Bloodwork Question

Jons_girl

Mika:
Yes my alk phos is from my bones. it has gone down a bit but watching it still. I'm going to be having a iron infusion due to on the low end of ferritin levels. And high iron binding capacity. So will see if maybe that helps my bones and all phos levels.

The test I had done was like a alk phos break out test. Telling you if the alk phos was from liver or bones I think. Forget what the test was called. Antibody test? Not sure. But yes it tells you where the alk phos is from.

ctmbsikia

It's the alk phos isoenzyme test that breaks out the liver and bone readings. Good luck with the iron infusion too.

Jons_girl

Yes!!!! Thank you!! That’s what it’s called! And it showed the alk phos was coming from my bones essentially

Have any of you had iron infusions? Can you share your personal experience with that? I started a thread can you share there?

leftshark

My ALP was up to 155 but is now at 134. I’m having pain in my lower left back, too. So I’m having an MRI and x-ray on Wednesday.

Does anyone know what is considered “high” for ALP? All other bloodwork is normal.

Thanks

SpecialK

leftshark - the "normal" range can be a bit different depending on the testing platform used - for mine the range is 44-147, but some go from 20-140, or 30-120. Some things to keep in mind, docs often look for trends, such as a continuing climb - even within the range, and unless your elevated value is sustained many docs don't get too alarmed at an occasional rise above the range, or fluctuation within the range. Also, it is important to note that these ranges were developed for adult men. Women often have differing values that would be considered normal for them. There are some things that can increase ALP and not be cancer driven - like invasive dental work, thyroid/parathyroid issues, malnutrition or mineral deficiencies, celiac, etc. That happened to me when I had an extraction followed by a dental implant, which involves placing a screw in the jawbone. My ALP was in the 170's on my annual labs, dropping to the 150's after several months - so above the range - for a solid year. Then it totally normalized and is now firmly within the mid-range. My MO wanted a nuclear bone scan but I held off waiting to see if the value would drop and had been caused by the dental work. My maxillofacial surgeon indicated the dental work would not have elevated the value for that long, but I am often an outlier. Hoping for an easy answer for you. Good luck!

leftshark

Thank you!! This does make me feel better. My oncologist’s PA seemed concerned because I’ve also been having lower left back pain. The range for my doctor’s office is 46-116. I had a test last May at my rheumatologist’s office and it was 155. She didn’t seem concerned at all.

I hate cancer. Thanks again!

ctmbsikia

Interesting there are so many values. My test results normal range for ALP says 34-104! Wonder why all the different ranges?

SpecialK

ctmbsikia - I know, right? It is confusing to the patient, but I also think it can account for the reason some docs don't get too excited about a mildly abnormal value. Here is a link that provides some info about ranges, how they are derived, and what they may mean:

https://labs.selfdecode.com/blog/normal-lab-values/

leftshark

That is so interesting. Thanks for sharing!

I’m also having a hard time finding out what really is considered “high” for ALP and an indicator of bone metastasis. Is 134 (or 155 🤪) elevated enough to mean cancer? Or is that number a lot greater?

SpecialK

Here is a study that I found that looked at ALP levels for breast cancer patients. It appears that the levels for metastatic disease are pretty high, definitely not minor elevations, but sometimes oncologists are looking for an upward trend.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824787/

leftshark

Reading this makes me feel a lot better. Thank you!!

Cancer is such a cruel disease. I’m ready for the day when it’s not all I think about. Every twitch ache and doctor’s appointment is so dang stressful!!

ctmbsikia

Hi. Chiming back in on this topic. Last fall I had some liver function tests done that the GI doc ordered due to elevated Alk Phos. The isoenzyme showed the bone high, my liver checks out pretty much Ok except for being larger than is should be and fatty. My insurance this year is covering Prolia, so wouldn't you know after having a shot in January my alk phos is now 84. This makes me more certain that my elevated levels had to do with my bones. Hope you are all doing well.

Jons_girl

my blood work showed my alk phos was connected to my bones too. It has fluctuated a bit. I think it’s ok now. But I keep having my blood work checked periodically. I am doing ok.

Hope all goes well for you too.