Alkaline phosphatase (ALP) is an enzyme found in the blood that helps break down proteins. As part of a routine liver function test Normal Results The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Procedure prep. What does a high 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. Pseudohyperparathyroidism. If blood test results show a high level of alkaline phosphatase (ALP), it could indicate liver damage or a bone disorder. Skip to Main Content; National Library of Medicine. 2012;3(3):478-83. Your liver can regenerate and heal itself. 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. It is crucial to take these exactly as directed. An ALP test is a blood test. Learn the signs and symptoms of gallbladder problems here. Chronic alcohol ingestion (in chronic alcoholism, alkaline phosphatase may be normal or increased, but often with high AST (SGOT) and/or high bilirubin and especially with high GT; MCV may be high). James Myhre is an American journalist and HIV educator. We'll help you find the best provider for your child. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. It can help your healthcare provider diagnose certain liver conditions. 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. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. When we compared the aforementioned 2 RIs, the latter range was wider than the former, which may be happening due . Gastroenterology. 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). A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. What is an alkaline phosphatase level test? Values obtained with different assay methods should not be used interchangeably in serial testing. Alkaline phosphatase is used as a tumor marker. ALP values are higher in children because their bones are actively growing, while the ALP values increase during pregnancy in tandem with the development of the placenta and the approach of childbirth. Pag. This also causes reduced activity of intestinal alkaline phosphatase [13]. By James Myhre & Dennis Sifris, MD Mutua DN, Nyaga E, Njagi M, Orinda G. Liver function tests in normal pregnant women. 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]. Familial increased serum intestinal alkaline phosphatase: A new variant associated with Gilbert's syndrome. Intestinal alkaline phosphatase can remove phosphate groups from LPS, which reduces its inflammatory effects [10]. This causes fragile bones that can easily fracture and are slow to heal. Learn where its typically located, why it occurs, and what to do about it. 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. What causes a high level of ALP in a blood test? Your email address will not be published. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. U.S. Department of health and human Services. 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. For the best experience, tryChrome or Any duplication or distribution of the information contained herein is strictly prohibited. Our website services, content, and products are for informational purposes only. 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). They are continually monitored by our internal peer-review process and if we see anyone making material science errors, we don't let them write for us again. 25th ed. Some foods and drinks can help protect liver health. Moss DW, Henderson RA. A similar increase is seen in patients with advanced primary liver cancer or widespread secondary hepatic metastases. 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. Intestinal ALP isoenzyme, an asialoglycoprotein normally cleared by the hepatic asialoglycoprotein receptors, is often increased in patients with liver cirrhosis. Most people with abnormal ALP levels have high, rather than low, levels. High levels may also indicate a concern related to the bones such as rickets, Pagets disease, bone cancer, or an overactive parathyroid gland. Enzymes are proteins that help chemical reactions happen. For children, this range is under 350 U/L. 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. Normal alkaline phosphatase (ALP) level in the blood. 1. Bottom number is diastolic pressure when heart is at rest. 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. Pregnancy can elevate the alkaline phosphatase (ALP) level in the blood because the placenta can produce ALP. 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. Alkaline phosphatase plays an important role in the development of bones and teeth because it is essential for mineralization. 6. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for We are dedicated to providing the most scientifically valid, unbiased, and comprehensive information on any given topic. Pulmonary infarct (one to three weeks after embolism. These ranges were extrapolated from published ranges in the following references. ALP tests are generally accurate, but they only show part of the picture. Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. 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). For children, this range is under 350 U/L. You can learn more about how we ensure our content is accurate and current by reading our. There are certain drugs that can interfere with the results. Accommodations. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. 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 This measures specific types of ALP, and the results help a doctor pinpoint the part of the body that the underlying illness is affecting. Postoperative cholestasis. ALP tests are quick and usually have no adverse effects. The test is done with a blood sample. . (Package insert: Alkaline Phosphatase reagent. People with cancer may need to a combination of surgery, chemotherapy, and radiation therapy. The renal function improvement seen in the study suggests alkaline phosphatase is a promising new treatment in patients infection induces acute kidney injury. Some of the highest levels of serum ALP are seen in Paget disease. Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. The type found in the gut is particularly important for health. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. However, the prevalence among healthy children is unknown. Having lower-than-normal ALP levels in your blood can indicate a protein deficiency or Wilsons disease. TH is most common in young children, with a peak prevalence between 6 and 24 months of age. Active bone growth phases in childhood and adolescence may produce alkaline phosphatase levels of 3 - 4 times the adult range. isoenzyme tests (to determine levels from the liver and bones), diagnostic imaging of liver and gall bladder. They then insert a needle into the vein to draw blood into a small tube. Abnormal ALP levels can indicate an underlying health problem. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. This helps protect against inflammation [14]. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. In: Goldman L, Schafer AI, eds. . We've got you covered. Discharge. ALP is also found in the placenta, kidneys . 2. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. Goldman-Cecil Medicine. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Blood pressure. Serum ALP is increased during pregnancy. 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. 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 often completed with other blood tests for assessment purposes. Philadelphia, PA: Elsevier Saunders; 2016:chap 146. Some labs set the range at 30 to 130 U/L. For this reason, an ALP level test is commonly used to help diagnose liver/gallbladder disorders and bone disorders [1]. There is evidence that thyroid hormone (T3) acts to stimulate bone alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5. ISBN: 978-93-5152-333-8. Methodology Immunochemiluminometric assay (ICMA) Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. However, you most likely wont need to do anything else to prepare ahead of time. . We believe that the most accurate information is found directly in the scientific source. SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. James Myhre is an American journalist and HIV educator. A considerable rise in the alkaline phosphatase activity is sometimes seen in children and teenagers. An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. 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. 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]. U.S. National Library of Medicine. J Liver. Mice deficient in intestinal alkaline phosphatase can develop type 2 diabetes. Testing schedules may vary. 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. Alkaline phosphatase (ALP) is a protein found in all body tissues. Background: Transient hyperphosphatasemia (TH) is an often unnoticed benign entity, primarily affecting children below 5 years of age. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. 2021 Laboratory Corporation of America Holdings and Lexi-Comp Inc. All Rights Reserved. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. ALP is an enzyme present in many parts of the body. Unusual ALP levels may be a sign of liver problems, a bone disorder, some types of cancer, and various other health conditions. 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. The presence of LPS in the blood can stimulate inflammation in the body [10]. An ALP test requires a healthcare professional to draw a small sample of blood from your arm. Blood pressure can be too low (hypotension) or too high (hypertension). Lindsay Cook, PharmD is a board-certified consultant pharmacist. 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. Normal: 120/70 to 120/80 millimeters of mercury (mmHg). Marked decline of high ALP of pregnancy is seen with placental insufficiency and imminent fetal demise. These may vary, depending on the specifics of the test and any requirements from the laboratory. Note that each number in parentheses [1, 2, 3, etc.] Required fields are marked *. What is alkaline phosphatase normal range by age? Learn about the causes of cirrhosis, diagnosis, prevention, and how to. When the results of your ALP test are in, your doctor will discuss them with you and suggest what to do next. Mg and Zn ions are required for minimal activity. Intervals are . What is a normal alkaline phosphatase level by age? 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. This test measures the amount of an enzyme called alkaline phosphatase in your blood. Gallbladder pain can be sudden, intense, and severe. Admission. Why take an alkaline phosphatase level test? While the test is generally painless, there may be a slight sting from the needle. The ranges can be different depending on the laboratory or on your personal circumstances. They then attach a plastic tube to the end of the needle and draw some blood. Lammers WJ, van Buuren HR, Hirschfield GM, et al: Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: An international follow-up study. How Alkaline Phosphatase Relates to Prostate Cancer, High Bilirubin Levels in Babies and Adults. Abnormal results may be due to the following conditions: Other conditions for which the test may be done: Berk PD, Korenblat KM. However, this research is limited and likely ongoing, so no alkaline phosphatase supplement currently available for sale. Please discuss with your doctor any questions or concerns you may have. Alkaline phosphatase is used as a tumor marker.3,4. Malnutrition has been reported to relate to low values, but in practice, diseases causing malnutrition relate often to high alkaline phosphatase results (eg, disseminated neoplasia). Is the ketogenic diet right for autoimmune conditions? Clin Liver Dis. 25th ed. The activity of ALP found in serum is a composite of isoenzymes from those sites and, in some circumstances, placental or Regan isoenzymes. 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). The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. In: Burtis CA, Ashwood ER, eds. 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. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. It is important to check the reference report that comes with the test results to fully understand the findings. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. DO NOT stop or change your medicines without talking to your provider first. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. Ramnik Sood. There are distinctive forms of ALP in the placenta and small intestine; hepatic, renal and osteoblast (bone) ALP are similar molecules. To confirm biliary abnormality, an additional useful test is GT. However, the injection did not cure the necrotizing enterocolitis [19]. Read our, Alkaline Phosphatase (ALP) Testing: What to Expect. Stress-free visits Information is shared for educational purposes only. 2001;39(Special Suppl):S346, 3. Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. The ALP isozyme test can distinguish between the bone and liver ALP. 2019;30(3):250-275. Best in Northern CA No statistically significant influence of blood type on enzyme activity was observed. In: Goldman L, Schafer AI, eds. 2023 Laboratory Corporation of America Holdings. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. Your email address will not be published. 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. Pregnant women have higher blood alkaline phosphatase activity. Low ALP can also indicate a rare condition called hypophosphatasia. Most labs will schedule the test early in the morning to accommodate for the fasting. Doctors usually use this test to diagnose bone and liver disorders. (2021). 1. In some cases, additional time should be Used alone, alkaline phosphatase may be misleading. By contrast, certain diseases or conditions can impair ALP synthesis and lead to a drop in the blood concentration. Medications can also change your ALP levels, so be sure to tell your doctor about any medicines you are taking. Healing infarcts in other organs, including kidney, may also cause increased alkaline phosphatase); other situations in which angiofibroplasia occurs, such as healing in a large decubitus ulcer. An alkaline phosphatase level test (ALP test) measures the amount of alkaline phosphatase enzyme in your bloodstream. Learn about the possible causes of elevated liver enzymes, Cirrhosis is a liver condition that causes irreversible scarring on the liver. Can diet help improve depression symptoms? Normal blood levels of alkaline phosphatase are 20 to 140 U/L in most nonpregnant adults. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. 5. This enzyme functions in an alkaline environment (optimum pH of 10). Therefore, alkaline phosphatase may not be used as a screening test to rule out vitamin D deficiency. It measures the amount of ALP in the blood, and abnormal levels can indicate an underlying health condition. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. ALP is also secreted from the placenta during pregnancy. Normal values may vary slightly from laboratory to laboratory. Han b 1, Itzhak Fischer b, Eric P. Sandgren c, Mahendra S. Rao a d 2. Turn off your ad blocker to continue reading. Sharma U, et al. Slightly abnormal ALP levels can occur naturally and without any underlying illness. Alkaline phosphatase. Paget's disease of bone (PDB) is a chronic focal metabolic bone disorder characterized by an increase in bone remodeling and disorganized bone formation [1].The literature reported that a proportion of around 27 to 50 % of patients with PDB are asymptomatic [2].This asymptomatic population may be diagnosed by an incidental finding on radiographs or by high serum total alkaline . ALP is an enzyme found in your bloodstream. You may feel slight pain or a sting when the needle is inserted. It is worth noting that a person may have elevated ALP levels but no underlying health problem. Hypophosphatasia: Very low alkaline phosphatase values are found in the presence of normocalcemia or hypocalcemia. Hypervitaminosis D may cause elevations in alkaline phosphatase. There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. Lieverse AG, van Essen GG, Beukeveld GJ, et al. Most clinicians order alkaline phosphatase levels to assess a patients bone and liver health, however so much promising research is appearing that confirms its positive role in gut health. What are the risks of an alkaline phosphatase level test? You will be asked to fast for 10 to 12 hours before the test to ensure an accurate reading. We're ranked #1 in pediatric cancer, heart surgery, cardiology & more. Many bad bacteria which are gram-negative have lipopolysaccharides (LPS) that can trigger either an acute infection episode (sepsis) or chronic inflammation. Approach to a patient with elevated serum alkaline phosphatase. SelfDecode does not treat, diagnose or cure any conditions, Fatty metamorphosis of liver (moderate increase occurs in acute fatty liver). Damage to these and other organs can trigger an increase of ALP in the bloodstream. Nathan, David G. Abnormal levels of ALP in your blood most often indicate a health concern with your liver, gallbladder, or bones. Its usually combined with other liver and kidney function tests. Narayanan S. Alkaline phosphatase as tumor marker. We need to show ads to keep on providing high quality medical information. 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 . What is the normal range of alkaline phosphatase? 2014;29(3):269-78. doi:10.1007/s12291-013-0408-y. If you experience this complication, apply a warm compress until the swelling goes down. Other types of this enzyme, found outside the gut, support brain function and bone health. One type of tissue nonspecific Alkaline phosphatase helps give birth to new neurons, enhancing neurogenesis in both children and adults. An obstruction of the liver or damage to it causes ALP levels to rise. Mice without intestinal alkaline phosphatase absorb fat very fast. The ALP test can be helpful in the diagnosis of bone concerns such as: ALP testing may also be helpful in investigating the presence of cancer tumors, unusual bone growth, or vitamin D deficiency. 23rd ed. How is this test done? 3,4. Ulcerative colitis with pericholangitis, other erosive lesions of colon. Values above 130 U/L are usually considered to be high. ALP levels also vary with age and gender, with levels higher in children and pregnant women [1]. 4. 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. The nature of further testing depends on whether your ALP levels are high or low. Tietz NW, Rinker D, Shaw LM. Alpha phosphatase is considered a biomarker for many disorders, with abnormally high and abnormally low ALP levels pointing the healthcare provider in the direction of the possible causes. ALP is an enzyme present in various parts of the body. If liver damage is suspected, high ALP levels may point to cirrhosis (scarring of the liver), hepatitis (liver inflammation), bile duct blockage, or mononucleosis ("kissing disease").
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alkaline phosphatase: normal range by age