I started on Oral Vancomycin back in June. 250 mg 3X daily. A month later in July I got another blood test which showed my Alk Phos had decreased from 250 to 150. GGT went from 538 to 328. AST and ALT were unchanged. Calprotectin went from 500 to 37 (normalized!). I am wondering how long it took for other people’s ALP to completely normalize. Based on the reductions I did see I assume the OV is at least doing something. I wonder if I should push for a higher dose. For reference I am a 25 year old male.
First blood test after vanco was 6 weeks I think, and all numbers normalized. Maybe wait another month, do a second blood test, then reaches dosage? Good luck!
For me it took about 2-3 months. This is not confirmed, but how fast you see a response might depend on how high your dose is (it requires more antibiotics to “flush out the system” than to just maintain the current bacteria flora).
If I were you, I would wait atleast 3 months before I did any changes. 
That makes sense! What dose are you on?
Right now I’m experimenting with 500 mg/day in order to try to save some money (previously I was on 1000 mg/day). I have been taking vanco for more than two years though and I’m on phase 0-1 of the disease. Therefor, these figures might not comparable for someone just starting vanco or being in a later phase of PSC.
My 5 year old son (PSC/Overlap/IBD-UC), Stage 3 Fibrosis per liver biopsy, has been on treatment for about a month with Ursodiol and Prednisone, and about 24 days with Oral Vanco 1,000 MG per day (switched to ANI brand 12 days ago). His labs today are:
ALP: 262 (Normal) (Normal Range: 142 - 335 U/L), down 73% in one month (normalized at 3 week test from beginning treatment, 2 weeks after beginning Vanco)
AST: 63 (1.5x Normal) (Normal: <41 U/L), down 68% in one month
ALT: 119 (about 3x Normal) (Normal: <42 U/L), down 46% in one month (largest reductions in last 2 weeks)
GGT: 236 (about 10x Normal) (Normal: 3 - 22 U/L), down 48% in one month (stable since last week after large drop in third week)
CRP: 1 (Well Below Normal) (Normal: <5) down from 22 one month ago (stabilized at high end of normal after one week of treatment, and substantial reduction to 1 after two weeks of treatment)
ESR: 10 (Well below Normal) (Normal: <15 mm/hr) down from 76 one month ago, substantial reductions over last two weeks
BILIRUBIN: Always normal
Most all other tests have been normal or near normal since beginning (or shortly after beginning treatment).
Regarding the above post, we obviously do not know if Vanco or Ursodiol has contributed most to the reduction in the labs. His ursodiol dosage I am told by our liver specialist has been at lower range (12MG/KG per day) and that is going to be increased to a more “normal” range of 20MG/KG per day.