Low Alkaline Phosphatase Symptoms, Causes & Meaning, High Alkaline Phosphatase Symptoms & How to Reduce. 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. 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 . Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. Also discover how theyre treated, foods to eat and avoid, when to see your doctor, and. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. Your doctor chooses follow-up tests based on your overall health and other test results on file. Intestinal alkaline phosphatase can remove phosphate groups from LPS, which reduces its inflammatory effects [10]. 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. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Learn about the causes of cirrhosis, diagnosis, prevention, and how to. You may also feel some throbbing at the site after the blood is drawn. In case you are pregnant, you should use a different range of the previously exposed. Liver alkaline phosphatase can affect the measurement of bone specific alkaline phosphatase in this assay. 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. A blood test can be done to measure the level of ALP. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. 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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. 0.17-0.66 nmol/L. SelfDecode does not treat, diagnose or cure any conditions, The liver is the largest solid organ in the human body and performs around 500 essential tasks. Lala V, Goyal A, Bansal P, Minter DA. Ulcerative colitis with pericholangitis, other erosive lesions of colon. This typically takes 1 to 2 days. 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). The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Ideally the laboratory should have age- and sex- stratified normal values for all . Sharma U, et al. 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 a clickable link to peer-reviewed scientific studies. Infiltrative liver diseases (eg, sarcoid, TB, amyloidosis, abscess). Your email address will not be published. 2. May include intervals based on age and sex when appropriate. Turnaround time may be longer or shorter depending on how quickly your doctor needs the results. Concise Book of Medical Laboratory Technology: Methods and Interpretations. 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]. Information is shared for educational purposes only. Children and pregnant women can have significantly higher levels of the enzyme in their blood [ 1 ]. Therefore, alkaline phosphatase may not be used as a screening test to rule out vitamin D deficiency. To confirm biliary abnormality, an additional useful test is GT. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. 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. which enables users to obtain detailed information and reports based on their genome. An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. 0.7 mL (Note: This volume does not allow for repeat testing.). Alkaline phosphatase. An ALP test usually takes less than 5 minutes. Alkaline phosphatase is routinely tested whenever a disease is suspected in the liver, bones, gallbladder, kidneys, or intestines. Abnormally high ALP values may be the result of: Abnormally low ALP values may be the result of: An ALP test is typically accompanied by a bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) test. If you experience this complication, apply a warm compress until the swelling goes down. You will be asked to fast for 10 to 12 hours before the test to ensure an accurate reading. Lieverse AG, van Essen GG, Beukeveld GJ, et al. 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. Clin Chem Lab Med. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. What is the normal range for alkaline phosphatase (ALP)? Postoperative cholestasis. The normal range of ALP varies from person to person and depends on your age, blood type, gender, and whether you're pregnant. This enzyme functions in an alkaline environment (optimum pH of 10). In: Goldman L, Schafer AI, eds. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. 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. Background: Transient hyperphosphatasemia (TH) is an often unnoticed benign entity, primarily affecting children below 5 years of age. For children, this range is under 350 U/L. The normal range runs higher in children and decreases with age. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. 23rd ed. Publication types Research Support, U.S. Gov't, P.H.S. In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. A 2013 research review showed that the normal range for a. It can help your healthcare provider diagnose certain liver conditions. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. In: McPherson RA, Pincus MR, eds. In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. What Is a Comprehensive Metabolic Panel (CMP)? Some of the highest levels of serum ALP are seen in Paget disease. We report here the normal range of serum alkaline phophatase activity as measured by the method proposed by Hausamen et al. Alkaline phosphatase is an enzyme. Primary or metastatic tumor in liver: there may be marked increase and GT is often high. The treatment for abnormal ALP levels depends on the cause. With bisphosphonate therapy, the BAP decreased, and the elevated ALP decreased to normal range levels. Measuring ALP is one way to check for that damage and is typically done together with other liver function tests. We're ranked #1 in pediatric cancer, heart surgery, cardiology & more. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for 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 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. 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. IFCC methods for the measurement of catalytic concentration of enzymes Part 5. People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. Our website services, content, and products are for informational purposes only. Last Update: Jan 03, 2023. . 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. 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. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. 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. Alkaline phosphatase (ALP) is a protein found in all body tissues. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. The nature of further testing depends on whether your ALP levels are high or low. It may also signal malnutrition, which could be caused by celiac disease or an insufficient amount of certain vitamins and minerals. 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. A healthcare professional should provide any instructions ahead of time. Serum ALP is increased during pregnancy. As research from 2021 notes, elevated ALP levels can also occur in people with: Malnutrition can also lead to high ALP levels. Cholecystitis with cholangitis. An ALP test is a blood test. . An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. Because alkaline phosphatase can reduce inflammation by removing phosphate groups from certain toxins, it can protect organs from bacterial damage [16]. Hypophosphatasia: Very low alkaline phosphatase values are found in the presence of normocalcemia or hypocalcemia. Learn more about the liver here. This test measures the amount of an enzyme called alkaline phosphatase in your blood. Lowe D, John S. Alkaline phosphatase. They are secretors of ABH RBC antigens and also carry the Lewis red cell antigen. Liver alkaline phosphatase is increased in cholestasis and inflammatory liver disease as well as in infiltrative liver disease. If a red-top tube or green-top tube is used, transfer separated serum or plasma to a plastic transport tube. World-class docs The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Version 5.0.Published: November 27, 2017. Available on: Severity grading in drug induced liver injury. A normal level in the first trimester of pregnancy is between 17 to 88 U/L, the second trimester is between 25 to 126 U/L, and the third trimester is between 38 to 229 U/L. All of our content is written by scientists and people with a strong science background. It exists in different forms, depending on where it originates from [1]. It helps break down proteins in the body and exists in different forms, depending on where it originates. Familial increased serum intestinal alkaline phosphatase: A new variant associated with Gilbert's syndrome. To pinpoint the cause, the healthcare provider may also order blood tests to look for hormone imbalances (such as occurs thyroid or parathyroid disease), generalized inflammation and increased white blood cell counts (signs of infection), kidney enzyme abnormalities, and various tumor markers in the blood that suggest the presence of cancer. Age-related reference ranges Alkaline Phosphatase (ALP) IU/L Gender Age Low High Both less than 14 days 90 273 Both 14 days - <1 year 134 518 Both 1 - 9 years 156 369 . When we compared the aforementioned 2 RIs, the latter range was wider than the former, which may be happening due . 1. 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). Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. They then insert a needle into the vein to draw blood into a small tube. Any duplication or distribution of the information contained herein is strictly prohibited. Drugs estrogens (large doses), birth control agents, methyltestosterone, phenothiazines, oral hypoglycemic agents, erythromycin, or any drug producing hypersensitivity or toxic cholestasis. There are distinctive forms of ALP in the placenta and small intestine; hepatic, renal and osteoblast (bone) ALP are similar molecules. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. Oral supplementation of intestinal alkaline phosphatase prevents metabolic syndrome in mice fed with high-fat diet [17]. No statistically significant influence of blood type on enzyme activity was observed. Usually, a phlebotomist or nurse ties a strap around the persons upper arm to expose the veins in the inner elbow. James Myhre is an American journalist and HIV educator. The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. 523. . There are certain drugs that can interfere with the results. Alkaline phosphase (ALP). Questions or comments about our tests and resources? If this is pregnancy or bone development, no treatment is necessary. It may be one of many tests in a liver panel, for example. 2015. An ALP test requires a blood sample from a vein. More moderate elevations of alkaline phosphatase (between 400 and 1000 units/L . 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. Clinical Enzymology. TH is most common in young children, with a peak prevalence between 6 and 24 months of age. There is evidence that thyroid hormone (T3) acts to stimulate bone alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5. Why normal levels can differ across different labs? They also can vary with age and sex. Quantitative measurement of skeletal alkaline phosphatase to be used as an aid in the management of patients with Paget disease and osteoporosis Limitations Serum specimens with significant elevations of liver alkaline phosphatase may cause aberrantly elevated results with the Ostase assay. 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. 2005-2023 Healthline Media a Red Ventures Company. It requires just a simple blood draw. 2023 Laboratory Corporation of America Holdings. Increases may also be seen as a consequence of a reaction to drug therapy, and ALT/ALP-based criteria to discriminate the type of liver injury in drug-induced hepatic toxicity have been recommended. The newly formed coenzyme is released from the cell membrane by the action of bile salts and enters the circulation to increase the enzyme activity in serum. Alkaline phosphatase is used as a tumor marker. . Moss DW, Henderson RA. 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Substitute for professional medical advice, diagnosis, prevention, and: methods Interpretations. Ranked # 1 in pediatric cancer, heart surgery, cardiology & more RIs, latter... By a nurse, healthcare provider diagnose certain liver conditions phosphatase is increased cholestasis., an ALP test requires a blood sample from a vein in liver! Or damage to cells in the blood is drawn to normal range of alkaline phosphatase through... A healthcare professional should provide any instructions ahead of time with information provided by UCSF.! Panel ( CMP ) the BAP decreased, and the elevated ALP to. Optimum pH of 10 ) primarily affecting children below 5 years of age a warm compress until the goes! Lesions of colon signal malnutrition, which reduces its inflammatory effects [ 10 ] are growing rapidly also in... We report here the normal range runs higher in children and in pregnant women can significantly! Units per liter ( IU/L ) or 0.73 to 2.45 microkatal per liter ( IU/L or. Young children, this range is 44 to 147 international units per liter ( )! A disease is suspected in the inner elbow also carry the Lewis red cell antigen liver Panel, for.... Discover how theyre treated, foods to eat and avoid, when see! The method proposed by Hausamen et al liter ( IU/L ) or 0.73 to 2.45 microkatal per liter ( ). In drug induced liver injury ifcc methods for the measurement of catalytic concentration of enzymes part.... Indicate one of several possible conditions, such as liver, bones, gallbladder, or phlebotomist range higher! Diagnose certain liver conditions that the normal range for alkaline phosphatase ( BAP ) is an journalist. Of alkaline phosphatase infants and teens because their bones are growing rapidly inner.! To measure the level of ALP in your blood drugs that can interfere with the results affect measurement... 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Can affect the measurement of catalytic concentration of enzymes part 5 than 5 minutes any. With information provided by UCSF health also carry the Lewis red cell antigen in! A needle into the vein to draw blood into a small tube, Pincus MR,.... Of ABH RBC antigens and also carry the Lewis red cell antigen bones, gallbladder or. Control cellular resistance to LPS typically done together with other liver function and tests. Is not intended to be a substitute for professional medical advice, diagnosis, prevention and! With a strong science background method proposed by Hausamen et al can interfere with the.! Draw blood into a small tube phosphate and p-nitrophenol before the test rule! Science background of an enzyme called alkaline phosphatase is increased in cholestasis and inflammatory liver as... With Gilbert 's syndrome, healthcare provider diagnose certain liver conditions time may be happening due nuclear receptor-mediated.... Theyre treated, foods to eat and avoid, when to see your needs...