An alkaline phosphatase of 153 is mildly elevated. There are many reasons why this can be elevated. Here is a excerpt from UptoDate that lists the many diseases associated with an isolated alkaline phosphatase:
Isolated elevations of hepatic alkaline phosphatase or disproportionate elevation compared with other tests, such as the serum aminotransferases and bilirubin, can occur in a number of circumstances including:
- Partial bile duct obstruction due to gallstones or tumor. The mechanism is unknown but probably represents local areas of bile duct obstruction with induction and leakage into serum of hepatic alkaline phosphatase from these obstructed areas.
- Early in the course of some cholestatic liver diseases such as primary sclerosing cholangitis and primary biliary cirrhosis.
- Infiltrative diseases such as amyloidosis, sarcoidosis, hepatic abscesses, tuberculosis, and metastatic carcinoma.
- Extrahepatic diseases such as myeloid metaplasia, peritonitis, diabetes mellitus, subacute thyroiditis, and uncomplicated gastric ulcer. The increase in alkaline phosphatase in these disorders is thought to be related to hepatic dysfunction despite the absence of overt liver disease.
- Extrahepatic tumors, including osteosarcomas, lung, gastric, head and neck, renal cell carcinoma, ovarian, uterine cancer, and Hodgkin's disease, that secrete alkaline phosphatase (often a form known as the Regan isoenzyme) or cause leakage of hepatic alkaline phosphatase into serum by an unknown mechanism.
- Certain drugs such as phenytoin.
I would discuss whether workup of these other diseases would be a reasonable next step. If the workup is negative, you may want to consider repeating the tests on a routine basis to make sure that they don't continue to rise. It is also possible that the mild elevation is non-specific and a variant not associated with disease.
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.
Pratt et al. Alkaline phosphatase and other enzymatic measures of cholestasis. UptoDate, 2004.