Hi doctor, My symptoms include a chest cold for approximately one month, 12 pound weight loss, nausea, dry heaves. Excessive bowel movements. Shortness of breath. Muscle aches. Left side rib pain. Fatigue. I had normal labs except mildly elevated alkaline phosphate. My doctor is now running a ALP isoenzyme test. Do I have multiple myeloma? Am I too young? What are my chances? What else besides my liver could make that test elevated?
Hi. After reviewing your complaints and your blood investigation (attachment removed to protect patient identity), I can draw the following conclusions: 1. It is highly unlikely that you have multiple myeloma, as your globulins (in blood report) are normal. Though it is a rare scenario before 40 years, it can happen to people. Your case seems something else. 2. There is however abnormally low carbon dioxide level in your report. This occurs because of hyperventilation, anxiety, some lung pathology. 3 . More importantly your medication are the most likely reason for your anxiety. Sometimes these can cause diarrhea as well. 4. Raised ALP can be from many causes. Liver (uncommon if you do not have jaundice), bone, intestine and placenta being most common. Isoenzyme assay that your doctor is doing will help isolate the source to some extent. 5. Given your age and your month old respiratory problem I would suspect a lung infection including Tuberculosis (TB). TB can also cause the left sided chest, fatigue and weight loss. Pain itself can lead to hyperventilation. 6. Moreover your your ALP is only mildly raised which is against the diagnosis of multiple myeloma (where it can be in thousands). Mildly raised ALP can be due to vitamin D deficiency as well, given you live in Montana (low sunlight). Please discuss with your doctor regarding need for a chest X-ray and possibility of TB and Vitamin D supplementation. Do not worry. The reason you might feel anxious is most probably your medications. Take a healthy balanced diet. Try some meditation as well.