Alkaline Phosphatase

marciejones10 · Post by **marciejones10** » Thu Oct 04, 2012 5:32 pm

I was diagnosed with Mastocytic Enterocolitis a few months ago. My blood tests from my annual checkup last week showed an elevated Alkaline Phosphatase level (212, normal range is 38 - 126). This is the third year in a row that my alkaline has been elevated (slowly increasing each year). My internal medicine doc has ordered an MRCP to check my liver ducts to check for sclerosis. He mentioned that the elevation could be due to an autoimmune issue. I'm wondering if this increase could have anything to do with my ME (I should mention that my internal medicine doctor has never heard of ME before). Anyone else had a problem with an increase in Alkaline levels? All of my other blood counts were normal except for a very slightly elevated WBC.

Post by **tex** » Thu Oct 04, 2012 7:31 pm

Marcie,

If the problem is located in your liver, then your bilirubin AST, and ALT should also be elevated. If they're not, and your calcium and phosphorus levels are abnormal, the problem may be due to a bone issue. However, gluten sensitivity can cause elevated liver enzymes and give the illusion of liver disease. I doubt that much research has been done on the relationship between liver enzymes and mast cells, but I wouldn't be surprised if there is a correlation, and if there is, that would mean that ME could affect liver enzymes.

Are you taking any drugs? Certain drugs are notorious for causing elevated liver enzymes. I see that you have gluten and casein listed as food sensitivities. Are you following a diet that strictly avoids them?

This old thread posted by a member who has mast cell issues mentions elevated liver enzymes.

http://www.perskyfarms.com/phpBB2/viewtopic.php?p=90190

Tex

marciejones10 · Post by **marciejones10** » Thu Oct 04, 2012 7:43 pm

Tex,

I am taking Zyrtec and Zantac and Welchol for the ME. Plus I also take Singulair, Vytorin, and Dexilant (a proton pump inhibitor) and birth control pill.

I am on a gluten free and casein free diet (I figured out several years ago that I couldn't tolerate those items long before I was ever diagnosed with the ME). Since my diagnosis I have been more vigilant in watching out for cross contamination in the last month which I had gotten a bit lax on.

Marcie

Post by **tex** » Thu Oct 04, 2012 7:54 pm

I don't recognize any of those meds as likely to cause liver enzyme changes, but I'll check them more carefully to be sure.

Please reread my previous post — I added some information while you were responding.

Tex

marciejones10 · Post by **marciejones10** » Thu Oct 04, 2012 8:08 pm

Thanks, Tex. My ALT, AST, bilirubin, calcium and phosphorus levels were all within normal range. But the gluten sensitivity may be the issue, as I probably had not been as vigilant in my diet as I have in the last month or so. So, I guess I'll try to keep my gluten diet in check more carefully and recheck my levels in a few months and see if there is any improvement with the diet improvement. I had a liver biopsy several years ago when my liver enzymes went crazy before and it was negative, so your idea that the gluten could create the false illusion of liver disease would make sense. Thanks for your input!

Post by **tex** » Thu Oct 04, 2012 8:11 pm

Marcie,

It appears that I was wrong. Leukotriene inhibitors (such as Singulair can raise the levels of liver enzymes. The FDA recommends liver function tests monthly for the first three months on medication, followed by quarterly monitoring for the next year, and continued interim testing. l

I apologize, I had forgotten about the problems with Vytorin. Vytorin is a combination of Zetia and simvastatin, and according to case reports, Zetia is notorious for causing elevated liver enzymes. Not only that, but it appears that the combination (Vytorin) can cause worse problems than either drug along.

I doubt that the Singulair is your problem, (though it's possible, of course). My guess is that your elevated ALP is due to the Vytorin. Vytorin is not a nice drug. Your doctor should know better than to prescribe it to his or her patients. There are safer choices available.

http://www.lawyersandsettlements.com/la ... ttack.html

You're very welcome,
Tex

marciejones10 · Post by **marciejones10** » Thu Oct 04, 2012 8:19 pm

Thanks Tex!

Nancy · Post by **Nancy** » Fri Oct 05, 2012 9:26 am

My mother had Pagets disease, a bone issue, and they always checked her phosphatase levels. I am pretty sure she had MC or celiac or both but she didn't want to change her eating habits and just suffered with the diarhhea.