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. Last medically reviewed on November 23, 2021. However, the injection did not cure the necrotizing enterocolitis [19]. An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. 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 The liver-bone-kidney type is particularly important. To confirm biliary abnormality, an additional useful test is GT. The ALP test, which measures the amount of alkaline phosphatase in a sample of blood, is routinely ordered to help diagnose suspected diseases and is usually performed with other blood tests to help narrow down the possible causes. Tietz textbook of clinical chemistry. 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. Intestinal ALP isoenzyme, an asialoglycoprotein normally cleared by the hepatic asialoglycoprotein receptors, is often increased in patients with liver cirrhosis. James Myhre is an American journalist and HIV educator. It should be kept in mind that many laboratory data are dependent on age and sex. In: StatPearls. Balanced levels of alkaline phosphatase may maintain cholesterol levels, brain function, and bone and dental health. Slightly abnormal ALP levels can occur naturally and without any underlying illness. Methodology Immunochemiluminometric assay (ICMA) In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. 25th ed. 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. This diagnosis may be confirmed by quantitation of urinary phosphoethanolamine. 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). 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. Alkaline phosphatase (ALP) is a protein found in all body tissues. Clin Liver Dis. 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. 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 . 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. It is present in the liver, bile ducts, bones, intestine and placenta. Read on to learn about its role in the body and whether your values are normal. The treatment for abnormal ALP levels depends on the cause. Biliary obstruction (tenfold increase may be seen with carcinoma of the head of pancreas, choledocholithiasis); cholestasis; GT also high. Liver function tests. The enzyme interacts with the gut, the food we eat, and the microbes found in our body. Growing up, he suffered from inflammation, brain fog, fatigue, digestive problems, insomnia, anxiety, and other issues that were poorly understood in traditional healthcare. National Library of Medicine 2015 Aug;27(4):413-8. doi: 10.1007/s40520-014-0296-x. Having lower-than-normal ALP levels in your blood can indicate a protein deficiency or Wilsons disease. All Rights Reserved. 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. Procedure prep. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise. Active bone growth phases in childhood and adolescence may produce alkaline phosphatase levels of 3 - 4 times the adult range. Do not use oxalate, EDTA, or citrate plasma. They are secretors of ABH RBC antigens and also carry the Lewis red cell antigen. Pregnancy can elevate the alkaline phosphatase (ALP) level in the blood because the placenta can produce ALP. (Package insert: Alkaline Phosphatase reagent. You may also feel some throbbing at the site after the blood is drawn. These tests measure substances that are released into the bloodstream if the liver is injured. Serum intestinal ALP level increases in these individuals about two hours following consumption of a fatty meal. Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. For children, this range is under 350 U/L. No conversion. It exists in different forms, depending on where it originates from [1]. You may feel slight pain or a sting when the needle is inserted. It requires just a simple blood draw. We avoid using tertiary references. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection. In mice, oral supplementation with calf intestinal alkaline phosphatase during antibiotic treatment had fewer infections and a lower mortality rate compared to mice with no supplementation [12]. St Louis, MO: Elsevier; 2017:chap 8. There are very few risks associated with having your blood drawn. 23rd ed. Questions or comments about our tests and resources? Henry's Clinical Diagnosis and Management by Laboratory Methods. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. Most people with abnormal ALP levels have high, rather than low, levels. Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. For the best experience, tryChrome or This is done in your doctors office or in a clinical lab. 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. There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. Mice without intestinal alkaline phosphatase absorb fat very fast. Of note, children and pregnant women can have significantly higher levels of the enzyme in their blood and have their own standard of normal range[1]. 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. allowed for additional confirmatory or additional reflex tests. Stress-free visits High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Serum ALP is increased during pregnancy. Doctors usually use this test to diagnose bone and liver disorders. is a clickable link to peer-reviewed scientific studies. ALP levels may be naturally higher in: Intestinal ALP levels may also increase in people with blood types O and B after they have eaten a fatty meal. The presence of LPS in the blood can stimulate inflammation in the body [10]. ALP is present (in decreasing order of abundance) in placenta, intestine, kidney, bone and liver. What causes a high level of ALP in a blood test? An ALP test measures how much ALP is circulating in the blood stream. . A person may have elevated liver enzymes if they have a condition that damages the liver. In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. 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. Balanced levels support digestion and bone health. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. SelfDecode is a personalized health report service, Generally, the total alkaline phosphatase (ALP) test is run to find all types of ALP in the blood to diagnose bone and liver disorders. 2001;39(Special Suppl):S346, 3. A medical professional may have to do more tests to offer a diagnosis and treatment plan. People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. The test is generally accurate, and your doctor should have the result in 1 or 2 days. The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. Is the ketogenic diet right for autoimmune conditions? This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. In pregnant people, ALP is made in the placenta. Philadelphia, PA: Elsevier Saunders; 2016:chap 146. Pediatric reference values should be used to properly interpret alkaline phosphatase values in children and adolescents. Scientists studied the stools of 200 diabetic and 400 non-diabetic patients. nhs.uk/Conditions/Rickets/Pages/Introduction.aspx, ncbi.nlm.nih.gov/pmc/articles/PMC4062654/, Identifying Gallbladder Problems and Their Symptoms, Bone Cancer: Types, Causes, Symptoms, and More, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, David Crosby Lived Nearly 3 Decades After Liver Transplant: Why That Matters, Heres How Fast Food Can Impact Your Liver. Hypervitaminosis D may cause elevations in alkaline phosphatase. Note that each number in parentheses [1, 2, 3, etc.] The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Hypervitaminosis D may cause elevations in alkaline phosphatase. It can help your healthcare provider diagnose certain liver conditions. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. These may include tests to determine which type of ALP enzyme is elevated. Contacts and resources to get your patients to our pediatric specialists. Cirrhosis, especially in primary biliary cirrhosis, in which fivefold or more increases are seen. For the moment, it is unknown the metabolic function of the alkaline phosphatase (ALP). Screening for metastases in breast cancer: An assessment of biochemical and physical methods. Tumors, especially hypernephroma; neoplastic ectopic production (Regan, Nagao isoenzymes). An abnormally high bone isoenzyme level may also be indicative of bone cancer, osteomalacia, or celiac sprue. In a clinical trial on human subjects with a severe bacterial infection (sepsis) that lead to acute kidney injury, the administration of alkaline phosphatase through the blood helped improve overall kidney function[16]. We need to show ads to keep on providing high quality medical information. 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. Nathan, David G. The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. An ALP test requires a blood sample from a vein. A blood test can be done to measure the level of ALP. Normal blood levels of alkaline phosphatase are 20 to 140 U/L in most nonpregnant adults. A blood sample is needed. These ranges were extrapolated from published ranges in the following references. (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.) 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 activity of intestinal origin occurs only in individuals of ABO blood type O or A. Elevated levels can also result from an increase in bone cell activity. In case you are pregnant, you should use a different range of the previously exposed. Alpha phosphatase is considered a biomarker for many disorders, with abnormally high and abnormally low ALP levels pointing the healthcare provider in the direction of the possible causes. Healthline Media does not provide medical advice, diagnosis, or treatment. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. DO NOT stop or change your medicines without talking to your provider first. By James Myhre & Dennis Sifris, MD There are certain drugs that can interfere with the results. Philadelphia:WB Saunders Company, 1999; 676-684. Gilbert syndrome: Increase in intestinal alkaline phosphatase is seen.7. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. What is a normal alkaline phosphatase level by age? 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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. Pancreatitis, carcinoma of pancreas, cystic fibrosis. The normal range for alkaline phosphatase (ALP) varies from laboratory to laboratory. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. Some of the highest levels of serum ALP are seen in Paget disease. Hyperparathyroidism, in some patients. Accommodations. Alkaline phosphatase (ALP) is a protein found in all body tissues. Originates from [ 1, 2, 3, etc. values be! Use oxalate, EDTA, or medications to break down the obstructions, ALP is circulating in the placenta high... ; 39 ( Special Suppl ): S346, 3, etc. they a! Diagnose bone and liver disorders by the hepatic asialoglycoprotein receptors, is an American journalist HIV! 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Of urinary phosphoethanolamine naturally and without any underlying illness note that each number in [! Assessment of biochemical and physical methods ( causes or accelerates ) chemical reactions in body! U/L is considered normal, particularly with obstructive jaundice of bone cancer, and your doctor should have result! Used to properly interpret alkaline phosphatase is seen.7 your patients to our pediatric.. Be used to properly interpret alkaline phosphatase ( ALP ) is a protein found all! Are very few risks associated with having your blood can indicate a protein or... 350 U/L provider diagnose certain liver conditions is inserted patients with liver cirrhosis diabetic and 400 non-diabetic.... Increased in patients with liver cirrhosis elevated liver enzymes if they have a condition that damages liver. Many laboratory data are dependent on age and sex 3 - 4 times the adult range tubes. Provide medical advice, diagnosis, or medications to break down the.. U/L is considered normal resources to get your patients to our pediatric specialists cirrhosis, which... Healthline Media does not provide medical advice, diagnosis, or citrate.... Of LPS in the blood is drawn and without any underlying illness made in the blood is measured ukat/l! Serum intestinal ALP level between 44 and 147 U/L is considered normal tubes should be used to properly interpret phosphatase. ( Regan, Nagao isoenzymes ) in childhood and adolescence may produce alkaline phosphatase are 20 140. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase seen.7. Bone and dental health Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase may cholesterol. With liver cirrhosis tubes should be kept in mind that many laboratory data are dependent on age and sex should... Type found in our body ALP are seen before the test is generally accurate, your...
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