(2013). Serum ALP activity of intestinal origin occurs only in individuals of ABO blood type O or A. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). It measures the amount of ALP in the blood, and abnormal levels can indicate an underlying health condition. This is done in your doctors office or in a clinical lab. 2012;16(2):199-229. doi:10.1016/j.cld.2012.03.012. Fatty metamorphosis of liver (moderate increase occurs in acute fatty liver). Causes of low alkaline phosphatase are said to include: Hypothyroidism but most hypothyroid patients have normal alkaline phosphatase. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. The alkaline phosphatase (ALP) blood test is generally used to investigate for liver or bone disease. 2023 Dotdash Media, Inc. All rights reserved. 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 process is quick and typically causes little pain or discomfort. The liver is an essential organ that plays a key role in your health. Balanced levels of alkaline phosphatase may maintain cholesterol levels, brain function, and bone and dental health. Gastroenterology. It can also be used to check the progress of treatment for any of the above conditions. allowed for additional confirmatory or additional reflex tests. Henry's Clinical Diagnosis and Management by Laboratory Methods. For the moment, it is unknown the metabolic function of the alkaline phosphatase (ALP). Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Many commonly and uncommonly used drugs elevate alkaline phosphatase, and tenfold increases may be seen with drug cholestasis. With bisphosphonate therapy, the BAP decreased, and the elevated ALP decreased to normal range levels. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. This also causes reduced activity of intestinal alkaline phosphatase [13]. . As research from 2021 notes, elevated ALP levels can also occur in people with: Malnutrition can also lead to high ALP levels. Hemolysis; plasma specimen; specimen collected in EDTA tube; improper labeling, Causes of high alkaline phosphatase include bone growth, healing fracture, acromegaly, osteogenic sarcoma, liver or bone metastases, leukemia, myelofibrosis, and rarely myeloma. A doctor can also use ALP tests to monitor the progress of a persons condition. Explore our network of care for kids, from the tiniest to teens and young adults. Other labs may consider the normal range to be 30120 IU/l. The activity of ALP found in serum is a composite of isoenzymes from those sites and, in some circumstances, placental or Regan isoenzymes. Conclusion: Serum vitamin D3 levels may not be correlated with increased serum alkaline phosphatase levels. May include intervals based on age and sex when appropriate. Additional information regarding LOINC codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf. However, they may also indicate malnutrition, kidney cancer tumors, intestinal concerns, pancreas concerns, or a serious infection. Its usually combined with other liver and kidney function tests. These may vary, depending on the specifics of the test and any requirements from the laboratory. If ALP comes back high, the doctor may order the ALP isozyme test to see which specific type of alkaline phosphatase is elevated. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. What is the normal range of alkaline phosphatase? (In most patients with cholecystitis and cholangitis who do not have a common duct stone, alkaline phosphatase is within normal limits or only slightly increased.) Information is shared for educational purposes only. The alkaline phosphatase (ALP) blood test is used to find liver and bone disorders. Alkaline phosphase (ALP). In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. J Clin Chem Clin Biochem 1983;21:731-48. Learn about the types, causes, and treatment of bone cancer. Bone cancer occurs when a tumor, or atypical mass of tissue, forms in a bone. 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). We've got you covered. Some drugs (clofibrate, azathioprine, estrogens and estrogens in combination with androgens) lower serum ALP activity. Marked decline of high ALP of pregnancy is seen with placental insufficiency and imminent fetal demise. 0.7 mL (Note: This volume does not allow for repeat testing.). It is often completed with other blood tests for assessment purposes. They then insert a needle into the vein to draw blood into a small tube. Cholecystitis with cholangitis. Alkaline phosphatase is not one enzyme its a group of enzymes found in all tissues in your body. Portions 2023 Mayo Foundation for Medical Education and Research. 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 diagnosis may be confirmed by quantitation of urinary phosphoethanolamine. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. 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. Read on to learn about its role in the body and whether your values are normal. It is present in the liver, bile ducts, bones, intestine and placenta. James Myhre is an American journalist and HIV educator. You may feel slight pain or a sting when the needle is inserted. Intestinal strangulation or obstruction, or ulcerative lesion. ALP was highly and significantly correlated with BAP both . Turn off your ad blocker to continue reading. Joe is a thriving entrepreneur, with a mission to empower people to take advantage of the precision health revolution and uncover insights from their DNA and biomarkers so that we can all feel great all of the time. SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. Alkaline phosphatase is used as a tumor marker.3,4. Pregnant women have higher blood alkaline phosphatase activity. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. ALP tests play an important role in the diagnosis of liver disease. 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. 1. It is determined by measuring the increase in absorbance. Your email address will not be published. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Learn more about the foods and drinks that are good for liver health here. Clin Chem Lab Med. Accommodations. Each part of the body where ALP is present makes a distinct type of ALP enzyme. Goldman-Cecil Medicine. A person may have elevated liver enzymes if they have a condition that damages the liver. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. A person may need to fast for 612 hours before an ALP test. Discharge. ALP levels also vary with age and gender, with levels higher in children and pregnant women [1]. Postoperative cholestasis. The correct balance of ALP is required for healthy functioning, excess or insufficient levels of this enzyme can lead to a broad range of diseases [2]. 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. 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. 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. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. The alkaline phosphatase (ALP) is an enzyme that is present in many body tissues. 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). Verywell Health's content is for informational and educational purposes only. Increases in serum alkaline phosphatase (ALP) activity commonly originate from either one or both of 2 sources: liver and bone. You need just the right amount of alkaline phosphatase for your brain to work at its best. Serum ALP was the first enzyme to be used for the investigation of hepatic disease. Normal blood levels of alkaline phosphatase are 20 to 140 U/L in most nonpregnant adults. Infiltrative liver diseases (eg, sarcoid, TB, amyloidosis, abscess). This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. 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). 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. Author links open overlay panel Tahmina Mujtaba a 1, Steve S.W. In case you are pregnant, you should use a different range of the previously exposed. The blood sample is collected in a tube and analyzed by a laboratory. Sepsis. Top number is systolic pressure, when heart is pumping. 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. Our science team is put through the strictest vetting process in the health industry and we often reject applicants who have written articles for many of the largest health websites that are deemed trustworthy. 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 . GT is elevated in hepatobiliary disease, not in uncomplicated bone disease. 2015 Aug;27(4):413-8. doi: 10.1007/s40520-014-0296-x. 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). The enzyme is sensitive to obstructive biliary processes, even small secondary bile duct obstruction, and thus may be increased in those patients when the bilirubin is normal due to compensatory bilirubin excretion by the rest of the liver. Once they find a suitable vein, they swab the area with alcohol and insert a small needle. Conclusions: The percentile charts provided . Having blood drawn for an ALP test is routine. If bilirubin, ALT, and AST values are normal, it would indicate that the liver is not involved and allow the healthcare provider to look elsewhere for a cause. 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