Alkaline Phosphatase

Also known as: ALP, Alk Phos. Alka, Alkaline Phosphatase Isoenzymes

Why do you need to get tested?

The test is ordered sometimes as a part of the routine liver panel or when the patient displays symptoms of a liver or bone disorder. It may also be ordered when the patient has signs related to gallstones and gallbladder disease.

When do you need to get tested?

Which kind of sample is required?

This is a blood test that requires a blood sample drawn from a vein in the arm using a syringe.

Do you need to prepare for the test?

It is ideal for you to fast overnight before the test. However, you may drink water. In addition to this, you are required to follow instructions given by your doctor or the lab which is performing the test.

What is being tested in Alkaline Phosphatase?

The test examines Alkaline phosphatase, which is an enzyme present in a number of tissues throughout the body. The enzyme comes mainly from the liver, with some of it coming from the bones. Higher levels of alkaline phosphatase in the blood are caused by liver disease, gallbladder disease, bone disorders, or bile duct obstruction. This test examines the percentage of ALP present in the blood. In the liver, ALP is located on the edges of the cells, which merge to form bile ducts, which direct bile from the liver into the bowels, where ALP is used to help digest fat in the diet. ALP is made in the bone by special cells called osteoblasts. All tissue types in the body make distinct forms of ALP which are called isoenzymes.

ALP levels may be high in the blood when bile ducts are blocked, and this is due to inflammation in the gallbladder or gallstones. On the other hand, lower levels of ALP are often due to cirrhosis and liver cancer, and hepatitis a. Conditions that lead to excessive bone formation, like Paget’s disease, a bone disorder, can also lead to higher levels of ALP found in the blood. Young children tend to have higher levels of ALP in the blood because their bones are still growing. Therefore, the ALP test should be examined with reference to the standard values for children and adults. Moreover, the doctor can distinguish between different isoenzymes of ALP made by the tissues. If the signs and symptoms do not clarify why the ALP level is high in the blood, a test may be performed to identify which isoenzyme is increased in the blood.

How is the test used?

The test is used to help detect liver disease or bone disorders in the blood. It may be ordered as part of the liver panel or alongside GGT.

When is the test ordered?

The doctor typically orders the test as part of routine testing. The Alkaline phosphatase is commonly ordered with a series of other tests called a liver panel. The test is also ordered with some other tests when the patient has some symptoms of liver disease or a bone disorder. Symptoms of diseases related to liver damage or disease typically include

Weakness, fatigue
Loss of appetite
Nausea, vomiting
Abdominal swelling and/or pain
Jaundice
Dark urine, light-colored stool
Itching (pruritus)

Bone and/or joint pain
Increased frequency of fractures
Deformed bones

Severe abdominal pain, especially at the top right side or center of the abdomen
Pain that spreads to the back or right shoulder blade
Nausea that occurs at the same time as abdominal pain
Abdominal pain that is linked to eating a fatty meal (when the gallbladder contracts)
Normally, the intense pain lasts at least 30 minutes but begins to subside within an hour. An attack of biliary colic usually lasts less than 6 hours.

What does the test result mean?

The results of this test are often interpreted alongside GGT (gamma-glutamyl transferase) and with other tests which have been carried out at the same time, like the tests in a liver panel. They are also assessed in light of the patient’s clinical history. High levels of ALP indicate that the liver has been damaged or some condition that is causing increased bone cell activity is at play. If tests which are part of the liver panel are high, then ALP is caused by liver damage. If the GGT is also high, then the ALP is due to liver disease. On the other hand, if the liver tests and GGT are normal, then high ALP is due to bone disease. If the signs and symptoms do not clarify why the ALP level is high in the blood, a test may be performed to identify which isoenzyme is increased in the blood. Moderately high ALP occurs due to Hodgkin’s lymphoma, ulcerative colitis, congestive heart failure, or some bacterial infections.

Related Tests: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT), Bilirubin, Liver Panel Bone Markers, calcium test kit, Phosphorus

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