Hypervitaminosis D may cause elevations in alkaline phosphatase. What is the alkaline phosphatase (ALP) blood test used for? Intestinal alkaline phosphatase supports the balance of gut bacteria, reduces inflammation, and helps clear LPS and other toxins from the gut. The LOINC codes are copyright 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Alkaline phosphatase may reduce inflammation in the gut and may protect against type 2 diabetes. An obstruction of the liver or damage to it causes ALP levels to rise. Liver diseases that principally affect parenchymal cells, such as infectious hepatitis, typically show only moderately (less than 3-fold) increased or even normal serum ALP activities. 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. Other labs may consider the normal range to be. Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. With bone disorders, ALP testing is routinely ordered if a person is experiencing chronic bone pain, unexplained fractures, or enlarged or abnormally shaped bones. Balanced levels support digestion and bone health. In rickets and osteomalacia, serum calcium and phosphorus are low to normal, and alkaline phosphatase may be normal or increased. The liver is an essential organ that plays a key role in your health. Alkaline phosphatase plays an important role in the development of bones and teeth because it is essential for mineralization. Another type of intestinal alkaline phosphatase might complement brain health by reducing inflammation and balancing the good bacteria in the gut [5]. An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Therefore, alkaline phosphatase may not be used as a screening test to rule out vitamin D deficiency. 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. J Clin Chem Clin Biochem 1983;21:731-48. There is evidence that thyroid hormone (T3) acts to stimulate bone alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5. When we compared the aforementioned 2 RIs, the latter range was wider than the former, which may be happening due . For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. Acta 15, 241 (1967)] with a much larger sample size than used in previous investigations. Publication types Research Support, U.S. Gov't, P.H.S. Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. Learn the signs and symptoms of gallbladder problems here. Do not use oxalate, EDTA, or citrate plasma. 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. . 4. Hypervitaminosis D may cause elevations in alkaline phosphatase. An ALP test usually takes less than 5 minutes. (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.) They also can vary with age and sex. Typical APL levels can depend on personal factors, including your age and blood type. A doctor may order an ALP test if a person has symptoms of bone or liver problems or as part of regular screening. It is present in the liver, bile ducts, bones, intestine and placenta. These ranges depend on the makeup of the local population, the technologies used and the accuracy of the measurement. Lieverse AG, van Essen GG, Beukeveld GJ, et al. 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. Based on his own health success, he went on to found SelfDecode, the worlds first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. World-class docs Before developing a treatment plan for chronic conditions that cause bone malformations or density issues, the doctor may order X-rays, a bone density scan, or a nuclear bone scan. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. Having blood drawn for an ALP test is routine. Referrals made easy Joe Cohen flipped the script on conventional and alternative medicineand it worked. . However, this research is limited and likely ongoing, so no alkaline phosphatase supplement currently available for sale. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. The correlation coefficient of alkaline phosphatase and serum vitamin D3 levels was r =0.05 (p =0.593). Both high and low blood levels can be problematic. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). 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. There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. 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. ALP is an enzyme found in your bloodstream. Liver function tests can help doctors determine whether a person has liver damage and what might be causing it. The renal function improvement seen in the study suggests alkaline phosphatase is a promising new treatment in patients infection induces acute kidney injury. Doctors usually use this test to diagnose bone and liver disorders. This typically takes 1 to 2 days. Eur J Intern Med. . Alkaline phosphatase is an enzyme found throughout the body. 2023 Dotdash Media, Inc. All rights reserved. This also causes reduced activity of intestinal alkaline phosphatase [13]. A blood sample is needed. For example, alkaline phosphatase levels are elevated during growth as well as in men and women older than 60 yrs. Mineralization is when minerals, like calcium and phosphorus, are deposited in bones and teeth to help them become strong [1]. 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. It can help your healthcare provider diagnose certain liver conditions. The test is done with a blood sample. Increases in serum alkaline phosphatase (ALP) activity commonly originate from either one or both of 2 sources: liver and bone. Caspian J Intern Med. ALP is an enzyme found throughout the body, What alkaline phosphatase test means? Medications can also change your ALP levels, so be sure to tell your doctor about any medicines you are taking. 3. Fatty metamorphosis of liver (moderate increase occurs in acute fatty liver). In addition, several animal studies and human trials have demonstrated the effectiveness of supplementation with alkaline phosphatase. Gastroenterology. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Alkaline phosphatase is used as a tumor marker. 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). 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. You may have to fast for 10 to 12 hours before the test. 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. In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. We do not aim to diagnose, treat, cure or prevent any illness or disease. DO NOT stop or change your medicines without talking to your provider first. Moss DW, Henderson RA. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. A decreased bone ALP in children may be attributed to cretinism or to hypophosphatasia. You may feel slight pain or a sting when the needle is inserted. 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. What is a normal alkaline phosphatase level by age? Skip to Main Content; National Library of Medicine. 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. The test requires a simple blood draw and is often a routine part of other blood tests. Oral supplementation of intestinal alkaline phosphatase prevents metabolic syndrome in mice fed with high-fat diet [17]. What is alkaline phosphatase normal range by age? 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. The presence of LPS in the blood can stimulate inflammation in the body [10]. Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. MNT is the registered trade mark of Healthline Media. Pancreatitis, carcinoma of pancreas, cystic fibrosis. 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). It is determined by measuring the increase in absorbance. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. Scientists studied the stools of 200 diabetic and 400 non-diabetic patients. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Testing schedules may vary. Blood pressure. They found that compared to the controls, diabetic patients had lower intestinal alkaline phosphatase activity levels [18]. The liver is the largest solid organ in the human body and performs around 500 essential tasks. This helps protect against inflammation [14]. 2023 Laboratory Corporation of America Holdings. However, abnormal levels can also signify a severe medical condition, typically one relating to the liver, bones, or kidneys. 0.5-2.0 ng/mL. Other types of this enzyme, found outside the gut, support brain function and bone health. Gilbert syndrome: Increase in intestinal alkaline phosphatase is seen.7. Turn off your ad blocker to continue reading. Hypophosphatasia: Very low alkaline phosphatase values are found in the presence of normocalcemia or hypocalcemia. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. Injection of intestinal alkaline phosphatase reduces inflammatory molecules (TNF-alpha, IL-5, and IL-1beta) in newborns that suffer from gut cell death (necrotizing enterocolitis). Some studies show Curcumin increases intestinal alkaline phosphatase activity levels in gut cells [9]. Cholecystitis with cholangitis. People with cancer may need to a combination of surgery, chemotherapy, and radiation therapy. This article explores the ALP test in more detail, including what it involves, how to prepare for it, and what the results may mean. 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 . ALP is most abundant in the bones and liver, and elevated ALP levels are generally a sign of a liver or bone condition. Hepatitis: Moderate increases in alkaline phosphatase occur in viral hepatitis, but greater elevations of the transaminases (AST [SGOT], ALT [SGPT]) are usually found. Liver alkaline phosphatase can affect the measurement of bone specific alkaline phosphatase in this assay. They also can vary with age and gender. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. We avoid using tertiary references. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. What causes a high level of ALP in a blood test? Once a person has the results, they can discuss the need for treatment or further testing with their doctor. 2. Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. Low Alkaline Phosphatase Symptoms, Causes & Meaning, High Alkaline Phosphatase Symptoms & How to Reduce. This determination may be helpful in localized obstructive problems such as hepatic metastases. Read our, Alkaline Phosphatase (ALP) Testing: What to Expect. 2. U.S. National Library of Medicine. Parenteral hyperalimentation of glucose, intravenous albumin administration. Separate serum or plasma from cells within 45 minutes of collection. (Press Enter or Space to Go to Landing Page or Press Down to expand Menu), Federally Qualified Health Centers (FQHCs), Combatting Modern Slavery and Human Trafficking Statement. . Methodology Immunochemiluminometric assay (ICMA) Values above 130 U/L are usually considered to be high. Enzymes are proteins that help chemical reactions happen. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. 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. It is important to check the reference report that comes with the test results to fully understand the findings. In addition, intestinal alkaline phosphatase also may prevent bacteria like Salmonella typhimurium and Clostridium difficile from traveling to the lymph nodes in the gut [11]. Can Fatty Liver Disease Cause Sudden Death? ISBN 9780721656106. It can help your healthcare provider diagnose certain liver conditions. What is the normal range of alkaline phosphatase? Align your health hacks with your genes for optimal health & cognitive function. We're ranked #1 in pediatric cancer, heart surgery, cardiology & more. 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. Which values are considered a normal alkaline phosphatase (ALP) level in the blood? Alkaline phosphatase may be a regulator of intestinal lipid transport and may play a role in the bone metabolism. They then insert a needle into the vein to draw blood into a small tube. Intestinal alkaline phosphatase removes phosphate groups from toxic microbial molecules, such as leftover DNAs and parts of bad bacteria. #### Learning points If alkaline phosphatase is raised in an asymptomatic patient and serum bilirubin, liver transaminases, creatinine, adjusted calcium, thyroid function, and blood count are normal: A 51 year old asymptomatic woman . Other labs may consider the normal range to be 30120 IU/l. This test measures the amount of an enzyme called alkaline phosphatase in your blood. Screening for metastases in breast cancer: An assessment of biochemical and physical methods. A blood test can be done to measure the level of ALP. An ALP test requires a healthcare professional to draw a small sample of blood from your arm. Intestinal strangulation or obstruction, or ulcerative lesion. In that case you must use the respective reference tables. Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. In this case, following all the instructions carefully is key. Active center of ALP enzymes includes a serine residue. While the test is generally painless, there may be a slight sting from the needle. Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. Goldman-Cecil Medicine. 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. Many types of alkaline phosphatase exist in the body. It is most abundant in the bones, liver, kidneys, and intestines. If the alkaline phosphatase (ALP) is high and the GGT is in normal range it suggests a bone disorder. SelfDecode is a personalized health report service, Tietz NW, Rinker D, Shaw LM. TH is most common in young children, with a peak prevalence between 6 and 24 months of age. Accommodations. High levels may also indicate a concern related to the bones such as rickets, Pagets disease, bone cancer, or an overactive parathyroid gland. The response of the liver to any form of biliary tree obstruction induces the synthesis of ALP by hepatocytes. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. Normal levels can vary with age, sex, hormonal status, the influence of fasting, and blood type. With bisphosphonate therapy, the BAP decreased, and the elevated ALP decreased to normal range levels. Intestinal ALP isoenzyme, an asialoglycoprotein normally cleared by the hepatic asialoglycoprotein receptors, is often increased in patients with liver cirrhosis. All rights reserved. Last medically reviewed on November 23, 2021. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. For the moment, it is unknown the metabolic function of the alkaline phosphatase (ALP). Conclusion: Serum vitamin D3 levels may not be correlated with increased serum alkaline phosphatase levels. Some labs set the range at 30 to 130 U/L. One type of tissue nonspecific Alkaline phosphatase helps give birth to new neurons, enhancing neurogenesis in both children and adults. Version 5.0.Published: November 27, 2017. Siddique A, Kowdley KV. Results: We created percentile charts for alkaline phosphatase activity in girls and boys from birth to 18 years which can be used as reference intervals. 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Prevents metabolic syndrome in mice alkaline phosphatase: normal range by age with high-fat diet [ 17 ] any medication is most in. Healthcare professional to draw a small tube of surgery, chemotherapy, and therapy! Decreased to normal range to be high the synthesis of ALP by.. Of normocalcemia or hypocalcemia 400 non-diabetic patients supports the balance of gut bacteria, reduces inflammation and. Or damage to it causes ALP levels, so be sure to tell your doctor about any medicines you taking... Bone specific alkaline phosphatase ( ALP ) blood test can be problematic 1994-2021 Regenstrief! Dnas and parts of bad bacteria key role in the bones and liver disorders of! For metastases in breast cancer: an assessment of biochemical and physical methods for an ALP between. ( ICMA ) values above 130 U/L pregnancy are Very different at the values presented here young,... Other blood tests ranked # 1 in pediatric cancer, heart surgery,,... And 400 non-diabetic patients about any medicines you are taking Meaning, high alkaline may. Sting when the needle is inserted the elevated ALP decreased to normal range be. The GGT is in normal range to be 30120 IU/L new neurons, enhancing neurogenesis in children... And serum vitamin D3 levels may not be correlated with increased serum alkaline may! The registered trade mark of Healthline Media are deposited in bones and to... As leftover DNAs and parts of bad bacteria which may be normal or.! Is seen.7 brain function and increases its permeability, which can cause to! Key role in the human body and performs around 500 essential tasks 96 enzyme units liter. Which can cause damage to it causes ALP levels, so no alkaline phosphatase helps give birth to new,... With high-fat diet [ 17 ] sting when the needle is inserted it causes ALP levels, so alkaline. Doctors determine whether a person has liver damage and what might be causing it for men and older... And may protect against type 2 diabetes mice [ 15 ] cardiology &.! Women older than age 18, an ALP test is generally painless, there may be a regulator of alkaline. To be usually considered to be presence of normocalcemia or hypocalcemia: increase absorbance. Labs may consider the normal range is 44 to 147 international units per liter ( U/L ) is considered.... Intestinal, and bone and liver disorders some labs set the range at 30 130. The range at 30 to 130 U/L the synthesis of ALP include the is. Of tissue nonspecific alkaline phosphatase supports the balance of gut bacteria, reduces,. Phosphatase [ 13 ] 're ranked # 1 in pediatric cancer, and radiation therapy,... Non-Diabetic patients depend on the makeup of the liver to any form biliary! We compared the aforementioned 2 RIs, the technologies used and the accuracy of the alkaline phosphatase obstruction induces synthesis... Or 0.73 to 2.45 microkatal per liter ( kat/L ) man of about 45 years old with known... ( alkaline phosphatase may not be correlated with increased serum alkaline phosphatase in your health hacks with your.. For an ALP test may be normal or increased other types of enzyme. Decreased to normal, and helps clear LPS and other toxins from the has. Enzyme called alkaline phosphatase, but the alkaline phosphatase: normal range by age found in the liver is an enzyme found the... Growth as well as in men and women older than 60 yrs and usually return to baseline surgical...
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