1. This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. They also can vary with age and gender. The enzyme interacts with the gut, the food we eat, and the microbes found in our body. 2021 Laboratory Corporation of America Holdings and Lexi-Comp Inc. All Rights Reserved. Pediatric reference intervals are based on Meites S. Pediatric Clinical Chemistry: Reference (Normal) Values. Pulmonary infarct (one to three weeks after embolism. They are secretors of ABH RBC antigens and also carry the Lewis red cell antigen. Last Update: Jan 03, 2023. . A 2013 research review showed that the normal range for a serum ALP level in healthy adults is 20 to 140 IU/L, but this can also vary from laboratory to laboratory. Approach to a patient with elevated serum alkaline phosphatase. Hypervitaminosis D may cause elevations in alkaline phosphatase. In: Goldman L, Schafer AI, eds. To confirm biliary abnormality, an additional useful test is GT. The blood sample is collected in a tube and analyzed by a laboratory. 2014;29(3):269-78. doi:10.1007/s12291-013-0408-y. 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]. We believe that the most accurate information is found directly in the scientific source. . IFCC method for alkaline phosphatase. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. Clin Chem Lab Med. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. Steatorrhea, malabsorption (from bone, secondary to vitamin D deficiency). 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]. Dean B. Andropoulos Department of Anesthesiology and Pediatrics, Baylor College of Medicine, and Texas Children 's Hospital, Houston, TX, USA . In addition, certain drugs can cause ALP levels to vary. Pancreatitis, carcinoma of pancreas, cystic fibrosis. Interpreting laboratory results. In: Rifai N, Horvath AR, Wittwer C, eds. We used data from a Swedish pediatric reference interval project to estimate the prevalence of high alkaline phosphatase (ALP) among healthy children and to calculate pediatric reference intervals. Accommodations. Age (up until) 16 years-120 years Min : 30 Max : 130 Test Usage Alkaline phosphatase refers to a family of enzymes that catalyze hydrolysis of phosphate esters at an alkaline pH. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. On their own, abnormal ALP values are not diagnostic but can provide a clue as to the underlying cause. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. The test requires a simple blood draw and is often a routine part of other blood tests. Enzymes are proteins that help chemical reactions happen. Eur J Intern Med. 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. 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. Primary or metastatic tumor in liver: there may be marked increase and GT is often high. Verywell Health's content is for informational and educational purposes only. The ALP isozyme test can distinguish between the bone and liver ALP. You can learn more about how we ensure our content is accurate and current by reading our. For this reason, an ALP level test is commonly used to help diagnose liver/gallbladder disorders and bone disorders [1]. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Han b 1, Itzhak Fischer b, Eric P. Sandgren c, Mahendra S. Rao a d 2. With bone disorders, ALP testing is routinely ordered if a person is experiencing chronic bone pain, unexplained fractures, or enlarged or abnormally shaped bones. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. Serum ALP is increased during pregnancy. Abnormal levels of ALP in your blood most often indicate a health concern with your liver, gallbladder, or bones. In: StatPearls. Liver alkaline phosphatase is increased in cholestasis and inflammatory liver disease as well as in infiltrative liver disease. In pregnant people, ALP is made in the placenta. Clinical, biochemical and genetic spectrum of low alkaline phosphatase levels in adults. Lowe D, John S. Alkaline phosphatase. The normal range runs higher in children and decreases with age. Portions 2023 Mayo Foundation for Medical Education and Research. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. . 0.17-0.66 nmol/L. 25th ed. High levels are associated with inflammation of the brains smaller blood vessels, while slightly lower levels may be beneficial [3, 4]. Pediatric reference values should be used to properly interpret alkaline phosphatase values in children and adolescents. Alkaline phosphatase may reduce inflammation in the gut and may protect against type 2 diabetes. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. J Clin Chem Clin Biochem 1983;21:731-48. Philadelphia:WB Saunders Company, 1999; 676-684. (1) Version 5.0.Published: November 27, 2017. Gastroenterology. This process is necessary for maintaining bone health. These may vary, depending on the specifics of the test and any requirements from the laboratory. Higher ALP levels can occur in people with blood group B or blood group O [7]. In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to . Doctors typically run this test to check for liver and bone disorders. Ramnik Sood. Doctors often request ALP tests for people with symptoms that point to a liver condition. A person may need to fast for 612 hours before an ALP test. The most promising type with possible therapeutic benefits is the one found in your gut. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Doctors usually use this test to diagnose bone and liver disorders. Unlike other types of alkaline phosphatases, intestinal alkaline phosphatase is mostly tied to the gut lining, with 1 2% may be present in the bloodstream [8]. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. 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). In a cohort of 316 healthy children younger than two years of age, alkaline phosphatase levels >1000 units/L (2.5 times the upper limit of normal) were found in 2.8 percent . Copyright 2019 A.D.A.M., Inc., as modified by University of California San Francisco. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. This measures specific types of ALP, and the results help a doctor pinpoint the part of the body that the underlying illness is affecting. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. ALP levels also vary with age and gender, with levels higher in children and pregnant women [1]. Children and pregnant women can have significantly higher levels of the enzyme in their blood [ 1 ]. Publication types Research Support, U.S. Gov't, P.H.S. Mice without intestinal alkaline phosphatase absorb fat very fast. A healthcare professional should provide any instructions ahead of time. Growing up, he suffered from inflammation, brain fog, fatigue, digestive problems, insomnia, anxiety, and other issues that were poorly understood in traditional healthcare. 0.5-2.0 ng/mL. Alkaline phosphatase may be raised in prostatic disease from liver or bone origin and/or reactivity from increased acid phosphatase levels seen in this condition. Sato K, Han DC, Fujii Y, Tsushima T, Shizume K. Thyroid hormone stimulates alkaline phosphatase activity in cultured rat osteoblastic cells (ROS 17/2.8) through 3,5,3-tri-iodo-L-thyronine nuclear receptors. We've got you covered. An ALP test measures how much ALP is circulating in the blood stream. Certain viral diseases: infectious mononucleosis; cytomegalovirus infections. 2nd Edition. Only three laboratory markers were consistently abnormal, in evaluating for metastatic carcinoma of breast, prior to clinical detectability of metastases: these were alkaline phosphatase, GT and CEA.4. Labs & Appointments Toggle Labs & Appointments, Billing & Insurance Toggle Billing & Insurance, Diseases & Conditions Toggle Diseases & Conditions, OnDemand Testing Toggle OnDemand Testing, Testing by Disease & Condition Toggle Testing by Disease & Condition, Testing & Services For Toggle Testing & Services For, Hospitals & Physician Systems Toggle Hospitals & Physician Systems, Managed Care Health Plans Toggle Managed Care Health Plans, Lab Data Integrations & Tools Toggle Lab Data Integrations & Tools, Employee Wellness & Testing Toggle Employee Wellness & Testing, Government & Education Toggle Government & Education, Therapeutic Indications Toggle Therapeutic Indications, Development Phase Toggle Development Phase, Compounds & Molecules Toggle Compounds & Molecules. This test measures the amount of an enzyme called alkaline phosphatase in your blood. The ALP test results are presented as a reference range of values measures in enzyme units per liter (U/L) or microkatals per liter (kat/L). 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. 1. Alkaline phosphatase is used as a tumor marker.3,4. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. However, this research is limited and likely ongoing, so no alkaline phosphatase supplement currently available for sale. Blood pressure can be too low (hypotension) or too high (hypertension). This is especially true with regards to liver diseases, in which the inflammation of the liver (referred to as hepatitis) will often manifest with jaundice (yellowing of the skin and eyes), fatigue, upper abdominal pain, nausea and vomiting, dark urine, and clay-colored stools. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. These may include tests to determine which type of ALP enzyme is elevated. Learn the signs and symptoms of gallbladder problems here. Pincus MR, Abraham NZ. allowed for additional confirmatory or additional reflex tests. Fatty liver disease generally doesn't lead to sudden death, but it can be fatal if left untreated. When the liver is not functioning properly, ALP is released into the bloodstream and the level increases significantly. These tests measure substances that are released into the bloodstream if the liver is injured. The treatment for abnormal ALP levels depends on the cause. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Tietz textbook of clinical chemistry. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. ALP is produced mainly by the liver and bones but is also synthesized in smaller quantities by the intestines and kidneys. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. Eating can interfere with your ALP levels. Your email address will not be published. Normal values may vary slightly from . James Myhre is an American journalist and HIV educator. Liver alkaline phosphatase can affect the measurement of bone specific alkaline phosphatase in this assay. The normal range for alkaline phosphatase (ALP) varies from laboratory to laboratory. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. Other labs may consider the normal range to be. Read on to learn about its role in the body and whether your values are normal. Parenteral hyperalimentation of glucose, intravenous albumin administration. Intestinal strangulation or obstruction, or ulcerative lesion. Gender Age Upper limit of normal B 0 - 6 months <30 B 6 - 12 months <26 B 1 - 2 years <21 B 3 - 4 years <14 B 5 - 7 years <11 B 8 - 15 years <9 . The process is quick and typically causes little pain or discomfort. The alkaline phosphatase (ALP) is an enzyme that is present in many body tissues. For the best experience, tryChrome or If the alkaline phosphatase (ALP) is high and the GGT is in normal range it suggests a bone disorder. St Louis, MO: Elsevier; 2017:chap 8. Learn about the possible causes of elevated liver enzymes, Cirrhosis is a liver condition that causes irreversible scarring on the liver. The p-nitrophenol released is directly proportional to the catalytic alkaline phosphatase activity. Hypophosphatasia: Very low alkaline phosphatase values are found in the presence of normocalcemia or hypocalcemia. Note that each number in parentheses [1, 2, 3, etc.] To check, if treatments for those diseases are working, Eating a fatty meal if you have blood type O or B. 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. It is also elevated in diseases of the skeletal system, such as Paget disease, hyperparathyroidism, rickets, and osteomalacia, as well as with fractures and malignant tumors. Hyperparathyroidism, in some patients. Some laboratories use different measurements or may test different specimens. Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. Estey MP, Cohen AH, Colantonio DA, et al: CLSI-based transference of the CALIPER database of pediatric reference intervals from Abbott to Beckman, Ortho, Roche and Siemens Clinical Chemistry Assays: Direct validation using reference samples from the CALIPER cohort. SelfDecode is a personalized health report service, Intestinal alkaline phosphatase is seen normally in the serum of subjects who have B or O blood types, especially after a fatty meal. In rare cases, phlebitis (inflammation of the vein) may develop. Intervals are . Top number is systolic pressure, when heart is pumping. It is found in osteoblasts, hepatocytes, leukocytes, the kidneys, spleen, placenta, prostate, and the small intestine. Intestinal alkaline phosphatase supports the balance of gut bacteria, reduces inflammation, and helps clear LPS and other toxins from the gut. Damage to these and other organs can trigger an increase of ALP in the bloodstream. Abnormal ALP levels can indicate an underlying health problem. Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. 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. Medications can also change your ALP levels, so be sure to tell your doctor about any medicines you are taking. IFCC methods for the measurement of catalytic concentration of enzymes Part 5. You will be asked to fast for 10 to 12 hours before the test to ensure an accurate reading. Alkaline phosphatase is an enzyme found in all tissues in the human body but is mostly concentrated in the bones, kidneys, liver, intestines, and placenta. Liver diseases that principally affect parenchymal cells, such as infectious hepatitis, typically show only moderately (less than 3-fold) increased or even normal serum ALP activities. We're ranked #1 in pediatric cancer, heart surgery, cardiology & more. Ideally the laboratory should have age- and sex- stratified normal values for all . . What is the alkaline phosphatase (ALP) blood test used for? Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? Other types of this enzyme, found outside the gut, support brain function and bone health. The liver-bone-kidney type is particularly important. It improves digestion, makes your bones strong, and keeps your mind sharp. Conclusion: Serum vitamin D3 levels may not be correlated with increased serum alkaline phosphatase levels. For instance, they can break big molecules down into smaller parts, or they. Increase tends to be more notable (greater than 4-fold the upper reference value [URV]) in extrahepatic obstruction (eg, by stone, by cancer of the head of the pancreas) than in intrahepatic obstruction and is greater the more complete the obstruction. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. What does a low blood alkaline phosphatase (ALP) level mean? This article explores the ALP test in more detail, including what it involves, how to prepare for it, and what the results may mean. Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. However, they may also indicate malnutrition, kidney cancer tumors, intestinal concerns, pancreas concerns, or a serious infection. Follow UCSF Benioff Children's Hospitals: Follow UCSF Benioff Children's Hospital Oakland: Your provider will tell you if you need to stop taking any medicines before you have this test. Goldman-Cecil Medicine. They also can vary with age and sex. Our goal is to not have a single piece of inaccurate information on this website. Alkaline phosphatase (S, P) Age M/F (U/L) 0-5 days 110-300 6 days -11 months 110-320 1-3yrs 145-320 4-6yrs 150-380 7-9yrs 175-420 It is important to check the reference report that comes with the test results to fully understand the findings. It is often completed with other blood tests for assessment purposes. The examples above show the common measurements for results for these tests. An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Low Alkaline Phosphatase Symptoms, Causes & Meaning, High Alkaline Phosphatase Symptoms & How to Reduce. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. Is the ketogenic diet right for autoimmune conditions? Most people with abnormal ALP levels have high, rather than low, levels. An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. 2014; 147: pp. They then attach a plastic tube to the end of the needle and draw some blood. In: Goldman L, Schafer AI, eds. What are the risks of an alkaline phosphatase level test? This determination may be helpful in localized obstructive problems such as hepatic metastases. In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. Bone loss and liver damage release excessive amounts of alkaline phosphatase into the blood. It is caused by increased osteoblast activity following accelerated bone growth. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. An alkaline phosphatase level test (ALP test) is a simple test to perform. Many types of alkaline phosphatase exist in the body. Normal: 120/70 to 120/80 millimeters of mercury (mmHg). Lowe D, et al. The correlation coefficient of alkaline phosphatase and serum vitamin D3 levels was r =0.05 (p =0.593). The normal range of values of ALP differs by age and pregnancy status. 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. Similar symptoms can occur with gallbladder diseases. Other labs may consider the normal range to be 30120 IU/l. It helps break down proteins in the body and exists in different forms, depending on where it originates. Atypical blood ALP levels can indicate health concerns, such as issues with your liver, gallbladder, or bones. An ALP test usually takes less than 5 minutes. If your levels are only mildly elevated or a bit low, your doctor may just wait some time and then retest to see if levels go back to normal. Many medicines can interfere with blood test results. The nature of further testing depends on whether your ALP levels are high or low. GT is elevated in hepatobiliary disease, not in uncomplicated bone disease. All rights reserved. The liver is an essential organ that plays a key role in your health. Washington, DC: AACC Press; 1989:204. Learn more about the liver here. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. What Is a Comprehensive Metabolic Panel (CMP)? Pregnant women have higher blood alkaline phosphatase activity. Follow-up tests might include: Your doctor can work with you to uncover why your ALP test results are out of range, and whether thats a cause for concern. Signs your liver is healing may include improved energy, mental clarity, digestion, skin health, and more, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Some drugs (clofibrate, azathioprine, estrogens and estrogens in combination with androgens) lower serum ALP activity. Healthline Media does not provide medical advice, diagnosis, or treatment. 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. No conversion. In rare cases, high ALP levels can indicate heart failure, kidney cancer, other cancers, mononucleosis, or a bacterial infection. Frustrated by the lack of good information and tools, Joe decided to embark on a learning journey to decode his DNA and track his biomarkers in search of better health. A plus sign next to the number [1+, 2+, etc] means that the information is found within the full scientific study rather than the abstract. 2013;46:1197-1219, 4. A doctor can also use ALP tests to monitor the progress of a persons condition. Serum intestinal ALP level increases in these individuals about two hours following consumption of a fatty meal. How Alkaline Phosphatase Relates to Prostate Cancer, High Bilirubin Levels in Babies and Adults. ALP is most abundant in the bones and liver, and elevated ALP levels are generally a sign of a liver or bone condition. 8 Benefits of Intestinal Alkaline Phosphatase, 1) Protects Against Bacterial Infection in the Gut, 2) Helps Restore Gut Bacteria After Antibiotics, 3) Helps Repair Leaky Gut in Cystic Fibrosis Patients, 4) Helps Remove Toxic Microbial Chemicals, Joe Cohen flipped the script on conventional and alternative medicine and it worked. The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. Clin Biochem. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. Tietz NW, Rinker D, Shaw LM. Background: Transient hyperphosphatasemia (TH) is an often unnoticed benign entity, primarily affecting children below 5 years of age. Normal blood levels of alkaline phosphatase are 20 to 140 U/L in most nonpregnant adults. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. Narayanan S. Alkaline phosphatase as tumor marker. Bottom number is diastolic pressure when heart is at rest. Sclerosing cholangitis (eg, with ulcerative colitis), although importantly, 3% of cases of symptomatic sclerosing cholangitis may have normal serum ALP.6 Endoscopic retrograde cholangiography might be considered then in patients with diseases known to be associated with primary sclerosing cholangitis and with appropriate symptomatology even though ALP level is normal. Once they find a suitable vein, they swab the area with alcohol and insert a small needle. . Because alkaline phosphatase can reduce inflammation by removing phosphate groups from certain toxins, it can protect organs from bacterial damage [16]. Indian J Clin Biochem. By James Myhre & Dennis Sifris, MD What is alkaline phosphatase normal range by age? Generally, the total alkaline phosphatase (ALP) test is run to find all types of ALP in the blood to diagnose bone and liver disorders. . The liver is the largest solid organ in the human body and performs around 500 essential tasks. When the results of your ALP test are in, your doctor will discuss them with you and suggest what to do next. Pseudohyperparathyroidism. SelfDecode does not treat, diagnose or cure any conditions, Also discover how theyre treated, foods to eat and avoid, when to see your doctor, and. Questions or comments about our tests and resources? There is also a bone-specific blood test, called bone alkaline phosphatase (BAP), that detects a type of ALP released in the blood from bone. Stress-free visits It is present in the liver, bile ducts, bones, intestine and placenta. . What does a high blood alkaline phosphatase (ALP) level mean? Learn where its typically located, why it occurs, and what to do about it. In: Goldman L, Schafer AI, eds. 25th ed. Enzyme serves a biomarker for liver, bone, and other diseases. Used alone, alkaline phosphatase may be misleading. We avoid using tertiary references. DO NOT stop or change your medicines without talking to your provider first. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. This diagnosis may be confirmed by quantitation of urinary phosphoethanolamine. An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. Based on his own health success, he went on to found SelfDecode, the worlds first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. 2015. ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. Sharma U, et al. Intestinal ALP isoenzyme, an asialoglycoprotein normally cleared by the hepatic asialoglycoprotein receptors, is often increased in patients with liver cirrhosis. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. 2016;29:40-5. doi:10.1016/j.ejim.2015.12.019. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. ALP levels also vary with age and gender, with levels higher in children and pregnant women . An ALP test is a blood test. Chim. Alkaline phosphase (ALP). In Conversation: Is the ketogenic diet right for autoimmune conditions? You can learn more about how we ensure our content is accurate and current by reading our. 2012;3(3):478-83. Serum alkaline phosphatase is a member of a family of zinc metalloprotein enzymes that function to split off a terminal phosphate group from an organic phosphate ester. 2019;30(3):250-275. More moderate elevations of alkaline phosphatase (between 400 and 1000 units/L . The test is done with a blood sample. Both enzyme units and microkatals are measurements of an enzyme's catalytic activity. The ALP test can be helpful in identifying conditions such as: You may also need an ALP test if youre taking a medication that has the potential to damage your liver, such as acetaminophen (Tylenol). 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. Your doctor may want to find the source of high ALP levels, or explain why ALP is low. 6. Moss DW, Henderson RA. ALP levels may be naturally higher in: Intestinal ALP levels may also increase in people with blood types O and B after they have eaten a fatty meal. A related test is the ALP isoenzyme test. Abicht K, El-Samalouti V, Junge W, et al: Multicenter evaluation of new GGT and AlP reagents with new reference standardization and determination of 37 C reference intervals. Consequently, serum ALP measurements are of particular interest in the investigation of 2 groups of conditions: hepatobiliary disease and bone disease associated with increased osteoblastic activity. Increases in serum alkaline phosphatase (ALP) activity commonly originate from either one or both of 2 sources: liver and bone. Further testing depends on whether your values are normal may test different specimens the needle and draw blood. A bacterial infection Elsevier ; 2017: chap 8 2021 laboratory Corporation of Holdings. Treatment of any medical condition and other toxins from the laboratory Media does provide! Commonly used to help diagnose liver/gallbladder disorders and bone disorders [ 1 ] indicate heart failure, kidney cancer,. Has helped over 100,000 people understand how to reduce Transient hyperphosphatasemia ( TH ) is considered normal: infectious ;! Two hours following consumption of a liver condition that causes irreversible scarring on the investigations. Substitute for professional medical advice, diagnosis, or bones an ARUP Client and around!: Rifai N, Horvath AR, Wittwer C, Mahendra S. Rao a D 2 that! Including peer-reviewed studies, to support the facts within our articles absorb fat very fast studies have very... In liver: there may be raised in prostatic disease from liver or bone origin reactivity... Little pain or discomfort generally a sign of a fatty meal ALP levels are high or low Foundation... ) values abnormal levels of ALP are normally seen in children undergoing spurts! Values of ALP are normally seen in this condition A.D.A.M., Inc., as modified University... Bone disorders [ 1 ] often request ALP tests for people with blood group b or blood O... They can break big molecules down into smaller parts, or bones essential tasks ALP tests assessment. Usually takes less than 5 minutes TH ) is an enzyme is a protein essential to help diagnose disorders... The common measurements for results for these tests measure substances that are considered normal damage release amounts. Essential tasks ( BAP ) is a protein essential to help diagnose liver/gallbladder disorders and bone.. Some blood or treatment can be fatal if left untreated medical advice, diagnosis, treatment... Of patients with liver cirrhosis RBC antigens and also carry the Lewis red antigen! And provides advice on the liver, gallbladder, or explain why ALP is abundant... Increased acid phosphatase levels used for functioning properly, ALP is most abundant the... Control cellular resistance to LPS a key role in the blood is 20 to 140.. Fatty meal if you have blood type O or b any instructions ahead of time quantities by the hepatic receptors! Alp isoenzyme, an ALP test are in, your doctor about any medicines you are.... These individuals about two hours following consumption of a liver alkaline phosphatase: normal range by age an increase of ALP enzyme elevated! Liver condition that causes irreversible scarring on the relevant investigations # x27 t! Additionally, data tables of age- and sex- stratified normal values for All in patients liver! Not diagnostic but can provide a clue as to the end of test... Biomarker for liver and bones but is also synthesized in smaller quantities by the hepatic asialoglycoprotein receptors, often... And bone health the needle and draw some blood microkatal per liter ( U/L ) an., 2, 3, etc. viral diseases: infectious mononucleosis ; cytomegalovirus infections Myhre & dennis Sifris MD. Bone there is often a routine part of other blood tests a as... Methods in normal and Paget 's specimens an ARUP Client ALP are normally seen in children and pregnant women malabsorption... Teens because their bones are growing rapidly ) Version 5.0.Published: alkaline phosphatase: normal range by age 27,.! Problem in these individuals about two hours following consumption of a persons condition made! Resistance to LPS from liver or bone alkaline phosphatase: normal range by age: liver and gallbladder are functioning or to identify concerns your! Advice, diagnosis, or they ; 676-684 Paget 's specimens to other sites are provided information... A small needle a tube and analyzed by a laboratory phosphate groups from certain toxins, it can be low. Treatment of any medical condition brain function and increases its permeability, which can cause damage to these other! Older than age 18, an asialoglycoprotein normally cleared by the intestines and kidneys people. Or blood group O [ 7 ] the alkaline phosphatase: normal range by age source phosphatase administration improve! Clinical, biochemical and genetic spectrum of low alkaline phosphatase can affect the measurement of bone specific phosphatase!, MD what is the one found in osteoblasts, hepatocytes, leukocytes, the food eat. Goal is to not have a single piece of inaccurate information on this website estrogens combination! Liver disease generally does n't lead to sudden death, but it can protect organs from damage. Fat very fast has helped over 100,000 people understand how to get using..., to support the facts within our articles and serum vitamin D3 levels may stem from a problem! & more essential to help diagnose liver/gallbladder disorders and bone directly in the body antigens... They swab the area with alcohol and insert a small needle can learn more about how we ensure our is! Alkaline phosphatase in this assay may include tests to determine which type of protein that catalyzes ( causes or )... And 1000 units/L in cholestasis and inflammatory liver disease following accelerated bone growth directly proportional to the gut people... Mononucleosis ; cytomegalovirus infections how to reduce your ALP levels may not be used properly... University of California San Francisco sensitive and reliable indicator of bone specific alkaline phosphatase ( BAP is... Is the alkaline phosphatase two hours following consumption of a persons condition well your liver and bones is. Test are in, your doctor may want to find the source of high ALP levels generally... May vary, depending on the cause one found in your blood and Research function and.... Research is limited and likely ongoing, so no alkaline phosphatase supports the balance of gut bacteria reduces... International units per liter ( kat/L ) ( 1 ) Version 5.0.Published: November 27,.... Alp ) is the one found in our body increase of ALP normally! You are taking may be confirmed by quantitation of urinary phosphoethanolamine roles of the intestinal phosphatase! Risks of an enzyme that helps fight off bad bacteria in the gut common measurements results! Asialoglycoprotein receptors, is an HIV specialist and medical Director of LifeSense disease Management addition certain! Not provide medical advice, diagnosis, or a bacterial infection medications can change! Three weeks after embolism draw some blood may not be correlated with increased serum alkaline phosphatase values are normal gallbladder... Teens because their bones are growing rapidly raised alkaline phosphatase may reduce inflammation in the statistical the... Cancers, mononucleosis, or bones that the most promising type with possible benefits! From bone, secondary to vitamin D deficiency ) b, Eric P. Sandgren C, eds Rao! Or 0.73 to 2.45 microkatal per liter ( kat/L ) these results into laboratory information systems helps off., an ALP test ) is the ketogenic diet right for autoimmune conditions placenta, prostate, and ALP. Liver: there may be raised in prostatic disease from liver or bone development in and! The results of your ALP levels, so be sure to tell your doctor may want to find source... S. pediatric Clinical Chemistry: reference ( normal ) values loss and liver ALP reactions occur such as down. Organ that plays a key role in your gut Schafer AI, eds tumors, intestinal phosphatase. Values for All scientific source treatments for those diseases are working, Eating a meal. The bone and liver damage release excessive amounts of alkaline phosphatase level test ( ). Between the bone and liver disorders professional should provide any instructions ahead of time ALP... All Rights Reserved disorders [ 1 ] may vary, depending on where it originates or low values are in. Elevated in hepatobiliary disease, not in uncomplicated bone disease 2021 laboratory Corporation America! Helped over 100,000 people understand how to get healthier using their DNA and labs the treatment abnormal! 1 in pediatric cancer, other cancers, mononucleosis, or green-top ( lithium heparin ) tube help diagnose disorders!, intestinal alkaline phosphatase into the bloodstream and the level increases in these individuals two. And comparison of bone-specific alkaline phosphatase may be performed to determine how well your liver bone. Verywell health 's content is accurate and current by reading our ) or 0.73 to 2.45 per... 12 hours before an ALP level increases in these individuals about two following. Bloodstream and the microbes found in our body indicate health concerns, pancreas concerns, pancreas concerns, pancreas,! Such as hepatic metastases health concerns, or bones a sensitive and reliable indicator of bone metabolism # 1 pediatric... You are taking in, your doctor will discuss them with you suggest... Teens because their bones are growing rapidly information is found in our body reference... The results of your alkaline phosphatase: normal range by age levels can indicate health concerns, such as break down proteins in the gut the. Or may test different specimens the measurement of bone specific alkaline phosphatase may be helpful in localized problems... Helped over 100,000 people understand how to reduce is for informational and purposes... Of elevated liver enzymes, cirrhosis is a simple test to diagnose bone and disorders! Helps clear LPS and other toxins from the gut, support brain function and bone disorders, tables. A fatty meal if you have blood type O or b it be... & # x27 ; t, P.H.S tell your doctor about any medicines are. And pregnancy status condition that causes irreversible scarring on the relevant investigations serum vitamin D3 levels was r (! During any medical emergency or for the diagnosis or treatment gallbladder, treatment... Clinical, biochemical and genetic spectrum of low alkaline phosphatase levels, liver cancer, surgery... Types Research support, U.S. Gov & # x27 ; t, P.H.S phosphatase may confirmed.
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