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Q. My partner has anxiety and his ALP and phosphate levels are raised. Please help.

Answered by
Dr. Pawar Satyajit Jalinder
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 24, 2021

Hi doctor,

My partner recently had a blood test that showed a high ALP (167) and raised phosphates (1.45) in his bone profile. All other levels in his kidneys and liver were fine, as well as his thyroid. He has another blood test, but we were wondering what could be causing the high levels? He has been dealing with anxiety (the reason he took these blood tests) and took a beta-blocker on and off for the past month. He is 27 years old, and his height is 5 feet 8 inches. He is not overweight (around 11.5 stone). Thanks.

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#

Hi,

Welcome to icliniq.com.

I have gone through your query and have looked at the reports you have provided (attachments removed to protect the patient's identity). The only abnormal report is a slightly high phosphate level - 1.45 mmol/L (0.81 mmol/L - 1.5 mmol/L) and alkaline phosphatase -167 IU/L (40 IU/L- 129 IU/L).

The levels are not that high to be of any concern yet. Phosphate is just high by 0.05 mmol/L. I would like to know if there is any history of taking vitamin D supplements or any laxatives regularly as they are known to increase phosphate by increasing phosphate absorption. Another possibility is due to laboratory error caused by a heparin mixed sample.

For alkaline phosphatase (ALP) - High levels can come from bone or liver. Is there any history of regular alcohol intake? As that can cause elevation of ALP. As his liver tests look fine, I would consider doing GGT (gamma-glutamyl transferase) test to see the cause of elevated ALP.

If there is no history of alcohol intake and GGT is also normal, ALP is coming from the bone. This shows there is some new bone formation going on. It is common with recent fractures, vitamin D deficiency, etc. If you can provide me with the above details, I would clarify your questions with certainty. If you have any other questions, you can always revert here.

Thank you.

Hi doctor,

Thanks for the reply.

He is a regular alcohol drinker (but mostly not to an excessive amount). He has not been taking any laxative or vitamin D supplements. I have attached another test he had. Is this what you are referring to?

#

Hi,

Welcome back to icliniq.com.

GGT (gamma-glutamyl transferase) - This is the test I was referring to. You have attached a serum iron study that looks fine (attachments removed to protect the patient's identity). If he is taking alcohol regularly, that could be the cause of elevated ALP. Confirmation would be done with GGT. If you have done any more tests, you can always attach them here to give a clue if we are missing something. Overall I would not give much importance to elevated phosphate (as it is elevated by only 0.05 mmol/L). I would say his ALP is related to drinking alcohol. As ALP is also not very much elevated, I would consider repeating tests after three months to see the levels. If they are still elevated, then further investigation may be needed. If you have any other questions, you can always revert here.

Thank you.


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