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Dr. Sohaib
Dr. Sohaib, Doctor
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I have raised alp and plasma viscosity and tested negative

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I have raised alp and plasma viscosity and tested negative for rheumatoid factor. My GP is now sending me for LFT, Bone Profile, U & E and CRP but in 6 weeks time to see if the alp and pv are still elevated. I originally went about my painful neck and which x-ray showed a narrowing between bones. I also get pain down from my neck to my shoulder and also in my ribs. I am impatient and don't want to wait that long to get an idea of what the cause could be. Can you help??
Thanks.
Sharon

Hello and thank you for the question.
Answers given are for informational purposes only and are not meant to replace an exam by an in-person.

I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.


ALP is an enzyme that comes from bone as well as the liver.

Any pathology affecting these areas can give you a high ALP reading.

Plasma viscosity is a non-specific test, which can be raised in any kind of inflammation in the body (similarly ESR/CRP can also be raised in any king of ongoing inflammation in the body irrespective of the site).

These acute phase reactants (ESR/CRP/PV) are only an indicator of active inflammation but they do not give a hint regarding the site of inflammation as well as the underlying cause).

As far a ALP is concerned, one has to ascertain whether this is coming from liver or bone.

For that complete LFT's have to be done, and if other liver enzymes are normal (include ALT/AST/GGT) and obstruction to the bile has been ruled out (by means of an ultrasound of liver) then nothing is wrong with your liver, which means the source of ALP is from the bones.

There are many bony pathologies which can give rise to high ALP, but the commonest one include vitamin D deficiency. Bony infections, Pagets disease and certain other hormonal disorders can also give rise to high ALP.

Many a times there are subclinical inflammations going on in the body which can give you high PV, but this settles down when you repeat the test after few weeks (and this is the usual way to monitor these tests if there are no specific symptoms pointing out towards a serious disorder as in your case).

Pain at multiple sites of the body is suggestive of Vitamin D deficiency or any related disorder, which need further investigations.

You can simply wait for the tests to be repeated, and meanwhile there is no harm in getting vitamin D levels checked which will further clarify the situation.

Can use Motrin or Aleve (anti-inflammatory as well as pain killer).

Maintain adequate hydration.

And discuss all the details i have mentioned with your doctor to get a management plan chalked out that suits best to your needs.

I would have been worried too if I were at your place, but let me reassure you that this does not sound serious at all. It is a treatable condition and carries a good prognosis with appropriate management.

It was a pleasure assisting you and thank you very much for visiting us.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Dr. Sohaib and 3 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

Hi - I forgot to mention that I have a vitamin D deficiency also.

Thank you Sharon for follow up.

This fairly explains the rise in ALP you have.

Appropriate replacement by vitamin D should solve the issue.

If you did not recently have vitamin d levels done, get these repeated (but after 3 months of vitamin D replacement therapy).

Goodluck.

It was a pleasure assisting you and thank you very much for visiting us.

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service.

If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

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