Liver Enzyme High

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Jenkins00
Jenkins00 Member Posts: 144
edited August 2020 in Chemotherapy - Before, During, and After

Hello - I was diagnosed in August 2018, double masectomy and completed 4 rounds of TC in March 2019. No radiation. October 2019 my alkaline phosphatase slowly started to rise and now its up to 146. Oncologist and PCP have checked my Vitamin D, GGT and parathyroid hormone all normal. Now, I need an ultrasound on my liver. All my doctors are telling me to not be concerned, but how can I not? All of this is mind boggling as before, during and after chemo all blood work was normal.

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  • BevJen
    BevJen Member Posts: 2,523
    edited March 2020

    ALP numbers can bounce around some. Having said that, my internist told me recently that that can be an indication of bone mets. I would check it out more thoroughly and insist on either retesting your blood in a few weeks, or other testing.

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  • Jenkins00
    Jenkins00 Member Posts: 144
    edited March 2020

    I have the Ultrasound next week and will see what the plan is after that. I hope its not bone mets. I am trying to not go there.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2020

    jenkins - have you had any invasive dental work done lately - like in the last six months? I had an extraction/bone graft/implant done over the course of a year (slowly with time for healing between each phase due to letrozole and Prolia use prior) and within the same year my ALP rose to greater than 170. Several months later dropped 20 points, but was still above the high end of the range. My MO suggested a nuclear bone scan, but I declined because I am often an outlier and I wanted to allow some time to see if the ALP number would continue to decline. Just had a CMP done about two weeks ago and my number is now back in the normal range. My maxillofacial surgeon had said my ALP should not be elevated that far from the work done, but it was. Also, did you have a baseline DEXA scan done before starting anti-hormonal therapy? These drugs can cause bone deterioration and might drive your ALP up also if this is happening. The baseline DEXA, with a follow up one now, might show an issue. My bone density worsened significantly after chemo and six months of letrozole. Wishing the best for you, I know this is scary, but hope my anecdotal story offers a little reassurance that this increase might be explained by something other than mets

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  • Jenkins00
    Jenkins00 Member Posts: 144
    edited March 2020

    SpecialK - No dental work done, just the normal cleaning. I did have a baseline DEXA scan done a little over a year ago. Started Letrozole last July and I do get very stiff now and my feet get pretty sore if I am on them to long. Takes a minute to get going. I did have an Ultrasound on my liver yesterday. Waiting on the results. Thank you for responding. I do appreciate it.

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  • RMC19
    RMC19 Member Posts: 27
    edited August 2020

    I'm going through this. How are you doing? My MO is always saying "wait and see" but my mind goes all over the place. :) It did start going up right after radiation (and I started the AI right after that). Dunno if related :)

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  • KMom57
    KMom57 Member Posts: 252
    edited August 2020

    I’m also going through this. Mine was consistently in the 60s until my diagnosis in oct when it was 81. In feb, still 81. In June and July, up above the range around 114 I think. High anyway. And high for me. I had a clear bone scan and a clear CT, the same day as the first elevated lab, but I always worry imaging is missing something since it missed my lobular BC for years. MO says we will follow it, but thatALP is non specific, and inflammation, surgeries etc can cause it to rise. But I’m still scared.

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  • KMom57
    KMom57 Member Posts: 252
    edited August 2020

    Jenkins00 did you hace resolution of this? My ALP rose again on my last labs, and MO wants PET. I’m scared.

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  • Jenkins00
    Jenkins00 Member Posts: 144
    edited August 2020

    Hello! I had a bone scan, ultrasound and a Fibroscan done and the diagnosis is fatty liver. I hate that word fatty. My number did go down from 140 to 130 in May. I have been doing intermittent fasting 16:8 and lost 12 lbs so far. I also have been referred to the weight loss clinic at UTSW. I went through the same emotions which to me is normal considering what we have gone through. I also think going through chemo and surgeries our liver takes a beating. Good luck and take care.

    Audra

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  • KMom57
    KMom57 Member Posts: 252
    edited August 2020

    Audra so glad for you! Must be a weight off your mind. Thanks for coming back and updating. I’m so worried I can’t think of anything else. It helps to hear a positive resolution.

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  • KMom57
    KMom57 Member Posts: 252
    edited August 2020

    For the benefit of future people searching this topic, my PET was clear. No answer yet on why the ALP has risen, but MO says sometimes inflammation and chemo can raise it. I’ll check back in as we track it.

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