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What Causes Elevated ALT And Alkaline Phosphate Levels?

Posted on Mon, 31 Aug 2015

Question: Hello I have a question concerning elevated ALT (41) and elevated Alkaline Phosphate (216)

Answered by Dr. Shailja Puri (43 minutes later)

Brief Answer:
ALT is normal ,ALP elevated due to obstruction of extrenal biliary tract

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Alanine aminotransferase ALT and alkaline phosphatase are both liver enzymes.
ALT and Alkaline phosphatase are raised in different diseases affecting liver.
The normal level of ALT may vary in different populations and different laboratories, however, a level below 40 IU/L is considered normal.
Thus, a level of 41 IU/L is within normal biological interval.
ALT level is always interpreted along with aspartate aminotransferase (AST).
Thus, you may post the level of AST also.
The normal biological interval for alkaline phosphatase is between 45 to 145 IU/L.
Thus, alevel of 216 IU/L is elevated.
Alkaline phosphatase is raised in variety of disorders of extra-hepatic biliary tract.
Extra-hepatic biliary tract is comprised by hepatic duct and common bile duct.
Obstruction of extra-hepatic biliary tract leads to elevated alkaline phosphatase.
Obstruction can be due to stones, growth, compression, cirrhosis etc.
Alcoholism can also lead to elevated alkaline phosphatase.

Thus, I suggest you to consult a gastroenterologist with the reports.
Other liver function tests may also be posted for interpretation.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Shailja Puri (5 hours later)

would you suspect hepatitis with these findings? Also her MCV was 78 MCH 24.4
RDW 18.6 AST 31 TIBC 470 UIBC 442 Iron Serum 28 Iron Saturation 6

Thank you for your help

Also is ALT 216 considered considerably high. We are very worried.
Thank You.

Answered by Dr. Shailja Puri (9 hours later)

Brief Answer:
Report suggestive of iron deficiency anemia; AST normal.

Detailed Answer:
Hello and welcome again,

The iron profile shows a low serum iron, high TIBC & UIBC and low iron saturation.
These findings suggest an iron deficiency state.
Iron deficiency causes iron deficiency anemia and affects red blood cells (RBCs).
RBCs become smaller in size and have low hemoglobin content.
A low MCV and low MCH are characteristic of iron deficiency anemia.
An elevated RDW suggests a variation in sizes of RBCs which is expected in iron deficiency anemia.
Thus, there is iron deficiency which needs to be corrected with iron supplements.
An AST level of 31 is within normal range.
ALT level of 41 IU/Land AST level of 31 IU/L are within normal range.
Normal ALT and AST rule out hepatitis.
Alkaline phosphatase level of 216 IU/L is above normal range and needs to be investigated.
You may consult your physician or a gastroenterologist for further work up.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shailja Puri (3 hours later)

The lab result sheet we have says the top end of ALT is 33. My wife was 41 but you are saying 41 is normal? Can you explain.

Answered by Dr. Shailja Puri (33 minutes later)

Brief Answer:
ALT levels upto 40 IU/L is acceptable as per international standards

Detailed Answer:
Hello and welcome again,
Different labs follow different cut off ranges depending on the kits used.
The level upto 40 IU/L is acceptable.
Your level is 41 which does not suggest any disease at this point of time.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shailja Puri (1 hour later)

Hello again. My wife is also being treated for bulging disc's in her neck. She has been having injections in her neck for this. 1 round 3 months ago and the latest one was a month ago. We have read on some forumns that these injections could cause liver enzymes to rise. Could this be the reason for the increase level of Alkaline Phosphatase?

Answered by Dr. Shailja Puri (3 hours later)

Brief Answer:
The drug details are required to know if it is the cause of elevated ALP

Detailed Answer:
Hello and welcome again,
Please mention the name of drug being injected for the neck problem.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (8 minutes later)

Not sure. Whatever they use for the epidural method. Is it cordizone?

It is a corticosteroid epidural injection.

Answered by Dr. Shailja Puri (13 minutes later)

Brief Answer:
Corticosteroids unlikely to raise level of alkaline phosphatase

Detailed Answer:
Hello and welcome again,

Corticosteroids can cause a variety of side effects, however, it is not known to raise level of alkaline phosphatase.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (31 minutes later)

So it sounds like your sticking to a bile obstruction. She presents with no pain or jaundice, weight loss, loss of appetite. Just tired often. Would you think any liver disease exists per her labs

Answered by Dr. Shailja Puri (10 minutes later)

Brief Answer:
Lab reports do not suggest primary liver disease

Detailed Answer:
Hello and welcome again,
The test results do not suggest any primary liver disease.
Besides bile tract obstruction alcoholism is also a cause of elevated alkaline phosphatase level.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (5 minutes later)

She didn't drink

Answered by Dr. Shailja Puri (19 minutes later)

Brief Answer:
If no risk factor exists, get ALP level repeated after a month

Detailed Answer:
Hello and welcome again,
If no abnormality is detected in the external biliary tract and there is no history of alcohol intake, the get the level of alkaline phosphatase repeated after a month or so.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Shailja Puri (3 hours later)

One thing I forgot to mention is her B-12 was 960. How does that figure in.

Answered by Dr. Shailja Puri (4 hours later)

Brief Answer:
Please mention the units and biological interval for vitamin B 12

Detailed Answer:
Hello and welcome again,

Please mention the units and the biological reference interval used by your laboratory.

Thanks
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shailja Puri (20 hours later)

Thank you for taking follow up. The B-12 showed 960 on the blood test. The normal range according to the lab is 200-946. She did take a B Complex supplement for a week up to a few days before the blood test. Could this have cause the elevated B-12 and is this related to the elevated ALP.
Again, Thank You.

Answered by Dr. Shailja Puri (11 hours later)

Brief Answer:
Vitamin B 12 intake is the probable cause for high B 12 levels

Detailed Answer:
Hello and welcome again,

The vitamin B 12 level is high but intake on vitamin B 12 in recent past is the probable cause for it.

Thanks and take care
Dr Shailja Puri

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj