Elevated ALP levels

[Jenn D]

My 12 year old son was diagnosed with Celiac o 4/20/23. At the time his bloodwork was done, his ALP ( which is a liver enzyme) was 489...( Normal level rangers from 150-409). the dr said it could be low vitamin D. His bloodwork was tested again 6 months later and his celiac numbers went down and his ALP went down to 467 and his Vitamin D levels were normal.  I expressed my concern to his Dr. but she wasn't concerned at all. Now he had his recent 6 month bloodwork done and his ALP is 441. It is still elevated but has been going down. Again she said she wasn't concerned, but is sending my son for further testing. I am beyond freaking out. Has anyone had these issues with themselves or their child? Should I be concerned? Thank you so much for all your help😊

[plumbago]

Hello,

My [insert cuss word here] diagnostic reference book does not mention celiac disease as a potential cause of elevated ALP! Grrr.... I am reading that, as you note, levels are higher for children than adults. Other pieces of information:

• "recent ingestion of a meal can increase levels;"
• certain drugs may increase levels - and it lists a bunch, mainly (but not all) antibiotics.

I wish I could be more help, but it's very smart of you to put it out there. Keep going, and good luck. Final question, though: are you sure your child is eating gluten free all the time?

[trents]

Welcome to the forum, @Jenn D!

Elevated liver enzymes was the driver that led to my celiac diagnosis over 20 years ago. In my case, the liver enzymes returned to normal levels within a few months after going gluten free. Now to be fair, it wasn't my alk phos that was high like in your son's case but both the ALT and AST were mildly elevated for about seven years before diagnosis. So, I'm not sure what difference that makes in comparing the two cases.

You say your son's celiac numbers "are down". Do you mean they are down into normal range or just lower than at diagnosis?

[Jenn D]

1 hour ago, plumbago said:

Hello,

My [insert cuss word here] diagnostic reference book does not mention celiac disease as a potential cause of elevated ALP! Grrr.... I am reading that, as you note, levels are higher for children than adults. Other pieces of information:

• "recent ingestion of a meal can increase levels;"
• certain drugs may increase levels - and it lists a bunch, mainly (but not all) antibiotics.

I wish I could be more help, but it's very smart of you to put it out there. Keep going, and good luck. Final question, though: are you sure your child is eating gluten free all the time?

He has been glutened once. His celiac level tested at a 6, which is a weak positive. So she feels him being glutened could've skewed the numbers or it just takes time. He is pretty good and eating clean so i dont feel he is ingesting any gluten.I did read that children do have elevated ALP due to puberty, but the dr never thought that as a reason. Although my son has grown almost 4 inches and gained 17 pounds since his diagnosis in 4/23. I'm praying that is the reason for his elevated ALP. Thank you so much for answering.  it helps not feeling so alone with this.

[Jenn D]

1 hour ago, trents said:

Welcome to the forum, @Jenn D!

Elevated liver enzymes was the driver that led to my celiac diagnosis over 20 years ago. In my case, the liver enzymes returned to normal levels within a few months after going gluten free. Now to be fair, it wasn't my alk phos that was high like in your son's case but both the ALT and AST were mildly elevated for about seven years before diagnosis. So, I'm not sure what difference that makes in comparing the two cases.

You say your son's celiac numbers "are down". Do you mean they are down into normal range or just lower than at diagnosis?

His numbers started off at +100 at first diagnosis. 

After 6 months down to 9.

And now down to 6.

0-3 would be considered normal. He is at a weak positive niw. His ALP is slowly coming down as well, but still not in normal range.

[trents]

Are his other liver enzymes such as ALT and AST within normal range? Bilirubin?

[knitty kitty]

@Jenn D,

I wouldn't worry about it because his numbers are coming down.  

Liver function changes following the introduction of a gluten-free diet in patients with celiac disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977883/

Supplementing with vitamins and minerals to ensure sufficient nutrients can help.

The Effect of a High-Dose Vitamin B Multivitamin Supplement on the Relationship between Brain Metabolism and Blood Biomarkers of Oxidative Stress: A Randomized Control Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316433/

And...

Thiamine and benfotiamine: Focus on their therapeutic potential

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682628/

[Jenn D]

On 3/1/2024 at 6:37 PM, trents said:

Are his other liver enzymes such as ALT and AST within normal range? Bilirubin?

yes they are.

[Jenn D]

15 hours ago, knitty kitty said:

@Jenn D,

I wouldn't worry about it because his numbers are coming down.  

Liver function changes following the introduction of a gluten-free diet in patients with celiac disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977883/

Supplementing with vitamins and minerals to ensure sufficient nutrients can help.

The Effect of a High-Dose Vitamin B Multivitamin Supplement on the Relationship between Brain Metabolism and Blood Biomarkers of Oxidative Stress: A Randomized Control Trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316433/

And...

Thiamine and benfotiamine: Focus on their therapeutic potential

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682628/

thank you for all the info😊