Anastrozole and high ALP and calcium on blood tests

Posted by sandyjr @sandyjr, Mar 27 8:57am

It seems that since starting anastrozole in May 2018 my bloodwork has indicated the alkaline phosphate ALP and calcium readings are higher than normal. I checked the information for anastrozole and found that this is one of the things that can happen while taking this drug. I understand that anything that goes through the liver can affect the liver enzymes. In addition, while checking this out, I found that anastrozole draws calcium from the bones and that could cause the elevated calcium reading. Neither the GP or oncologist seem to be concerned with this. Do others check your blood test reports and have you found elevations in the ALP and calcium levels…or increases in what is normal for you?

Liked by Dee, trixie1313

@sandyjr
An interesting question. Most oncologists also are hematologists, and therefore have a good grasp of what is important and what is not. They also are human and sometimes things slip through the cracks because of extremely busy schedules. My approach has been to take any blood test concerns to my PCP who explains practically everything which I've raised, and takes action when necessary.

For example, I had excellent bone density in 2017, started on anastrozole in 2018 and slowly my serum calcium rose (although well within what the lab regarded as normal). It was my PCP who suggested in 2019 that I take 500 mg of calcium citrate/day. (I take 250mg, twice a day.) Soon after the suggestion, another bone density test showed a slight degeneration in density, although still not in the osteopenia range. In 2020, I noticed that my calcium serum had come down to pre-chemo/anastrozole levels. Another bonus for me is that the added calcium helps with the muscle spasms from the chemo-induced peripheral neuropathy.

Mildly elevated serum calcium is not considered an issue, as such, however, I am of the opinion that those of us on AIs are at an age where this should be a discussion point with our doctors, and especially in light of our bone density tests.

ALP is part of a liver function panel, but elevated ALP (above the normal range) signals an issue with bones and/or the liver. If your ALP is above the normal range (the range used by your particular lab, as different labs use different ranges and measurements), then I would strongly encourage you to get the attention of your oncologist and PCP to provide a sufficient explanation, and whether any action is called for. (For example, my PCP once changed my statin which caused havoc on the liver function panel, and an immediate return to my old statin.)

You are doing the right thing to be self-advocating on such things. Go get 'em!

Liked by Dee, kathyomaha55

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I also had good bone density before I started on anastrozole. I believe all of them, since they are counter acting Estrogen, have a problem with weakening the bones. I was told Vit D3 oil (2000 units a day) was a good thing to take along with calcium. I switched at the 1 year mark to exemestane – from extreme hand pain. I'm doing much better (since Nov.) on the new drug. I'm not sure if they gave me an ALP test. I see my oncologist next week (my 2 year mark) and will ask her about it. I think I'm due for a new bone scan as well. Good luck! Do not be afraid to talk to your doctor about a different drug vs, anastrozole. I want to go the whole 5 yrs, so I wanted to switch vs. stop taking anything,

Liked by trixie1313

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@kathyomaha55

I also had good bone density before I started on anastrozole. I believe all of them, since they are counter acting Estrogen, have a problem with weakening the bones. I was told Vit D3 oil (2000 units a day) was a good thing to take along with calcium. I switched at the 1 year mark to exemestane – from extreme hand pain. I'm doing much better (since Nov.) on the new drug. I'm not sure if they gave me an ALP test. I see my oncologist next week (my 2 year mark) and will ask her about it. I think I'm due for a new bone scan as well. Good luck! Do not be afraid to talk to your doctor about a different drug vs, anastrozole. I want to go the whole 5 yrs, so I wanted to switch vs. stop taking anything,

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The ALP is part of the liver function tests. I get it done when I get my yearly physical. I noticed that it had increased when I started taking the anastrozole. I asked the oncologist and he was not concerned and doubted if the anastrozole had anything to do with the level. I have very little discomfort from the anastrozole…sometimes light pain in my wrists and occasionally a pain in one thumb. This is not enough reason for me to change drugs. My doctor always asks how I am doing with the effects and is happy that I have few problems. I just completed 2 years in April. I feel like I am finally feeling better mentally…the second occurrence put me right over the edge.

Liked by trixie1313

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I had a bone density test after all my treatment and found I have osteoporosis. I now take the Prolia shot every 6 months but still take Arimidex.

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