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Gastroenterology  (Expert Forum)
 | 
Liver Enzymes/acid phosphatase/celiac disease
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.

Liver Enzymes/acid phosphatase/celiac disease

by aimeenky, Apr 03, 2008 11:32AM
I hope my question doesn't come out as confusing as it is in my head haha. I have tried to call my primary care dr. to ask this but she is out of town for a week and it's driving me crazy.

A month ago I had some blood work done following a benign sinus tachycardia event.  My liver enzymes were elevated   as follows: AST - 48, ALT, 102 and ALP 314.  I was also just shy of being anemic but she said it looked like my body was doing a good job trying to compensate. She ran the tests again and scheduled me for a liver ultrasound on April 10.  The results were improved on the second panel. AST and ALT were back in normal range and ALP dropped to 185. She asked me to re run the profile 2 to 3 weeks later. We discussed possible celiac disease because of IBS and these other symptoms and I've been trying a gluten free diet with great success on my bowel symptoms. I have also been taking milk thistle, a multi with iron and folic acid, calcium, krill oil, zyrtec and prilosec. I was not good about the supplements and vitamins before all this started, but I've been religious about them since.

My main question is this: I went yesterday to have the blood re checked and she was only checking ALP and then added acid phosphatase. When I try to google the later I only get results that talk about prostate cancer. I'm a 36 year old overweight female who obviously doesn't have a prostate. What would this blood test be able to tell us? Is she looking for another kind of cancer? Or is she just trying to see if the higher alk phos is coming from bone? I'm so confused.

by Kevin Pho, MD, Apr 03, 2008 07:51PM
The ALT can be elevated in a variety of liver diseases.  

I would obtain blood tests to exclude hepatitis.  I also agree with the ultrasound to evaluate for anatomic liver diseases or masses.  

The alkaline phosphatase can be elevated can also be elevated in gallbladder or liver disease.  If the ultrasound is negative, I would pursue a CT scan as the next step.

The definitive test would be a liver biopsy, and can be considered if the tests remain negative.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
Member Comments (3)

by aimeenky, Apr 03, 2008 07:57PM
I still don't know what acid phosphatase is ....

by Missy1018, Apr 15, 2008 09:12PM
To: aimeenky
I also had a high ALK ALK level and my doctor told me that it would have to be much higher before she would do anything about it (as in medication and the like).  I suffer from extremely bad upper left quadrant pain and I'd give anything for an answer to this.

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