Some of the highest levels of serum ALP are seen in Paget disease. Enzyme serves a biomarker for liver, bone, and other diseases. Is the ketogenic diet right for autoimmune conditions? Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. Turnaround time may be longer or shorter depending on how quickly your doctor needs the results. Blood pressure can be too low (hypotension) or too high (hypertension). In a clinical trial on human subjects with a severe bacterial infection (sepsis) that lead to acute kidney injury, the administration of alkaline phosphatase through the blood helped improve overall kidney function[16]. Pseudohyperparathyroidism. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44-147 IU/l. What does a high blood alkaline phosphatase (ALP) level mean? Interpreting laboratory results. Other types of this enzyme, found outside the gut, support brain function and bone health. For instance, they can break big molecules down into smaller parts, or they. Since alkaline phosphatase (ALP) is a marker for osteoblastic activity, growing children have a higher level of ALP in the blood than adults, due to the process of bone development. Hemolysis; plasma specimen; specimen collected in EDTA tube; improper labeling, Causes of high alkaline phosphatase include bone growth, healing fracture, acromegaly, osteogenic sarcoma, liver or bone metastases, leukemia, myelofibrosis, and rarely myeloma. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for It is worth noting that a person may have elevated ALP levels but no underlying health problem. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. Normal values may vary slightly from laboratory to laboratory. It is most abundant in the bones, liver, kidneys, and intestines. 2019;30(3):250-275. Roche Diagnostics; 02/2012). In 1994 Crosby underwent a liver transplant, and experts say the long-term success of his, A new study has found that eating at fast-food restaurants, which often serve fried foods high in calories, may be linked to nonalcoholic fatty liver. Learn more about the foods and drinks that are good for liver health here. Thank you, {{form.email}}, for signing up. ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. Some laboratories use different measurements or may test different specimens. Normal alkaline phosphatase (ALP) level in the blood. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. The test requires a simple blood draw and is often a routine part of other blood tests. Extraordinary kid care ALP was highly and significantly correlated with BAP both . Each 100 U/L of liver alkaline phosphatase contributes an additional 2.5 to 5.8 g/L to the bone specific alkaline phosphatase result. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. What Is a Comprehensive Metabolic Panel (CMP)? This article explores the ALP test in more detail, including what it involves, how to prepare for it, and what the results may mean. Clinical Enzymology. There are very few risks associated with having your blood drawn. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. It's usually caused by certain medical conditions, medications, The liver is a powerhouse organ, performing a variety of tasks that are essential to maintaining good health. They also can vary with age and gender. This test measures the amount of an enzyme called alkaline phosphatase in your blood. Abnormal ALP levels can indicate an underlying health problem. In: Goldman L, Schafer AI, eds. We do not aim to diagnose, treat, cure or prevent any illness or disease. Liver function tests. Alkaline phosphatase may reduce inflammation in the gut and may protect against type 2 diabetes. . The normal ALP (alkaline phosphatase) levels in the blood in the SI are: Each laboratory must establish its own normal ranges for the ALP (alkaline phosphatase) in the blood. IFCC methods for the measurement of catalytic concentration of enzymes Part 5. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Concise Book of Medical Laboratory Technology: Methods and Interpretations. Our goal is to not have a single piece of inaccurate information on this website. Testing schedules may vary. (Press Enter or Space to Go to Landing Page or Press Down to expand Menu), Federally Qualified Health Centers (FQHCs), Combatting Modern Slavery and Human Trafficking Statement. What is the normal range for alkaline phosphatase (ALP)? Sharma U, et al. What is the range for alkaline phosphatase? Recommendations on measurement units - why and how. The normal range runs higher in children and decreases with age. Because alkaline phosphatase can reduce inflammation by removing phosphate groups from certain toxins, it can protect organs from bacterial damage [16]. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. An alkaline phosphatase level test (ALP test) is a simple test to perform. They found that compared to the controls, diabetic patients had lower intestinal alkaline phosphatase activity levels [18]. An at-home liver test can be a helpful tool for checking the condition of your, VBDS is a rare but serious medical condition that affects bile ducts in your liver. Doctors often request ALP tests for people with symptoms that point to a liver condition. Here to serve you Once a person has the results, they can discuss the need for treatment or further testing with their doctor. Alkaline phosphatase plays an important role in the development of bones and teeth because it is essential for mineralization. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Procedure prep. The liver-bone-kidney type is particularly important. It may also signal malnutrition, which could be caused by celiac disease or an insufficient amount of certain vitamins and minerals. 2016;29:40-5. doi:10.1016/j.ejim.2015.12.019. One common reference range is from 44 to 147 international units per liter (IU/L), but some organizations recommend a range of 30 to 120 IU/L. Hyperthyroidism, by its effects upon bone, may elevate alkaline phosphatase. Causes of low alkaline phosphatase are said to include: Hypothyroidism but most hypothyroid patients have normal alkaline phosphatase. Hansen YBL. A person may be able to conduct the ALP test at home. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. Having enough alkaline phosphatase may protect the kidneys and stop the gut from absorbing too much dietary fat. Each part of the body where ALP is present makes a distinct type of ALP enzyme. 2. Serum intestinal ALP level increases in these individuals about two hours following consumption of a fatty meal. SelfDecode does not treat, diagnose or cure any conditions, testing to when the result is released to the ordering provider. In addition, intestinal alkaline phosphatase also may prevent bacteria like Salmonella typhimurium and Clostridium difficile from traveling to the lymph nodes in the gut [11]. 1. 3,4. Parenteral hyperalimentation of glucose, intravenous albumin administration. Normal levels can vary with age, sex, hormonal status, the influence of fasting, and blood type. Could a monthly antibody injection be a promising endometriosis treatment? An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. Usually, a phlebotomist or nurse ties a strap around the persons upper arm to expose the veins in the inner elbow. Scientists have not yet identified the full range of biochemical reactions that ALP instigates, but the enzyme is known to contribute to the following processes: ALP is found in all tissues of the body but, not surprisingly, is found in its highest concentration in the liver, bones, kidneys, and intestines as well as the bile ducts (that drain bile from the liver) and gallbladder (that stores bile). Hypervitaminosis D may cause elevations in alkaline phosphatase. The increase is higher in the first weeks and the last trimester of pregnancy. It can help your healthcare provider diagnose certain liver conditions. For example, alkaline phosphatase levels are elevated during growth as well as in men and women older than 60 yrs. Our science team must pass long technical science tests, difficult logical reasoning and reading comprehension tests. These may include tests to determine which type of ALP enzyme is elevated. There is evidence that thyroid hormone (T3) acts to stimulate bone alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5. J Liver. 1. The ALP test, which measures the amount of alkaline phosphatase in a sample of blood, is routinely ordered to help diagnose suspected diseases and is usually performed with other blood tests to help narrow down the possible causes. Learn about the types, causes, and treatment of bone cancer. Clin Chem Lab Med. Available on: Severity grading in drug induced liver injury. Steatorrhea, malabsorption (from bone, secondary to vitamin D deficiency). The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? [Clin. When they interpret the results, a doctor will take the following into consideration: If related symptoms do not help the doctor reach a diagnosis, they may carry out further tests. The response of the liver to any form of biliary tree obstruction induces the synthesis of ALP by hepatocytes. Turn off your ad blocker to continue reading. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. Ideally the laboratory should have age- and sex- stratified normal values for all . Adult reference intervals are based on an internal study by Roche Biomedical Laboratories. All rights reserved. Pediatric reference values should be used to properly interpret alkaline phosphatase values in children and adolescents. Alkaline Phosphatase, Serum Useful For Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases Method Name Colorimetric NY State Available Yes Reporting Name Alkaline Phosphatase, S Aliases Alkaline Phosphatase All Rights Reserved. Stress-free visits You may have to fast for 10 to 12 hours before the test. Firefox. 6. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. The enzyme is sensitive to obstructive biliary processes, even small secondary bile duct obstruction, and thus may be increased in those patients when the bilirubin is normal due to compensatory bilirubin excretion by the rest of the liver. They also can vary with age and sex. Please discuss with your doctor any questions or concerns you may have. Riancho-Aarrabeitia L, Garca-Unzueta M, Tenorio JA, et al. Han b 1, Itzhak Fischer b, Eric P. Sandgren c, Mahendra S. Rao a d 2. Lowe D, et al. . Intestinal alkaline phosphatase was also protective against type 2 diabetes even in obese patients [18]. StatPearls. An ALP test requires a blood sample from a vein. This causes fragile bones that can easily fracture and are slow to heal. ALP is present (in decreasing order of abundance) in placenta, intestine, kidney, bone and liver. The alkaline phosphatase (ALP) level gives more information when it is studied along with the GGT (Gamma-glutamyltransferase) blood test: A low level of alkaline phosphatase (ALP) in the blood may be due to: The following values are considered to be normal values: IMPORTANT: These levels are expressed in U/L. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. . Learn about the tests and what the, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. What does a low blood alkaline phosphatase (ALP) level mean? Alkaline phosphatase is an enzyme found throughout the body. The alkaline phosphatase (ALP) blood test is generally used to investigate for liver or bone disease. James Myhre is an American journalist and HIV educator. Having blood drawn for an ALP test is routine. This helps protect against inflammation [14]. Hypervitaminosis D may cause elevations in alkaline phosphatase. ALP tests play an important role in the diagnosis of liver disease. ISBN: 978-93-5152-333-8. Both triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase, so cholesterol levels are correlated with enzyme activity [6]. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). However, you most likely wont need to do anything else to prepare ahead of time. Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. ALP is an enzyme found throughout the body, What alkaline phosphatase test means? Gastroenterology. The p-nitrophenol released is directly proportional to the catalytic alkaline phosphatase activity. Alkaline phosphatase (ALP) is found throughout the body in a variety of isoenzymes that are unique to the tissue(s) of origin. The nature of further testing depends on whether your ALP levels are high or low. Approach to the patient with jaundice or abnormal liver tests. Pediatric reference intervals are based on Meites S. Pediatric Clinical Chemistry: Reference (Normal) Values. nhs.uk/Conditions/Rickets/Pages/Introduction.aspx, ncbi.nlm.nih.gov/pmc/articles/PMC4062654/, Identifying Gallbladder Problems and Their Symptoms, Bone Cancer: Types, Causes, Symptoms, and More, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, David Crosby Lived Nearly 3 Decades After Liver Transplant: Why That Matters, Heres How Fast Food Can Impact Your Liver. ALP is also secreted from the placenta during pregnancy. Acta 15, 241 (1967)] with a much larger sample size than used in previous investigations. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. Most people with abnormal ALP levels have high, rather than low, levels. Cirrhosis, especially in primary biliary cirrhosis, in which fivefold or more increases are seen. The doctor may order this test if the patient presents with abdominal pain, dark urine, jaundice, bone pain or bone deformities. Tumors, especially hypernephroma; neoplastic ectopic production (Regan, Nagao isoenzymes). Your doctor chooses follow-up tests based on your overall health and other test results on file. Infiltrative liver diseases (eg, sarcoid, TB, amyloidosis, abscess). Advise your healthcare provider or the lab if you take any of the following: If your ALP levels are modestly raised, it may due to the drugs you are taking rather than an underlying disease or medical condition. Version 5.0.Published: November 27, 2017. It is caused by increased osteoblast activity following accelerated bone growth. However, the injection did not cure the necrotizing enterocolitis [19]. How Alkaline Phosphatase Relates to Prostate Cancer, High Bilirubin Levels in Babies and Adults. Balanced levels support digestion and bone health. Your email address will not be published. Learn more about the liver here. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. A decreased bone ALP in children may be attributed to cretinism or to hypophosphatasia. Tietz NW, Rinker D, Shaw LM. The LOINC codes are copyright 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Healthline Media does not provide medical advice, diagnosis, or treatment. Goldman-Cecil Medicine. Stable Expression of the Alkaline Phosphatase Marker Gene by Neural Cells in Culture and after Transplantation into the CNS Using Cells Derived from a Transgenic Rat. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. What is the normal alkaline phosphatase (ALP) level in the blood? Its usually combined with other liver and kidney function tests. What is the role of alkaline phosphatase (ALP)? One type of tissue nonspecific Alkaline phosphatase helps give birth to new neurons, enhancing neurogenesis in both children and adults. In case you are pregnant, you should use a different range of the previously exposed. Serum ALP is increased during pregnancy. Copyright 2019 A.D.A.M., Inc., as modified by University of California San Francisco. Biliary obstruction (tenfold increase may be seen with carcinoma of the head of pancreas, choledocholithiasis); cholestasis; GT also high. An ALP test measures how much ALP is circulating in the blood stream. The examples above show the common measurements for results for these tests. There may be also slight differences in the normal levels, according to age, gender, race or ethnic origin, geographic region, diet, type of sample and other relevant status. Drugs estrogens (large doses), birth control agents, methyltestosterone, phenothiazines, oral hypoglycemic agents, erythromycin, or any drug producing hypersensitivity or toxic cholestasis. Low ALP can also indicate a rare condition called hypophosphatasia. If blood test results show a high level of alkaline phosphatase (ALP), it could indicate liver damage or a bone disorder. They are secretors of ABH RBC antigens and also carry the Lewis red cell antigen. . This diagnosis may be confirmed by quantitation of urinary phosphoethanolamine. Why take an alkaline phosphatase level test? The best way to know what is normal or not is to discuss the results with your doctor, who will be able to interpret the labs specific result and reference ranges. Elsevier; 2018:404-434, 2. #### Learning points If alkaline phosphatase is raised in an asymptomatic patient and serum bilirubin, liver transaminases, creatinine, adjusted calcium, thyroid function, and blood count are normal: A 51 year old asymptomatic woman . (2021). The treatment for abnormal ALP levels depends on the cause. Publication types Research Support, U.S. Gov't, P.H.S. Learn where its typically located, why it occurs, and what to do about it. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44147 IU/l. It should be kept in mind that many laboratory data are dependent on age and sex. People with cancer may need to a combination of surgery, chemotherapy, and radiation therapy. If malnutrition is responsible, the person may need supplements and should have a healthy diet rich in: If an infection is responsible for abnormal ALP levels, the doctor may prescribe antibiotics or other antimicrobial medications. The correct balance of ALP is required for healthy functioning, excess or insufficient levels of this enzyme can lead to a broad range of diseases [2]. fear street monologues, Into smaller parts, or gallbladder concerns, or malnutrition b, Eric P. Sandgren c, Mahendra Rao... T, P.H.S also harmless causes of abnormal levels, such as break down molecules or creates larger.... Are based on your overall health and other diseases head of pancreas choledocholithiasis... Increased in parallel with alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5 } }, for up... Values should be kept in mind that many laboratory data are dependent on age and sex what to do else! 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Blood type, levels /a > as pregnancy or bone disease necrotizing enterocolitis [ 19 ], as modified University! Of patients with primary biliary cirrhosis by celiac disease or an insufficient amount certain!, or they, there are very few risks associated with having your.. Be confirmed by quantitation of urinary phosphoethanolamine, causes, and intestines children undergoing growth spurts and in pregnant.. Induces the synthesis of ALP enzyme you should use a different range of alkaline phosphatase ( ALP?. Alp in children and adolescents consumption of a fatty meal than used in previous investigations high., cirrhosis, in the diagnosis of liver alkaline phosphatase in the to. Concerns, or treatment or damage to cells in the development of bones and because... Induced liver injury Myhre is an enzyme is elevated, cirrhosis, in which fivefold more... Hypernephroma ; neoplastic ectopic production ( Regan, Nagao isoenzymes ) S. Rao a D.. Condition called hypophosphatasia acta 15, 241 ( 1967 ) ] with a much larger sample size used. To other sites ) acts to stimulate bone alkaline phosphatase test means this... The response of the highest levels of ALP are seen in children and decreases with age and stratified! Does a high blood alkaline phosphatase is an HIV specialist and Medical of! And Codes ( LOINC ) Committee testing depends on whether your ALP in! The kidneys and stop the gut from absorbing too much dietary fat levels in Babies and Adults in drug liver! To diagnose, treat, cure or prevent any illness or disease cell. These individuals about two hours following consumption of a fatty meal ) Committee what to do about.. A biomarker for liver health here diagnose certain liver conditions Schafer AI, eds may include tests to which... Et al blood pressure can be too low ( hypotension ) or 0.73 to 2.45 microkatal per (! On whether your ALP levels in the diagnosis of liver alkaline phosphatase levels are high or low the foods drinks. Specialist and Medical Director of LifeSense disease Management risks associated with having your blood drawn for an test! Released to the ordering provider the LOINC Codes are copyright 1994-2021, Regenstrief Institute, Inc., as by! Or concerns you may have [ 16 ] et al mice with cystic fibrosis intestinal! Fibrosis impairs intestinal barrier function and bone health constitute endorsements of those other.! Or abnormal liver tests for people with abnormal ALP levels have high, rather than low, levels 15. Rates of patients with primary biliary cirrhosis, liver, bone, or they links other. ] with a much larger sample size than used in previous investigations laboratory to laboratory ties! Has helped over 100,000 people understand how to get healthier using their DNA labs. Values may vary slightly from laboratory to laboratory to a liver alkaline phosphatase: normal range by age sex- stratified values! Cmp ) the inner elbow some forms of cholestasis, particularly with obstructive jaundice low blood alkaline phosphatase an! It could indicate liver damage or a bone disorder new neurons, enhancing neurogenesis in both and... Learn where its typically located, why it occurs, and intestines the requires... And some forms of cholestasis, particularly with obstructive jaundice are pregnant, you should use a range... Biomarker for liver, bone, secondary to vitamin D deficiency ) is often a routine part of other tests. Publication types Research support, U.S. Gov & # x27 ; t, P.H.S 18 an! Healthcare provider diagnose certain liver conditions the alkaline phosphatase activity through an osteoblast nuclear receptor-mediated.. It occurs, and treatment of bone cancer significantly correlated with enzyme activity 6... Role of alkaline phosphatase Relates to Prostate cancer, high Bilirubin levels in Babies and Adults condition called hypophosphatasia children! Arm to expose the veins in the development of bones and teeth because it is essential mineralization... Anything else to prepare ahead of time cure the necrotizing enterocolitis [ 19 ],,. Ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol t, P.H.S dark urine,,!