Question about Lab Results ALP

[rainypass]

I understand that ALT/AST can be indicators of liver function and there is a lot of information about what those results are about. I was wondering about the significance of ALP(alkaline phosphatase) I have done some research but have not found much information. My ALP was low prior to treatment and normalized during treatment, now two months post treatment it has dropped back down to below normal.

ALP pretreatment 37
ALP during treatment 50-60
ALP 8 weeks post 32
Normal range 40-100

Since I am a research participant I am being tested every 4 weeks post treatment, I did interferon/riba for 24 weeks.
Most of my lab results are now back in the normal range(8 weeks post) other than the drop in ALP, I'm still waiting for the viral load results from the recent blood tests. My week 4 post treatment the virus was undetected so hopefully that is still the same.  

The research that I have done so far says low ALP can be from malnutrition and low protein. During treatment I was supplementing with whey protein and have not been doing that since being done so maybe that is what is going on.  

[orphanedhawk]

My alk phos has been on the high side.  My hepatologist said it can be an indicator of a number of different things.
He mentioned it could have to do with your bones as well as other things.
The point being, since this may have nothing to do with your liver, the best person to answer your question is your doctor.

[HectorSF]

Only your doctor who know your health history and current status can determine the cause if any.

A decreased serum alkaline phosphatase may be due to:

Zinc deficiency.
Hypothyroidism.
Vitamin C deficiency/Scurvy.
Folic acid deficiency.
Excess Vitamin D intake.
Low phosphorus levels (hypophosphatasia)
Celiac disease.
Malnutrition with low protein assimilation (including low stomach acid production/hypochlorhydria).
Insufficient Parathyroid gland function.
Pernicious anemia
Vitamin B6 insufficiency

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ALP is commonly used in conjunction with AST and ALT to determine the type of disease the liver has. I have never heard of it being relevant to treatment out come.

* When AST, ALT is higher than alkaline phosphatase level it indicates Hepatocellular disease. (typical liver disease)

* Alkaline phosphatase higher than AST, ALT levels indicated Cholestatic disease. (the gradual destruction of the biliary system)

* Elevation of alkaline phosphatase with near-normal AST, ALT levels indicates Infiltrative. (Malignant diseases including primary tumors (e.g., hepatocellular carcinoma, cholangiocarcinoma), metastases, lymphoma, and leukemia, may produce infiltrative liver disease. Granulomatous liver infiltration may result from infections (e.g., tuberculosis and histoplasmosis), sarcoidosis, and numerous medications.)

"Serum alkaline phosphatase is comprised of a heterogeneous group of enzymes. Hepatic alkaline phosphatase is most densely represented near the canalicular membrane of the hepatocyte. Accordingly, diseases that predominately affect hepatocyte secretion (e.g., obstructive diseases) will be accompanied by elevations of alkaline phosphatase levels. Bile duct obstruction, primary sclerosing cholangitis and primary biliary cirrhosis, are some examples of diseases in which elevated alkaline phosphatase levels are often predominant over transaminase level elevations.

It is apparent that infiltrative liver diseases most often result in a pattern of liver test result abnormalities similar to those of cholestatic liver disease. Differentiation often requires imaging studies of the liver. Liver imaging by ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) most often identifies infiltration of the liver by mass lesions such as tumors. Imaging by cholangiography—endoscopic retrograde cholangiography, transhepatic cholangiography, or magnetic resonance cholangiography—identifies many bile duct lesions that cause cholestatic liver disease. Liver biopsy is often needed to confirm certain infiltrative disorders (e.g., amyloidosis) and microscopic biliary disorders such as primary biliary cirrhosis."

Good luck.
Hector

[rainypass]

Thank you for the replies Hector and orphanedhawk, I have sent a note to the research team and am awaiting an answer. I will try to eat better since it could be nutrition related.