and rate the answer.

Thanks again for asking.
Dr. Jyothi BL
Above answer was peer-reviewed by : Dr. Prasad
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