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Slightly elevated ALT and ALKP
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Slightly elevated ALT and ALKP

Hi,

I have acid reflux problem . Doctor did endoscopy and ultrasound . Ultrasound of liver,gallblader (gallbladder) looks good .One  week after  they did blood test and found my liver engymes slightly elevated .ALT - 32 , ALKP -141 and AST is normal . So Doctor did test for HEP A,B and c.Everything is negative . After one week he again repeated the blood test .That time
ALT - 31 ,ALKP - 138 and AST is normal . Then he did test for Antismooth muscle ab and Antimicrochondrial ab . Everything is negative .Again he repeated the blood test .Now ALT - 40 , ALKP - 133 and AST is normal . I am taking nexium for my acid reflux problem. I am non alchoholic and non somker .Please advice whether this elevation is normal
or what type of diseases is possible ?.

Thanks,
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The alkaline phosphatase is minimally elevated with normal liver enzymes.  With such a minimal elevation, I would consider watching it to make sure it remains stable, especially with negative hepatitis screen, ultrasound and antibodies.

If there is acid reflux, the best test to evaluate this would be a 24-hr pH study.  This is the definitive test for GERD.  If positive, and the symptoms continue to be present despite nexium, you may want to evauate surgical options for treatment.

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.

Thanks,
Kevin, M.D.
10 Comments
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Avatar_n_tn
Hi ,

My age is 33 .From India .

Thanks.
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Avatar_n_tn
Hi ,

Sorry i missed another factor.I had normal blood sugar level three months back .Now it is showing 128 .For the last one month
i was very much mentally stressed and was in depression .

Thanks.

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Avatar_n_tn
Hi Dr,

That lab's normal range for ALT is 5 to 30,ALKP is 53 to 128 .
My cholestrol level is normal .The elevation is due to any liver disease or due to blood sugar (127) or due to the stress and mental depression i had for the last one month or might be due to
Nexium ?.Please advice .

Thanks.


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Avatar_m_tn

  I wouldn't be too worried about those minor elevations, nexium does this to a number of people.

   Since is seems to cause you a good deal of stress,  you should ask your doctor to switch you to a prescription h2 blocker -- Ranitidine, perhaps-- and then after a while, have the tests redone. There's a very good chance values will return to normal once you are off of the nexium.





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Avatar_n_tn
Hi TJV ,

Thanks for the reply . Do you know or heard for anybody that
nexium slightly elevated the ALT and ALKP levels?.Please advice .

Thanks.
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Avatar_m_tn

  Hi Yes i know of a couple of people this happened to and their doctors both said it was probably the nexium-- and put them on H2 blockers to see-- and they were rechecked later. Their levels are both fine now.

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Avatar_n_tn
Hi TJV ,

Thanks a lot . What about Aciphex?.Please advice .

Thanks.
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Avatar_m_tn

  Hi  You could try-- each PPI is processed by the liver slightly differently--but on one of the Gerd message boards there was a girl on aciphex with elevated levels.

  If you really want to find out if this is the cause-- which it probably is- because there are so many people with this problem on PPIS- you are best to try an H2 blocker. H2 blockers can cause elevated levels as well-- but this is a lot more rare.

  When your levels go down, then you can perhaps experiment with other PPIS

  You are lucky your levels are only slightly elevated-- i saw someone with very high levels on nexium -- so he switched to an H2 blocker and levels went back to normal-- but he is not getting the same releif with his gerd. It's a problem for those who need acid supression. Good luck to you.
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Avatar_n_tn
Hi TJV,

Thanks for all your advices .

Thanks.
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Avatar_m_tn

  Good luck to you, i hope you get things sorted out.
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Avatar_n_tn
A related discussion, hight alkp low alt and ast was started.
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