Q: I am a 50-year-old male. I went to get a routine physical at the doctor’s office and he ordered some blood tests. As a result I found out that my blood level of alkaline phosphatase is low. The normal range is 40 to 129 and mine is 37. Should I be concerned? Do I have a liver problem?
A: As part of the routine physical examination, blood tests are often ordered to cover 12 to 20 factors at the same time.
The results of most blood tests are interesting only when the numbers are increased, not decreased, from the normal range. There are a few exceptions to this rule. Tests of the thyroid gland function can indicate a problem if the results are either too high or too low. Abnormal amounts of either white or red blood cells may also be indicative of illness.
Remember the normal range is only a statistical value, meaning the average. About five percent of normal individuals may have results that vary as much as five percent above or below normal.
Alkaline phosphatase is an enzyme produced by either the liver or the bones. A rise in the level can show that there could be a problem in either of these places. In the liver, there could be a disease such as bile duct obstruction by gallstones. Problems with the bones might be a simple fracture or something more serious such as a tumour. Certain medications, particularly those prescribed for psychiatric conditions or epilepsy, may lead to increased alkaline phosphatase levels. Low levels are occasionally an indication of liver disease at a cellular level, such as cirrhosis or chronic hepatitis, but the reading would probably be much lower than 37 and I expect other blood tests would have shown abnormal results.
Are you a heavy drinker? If your doctor is concerned at all, he would have ordered more tests. The bottom line is don’t worry; I am sure you are fine.
Q: Is it true that you have to drink eight glasses of water a day to stay healthy? I find it difficult to do. I don’t much care for water.
A: This is one of those health myths. It is not true. You only need to drink about three-quarters to one litre of fluids a day to stay healthy because most of the body’s daily requirements are met by eating food that contains liquids. If you are not fond of plain water, weak tea or juice are just as good. Don’t forget that there is lot of sugar in juice, so don’t drink too much if you are overweight.
In hot weather or after vigorous exercise, your body may need more water, but you don’t have to worry about forcing yourself to drink more, because you will automatically feel thirsty and have no difficulty drinking the required amount.
Drinking lots of water does not flush more toxins out of the body. The kidneys do this automatically if they are healthy. In fact, excessive water drinking just makes the kidneys work harder and too much can dilute necessary natural chemicals in the blood such as sodium and chloride. This can cause light-headedness or mental confusion.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.