People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. Pregnancy can elevate the alkaline phosphatase (ALP) level in the blood because the placenta can produce ALP. Tumors, especially hypernephroma; neoplastic ectopic production (Regan, Nagao isoenzymes). An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. Your doctor may want to find the source of high ALP levels, or explain why ALP is low. Henry's Clinical Diagnosis and Management by Laboratory Methods. Enzyme activity is localized in the brush border of the proximal convoluted tubule of the kidney, intestinal mucosal epithelial cells, hepatic sinusoidal membranes, vascular endothelial cells and osteoblasts of bone. Learn about the types, causes, and treatment of bone cancer. 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 . 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. 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. This may be true for people with type O or B blood, who tend to have high ALP levels for up to 12 hours after a fatty meal. Adult reference intervals are based on an internal study by Roche Biomedical Laboratories. 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. Once a person has the results, they can discuss the need for treatment or further testing with their doctor. Its usually combined with other liver and kidney function tests. Alkaline phosphatase is an enzyme found throughout the body. This measures specific types of ALP, and the results help a doctor pinpoint the part of the body that the underlying illness is affecting. Our specialists handle conditions ranging from the common to the most rare. It should be kept in mind that many laboratory data are dependent on age and sex. Philadelphia, PA: Elsevier Saunders; 2016:chap 155. Tietz NW, Rinker D, Shaw LM. In some cases, additional time should be 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). However, you most likely wont need to do anything else to prepare ahead of time. Mutua DN, Nyaga E, Njagi M, Orinda G. Liver function tests in normal pregnant women. There are very few risks associated with having your blood drawn. 1. 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]. but is for informational and educational purposes alone. Serum ALP is increased during pregnancy. J Clin Chem Clin Biochem 1983;21:731-48. 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). Active bone growth phases in childhood and adolescence may produce alkaline phosphatase levels of 3 - 4 times the adult range. Philadelphia, PA: Elsevier Saunders; 2016:chap 147. Your liver can regenerate and heal itself. However, they may also indicate malnutrition, kidney cancer tumors, intestinal concerns, pancreas concerns, or a serious infection. Peptic ulcer, erosion. There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. In mice, oral supplementation with calf intestinal alkaline phosphatase during antibiotic treatment had fewer infections and a lower mortality rate compared to mice with no supplementation [12]. Extraordinary kid care Mice deficient in intestinal alkaline phosphatase can develop type 2 diabetes. U.S. Department of health and human Services. Unusual ALP levels may be a sign of liver problems, a bone disorder, some types of cancer, and various other health conditions. Methodology Immunochemiluminometric assay (ICMA) It helps break down proteins in the body and exists in different forms, depending on where it originates. Butch AW, Goodnow TT, Brown WS, McClellan A, Kessler G, Scott MG. Stratus automated creatine kinase-MB assay evaluated: Identification and elimination of falsely increased results associated with high-molecular-mass form of alkaline phosphatase. ALP is also secreted from the placenta during pregnancy. 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. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. 2014; 147: pp. Abnormal ALP levels can indicate an underlying health problem. Approach to a patient with elevated serum alkaline phosphatase. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition. Questions or comments about our tests and resources? It is crucial to take these exactly as directed. ALP tests play an important role in the diagnosis of liver disease. A glycoprotein that is found on the surface of osteoblasts, BAP reflects the biosynthetic activity of these bone-forming cells. Version 5.0.Published: November 27, 2017. 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. Cirrhosis, especially in primary biliary cirrhosis, in which fivefold or more increases are seen. SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. ALP values that fall outside these reference ranges are considered abnormal. Alkaline phosphatase may reduce inflammation in the gut and may protect against type 2 diabetes. Serum ALP activity of intestinal origin occurs only in individuals of ABO blood type O or A. It is present in the liver, bile ducts, bones, intestine and placenta. (Package insert: Alkaline Phosphatase reagent. Some foods and drinks can help protect liver health. 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]. Fatty liver disease generally doesn't lead to sudden death, but it can be fatal if left untreated. Philadelphia:WB Saunders Company, 1999; 676-684. Measuring ALP is one way to check for that damage and is typically done together with other liver function tests. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. 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. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. Primary or metastatic tumor in liver: there may be marked increase and GT is often high. 2023 Dotdash Media, Inc. All rights reserved. Having enough alkaline phosphatase may protect the kidneys and stop the gut from absorbing too much dietary fat. You may also feel some throbbing at the site after the blood is drawn. Abnormal results may be due to the following conditions: Other conditions for which the test may be done: Berk PD, Korenblat KM. 2023 Laboratory Corporation of America Holdings. Based on the results of these blood tests, a healthcare provider can expand the investigation and order the appropriate tests and procedures (including imaging studies and biopsies) to definitively diagnose the cause. Referrals made easy What is the normal range for alkaline phosphatase (ALP)? 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"). The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. In: Goldman L, Schafer AI, eds. Alkaline phosphatase (ALP) is an enzyme found in the blood that helps break down proteins. An electrophoretically slow moving isoenzyme with high relative mass may occur in some patients with bile duct obstruction and hepatic metastases and may result in false elevation of CK-MB.7. They also can vary with age and gender. These may vary, depending on the specifics of the test and any requirements from the laboratory. 3rd ed. Other types of this enzyme, found outside the gut, support brain function and bone health. 1.Introduction. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. In that case you must use the respective reference tables. If your test results are high or low, many factors help determine what to do next. C peptide. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. In Conversation: Is the ketogenic diet right for autoimmune conditions? 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. Hypervitaminosis D may cause elevations in alkaline phosphatase. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Doctors usually use this test to diagnose bone and liver disorders. Learn where its typically located, why it occurs, and what to do about it. Other labs may consider the normal range to be 30120 IU/l. Normal: 120/70 to 120/80 millimeters of mercury (mmHg). If you experience this complication, apply a warm compress until the swelling goes down. Best in Northern CA What to Expect During Liver Function Tests, Transaminitis (Liver Enzyme) Result: Meaning and Causes, High Ammonia Levels: Symptoms, Causes, Treatment, Symptoms of High Prolactin Hormone Levels, aspartate aminotransferase (AST), and alanine aminotransferase (ALT), Approach to a patient with elevated serum alkaline phosphatase, Recommendations on measurement units - why and how, Liver function tests in normal pregnant women, Clinical, biochemical and genetic spectrum of low alkaline phosphatase levels in adults, Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens, Transporting nutrients and enzymes to and from the liver, Aiding in the development, growth, and maintenance of bone, Transporting fatty acids to store energy in, Regulating cell growth in fetuses during pregnancy, Hypophosphatasia (a congenital disorder affecting bone growth). What does a low blood alkaline phosphatase (ALP) level mean? Why normal levels can differ across different labs? Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. Intestinal alkaline phosphatase supports the balance of gut bacteria, reduces inflammation, and helps clear LPS and other toxins from the gut. When the results of your ALP test are in, your doctor will discuss them with you and suggest what to do next. Bone loss and liver damage release excessive amounts of alkaline phosphatase into the blood. StatPearls. While the test is generally painless, there may be a slight sting from the needle. 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 . For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. It can help your healthcare provider diagnose certain liver conditions. National Library of Medicine An ALP test usually takes less than 5 minutes. Caspian J Intern Med. The test is generally accurate, and your doctor should have the result in 1 or 2 days. 8 Benefits of Intestinal Alkaline Phosphatase There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. Usually, a phlebotomist or nurse ties a strap around the persons upper arm to expose the veins in the inner elbow. The results may go first to your ordering physician or healthcare professional. 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). For instance, they can break big molecules down into smaller parts, or they. Sharma U, et al. Which values are considered a normal alkaline phosphatase (ALP) level in the blood? Accommodations. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Both high and low blood levels can be problematic. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Another type of intestinal alkaline phosphatase might complement brain health by reducing inflammation and balancing the good bacteria in the gut [5]. Alkaline phosphatase is one kind enzyme found in your body. Alkaline phosphase (ALP). The response of the liver to any form of biliary tree obstruction induces the synthesis of ALP by hepatocytes. 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. This helps protect against inflammation [14]. Recommendations on measurement units - why and how. Alkaline phosphatase: An overview. If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please leave a comment or contact us at support@selfdecode.com. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. We need to show ads to keep on providing high quality medical information. 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. Read our, Alkaline Phosphatase (ALP) Testing: What to Expect. Many medicines can interfere with blood test results. Firefox. In addition, certain drugs can cause ALP levels to vary. The renal function improvement seen in the study suggests alkaline phosphatase is a promising new treatment in patients infection induces acute kidney injury. Our goal is to not have a single piece of inaccurate information on this website. Call 911 for all medical emergencies. 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. You may experience some bruising around the puncture site, but this can be avoided by putting pressure on the wound. Doctors usually use this test to diagnose bone and liver disorders. 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. 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Why it occurs, and high ALP levels may stem from a health problem generally does n't to... Help protect liver health healthcare provider diagnose certain liver conditions the health industry and we almost exclusively link to peer-reviewed! If your test results are high or low, many factors help determine what to next... Of biliary tree obstruction induces the synthesis of ALP by hepatocytes healthcare professional can cause ALP levels may from! Because their bones are growing rapidly liver health from a health problem extraordinary kid care mice deficient in intestinal phosphatase! Out of range can indicate one of several possible conditions, such as liver, gallbladder, or explain ALP. Disease and not taking any medication osteoblasts, BAP reflects the biosynthetic of. For alkaline phosphatase in the blood that helps break down proteins may reduce in... After the blood because the placenta during pregnancy the study suggests alkaline phosphatase is one kind enzyme in. 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