Labs came back...Low ALK PHOS again. WTF?

So I've posted and posted and posted and have been dealing a whole raft of weird symptoms over the last couple of years but I just had my complete fasting metabolic panel done and it came back with a low (29 U/L) Alkaline Phosphatase reading. I got this same flag the last time I went into the doctor to complain about these general symptoms, some of which match what I'm going through. Has anyone else dealt with this?

Apparently from what I've read it has to do with some sort of deficiency or inability to process protein right, but my doctor didn't even seem to notice last time this flag came up.

How is your B12? How is your copper? How is your zinc, if you've had that tested? Do you take birth control pills?

My Alkaline Phosphatase has been trending downward and, when I got my last labs and noticed, I did a lot of research. FOR ME, and please note that this is ONLY FOR ME, it's linked to birth control pills. I've learned that birth control pills cause my copper to increase and my zinc to decrease and my ALP to decrease. When I'm not taking BCP, all of these values stay within healthy/normal ranges again.

Well I can rule out birth control, on account of being a dude. Also they did not apparently test for copper or zinc or mag or B12 this time. However the last time my AlkPhos was low my B12 was high (I was supplementing) and my copper and zinc were within normal ranges.

Hm.

https://en.wikipedia.org/wiki/Alkaline_phosphatase#Lowered_l evels

While wiki is not a valid source, it can be a good start to FIND valid sources. How's your magnesium? Any iron anemia issues? I assume that you'd have other indications if you had leukemia.

I am not familiar with this but, I did find this info on the net. It may be helpful to you.

"The normal range of alkaline phosphatase in blood is 20 to 140U/L, although this can vary from lab to lab. Children and pregnant women can have significantly higher levels of the enzyme in their blood (R)"

Here is the link. https://selfhacked.com/blog/alkaline-phosphatase/#1_Starvati onand_Fasting

Hope it helps and good luck.

Huh this is an interesting find. I've actually seen the range from 30 or even 40 up so it seems like it's a bit subjective based on what medical authority decides what range is healthy. Even if 29 is within that definition of a normal range it definitely seems to be on the low side, and it was flagged as the only anomaly in my labs on Kaiser's website.

If it's trending lower, that's a sign of concern.

Low alk phos can be an indicator of poor nutrition, particularly zinc, but also other vitamins. Are you taking multivitamin, iron, b-12, and Calcium daily? This is what my surgical team recommends for life. I thought this article below was decent in illustrating the nutrition connection and food recommendations in order to raise the level.

https://www.livestrong.com/article/274487-what-foods-raise-alkaline-phosphatase-levels/

I would get a referral to a specialist if the reading continues to trend downward, or get a second opinion.

Mine was low even before WLS, and it was one of the first signs I had Celiac disease. Many things including hepatitis and other disorders can impact this severely.

I should definitely mention I haven't really been supplementing at all the last six months, and only sporadically since my surgery. But the last time my reading was low I think I was, indeed, supplementing with a multi and B12 complex and had the same symptoms.

The only thing I can think of for what might be behind this, which I know is not good, is that these symptoms started when I shifted from less protein to more carbs. Since I was still able to control my gain, I thought it meant things were okay, but one of the causes of low AP is apparently poor protein absorbtion through low stomach acidity, etc. This might be because I got in the foolish habit of drinking too soon after meals. I've tried to remedy this lately by waiting after meals once more and my reflux, at least, seems greatly reduced.

I am going to send an email to my PCP to first get his opinion on the matter, but if I don't hear back or he seems to think it's nothing I'm going to go ahead and email Bariatrics to ask for a followup.

This is so frustrating, but I have a feeling I've only got myself to thank for this mess.