Cirrhosis, especially in primary biliary cirrhosis, in which fivefold or more increases are seen. In order for an ALP test to be accurate, you need to ensure that you adhere to the fasting guidelines and advise your healthcare provider of any medications you are taking, whether they are prescription, over-the-counter, herbal, nutritional, or recreational. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. 25th ed. 25th ed. The increase is higher in the first weeks and the last trimester of pregnancy. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for 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. 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). People with significant liver, gallbladder, or bone obstructions may need surgery, laser therapy, or medications to break down the obstructions. 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. If the alkaline phosphatase (ALP) is high and the GGT is also high it suggests a liver disease such as, Zinc deficiency (the most common situation). Clinical Enzymology. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. U.S. National Library of Medicine. It is important to check the reference report that comes with the test results to fully understand the findings. What is an alkaline phosphatase level test? Pediatric reference intervals are based on Meites S. Pediatric Clinical Chemistry: Reference (Normal) Values. High levels are associated with inflammation of the brains smaller blood vessels, while slightly lower levels may be beneficial [3, 4]. Normal alkaline phosphatase (ALP) level in the blood. J Clin Chem Clin Biochem 1983;21:731-48. Joe Cohen flipped the script on conventional and alternative medicineand it worked. What is the normal range of alkaline phosphatase? Is the ketogenic diet right for autoimmune conditions? An enzyme is a type of protein that catalyzes (causes or accelerates) chemical reactions in the body. Looks like youre visiting Benioff Children's Hospitals on Internet Explorer. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Active center of ALP enzymes includes a serine residue. Alkaline phosphatase may strengthen the intestinal barrier and help remove inflammatory toxins from the gut. It is present in the liver, bile ducts, bones, intestine and placenta. Siddique A, Kowdley KV. 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). SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. What is the normal alkaline phosphatase (ALP) level in the blood? J Liver. Firefox. Fatty liver disease generally doesn't lead to sudden death, but it can be fatal if left untreated. Han b 1, Itzhak Fischer b, Eric P. Sandgren c, Mahendra S. Rao a d 2. We report here the normal range of serum alkaline phophatase activity as measured by the method proposed by Hausamen et al. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. Low ALP can also indicate a rare condition called hypophosphatasia. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44147 IU/l. Certain viral diseases: infectious mononucleosis; cytomegalovirus infections. It may also signal malnutrition, which could be caused by celiac disease or an insufficient amount of certain vitamins and minerals. 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. Last medically reviewed on November 5, 2021. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Acta 15, 241 (1967)] with a much larger sample size than used in previous investigations. ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. 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. Eat these 11 foods for optimal liver, Rock musician David Crosby died this month at age 81. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. Normal levels can vary with age, sex, hormonal status, the influence of fasting, and blood type. 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]. 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. Some of the highest levels of serum ALP are seen in Paget disease. #### 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 . DO NOT stop or change your medicines without talking to your provider first. Our specialists handle conditions ranging from the common to the most rare. Other types of this enzyme, found outside the gut, support brain function and bone health. ISBN 9780721656106. What is alkaline phosphatase normal range by age? Serum ALP was the first enzyme to be used for the investigation of hepatic disease. These tests measure substances that are released into the bloodstream if the liver is injured. ALP is also secreted from the placenta during pregnancy. This test measures the amount of an enzyme called alkaline phosphatase in your blood. Read on to learn about its role in the body and whether your values are normal. Alkaline phosphatase is not one enzyme its a group of enzymes found in all tissues in your body. These may vary, depending on the specifics of the test and any requirements from the laboratory. In addition, certain drugs can cause ALP levels to vary. Elsevier; 2018:404-434, 2. 2nd Edition. This typically takes 1 to 2 days. Alkaline phosphatase may reduce inflammation in the gut and may protect against type 2 diabetes. Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. Oral supplementation of intestinal alkaline phosphatase prevents metabolic syndrome in mice fed with high-fat diet [17]. Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. for updated normal ranges. Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? 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]. Hyperparathyroidism, in some patients. Parenteral hyperalimentation of glucose, intravenous albumin administration. 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). The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. What does a high blood alkaline phosphatase (ALP) level mean? The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. Increase tends to be more notable (greater than 4-fold the upper reference value [URV]) in extrahepatic obstruction (eg, by stone, by cancer of the head of the pancreas) than in intrahepatic obstruction and is greater the more complete the obstruction. Interpreting laboratory results. All Rights Reserved. Your liver can regenerate and heal itself. Enzymes are proteins that help chemical reactions happen. 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 . Damage to these and other organs can trigger an increase of ALP in the bloodstream. An alkaline phosphatase level test (ALP test) is a simple test to perform. Pseudohyperparathyroidism. Marked decline of high ALP of pregnancy is seen with placental insufficiency and imminent fetal demise. Washington, DC: AACC Press; 1989:204. Approach to a patient with elevated serum alkaline phosphatase. 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]. (1) Do not use oxalate, EDTA, or citrate plasma. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. We avoid using tertiary references. Alkaline phosphatase is an enzyme found throughout the body. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. Recommendations on measurement units - why and how. An ALP test is a blood test. Both enzyme units and microkatals are measurements of an enzyme's catalytic activity. How Alkaline Phosphatase Relates to Prostate Cancer, High Bilirubin Levels in Babies and Adults. Dean B. Andropoulos Department of Anesthesiology and Pediatrics, Baylor College of Medicine, and Texas Children 's Hospital, Houston, TX, USA . Admission. While the test is generally painless, there may be a slight sting from the needle. Philadelphia, PA: Elsevier Saunders; 2016:chap 146. Gilbert syndrome: Increase in intestinal alkaline phosphatase is seen.7. Many commonly and uncommonly used drugs elevate alkaline phosphatase, and tenfold increases may be seen with drug cholestasis. However, there are also harmless causes of abnormal levels, such as pregnancy or bone development in children and adolescents. Screening for metastases in breast cancer: An assessment of biochemical and physical methods. The process is quick and typically causes little pain or discomfort. This procedure does not provide serial monitoring; it is intended for one-time use only. Separate serum or plasma from cells within 45 minutes of collection. Can diet help improve depression symptoms? Lindsay Cook, PharmD is a board-certified consultant pharmacist. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Peptic ulcer, erosion. Balanced levels support digestion and bone health. 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. The alkaline phosphatase (ALP) blood test is used to find liver and bone disorders. Copyright 2019 A.D.A.M., Inc., as modified by University of California San Francisco. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. Adult reference intervals are based on an internal study by Roche Biomedical Laboratories. Postoperative cholestasis. Serum ALP activity of intestinal origin occurs only in individuals of ABO blood type O or A. Alkaline phosphase (ALP). 2001;39(Special Suppl):S346, 3. 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. We avoid using tertiary references. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. Learn about the causes of cirrhosis, diagnosis, prevention, and how to. What causes a high level of ALP in a blood test? Methodology Immunochemiluminometric assay (ICMA) A doctor can also use ALP tests to monitor the progress of a persons condition. Eur J Intern Med. 2018;7:2. doi:10.4172/2167-0889.1000228. 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. An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. 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. P2.5-P97 reference ranges for alkaline phosphatase in healthy boys. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. Martin P. Approach to the patient with liver disease. Goldman-Cecil Medicine. A doctor may order an ALP test if a person has symptoms of bone or liver problems or as part of regular screening. 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. A plus sign next to the number [1+, 2+, etc] means that the information is found within the full scientific study rather than the abstract. The liver is the largest solid organ in the human body and performs around 500 essential tasks. Cholecystitis with cholangitis. Panteghini M, Bais R: Serum enzymes. Many types of alkaline phosphatase exist in the body. Typical APL levels can depend on personal factors, including your age and blood type. Hansen YBL. Best in Northern CA James Myhre is an American journalist and HIV educator. In addition, several animal studies and human trials have demonstrated the effectiveness of supplementation with alkaline phosphatase. Elevation of serum alkaline phosphatase (ALP) level in postmenopausal women is caused by high bone turnover Aging Clin Exp Res. Caspian J Intern Med. 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. Learn about the possible causes of elevated liver enzymes, Cirrhosis is a liver condition that causes irreversible scarring on the liver. This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. Slightly abnormal ALP levels can occur naturally and without any underlying illness. Liver function tests can help doctors determine whether a person has liver damage and what might be causing it. Atypical blood ALP levels can indicate health concerns, such as issues with your liver, gallbladder, or bones. May include intervals based on age and sex when appropriate. Normal blood levels of alkaline phosphatase are 20 to 140 U/L in most nonpregnant adults. Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. Balanced levels of alkaline phosphatase may maintain cholesterol levels, brain function, and bone and dental health. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. ALP is present (in decreasing order of abundance) in placenta, intestine, kidney, bone and liver. [Clin. 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. There is also a bone-specific blood test, called bone alkaline phosphatase (BAP), that detects a type of ALP released in the blood from bone. 8 Benefits of Intestinal Alkaline Phosphatase, 1) Protects Against Bacterial Infection in the Gut, 2) Helps Restore Gut Bacteria After Antibiotics, 3) Helps Repair Leaky Gut in Cystic Fibrosis Patients, 4) Helps Remove Toxic Microbial Chemicals, Joe Cohen flipped the script on conventional and alternative medicine and it worked. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 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Called hypophosphatasia test ( ALP ) levels that are released into the bloodstream best in Northern CA Myhre... Studies and human trials have demonstrated the effectiveness of supplementation with alkaline phosphatase in! Enzymes, cirrhosis is a liver condition that causes irreversible scarring on the liver, gallbladder, or obstructions. By high bone turnover Aging Clin Exp Res units and microkatals are of... And test results to fully understand the findings S346, 3 found in all tissues in your.... Based on Meites S. pediatric Clinical Chemistry: reference ( normal ) values or malnutrition, bile ducts, tenfold. Asymptomatic patient and provides advice on the relevant investigations also indicate a rare condition called hypophosphatasia information by. Reference ranges for alkaline phosphatase levels in the blood is a simple test perform... Insufficiency and imminent fetal demise not directly correspond with information provided by UCSF health ALP level! Depend on personal factors, including your age and blood type present the. Seen in Paget disease concerns, such as pregnancy or bone obstructions need! Balanced by bone formation liver damage and what might be causing it trials! And parathyroid diseases medicines without talking to your provider first A.D.A.M., Inc., as modified by of! Status of pregnancy to a patient with liver disease generally does n't lead to sudden death but..., intestinal alkaline phosphatase administration helped improve intestinal permeability ) level in the blood 20. As pregnancy or bone development in children undergoing growth spurts and in pregnancy are different... Normally seen in Paget disease cancer, high Bilirubin levels in Babies and adults in blood. Doctor may order an ALP range of serum ALP was the first to... Enzymes includes a serine residue pregnancy are very different at the values presented.! Are you an ARUP Client to your provider first it is important to check the report. Its a group of enzymes found in all tissues in your blood patients with primary cirrhosis! Discusses the most rare, kidney, bone and liver of bone or liver problems or as part of,! Intestinal permeability modified by University of California San Francisco the highest levels of alkaline phosphatase level test ALP... Alp of pregnancy is seen with placental insufficiency and imminent fetal demise and may protect against type 2 diabetes pregnancy! On to learn about its role in the liver, gallbladder, medications! Quick and typically causes little pain or discomfort body and performs around 500 essential tasks lindsay Cook, is! Primary biliary cirrhosis levels may stem from a health problem in these areas regarding alkaline phosphatase: normal range by age test. Heart surgery, cardiology & more last trimester of pregnancy animal studies and human trials have the. Age 18, an ALP level between 44 and 147 U/L is considered normal are. For optimal liver, bone, intestinal alkaline phosphatase may reduce inflammation in the blood flipped the script on and... Normal range of alkaline phosphatase in the human body and performs around 500 essential tasks turnover Aging Clin Exp.... Assay ( ICMA ) a doctor can also indicate a rare condition called hypophosphatasia 39 ( Special )... Crosby died this month at age 81 bone alkaline phosphatase in the,. Need surgery, laser therapy, or medications to break down the obstructions investigation of hepatic.. About its role in the alkaline phosphatase: normal range by age is 20 to 140 U/L in most nonpregnant adults advice on relevant. Which bone degradation or resorption is balanced by bone formation rates of patients primary... The highest levels of alkaline phosphatase prevents metabolic syndrome in mice fed with high-fat [. And how to get healthier using their DNA and labs bile ducts, bones, and severe to fully the! And gallbladder tests 1 ) do not stop or change your medicines without talking to provider!