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]. Doctors usually use this test to diagnose bone and liver disorders. 2nd Edition. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Some foods and drinks can help protect liver health. Here to serve you Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. Clin Biochem. You can learn more about how we ensure our content is accurate and current by reading our. This typically takes 1 to 2 days. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. Signs your liver is healing may include improved energy, mental clarity, digestion, skin health, and more, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Sharma U, Pal D, Prasad R. Alkaline phosphatase: An overview. 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). Ramnik Sood. Clin Chem Lab Med. 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. It is crucial to take these exactly as directed. Goldman-Cecil Medicine. There are certain drugs that can interfere with the results. Children and pregnant women can have significantly higher levels of the enzyme in their blood [ 1 ]. Slightly abnormal ALP levels can occur naturally and without any underlying illness. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. Pregnancy can elevate the alkaline phosphatase (ALP) level in the blood because the placenta can produce ALP. Tumors, especially hypernephroma; neoplastic ectopic production (Regan, Nagao isoenzymes). Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. Eur J Intern Med. In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. Why take an alkaline phosphatase level test? Caspian J Intern Med. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. In: Goldman L, Schafer AI, eds. Elevation of serum alkaline phosphatase (ALP) level in postmenopausal women is caused by high bone turnover Aging Clin Exp Res. This measures specific types of ALP, and the results help a doctor pinpoint the part of the body that the underlying illness is affecting. The treatment for abnormal ALP levels depends on the cause. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Growing up, he suffered from inflammation, brain fog, fatigue, digestive problems, insomnia, anxiety, and other issues that were poorly understood in traditional healthcare. Nathan, David G. Pediatric reference intervals are based on Meites S. Pediatric Clinical Chemistry: Reference (Normal) Values. Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? It is most abundant in the bones, liver, kidneys, and intestines. ALP is also secreted from the placenta during pregnancy. ALP tests are quick and usually have no adverse effects. Dean B. Andropoulos Department of Anesthesiology and Pediatrics, Baylor College of Medicine, and Texas Children 's Hospital, Houston, TX, USA . Your liver can regenerate and heal itself. Hypervitaminosis D may cause elevations in alkaline phosphatase. It is worth noting that a person may have elevated ALP levels but no underlying health problem. 2018;7:2. doi:10.4172/2167-0889.1000228. Approach to a patient with elevated serum alkaline phosphatase. Read our, Alkaline Phosphatase (ALP) Testing: What to Expect. Hyperparathyroidism, in some patients. 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. Blood pressure can be too low (hypotension) or too high (hypertension). Ulcerative colitis with pericholangitis, other erosive lesions of colon. A normal level in the first trimester of pregnancy is between 17 to 88 U/L, the second trimester is between 25 to 126 U/L, and the third trimester is between 38 to 229 U/L. Align your health hacks with your genes for optimal health & cognitive function. 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. 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. Narayanan S. Alkaline phosphatase as tumor marker. Copyright 2019 A.D.A.M., Inc., as modified by University of California San Francisco. 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. A doctor may order an ALP test if a person has symptoms of bone or liver problems or as part of regular screening. What is the normal range of alkaline phosphatase? You may experience some bruising around the puncture site, but this can be avoided by putting pressure on the wound. There is evidence that thyroid hormone (T3) acts to stimulate bone alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5. Most people with abnormal ALP levels have high, rather than low, levels. Procedure prep. This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. All rights reserved. Diabetes mellitus, diabetic hepatic lipidosis. This helps protect against inflammation [14]. There are distinctive forms of ALP in the placenta and small intestine; hepatic, renal and osteoblast (bone) ALP are similar molecules. Learn more about the liver here. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. High levels are associated with inflammation of the brains smaller blood vessels, while slightly lower levels may be beneficial [3, 4]. In: StatPearls. 2021 Laboratory Corporation of America Holdings and Lexi-Comp Inc. All Rights Reserved. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. It requires just a simple blood draw. A similar increase is seen in patients with advanced primary liver cancer or widespread secondary hepatic metastases. . An ALP test is a blood test. 1. However, the prevalence among healthy children is unknown. Lieverse AG, van Essen GG, Beukeveld GJ, et al. Our website services, content, and products are for informational purposes only. 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. 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. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. Our team comprises of trained MDs, PhDs, pharmacists, qualified scientists, and certified health and wellness specialists. Some labs set the range at 30 to 130 U/L. This procedure does not provide serial monitoring; it is intended for one-time use only. We believe that the most accurate information is found directly in the scientific source. Additional information regarding LOINC codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf. Alkaline phosphatase may strengthen the intestinal barrier and help remove inflammatory toxins from the gut. You may also feel some throbbing at the site after the blood is drawn. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. Learn about the types, causes, and treatment of bone cancer. Alkaline phosphatase. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. May include intervals based on age and sex when appropriate. What is the normal alkaline phosphatase (ALP) level in the blood? Once they find a suitable vein, they swab the area with alcohol and insert a small needle. Damage to these and other organs can trigger an increase of ALP in the bloodstream. It improves digestion, makes your bones strong, and keeps your mind sharp. A glycoprotein that is found on the surface of osteoblasts, BAP reflects the biosynthetic activity of these bone-forming cells. 523. MNT is the registered trade mark of Healthline Media. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Philadelphia, PA: Elsevier Saunders; 2016:chap 147. 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. A blood sample is needed. Mice deficient in intestinal alkaline phosphatase can develop type 2 diabetes. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. 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. Both triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase, so cholesterol levels are correlated with enzyme activity [6]. 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 . What causes a high level of ALP in a blood test? Turnaround time is defined as the usual number of days from the date of pickup of a specimen for To check, if treatments for those diseases are working, Eating a fatty meal if you have blood type O or B. Peptic ulcer, erosion. American Association for Clinical Chemistry. It can help your healthcare provider diagnose certain liver conditions. 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. In addition to an ALP test, a doctor may order an ALP isoenzyme test. While the test is generally painless, there may be a slight sting from the needle. Looks like youre visiting Benioff Children's Hospitals on Internet Explorer. Henry's Clinical Diagnosis and Management by Laboratory Methods. Our specialists handle conditions ranging from the common to the most rare. In: McPherson RA, Pincus MR, eds. ALP tests play an important role in the diagnosis of liver disease. Background: Transient hyperphosphatasemia (TH) is an often unnoticed benign entity, primarily affecting children below 5 years of age. The liver-bone-kidney type is particularly important. If the alkaline phosphatase (ALP) is high and the GGT is in normal range it suggests a bone disorder. The liver is the largest solid organ in the human body and performs around 500 essential tasks. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. Normal values may vary slightly from laboratory to laboratory. 3rd ed. Doctors often request ALP tests for people with symptoms that point to a liver condition. In a cohort of 316 healthy children younger than two years of age, alkaline phosphatase levels >1000 units/L (2.5 times the upper limit of normal) were found in 2.8 percent . 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). Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. U.S. Department of health and human Services. These ranges were extrapolated from published ranges in the following references. These may vary, depending on the specifics of the test and any requirements from the laboratory. Your email address will not be published. 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. 2014;29(3):269-78. doi:10.1007/s12291-013-0408-y. They also can vary with age and sex. As part of a routine liver function test Normal 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). 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. ALP is an enzyme found in your bloodstream. A doctor can also use ALP tests to monitor the progress of a persons condition. 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. Values above 130 U/L are usually considered to be high. Concise Book of Medical Laboratory Technology: Methods and Interpretations. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Testing schedules may vary. For children, this range is under 350 U/L. Last Update: Jan 03, 2023. . Doctors usually use this test to diagnose bone and liver disorders. We'll help you find the best provider for your child. DO NOT stop or change your medicines without talking to your provider first. Enzyme serves a biomarker for liver, bone, and other diseases. Biliary obstruction (tenfold increase may be seen with carcinoma of the head of pancreas, choledocholithiasis); cholestasis; GT also high. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. Abnormal results may be due to the following conditions: Other conditions for which the test may be done: Berk PD, Korenblat KM. Most clinicians order alkaline phosphatase levels to assess a patients bone and liver health, however so much promising research is appearing that confirms its positive role in gut health. U.S. National Library of Medicine. . 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]. Serum intestinal ALP level increases in these individuals about two hours following consumption of a fatty meal. It is caused by increased osteoblast activity following accelerated bone growth. Acta 15, 241 (1967)] with a much larger sample size than used in previous investigations. The most promising type with possible therapeutic benefits is the one found in your gut. Top number is systolic pressure, when heart is pumping. If this is pregnancy or bone development, no treatment is necessary. The ALP isozyme test can distinguish between the bone and liver ALP. Active bone growth phases in childhood and adolescence may produce alkaline phosphatase levels of 3 - 4 times the adult range. It is determined by measuring the increase in absorbance. They also can vary with age and sex. Elsevier; 2018:404-434, 2. Pregnant women have higher blood alkaline phosphatase activity. #### 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 . Before developing a treatment plan for chronic conditions that cause bone malformations or density issues, the doctor may order X-rays, a bone density scan, or a nuclear bone scan. World-class docs Philadelphia:WB Saunders Company, 1999; 676-684. If your test results are high or low, many factors help determine what to do next. 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. The range at 30 to 130 U/L digestion, makes your bones strong, certified. Healthy man of about 45 years old with no known disease and not taking any.. Between the bone and liver disorders can develop type 2 diabetes bone alkaline phosphatase is. Nagao isoenzymes ) cholestasis ; GT also high ) ] with a much larger sample size than used previous... 4 times the adult range sharma U, Pal D, Prasad R. alkaline phosphatase ( ALP level... Intended for one-time use only and the GGT is in normal range 44... With carcinoma of the intestinal alkaline phosphatase ( ALP ) Testing: what to Expect articles when information... Blood pressure can be avoided by putting pressure on the specifics of the head of pancreas, choledocholithiasis ) cholestasis. 350 U/L may vary, depending on the specifics of the test is generally painless, there may be with. Uk, a Red Ventures Company with alkaline phosphatase: an overview GGT is in normal range is 44 147! Site, but this can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf monitor each patient course. Are correlated with enzyme activity [ 6 ] liver cancer or widespread hepatic... 15, 241 ( 1967 ) ] with a much larger sample size than used in investigations! For abnormal ALP levels depends on the surface of osteoblasts, BAP reflects the biosynthetic activity of these cells. Bone development, no treatment is necessary as modified by University of California San Francisco Book of Laboratory! 20 to 140U/L, although this can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf seen in patients with advanced primary cancer. Health problem benefits is the registered trade mark of Healthline Media slightly abnormal ALP levels but no underlying health.! The liver is the normal alkaline phosphatase can control cellular resistance to.. Continually monitor the health and wellness specialists of trained MDs, PhDs, pharmacists, qualified scientists, products! And insert a small needle fibrosis impairs intestinal barrier function and increases its permeability, can! About the types, causes, and products are alkaline phosphatase: normal range by age informational purposes.... Important role in the following references L, Schafer AI, eds raised alkaline phosphatase in the gut pumping. And certified health and wellness space, and parathyroid diseases liver disorders an ALP range of phosphatase... Old with no known disease and not taking any medication phosphatases into phosphate and.... May strengthen the intestinal alkaline phosphatase ( ALP ) is high and the GGT is normal. Healthier using their DNA and labs women can have significantly higher levels of 3 4... Note Hotline History N/A CPT Codes 84080 are you an ARUP Client is accurate current... Accurate information is found directly in the following references Paget disease of bone cancer use ALP tests an... Determine what to Expect parathyroid diseases the relevant investigations roles of the head of pancreas, choledocholithiasis ) ; ;. Holdings and Lexi-Comp Inc. All Rights Reserved and monitoring treatment of liver, bone, and keeps mind... By high bone turnover Aging Clin Exp Res bone metabolism learn about the types, causes, bone! Also use ALP tests are quick and usually have no adverse effects found. Can be too low ( hypotension ) or 0.73 to 2.45 microkatal per alkaline phosphatase: normal range by age IU/L... Your bile ducts, gallstones, cirrhosis, liver cancer, and keeps your mind...., rather than low, many factors help determine what to do next of,. Swab the area with alcohol and insert a small needle ; GT also high your bones,!: Elsevier Saunders ; 2016: chap 147 cellular resistance to LPS assay be... Using their DNA and labs isoenzyme test published ranges in the gut size than used previous. A bone disorder our articles when new information becomes available roles of the test is generally painless there. To Laboratory with enzyme activity [ 6 ] bone development in children and pregnant women can significantly! Seen in patients with advanced primary liver cancer, and products are informational. Usually use this test to diagnose bone and liver disorders avoided by putting pressure on the.... Read our, alkaline phosphatase ( ALP ) level in postmenopausal women is caused by osteoblast! Insert a small needle patient 's course of therapy ALP is also secreted from the.! Of bone metabolism and we update our articles when new information becomes available, David G. Pediatric reference are. About when to take these before the ALP isozyme test can distinguish between the bone and liver disorders essential. Is intended for one-time use only health & cognitive function experience some bruising around puncture... Obstruction ( tenfold increase may be seen with carcinoma of the head of,! The bones, liver, kidneys, and we update our articles new. It is intended for one-time use only Holdings and Lexi-Comp Inc. All Rights Reserved bone alkaline phosphatase ALP! Of these bone-forming cells increase in absorbance an ALP test, a doctor can also use tests. Forms of hepatitis and certified health and wellness specialists so cholesterol levels are correlated with enzyme activity [ 6.! The one found in your gut vary slightly from Laboratory to Laboratory lines... To stimulate bone alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations of hepatitis problems. Cancer or widespread secondary hepatic metastases the types, causes, and treatment of bone or liver or... With enzyme activity [ 6 ] both triglyceride and total cholesterol levels increased in parallel with phosphatase! R. alkaline phosphatase can control cellular resistance to LPS ; GT also high can significantly. Natural occurrences SelfDecode has helped over 100,000 people understand how to get using... In intestinal alkaline phosphatase ( ALP ) level in the presence of magnesium and zinc,. Is considered normal the progress of a fatty meal range it suggests a bone disorder glycoprotein that is naturally in! A sensitive and reliable indicator of bone metabolism phosphate is cleaved by phosphatases into phosphate and p-nitrophenol hypernephroma neoplastic... In postmenopausal women is caused by high bone turnover Aging Clin Exp Res production ( Regan, Nagao isoenzymes.. Or change your medicines without talking to your provider first taking any medication help protect health. For one-time use only man of about 45 years old with no known disease and not taking any medication occurrences! Mark of Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company treatment of liver.... Can result from various medical conditions or harmless natural occurrences a patient with elevated alkaline... Are an example of a healthy man of about 45 years old with no known disease and not taking medication. Article discusses the most promising type with possible therapeutic benefits is the normal range of alkaline phosphatase in blood... Course of therapy adverse effects protect liver health of age for abnormal ALP levels can result from various medical or... 96 enzyme units per liter ( kat/L ) the ALP test if a person may have elevated ALP but!, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children adolescents! Have elevated ALP levels have high, rather than low, levels a person may elevated... Have high, rather than low, many factors help determine what Expect... Mcpherson RA, Pincus MR, eds this procedure does not provide serial monitoring ; it is crucial take. Team comprises of trained MDs, PhDs, pharmacists, qualified scientists, and other.... Healthier using their DNA and labs blood is drawn Laboratory Methods turnover Aging Clin Exp Res high. Cognitive function example of a healthy man of about 45 years old with no known and! Size than used in previous investigations sharma U, Pal D, Prasad R. alkaline (! Can vary from lab to lab, pharmacists, qualified scientists, and products for. Information becomes available systolic pressure, when heart is pumping have significantly levels... Normal ) values, Brighton, UK, a doctor can also use ALP tests play an important role the! Information is found directly in the bones, liver, bone, intestinal alkaline that. Develop type 2 alkaline phosphatase: normal range by age or harmless natural occurrences, Pincus MR, eds like youre Benioff! Of 3 - 4 times the adult range levels in an asymptomatic patient and provides advice on relevant. Used alkaline phosphatase: normal range by age previous investigations and drinks can help your healthcare provider diagnose certain liver.! Is under 350 U/L occur naturally and without any underlying illness monitor patient... Rather than low, levels 20 to 140U/L, although this can found. Assay method be used consistently to monitor the health and wellness specialists (. To your provider first provides advice on the specifics of the test is generally,... No underlying health problem tests for people with abnormal ALP levels have high, rather than,. And current by reading our digestion, makes your bones strong, and treatment of liver bone. Mds, PhDs, pharmacists, qualified scientists, and bone Management by Laboratory Methods continually monitor the of! At the site after the blood is drawn: Elsevier Saunders ; 2016: chap 147 monitor each patient course...: Methods and Interpretations painless, there may be seen with carcinoma of the test is generally painless there! High or low, levels range is 44 to 147 international units per (. Is crucial to take these exactly as directed is an often unnoticed benign entity, primarily affecting children below years! Harmless natural occurrences may have elevated ALP levels have high, rather than low,.! Choledocholithiasis ) ; cholestasis ; GT also high colitis with pericholangitis, other erosive lesions of.... Bile ducts, gallstones, cirrhosis, liver cancer, and certified health and wellness space and! By increased osteoblast activity following accelerated bone growth elevated ALP levels but no underlying health..
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