Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Are Elevated GGT And Alkaline Phosphate Levels Due To Chemotherapy For Invasive Ductal Carcinoma Grade II?
Question: Hello Doc
My recent medical history is available in my dash board. I was diagnosed with Invasive Ductal Carcinoma Grade II (Breast Cancer) in end of Oct last year. Lumpectomy was performed in end of Nov last year followed by 8 cycles of chemotherapy - My 1st chemo was done on XXXXXXX 05th and last chemo (Taxol Dens) was done on April 20th, 2018 (15 days ago). During my entire chemo period my GGT and Alkaline Phosphate remained on a higher side (both around 250)
My Onco never advised me to get LIPID PROFILE done during chemo. I got it done with few other vitals yesterday and my reports are very disturbing. Let me write down the points (only the results that are disturbing) & questions for your review / analysis and answers:
Triglycerides: 569 VLDL: 114
Cholesterol: 219
HDL: 20
Uric Acid: 6.75
Questions:
I asked few questions to from an on-line ONCOLOGIST but unfortunately I did not get a satisfactory reply so I thought I should with a cardiologist
1. Are these values so bad due to chemo (4 x AC Dens + 4 x Taxol Dens with a gap of weeks each)? The oncologist said that they have nothing to do with Chemo which is a bit surprising because I was very fit before chemo and had no upset LIPIDs. Also on internet various studies show that LIPIDs go bad due to chemo specially in breast cancer patients
2. I ate a lot of outside food & home food etc during chemo to keep a good immunity. I gained almost 6 KGs during past 4 months? Is this the reason for my bad test results?
3. I followed a nutrients plan (I showed the plan to my oncologist here in Pakistan before starting it) alongside my treatment which includes various vitamins, healthy heart, liver protection supplements etc etc. Is it because of the nutrients that my results have gone bad
4. Do you suggest that I should start a medication for triglycerides and cholesterol immediately? Are these results going to affect my heart? I have been physically fit since past 25 years with loads of stressful exercise. I stopped excersize a day before my chemo and started the same again mid way of my chemo (after 5 cycles) and even nowadays I do 45 mins cardio plus stretching etc but so far no weights. I have already lost almost 2 KGs in 15 days after my last chemo. I don't feel anything wrong during exercise though I don't do the same amount of work out as I use to before chemo. Should I continue my exercise or give my body a break?
Please kindly answer all my questions one by one (if you can) as they help me a lot in understanding my situation. I am very worried specially due to triglycerides
My nutrients Doctor is saying that triglycerides (569) & VLDL (114) are dangerously high and he thinks that its not a side affect of chemo but due to me eating a lot of food during chemotherapy. He is saying that I should not have eaten outside food at all. He is saying that he gave me enough nutrients in a balance format to fight the side affects of chemo so I should not have eaten outside food such as pizzas & KFC at all?
On the other hand my Onco told me that it would be wise to eat as much food as possible during chemo to keep my immune system well and to avert the bad side affects of chemo such as weakness, fatigue, body aches, neuropathy etc. She told me that when I will shift to Taxol, I can start exercise as it would be comparatively easier compared to AC Dens. She was right because my body took Taxol very easily and since I had energy due to excess food intake during AC Dens time, I was able to start my exercise
My Onco kept telling me that LFTs usually go bad during chemo so I should not worry too much about them but she never advised LIPID to be done. Now that it has been performed after 15 days of my last (8th) cycle, the results are disturbing along with high uric acid and fasting sugar was also 114 (a bit high).
Please kindly answer to my 5 questions and sorry for providing you with so much detail but my intent is to help you understand my situation and recent history to give your answers / analysis
Thanks
Mrs IK
My recent medical history is available in my dash board. I was diagnosed with Invasive Ductal Carcinoma Grade II (Breast Cancer) in end of Oct last year. Lumpectomy was performed in end of Nov last year followed by 8 cycles of chemotherapy - My 1st chemo was done on XXXXXXX 05th and last chemo (Taxol Dens) was done on April 20th, 2018 (15 days ago). During my entire chemo period my GGT and Alkaline Phosphate remained on a higher side (both around 250)
My Onco never advised me to get LIPID PROFILE done during chemo. I got it done with few other vitals yesterday and my reports are very disturbing. Let me write down the points (only the results that are disturbing) & questions for your review / analysis and answers:
Triglycerides: 569 VLDL: 114
Cholesterol: 219
HDL: 20
Uric Acid: 6.75
Questions:
I asked few questions to from an on-line ONCOLOGIST but unfortunately I did not get a satisfactory reply so I thought I should with a cardiologist
1. Are these values so bad due to chemo (4 x AC Dens + 4 x Taxol Dens with a gap of weeks each)? The oncologist said that they have nothing to do with Chemo which is a bit surprising because I was very fit before chemo and had no upset LIPIDs. Also on internet various studies show that LIPIDs go bad due to chemo specially in breast cancer patients
2. I ate a lot of outside food & home food etc during chemo to keep a good immunity. I gained almost 6 KGs during past 4 months? Is this the reason for my bad test results?
3. I followed a nutrients plan (I showed the plan to my oncologist here in Pakistan before starting it) alongside my treatment which includes various vitamins, healthy heart, liver protection supplements etc etc. Is it because of the nutrients that my results have gone bad
4. Do you suggest that I should start a medication for triglycerides and cholesterol immediately? Are these results going to affect my heart? I have been physically fit since past 25 years with loads of stressful exercise. I stopped excersize a day before my chemo and started the same again mid way of my chemo (after 5 cycles) and even nowadays I do 45 mins cardio plus stretching etc but so far no weights. I have already lost almost 2 KGs in 15 days after my last chemo. I don't feel anything wrong during exercise though I don't do the same amount of work out as I use to before chemo. Should I continue my exercise or give my body a break?
Please kindly answer all my questions one by one (if you can) as they help me a lot in understanding my situation. I am very worried specially due to triglycerides
My nutrients Doctor is saying that triglycerides (569) & VLDL (114) are dangerously high and he thinks that its not a side affect of chemo but due to me eating a lot of food during chemotherapy. He is saying that I should not have eaten outside food at all. He is saying that he gave me enough nutrients in a balance format to fight the side affects of chemo so I should not have eaten outside food such as pizzas & KFC at all?
On the other hand my Onco told me that it would be wise to eat as much food as possible during chemo to keep my immune system well and to avert the bad side affects of chemo such as weakness, fatigue, body aches, neuropathy etc. She told me that when I will shift to Taxol, I can start exercise as it would be comparatively easier compared to AC Dens. She was right because my body took Taxol very easily and since I had energy due to excess food intake during AC Dens time, I was able to start my exercise
My Onco kept telling me that LFTs usually go bad during chemo so I should not worry too much about them but she never advised LIPID to be done. Now that it has been performed after 15 days of my last (8th) cycle, the results are disturbing along with high uric acid and fasting sugar was also 114 (a bit high).
Please kindly answer to my 5 questions and sorry for providing you with so much detail but my intent is to help you understand my situation and recent history to give your answers / analysis
Thanks
Mrs IK
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello,
I passed through your question carefully and would explain as follows:
1. There are many studies which show that chemotherapy can alter the lipid metabolism and thus increase VLDL, Triglycerides, and LDL. But there are not enough studies which support this adverse effect related to your specific therapy.
So, I would conclude that we can not exclude the chemotherapy possible implications on the high triglycerides levels.
2. The wrong diet (fast food, fatty, sugar) has a direct impact on high triglycerides. For this reason, I would recommend modifying your diet and try to eat more vegetables and fibers in your diet.
3. I don't think that these triglyceride levels are related to the supplements that you have taken.
4. The best therapy would be omega 3 supplements, which do not have adverse effects. I recommend taking them. Fibrates( fenofibrate, gemfibrozil) are another treatment option. But they may lead to adverse effects like fatigue, muscle cramps, high liver enzymes.
Anyway, high triglycerides levels can lead to serious medical conditions like acute pancreatitis.
So, if diet modifications coupled with omega 3 supplements do not lower triglyceride levels, fibrates should be taken into consideration despite their adverse effects.
Regarding high uric acid levels, they are directly related to chemotherapy. Treatment with allopurinol may be considered if these levels are persistently high.
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Iliri
I would recommend as follows:
Detailed Answer:
Hello,
I passed through your question carefully and would explain as follows:
1. There are many studies which show that chemotherapy can alter the lipid metabolism and thus increase VLDL, Triglycerides, and LDL. But there are not enough studies which support this adverse effect related to your specific therapy.
So, I would conclude that we can not exclude the chemotherapy possible implications on the high triglycerides levels.
2. The wrong diet (fast food, fatty, sugar) has a direct impact on high triglycerides. For this reason, I would recommend modifying your diet and try to eat more vegetables and fibers in your diet.
3. I don't think that these triglyceride levels are related to the supplements that you have taken.
4. The best therapy would be omega 3 supplements, which do not have adverse effects. I recommend taking them. Fibrates( fenofibrate, gemfibrozil) are another treatment option. But they may lead to adverse effects like fatigue, muscle cramps, high liver enzymes.
Anyway, high triglycerides levels can lead to serious medical conditions like acute pancreatitis.
So, if diet modifications coupled with omega 3 supplements do not lower triglyceride levels, fibrates should be taken into consideration despite their adverse effects.
Regarding high uric acid levels, they are directly related to chemotherapy. Treatment with allopurinol may be considered if these levels are persistently high.
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
