9 answers WOW really? Im new to all of this, and I've NEVER had a ALP over 100. However I think my situation is a lil different in the fact that I have fibrosis, and my biopsy showed cholestasis. I think my bile ducts have already been destroyed, so if I've ever had really high ALP I'm not aware of it, or never had blood work done to show it. The following is from PBCer's a group in USA. It was part of a Q & A section - the answers are by doctors specializing in PBC. Question Is it possible to be in stage 3 or 4 by the biopsy and have normal LFTs taking Actigall or URSO? Are the LFTs actual indicators of the disease progress? Answer I always tell the second year medical students that "liver enzymes are NOT liver function tests (LFTs)." The term "LFTs" is a terrible one and really should not be used. [Help me convince your doctors!] The values of the blood ALT, AST, alkaline phosphatase and gamma-glutamyltranspeptidase (GGT) activities do NOT tell you about the function of the liver. They also do not tell you about disease progression (i.e. the development of cirrhosis or deteriorating liver function). The so-called "LFTs" can be normal in individuals with end-stage liver disease. In contrast, they can be markedly elevated in individuals with liver disease but normally functioning liver. In PBC, ursodiol (Actigall or URSO) may lower the blood alkaline phosphatase activity in the setting of