why is my alkaline phosphatase level increasing?

[aries817]

Hi there! I am a 45 y/o female who was diagnosed in March with advanced cirrhosis of the liver after spending 3 days in the hospital once I noticed the whites of my eyes were looking yellow. I couldn't believe it because although I'd always loved my beer, I had never been a drinker of the "hard stuff". Now I know it's not so much about what you drink, but how much. I have some feelings of anger at myself because of my current situation. So much regret. But I'm trying to learn as much as I can about cirrhosis, and I'm so glad I came across this forum!
My CMP in March showed my alkaline phosphatase level in the 270's. I had another CMP last week that shows it at 418. Any idea what this means?
I'm scheduled for a liver biopsy tomorrow morning, and an EGD/banding at the end of the month. When I was discharged from the hospital I was told to continue taking a multivitamin daily, limit my sodium intake, and abstain from alcohol. I had my last beer the day before I was admitted and so far don't miss it enough to have another, for which I am grateful.
Thank you for any information you can share!

[fntn]

Hector has filled you in wonderfully as always. I have a great deal of experience as well with that particular little ol' number, ALP, and all the fun it implies. I'll keep an eye on your posting as well, take care!

[HectorSF]

One blood test tells very little about a diagnosis of cirrhosis. You also must have had other abnormal blood levels such as bilirubin if you had jaundice. Many other blood tests and other tests need to be performed to get a true picture of cirrhosis, how advanced it is, the cause, its complications, prognosis etc.

A liver biopsy in someone diagnosed with cirrhosis is unnecessary unless the exact cause of the cirrhosis is unknown. Alcoholic cirrhosis or other causes of the cirrhosis can be seen in the liver samples.

EGD/banding is performed on people with complete cirrhosis with portal hypertension and resulting splenomegaly (enlarged spleen) to prevent the bursting of esophageal (esophagus) or gastric (stomach) varices (enlarged veins) which are caused by changes in blood flow as the liver is too scarred to pass blood normally.


There are many causes of an elevated alkaline phosphatase level including alcohol abuse which is usually accompanied by a high GGT level as well, gallstone disease, drug-induced hepatitis or less commonly Primary biliary cirrhosis, an autoimmune disease of the liver marked by the slow progressive destruction of the small bile ducts of the liver. When these ducts are damaged, bile builds up in the liver and over time damages the tissue. This disease is 9 times more common in women than men. Or rarely biliary tumors.

Further testing in needed to discover what is going on.

I would strongly advice you to get help at a liver transplant hospital were they have experts who work with patients with all of these issues on the daily basis. A typical hospital does not have the expertise nor resources to properly diagnosis all forms of liver disease especially in patients with cirrhosis who have more issues than just liver related issues.

Alcohol is toxic to the liver and will speed up the destruction of the cirrhotic liver and the resulting life-threatening complications of the disease. Total abstinence is required for the best outcome and people that continue to drink are excluded from being eligible for a liver transplant should their cirrhosis become irreversible.

I would encourage you to get copies of all of your medical records if you want to truly understand the nature and degree of your liver disease and what options may be available for maintaining your health for as long as possible. Advanced liver disease is a very complex disease and the accurate results of blood test, scans, procedures are required to understand the disease a person has and what options are available to them.

Good luck to you.
Hector