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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16324
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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Having some pain in upperr ight breastbone mainly when

Customer Question

having some pain in upperr ight breastbone mainly when starting to eat a meal . did bloodwork and it's beautiful but for a very low ALP (it's around 30). Should I be concerned, ask doc to do any future tests, etc
47 year old female, never had kids, do not smoke, or drink. weight slightly below normal / normal
Submitted: 1 year ago.
Category: Health
Expert:  A. Schuyler, NP replied 1 year ago.

Hello,

The reference range for my lab for ALP is 44-147. It varies from lab to lab depending on what equipment they use. Typical reasons for low ALP are malnutrition or protein deficiency. More unusual causes are genetic hypophosphatemia (which would have shown up in previous tests over the years), Wilson's Disease (another genetic disorder that would have been apparent in previous testing). The usual protocol is to repeat the test in 4-6 weeks.

Please let me know if you need additional information.

Kind regards,

Schuyler

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Customer: replied 1 year ago.

WHAT tests would indicate this ? You're assuming I have testing of any kind done to flag these which I've not.I want specifically what tests can I have done to help determine if these diseases are perhaps present

Expert:  A. Schuyler, NP replied 1 year ago.

I'm not assuming anything.

If you had had any of the other disorders, you would have had symptoms from at least the time you were in your teens.

Wilson's Disease is a genetic disorder of copper metabolism that causes a buildup in the brain, liver and kidneys. It causes routine blood tests to be totally out of whack.

Hypophosphatemia can be caused by alcoholism, starvation, too little vitamin D, overactive parathyroid (which also causes high blood calcium), overuse of antacids, and some medications including acetazolamide, foscarnet, imatinib, pentamidine, and sorafenib. Fanconi syndrome is another possible cause. It's a kidney disease that will also cause normal blood work to be abnormal.

The only test that needs to be run in the short term is a repeat of the liver panel to see if ALP is still low.

Please let me know if you need additional information.

Best regards,

Schuyler

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Customer: replied 1 year ago.

and if still low in 4-6 weeks?

Expert:  A. Schuyler, NP replied 1 year ago.

If it's still low then checking protein levels, vitamin d levels would be the next step.

The most common causes are alcoholism, starvation, and protein deficiencies. So a person is advised to avoid all alcohol, and eat a healthy diet including protein. It is more common in vegetarians and vegans.

By the way the most common causes of upper right side discomfort are reflux and muculoskeletal pain (usually from an overextended muscle).

Kind regards,

Schuyler

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