ALP - blood test
Alkaline phosphatase
Alkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone.
Bile
Bile is a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acid...
A blood test can be done to measure the level of ALP.
A related test is the ALP isoenzyme test .
ALP isoenzyme test
Alkaline phosphatase (ALP) is an enzyme found in many body tissues such as liver, bile ducts, bone, and intestine. There are several different forms...
How the Test is Performed
A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand.
Drawn from a vein
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
How to Prepare for the Test
You should not to eat or drink anything for 6 hours before the test, unless your health care provider tells you otherwise.
Many medicines can interfere with blood test results.
- Your provider will tell you if you need to stop taking any medicines before you have this test.
- DO NOT stop or change your medicines without talking to your provider first.
How the Test will Feel
You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.
Why the Test is Performed
Reasons the test may be done include:
- To diagnose liver or bone disease
- To check, if treatments for those diseases are working
- As part of a routine liver function test
Normal Results
The normal range is 44 to 147 IU/L (international units per liter) or 0.73 to 2.45 microkat/L.
Normal values may vary slightly from laboratory to laboratory. They also can vary with age and gender. High levels of ALP are normally seen in children undergoing growth spurts and in pregnant women.
The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.
What Abnormal Results Mean
Abnormal results may be due to the following conditions:
Higher-than-normal ALP levels
-
Biliary obstruction
Biliary obstruction
Bile duct obstruction is a blockage in the tubes that carry bile from the liver to the gallbladder and small intestine.
- Bone conditions
-
Osteoblastic bone tumors
,
osteomalacia
, a fracture that is healing
Osteoblastic bone tumors
A bone tumor is an abnormal growth of cells within a bone. A bone tumor may be cancerous (malignant) or noncancerous (benign).
Osteomalacia
Osteomalacia is softening of the bones. It most often occurs because of a problem with vitamin D, which helps your body absorb calcium. Your body n...
- Liver disease or hepatitis
- Eating a fatty meal if you have blood type O or B
-
Hyperparathyroidism
Hyperparathyroidism
Hyperparathyroidism is a disorder in which the parathyroid glands in your neck produce too much parathyroid hormone (PTH).
- Leukemia
- Lymphoma
-
Paget disease
Paget disease
Paget disease is a disorder that involves abnormal bone destruction and regrowth. This results in deformity of the affected bones.
-
Rickets
Rickets
Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.
- Sarcoidosis
Lower-than-normal ALP levels
- Hypophosphatasia
- Malnutrition
-
Protein
deficiency
Protein
Proteins are the building blocks of life. Every cell in the human body contains protein. The basic structure of protein is a chain of amino acids. ...
- Wilson disease
Other conditions for which the test may be done:
-
Alcoholic liver disease (hepatitis/cirrhosis)
Alcoholic liver disease (hepatitis/cirr...
Alcoholic liver disease is damage to the liver and its function due to alcohol abuse.
-
Alcoholism
Alcoholism
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
-
Biliary stricture
Biliary stricture
A bile duct stricture is an abnormal narrowing of the common bile duct, the tube that moves bile from the liver to the small intestine. Bile is a su...
- Gallstones
-
Giant cell (temporal, cranial) arteritis
Giant cell (temporal, cranial) arteriti
Temporal arteritisis inflammation and damage to the blood vessels that supply blood to the head, neck, upper body and arms. It is also called giant ...
-
Multiple endocrine neoplasia (MEN) II
Multiple endocrine neoplasia (MEN) II
Multiple endocrine neoplasia, type II (MEN II) is a disorder passed down through families in which one or more of the endocrine glands are overactive...
- Pancreatitis
-
Renal cell carcinoma
Renal cell carcinoma
Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney.
References
Berk P, Korenblat K. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 147.
Fogel EL, Sherman S, eds. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 155.
Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 146.
Review Date: 4/30/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.