An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. It is most abundant in the bones, liver, kidneys, and intestines. The type found in the gut is particularly important for health. If blood test results show a high level of alkaline phosphatase (ALP), it could indicate liver damage or a bone disorder. . The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). All of our content is written by scientists and people with a strong science background. Here to serve you 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 this case, following all the instructions carefully is key. Clin Biochem. Last Update: Jan 03, 2023. . Learn about the types, causes, and treatment of bone cancer. The ALP isozyme test can distinguish between the bone and liver ALP. Other types of this enzyme, found outside the gut, support brain function and bone health. Both triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase, so cholesterol levels are correlated with enzyme activity [6]. The normal range of values of ALP differs by age and pregnancy status. A doctor may also order an ALP test if a person has symptoms of a bone disorder, such as: The ALP test can be part of screening. 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). What is a normal alkaline phosphatase level by age? SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. Procedure prep. You can learn more about how we ensure our content is accurate and current by reading our. J Clin Chem Clin Biochem 1983;21:731-48. Your doctor may want to find the source of high ALP levels, or explain why ALP is low. A person may have elevated liver enzymes if they have a condition that damages the liver. Available on: Severity grading in drug induced liver injury. 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. 3rd ed. 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). You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise. 25th ed. 2018;7:2. doi:10.4172/2167-0889.1000228. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. Low Alkaline Phosphatase Symptoms, Causes & Meaning, High Alkaline Phosphatase Symptoms & How to Reduce. 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. Best in Northern CA Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. Panteghini M, Bais R: Serum enzymes. Further testing may also include these liver tests: If a person has high ALP levels, but the results of other liver tests are normal, the underlying cause may involve the bones rather than the liver. St Louis, MO: Elsevier; 2017:chap 8. If this is pregnancy or bone development, no treatment is necessary. Learn about the causes of cirrhosis, diagnosis, prevention, and how to. For children, this range is under 350 U/L. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. Why normal levels can differ across different labs? What causes a high level of ALP in a blood test? The process is quick and typically causes little pain or discomfort. 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. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests. Joe Cohen flipped the script on conventional and alternative medicineand it worked. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. Caspian J Intern Med. Hypervitaminosis D may cause elevations in alkaline phosphatase. On their own, abnormal ALP values are not diagnostic but can provide a clue as to the underlying cause. What is an alkaline phosphatase level test? Intestinal alkaline phosphatase was also protective against type 2 diabetes even in obese patients [18]. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. All rights reserved. Lala V, Goyal A, Bansal P, Minter DA. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. What are the risks of an alkaline phosphatase level test? Alkaline phosphatase is used as a tumor marker. May include intervals based on age and sex when appropriate. (2021). Liver alkaline phosphatase can affect the measurement of bone specific alkaline phosphatase in this assay. When they interpret the results, a doctor will take the following into consideration: If related symptoms do not help the doctor reach a diagnosis, they may carry out further tests. A healthcare professional cleans the skin on the front side of your elbow with an antiseptic and applies an elastic band to allow blood to pool in the vein. Intestinal strangulation or obstruction, or ulcerative lesion. Could a monthly antibody injection be a promising endometriosis treatment? Cirrhosis, especially in primary biliary cirrhosis, in which fivefold or more increases are seen. Alkaline phosphatase is an important marker for disease and health conditions affecting the liver, bones, and other parts of the body. U.S. Department of health and human Services. Approach to a patient with elevated serum alkaline phosphatase. Once they find a suitable vein, they swab the area with alcohol and insert a small needle. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). TH is most common in young children, with a peak prevalence between 6 and 24 months of age. EJIFCC. They also can vary with age and sex. 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. Roche Diagnostics; 02/2012). 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. Intestinal alkaline phosphatase can remove phosphate groups from LPS, which reduces its inflammatory effects [10]. 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. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. 3. 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. You may feel slight pain or a sting when the needle is inserted. In rickets and osteomalacia, serum calcium and phosphorus are low to normal, and alkaline phosphatase may be normal or increased. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. The enzyme interacts with the gut, the food we eat, and the microbes found in our body. Peptic ulcer, erosion. Philadelphia, PA: Elsevier Saunders; 2016:chap 147. Our goal is to not have a single piece of inaccurate information on this website. Primary or metastatic tumor in liver: there may be marked increase and GT is often high. Stable Expression of the Alkaline Phosphatase Marker Gene by Neural Cells in Culture and after Transplantation into the CNS Using Cells Derived from a Transgenic Rat. ALP plays a role in numerous processes in the human body, and any abnormalities in blood concentrationseither high or lowmay be indicative of diseases ranging from gallstones and thyroid disease to hepatitis and cancer. Tumors, especially hypernephroma; neoplastic ectopic production (Regan, Nagao isoenzymes). In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to influence enzyme activity. Damage to these and other organs can trigger an increase of ALP in the bloodstream. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. (2013). Washington, DC: AACC Press; 1989:204. Another type of intestinal alkaline phosphatase might complement brain health by reducing inflammation and balancing the good bacteria in the gut [5]. Learn more about the foods and drinks that are good for liver health here. There are distinctive forms of ALP in the placenta and small intestine; hepatic, renal and osteoblast (bone) ALP are similar molecules. Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. Henry's Clinical Diagnosis and Management by Laboratory Methods. Bottom number is diastolic pressure when heart is at rest. Drugs estrogens (large doses), birth control agents, methyltestosterone, phenothiazines, oral hypoglycemic agents, erythromycin, or any drug producing hypersensitivity or toxic cholestasis. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. It is crucial to take these exactly as directed. 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. 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. Lowe D, et al. What is the normal alkaline phosphatase (ALP) level in the blood? Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. 0.17-0.66 nmol/L. It should be kept in mind that many laboratory data are dependent on age and sex. Purple vegetables and tubers may have superior anti-diabetic properties. . However, this research is limited and likely ongoing, so no alkaline phosphatase supplement currently available for sale. A similar increase is seen in patients with advanced primary liver cancer or widespread secondary hepatic metastases. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Serum ALP was the first enzyme to be used for the investigation of hepatic disease. In: Goldman L, Schafer AI, eds. This typically takes 1 to 2 days. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. Riancho-Aarrabeitia L, Garca-Unzueta M, Tenorio JA, et al. People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. Common Terminology Criteria for Adverse Events (CTCAE). Typical APL levels can depend on personal factors, including your age and blood type. 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. Values above 130 U/L are usually considered to be high. Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. It is present in the liver, bile ducts, bones, intestine and placenta. Other labs may consider the normal range to be 30120 IU/l. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. In: Burtis CA, Ashwood ER, eds. Cohen flipped the script on conventional and alternative medicineand it worked are dependent on age and sex appropriate... This is pregnancy or bone development in children and adolescents provided by UCSF health result these... 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