ALP levels also vary with age and gender, with levels higher in children and pregnant women . 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. Last medically reviewed on November 5, 2021. Elsevier; 2018:404-434, 2. What Is a Comprehensive Metabolic Panel (CMP)? 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. Enzymes are proteins that help chemical reactions happen. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests. A healthcare professional cleans the skin on the front side of your elbow with an antiseptic and applies an elastic band to allow blood to pool in the vein. An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Additionally, any condition that affects bone growth or causes the increased activity of bone cells can increase ALP levels in the blood. Intestinal ALP isoenzyme, an asialoglycoprotein normally cleared by the hepatic asialoglycoprotein receptors, is often increased in patients with liver cirrhosis. 2005-2023 Healthline Media a Red Ventures Company. Your doctor chooses follow-up tests based on your overall health and other test results on file. Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. The alkaline phosphatase (ALP) level gives more information when it is studied along with the GGT (Gamma-glutamyltransferase) blood test: A low level of alkaline phosphatase (ALP) in the blood may be due to: The following values are considered to be normal values: IMPORTANT: These levels are expressed in U/L. Narayanan S. Alkaline phosphatase as tumor marker. U.S. National Library of Medicine. Coombes RC, Powles TJ, Gazet JC, et al. 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. Unlike other types of alkaline phosphatases, intestinal alkaline phosphatase is mostly tied to the gut lining, with 1 2% may be present in the bloodstream [8]. Lowe D, John S. Alkaline phosphatase. 2012;3(3):478-83. 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]. Serum intestinal ALP level increases in these individuals about two hours following consumption of a fatty meal. It is important to check the reference report that comes with the test results to fully understand the findings. If the results of the test are inconclusive, your doctor may order a follow-up test. These may include tests to determine which type of ALP enzyme is elevated. Our goal is to not have a single piece of inaccurate information on this website. Diabetes mellitus, diabetic hepatic lipidosis. What does a high blood alkaline phosphatase (ALP) level mean? Moss DW, Henderson RA. It is determined by measuring the increase in absorbance. Inform your doctor before your blood is taken if you have any bleeding disorders or take any blood thinners. SelfDecode is a personalized health report service, Learn about the causes of cirrhosis, diagnosis, prevention, and how to. Primary or metastatic tumor in liver: there may be marked increase and GT is often high. Intestinal alkaline phosphatase is seen normally in the serum of subjects who have B or O blood types, especially after a fatty meal. Approach to a patient with elevated serum alkaline phosphatase. Gilbert syndrome: Increase in intestinal alkaline phosphatase is seen.7. Having enough alkaline phosphatase may protect the kidneys and stop the gut from absorbing too much dietary fat. 1. . An obstruction of the liver or damage to it causes ALP levels to rise. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. Serum ALP activity of intestinal origin occurs only in individuals of ABO blood type O or A. Intestinal alkaline phosphatase can remove phosphate groups from LPS, which reduces its inflammatory effects [10]. Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. A medical professional may have to do more tests to offer a diagnosis and treatment plan. You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise. Alkaline phosphatase helps re-balance the gut microbiome during and after antibiotic treatment. 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. There are certain drugs that can interfere with the results. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Most people with abnormal ALP levels have high, rather than low, levels. What is an alkaline phosphatase level test? The normal range runs higher in children and decreases with age. High levels may also indicate a concern related to the bones such as rickets, Pagets disease, bone cancer, or an overactive parathyroid gland. Read on to learn about its role in the body and whether your values are normal. Alkaline phosphatase may be a regulator of intestinal lipid transport and may play a role in the bone metabolism. Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Alkaline phosphatase (ALP) is an enzyme found in the blood that helps break down proteins. Admission. Normal alkaline phosphatase (ALP) level in the blood. 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). What is the normal range for alkaline phosphatase (ALP)? Here to serve you Balanced levels of alkaline phosphatase may maintain cholesterol levels, brain function, and bone and dental health. The alkaline phosphatase (ALP) is an enzyme that is present in many body tissues. Methodology Immunochemiluminometric assay (ICMA) This enzyme functions in an alkaline environment (optimum pH of 10). If ALP comes back high, the doctor may order the ALP isozyme test to see which specific type of alkaline phosphatase is elevated. Clin Liver Dis. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. It may be one of many tests in a liver panel, for example. Pseudohyperparathyroidism. Verywell Health's content is for informational and educational purposes only. The correlation coefficient of alkaline phosphatase and serum vitamin D3 levels was r =0.05 (p =0.593). The alkaline phosphatase (ALP) blood test is used to find liver and bone disorders. If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please leave a comment or contact us at support@selfdecode.com. Interpreting laboratory results. Serum ALP was the first enzyme to be used for the investigation of hepatic disease. 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. Learn about the possible causes of elevated liver enzymes, Cirrhosis is a liver condition that causes irreversible scarring on the liver. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. Symptoms such as jaundice, abdominal pain, nausea, and vomiting may lead your doctor to suspect somethings wrong with your liver or gallbladder. 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. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. 8 Benefits of Intestinal Alkaline Phosphatase There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Once there is enough blood in the collection tube, the nurse gently removes the needle and covers the area with a small bandage or dressing. The normal range for alkaline phosphatase (ALP) varies from laboratory to laboratory. Postoperative cholestasis. Having lower-than-normal ALP levels in your blood can indicate a protein deficiency or Wilsons disease. C peptide. Version 5.0.Published: November 27, 2017. Adult reference intervals are based on an internal study by Roche Biomedical Laboratories. 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. Normal values may vary slightly from laboratory to laboratory. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. In this case, the doctor may request imaging tests to check the bones. ALP is an enzyme found in your bloodstream. 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. An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. The alkaline phosphatase (ALP) is an enzyme that is present in many body tissues. ALP is an enzyme found throughout the body, What alkaline phosphatase test means? 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. What is the normal alkaline phosphatase (ALP) level in the blood? This test measures the amount of an enzyme called alkaline phosphatase in your blood. An at-home liver test can be a helpful tool for checking the condition of your, VBDS is a rare but serious medical condition that affects bile ducts in your liver. Fatty liver disease generally doesn't lead to sudden death, but it can be fatal if left untreated. Liver function tests. Philadelphia, PA: Elsevier Saunders; 2016:chap 147. Henry's Clinical Diagnosis and Management by Laboratory Methods. World-class docs Our website services, content, and products are for informational purposes only. 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]. Learn more about the foods and drinks that are good for liver health here. These tests measure substances that are released into the bloodstream if the liver is injured. When the liver is not functioning properly, ALP is released into the bloodstream and the level increases significantly. . Thank you, {{form.email}}, for signing up. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. ALP is produced mainly by the liver and bones but is also synthesized in smaller quantities by the intestines and kidneys. The best way to know what is normal or not is to discuss the results with your doctor, who will be able to interpret the labs specific result and reference ranges. 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. 3. Lowe D, et al. 1. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. Alkaline phosphatase may strengthen the intestinal barrier and help remove inflammatory toxins from the gut. In: McPherson RA, Pincus MR, eds. Ideally the laboratory should have age- and sex- stratified normal values for all . (2021). 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). They also can vary with age and sex. 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 . 2021 Laboratory Corporation of America Holdings and Lexi-Comp Inc. All Rights Reserved. If a red-top tube or green-top tube is used, transfer separated serum or plasma to a plastic transport tube. Separate serum or plasma from cells within 45 minutes of collection. For children, this range is under 350 U/L. Goldman-Cecil Medicine. for updated normal ranges. 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). Skip to Main Content; National Library of Medicine. Abnormal levels of ALP in your blood most often indicate a health concern with your liver, gallbladder, or bones. They found that compared to the controls, diabetic patients had lower intestinal alkaline phosphatase activity levels [18]. Please discuss with your doctor any questions or concerns you may have. Sharma U, et al. Could a monthly antibody injection be a promising endometriosis treatment? 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. ALP was highly and significantly correlated with BAP both . The doctor may order this test if the patient presents with abdominal pain, dark urine, jaundice, bone pain or bone deformities. 6. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. The test is generally accurate, and your doctor should have the result in 1 or 2 days. ALP is an enzyme present in various parts of the body. Referrals made easy 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. We do not aim to diagnose, treat, cure or prevent any illness or disease. Our science team must pass long technical science tests, difficult logical reasoning and reading comprehension tests. Pregnant women have higher blood alkaline phosphatase activity. A related test is the ALP isoenzyme test. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. 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