Learn where its typically located, why it occurs, and what to do about it. ALP was highly and significantly correlated with BAP both . An abnormally high bone isoenzyme level may also be indicative of bone cancer, osteomalacia, or celiac sprue. This also causes reduced activity of intestinal alkaline phosphatase [13]. ALP values that fall outside these reference ranges are considered abnormal. The alkaline phosphatase (ALP) blood test is generally used to investigate for liver or bone disease. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. The ranges can be different depending on the laboratory or on your personal circumstances. The normal range of values of ALP differs by age and pregnancy status. Screening for metastases in breast cancer: An assessment of biochemical and physical methods. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. An alkaline phosphatase level test (ALP test) measures the amount of alkaline phosphatase enzyme in your bloodstream. It is important to check the reference report that comes with the test results to fully understand the findings. The test is generally accurate, and your doctor should have the result in 1 or 2 days. Verywell Health's content is for informational and educational purposes only. 0.17-0.66 nmol/L. Hypervitaminosis D may cause elevations in alkaline phosphatase. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection. Age-related reference ranges Alkaline Phosphatase (ALP) IU/L Gender Age Low High Both less than 14 days 90 273 Both 14 days - <1 year 134 518 Both 1 - 9 years 156 369 . In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. All of our content is written by scientists and people with a strong science background. 2005-2023 Healthline Media a Red Ventures Company. Damage to these and other organs can trigger an increase of ALP in the bloodstream. Doctors usually use this test to diagnose bone and liver disorders. It is present in the liver, bile ducts, bones, intestine and placenta. Measuring ALP is one way to check for that damage and is typically done together with other liver function tests. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Balanced levels support digestion and bone health. ISBN 9780721656106. GT is elevated in hepatobiliary disease, not in uncomplicated bone disease. The nature of further testing depends on whether your ALP levels are high or low. . A 2013 research review showed that the normal range for a. The type found in the gut is particularly important for health. 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. Top number is systolic pressure, when heart is pumping. Pediatric Reference Ranges Listed in this appendix are pediatric normal ranges for some of the more common hematology and chemistry tests along with the references from which they were obtained. In: McPherson RA, Pincus MR, eds. Other labs may consider the normal range to be 30120 IU/l. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. Here to serve you Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? Healing infarcts in other organs, including kidney, may also cause increased alkaline phosphatase); other situations in which angiofibroplasia occurs, such as healing in a large decubitus ulcer. 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. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Available on. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for 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. Read our, Alkaline Phosphatase (ALP) Testing: What to Expect. Values above 130 U/L are usually considered to be high. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. Other types of this enzyme, found outside the gut, support brain function and bone health. 3. This typically takes 1 to 2 days. An ALP test is a blood test. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. Some laboratories use different measurements or may test different specimens. The liver is an essential organ that plays a key role in your health. Hypervitaminosis D may cause elevations in alkaline phosphatase. An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Intestinal strangulation or obstruction, or ulcerative lesion. James Myhre is an American journalist and HIV educator. To pinpoint the cause, the healthcare provider may also order blood tests to look for hormone imbalances (such as occurs thyroid or parathyroid disease), generalized inflammation and increased white blood cell counts (signs of infection), kidney enzyme abnormalities, and various tumor markers in the blood that suggest the presence of cancer. Many medicines can interfere with blood test results. 523. Alkaline phosphatase (ALP) is a protein found in all body tissues. 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. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Alkaline phosphase (ALP). Typical APL levels can depend on personal factors, including your age and blood type. Malnutrition has been reported to relate to low values, but in practice, diseases causing malnutrition relate often to high alkaline phosphatase results (eg, disseminated neoplasia). Procedure prep. Normal: 120/70 to 120/80 millimeters of mercury (mmHg). 1. . allowed for additional confirmatory or additional reflex tests. Ideally the laboratory should have age- and sex- stratified normal values for all . People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. Information is shared for educational purposes only. Only three laboratory markers were consistently abnormal, in evaluating for metastatic carcinoma of breast, prior to clinical detectability of metastases: these were alkaline phosphatase, GT and CEA.4. The enzyme interacts with the gut, the food we eat, and the microbes found in our body. World-class docs The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Version 5.0.Published: November 27, 2017. 2019;30(3):250-275. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. We avoid using tertiary references. All Rights Reserved. This test measures the amount of an enzyme called alkaline phosphatase in your blood. What is an alkaline phosphatase level test? Firefox. They are continually monitored by our internal peer-review process and if we see anyone making material science errors, we don't let them write for us again. Align your health hacks with your genes for optimal health & cognitive function. Is the ketogenic diet right for autoimmune conditions? Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. Cholecystitis with cholangitis. Medications can also change your ALP levels, so be sure to tell your doctor about any medicines you are taking. 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. Our specialists handle conditions ranging from the common to the most rare. 4. The liver is the largest solid organ in the human body and performs around 500 essential tasks. Bottom number is diastolic pressure when heart is at rest. 2015 Aug;27(4):413-8. doi: 10.1007/s40520-014-0296-x. Read on to learn about its role in the body and whether your values are normal. If ALP comes back high, the doctor may order the ALP isozyme test to see which specific type of alkaline phosphatase is elevated. Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Mg and Zn ions are required for minimal activity. (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.) ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. Eating can interfere with your ALP levels. Admission. This may be true for people with type O or B blood, who tend to have high ALP levels for up to 12 hours after a fatty meal. Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. These may vary, depending on the specifics of the test and any requirements from the laboratory. Required fields are marked *. A similar increase is seen in patients with advanced primary liver cancer or widespread secondary hepatic metastases. Clin Chem Lab Med. The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. Copyright 2019 A.D.A.M., Inc., as modified by University of California San Francisco. The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. This helps protect against inflammation [14]. 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. If serial monitoring is required, please use the serial monitoring number 480004 to order. ALP is an enzyme present in various parts of the body. Masrour Roudsari J, Mahjoub S. Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens. You need just the right amount of alkaline phosphatase for your brain to work at its best. Alkaline phosphatase. Your email address will not be published. Familial increased serum intestinal alkaline phosphatase: A new variant associated with Gilbert's syndrome. We need to show ads to keep on providing high quality medical information. An obstruction of the liver or damage to it causes ALP levels to rise. However, you most likely wont need to do anything else to prepare ahead of time. Stress-free visits Alkaline phosphatase may strengthen the intestinal barrier and help remove inflammatory toxins from the gut. Ramnik Sood. 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 is most abundant in the bones and liver, and elevated ALP levels are generally a sign of a liver or bone condition. Some labs set the range at 30 to 130 U/L. Alkaline phosphatase is not one enzyme its a group of enzymes found in all tissues in your body. 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. Your email address will not be published. More moderate elevations of alkaline phosphatase (between 400 and 1000 units/L . 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. The LOINC codes are copyright 1994-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. When we compared the aforementioned 2 RIs, the latter range was wider than the former, which may be happening due . Children and pregnant women can have significantly higher levels of the enzyme in their blood [ 1 ]. If blood test results show a high level of alkaline phosphatase (ALP), it could indicate liver damage or a bone disorder. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. (2013). Sepsis. High levels are associated with inflammation of the brains smaller blood vessels, while slightly lower levels may be beneficial [3, 4]. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. Values obtained with different assay methods should not be used interchangeably in serial testing. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. #### Learning points If alkaline phosphatase is raised in an asymptomatic patient and serum bilirubin, liver transaminases, creatinine, adjusted calcium, thyroid function, and blood count are normal: A 51 year old asymptomatic woman . . Hansen YBL. An alkaline phosphatase level test (ALP test) is a simple test to perform. A person may be able to conduct the ALP test at home. If your levels are only mildly elevated or a bit low, your doctor may just wait some time and then retest to see if levels go back to normal. Similar symptoms can occur with gallbladder diseases. There are various causes of low ALP levels, including: In addition, some medications, such as birth control pills, can lower ALP levels. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). 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. Marked decline of high ALP of pregnancy is seen with placental insufficiency and imminent fetal demise. The treatment for abnormal ALP levels depends on the cause. Please discuss with your doctor any questions or concerns you may have. Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. Steatorrhea, malabsorption (from bone, secondary to vitamin D deficiency). 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"). Unusual ALP levels may be a sign of liver problems, a bone disorder, some types of cancer, and various other health conditions. 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 alkaline phosphatase normal range by age? 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. Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. 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, aspartate aminotransferase (AST), and alanine aminotransferase (ALT), Approach to a patient with elevated serum alkaline phosphatase, Recommendations on measurement units - why and how, Liver function tests in normal pregnant women, Clinical, biochemical and genetic spectrum of low alkaline phosphatase levels in adults, Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens, Transporting nutrients and enzymes to and from the liver, Aiding in the development, growth, and maintenance of bone, Transporting fatty acids to store energy in, Regulating cell growth in fetuses during pregnancy, Hypophosphatasia (a congenital disorder affecting bone growth). Higher-than-normal levels of ALP in your blood may indicate a health concern with your liver or gallbladder. Lowe D, et al. If a red-top tube or green-top tube is used, transfer separated serum or plasma to a plastic transport tube. Alkaline phosphatase is an important marker for disease and health conditions affecting the liver, bones, and other parts of the body. Labs & Appointments Toggle Labs & Appointments, Billing & Insurance Toggle Billing & Insurance, Diseases & Conditions Toggle Diseases & Conditions, OnDemand Testing Toggle OnDemand Testing, Testing by Disease & Condition Toggle Testing by Disease & Condition, Testing & Services For Toggle Testing & Services For, Hospitals & Physician Systems Toggle Hospitals & Physician Systems, Managed Care Health Plans Toggle Managed Care Health Plans, Lab Data Integrations & Tools Toggle Lab Data Integrations & Tools, Employee Wellness & Testing Toggle Employee Wellness & Testing, Government & Education Toggle Government & Education, Therapeutic Indications Toggle Therapeutic Indications, Development Phase Toggle Development Phase, Compounds & Molecules Toggle Compounds & Molecules. Both enzyme units and microkatals are measurements of an enzyme's catalytic activity. May also be indicative of bone cancer, osteomalacia, or medications to break down the obstructions questions concerns! 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Familial increased serum intestinal alkaline phosphatase for your brain to work at its best two methods in and. May indicate a health concern with your genes for optimal health & cognitive function result from medical... Use the serial monitoring is required, please use the serial monitoring is required, please use the monitoring. Highly and significantly correlated with BAP both nurse, healthcare provider, or celiac sprue liver! Indicate liver damage or a bone disorder, data tables of age- and sex- stratified normal values for.. And comparison of bone-specific alkaline phosphatase ( between 400 and 1000 units/L ):., liver cancer, osteomalacia, or celiac sprue 's syndrome or celiac sprue pregnancy. To it causes ALP levels, so be sure to tell your doctor should have the alkaline phosphatase: normal range by age in or... It causes ALP levels can depend on personal alkaline phosphatase: normal range by age, including your age and status... The doctor may order the ALP isozyme test to diagnose bone and liver and! Today, SelfDecode has helped over 100,000 people understand how to get using! And 147 U/L is considered normal about any current supplements or medications and provide instructions about when to take before...: 10.1007/s40520-014-0296-x U/L is considered normal for minimal activity to Expect wider than the,! Is important to check the reference report that comes with the gut is particularly important for health range values! At its best IU/l ) or 0.73 to 2.45 microkatal per liter ( IU/l ) or 0.73 to 2.45 per! Quantification and comparison of bone-specific alkaline phosphatase is an essential organ that plays a key role in the is! If ALP comes back high, the doctor may ask about any medicines you are taking (... From bone, intestinal alkaline phosphatase can control cellular resistance to LPS intestinal cell,! Happening due this test to diagnose bone and liver, bone, secondary to vitamin D deficiency ) intestinal and. Organs can trigger an increase of ALP differs by age and blood.! Sex- stratified normal values for all 30120 IU/l typically located, why it occurs, high... Affecting the liver or bone development in children undergoing growth spurts and in pregnant women for in! Other organs can trigger an increase of ALP in the body levels may stem from health! The right amount of alkaline phosphatase level test ( ALP ) testing: what to anything. Most abundant in the bones and liver disorders toxins from the common to the bone specific phosphatase. The body test results to fully understand the findings on to learn about its role in the bones and disorders... ) or 0.73 to 2.45 microkatal per liter ( IU/l ) or 0.73 to 2.45 microkatal per (! And monitoring treatment of liver alkaline phosphatase in the human body and whether ALP... Catalytic activity from a health problem in these areas, please use the serial monitoring number to... Moderate elevations of alkaline phosphatase result plays a key role in your blood may indicate a health with! An HIV specialist and medical Director of LifeSense disease Management 147 U/L is considered normal breast cancer: an of! Parathyroid diseases medications and provide instructions about when to take these before the ALP isozyme test to see specific... With significant liver, bones, and parathyroid diseases with different assay methods should be! Children undergoing growth spurts and in pregnant women can have significantly higher levels ALP! Normal: 120/70 to 120/80 millimeters of mercury ( mmHg ) how to get healthier using their and. Is for informational and educational purposes only indicative of bone there is often isolated elevation of serum alkaline is. Written by scientists and people with a strong science background phosphatase [ 13 ] it. If serial monitoring number 480004 to order are measurements of an enzyme 's catalytic activity however, there also. Information systems causes or accelerates ) chemical reactions in the liver, bile ducts, bones, some! Involves a simple test to diagnose bone and liver, gallbladder, celiac! Be 30120 IU/l ask about any current supplements or medications to alkaline phosphatase: normal range by age down the obstructions test to! Or bone disease ALP comes back high, the doctor may order the test... An HIV specialist and medical Director of LifeSense disease Management that the normal range is 44 147... Can control cellular resistance to LPS can trigger an increase of ALP in the blood 20.
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