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What Does High Alkaline Phosphatase Indicate?

November 17, 2021 | Farah Jassawalla

Have you ever had a test for alkaline phosphatase (ALP) and had a high result? Maybe you're concerned about how this will affect your health. In this blog, we'll delve into what a high ALP level, or 'alk phos high,' means and the possible conditions it's linked to.

We'll also talk about when you should consult a medical professional and how you can take charge of your health with the help of modern technologies like telemedicine and at-home diagnostic labs. Let's dive in and learn more about high alkaline phosphatase levels and the causes of high alkaline phosphatase levels.

Alkaline Phosphatase: What is it?

"ALP" stands for "alkaline phosphatase," another name for this enzyme. This enzyme circulates in the blood and is found in various tissues of the body, and plays a role in metabolism of phosphates. The liver, bones, intestines and kidneys are significant sources of ALP, with additional production occurring in other organs. The placenta is also responsible for producing ALP in pregnant women.

While scientists have yet to pinpoint ALP's precise role, they know it plays a significant one in several vital physiological processes. Specifically, it's crucial for proper liver function and skeletal growth. 

High alkaline phosphatase levels, often referred to as 'alk phos high,' can be associated with various medical conditions affecting the liver, bones, or other organs. While elevated alkaline phosphatase levels can sometimes be seen in kidney cancer, they are not the most common or specific marker for this condition. Other possible causes of high alkaline phosphatase (ALP) levels include liver diseases such as hepatitis or cirrhosis, bone diseases like Paget’s disease or osteomalacia, infections, malnutrition, problems in the intestines or pancreas, or even kidney tumors.

Each individual has a unique range of normal ALP levels in their body. Factors such as age, gender, blood type, and pregnancy status can influence the optimal range. In most cases, the normal range is more comprehensive for younger people and narrower for older people.  

ALP normal ranges get determined by consulting with your doctor, who will then use the specific results and reference ranges provided by the lab that performed your test.

Alkaline Phosphatase Blood Test: What is it?

An alkaline phosphatase blood test measures ALP concentrations in the body. The blood test is performed by drawing blood from the arm and sending the sample to the lab for analysis.You'll find that out from the results if your alkaline phosphatase levels are low, high, or within the normal range. The highest concentrations of ALP are in the liver and the bones, but it is also present in many other tissues.

A high ALP level does not necessarily indicate a serious health problem. If your doctor notices that your ALP level is abnormally high, he or she will likely order more tests to determine why. The ALP blood test is fast and straightforward when screening for liver or bone issues.

CMP vs. ALP: What is the Difference?

While an alkaline phosphatase (ALP) test may be included in a liver panel or comprehensive metabolic panel (CMP), it should be noted that these tests are distinct and used for different purposes.

The ALP test measures explicitly the level of the ALP enzyme in the blood, which is found in very high concentrations in the liver and bones.

In contrast, a liver panel is a group of blood tests that measure different chemicals in the blood produced by the liver. These tests can help evaluate liver function and detect liver damage or disease. A liver panel typically includes tests for alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, albumin, and alkaline phosphatase (ALP).

A comprehensive metabolic panel (CMP) is a group of blood tests that measure a variety of chemicals in the blood, including electrolytes, glucose, kidney function, and liver function markers (including ALP). A CMP is often ordered as part of a routine check-up or to evaluate overall health.

So, while the ALP test is a specific test that measures the level of the ALP enzyme in the blood, a liver panel and CMP are broader tests that include markers of liver function and other health indicators.

Alkaline Phosphatase Blood Test: Why is it Suggested?

A healthcare provider orders an alkaline phosphatase (ALP) blood test to measure the levels of the ALP enzyme in the blood. This test is commonly called as part of a routine blood panel or an evaluation for specific medical conditions.

Here are some reasons why a healthcare provider may order an ALP blood test:

  • To diagnose or monitor liver disease: ALP is primarily produced by the liver, so a high level of ALP in the blood can indicate liver damage or disease, such as hepatitis, cirrhosis, or liver cancer.

  • To diagnose or monitor bone disease: ALP is also produced by bone cells, so a high level of ALP in the blood can indicate bone diseases, such as Paget's disease or osteomalacia.

  • To monitor treatment for specific medical conditions: If you have a pre-exsiting medical condition that affects the liver or bones, such as hepatitis or Paget's disease, your healthcare provider may order an ALP blood test to monitor your response to treatment.

  • As part of a routine blood panel: ALP is usually included in a routine blood panel to evaluate overall health and detect any potential health problems.

Your doctor will first check your symptoms and medical history to determine if an ALP blood test is necessary. If you have worries about your health or have symptoms related to liver or bone disease, you should speak with your doctor about whether an ALP blood test is appropriate for you.

Alkaline Phosphatase (ALP) Blood Test: Who Performs it?

An alkaline phosphatase (ALP) blood test is a standard laboratory test performed by a healthcare professional, such as a nurse, phlebotomist, or medical laboratory technician.

The healthcare professional will typically take a small blood sample from your arm using a syringe. 

The doctor who ordered the test will get the results and discuss them with you. Depending on the results, they may recommend additional testing or treatments. Overall, the ALP blood test is a quick and easy procedure that can help healthcare providers diagnose and monitor liver or bone disease, among other conditions.

During ALP Blood Test: What Should you Expect?

During an alkaline phosphatase blood test, you can expect the following:

Preparation

There is no preparation needed for an ALP blood test. You can eat and drink as you normally do before the test.

Procedure

A nurse will use a needle to draw a small amount of blood from any vein in your arm. You will feel a slight prick when the needle enters, but the test only takes a few minutes.

After the procedure: 

After the blood sample is taken, a small bandage will get placed over the site to stop bleeding. You can also resume your normal activities right away.

Results: 

The results of the ALP blood test will typically be available within a few days. Your primary physician will review the results with you and discuss any necessary follow-up testing or treatment.

Overall, an ALP blood test is a quick procedure that can be performed at a laboratory or medical office. If you have any concerns or questions about the test, discuss them with your primary physician before the test is performed.

After the Alkaline Phosphatase Blood Test: What Should You Expect?

After your alkaline phosphatase (ALP) blood test, there are generally no specific precautions or restrictions to follow. You can easily resume your normal activities immediately after the test.

If you do experience any pain at the site where the blood was drawn, apply a cold bag to the area for a few minutes to reduce swelling and discomfort. You can also take OTC pain relievers, such as acetaminophen, if needed.

The results of the ALP test usually take a few days to become available. Your primary physician will review the results with you and discuss any necessary follow-up testing or treatment, if needed. If the results are abnormal, your primary physician will order extra tests to determine the cause of the abnormal levels and develop a treatment plan.

If you have any questions about the test or the results, discuss them with your healthcare provider.

ALP Blood Test Results: What Does it Mean When Your Alkaline Phosphatase is High?

The results of an alkaline phosphatase (ALP) blood test can provide information about the level of ALP enzyme in your blood.

An alkaline phosphatase high level can indicate conditions, including:

  • Liver disease: The liver produces ALP, so a high ALP level can indicate liver damage or disease, such as hepatitis, cirrhosis, or liver cancer.

  • Bone disease: Bone cells also produce ALP, so a high ALP level can indicate bone diseases, such as Paget's disease or osteomalacia.

  • Certain medications or supplements: Some medications and supplements can cause a temporary increase in ALP levels, such as birth control pills, antibiotics, and vitamin D.

  • Pregnancy:ALP levels naturally increase during pregnancy.Mild to moderate increase in ALP levels are generally considered normal and do not necessarily indicate a medical problem.

Overall, the ALP blood test is helpful for healthcare providers to evaluate liver or bone disease, among other conditions. However, it's important to note that a high ALP level doesn't necessarily mean you have a serious medical condition; additional testing may be needed to determine the cause.

Low ALP Level: What Does it Mean When Your Alkaline Phosphatase is Low?

If your alkaline phosphatase (ALP) level is low, it can indicate a few different conditions, including:

  • Malnutrition: A diet low in phosphorus or protein can lead to a low ALP level.

  • Magnesium deficiency: Low magnesium levels can cause a low ALP level.

  • Hypophosphatasia: This rare genetic disorder causes low levels of ALP and can lead to skeletal abnormalities and other health problems.

In some cases, a low ALP level may not indicate a health problem and may be within your normal range.It's important to note that a low ALP level is less common than a high level, and your healthcare provider will likely perform additional tests to determine the underlying cause and develop a treatment plan, if necessary.

What level of Alkaline Phosphatase is dangerous?

While a normal range for ALP typically falls between 20 to 140 international units per liter (IU/L) (serves as a general reference guideline and may vary among different laboratories), the question arises: What level of Alkaline phosphatase is dangerous?

Elevated levels of alkaline phosphatase can be indicative of underlying health issues, and it's essential to monitor and understand these changes. However, determining a specific "dangerous" level can be complex and depends on various factors, including age, overall health, and the presence of symptoms. In general, significantly high ALP levels may suggest more severe conditions such as liver disease or bone disorders.

It's crucial to remember that isolated ALP results may not provide a complete picture of one's health. Interpretation requires a comprehensive assessment by a healthcare professional, considering additional diagnostic tests and the individual's medical history. If you find your ALP levels outside the normal range, it's advisable to consult with your healthcare provider promptly. They can provide personalized guidance, investigate potential underlying causes, and recommend appropriate steps for further evaluation and management. Remember, understanding your specific health context is key to determining the significance of elevated alkaline phosphatase levels.

High ALP Levels: What is the Treatment of High Alkaline Phosphatase?

The treatment for elevated alkaline phosphatase (ALP) levels depends on the underlying cause. Sometimes, no treatment may be needed if the elevated ALP levels are due to a temporary condition, such as pregnancy or medication use. 

However, treatment may be necessary if the high ALP levels are due to an underlying medical condition, such as liver or bone disease. Treatment options may include:

  • Medications: Depending on the underlying condition, you should know what does it mean if your alkaline phosphatase is high? Medications are usually prescribed to treat the disease and lower ALP levels as a treatment plan.

  • Lifestyle changes: Lifestyle modifications, such as changes to diet or exercise habits, may be recommended to help manage the underlying condition and lower ALP levels.

  • Surgery: Surgery can also be necessary to treat the underlying condition, such as liver cancer or bone tumors.

Your healthcare provider will discuss the appropriate treatment options with you based on the underlying cause of the high ALP levels. Following your healthcare provider's recommended treatment plan and attending any necessary follow-up appointments to monitor your progress is essential.

Conclusion

If you have a high ALP level or any concerning symptoms, it's essential to involve a healthcare provider. They can perform additional tests, if needed, and develop a tailored treatment plan tailored to your specific needs.

If you're interested in getting an ALP blood test or other medical services, you may want to consider Cura4U, a healthcare company that offers telemedicine and laboratory services to patients. 

With Cura4U, you can conveniently and affordably access medical care from your home. Contact Cura4U today to learn more about our services and how they will help you manage your healthcare needs.

 

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on November 29th, 2023.

References 

"Serum Alkaline Phosphatase Test" by A.D.A.M. Medical Encyclopedia.

https://medlineplus.gov/ency/article/003470.htm

"Liver Function Tests" by A.D.A.M. Medical Encyclopedia.

https://medlineplus.gov/lab-tests/liver-function-tests/

"Hypophosphatasia" by National Organization for Rare Disorders.

Alkaline Phosphatase: An Overview - PMC - (nih.gov)- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062654/

Alkaline Phosphatase: MedlinePlus Medical Test - https://medlineplus.gov/lab-tests/alkaline-phosphatase/

Alkaline Phosphatase - Health Encyclopedia - University of Rochester Medical Center - https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=alkaline_phosphatase

Alkaline Phosphatase - StatPearls - NCBI Bookshelf (nih.gov) - https://www.ncbi.nlm.nih.gov/books/NBK459201/

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