Please talk me off of the ledge

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Anonymous
Anonymous Member Posts: 1,376
edited June 2019 in Not Diagnosed With a Recurrence or Metastases but Concerned
Please talk me off of the ledge
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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    HAS ANYONE EVER HAD ALP LEVEL RISE AND IT NOT BE METS?

    Only other out of the ordinary result was high triglycerides and cholesterol

    I have had mild stomach discomfort since my oopherectomy at the end of January 2016 and starting Anastrozole and Cymbalta in 2016. Mainly bloating and irritation, especially if I eat poorly. upper abdomen- center. Blood work on 9/16/17 shows elevates ALP at 139. At diagnosis in 2015 it was 87. All other liver function tests are normal. Bone and CT scan prior to mastectomy in 2015 were good. Can it be anything other than METS?

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  • kcat2013
    kcat2013 Member Posts: 391
    edited September 2017

    I have pain in the upper center of my abdomen that is caused by GERD, is that a possibility for you? The pain after eating specifically makes me think of that.


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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    it could be GERD. I never though of that. But would that affect the ASP level?

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  • kcat2013
    kcat2013 Member Posts: 391
    edited September 2017

    Is the ASP, alkaline phosphatase? If so I *think* if elevated it can indicate liver or bone problems (which metastasis could be one cause).

    Sorry I'm not more help!


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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    yes the mets is what I am concerned about. I was hoping Arimidex could be the cause.

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  • Freya244117
    Freya244117 Member Posts: 603
    edited September 2017
    These are the liver enzymes I get tested for, there is no ASP so not sure what is elevated. There are so many reasons for elevated liver enzymes other than mets, including taking OTC pain meds such as Tylenol, statins can affect the result as well. IBS and celiac disease can cause elevated results, so perhaps GERD could do the same.
    • Alanine transaminase (ALT)
    • Aspartate transaminase (AST)
    • Alkaline phosphatase (ALP)
    • Gamma-glutamyl transpeptidase (GGT)
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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    ALP- I cannot even type. I am sick to my stomach.

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  • KSteve
    KSteve Member Posts: 486
    edited September 2017

    Jojo0529 - I had an increased ALP level one time a couple years after treatment. They had me retest blood work for that specifically and it was normal. I believe I was told at the time that "fatty" food intake can cause raised ALP levels. I had eaten a chipotle burrito bowl with guacamole right before my appointment. Just to be safe, I fasted (not required) before the next one and it was normal. Would your doctor redo your blood work to check again?

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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    Do you take Ibuprofen? My sister has fatty liver, it was found with ALP out of range. Or it could be bone loss

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    thank you. i only had coffee before the appointment. The night before I ate poorly.

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    Hi Marijen I sometimes takes aspirin, but i wonder if Cymbalta could be the culprit. My onco is not worried, she thinks it is a fatty liver. I however am panicked out of my mind.

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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    Don't worry, if it's fatty liver it's good the doctor caught it. Fatty liver can be reversed with losing weight and healthy diet. Even ten pounds can make a difference. You'll be fine. I forget what the number is but a lot ofAmericans that are overweight have fatty liver and don't know it. If you aren't overweight then you need to correct your diet. But listen to your doctor, not me.

    PS I took one cymbalta for pain and was sick for a week, horrible. Luckily my PCP understands some of us have reverse reactions to drugs.

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    xoxox marijen. I am definitely overweight. I out on 30 lbs since starting arimidex. I have already started my diet. Im hoping weight loss will reduce the numbers.

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  • marijen
    marijen Member Posts: 3,731
    edited September 2017

    There are some diet sites here I think. And you should do some research on it. Knowledge is power

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited September 2017

    jojo - I obviously have no idea, but have you had your gall bladder checked? An incidental finding of a large gall stone when I was first dx with BC led me to have mine removed before it caused trouble.

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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    When my sister had high ALP the doctor thought it was her gallblader, so I was just going to say maybe that should be checked with a US. It could be both things. Green tea is great for moving the bile. But not gree tea extract! It's toxic. Lemon juice (real) in warm water too

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    thank you ladies. i hope so! I called my primary to see if it may be the cymbalta. It seems it may be a side effect. Also, this is the first bloodworm since being on arimidex. Anything but the dreaded M word.

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    Steve-that you for your response. I only had a large coffee with milk right before. 😫. Your chipotle was right before

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  • KBeee
    KBeee Member Posts: 5,109
    edited September 2017

    Lever enzymes rise for a lot of reasons. Any Med processed through liver can cause a rise. Tylenol can cause them to rise you. Docs usually do not get too worked until they get to 2-3 times the normal level, though any sudden rise should be repeated in a month or so to see if it is still jigh

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    thank you kbee. The tests were 18 months apart so I am not sure if it is sudden. The only difference in the two tests is that the first was March 2016 (ASP- 89) I was 1.5 months since oophorectomy and on Tamox. weight 180 lbs. I was switched to Arimidex and cymbalta end of March 2016. September 2017 was 1.5 years on arimidex and cymbalta and weight 200lbs (ASP 139) -gain of 20lbs).

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  • KSteve
    KSteve Member Posts: 486
    edited September 2017

    jojo - I highly suggest you request that your blood work be done again. That would be a quick way to see if it's even an issue or if it resolved itself. From what I understand, ALP is one of those that can be affected by lots of things and can resolve itself. It could save you a lot of sleepless nights. Just a suggestion.

    Kathy

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    Thank you Kathy. I guess my fear is that 130+ may be my new normal. Right now I am on a weight loss plan and deciding if I should get a new one now or lose a few pounds first.

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  • marijen
    marijen Member Posts: 3,731
    edited October 2017

    Jojo better late than never? I just remembered I had this link for ALP

    Blood alkaline phosphatase increased has been reported by people with high blood pressure, rheumatoid arthritis, osteoporosis, depression, hiv infection (latest reports from 22,984 Blood alkaline phosphatase increased patients).

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    thank you marijen. I have heard that bone turnover happens on ai's.

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  • marijen
    marijen Member Posts: 3,731
    edited September 2017

    Yes bone loss is one of the major side effects. Take your calcium, K2, magnesium, and Vit D3. There's a K2 topic here.

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  • Kiks1
    Kiks1 Member Posts: 254
    edited September 2017

    Jojo, I just dealt with this for the last 2 weeks. My ALP levels were in the 80s to the 90s range after chemo last year. I started on Aromasin right after and had an Oophorectomy . My blood test earlier this year registered an ALP level of 131. My MO never brought it up and I actually never noticed. However, after my last blood test 3 weeks ago, for some reason, the ALP level caught my attention. It did go down to 129, but still elevated. I asked my MO who was not too worried. Her reason was that the calcium levels and the other liver tests were well in the normal range. Of course by then I was panicking and it does not help that aromasin has caused some bone pain. Then, my right leg, hip and sciatic nerve started to act up. I finally called my MO and insisted on more tests. She agreed to order a bone scan. I got the all clear just yesterday. It was a nerve wrecking experience to say the least. I did, also, read that als can cause ALP levels to increase because of bone loss. My Mo was willing to order more tests if that would give me peace of mind. Perhaps, reach out to your MO and ask for their opinion.

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  • Sara536
    Sara536 Member Posts: 7,032
    edited September 2017

    Hi, Did you start taking Arimidex and Cymbalta at same time? They both have some pretty serious side effects. I would think it would be difficult to know which one is causing what, but I would suspect the drugs before I would suspect metastasis. (I am not a medical professional but I have been prescribed Cymbalta.) I took one capsule and that was enough to convince me that nothing mother nature nor the surgeon nor cancer could throw my way could possibly justify the side effects. It is prescribed for both pain and anxiety/depression. If yours was prescribed for anxiety, (mine was for pre-surgery anxiety) I would recommend looking instead for a "talk" therapist who doesn't own a prescription pad. I've done that when I needed. Many cancer centers and hospitals have free or low cost 1-on-1 therapists or groups. ---Drugs.com is a good place to look up the side effects of any drug. They have a great app. I read that it is difficult to quit Cymbalta and people need some supervision to help with withdrawal if they decide to quit.



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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    Hi Sara -I started both at exactly the same time. I stopped/ weaned off if cybalta and my stomach is already starting to feel better, it normally felt like a drank a bottle of hot sauce. Irritated and sore. I thought it was the arimidex. Now I think it was the cymbalta.

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    like that is the best post ever! You brought my off the ledge. Still anxious but less obsessed. I was also in the 80's then bam 139!. I thought for sure mets. After all of the great information for you sisters I'm thinking maybe I have some bone turnover from the ooph and arimidex.

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  • Jojo0529
    Jojo0529 Member Posts: 193
    edited September 2017

    did you have a bone scan before chemo

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