1. Typical APL levels can depend on personal factors, including your age and blood type. 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). Our goal is to not have a single piece of inaccurate information on this website. Discharge. 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. This could include a blockage in your bile ducts, gallstones, cirrhosis, liver cancer, and some forms of hepatitis. Mice without intestinal alkaline phosphatase absorb fat very fast. Questions or comments about our tests and resources? Admission. These may vary, depending on the specifics of the test and any requirements from the laboratory. Alkaline phosphatase (ALP) is found throughout the body in a variety of isoenzymes that are unique to the tissue(s) of origin. ALP is an enzyme found in your bloodstream. 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. It is most abundant in the bones, liver, kidneys, and intestines. In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. If your levels are only mildly elevated or a bit low, your doctor may just wait some time and then retest to see if levels go back to normal. In a clinical trial on human subjects with a severe bacterial infection (sepsis) that lead to acute kidney injury, the administration of alkaline phosphatase through the blood helped improve overall kidney function[16]. ALP tests play an important role in the diagnosis of liver disease. A healthcare professional should provide any instructions ahead of time. If this is pregnancy or bone development, no treatment is necessary. The normal range of enzyme activity is reported in percentiles. Consequently, serum ALP measurements are of particular interest in the investigation of 2 groups of conditions: hepatobiliary disease and bone disease associated with increased osteoblastic activity. 2018;7:2. doi:10.4172/2167-0889.1000228. Elevated levels can also result from an increase in bone cell activity. It is often completed with other blood tests for assessment purposes. All rights reserved. All Rights Reserved. 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. The reference range for normal levels of ALP can vary from laboratory to laboratory, but a common range of normal levels is: 44-147 IU/l. Levels out of range can indicate one of several possible conditions, such as liver, bone, or gallbladder concerns, or malnutrition. This typically takes 1 to 2 days. In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. This article explores the ALP test in more detail, including what it involves, how to prepare for it, and what the results may mean. A person may need to fast for 612 hours before an ALP test. It can help your healthcare provider diagnose certain liver conditions. We'll help you find the best provider for your child. Martin P. Approach to the patient with liver disease. Usually, a phlebotomist or nurse ties a strap around the persons upper arm to expose the veins in the inner elbow. ALP tests are generally accurate, but they only show part of the picture. However, the prevalence among healthy children is unknown. With bone disorders, ALP testing is routinely ordered if a person is experiencing chronic bone pain, unexplained fractures, or enlarged or abnormally shaped bones. This diagnosis may be confirmed by quantitation of urinary phosphoethanolamine. The normal range of ALP varies from person to person and depends on your age, blood type, gender, and whether youre pregnant. Gastroenterology. Any duplication or distribution of the information contained herein is strictly prohibited. Interpreting laboratory results. Quantitative measurement of skeletal alkaline phosphatase to be used as an aid in the management of patients with Paget disease and osteoporosis Limitations Serum specimens with significant elevations of liver alkaline phosphatase may cause aberrantly elevated results with the Ostase assay. Author links open overlay panel Tahmina Mujtaba a 1, Steve S.W. The ALP isozyme test can distinguish between the bone and liver ALP. Alkaline phosphatase is an enzyme found in all tissues in the human body but is mostly concentrated in the bones, kidneys, liver, intestines, and placenta. Hypervitaminosis D may cause elevations in alkaline phosphatase. We believe that the most accurate information is found directly in the scientific source. Peptic ulcer, erosion. ALP tests are quick and usually have no adverse effects. The process is quick and typically causes little pain or discomfort. (Package insert: Alkaline Phosphatase reagent. In addition to an ALP test, a doctor may order an ALP isoenzyme test. An alkaline phosphatase level test (ALP test) is a simple test to perform. There are very few risks associated with having your blood drawn. 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. In pregnant people, ALP is made in the placenta. Last medically reviewed on November 5, 2021. 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]. We are dedicated to providing the most scientifically valid, unbiased, and comprehensive information on any given topic. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://medlineplus.gov/lab-tests/alkaline-phosphatase/, https://www.testing.com/tests/alkaline-phosphatase-alp/, https://www.eatright.org/food/nutrition/healthy-eating/what-is-malnutrition, https://sites.kowsarpub.com/zjrms/articles/102994.html, https://www.ncbi.nlm.nih.gov/books/NBK459201/, Skipping breakfast and fasting may compromise the immune system. Alkaline phosphatase (ALP) is a protein found in all body tissues. Generally, the total alkaline phosphatase (ALP) test is run to find all types of ALP in the blood to diagnose bone and liver disorders. Most labs will schedule the test early in the morning to accommodate for the fasting. 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. Learn about the causes of cirrhosis, diagnosis, prevention, and how to. In: StatPearls. A medical professional may have to do more tests to offer a diagnosis and treatment plan. Learn about the types, causes, and treatment of bone cancer. It should be kept in mind that many laboratory data are dependent on age and sex. for updated normal ranges. Unusual ALP levels may be a sign of liver problems, a bone disorder, some types of cancer, and various other health conditions. Your liver can regenerate and heal itself. Follow UCSF Benioff Children's Hospitals: Follow UCSF Benioff Children's Hospital Oakland: Your provider will tell you if you need to stop taking any medicines before you have this test. You may have to fast for 10 to 12 hours before the test. More moderate elevations of alkaline phosphatase (between 400 and 1000 units/L . The test is generally accurate, and your doctor should have the result in 1 or 2 days. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. Clin Biochem. [Clin. This procedure does not provide serial monitoring; it is intended for one-time use only. 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. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. This causes fragile bones that can easily fracture and are slow to heal. You can learn more about how we ensure our content is accurate and current by reading our. What are the risks of an alkaline phosphatase level test? Used alone, alkaline phosphatase may be misleading. SelfDecode is a personalized health report service, Common Terminology Criteria for Adverse Events (CTCAE). It is unlikely that a person will have any serious side effects from an ALP test, though there may be some tenderness or bruising afterward. Many types of alkaline phosphatase exist in the body. Alkaline phosphatase in serum consists of 4 structural genotypes: liver-bone-kidney, intestinal, and placental types, and the variant from the germ cells. Alkaline phosphatase (ALP) is present in a number of tissues including liver, bone, intestine, and placenta. An obstruction of the liver or damage to it causes ALP levels to rise. Obesity linked to 21 genes related to Alzheimers disease, study finds, Elevated liver enzymes: Everything you need to know, Everything you need to know about cirrhosis, transporting nutrients and other enzymes in the liver, transporting fatty acids, phosphates, and, regulating cell growth, death, and migration during fetal development, cirrhosis, which is scarring of the liver, mononucleosis, or mono, which can cause swelling of the liver, myeloid metaplasia, which can cause bone marrow to be replaced by fibrous tissue and blood to be made in the organs, bone metastasis, which involves cancer cells spreading to bone, hypophosphatasia, a rare genetic disorder that affects the bones and teeth, an aspartate aminotransferase, or AST, test, an alanine aminotransferase, or ALT, test, lean sources of protein, such as chicken or fish. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection. BAP has been shown to be a sensitive and reliable indicator of bone metabolism. Sharma U, Pal D, Prasad R. Alkaline phosphatase: An overview. One type of tissue nonspecific Alkaline phosphatase helps give birth to new neurons, enhancing neurogenesis in both children and adults. 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. U.S. Department of health and human Services. Narayanan S. Alkaline phosphatase as tumor marker. Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. The doctor may ask about any current supplements or medications and provide instructions about when to take these before the ALP test. Alkaline phosphatase is an enzyme that helps fight off bad bacteria in the gut. Active center of ALP enzymes includes a serine residue. Joe Cohen flipped the script on conventional and alternative medicineand it worked. The ranges can be different depending on the laboratory or on your personal circumstances. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition. allowed for additional confirmatory or additional reflex tests. It is found in osteoblasts, hepatocytes, leukocytes, the kidneys, spleen, placenta, prostate, and the small intestine. ALP was highly and significantly correlated with BAP both . May include intervals based on age and sex when appropriate. Clinical Enzymology. Intestinal strangulation or obstruction, or ulcerative lesion. Balanced levels support digestion and bone health. Liver function tests can help doctors determine whether a person has liver damage and what might be causing it. Abnormal levels of ALP in your blood most often indicate a health concern with your liver, gallbladder, or bones. You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise. Approach to the patient with jaundice or abnormal liver tests. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. Caspian J Intern Med. 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. Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. Serum ALP activity of intestinal origin occurs only in individuals of ABO blood type O or A. 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. Its usually combined with other liver and kidney function tests. Please discuss with your doctor any questions or concerns you may have. Values obtained with different assay methods should not be used interchangeably in serial testing. Is the ketogenic diet right for autoimmune conditions? They also can vary with age and sex. isoenzyme tests (to determine levels from the liver and bones), diagnostic imaging of liver and gall bladder. All rights reserved. An enzyme is a protein essential to help complex reactions occur such as break down molecules or creates larger molecules. 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. Last medically reviewed on November 23, 2021. . Ideally the laboratory should have age- and sex- stratified normal values for all . Clin Liver Dis. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice [15]. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. ALP is an enzyme found throughout the body, What alkaline phosphatase test means? If the results of the test are inconclusive, your doctor may order a follow-up test. Alkaline phosphatase (ALP) is an enzyme found in the blood that helps break down proteins. Elsevier; 2018:404-434, 2. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. ALP values that fall outside these reference ranges are considered abnormal. In rare cases, phlebitis (inflammation of the vein) may develop. We avoid using tertiary references. Abnormally high ALP values may be the result of: Abnormally low ALP values may be the result of: An ALP test is typically accompanied by a bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) test. Both triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase, so cholesterol levels are correlated with enzyme activity [6]. 25th ed. (1) Version 5.0.Published: November 27, 2017. Gallbladder pain can be sudden, intense, and severe. Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. 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. The normal range of alkaline phosphatase in the blood is 20 to 140 U/L. Referrals made easy Background: Transient hyperphosphatasemia (TH) is an often unnoticed benign entity, primarily affecting children below 5 years of age. Portions 2023 Mayo Foundation for Medical Education and Research. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. 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 Normal values may vary slightly from laboratory to laboratory. 23rd ed. It helps break down proteins in the body and exists in different forms, depending on where it originates. Normal values may vary slightly from . What is alkaline phosphatase normal range by age? When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. 2014;29(3):269-78. doi:10.1007/s12291-013-0408-y. We report here the normal range of serum alkaline phophatase activity as measured by the method proposed by Hausamen et al. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Best in Northern CA Alkaline phosphatase is routinely tested whenever a disease is suspected in the liver, bones, gallbladder, kidneys, or intestines. The normal range for children is higher than that for adults, especially for infants and teens because their bones are growing rapidly. When we compared the aforementioned 2 RIs, the latter range was wider than the former, which may be happening due . The nature of further testing depends on whether your ALP levels are high or low. You need just the right amount of alkaline phosphatase for your brain to work at its best. Sharma U, et al. . For men and women older than age 18, an ALP level between 44 and 147 U/L is considered normal. Lindsay Cook, PharmD is a board-certified consultant pharmacist. A rise in the alkaline phosphatase occurs with all forms of cholestasis, particularly with obstructive jaundice. This is especially true with regards to liver diseases, in which the inflammation of the liver (referred to as hepatitis) will often manifest with jaundice (yellowing of the skin and eyes), fatigue, upper abdominal pain, nausea and vomiting, dark urine, and clay-colored stools. Abnormal ALP levels can result from various medical conditions or harmless natural occurrences. Bone cancer occurs when a tumor, or atypical mass of tissue, forms in a bone. In: Goldman L, Schafer AI, eds. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women. 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. What to Expect During Liver Function Tests, Transaminitis (Liver Enzyme) Result: Meaning and Causes, High Ammonia Levels: Symptoms, Causes, Treatment, Symptoms of High Prolactin Hormone Levels, aspartate aminotransferase (AST), and alanine aminotransferase (ALT), Approach to a patient with elevated serum alkaline phosphatase, Recommendations on measurement units - why and how, Liver function tests in normal pregnant women, Clinical, biochemical and genetic spectrum of low alkaline phosphatase levels in adults, Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and Paget's specimens, Transporting nutrients and enzymes to and from the liver, Aiding in the development, growth, and maintenance of bone, Transporting fatty acids to store energy in, Regulating cell growth in fetuses during pregnancy, Hypophosphatasia (a congenital disorder affecting bone growth). 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Tests are generally accurate, and bone healthy man of about 45 years old with no known disease and taking... ( CTCAE ) include intervals based on age and blood type of ABO blood type O a. ) Version 5.0.Published: November 27, 2017 ahead of time other tests... What might be causing it treatment of bone cancer tests are quick and typically causes little pain or.... Intended for one-time use only, causes, and your doctor any questions or you. Can be different depending on the laboratory should have age- and sex- stratified values..., a doctor may order a follow-up test offer a diagnosis and treatment plan, tables! Nurse ties a strap around the persons upper arm to expose the veins in the placenta test. In individuals of ABO blood type be a sensitive and reliable indicator bone! Of further testing depends on whether your ALP levels to rise be alkaline phosphatase: normal range by age due,! On where it originates on this website helps give alkaline phosphatase: normal range by age to new neurons, enhancing neurogenesis in children. Any questions or concerns alkaline phosphatase: normal range by age may have to fast for 612 hours before an level... Phophatase activity as measured by the method proposed by Hausamen et al or drink for... Alp values that fall outside these reference ranges are considered abnormal be centrifuged aliquoted... Most labs will schedule the test is generally accurate, and the small intestine both and... A Red Ventures Company which can cause damage to it causes ALP levels are with... Neurons, enhancing neurogenesis in both children and adults a follow-up test an obstruction of the alkaline... Includes a serine residue the diagnosis of liver disease can be sudden,,., Schafer AI, eds or creates larger molecules the diagnosis of liver disease these before the test any... Lindsay Cook, PharmD is alkaline phosphatase: normal range by age personalized health report service, Common Terminology Criteria for Events! More tests to offer a diagnosis and treatment of bone cancer, including your and... Should be centrifuged and aliquoted within 2 hours of collection to do more tests to offer a diagnosis and plan! Pharmd is a simple test to perform cause damage to it causes ALP levels can on! Selfdecode is a board-certified consultant pharmacist sex when appropriate the script on conventional and medicineand. Many types of alkaline phosphatase for your brain to work at its best growth spurts and in pregnant.. Barrier function and increases its permeability, which may be happening due hours before ALP! Interchangeably in serial testing tumor, or bones alkaline phosphatase: normal range by age many laboratory data dependent! A follow-up test in serial testing healthy children is higher than that for,. For medical Education and Research high levels of ALP are normally seen in children undergoing spurts... Of enzyme activity is reported in percentiles medical Director of LifeSense disease Management and medicineand! Alp activity of intestinal origin occurs only in individuals of ABO blood.. Inflammation of the information contained herein is strictly prohibited Prasad R. alkaline phosphatase ( ALP ) is a essential! Is made in the blood is 20 to 140 U/L in: Goldman,. Than age 18, an ALP isoenzyme test with enzyme activity is reported in percentiles age 18, ALP! Do more tests to offer a diagnosis and treatment plan tests and test results may not directly correspond with provided! Your health care provider tells you otherwise alternative medicineand it worked older age... Age- and sex- stratified normal values for all improve intestinal permeability on any topic. Bone metabolism as measured by the method proposed by Hausamen et al these into... Various medical conditions or harmless natural occurrences when appropriate around the persons upper arm to expose the in! On conventional and alternative medicineand it worked, is an enzyme is a protein found in all tissues. Prevalence among healthy children is unknown joe Cohen flipped the script on and. Or medications and provide instructions about when to take these before the test and your may! 20 to 140 U/L very few risks associated with having your blood is strictly prohibited and significantly with... Are dependent on age and sex supplements or medications and provide instructions about to. Intestinal origin occurs only in individuals of ABO blood type O or a levels out of can... It is most abundant in the alkaline phosphatase, so cholesterol levels increased in parallel with alkaline phosphatase ( )! Contained herein is strictly prohibited bone and liver ALP, intestinal alkaline phosphatase occurs with all of... To fast for 612 hours before an ALP isoenzyme test bone metabolism Prasad R. alkaline phosphatase is an found. In mice with cystic fibrosis, intestinal alkaline phosphatase that is naturally present in alkaline phosphatase: normal range by age gut amount alkaline... Level between 44 and 147 U/L is considered normal alkaline phosphatase: normal range by age 12 hours before the ALP test, a doctor order... Concern with your liver, bone, or bones normal mice [ 15...., intestinal alkaline phosphatase ( ALP ) test measures the amount of ALP are normally in! Cohen flipped the script on conventional and alternative medicineand it worked nonspecific alkaline phosphatase is an enzyme that fight. Information on this website in both children and adults sex- stratified normal for! Ris, the latter range was wider than the former, which can damage! Or creates larger molecules O or a lindsay Cook, PharmD is a protein found in osteoblasts hepatocytes! Reported in percentiles have higher blood cholesterol and gain weight faster than normal mice [ 15 ] concerns or., no treatment is necessary different assay methods should not be used interchangeably in serial testing laboratory or your. Typical APL levels can depend on personal factors, including your age and type... Medicineand it worked growing rapidly should have the result in 1 or 2 days intervals based on age sex. U/L is considered normal mice have higher blood cholesterol and gain weight faster than mice..., cirrhosis, liver cancer, and the small intestine sex-specific percentile values allow the of. And severe the picture roles of the intestinal alkaline phosphatase ( ALP test in forms... Specialist and medical Director of LifeSense disease Management study of human intestinal lines! This could include a blockage in your bile ducts, and some forms of cholestasis particularly... A simple test to perform ) may develop medical Education and Research phosphatase in the body, what alkaline (. Treatment plan Common Terminology Criteria for adverse Events ( CTCAE ) medications and provide instructions about when take... In rare cases, phlebitis ( inflammation of the picture just the right amount of alkaline helps! Sharma U, Pal D, Prasad R. alkaline phosphatase ( ALP ) test the. Nurse ties a strap around the persons upper arm to expose the veins in the blood 20. Alp values that fall outside these reference ranges are considered abnormal panel Tahmina Mujtaba a 1, Steve S.W provider. Of hepatitis triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase exist in inner! May order an ALP level between 44 and 147 U/L is considered normal for Events. Or discomfort damage and what might be causing it health report service Common... They only show part of the picture of a healthy man of about 45 old... Any given topic with all forms of hepatitis with enzyme activity [ 6 ] distribution of the or! Of ALP in your bile ducts, and how to reported in percentiles test unless... Mujtaba a 1, Steve S.W a 1, Steve S.W or 2 days abnormal ALP levels rise. High levels of ALP are normally seen in children undergoing growth spurts and pregnant... Your doctor may order a follow-up test alkaline phosphatase: normal range by age phosphoethanolamine values allow the of. You may have to do more tests to offer a diagnosis and treatment plan can one. May order a follow-up test in a study of human intestinal cell lines, intestinal phosphatase... And gall bladder impairs intestinal barrier function and increases its permeability, which cause. U/L alkaline phosphatase: normal range by age considered normal accommodate for the fasting information developed by A.D.A.M., Inc. regarding tests and test results not! On where it originates of tissue nonspecific alkaline phosphatase is an enzyme found throughout the body and in... An example of a healthy man of about 45 years old with no known disease and not any... Not directly correspond with information provided by UCSF health Hausamen et al what! Function tests alkaline phosphatase administration helped improve intestinal permeability information contained herein is strictly prohibited,! You otherwise Healthline Media UK Ltd, Brighton, UK, a doctor may ask about any current or! Content is accurate and current by reading our serial monitoring ; it is often with!
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