Awefully Elevated Bilirubin and alkaline phosphatase

[eldeladi]

I have had this blood test and received a letter about abnormally high levels of Bilirubin and alkaline phosphatase. They said they can be elevated in situations of liver disease but can't say for sure without further testing.
                                                                                               Reference Range
Bilirubi                     3.8 mg/dL Clinically Significant 0.2-1.9
Alkaline Phosphatase     263 IU/L CS                                  25-110

other Normal chems
Glucose                        95 mg/dL                                               75-110
BUN                             12mg/dL                                                4-19
Creatinine                     0.6mg/dL                                               0.6-1.4
Total Protein                 6.8  g/dL                                                6-7.8
Albumin                       4.2  g/dL                                                3.5-5
ALT (SGPT)                   34  IU/L                                                5-57
AST (SGOT)                  29 IU/L                                                 5-46

One noticeably high Chemestry is
Phosphorus                   5.6mg/dL     but  Not Clinically Significant, range is 3.0-5.0

Please let me know what could these abnormal levels mean. I do plan on visiting a doctor, I have never gone to a doctor in my adult life.
I'm a healthy 24 yr old, 5'3" 135lbs.
One thing that could have caused this, I was 165lbs this time last year, I just started eating more fruits, eating healthy and gone down to 135-140lbs.
I have read that it could be Gibert Syndrome as far as high Bilirubin and that it could be Paget's disease as far as high ALK.
I have not found anything that relates the two chemicals when they are both high.

Thank you so much for taking a look at my question, and I hope I can hear back from knowledgeable people in here.

[simplelifemusiclover]

Do you mind to tell us what is the result? Have all your test returned to normal level after half year? What is the root cause of your problem?

I have similar problem. My test result is

Bilirubin, Total                    7.2 mg/dL                                      0.1-1.4
Bilirubin, Direct                    4.8 mg/dL                                     0.00-0.4
Alkaline Phosphatase     173 IU/L CS                                     30-130

other Normal chems
Glucose                        92 mg/dL                                               65-99
BUN                             12mg/dL                                                8-25
Creatinine                     0.6mg/dL                                               0.6-1.4
Total Protein                 6.7  g/dL                                                6-8.5
Albumin                       4.1  g/dL                                                3.5-5
ALT (SGPT)                   45  IU/L                                                0-52
AST (SGOT)                  40 IU/L                                                 0-48
Hepatitis A Total AB      Reactive

Also I have Hepatitis A active, why AST and ALT are not that high? I did ultra-sound on liver, gallbladder, panceas,biliary tree, and spleen. They didn't see any dilatation. Everything looks fine.

Why my bilirubin and ALP so high? What potential problem I have?

Thanks in advance!

[mikesimon]

I look forward to hearing good news from you.
Again, Good Luck,
Mike

[LivingInHope]

You're welcome!  And please do!

[eldeladi]

Thanks so much to both of you. I really appreciate it.

I will schedule a visit with the doctor and try to find what's the root of this problem. Hopefully that whatever it is, that it's curable

I will also make sure to update you on this.

[mikesimon]

I am not a doctor or in the medical field. I have had liver disease and learned a little as a result.

I doubt that your diet and weight loss is causing these elevations.
I also doubt you have Gilbert's Syndrome because your Alkaline Phosphatase is elevated.

Your bilirubin of 3.8 is your Total Bilirubin which is the sum of your direct bilirubin(liver related) and your indirect bilirubin(not liver related). With Gilbert's only the indirect bilirubin would be elevated. There is a test sometimes called a "Fractionalized Bilirubin Test" which sets out the number for each component - indirect and direct bilirubin - and tells you whether your increased total bilirubin is due an increased direct bilirubin which could suggest a liver problem. If only the indirect bilirubin is elevated then Gilbert's Syndrome could be a possibility.

But, when I see an elevated alkaline phosphatase with an elevated bilirubin I wonder whether a bile duct blockage is a possibility. You're a bit young to have a gallstone problem but it's possible and it also might be a narrowing of the bile duct which would slow the bile flow and cause a buildup of bilirubin in the blood.

Do you have results for GGT?
Have you experienced any abdominal pain?

Sometimes a sonogram can detect the problem if it is a stone or a narrowing of your bile duct. I would definitely follow up with your doctor and undergo further testing.

Good luck,
Mike

[LivingInHope]

I have an old book by France Fischbach, a second edition called A Manual of Laboratory Diagnostic Tests.

It's pretty complicated about bilirubin elevations, but here's some info you might find something you can use in:

It says regarding alkaline phosphatase: "Clinical Implications
A. Elevated levels
1. Liver disease (correlates with abnormal liver function tests) An elevation of alkaline phosphatase is often associated with elevated SGOT/AST and elevated bilirubin.

(a) Marked increases
(1) Obstructive jaundice (gallstones obstructing major biliary ducts; accompanies elevated bilirubin)
(2) Space-occupying lesions of the liver such as cancer and abscesses
(3) Hepatocellular cirrhosis
(4) Biliary cirrhosis

(b) Moderate increases
(1) Hepatitis
(2) Cirrhosis of liver

2. Bone disease
(a) Marked increases
(1) Paget's disease
(2) Metastatic bone disease
(3) Osteititis deformans

(b) Moderate increases
(1) Osteomalacia (elevated levels help differentiate between osteomalacia and osteoporosis, in which there is no elevation)
(2) rickets

3. Other diseases
(a) Hyperparathyroidism (accompanied by hypercalcemia)
(b) Infectious mononucleosis"