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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could low ALP levels with high bilirubin indicate Celiac disease?

My husband had high AST, ALT, and Low ALP. The dr. said to wait a couple of months and retest. Upon doing that his AST, ALT came back in the normal range the ALP is still low 22 U/L and he now has high 1.7 mg/dl Bilirubin level. They are now having him go back for GGT tests and an ultrasound. Any idea what this is looking for? Is it possible Celiac Disease would cause the low ALP and high bilirubin?
Mon, 26 Oct 2015
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
Celiac disease affects the small intestine resulting in mal-absorption of nutrients from small intestine.
It results in diarrhea and features of mal-absorption like weakness, tiredness, stunted growth in children, iron deficiency anemia.
Liver enzymes may be mildly elevated in celiac disease.
However, liver enzyme and bilirubin can be elevated in various conditions.
High liver enzymes and high bilirubin are seen in conditions which damage the liver cells or hepatocytes like infection, inflammation, drugs, toxins etc.
GGT level is raised in alcoholism and obstruction in extra-hepatic biliary apparatus.
Ultrasound will determine the status of liver and extra-hepatic biliary tree.
In case, your husband is suffering from celiac disease, abnormal liver functions may be associated with celiac disease.
You need to consult your referring doctor for further investigations and thus management.

Thanks and take care
Dr Shailja Puri
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