My doctors have no clue. I take an old medication called primidone. It causes an elevated alkaline phosphatase. No one seems to know why. My primary and my neurologist have ignored it for years. An intern started asking questions. Nobody seems to know.
Does an elevated alkaline phosphotse caused by medication mean anything?
It depends on the medication.
As a rule, an isolated lab abnormality from a drug is probably not a concern so long as the level is not hugely out of whack, stable over time, and not associated with any other evidence of a problem.
This is an especially reasonable approach if the medication is being used (and is working as expected) for an otherwise untreatable problem.
But, primidone may be an exception. I say may. Why? Alkaline phosphatase elevation can be the only sign of occult bone trouble arising from a drug (such as primidone). As you may know, long term use of primidone and similar drugs can lead to what’s called osteomalacia and other disorders of bone metabolism. So, you might wish to double check that the elevation in alk phos is not associated with some smoldering bone disorder (i.e. so maybe see an endocrinologist interested in bone disorders or just ask the family doc to consider bone scan and/or bone density testing (with the latter pretty routine for many middle-aged and older women, anyway)).
(I think I’m supposed to say ‘this is not medical advice, nor should it be taken as such’. There, I said it!)
ETA: janeslogin, can you indicate that you’ve seen this post, please. You are not ‘contactable’, it seems.
Karl would testing to see what isozyme it is (bone, liver, or intestinal) be useful and a very simple to do in such a case? In peds we sometimes see dramatically elevated alk phos in isolation of other lab abnormalities, usually of mixed isozymes, which is an idiopathic benign condition almost always transient, of value to know about only to avoid embarking on a fruitless search for nonexistant pathology.
No idea if this applies to the op of course! But if it is not almost all bone isozyme then a significant bone metabolism cause is effectively crossed off the list.
Yes, that is a terrific approach.
In this case, if the elevated ALP wasn’t the bone isoenzyme, I agree, janeslogin could stop right there and just carry on as in the past (IMO)
The alkaline phosphatase has been slowly creeping up for about a decade. Like I said my primary and the neurologists paid no attention. Then this intern or whatever you call a NP in training got all excited about it. I will mention it when I see the doctors routinely again in April.