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Gastroenterology (Expert Forum)
Alkaline Phosphates elevated -- could it be Hypothyroidism?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Alkaline Phosphates elevated -- could it be Hypothyroidism?
by msteed, Jan 23, 2006 12:00AM
I am female (age 37). I have had the following symptoms for the past several months: Fatigue, forgetfulness, excessive hair shedding, brittle hair & nails, dry skin, constipation, sore muscles, weight gain (fluid retention too), heavy and irregular menstrual flow, etc. Family physician ran a blood test and said my alkaline phosphates were elevated and requested I return (fasting) for another blood test. Upon my next visit, I suggested they check my thyroid (since my mother, 2 maternal aunts, and 2 maternal cousins have been diagnosed with thyroid dysfunctions). The test came back and my TSH was 4.12 -- which the lab reported as "normal"; however, when I researched the "normal" range and found the National Association of Clinical Endocrinologists' website, I learned that the range changed in 2003 from .5-5.0 to .3-3.0 -- which would indicate that I could have Hypothyroidism. I requested a referral to my family's endocrinologist -- based on my number being outside the current "normal" guidelines, but my family physician wants to do more "bloodwork" and a "thyroid scan" and said that I don't need an Endocrinologist -- and that she doesn't know anything about "new guidelines". What do you recommend? Do you think my symptoms are indicative of thyroid dysfunction -- and what else could elevated alkaline phosphates indicate?
Doctor's Answer
by Kevin Pho, MD, Jan 24, 2006 12:00AM
, Jan 24, 2006 12:00AM
Elevated alkaline phosphatase level can come from liver/gallbladder disease or bone disease.
One way to differentiate between the two would be to perform liver function tests (i.e. a GGT, ALT and AST level). If elevated, you can pursue tests to evaluate the liver/gallbladder - likely an ultrasound first.
If the liver tests are not elevated, you can look at bone disease as a cause for the elevated level. A bone scan can be considered if this is suspected.
As for the thyroid level - I typically use a range up to 5.0. However, you can discuss this with an endocrinologist referral.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
One way to differentiate between the two would be to perform liver function tests (i.e. a GGT, ALT and AST level). If elevated, you can pursue tests to evaluate the liver/gallbladder - likely an ultrasound first.
If the liver tests are not elevated, you can look at bone disease as a cause for the elevated level. A bone scan can be considered if this is suspected.
As for the thyroid level - I typically use a range up to 5.0. However, you can discuss this with an endocrinologist referral.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
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Hope that you can give some good insight regarding this matter.
Thank you very much!
Hope that you can give some good insight regarding this matter.
Thank you very much!