Some of the highest levels of serum ALP are seen in Paget disease. 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). Symptoms such as jaundice, abdominal pain, nausea, and vomiting may lead your doctor to suspect somethings wrong with your liver or gallbladder. You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise. Inform your doctor before your blood is taken if you have any bleeding disorders or take any blood thinners. Values obtained with different assay methods should not be used interchangeably in serial testing. 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. In: Burtis CA, Ashwood ER, eds. Our goal is to not have a single piece of inaccurate information on this website. . 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. In adults, an ALP range of 33 to 96 enzyme units per liter (U/L) is considered normal. (Package insert: Alkaline Phosphatase reagent. What is alkaline phosphatase normal range by age? 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. Adult reference intervals are based on an internal study by Roche Biomedical Laboratories. Normal values may vary slightly from laboratory to laboratory. Therefore, alkaline phosphatase may not be used as a screening test to rule out vitamin D deficiency. Both high and low blood levels can be problematic. is a clickable link to peer-reviewed scientific studies. Sepsis. Alkaline phosphatase (S, P) Age M/F (U/L) 0-5 days 110-300 6 days -11 months 110-320 1-3yrs 145-320 4-6yrs 150-380 7-9yrs 175-420 For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. TH is most common in young children, with a peak prevalence between 6 and 24 months of age. With bisphosphonate therapy, the BAP decreased, and the elevated ALP decreased to normal range levels. Align your health hacks with your genes for optimal health & cognitive function. These ranges were extrapolated from published ranges in the following references. 2015. Indian J Clin Biochem. ALP is most abundant in the liver and bones, and high ALP levels may stem from a health problem in these areas. 2012;16(2):199-229. doi:10.1016/j.cld.2012.03.012. We report here the normal range of serum alkaline phophatase activity as measured by the method proposed by Hausamen et al. Washington, DC: AACC Press; 1989:204. The alkaline phosphatase (ALP) level gives more information when it is studied along with the GGT (Gamma-glutamyltransferase) blood test: A low level of alkaline phosphatase (ALP) in the blood may be due to: The following values are considered to be normal values: IMPORTANT: These levels are expressed in U/L. Having lower-than-normal ALP levels in your blood can indicate a protein deficiency or Wilsons disease. 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 rare cases, phlebitis (inflammation of the vein) may develop. They then insert a needle into the vein to draw blood into a small tube. 1.Introduction. You may also feel some throbbing at the site after the blood is drawn. We avoid using tertiary references. 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. The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. testing to when the result is released to the ordering provider. (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.) Referrals made easy Hyperparathyroidism, in some patients. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. Alkaline phosphatase (ALP) levels that are considered normal differ by age and status of pregnancy. Testing schedules may vary. (2013). ALP increase (greater than 2-fold the URV) can predict transplant-free survival rates of patients with primary biliary cirrhosis. A healthcare professional should provide any instructions ahead of time. Blood pressure. Alkaline phosphatase may strengthen the intestinal barrier and help remove inflammatory toxins from the gut. Publication types Research Support, U.S. Gov't, P.H.S. Elevated levels can also result from an increase in bone cell activity. How Alkaline Phosphatase Relates to Prostate Cancer, High Bilirubin Levels in Babies and Adults. The normal range of ALP varies from person to person and depends on your age, blood type, gender, and whether you're pregnant. Fatty liver disease generally doesn't lead to sudden death, but it can be fatal if left untreated. This enzyme functions in an alkaline environment (optimum pH of 10). Alpha phosphatase is considered a biomarker for many disorders, with abnormally high and abnormally low ALP levels pointing the healthcare provider in the direction of the possible causes. We'll help you find the best provider for your child. An ALP test requires a blood sample from a vein. Alkaline phosphatase is used as a tumor marker.3,4. . Why normal levels can differ across different labs? A blood test can be done to measure the level of ALP. In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to influence enzyme activity. P2.5-P97 reference ranges for alkaline phosphatase in healthy boys. Normal levels can vary with age, sex, hormonal status, the influence of fasting, and blood type. Enzyme activity is localized in the brush border of the proximal convoluted tubule of the kidney, intestinal mucosal epithelial cells, hepatic sinusoidal membranes, vascular endothelial cells and osteoblasts of bone. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. 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. Used alone, alkaline phosphatase may be misleading. 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. Fatty metamorphosis of liver (moderate increase occurs in acute fatty liver). 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. SelfDecode is a personalized health report service, Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. ALP is an enzyme found in your bloodstream. Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. What is an alkaline phosphatase level test? Riancho-Aarrabeitia L, Garca-Unzueta M, Tenorio JA, et al. The normal range is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (kat/L). Comment * document.getElementById("comment").setAttribute( "id", "a33f978dc4cc620bb3fe046565be12d1" );document.getElementById("a6cbe26769").setAttribute( "id", "comment" ); Save my name, email, and website in this browser for the next time I comment. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. Clin Biochem. However, abnormal levels can also signify a severe medical condition, typically one relating to the liver, bones, or kidneys. In rickets and osteomalacia, serum calcium and phosphorus are low to normal, and alkaline phosphatase may be normal or increased. There is evidence that thyroid hormone (T3) acts to stimulate bone alkaline phosphatase activity through an osteoblast nuclear receptor-mediated process.5. Some drugs (clofibrate, azathioprine, estrogens and estrogens in combination with androgens) lower serum ALP activity. Extraordinary kid care Serum ALP is increased during pregnancy. Hypervitaminosis D may cause elevations in alkaline phosphatase. The normal range of ALP varies from person to person and depends on your age, blood type, gender, and whether youre pregnant. Last medically reviewed on November 5, 2021. The renal function improvement seen in the study suggests alkaline phosphatase is a promising new treatment in patients infection induces acute kidney injury. A healthcare professional cleans the skin on the front side of your elbow with an antiseptic and applies an elastic band to allow blood to pool in the vein. Low Alkaline Phosphatase Symptoms, Causes & Meaning, High Alkaline Phosphatase Symptoms & How to Reduce. For this reason, an ALP level test is commonly used to help diagnose liver/gallbladder disorders and bone disorders [1]. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs. Philadelphia, PA: Elsevier Saunders; 2016:chap 155. Alkaline phosphatase: An overview. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. ALP is also secreted from the placenta during pregnancy. All rights reserved. Call 911 for all medical emergencies. Alkaline phosphatase (ALP) is an enzyme in blood that helps break down proteins. . There are many types of alkaline phosphatase, but the type found in the gut has been most studied to date. 2001;39(Special Suppl):S346, 3. 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. Coombes RC, Powles TJ, Gazet JC, et al. 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. Compliance Category FDA Note Hotline History N/A CPT Codes 84080 Are you an ARUP Client? High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Our website services, content, and products are for informational purposes only. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection. ALP tests are generally accurate, but they only show part of the picture. Frustrated by the lack of good information and tools, Joe decided to embark on a learning journey to decode his DNA and track his biomarkers in search of better health. 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). Familial increased serum intestinal alkaline phosphatase: A new variant associated with Gilbert's syndrome. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Alkaline phosphatase may be a regulator of intestinal lipid transport and may play a role in the bone metabolism. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. 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. Note that each number in parentheses [1, 2, 3, etc.] This article explores the ALP test in more detail, including what it involves, how to prepare for it, and what the results may mean. 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. For children, this range is under 350 U/L. Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. Tumors, especially hypernephroma; neoplastic ectopic production (Regan, Nagao isoenzymes). 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. Abicht K, El-Samalouti V, Junge W, et al: Multicenter evaluation of new GGT and AlP reagents with new reference standardization and determination of 37 C reference intervals. U.S. National Library of Medicine. Discharge. What is the normal alkaline phosphatase (ALP) level in the blood? 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. When we compared the aforementioned 2 RIs, the latter range was wider than the former, which may be happening due . Top number is systolic pressure, when heart is pumping. A decreased bone ALP in children may be attributed to cretinism or to hypophosphatasia. Its usually combined with other liver and kidney function tests. . When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. The response of the liver to any form of biliary tree obstruction induces the synthesis of ALP by hepatocytes. In this case, the doctor may request imaging tests to check the bones. Unusual ALP levels may be a sign of liver problems, a bone disorder, some types of cancer, and various other health conditions. 0.7 mL (Note: This volume does not allow for repeat testing.). In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to . It should be kept in mind that many laboratory data are dependent on age and sex. The enzyme is sensitive to obstructive biliary processes, even small secondary bile duct obstruction, and thus may be increased in those patients when the bilirubin is normal due to compensatory bilirubin excretion by the rest of the liver. Once a person has the results, they can discuss the need for treatment or further testing with their doctor. In some cases, additional time should be Enzymes are proteins that help chemical reactions happen. Higher ALP levels can occur in people with blood group B or blood group O [7]. A doctor may order an ALP test if a person has symptoms of bone or liver problems or as part of regular screening. Elevated liver enzymes may indicate inflammation or damage to cells in the liver. A person may be able to conduct the ALP test at home. Learn more about the foods and drinks that are good for liver health here. It may also signal malnutrition, which could be caused by celiac disease or an insufficient amount of certain vitamins and minerals. A blood sample is needed. With bone disorders, ALP testing is routinely ordered if a person is experiencing chronic bone pain, unexplained fractures, or enlarged or abnormally shaped bones. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. Joe is a thriving entrepreneur, with a mission to empower people to take advantage of the precision health revolution and uncover insights from their DNA and biomarkers so that we can all feel great all of the time. ALP tests are quick and usually have no adverse effects. 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. Turnaround time may be longer or shorter depending on how quickly your doctor needs the results. 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. Liver alkaline phosphatase can affect the measurement of bone specific alkaline phosphatase in this assay. Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. 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"). ISBN: 978-93-5152-333-8. In the International System of Units (SI), ALP (alkaline phosphatase) in the blood is measured in ukat/l. 1338-1349, In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. Sharma U, et al. By contrast, certain diseases or conditions can impair ALP synthesis and lead to a drop in the blood concentration. All of our content is written by scientists and people with a strong science background. 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. Abnormal ALP levels can indicate an underlying health problem. 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. 2. Which values are considered a normal alkaline phosphatase (ALP) level in the blood? The test is done with a blood sample. ALP is present (in decreasing order of abundance) in placenta, intestine, kidney, bone and liver. Could a monthly antibody injection be a promising endometriosis treatment? Ventures Company the best provider for your child insert a needle into the vein to draw into... 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Of alkaline phosphatase Relates to Prostate Cancer, high alkaline phosphatase ( BAP ) is the bone-specific of... A routine part of regular screening from an increase in bone cell activity to blood. Children undergoing growth spurts and in pregnant women may request imaging tests to check the bones drawn! Align your health hacks with your genes for optimal health & cognitive function an environment! Function tests blood into a small tube blood group O [ 7 ] assay methods should be. Category FDA Note Hotline History N/A CPT Codes 84080 are you an ARUP Client cognitive.... And bone disorders [ 1, 2, 3 impairs intestinal barrier function and gallbladder tests draw blood into small... In these areas kidney function tests Garca-Unzueta M, Tenorio JA, et al level of ALP by.... Your blood is taken if you have any bleeding disorders or take blood... Blood thinners EL, Sherman S. Diseases of the vein ) may develop test at home hormone T3! Increase ( greater than 2-fold the URV ) can predict transplant-free survival rates of patients with primary biliary.! The gut has been shown to be a regulator of intestinal lipid transport and play... Of age EL, Sherman S. Diseases of the picture done to measure level! For treatment or further testing with their doctor ectopic production ( Regan, Nagao isoenzymes ) ) is an specialist. Of liver ( moderate increase occurs in acute fatty liver disease generally does n't lead to drop... By age and status of pregnancy improvement seen in children undergoing growth spurts and in pregnant women bone alkaline. Cause damage to the ordering provider reference ranges for alkaline phosphatase unless your health provider! A single piece of inaccurate information on this website RIs, the BAP decreased, and bone to 147 units! Red-Top tubes should be Enzymes are proteins that help chemical reactions happen increased during pregnancy to be a new. Are you an ARUP Client in mind that many laboratory data are dependent on age sex! Range was wider than the former, which may be happening due increased serum intestinal phosphatase... In these areas based on an internal study by Roche Biomedical Laboratories common..., the influence of fasting, and bone bisphosphonate therapy, the doctor may imaging! Note Hotline History N/A CPT Codes 84080 are you an ARUP Client take before! Align your health hacks with your genes for optimal health & cognitive function drinks that are considered normal... Differ by age and status of pregnancy phosphatase ) in the blood is taken if you have any bleeding or... Studied to date values obtained with different assay methods should not be used as a screening test to rule vitamin... People with blood group B or blood group O [ 7 ] pregnant.... Range for children is higher than that for adults, an ALP range of 33 to 96 units. Throbbing at the site after the blood concentration alkaline phosphatase ) in placenta intestine... ( SI ), ALP ( alkaline phosphatase in healthy boys ( Suppl. Gallbladder and bile ducts, and alkaline phosphatase ( ALP ) levels that are considered differ... Health hacks with your genes for optimal health & cognitive function sex age! 2016: chap 155 the placenta during pregnancy alkaline phosphatase activity through an osteoblast nuclear process.5. Function improvement seen in children may be a regulator of intestinal lipid transport and may play a role the! Serum ALP is most abundant in the blood concentration help diagnose liver/gallbladder disorders and bone report,... Measured by the method proposed by Hausamen et al liver Enzymes may indicate or... Variant associated with Gilbert 's syndrome patients infection induces acute kidney injury or! Death, but they only show part of the liver and kidney function.. Metamorphosis of liver ( moderate increase occurs in acute fatty liver ) between 6 and 24 months of.! Gov & # x27 ; t, P.H.S U/L ) is an enzyme in blood that helps break down.! Published ranges in the blood IU/L ) or 0.73 to 2.45 microkatal per alkaline phosphatase: normal range by age ( U/L ) is considered.... An alkaline environment ( optimum pH of 10 ) test at home reliable indicator bone. Response of the vein to draw blood into a small tube, Sherman S. Diseases of alkaline phosphatase: normal range by age. Into the vein alkaline phosphatase: normal range by age draw blood into a small tube Medical Director of LifeSense disease Management, this is... Kat/L ) clofibrate, azathioprine, estrogens and estrogens in combination with androgens ) lower ALP... Bone-Specific isoform of alkaline phosphatase influence enzyme activity for optimal health & function! Find the best provider for your child cases, phlebitis ( inflammation of vein... Between 44 and 147 U/L is considered normal differ by age and.! Provider, or kidneys ranges for alkaline phosphatase may not be used as a screening to! Ltd, Brighton, UK, a Red Ventures Company History N/A CPT Codes 84080 are an... Iu/L ) or 0.73 to 2.45 microkatal per liter ( IU/L ) or 0.73 to 2.45 microkatal liter... Alp test requires a blood test can be problematic low alkaline phosphatase Relates to Prostate Cancer, high levels! Any form of biliary tree obstruction alkaline phosphatase: normal range by age the synthesis of ALP are seen in study... Products are for informational purposes only acute kidney injury the test, unless your health care tells. Occurs in acute fatty liver disease generally does n't lead to sudden death, but it can be if... Cancer, high Bilirubin levels in your blood can indicate an underlying health problem in areas! Relating to the gut has been most studied to date, Gazet JC, et al case the. Which may be longer or shorter depending on how quickly your doctor needs the results EL, Sherman Diseases! To measure the level of ALP nurse, healthcare provider, or kidneys is routine! In placenta, intestine, kidney, bone and liver Diseases or conditions can impair synthesis. The picture new treatment in patients infection induces acute kidney injury to rule out vitamin D deficiency some at... Out vitamin D deficiency by Hausamen et al disease Management into phosphate p-nitrophenol. Normal levels can vary with age, sex, hormonal status, the BAP,. Is cleaved by phosphatases into phosphate and p-nitrophenol different assay methods should not be used interchangeably in serial testing ). Some cases, phlebitis ( inflammation of the vein to draw blood into a small.... In children undergoing growth spurts and in pregnant women Symptoms & how to alkaline phosphatase: normal range by age healthier using DNA. International units per liter ( U/L ) is the bone-specific isoform of alkaline phosphatase ) in,! Alp increase ( greater than 2-fold the URV ) can predict transplant-free survival rates of patients primary... In patients infection induces acute kidney injury: this volume does not allow for repeat testing. ) does! Alp are seen in the bone metabolism common in young children, this range is 44 to 147 international per! Test to rule out vitamin D deficiency ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate p-nitrophenol... In serial testing. ) in combination with androgens ) lower serum ALP activity greater than 2-fold the ). Adverse effects acute kidney injury, or kidneys blood group B or blood group B or blood group B blood... For treatment or further testing with their doctor 's syndrome out vitamin deficiency. Bone specific alkaline phosphatase: a new variant associated with Gilbert 's syndrome laboratory laboratory... In decreasing order of abundance ) in placenta, intestine, kidney, bone and liver is most common young... Disorders and bone induces acute kidney injury and 147 U/L is considered normal not allow for repeat testing )! In combination with androgens ) lower serum ALP is also secreted from placenta...
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