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Bloodwork Question

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Hi Friends:

So I got recent blood work results back. And some of my numbers are higher than normal.

My Alk Phos numbers seem to keep going up. Starting in 2017 at my cancer dx timeframe my number was 70 then May of 2020 78 then sept 2020 jumped to 92 then Jan 2021 102. Feb 2021 114 and April 2021 110. It’s gone up quite a bit

I had my alk phos isoenzymes tested too. That test is supposed to show where the elevated alk phos is coming from. It showed it's coming from my bones not from liver. Liver alk phos is normal

So I'm a little concerned. I've been having joint/bone pain for awhile now. I think my MO thought this could just be menopausal pain. I chat with my MO this next month.

I am not on a AI inhibitor, haven’t had rads or chemo and no tamoxifen so I know the pain isn’t from meds or anything like that

Also my calcium has jumped from the 9s to now 10.2. So I don't know if that's concerning.

It's interesting that I have osteopenia and my calcium blood level is high. Strange.

Just sharing because I’m concerned. Maybe this is nothing to be concerned about. I’ve never had my bones checked other than a dexascan.

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  • moderators
    moderators Posts: 7,918
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    Bumping for Jons_girl -- can anyone weigh in?

  • jons_girl
    jons_girl Member Posts: 444
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    thank you moderators! I am hoping someone can give me some guidance on this. My alk phos keeps rising. I’ve read what some other posts have said and it doesn’t appear to be a good trend.

  • kathabus
    kathabus Member Posts: 45
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    Hi—I hope someone comes along soon that has personal experience. I wanted to tell you that rising alk phos and calcium could be related to hyper parathyroidism. I wanted to share that to let you know it could be something not related to the breast cancer.

    Obviously we can’t ignore that we have had breast cancer...but I would try not to jump to that just yet. Menopause and changing hormones can cause changing levels. I’m sorry you’re going through this Hang in there!

  • jons_girl
    jons_girl Member Posts: 444
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    Hi Kathabus:

    Thank you for responding to my post. I did have myna parathyroid tested. I was 22 well within normal. The parathyroid calcium number was 10. So that was a little high but not super high? So I’m unsure if I should be concerned about that or not. I didn’t know rising alk pho’s can be related to parathyroid issues.

    Thank you for posting. Yeah I’m trying not to assume it’s cancer. Maybe it’s something else.

  • jons_girl
    jons_girl Member Posts: 444
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    anyone else with thoughts on this

  • wallycat
    wallycat Member Posts: 1,249
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    I hope you can figure out what the cause is. Two examples, but both are in men. My DH has metastatic prostate cancer spread to bone and his Alk Phos was in the 1000s prior to treatments.

    A friend of mine's husband has had high Alk Phos for the last 5 years or so. They've done every urine test, scan, and lab imaginable and they have zero clue. His scans are clear, labs, except for that one, normal...5 years and they still don't know.

  • jons_girl
    jons_girl Member Posts: 444
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    Wallycat: thank you for posting! Thank you! My Alk Phos isn't in the 1000's, but between 100-200. So it is higher than it should be. And I found out that the isoenzymes are bone. So I am just a bit worried. But hope to talk with my oncologist soon. Thank you for sharing your examples of people you know that have had high alk phos. I am hoping this is nothing.

  • jons_girl
    jons_girl Member Posts: 444
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    thought I'd post a update. Maybe others will respond that have had elevated alkaline phosphate levels.

    I'm having a dexa scan today to see if my bones are getting worse (have had osteopenia in the past). Checking this to see if rising alk Phos level is just osteoporosis related. If not then asking for referral to parathyroid center here.

    I had the alk Phos isoenzyme test and my higher numbers are definitely coming from my bones not my liver. So if the dexa scan doesn't show a lot of change I will prob have a nuclear study done.

    I'm also having my vit d checked today (calcium level jumped higher) to see if that's what's causing calcium to go up.

    A little concerned but waiting for today's results.

    I've been having joint/bone pain that hasn't really gone away.

    Anyone with similar experience can you please post??

    Thanks! Tami


  • jons_girl
    jons_girl Member Posts: 444
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    update from yesterday:

    My vit d test results are good. And dexascan results show some significant change in my lumbar but nothing much other than that I don't think from what I read. So I don't think my pain is from either of those.

    I will be asking for parathyroid eval and bone scan if she thinks we need to do that.

  • LivinLife
    LivinLife Member Posts: 301
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    Just wondering if you've reached any other conclusions about your elevated alk phos? Mine have been rising too and now at 123 - so just a little over. I also have hyperlipidemia - the nurse who called about BOTH of these says things are mild and the doc will talk to me next week at my appointment. I have autoimmune issues so wondering about PBC (primary biliary cho.....) where bile ducts get plugged, etc. they believe PBC is autoimmune related and it would relate to 2 of my other autoimmune issues. Sounds like yours may be more related to bone though? It's possible mine will be too - or fall back in the normal range next time I have blood work done?

  • jons_girl
    jons_girl Member Posts: 444
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    livinlife: sorry for my late response. I’m having more bloodwork done next wk. so far no real answers. Dr wasn’t worried. Will see if all is ok next wk.

  • wallycat
    wallycat Member Posts: 1,249
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    My friend's husband, who had all those tests, scans, etc. over 5 years...this year, his labs were all perfect. They have zero idea what caused his alk phos to elevate for years and then suddenly be in the normal range.

    Best to you ladies and hopeful it is just a lab issue not a body issue.

  • KBeee
    KBeee Member Posts: 695
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    My friend (who's had a liver transplant and also happens to be a doctors and talk to me a lot about medical stuff) has always said that doctors don't worry too much about liver numbers unless they're about double to triple normal. They'll watch the trends, but elevations which are alarming to us, may not be to them.

  • jons_girl
    jons_girl Member Posts: 444
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    thank you wallycat. It doesn't seem to bother my doctor.

    Karen that's good info to know. Thanks for sharing that info

    My alk Phos was in 100 range and now in 80s most recent blood work. So will see what it is in 3 mo. But ok so far I think.

  • littlebee72
    littlebee72 Member Posts: 19
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    Hi everyone. I just started researching this as my alkaline phosphatase has steadily been going up (76, 84, 96, 107, 113) This past round of bloodwork it was 113. My onc is scheduling me for a bone scan, and I am terrified that this is bone mets. I started doing a little research online and I have been seeing where AIs can increase your alk. phos. levels, especially exemestane, which I had been switched to or over a year ago....coincidentally when my numbers started going up.

    Any other thoughts on this?

  • jons_girl
    jons_girl Member Posts: 444
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    littlebee: hopefully someone else will comment on this. I haven't been on any post surgery hormone blockers

    Keep us posted on how your testing goes. Sending a hug your way and we are here to chat with too.

  • seeq
    seeq Member Posts: 1,084
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    jons_girl - this is in regards to the osteopenia and high calcium, which I also had. The parathyroid gland controls blood calcium levels and, when not working right, rob calcium from your bones (eventually leading to osteopenia or osteoporosis).

    Check out the website parathyroid.com for lots of information about hyperparathyroidism, including inconclusive blood test results and negative sestamibi scans.

    I had the surgery at their location in Tampa - a 3 day trip for outpatient surgery on the middle day. My calcium levels are good now, and I'm hoping for improvement on my next dexa scan.

  • jons_girl
    jons_girl Member Posts: 444
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    seeq:

    I had parathyroid tests and it’s not my parathyroid that’s the issue. My calcium number came down on my last bloodwork I think. I’m getting new bloodwork drawn in a week or so. So will see what things look like in my bloodwork

    I’m glad all is going well for you tho in regards to your calcium number and parathyroid.

  • ctmbsikia
    ctmbsikia Member Posts: 752
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    HI Chiming in as another who has elevated alk phos readings. I don't think it's the AI since my level was over back when I was diagnosed. Had parathyroid hormone tested, normal. Vit D was low at diagnosis but has since been normal. Calcium has been OK as well. Isoenzymes has the bone over range (84) and liver is within range. Have worse dexa scores so MO has put in a claim for Prolia. I had one shot a couple years ago before my insurance decided I don't need it, and lab work around that time is the only within normal range of alk phos I've had. So, will see what happens.

  • littlebee72
    littlebee72 Member Posts: 19
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    I have a bone scan for February 11th.....apparently my onc feels I need this due to my increasing levels of Alk. phos. Fingers crossed that it comes back clear. I will keep you all posted!

  • jons_girl
    jons_girl Member Posts: 444
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    ctmbsitkia:Thanks for sharing that info. Mine has been similar too. Yet no explanation for raised alk phos. It’s coming from my bones too. I don’t understand that. And prefer not to take prolia or other stuff like that. But will see what my next blood tests say. I’m having a blood draw next wk

  • jons_girl
    jons_girl Member Posts: 444
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    littlebee: keep us updated on your bone scan results. Hopefully the alk phos levels going up is nothing to be concerned about. 💐I had that done pet scan/bonescan and mine was ok. What was your cancer grade? Don't think you had that listed in your signature line. We are here to chat with. Hoping all goes well on the 11th.

    My alk phosnumbers looking back were 70 in 2017(when I had cancer) 78 and 92 in 2020 and then in 2021 numbers were 102, 114,110, 106 then hopped down to 84. All above normal ranges. interestingly to me tho as I'm looking at this… I was in the menopausal stage around 2020 I think. And definitely past it in 2021. So I wonder if menopause has anything to do with alk phos numbers?

    I'm interested to see if my number has continued to go down at my next blood draw next wk.

  • littlebee72
    littlebee72 Member Posts: 19
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    Jons_girl,

    My cancer grade was 2. I am trying not to be overly worried as all my other numbers were normal, and I believe last year my alk. phos. spiked to 110. I did have a hysterectomy with bilateral salpingo oopherectomy at that time, so maybe that is the reason for the increase.

  • ctmbsikia
    ctmbsikia Member Posts: 752
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    The insurance I have this year approved Prolia. So if I remember next bloodwork I will come back and let you know if alk phos still elevated or normal sinc I'm scheduled for the shot next week.

  • jons_girl
    jons_girl Member Posts: 444
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    Littlebee keep us posted on how things go for you. If you don’t mind sharing.

    Ctm: ok keep us posted. That would be good info to know. If you don’t mind sharing.

  • vandercat
    vandercat Member Posts: 43
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    I am curious as to where you find normal ranges for all the results from this kind of blood test - do they provide one on the report? I was diagnosed with DCIS a month ago, and had a lumpectomy three days ago. In two days (Monday morning) I will get results of the path tests and recommendations for further actions.

    I'm a retired librarian and can't help gathering information. Information is power. I want to be the ringmaster of this circus, not just one of the clowns.

  • jons_girl
    jons_girl Member Posts: 444
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    yes there is a normal range listed on my blood work. So sorry to hear you’ve joined the cancer group. ❤️💐I hope your recovery goes well. We are here for support vandercat. Sending a virtual hug to you.

  • littlebee72
    littlebee72 Member Posts: 19
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    Hey guys.....had my bone scan on Friday and got the results the same day. No evidence of metastasis! I am so relieved, but frustrated that this has to be something we continually worry about. Not sure why my alk phosp. levels have been rising, and I am sure my oncologist will want to keep an eye on this marker, but for now I am going to consider this a win!

  • jons_girl
    jons_girl Member Posts: 444
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    that’s so good your bone scan went well! Thank you for updating us on your results. Hope all continues to go well for you let us know if you get answers about your alk phos bloodlevels

    I’m wondering about my alk phos and iron levels right now. My bones hurt. Joints mainly. Think something is off. But try not to worry!

  • mikamika
    mikamika Member Posts: 242
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    Hi,

    My NP once told me, that if am worried about ALP and bones, endocrinologist can order the bone turnover markers. My ALP went down a little bit, so I didn't do those tests.

    Did anyone get them done?