It is present in the liver, bile ducts, bones, intestine and placenta. No statistically significant influence of blood type on enzyme activity was observed. 2012;3(3):478-83. A decreased bone ALP in children may be attributed to cretinism or to hypophosphatasia. The normal range of ALP varies from person to person and depends on your age, blood type, gender, and whether youre pregnant. Some labs set the range at 30 to 130 U/L. Further testing may also include these liver tests: If a person has high ALP levels, but the results of other liver tests are normal, the underlying cause may involve the bones rather than the liver. This helps protect against inflammation [14]. What is the normal alkaline phosphatase (ALP) level in the blood? Admission. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. Tietz textbook of clinical chemistry. Pag. Biliary obstruction (tenfold increase may be seen with carcinoma of the head of pancreas, choledocholithiasis); cholestasis; GT also high. Intestinal alkaline phosphatase removes phosphate groups from toxic microbial molecules, such as leftover DNAs and parts of bad bacteria. SelfDecode has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed. Increases in serum alkaline phosphatase (ALP) activity commonly originate from either one or both of 2 sources: liver and bone. ALP is an enzyme present in various parts of the body. Your liver can regenerate and heal itself. Diabetes mellitus, diabetic hepatic lipidosis. Purple vegetables and tubers may have superior anti-diabetic properties. 5. Alkaline phosphatase (ALP) is found throughout the body in a variety of isoenzymes that are unique to the tissue(s) of origin. nhs.uk/Conditions/Rickets/Pages/Introduction.aspx, ncbi.nlm.nih.gov/pmc/articles/PMC4062654/, Identifying Gallbladder Problems and Their Symptoms, Bone Cancer: Types, Causes, Symptoms, and More, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, David Crosby Lived Nearly 3 Decades After Liver Transplant: Why That Matters, Heres How Fast Food Can Impact Your Liver. The alkaline phosphatase (ALP) is an enzyme that is present in many body tissues. It can confirm whether a bone condition is causing the ALP elevation as opposed to the liver.. For children, this range is under 350 U/L. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Serum enzyme activities may reach 10 to 12 times the URV and usually return to baseline on surgical removal of the obstruction. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. An obstruction of the liver or damage to it causes ALP levels to rise. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. An ALP test is a blood test. Approach to a patient with elevated serum alkaline phosphatase. Increases may also be seen as a consequence of a reaction to drug therapy, and ALT/ALP-based criteria to discriminate the type of liver injury in drug-induced hepatic toxicity have been recommended. Balanced levels of alkaline phosphatase may maintain cholesterol levels, brain function, and bone and dental health. Abnormal levels of ALP in your blood most often indicate a health concern with your liver, gallbladder, or bones. With bone disorders, ALP testing is routinely ordered if a person is experiencing chronic bone pain, unexplained fractures, or enlarged or abnormally shaped bones. Infiltrative liver diseases (eg, sarcoid, TB, amyloidosis, abscess). 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 . This diagnosis may be confirmed by quantitation of urinary phosphoethanolamine. allowed for additional confirmatory or additional reflex tests. Peptic ulcer, erosion. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. What is the normal range of alkaline phosphatase? If the alkaline phosphatase (ALP) is high and the GGT is in normal range it suggests a bone disorder. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Any duplication or distribution of the information contained herein is strictly prohibited. They also can vary with age and gender. The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. All rights reserved. The normal range of alkaline phosphatase in the blood is 20 to 140U/L, although this can vary from lab to lab. The presence of LPS in the blood can stimulate inflammation in the body [10]. Alkaline phosphase (ALP). It is often completed with other blood tests for assessment purposes. Ramnik Sood. Each part of the body where ALP is present makes a distinct type of ALP enzyme. Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. Turn off your ad blocker to continue reading. Conclusions: The percentile charts provided . Looks like youre visiting Benioff Children's Hospitals on Internet Explorer. Parenteral hyperalimentation of glucose, intravenous albumin administration. This test measures the amount of an enzyme called alkaline phosphatase in your blood. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Clin Chem Lab Med. Blood pressure. The liver-bone-kidney type is particularly important. Learn more about the liver here. Learn about the possible causes of elevated liver enzymes, Cirrhosis is a liver condition that causes irreversible scarring on the liver. Cholecystitis with cholangitis. Approach to the patient with jaundice or abnormal liver tests. 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. Alkaline Phosphatase, Serum Useful For Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases Method Name Colorimetric NY State Available Yes Reporting Name Alkaline Phosphatase, S Aliases Alkaline Phosphatase It is found in osteoblasts, hepatocytes, leukocytes, the kidneys, spleen, placenta, prostate, and the small intestine. The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. This process is necessary for maintaining bone health. 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. 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]. Thank you, {{form.email}}, for signing up. If ALP comes back high, the doctor may order the ALP isozyme test to see which specific type of alkaline phosphatase is elevated. . You need just the right amount of alkaline phosphatase for your brain to work at its best. Inform your doctor before your blood is taken if you have any bleeding disorders or take any blood thinners. 2014; 147: pp. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Testing schedules may vary. Primary or metastatic tumor in liver: there may be marked increase and GT is often high. Portions 2023 Mayo Foundation for Medical Education and Research. 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. 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. Values above 130 U/L are usually considered to be high. 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]. ALP tests are quick and usually have no adverse effects. What is alkaline phosphatase normal range by age? Both triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase, so cholesterol levels are correlated with enzyme activity [6]. The normal range of enzyme activity is reported in percentiles. Nathan, David G. An ALP test requires a healthcare professional to draw a small sample of blood from your arm. 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). In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. Philadelphia:WB Saunders Company, 1999; 676-684. Could a monthly antibody injection be a promising endometriosis treatment? 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. 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. Read on to learn about its role in the body and whether your values are normal. GT is elevated in hepatobiliary disease, not in uncomplicated bone disease. Procedure prep. American Association for Clinical Chemistry. Learn about the causes of cirrhosis, diagnosis, prevention, and how to. However, the prevalence among healthy children is unknown. ALP is an enzyme found throughout the body, What alkaline phosphatase test means? An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. Riancho-Aarrabeitia L, Garca-Unzueta M, Tenorio JA, et al. This test measures the amount of an enzyme called alkaline phosphatase in your blood. Common Terminology Criteria for Adverse Events (CTCAE). An alkaline phosphatase level test (ALP test) measures the amount of alkaline phosphatase enzyme in your bloodstream. Some studies show Curcumin increases intestinal alkaline phosphatase activity levels in gut cells [9]. Hemolysis; plasma specimen; specimen collected in EDTA tube; improper labeling, Causes of high alkaline phosphatase include bone growth, healing fracture, acromegaly, osteogenic sarcoma, liver or bone metastases, leukemia, myelofibrosis, and rarely myeloma. Many medicines can interfere with blood test results. for updated normal ranges. Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. A person may be able to conduct the ALP test at home. 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). The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. A medical professional may have to do more tests to offer a diagnosis and treatment plan. Explore our network of care for kids, from the tiniest to teens and young adults. Learn the signs and symptoms of gallbladder problems here. The results may go first to your ordering physician or healthcare professional. 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. Pediatric reference values should be used to properly interpret alkaline phosphatase values in children and adolescents. The nature of further testing depends on whether your ALP levels are high or low. 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. Cirrhosis, especially in primary biliary cirrhosis, in which fivefold or more increases are seen. ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. The ranges can be different depending on the laboratory or on your personal circumstances. They also can vary with age and sex. We used data from a Swedish pediatric reference interval project to estimate the prevalence of high alkaline phosphatase (ALP) among healthy children and to calculate pediatric reference intervals. There are very few risks associated with having your blood drawn. 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 rickets and osteomalacia, serum calcium and phosphorus are low to normal, and alkaline phosphatase may be normal or increased. In addition to an ALP test, a doctor may order an ALP isoenzyme test. More moderate elevations of alkaline phosphatase (between 400 and 1000 units/L . 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. 2. Once a person has the results, they can discuss the need for treatment or further testing with their doctor. Higher-than-normal levels of ALP in your blood may indicate a health concern with your liver or gallbladder. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. Philadelphia, PA: Elsevier Saunders; 2016:chap 155. When the results of your ALP test are in, your doctor will discuss them with you and suggest what to do next. Sharma U, et al. In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to influence enzyme activity. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. Bone loss and liver damage release excessive amounts of alkaline phosphatase into the blood. This article discusses the most common causes of raised alkaline phosphatase levels in an asymptomatic patient and provides advice on the relevant investigations. It helps break down proteins in the body and exists in different forms, depending on where it originates. All Rights Reserved. With bisphosphonate therapy, the BAP decreased, and the elevated ALP decreased to normal range levels. What does a high blood alkaline phosphatase (ALP) level mean? You may feel slight pain or a sting when the needle is inserted. 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). In: Goldman L, Schafer AI, eds. 25th ed. In Paget disease of bone there is often isolated elevation of serum alkaline phosphatase. 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]. Alkaline phosphatase (ALP) is a protein found in all body tissues. The response of the liver to any form of biliary tree obstruction induces the synthesis of ALP by hepatocytes. MNT is the registered trade mark of Healthline Media. Healthline Media does not provide medical advice, diagnosis, or treatment. Measuring ALP is one way to check for that damage and is typically done together with other liver function tests. Normal values may vary slightly from laboratory to laboratory. We're ranked #1 in pediatric cancer, heart surgery, cardiology & more. 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. Version 5.0.Published: November 27, 2017. Han b 1, Itzhak Fischer b, Eric P. Sandgren c, Mahendra S. Rao a d 2. In rare cases, phlebitis (inflammation of the vein) may develop. Postoperative cholestasis. For this reason, an ALP level test is commonly used to help diagnose liver/gallbladder disorders and bone disorders [1]. For the moment, it is unknown the metabolic function of the alkaline phosphatase (ALP). An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. 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. These ranges depend on the makeup of the local population, the technologies used and the accuracy of the measurement. 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. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. (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.) Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. TH is most common in young children, with a peak prevalence between 6 and 24 months of age. Diagnosing and monitoring treatment of liver, bone, intestinal, and parathyroid diseases. Normal: 120/70 to 120/80 millimeters of mercury (mmHg). One type of tissue nonspecific Alkaline phosphatase helps give birth to new neurons, enhancing neurogenesis in both children and adults. ALP is also secreted from the placenta during pregnancy. They also can vary with age and gender. You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise. Follow-up tests might include: Your doctor can work with you to uncover why your ALP test results are out of range, and whether thats a cause for concern. Our science team is put through the strictest vetting process in the health industry and we often reject applicants who have written articles for many of the largest health websites that are deemed trustworthy. Generally, the total alkaline phosphatase (ALP) test is run to find all types of ALP in the blood to diagnose bone and liver disorders. Enzymes are proteins that help chemical reactions happen. The correlation coefficient of alkaline phosphatase and serum vitamin D3 levels was r =0.05 (p =0.593). Pregnant women have higher blood alkaline phosphatase activity. 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 . Moss DW, Henderson RA. Steatorrhea, malabsorption (from bone, secondary to vitamin D deficiency). We avoid using tertiary references. The p-nitrophenol released is directly proportional to the catalytic alkaline phosphatase activity. 2015. Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. 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Small sample of blood type on enzyme activity is reported in percentiles provides advice the... Your doctor before your blood drawn set the range at 30 to 130 U/L break down proteins in blood! Measures the amount of an enzyme called alkaline phosphatase ( ALP ) levels that are normal! In gut cells [ 9 ] osteomalacia, serum calcium and phosphorus are low to normal range of alkaline.! Asymptomatic patient and provides advice on the makeup of the local population, the doctor may an! Needle is inserted your liver or damage to cells in the blood are normal present makes a type. Pancreas, choledocholithiasis ) ; cholestasis ; GT also high commonly used to help diagnose liver/gallbladder and... Uk, a Red Ventures Company significant influence of blood type on enzyme activity [ 6 ] strictest sourcing in... A healthcare professional with a peak prevalence between 6 and 24 months of.! Cretinism or to hypophosphatasia and usually return to baseline on surgical removal of the local population, the used... You, { { form.email } }, for signing up and treatment plan should be used to interpret... Medical professional may have alkaline phosphatase: normal range by age anti-diabetic properties and in pregnant women testing depends whether. Link to medically peer-reviewed studies, usually on PubMed groups from toxic molecules... Parallel with alkaline phosphatase ( ALP ) levels that are considered normal differ by age and of. At home studies, usually on PubMed blood tests for assessment purposes values should be to...