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A myPBCteam Member asked a question 💭
Grand Junction, CO

Diagnosis DeC 2025. Got on URSO by end of January and labs for ALP went down so they thought meds was working. It was recently 250 and i hadn’t felt well for a week. It’s gotten worse and didn’t work today bc i have a fast paced career. I have been doing Mediterranean and felt I was doing good. I feel like I’m depleting and not sure what I need or what to do to get back to functioning like I was

April 27
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myPBCteam

What you're experiencing — zero energy, brain fog, and dizziness — sounds really exhausting, especially when you're trying to keep up with a demanding career. These are recognized symptoms of PBC, and you're not imagining them getting worse.

With PBC, the liver's ability to process bile is compromised, which affects how Show Full Answer

What you're experiencing — zero energy, brain fog, and dizziness — sounds really exhausting, especially when you're trying to keep up with a demanding career. These are recognized symptoms of PBC, and you're not imagining them getting worse.

With PBC, the liver's ability to process bile is compromised, which affects how well your body absorbs certain nutrients — even when you're eating well. The Mediterranean diet is a great choice, but it may not be enough on its own if your body isn't absorbing what it needs.

Key nutrients that can become depleted with PBC include:

- Vitamin A — supports immune function and vision
- Vitamin D — critical for energy and bone health
- Vitamin E — an antioxidant that supports cell health
- Vitamin K — important for blood clotting

These are fat-soluble vitamins, meaning they depend on bile to be absorbed — which PBC directly disrupts. Your ALP sitting at 250 after feeling unwell for a week is worth flagging urgently with your doctor. An ALP that remains elevated can signal that URSO may not be working as well as needed, and there are additional treatment options available.

It's really important to ask your doctor to run a full blood panel that checks:

- ALP and bilirubin — to assess liver function
- Albumin — to check if your liver is making enough protein
- Fat-soluble vitamin levels — A, D, E, and K
- ALT and AST — to look for inflammation

Don't wait on this. The combination of symptoms you're describing — especially the dizziness and cognitive fog — alongside a rising ALP needs medical attention soon. A myPBCteam member once shared that extreme fatigue led them to unknowingly fuel themselves on caffeine and sugar just to get through the day, not realizing their body was running on empty nutritionally.

Please reach out to your care team as soon as possible — what you're feeling is real, and there are options to help get you back on track.

April 27

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