ALP elevated, Lipitor?

Nomad · May 24, 2023

My ALP has been around 140 for the last two weeks. It was normal before Lipitor I started in February. My doctor is testing it because I want to go back on accutane.

Is this normal? My total cholesterol is <100 now. I had a 60% drop in LDL on 10mg of Lipitor daily.

EDIT: welp doctor called they can’t start accutane with elevated ALP levels…

Systemlord · May 25, 2023

Nomad said:
EDIT: welp doctor called they can’t start accutane with elevated ALP levels…

WTF?

Nomad · May 25, 2023

Systemlord said:
WTF?

Yeah, my primary care doctor kind of got me freaking out earlier saying it could be cancer or even the testosterone injections. I’m going in tomorrow for a specific test which will determine where I’m my body the ALP is coming from.

From my research it’s odd that my ALT and AST isn’t elevated as well indicating it may not be my liver.

Last time I ran accutane (20mg daily) from a UGL my AST was the only value that raised and it went to 50 about 4 months in.

Edit: on 1/19 this year I had the minor heart attack and about 10 days later I was in the hospital with COVID.

Nomad · May 25, 2023

Here’s the recent results I started taking NAC 600mg twice daily between these last two tests.

sammmy · May 25, 2023

My ALP elevated from 40 to 75 U/L, while I was having a severe C. Difficile intestinal infection with diarrhea/colitis. The creatitine was also elevated from 0.95 to 1.22 mg/dL. The bacterial infection was notable on my CBC test as very elevated Neutrophils and Platelets.

Nomad · May 25, 2023

sammmy said:
My ALP elevated from 40 to 75 U/L, while I was having a severe C. Difficile intestinal infection with diarrhea/colitis. The creatitine was also elevated from 0.95 to 1.22 mg/dL. The bacterial infection was notable on my CBC test as very elevated Neutrophils and Platelets.

What’s weird is I feel fine.

sammmy · May 25, 2023

I was just giving an example that ALP elevation may not be due to cancer or liver problem but a bacterial infection.

Which lab do you use that shows the same test over time? This is genius and allows to easily spot trends. I wish all labs did that.

Nomad · May 25, 2023

sammmy said:
I was just giving an example that ALP elevation may not be due to cancer or liver problem but a bacterial infection.

Which lab do you use that shows the same test over time? This is genius and allows to easily spot trends. I wish all labs did that.

That’s my primary care/local hospitals webpage option, you can also view it as a line chart, I love it too!

EDIT. They out source a lot of their labs to quest diagnostics I just checked.

sammmy · May 26, 2023

So it's a lab data aggregating software. Quest plots line charts on their own patient portal but they are often not optimal to read - can't change the vertical axis. I'd rather have the number data.

What is the login page of your hospital if you don't mind?

I'll try to set up an account to see if it can pull and aggregate my Quest Diagnostics data. I'm tired of manually keeping track of it in Excel.

Nomad · May 26, 2023

sammmy said:
So it's a lab data aggregating software. Quest plots line charts on their own patient portal but they are often not optimal to read - can't change the vertical axis. I'd rather have the number data.

What is the login page of your hospital if you don't mind?

I'll try to set up an account to see if it can pull and aggregate my Quest Diagnostics data. I'm tired of manually keeping track of it in Excel.

My.PeaceHealth.org

Nomad · May 28, 2023

Just a weekend update: will probably have more testing on Tuesday.

sammmy · May 28, 2023

It could be liver damage by Lipitor. The easiest way to check that is to stop Lipitor and retest.

How much is your total cholesterol without Lipitor? Dropping total cholesterol below 100 is a rather aggressive treatment, when controlling triglycerides probably matters more than dropping the cholesterol to the ground.

Nomad · May 28, 2023

sammmy said:
It could be liver damage by Lipitor. The easiest way to check that is to stop Lipitor and retest.

How much is your total cholesterol without Lipitor? Dropping total cholesterol below 100 is a rather aggressive treatment, when controlling triglycerides probably matters more than dropping the cholesterol to the ground.

Attached is my most recent lipid panel.

The test results I shared earlier this afternoon signal it’s not a liver issue, but can be a bone or vitamin D deficiency thing which also points towards the Lipitor.

sammmy · May 28, 2023

Your Triglycerides are fine.

The test interpretation of high ALP and low normal GGT use the word "likely", so they do not rule out liver damage at 100%.

Statins are known to cause liver damage but typically more liver enzymes will be abnormal. What is strange is that you are on the lowest dose of Lipitor and yet your LDL is in the ground, showing an exaggerated response to it.

Nomad · May 28, 2023

sammmy said:
Your Triglycerides are fine.

The test interpretation of high ALP and low normal GGT use the word "likely", so they do not rule out liver damage at 100%.

Statins are known to cause liver damage but typically more liver enzymes will be abnormal. What is strange is that you are on the lowest dose of Lipitor and yet your LDL is in the ground, showing an exaggerated response to it.

I agree my LDL was 114 on January 20th. It’s more than a 60% reduction in a few months.

t_spacemonkey · May 29, 2023

do your body a favor and stop this poison. the evidence for statins is extremly weak

Nomad · Jun 2, 2023

UPDATE: I finally got the results back from the specialized test.

I have an in-person appointment with my PCP next Friday. What questions should I ask? I know she said based on this tests results she would test my testosterone level she says that can be a possibility if it’s too high and vitamin D amongst other things.

I’m still waiting on my testosterone to get here from the pharmacy, it’s been like two weeks now, so it will be interesting where that sits this long without everyday injections.

Nomad · Jun 6, 2023

@Nelson Vergel do you have any insight? I’ve been trying to find a study showing testosterone increases ALP. I’ve only been able to find studies showing men with low testosterone being treated with TRT and their ALP dropping.

Nelson Vergel · Jun 7, 2023

Yes, testosterone can affect ALP (Alkaline Phosphatase) levels in the body. ALP is an enzyme found in several tissues throughout the body, including the liver and bone. In general, higher levels of testosterone can stimulate bone growth, which could increase the activity of ALP, as it is a key enzyme involved in bone mineralization.

However, it's important to note that many factors can affect ALP levels, not just testosterone. For example, conditions like liver disease, bone disorders, and certain cancers can also significantly affect ALP levels. Therefore, it is recommended to seek professional medical advice for interpretation of these levels.

What’s your vitamin D?

Alkaline phosphatase ALP (adults)

Alkaline phosphatase is also known as ALP and it's found in different tissues in the body. This enzyme is mostly present in the bones and liver. It plays a vital role in bone formation and mineralization.

This test is sold as part of a Comprehensive Metabolic Panel (CMP test)

Normal Alkaline Phosphatase (ALP_

45-115 U/liter for males
30-100 U/liter for females

When ALP blood test is high

It might be a sign of biliary obstruction or liver diseases such as hepatitis or cirrhosis
Sign of bone disorder or even renal problems
In some cases, it might indicate thyroid issues

When ALP blood test is low

It might signify nutritional deficiencies such as a lack of vitamin D, B12, magnesium or zinc
Might be caused by anemia

Nomad · Jun 7, 2023

Nelson Vergel said:
Yes, testosterone can affect ALP (Alkaline Phosphatase) levels in the body. ALP is an enzyme found in several tissues throughout the body, including the liver and bone. In general, higher levels of testosterone can stimulate bone growth, which could increase the activity of ALP, as it is a key enzyme involved in bone mineralization.

However, it's important to note that many factors can affect ALP levels, not just testosterone. For example, conditions like liver disease, bone disorders, and certain cancers can also significantly affect ALP levels. Therefore, it is recommended to seek professional medical advice for interpretation of these levels.

What’s your vitamin D?

Alkaline phosphatase ALP (adults)
Alkaline phosphatase is also known as ALP and it's found in different tissues in the body. This enzyme is mostly present in the bones and liver. It plays a vital role in bone formation and mineralization.

This test is sold as part of a Comprehensive Metabolic Panel (CMP test)

Normal Alkaline Phosphatase (ALP_

45-115 U/liter for males

30-100 U/liter for females

When ALP blood test is high

It might be a sign of biliary obstruction or liver diseases such as hepatitis or cirrhosis

Sign of bone disorder or even renal problems

In some cases, it might indicate thyroid issues

When ALP blood test is low

It might signify nutritional deficiencies such as a lack of vitamin D, B12, magnesium or zinc

Might be caused by anemia

My doctor seems uninterested in checking my vitamin d (I take 5000 iu daily. The last message I sent her was asking if she wanted me to have my vitamin D or any other tests done before my appointment on Friday. She seems pretty convinced it’s the testosterone despite not even testing my level.

The isoenzyme test was also performed 2 weeks without my daily testosterone injection due to a back order from my pharmacy so my level was probably much lower than usual as I’ve felt very lethargic going so long without testosterone after 5 years, that’s my biggest concern, the doctor writing it off as the testosterone but it being something much more serious.

Would taking TUDCA help? I’m at a loss of what I should ask on Friday.