If you experience this complication, apply a warm compress until the swelling goes down. 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. If the results of the test are inconclusive, your doctor may order a follow-up test. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. A medical professional may have to do more tests to offer a diagnosis and treatment plan. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. Sclerosing cholangitis (eg, with ulcerative colitis), although importantly, 3% of cases of symptomatic sclerosing cholangitis may have normal serum ALP.6 Endoscopic retrograde cholangiography might be considered then in patients with diseases known to be associated with primary sclerosing cholangitis and with appropriate symptomatology even though ALP level is normal. Last medically reviewed on November 5, 2021. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. 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. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. If ALP comes back high, the doctor may order the ALP isozyme test to see which specific type of alkaline phosphatase is elevated. The ALP isozyme test can distinguish between the bone and liver ALP. While the test is generally painless, there may be a slight sting from the needle. There are very few risks associated with having your blood drawn. Turnaround time may be longer or shorter depending on how quickly your doctor needs the results. ALP is present (in decreasing order of abundance) in placenta, intestine, kidney, bone and liver. Alkaline phosphatase (S, P) Age M/F (U/L) 0-5 days 110-300 6 days -11 months 110-320 1-3yrs 145-320 4-6yrs 150-380 7-9yrs 175-420 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. In rickets and osteomalacia, serum calcium and phosphorus are low to normal, and alkaline phosphatase may be normal or increased. 6. When the results of your ALP test are in, your doctor will discuss them with you and suggest what to do next. When the liver is not functioning properly, ALP is released into the bloodstream and the level increases significantly. This typically takes 1 to 2 days. Learn the signs and symptoms of gallbladder problems here. . Mg and Zn ions are required for minimal activity. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. In: Rifai N, Horvath AR, Wittwer C, eds. Treating antibiotic-treated mice with intestinal alkaline phosphatase (IAP) before Salmonella and Clostridium infection protects the mice from the infection, suggesting that it helped to rapidly restore gut flora. Best in Northern CA If the alkaline phosphatase (ALP) is high and the GGT is in normal range it suggests a bone disorder. An abnormally high bone isoenzyme level may also be indicative of bone cancer, osteomalacia, or celiac sprue. It may also signal malnutrition, which could be caused by celiac disease or an insufficient amount of certain vitamins and minerals. 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. In rare cases, phlebitis (inflammation of the vein) may develop. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. The LOINC codes are copyright 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Inform your doctor before your blood is taken if you have any bleeding disorders or take any blood thinners. ALP tests are quick and usually have no adverse effects. 2012;3(3):478-83. In addition, several animal studies and human trials have demonstrated the effectiveness of supplementation with alkaline phosphatase. Can Fatty Liver Disease Cause Sudden Death? Why normal levels can differ across different labs? The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. For example, alkaline phosphatase levels are elevated during growth as well as in men and women older than 60 yrs. The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. 2014;29(3):269-78. doi:10.1007/s12291-013-0408-y. Align your health hacks with your genes for optimal health & cognitive function. Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. Other labs may consider the normal range to be 30120 IU/l. High levels may also indicate a concern related to the bones such as rickets, Pagets disease, bone cancer, or an overactive parathyroid gland. Alkaline phosphatase is used as a tumor marker. ALP tests are generally accurate, but they only show part of the picture. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). 2014; 147: pp. Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. The treatment for abnormal ALP levels depends on the cause. Learn where its typically located, why it occurs, and what to do about it. Lindsay Cook, PharmD is a board-certified consultant pharmacist. Sato K, Han DC, Fujii Y, Tsushima T, Shizume K. Thyroid hormone stimulates alkaline phosphatase activity in cultured rat osteoblastic cells (ROS 17/2.8) through 3,5,3-tri-iodo-L-thyronine nuclear receptors. Lammers WJ, van Buuren HR, Hirschfield GM, et al: Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: An international follow-up study. Alkaline phosphatase is an enzyme found in all tissues in the human body but is mostly concentrated in the bones, kidneys, liver, intestines, and placenta. 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. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. 523. ALP is also found in the placenta, kidneys . Each 100 U/L of liver alkaline phosphatase contributes an additional 2.5 to 5.8 g/L to the bone specific alkaline phosphatase result. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. Looks like youre visiting Benioff Children's Hospitals on Internet Explorer. Narayanan S. Alkaline phosphatase as tumor marker. Normal values may vary slightly from laboratory to laboratory. We'll help you find the best provider for your child. Hepatitis: Moderate increases in alkaline phosphatase occur in viral hepatitis, but greater elevations of the transaminases (AST [SGOT], ALT [SGPT]) are usually found. 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. Values obtained with different assay methods should not be used interchangeably in serial testing. DO NOT stop or change your medicines without talking to your provider first. They are secretors of ABH RBC antigens and also carry the Lewis red cell antigen. 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. All rights reserved. There is also a bone-specific blood test, called bone alkaline phosphatase (BAP), that detects a type of ALP released in the blood from bone. In rare cases, high ALP levels can indicate heart failure, kidney cancer, other cancers, mononucleosis, or a bacterial infection. Alkaline phosphatase may strengthen the intestinal barrier and help remove inflammatory toxins from the gut. P2.5-P97 reference ranges for alkaline phosphatase in healthy boys. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Philadelphia, PA: Elsevier Saunders; 2016:chap 147. We are dedicated to providing the most scientifically valid, unbiased, and comprehensive information on any given topic. What are the risks of an alkaline phosphatase level test? Verywell Health's content is for informational and educational purposes only. Intestinal alkaline phosphatase supports the balance of gut bacteria, reduces inflammation, and helps clear LPS and other toxins from the gut. Your email address will not be published. For instance, they can break big molecules down into smaller parts, or they. Serum alkaline phosphatase is a member of a family of zinc metalloprotein enzymes that function to split off a terminal phosphate group from an organic phosphate ester. Goldman-Cecil Medicine. It is present in the liver, bile ducts, bones, intestine and placenta. IFCC methods for the measurement of catalytic concentration of enzymes Part 5. Normal values may vary slightly from laboratory to laboratory. The presence of LPS in the blood can stimulate inflammation in the body [10]. Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? Hypophosphatasia: Very low alkaline phosphatase values are found in the presence of normocalcemia or hypocalcemia. Higher ALP levels can occur in people with blood group B or blood group O [7]. Note that each number in parentheses [1, 2, 3, etc.] Doctors usually use this test to diagnose bone and liver disorders. In: Burtis CA, Ashwood ER, eds. We've got you covered. If serial monitoring is required, please use the serial monitoring number 480004 to order. Many bad bacteria which are gram-negative have lipopolysaccharides (LPS) that can trigger either an acute infection episode (sepsis) or chronic inflammation. Damage to these and other organs can trigger an increase of ALP in the bloodstream. It measures the amount of ALP in the blood, and abnormal levels can indicate an underlying health condition. Alkaline phosphatase is an important marker for disease and health conditions affecting the liver, bones, and other parts of the body. Alkaline phosphatase is routinely tested whenever a disease is suspected in the liver, bones, gallbladder, kidneys, or intestines. It is important to check the reference report that comes with the test results to fully understand the findings. Nathan, David G. Some laboratories use different measurements or may test different specimens. It is worth noting that a person may have elevated ALP levels but no underlying health problem. Pregnancy can elevate the alkaline phosphatase (ALP) level in the blood because the placenta can produce ALP. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. Hansen YBL. Comment * document.getElementById("comment").setAttribute( "id", "a33f978dc4cc620bb3fe046565be12d1" );document.getElementById("a6cbe26769").setAttribute( "id", "comment" ); Save my name, email, and website in this browser for the next time I comment. (1) Alkaline phosphatase is an enzyme. We do not aim to diagnose, treat, cure or prevent any illness or disease. 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"). 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. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. 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. 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. 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). Researchers still do not know the full range of ALPs functions, but it seems to contribute to many processes, such as: ALP levels are measured in international units per liter (IU/l). A blood sample is needed. Sharma U, et al. What causes a high level of ALP in a blood test? for updated normal ranges. Alkaline phosphatase (ALP) is a protein found in all body tissues. Enzyme serves a biomarker for liver, bone, and other diseases. 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