We do not endorse non-Cleveland Clinic products or services. Panteghini M, Bais R: Serum enzymes. Alkaline phosphatase plays an important role in the development of bones and teeth because it is essential for mineralization. A general ALP test is usually included in a blood test known as a comprehensive metabolic panel (CMP) and a liver panel (HFP or LFT). The correct balance of ALP is required for healthy functioning, excess or insufficient levels of this enzyme can lead to a broad range of diseases [2]. What is an alkaline phosphatase level test? [Clin. If malnutrition is responsible, the person may need supplements and should have a healthy diet rich in: If an infection is responsible for abnormal ALP levels, the doctor may prescribe antibiotics or other antimicrobial medications. SelfDecode is a personalized health report service, In case you are pregnant, you should use a different range of the previously exposed. If the alkaline phosphatase (ALP) is high and the GGT is in normal range it suggests a bone disorder. StatPearls. Serum gel tubes should be centrifuged within 2 hours of collection. They also can vary with age and sex. A decreased bone ALP in children may be attributed to cretinism or to hypophosphatasia. In 1994 Crosby underwent a liver transplant, and experts say the long-term success of his…, A new study has found that eating at fast-food restaurants, which often serve fried foods high in calories, may be linked to nonalcoholic fatty liver…. Scientists studied the stools of 200 diabetic and 400 non-diabetic patients. Liver function tests. A considerable rise in the alkaline phosphatase activity is sometimes seen in children and teenagers. The degree to which the ALP level is elevated or lower than usual may indicate the type or severity of a condition. (Package insert: Alkaline Phosphatase reagent. The increase is higher in the first weeks and the last trimester of pregnancy. 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. Eating can interfere with your ALP levels. Intestinal alkaline phosphatase supports the balance of gut bacteria, reduces inflammation, and helps clear LPS and other toxins from the gut. Because of this, it’s important to check your test result report to see what your specific lab’s reference range is. Other factors can affect your levels, including: Before determining if you need to undergo further tests, your healthcare provider will take into consideration many aspects of your health and situation, including: If you’re experiencing symptoms of liver damage, such as jaundice, or bone disorders, such as bone or joint pain, call your healthcare provider. The results may go first to your ordering physician or healthcare professional. Liver damage creates a different type of ALP than bone disorders do. Normal range/expected value(s) for a specific disease state. 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. James Myhre is an American journalist and HIV educator. Hansen YBL. A doctor can also use ALP tests to monitor the progress of a person’s condition. Alkaline phosphatase (ALP) is an enzyme that’s found throughout your body. Alkaline phosphatase (ALP) is a protein found in all body tissues. Why normal levels can differ across different labs? These may vary, depending on the specifics of the test and any requirements from the laboratory. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. Eur J Intern Med. If your liver isn’t working right, the amount of ALP in your blood may be high. There are certain drugs that can interfere with the results. An ALP test measures how much ALP is circulating in the blood stream. 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. . Version 5.0.Published: November 27, 2017. Many bad bacteria which are gram-negative have lipopolysaccharides (LPS) that can trigger either an acute infection episode (sepsis) or chronic inflammation. 2012;16(2):199-229. doi:10.1016/j.cld.2012.03.012. It is found in osteoblasts, hepatocytes, leukocytes, the kidneys, spleen, placenta, prostate, and the small intestine. 2019;30(3):250-275. If you only have a mild elevation in your ALP levels, your healthcare provider will likely not have you undergo extensive evaluation. Serum or Plasma Age Group IU/L . Other labs may consider the normal range to be 30–120 IU/l. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44–147 IU/l. The normal measurement range for that test. If blood test results show a high level of alkaline phosphatase (ALP), it could indicate liver damage or a bone disorder. 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 ]. 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. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. The liver-bone-kidney type is particularly important. Signs and symptoms of liver disease include: Signs and symptoms of bone disorders include: A panel blood test involves more than one measurement from a blood sample. . It is most abundant in the bones, liver, kidneys, and intestines. Clinical, biochemical and genetic spectrum of low alkaline phosphatase levels in adults. 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. 2001;39(Special Suppl):S346, 3. Chim. We report here the normal range of serum alkaline phophatase activity as measured by the method proposed by Hausamen et al. Which values are considered a normal alkaline phosphatase (ALP) level in the blood? May also include abnormal ranges. Our goal is to not have a single piece of inaccurate information on this website. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Having blood drawn for an ALP test is routine. Typically the range for normal AST is reported between 10 to 40 units per liter and ALT between 7 to 56 units per liter. © 2005 - 2023 WebMD LLC. There’s very little risk to having blood tests. High Bilirubin Levels in Babies and Adults, 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. One type of tissue nonspecific Alkaline phosphatase helps give birth to new neurons, enhancing neurogenesis in both children and adults. Information that indicates if your result is normal or abnormal or high or low. Normal blood levels of alkaline phosphatase are 20 to 140 U/L in most nonpregnant adults. Read on to learn about its role in the body and whether your values are normal. It’s important to note that elevated levels of ALP can range in severity. Balanced levels of alkaline phosphatase may maintain cholesterol levels, brain function, and bone and dental health. Recommendations on measurement units - why and how. This causes fragile bones that can easily fracture and are slow to heal. The ranges can be different depending on the laboratory or on your personal circumstances. Treasure Island, FL: StatPearls Publishing; 2021. 67-382 . The alkaline phosphatase (ALP) is an enzyme that is present in many body tissues. Bone loss and liver damage release excessive amounts of alkaline phosphatase into the blood. Both high and low blood levels can be problematic. Comment * document.getElementById("comment").setAttribute( "id", "a0a529d9eaaa18bffd39ce492ee47782" );document.getElementById("a6cbe26769").setAttribute( "id", "comment" ); Save my name, email, and website in this browser for the next time I comment. Coming to a Cleveland Clinic location?Cole Eye entrance closingVisitation, mask requirements and COVID-19 information. Your doctor may use a liver elastography to help identify scarring on the liver. Eat these 11 foods for optimal liver…, Learn the signs and symptoms of gallbladder problems here. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. Your healthcare provider may have you undergo an ALP isoenzyme test as a follow-up if you had an abnormal ALP level on a previous test. Having an abnormally low level of alkaline phosphatase (ALP) is less common than having an elevated level. Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. If your alkaline phosphatase (ALP) test is part of a comprehensive metabolic panel (CMP), you’ll likely need to fast for 10 to 12 hours before your CMP blood test. SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. However, the injection did not cure the necrotizing enterocolitis [19]. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, COVID Could Reactivate Chronic Fatigue Symptoms, Climate Change Harms Physical and Mental Health, Most Cancers Are Not Found Through Screenings, New Blood Test Could Spot Alzheimer’s Earlier, Dr. Whyte's Book: Take Control of Your Diabetes Risk, Street Medicine Reaches People Where They Live, Health News and Information, Delivered to Your Inbox, Gastroparesis: What to Eat and What to Avoid, Newly Diagnosed With Crohn's? 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 crucial to take these exactly as directed. . Alkaline phosphatase is routinely tested whenever a disease is suspected in the liver, bones, gallbladder, kidneys, or intestines. 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. A person may need to fast for 6–12 hours before an ALP test. (2021). Each monomer contains five cysteine residues, two zinc atoms. A person may be able to conduct the ALP test at home. The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. 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. What causes a high level of ALP in a blood test? . The process is quick and typically causes little pain or discomfort. All rights reserved. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. In rare cases, phlebitis (inflammation of the vein) may develop. In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. Slightly abnormal ALP levels can occur naturally and without any underlying illness. Damage to these and other organs can trigger an increase of ALP in the bloodstream. You may have to fast for 10 to 12 hours before the test. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. 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. ALP blood tests measure the level of ALP in your blood that comes from your liver and bones, and it’s one of the tests included in a comprehensive metabolic panel. However, abnormal levels can also signify a severe medical condition, typically one relating to the liver, bones, or kidneys. Lindsay Cook, PharmD is a board-certified consultant pharmacist. An alkaline phosphatase level test (ALP test) measures the amount of alkaline phosphatase enzyme in your bloodstream. Learn about the stages of liver fibrosis and how this condition is treated. Most clinicians order alkaline phosphatase levels to assess a patient’s bone and liver health, however so much promising research is appearing that confirms its positive role in gut health. Your email address will not be published. In: Burtis CA, Ashwood ER, eds. Your age — teens and children may have higher levels because their bones are growing. The lab tech will clean an area of your skin with a germ-killing solution. Pregnant women have higher blood alkaline phosphatase activity. Hepatocellular injury and not necessarily cell death triggers the release of these enzymes into circulation. SelfDecode does not treat, diagnose or cure any conditions, In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. The number or measurement of your blood test result. It helps break down proteins in the body and exists in different forms, depending on where it originates. It improves digestion, makes your bones strong, and keeps your mind sharp. Elevated levels can also result from an increase in bone cell activity. . The normal value for alkaline phosphatase is 53 to 128 U/L for a 20- to 50-year-old man and 42 to 98 U/L for a 20- to 50-year-old woman. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Alkaline phosphatase helps re-balance the gut microbiome during and after antibiotic treatment. Alkaline phosphatase (ALP) is an enzyme in blood that helps break down proteins. Background: The normal serum concentration of alkaline phosphatase (ALP) in adults over the age of 18 ranges from 37 to 116 U/L, while in pregnant women levels of up to twice that upper limit can still be normal. In this case, following all the instructions carefully is key. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (µkat/L). Higher-than-normal levels of ALP in your blood may indicate a health concern with your liver or gallbladder. This typically takes 1 to 2 days. Roche Diagnostics; 02/2012). Pediatric reference values should be used to properly interpret alkaline phosphatase values in children and adolescents. Viagra, other ED drugs may lower cardiovascular risk in healthy men. Consequently, serum ALP measurements are of particular interest in the investigation of 2 groups of conditions: hepatobiliary disease and bone disease associated with increased osteoblastic activity. Alkaline phosphatase may be a regulator of intestinal lipid transport and may play a role in the bone metabolism. James Myhre is an American journalist and HIV educator. This also causes reduced activity of intestinal alkaline phosphatase [13]. The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. High levels of ALP in your blood may indicate liver disease or certain bone disorders. Growing up, he suffered from inflammation, brain fog, fatigue, digestive problems, insomnia, anxiety, and other issues that were poorly understood in traditional healthcare. WebMD does not provide medical advice, diagnosis or treatment. 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. We avoid using tertiary references. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. Mice without intestinal alkaline phosphatase absorb fat very fast. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (µkat/L). What does a high blood alkaline phosphatase (ALP) level mean? You can expect to experience the following during a blood test, or blood draw: The entire procedure usually takes less than five minutes. Results: Six children had ALP levels >16.7 µkat/l (>1,000 U/l), including 4 females and 2 males aged 7-22 months. 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]. 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. We believe that the most accurate information is found directly in the scientific source. Laboratory Procedure Manual . Don’t be afraid to ask your provider questions. The ALP isozyme test can distinguish between the bone and liver ALP. Healthline Media does not provide medical advice, diagnosis, or treatment. Learn about the types, causes, and treatment of bone cancer. Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. Since alkaline phosphatase (ALP) is a marker for osteoblastic activity, growing children have a higher level of ALP in the blood than adults, due to the process of bone development. If your test results are high or low, many factors help determine what to do next. The enzyme interacts with the gut, the food we eat, and the microbes found in our body. It exists in different forms, depending on where it originates from [1]. ALP is an enzyme found in your bloodstream. Although ALP exists throughout your body, the two main sources of ALP in your blood are your liver and bones. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. In adults, more than 80% of serum ALP activity derives from liver and bone. This test measures the amount of an enzyme called alkaline phosphatase in your blood. 2013;46:1197-1219, 4. Instead, they’ll likely monitor your levels over time to make sure they don’t get worse. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44-147 IU/l. 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. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. You may experience some bruising around the puncture site, but this can be avoided by putting pressure on the wound. While an isoenzyme test can provide more detailed information, it’s more technically challenging and expensive, and some laboratories may not offer it. Based on his own health success, he went on to found SelfDecode, the world’s first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. 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. This enzyme functions in an alkaline environment (optimum pH of 10). In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to . Other labs may consider the normal range to be 30-120 . High alkaline phosphatase levels in the liver may indicate the following conditions: High bone alkaline phosphatase levels may indicate the following conditions: A high level of ALP may also be a sign of untreated celiac disease. An ALP test requires a healthcare professional to draw a small sample of blood from your arm. ALP is also found in the placenta, kidneys . However, researchers believe it’s important for multiple different processes. Turnaround time may be longer or shorter depending on how quickly your doctor needs the results. 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. . Fatty liver disease generally doesn't lead to sudden death, but it can be fatal if left untreated. The normal range for alkaline phosphatase (ALP) varies from laboratory to laboratory. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Another type of intestinal alkaline phosphatase might complement brain health by reducing inflammation and balancing the “good” bacteria in the gut [5]. Scientists reversed aging in mice. Having dark-colored pee and/or light-colored poop. Bone cancer occurs when a tumor, or atypical mass of tissue, forms in a bone. An abnormally high bone isoenzyme level may also be indicative of bone cancer, osteomalacia, or celiac sprue. Approach to a patient with elevated serum alkaline phosphatase. While you can undergo a blood test that just measures your ALP, it’s most often included in a panel with other measurements, such as liver enzymes, to get a more complete picture of your liver’s health. ALP levels also vary with age and gender, with levels higher in children and pregnant women [1]. Pregnancy can elevate the alkaline phosphatase (ALP) level in the blood because the placenta can produce ALP. Your liver can regenerate and heal itself. Caspian J Intern Med. Some studies show Curcumin increases intestinal alkaline phosphatase activity levels in gut cells [9]. Tietz NW, Rinker D, Shaw LM. Because of this, a liver panel or comprehensive metabolic panel (CMP) provides more information than a test for just alkaline phosphatase. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44-147 IU/l. StatPearls [Internet]. 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. EJIFCC. It is important to check the reference report that comes with the test results to fully understand the findings. Learn where it’s typically located, why it occurs, and what to do about it. Moss DW, Henderson RA. ALP results are reported in units per liter (U/L). After a healthcare provider has collected your blood sample, they’ll send it to a laboratory for testing. Gastroenterology. The examples above show the common . Learn more about the liver here. 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. Age Male Female; 6 months-2 years: 31.6- 122.6 µg/L: 33.4- 145.3 µg/L: 3-6 years: 31.3-103.4 µg/L: . You can learn more about how we ensure our content is accurate and current by reading our. It may be one of many tests in a liver panel, for example. Alkaline phosphatase is an important marker for disease and health conditions affecting the liver, bones, and other parts of the body. They then insert a needle into the vein to draw blood into a small tube. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (µkat/L). Available on. 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"). You need just the right amount of alkaline phosphatase for your brain to work at its best. Last medically reviewed on November 23, 2021. There are very few risks associated with having your blood drawn. 2nd Edition. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. REFERENCE RANGES (NORMAL VALUES) Alkaline Phosphatase . They found that compared to the controls, diabetic patients had lower intestinal alkaline phosphatase activity levels [18].
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