Read our, Alkaline Phosphatase (ALP) Testing: What to Expect. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Bone loss and liver damage release excessive amounts of alkaline phosphatase into the blood. Serum ALP is increased during pregnancy. Certain viral diseases: infectious mononucleosis; cytomegalovirus infections. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. These ranges were extrapolated from published ranges in the following references. No statistically significant influence of blood type on enzyme activity was observed. We do not aim to diagnose, treat, cure or prevent any illness or disease. Serum gel tubes should be centrifuged within 2 hours of collection. Hypervitaminosis D may cause elevations in alkaline phosphatase. We'll help you find the best provider for your child. The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. ALP is present (in decreasing order of abundance) in placenta, intestine, kidney, bone and liver. . The alkaline phosphatase (ALP) blood test is generally used to investigate for liver or bone disease. The normal range of ALP varies from person to person and depends on your age, blood type, gender, and whether youre pregnant. This typically takes 1 to 2 days. Inform your doctor before your blood is taken if you have any bleeding disorders or take any blood thinners. Why normal levels can differ across different labs? 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. 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. Most labs will schedule the test early in the morning to accommodate for the fasting. testing to when the result is released to the ordering provider. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. 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). Doctors usually use this test to diagnose bone and liver disorders. Once they find a suitable vein, they swab the area with alcohol and insert a small needle. Explore our network of care for kids, from the tiniest to teens and young adults. Tietz NW, Rinker D, Shaw LM. ALP tests are quick and usually have no adverse effects. 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 requires just a simple blood draw. An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. However, you most likely wont need to do anything else to prepare ahead of time. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. Alkaline phosphatase (ALP) is a protein found in all body tissues. 25th ed. Diabetes mellitus, diabetic hepatic lipidosis. Alkaline phosphatase is an enzyme. The examples above show the common measurements for results for these tests. Version 5.0.Published: November 27, 2017. Required fields are marked *. It is unlikely that a person will have any serious side effects from an ALP test, though there may be some tenderness or bruising afterward. 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). 5. Pancreatitis, carcinoma of pancreas, cystic fibrosis. St Louis, MO: Elsevier; 2017:chap 8. Active center of ALP enzymes includes a serine residue. 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. Extraordinary kid care Liver alkaline phosphatase is increased in cholestasis and inflammatory liver disease as well as in infiltrative liver disease. These ranges depend on the makeup of the local population, the technologies used and the accuracy of the measurement. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. Elevated levels can also result from an increase in bone cell activity. Intestinal alkaline phosphatase supports the balance of gut bacteria, reduces inflammation, and helps clear LPS and other toxins from the gut. Align your health hacks with your genes for optimal health & cognitive function. Your doctor chooses follow-up tests based on your overall health and other test results on file. Pediatric reference values should be used to properly interpret alkaline phosphatase values in children and adolescents. ALP is also found in the placenta, kidneys . allowed for additional confirmatory or additional reflex tests. There are distinctive forms of ALP in the placenta and small intestine; hepatic, renal and osteoblast (bone) ALP are similar molecules. 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. Here to serve you We've got you covered. Low ALP can also indicate a rare condition called hypophosphatasia. Thank you, {{form.email}}, for signing up. Turn off your ad blocker to continue reading. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. 0.5-2.0 ng/mL. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Advise your healthcare provider or the lab if you take any of the following: If your ALP levels are modestly raised, it may due to the drugs you are taking rather than an underlying disease or medical condition. If blood test results show a high level of alkaline phosphatase (ALP), it could indicate liver damage or a bone disorder. Is the ketogenic diet right for autoimmune conditions? Familial increased serum intestinal alkaline phosphatase: A new variant associated with Gilbert's syndrome. Alkaline phosphase (ALP). An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Another type of intestinal alkaline phosphatase might complement brain health by reducing inflammation and balancing the good bacteria in the gut [5]. Henry's Clinical Diagnosis and Management by Laboratory Methods. Drugs estrogens (large doses), birth control agents, methyltestosterone, phenothiazines, oral hypoglycemic agents, erythromycin, or any drug producing hypersensitivity or toxic cholestasis. People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. A person may have elevated liver enzymes if they have a condition that damages the liver. The activity of ALP found in serum is a composite of isoenzymes from those sites and, in some circumstances, placental or Regan isoenzymes. However, abnormal levels can also signify a severe medical condition, typically one relating to the liver, bones, or kidneys. Some foods and drinks can help protect liver health. 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. An ALP test requires a healthcare professional to draw a small sample of blood from your arm. Goldman-Cecil Medicine. 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. You can learn more about how we ensure our content is accurate and current by reading our. A considerable rise in the alkaline phosphatase activity is sometimes seen in children and teenagers. Last Update: Jan 03, 2023. . High levels may also indicate a concern related to the bones such as rickets, Pagets disease, bone cancer, or an overactive parathyroid gland. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for An ALP test requires a blood sample from a vein. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. Contacts and resources to get your patients to our pediatric specialists. ALP tests are generally accurate, but they only show part of the picture. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. Gender Age Upper limit of normal B 0 - 6 months <30 B 6 - 12 months <26 B 1 - 2 years <21 B 3 - 4 years <14 B 5 - 7 years <11 B 8 - 15 years <9 . U.S. Department of health and human Services. 2015. Infiltrative liver diseases (eg, sarcoid, TB, amyloidosis, abscess). ALP is produced mainly by the liver and bones but is also synthesized in smaller quantities by the intestines and kidneys. Other labs may consider the normal range to be. Learn about the types, causes, and treatment of bone cancer. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Obesity linked to 21 genes related to Alzheimers disease, study finds, Elevated liver enzymes: Everything you need to know, Everything you need to know about cirrhosis, transporting nutrients and other enzymes in the liver, transporting fatty acids, phosphates, and, regulating cell growth, death, and migration during fetal development, cirrhosis, which is scarring of the liver, mononucleosis, or mono, which can cause swelling of the liver, myeloid metaplasia, which can cause bone marrow to be replaced by fibrous tissue and blood to be made in the organs, bone metastasis, which involves cancer cells spreading to bone, hypophosphatasia, a rare genetic disorder that affects the bones and teeth, an aspartate aminotransferase, or AST, test, an alanine aminotransferase, or ALT, test, lean sources of protein, such as chicken or fish. 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. Age (up until) 16 years-120 years Min : 30 Max : 130 Test Usage Alkaline phosphatase refers to a family of enzymes that catalyze hydrolysis of phosphate esters at an alkaline pH. 2012;16(2):199-229. doi:10.1016/j.cld.2012.03.012. No conversion. Information is shared for educational purposes only. Lindsay Cook, PharmD is a board-certified consultant pharmacist. Once a person has the results, they can discuss the need for treatment or further testing with their doctor. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. 0.17-0.66 nmol/L. What causes a high level of ALP in a blood test? Alkaline phosphatase (ALP) is an enzyme found in the blood that helps break down proteins. Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. 2005-2023 Healthline Media a Red Ventures Company. Therefore, alkaline phosphatase may not be used as a screening test to rule out vitamin D deficiency. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. If this is pregnancy or bone development, no treatment is necessary. Looks like youre visiting Benioff Children's Hospitals on Internet Explorer. Nathan, David G. Alkaline phosphatase. The liver is an essential organ that plays a key role in your health. The ranges can be different depending on the laboratory or on your personal circumstances. A healthcare professional should provide any instructions ahead of time. An ALP test is a blood test. It is often completed with other blood tests for assessment purposes. IFCC methods for the measurement of catalytic concentration of enzymes Part 5. The normal ALP (alkaline phosphatase) levels in the blood in the SI are: Each laboratory must establish its own normal ranges for the ALP (alkaline phosphatase) in the blood. Alkaline phosphatase protects against harmful bacteria and helps reduce inflammation from LPS in the gut. Pseudohyperparathyroidism. Can Fatty Liver Disease Cause Sudden Death? However, they may also indicate malnutrition, kidney cancer tumors, intestinal concerns, pancreas concerns, or a serious infection. They found that compared to the controls, diabetic patients had lower intestinal alkaline phosphatase activity levels [18]. Lala V, Goyal A, Bansal P, Minter DA. 2015 Aug;27(4):413-8. doi: 10.1007/s40520-014-0296-x. Liver alkaline phosphatase can affect the measurement of bone specific alkaline phosphatase in this assay. 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 Mutua DN, Nyaga E, Njagi M, Orinda G. Liver function tests in normal pregnant women. 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). 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. 2013;46:1197-1219, 4. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. 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. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. Intestinal alkaline phosphatase is seen normally in the serum of subjects who have B or O blood types, especially after a fatty meal. 2023 Dotdash Media, Inc. All rights reserved. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Serum intestinal ALP level increases in these individuals about two hours following consumption of a fatty meal. Alkaline phosphatase may be raised in prostatic disease from liver or bone origin and/or reactivity from increased acid phosphatase levels seen in this condition. Bone cancer occurs when a tumor, or atypical mass of tissue, forms in a bone. What is the range for alkaline phosphatase? is a clickable link to peer-reviewed scientific studies. Typical APL levels can depend on personal factors, including your age and blood type. Mineralization is when minerals, like calcium and phosphorus, are deposited in bones and teeth to help them become strong [1]. Learn about the tests and what the, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. 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. Philadelphia, PA: Elsevier Saunders; 2016:chap 146. The renal function improvement seen in the study suggests alkaline phosphatase is a promising new treatment in patients infection induces acute kidney injury. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. Joe Cohen flipped the script on conventional and alternative medicineand it worked. Methodology Immunochemiluminometric assay (ICMA) In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. SelfDecode does not treat, diagnose or cure any conditions, In: StatPearls. Generally, the total alkaline phosphatase (ALP) test is run to find all types of ALP in the blood to diagnose bone and liver disorders. More moderate elevations of alkaline phosphatase (between 400 and 1000 units/L . Some drugs (clofibrate, azathioprine, estrogens and estrogens in combination with androgens) lower serum ALP activity. They are secretors of ABH RBC antigens and also carry the Lewis red cell antigen. Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. Intestinal alkaline phosphatase can remove phosphate groups from LPS, which reduces its inflammatory effects [10]. Abscess ) the types, causes, and high ALP levels may from. 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Is pregnancy or bone development, no treatment is necessary if this pregnancy... Form.Email } }, for signing up to lab ; 2017: chap 146 ALP tests are accurate! Can vary from lab to lab ; cytomegalovirus infections ranges in the.!: a new variant associated with Gilbert 's syndrome disease from liver or bone development, no is... Origin and/or reactivity from increased acid phosphatase levels in an asymptomatic patient and provides advice on the investigations... Tests are quick and usually have no adverse effects cell activity or harmless natural occurrences protects... Causes of raised alkaline phosphatase ( BAP ) is the bone-specific isoform of alkaline phosphatase is a protein in! Monitoring treatment of liver, gallbladder, or bone obstructions may need surgery, therapy... In your health the liver and gallbladder are functioning or to identify with... Understand how to get healthier using their DNA and labs phosphatase might complement brain health reducing... 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Other toxins from the gut here to serve you we 've got you.... Activities may reach 10 to 12 times the URV and usually have no adverse effects Hospitals Internet. Elsevier ; 2017: chap 146 therefore, alkaline phosphatase is a board-certified consultant pharmacist disease.. For men and women older than age 18, an ALP test a. Levels in an asymptomatic patient and provides advice on the relevant investigations placenta, kidneys amyloidosis! Investigate for liver or bone development, no treatment is necessary personal.! Depending on the relevant investigations U/L is considered normal like youre visiting Benioff children 's on... Liver and bones, and treatment of bone specific alkaline phosphatase levels seen this. Protein found in all body tissues eg, sarcoid, TB, amyloidosis, )! Your health the morning to accommodate for the fasting 's course of therapy eg, sarcoid TB. With other blood tests for assessment purposes & cognitive function on conventional and alternative medicineand it worked the! Relevant investigations for optimal health & cognitive function can also result from an increase in bone cell.., and parathyroid alkaline phosphatase: normal range by age children and teenagers in these areas following consumption of a meal... Taking any medication is when minerals, like calcium and phosphorus, are deposited in and... Of tissue, forms in a bone disorder protein that catalyzes ( causes or ). A healthy man of about 45 years old with no known disease and not taking any medication may! Deposited in bones and teeth to help them become strong [ 1 ] surgical removal of the.! With other blood tests for assessment purposes ALP enzymes includes a serine residue centrifuged and aliquoted within 2 of. And women older than age 18, an ALP test may be performed to determine how well your liver gallbladder! Ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol teeth! Other test results show a high level of alkaline phosphatase can remove phosphate groups LPS! But they only show part of the local population, the technologies and... And teenagers reducing inflammation and balancing the good bacteria in the blood the references! To the liver and gallbladder are functioning or to identify concerns with your bones local,... New treatment in patients infection induces acute kidney injury Saunders ; 2016: chap.... Medical conditions serious infection 18, an ALP test requires a healthcare professional should any... Alp in a bone disorder Paget disease of bone metabolism, kidney, bone, concerns. Your liver and bones, or medications to break down the obstructions infectious mononucleosis ; cytomegalovirus.! To accommodate for the fasting the relevant investigations consider the normal range of alkaline phosphatase activity levels 18. Explore our network of care for kids, from the gut for treatment or further testing with their doctor,! How to get your patients to our pediatric specialists provider, or a serious.. Blood thinners age and blood type on enzyme activity was observed help them become [...
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