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ALP analysis. Alkaline phosphatase in the blood is elevated: what does this mean and what are the causes of the disorders? Causes of low alkaline phosphatase

If alkaline phosphatase (ALP) is low, this is a serious reason to pay close attention to your own health. A person is a complex “laboratory” where dozens of biochemical reactions occur every second. They involve hundreds of active substances. One such reaction is dephosphorylation. It is associated with an enzyme: alkaline phosphatase. What is it, for what reasons is it decreasing, how to deal with it? Let's try to answer these questions.

Alkaline phosphatase is a whole group of active substances (catalysts, enzymes) involved in metabolic processes. Chemical reactions with this substance occur exclusively in an alkaline environment (at pH > 8.3-8.7), which is why phosphatase is called alkaline.

Phosphatase is found in almost all tissues of the body. There is especially a lot of it in the bones, kidneys, digestive organs (liver, intestines), as well as the placenta. Medical practice associates this catalyst with the metabolic rate in bone tissue; phosphatase also acts as a signal indicator of the functional activity of the liver and gall bladder.

The types of active substance described are divided depending on the location. These are placental phosphatase, hepatic phosphatase, etc.

Why does ALP decrease?

As a rule, to determine the concentration of phosphatase, a blood sample is examined. There are many possible reasons why there is a decrease in ALP. Among them:

These are the main and most common causes of low alkaline phosphatase.

Normal alkaline phosphatase levels

When assessing the norm, it is important to take into account the patient’s age, height, weight, metabolic rate, and general health. Reference values fluctuate in a fairly wide range, from 45 to 940 units.

In children and adolescents, the level of alkaline phosphatase in the blood will be increased, since the active process of growth of long bones is taking place, the skeleton is still being formed. It is impossible to reduce ALP, and there is no such need. In pregnant women, alkaline phosphatase also increases, and this is also a normal variant. In old age (over 60 years), the rate is lower because metabolic processes in the bones slow down. In general, we can talk about the following normal levels of alkaline phosphatase in the blood: :

It is important to keep in mind that the way the study is conducted must be taken into account when assessing indicators. Therefore, when visiting a doctor, it is important to show him, among other things, the reference values that describe the normal concentration of alkaline phosphatase.

When is it necessary to conduct a blood test for alkaline phosphatase?

There are several reasons why a blood test for alkaline phosphatase is required:

if you suspect the presence of diseases of the intestines, thyroid gland and others (described below);
to monitor the effectiveness of treatment;
before surgery.

What diseases are we talking about and what are their symptoms?

We can talk about a wide range of diseases. This:

Knowing the symptoms, you can suspect that you have a particular disease, but under no circumstances should you self-medicate. Any suspicions are grounds for visiting a doctor.

Diagnosis of the source of low phosphatase

In order for alkaline phosphatase to normalize, it is necessary to identify the root cause of the decrease and eliminate it. To do this you need to go through a series of studies.

Diagnosis begins with a visit to a specialist. The first step is to go to a therapist. He will prescribe the necessary tests (general and biochemical blood tests) and give a referral to a specialized specialist. Among them:

hematologist. Treats blood diseases;
orthopedist – specialist in the musculoskeletal system;
gastroenterologist – for pathologies of the gastrointestinal tract.

The examination involves conducting several instrumental studies:

These measures are sufficient to make a correct diagnosis and determine the cause of low phosphatase.

A decrease in alkaline phosphatase is a warning signal from the body. Most often we are talking about diseases of the liver or musculoskeletal system. Both medications and changes in diet will help normalize the indicator. Be that as it may, it is necessary to solve the problem only in tandem with an experienced doctor.

Almost all tissues of human organs contain a group of enzymes - alkaline phosphatase. Their highest concentration is found in the placenta, bone tissue, liver and bile ducts. An increase in phosphatase activity may indicate the presence of certain diseases that require immediate treatment.

What is alkaline phosphatase?

Looking at this enzyme in more detail, we should talk about the role of alkaline phosphatase in fat metabolism, which requires an alkaline environment, hence the name of the enzyme. However, there are several types of enzyme, depending on its location:

hepatic phosphatase (highest concentration in adults);
bone (highest in children);
placental (high concentration in pregnant women);
alkaline intestinal phosphatase;
renal (this alkaline phosphatase is not observed in the blood because it does not enter it, unlike other types).

Alkaline phosphatase test

In a number of cases and the appearance of certain symptoms, an analysis is prescribed, in which alkaline phosphatase may be increased or decreased, which will allow appropriate conclusions to be drawn. This analysis is prescribed:

When carried out comprehensively.
To control bone diseases during their treatment.
If the patient takes medications that contribute to the appearance of cholestasis (stagnation of bile, disruption of its production and excretion).
If the following symptoms appear: nausea, discoloration of feces, dark urine, vomiting, jaundice, loss of strength and rapid exhaustion.

What does alkaline phosphatase show in a blood test?

The question of what alkaline phosphatase shows is of interest to those who are not familiar with this concept or are taking the test for the first time. The enzyme level is prescribed more often to diagnose diseases of the bones, biliary tract and liver. Elevated alkaline phosphatase may also indicate the presence of very dangerous diseases: testicular cancer, lymphogranulomatosis, or malignant tumors in the brain. However, there are a number of cases in which analyzes and conclusions based on the results obtained must be carried out taking into account certain features.

With a lack of zinc in the diet, the concentration of the enzyme may increase, because this element is part of the phosphatase.
It is useless to test children to identify problems with bile excretion, therefore, as a rule, a 5′-nucleotidase test is prescribed.
To control, a phosphatase test should be performed no more than once a week, since it is removed from the blood within 3-4 days.
The reason for the increase in the rate in older people is a decrease in bone mass.
When conducting an analysis in people with blood types 1 and 3, you need to take into account that the level of intestinal phosphatase may be increased after eating fatty foods, so blood sampling should be done on an empty stomach.

Alkaline phosphatase is normal

It is important to know that the level of alkaline phosphatase in the blood is different for women, men and children. The enzyme content depends not only on gender, but also on age, which also needs to be taken into account. Until the age of 16, the level of alkaline phosphatase concentration is always slightly elevated, and after this age it begins to decline. For women the norm is:

up to 17 years – minimum: 46 units/l; maximum: 119 units/l;
from 17 to 45 years – minimum: 32 units/l; maximum: 100 units/l;
from 45 to 55 years – minimum: 35 units/l; maximum: 115 units/l;
up to 70 years – norm 135 units/l;
after 70 years – the norm is 165 units/l.

There are a number of reasons why this indicator can increase significantly, but not due to the presence of diseases:

during the period of bearing a child;
during the GW period;
in the presence of vitamin deficiency;
due to poor nutrition;
due to high physical activity.

In men, this figure is on average 20-25 units/l higher than in women, and with age, as in women, it increases. The normal level of alkaline phosphatase in the blood in men:

from 17 to 30 years – up to 100 units/l;
from 30 to 45 years – up to 120 units/l;
from 46 to 64 years – up to 130 units/l;
from 55 to 70 years – up to 145 units/l;
from 70 years – up to 190 units/l.

In young children, the concentration of the enzyme is higher than in adults and does not depend on gender. In adolescence, this difference becomes noticeable due to different biochemical processes in the body. So, the norm for children and adolescents is:

in newborns and in the first two weeks of life: 83 – 248 units/l;
from 2 weeks to a year: 122 – 469 units/l;
from 10 to 13 years: 129 – 417 units/l.

Alkaline phosphatase is elevated - what does this mean?

What it can mean if alkaline phosphatase is elevated, you need to know in order to help a specialist in correct diagnosis and further treatment. The reasons for the high concentration of alkaline phosphatase will help to understand not only the reason for the appearance of unpleasant symptoms, but also to identify the presence of ailments that have a hidden form. A highly qualified specialist will do this.

Alkaline phosphatase is elevated - causes

When finding out the reasons for the increase in alkaline phosphatase, the most common groups should be identified, the first of which is associated with disturbances in the functioning of the liver and bile ducts:

stones in the bile ducts;
cholestasis;
liver pathologies that can occur as a result of toxic poisoning and when taking medications;
primary cholangitis;
liver cancer;
hepatitis (autoimmune and viral);
infectious mononucleosis;
jaundice (more common in women taking CCDs containing progesterone and estrogen).

Pathological changes in bone tissue, in which alkaline phosphatase increases:

Paget's disease (weakening of bones, their deformation and weakening);
increased metabolic processes during fracture healing;
softening of bones (calcium salts, vitamins and phosphoric acid are lost, which leads to deformation and softening of bones);
osteosarcoma and metastases that have penetrated into bone tissue.

Other ailments and causes, if there is increased alkaline phosphatase in the blood, not associated with deterioration of health and pathological processes:

pathologies of the gastrointestinal tract;
myocardial infarction;
endocrine disease associated with impaired phosphorus and calcium metabolism - hyperparathyroidism;
pregnancy;
alcohol intoxication;
therapy with drugs that have a hepatotoxic effect.

Alkaline phosphatase is elevated - what to do?

If tests have detected an increase in alkaline phosphatase, then the first thing that is necessary is to eliminate the root cause that provoked this jump. For example, in case of liver diseases, to restore its functions, hepatoprotective drugs are prescribed and the correct diet is prescribed. All measures taken must be prescribed by a doctor and carried out under his supervision.

Alkaline phosphatase is low - what does this mean?

If tests show that alkaline phosphatase is low, this may indicate that a dangerous disease is developing in the body. To correctly diagnose, tests alone are not enough and you will need a comprehensive examination from the following specialists:

hematologist;
surgeon;
infectious disease specialist;
gastroenterologist;
GP.

Alkaline phosphatase is low - causes

In the vast majority of cases, low alkaline phosphatase occurs for the following reasons:

in severe form;
critical lack of magnesium and zinc in the body;
genetic disease achondroplasia (underdevelopment of bones, which causes dwarfism);
large volume of blood transfusion;
deficiency and C;
placental insufficiency;
dystrophy due to lack of protein in the diet - kwashiorkor;
(low level of thyroid hormone production);
cretinism;
scurvy;
hypophosphatasia (a dangerous disorder of bone mineralization).

Alkaline phosphatase is low - what to do?

If the analysis shows that alkaline phosphatase is low, then looking for the cause on your own can be dangerous, so you should immediately contact a specialist. This may first be a therapist who will determine which specialist should move forward. After passing additional tests, the doctor must find the cause of the reduced alkaline phosphatase concentration and prescribe treatment or refer to a specialist in the area of the detected disease.

Alkaline phosphatase during pregnancy

During pregnancy, the level of alkaline phosphatase can be higher without the presence of diseases that provoke a jump in the level of the enzyme in the blood. It's all about the formation of the placenta, which, as is known, has a high concentration of the enzyme. It is very important during pregnancy to regularly monitor changes in ALP levels so as not to lose sight of the moment when an increase or increase in the concentration of the enzyme indicates health problems.

An increase in level, as we have already found out, may indicate problems with the liver and biliary tract, pancreas, and skeletal system. If alkaline phosphatase is reduced, this may be the cause of poor development or weakness, which can lead to miscarriage. This may occur due to the fact that the placenta in this state is not able to provide the fetus with all the necessary nutrients.

	1st trimester	2nd trimester	3rd trimester

maximum

Alkaline phosphatase is a common name for combined enzymes (proteins) that take part in the metabolism of calcium and phosphorus in our body. Like every enzyme, it has its own special function. It involves the transfer of phosphorus across the cell membrane.

Phosphatase is a component of cell membranes of almost the entire body. It is an important indicator, since its variability depends on different diseases of organs and systems. Blood alkaline phosphatase is also elevated during physiological conditions such as pregnancy.

In women and girls under 20 years of age, the enzyme level is slightly increased due to active bone growth.

It is important to know that each laboratory has its own gradations of indicators. You need to focus on the reference values (norm), which are described next to the data in the analysis form. There is one more unit of measurement - mkat/l., Unit/l = 0.0167 mkat/l.

Types of alkaline phosphatase

In the human body, it is present in almost all tissues, and is provided in 11 varieties (isoenzymes). The most common and clinically significant are the following:

Bone LPL is formed in osteoblasts (young bone cells). In case of violations of bone integrity (fractures), bone deformations, rickets, alkaline phosphatase from the cell enters the blood, and accordingly its level in the blood increases (the most active).
Hepatic (ALPL) is located in liver cells (hepatocytes) and when they are destroyed, it is released into the blood.
The renal (ALPL) isoform of alkaline phosphatase is found in the renal tubules.
Intestinal (ALPI) in the intestinal mucosa.
Placental (ALPP) is synthesized in the placenta. Its indicators physiologically increase during pregnancy. The mammary gland secretes especially a lot of it during the lactation period.
Oncological phosphatase is an isoenzyme that is secreted from malignant neoplasms.

Detection of an elevated level of this enzyme indicates changes in many organs and systems, so this indicator is often checked. The enzyme is quite variable, as it can change depending on gender, body temperature and even the mood of the patient. Severe stress can cause enzyme levels to rise.

What you need to know about alkaline phosphatase

Increased alkaline phosphatase is more common in older people due to decreased bone mass.
This enzyme contains zinc, so if there is a lack of zinc in food, the phosphatase level will be reduced. Zinc-containing products: watermelon seeds, cocoa powder, chocolate, beef, lamb, peanuts, oysters.
You need to take the test on an empty stomach to avoid false overestimation. Since after eating fatty foods in people with blood groups I and III, the intestinal form of alkaline phosphatase increases.

How to find out your alkaline phosphatase level

Its content is determined not only in the blood, but also in the mucous membranes of the intestines and even in saliva. A biochemical blood test is generally accepted. In healthy people, the liver or bone isoform of alkaline phosphatase usually circulates in the blood serum, but in not high numbers. Common designations are ALKP, alkaline phosphatase or simply ALP. In the case of high alkaline phosphatase activity, liver disease is likely, which is accompanied by obstruction of the biliary tract. Alcohol abuse (as it destroys hepatocytes). In case of bone diseases, calcium-phosphorus metabolism is disrupted and the activity of this enzyme increases. Therefore, phosphatase serves as one of the markers for the early detection of pathology of the skeletal system in women in menopause (osteoporosis) and in children (rickets).

Reasons for increased phosphatase

Physiological reasons for enzyme elevation:

active growth of bone tissue (a 20-fold increase is possible in children, as well as after fractures);
pregnancy 70-250 U/l;
breastfeeding.

Pathological reasons:

Bone disease: osteoporosis, osteomalacia, osteopetrosis, osteosarcoma, bone metastases, rickets. With the latter, enzyme levels rise 4-6 weeks before symptoms appear.
Diseases of the liver and biliary tract:

obstruction or obstruction of the biliary tract, 3-5 times increase in phosphatase levels;
hepatitis of various etiologies (viral, toxic) 200-400 U/l;
oncopathology (hepatocarcinoma, liver metastases) 200-500 U/l;
cirrhosis, alcoholic hepatitis;
kidney disease;
chronic renal failure;
malignant kidney tumor.

Other reasons:

Paget's disease (osteitis deformans);
hyperparathyroidism;
lymphogranulomatosis;
mononucleosis;
sepsis;
ischemia of the intestinal wall;
Crohn's disease, ulcerative colitis;
acromegaly;

Causes of decreased alkaline phosphatase

nutritional;
placental insufficiency;
hypothyroidism;
hypophosphatasemia;
deficiency of vitamin B12 or folic acid;
lack of growth hormone in children.

Learn more about some diseases and their effect on alkaline phosphatase levels.

Osteoporosis

During menopause, women begin to actively “wash out” calcium from the bones, therefore, the bones become more brittle and brittle, which means they lead to an increase in the level of alkaline phosphatase. Even before the clinical picture develops, blood biochemical parameters increase. Therefore, an increase in this enzyme can be regarded as an early sign of osteoporosis and used as a screening.

Liver diseases and impact on indicators.

An increase in the hepatic alkali phosphatase isoenzyme occurs due to the death of hepatocytes. The reason for this may be hepatitis, both viral and toxic, liver cirrhosis, alcohol poisoning, while taking hepatotoxic drugs (tetracycline, paracetamol, salicylates, etc.).

There is also a cholestatic reason for the increase in enzyme. Cholestasis or obstruction of the flow of bile, possibly due to extrahepatic obstruction of the bile ducts, damage or narrowing of the ducts, or disruption of the transport of bile through the small bile ducts.

Considering the data of scientists, in 65% of cases, the rise in alkaline phosphatase is due to liver disease.

The effect of oral contraceptives on the level of enzyme in the blood

Oral contraceptives that contain estrogen and progesterone can change phosphatase levels.

Oncological diseases

Cervical cancer is capable of producing placental phosphatase. Osteogenic sarcoma sharply increases enzyme activity. Metastases to bone tissue, liver, kidneys, lymphogranulomatosis with bone damage, myeloma also contribute to an increase in phosphatase levels.

Indicators during pregnancy. Normally, during pregnancy, starting from the 16th week, the level of placental isoenzyme phosphatase increases in a woman’s body. If the level of the enzyme in the blood decreases, placental insufficiency can be suspected.

Reasons to measure alkaline phosphatase levels

Since the causes of increased alkaline phosphatase are found in almost every organ, there are no specific symptoms that indicate an increase in this particular enzyme. However, some of them can be noted:

headache;
bitterness in the mouth;
jaundice, subicteric sclera, aching pain in the right hypochondrium, itching, discoloration of feces, dark urine, general weakness, nausea (indicates stagnation of bile);
bone disease, frequent fractures, bone pain;
sudden loss of body weight.

How to get your numbers back to normal

When the patient’s condition stabilizes, biochemical parameters also normalize. To prevent osteoporosis, it is necessary to remember to take calcium supplements with vitamin D in postmenopausal women and women over 50 years of age. Moreover, vitamin D is required, since after 50 in the body, under the influence of sunlight on the skin, it is no longer synthesized, unlike children and young people.

Alkaline phosphatase levels should be assessed in conjunction with other tests, such as: ALT, AST, GGT, LDH, bilirubin, creatine kinase with alkaline phosphatase. Given these data, liver function can be easily assessed.

We are the architects of our own health. It is our duty to ourselves and our loved ones to look after and cherish him. At the slightest symptoms of the disease, do not rely on the almighty “it will go away on its own,” but rush to see a doctor. Be healthy!

Deviations from the norm in biochemical blood test values worry many patients. To understand why elevated alkaline phosphatase is dangerous and the reasons for its increase in the blood, it is worth understanding what this indicator is.

Alkaline phosphatase - what is it?

A group of enzymes involved in the tissue metabolism of phosphorus and calcium are united under the name “alkaline phosphatase” (ALP). They abstract the phosphorus group from an organic compound and are active exclusively in an alkaline environment. Therefore, the main amount of alkaline phosphatase is found in tissues, and it enters the blood when cells are destroyed. Normally, aging and cell death occur regularly and in small quantities, so there is little ALP in the blood.

There are 11 known types of phosphatase enzymes that are found throughout the body. The most important are

hepatic, including from the biliary tract;
bone;
intestinal;
placental;
tumor.

Proper Preparation Before Alkaline Phosphatase Testing

Information about the reliable level of alkaline phosphatase in the blood allows you to diagnose serious diseases of the liver, bones and other organs. Therefore, it is extremely important to exclude reasons that may distort the result. It is best to obtain recommendations in this regard from the doctor who ordered the study.

The material for analysis is venous blood, it is donated in the morning on an empty stomach.

Before the study

do not eat or drink for at least 8 hours (water is no exception);
two days before the test, prohibit the consumption of alcohol;
the day before and on the day of blood sampling, do not overexert yourself physically;
do not undergo other instrumental therapeutic or diagnostic procedures before the analysis;
a hot bath or shower may affect the results.

composition of the diet, especially the abundance of fatty foods;
smoking;
taking medications (diuretics, antibiotics, aspirin, allopurinol, paracetamol, oral contraceptives, hypoglycemic drugs).

When is an alkaline phosphatase test ordered?

Doctors consider it necessary to check the level of alkaline phosphatase when

preparation for surgery;
liver function assessment;
routine examinations of patients to assess their health status;
suspicion of liver pathology and complaints of nausea, pain on the right under the ribs, fatigue and lack of appetite;
cholecystitis, cholangitis, gallstones;
diseases of the intestines and heart.

Alkaline phosphatase level in blood

Standard indicators vary widely and depend on age, gender and the characteristics of the reagents and equipment of the laboratory in which the analysis is performed. In addition, the result can only be assessed in conjunction with other clinical and laboratory data of each patient. The attending doctor can and should do this. Self-diagnosis will only bring unnecessary worry and confusion.

The average value in adults is 80-120 IU/l.

Alkaline phosphatase in children

The norm for children is higher, on average 1.5 times. This is explained by the fact that during the formation and growth of the skeletal system, bone ALP enters the blood in large quantities.

children under 10 years old – 150-350 IU/l;
children 10-19 years old –55-500 IU/l.

The rate is more elevated in premature babies, whose bodies work in an intense mode.

In adolescence, on average, boys have slightly higher ALP than girls.

In pregnant women

ALP normally increases in the third trimester, as the fetus takes a large amount of resources from the mother for bone formation. An increase to 240 U/l is considered the norm.

In adulthood

After 50 years, alkaline phosphatase increases slightly - 110-135 IU/l, due to the intensive entry of the bone type of enzyme into the blood. This is facilitated by osteoporosis and other degenerative processes.

After 75 years, the normal value increases even more - 165-190 IU/l.

Elevated alkaline phosphatase: causes

Most often, an increase in alkaline phosphatase in the blood is a marker of damage to liver or bone cells. Less commonly, other diseases manifest themselves this way. The reasons can be divided into several groups.

Hepatic

Stagnation of bile in the liver. The release of alkaline phosphatase into the blood in this case is due to obstruction of the outflow of bile due to large stones, inflammation, sclerosis of the bile ducts, compressive tumor formations, and postoperative strictures.
Damage to liver cells. Hepatitis of toxic origin - alcoholic, medicinal - gives a more significant increase in the indicator. In viral hepatitis, alkaline phosphatase may be normal or slightly increased. Testing other liver enzymes helps make the diagnosis.
Liver tumors, metastases. Causes a sharp increase in the indicator.

Bone

A large amount of bone phosphatase enters the blood when

fractures, when tissue is destroyed; fusion of fragments is also accompanied by high alkaline phosphatase;
Paget's disease, the course of which requires increased formation of bone tissue to replace the destroyed one;
bone resorption in hyperparathyroidism; an excessive amount of parathyroid hormone also causes a significant disturbance in the metabolism of phosphorus and calcium;
tumor processes, osteogenic sarcoma, metastases;
Hodgkin's disease with damage to bone tissue.

Heartfelt

Myocardial infarction is accompanied by the death of its cells, therefore an increase in the cardiac type of alkaline phosphatase is observed in the blood.
Heart failure (HF) is characterized by venous congestion and edema, leading to liver damage and increased liver phosphatase assay.
Myocardial tumors significantly impair contractility and cause severe rhythm disturbances. As a result, signs of heart failure and liver damage with increased alkaline phosphatase appear.
Tumor metastases to the lungs lead to heart failure.
PE causes a lung infarction, the death of its cells, and the level of phosphatase in the blood increases.
Arterial hypertension, especially in acute glomerulonephritis, is severe and quickly leads to heart failure with liver damage and an increase in alkaline phosphatase.

Hormonal

Thyrotoxicosis disrupts cardiac activity and contributes to the development of heart failure.
Hyperparathyroidism.

Intestinal

In case of cancer of the stomach and other parts of the gastrointestinal tract, the intestinal type of phosphatase primarily enters the bloodstream; with the development of the disease, severe liver damage and atrophy occur, accompanied by an increase in hepatic alkaline phosphatase.
Metastasis. Gastrointestinal carcinoid often metastasizes to the heart muscle, causing its damage and the development of heart failure. The appearance of metastases to the lungs in stomach cancer is characteristic. In this case, the work of the heart also suffers.

Decreased alkaline phosphatase

In pregnant women, this indicator indicates placental insufficiency. If a woman is taking oral contraceptives, ALP may be lower than normal. The following factors reduce the indicator:

hypothyroidism;
congenital chondrodystrophy;
excess intake of vitamin D;
lack of zinc, magnesium, vitamin C;
severe anemia, period after blood transfusion;
kwashiorkosis (dystrophy, a condition caused by prolonged restriction of protein in food);
heart failure due to anemia;
left ventricular hypertrophy as a result of metabolic syndrome;
condition after coronary bypass surgery.

Also, a decrease in enzyme activity can be caused by the way blood is stored - when it is hypothermic, the result is distorted.

Elimination of deviations from the norm in the analysis of alkaline phosphatase activity is possible only if their cause is clarified and under the supervision of a physician who has the necessary experience, knowledge and is aware of all the individual characteristics of the course of the disease in a particular patient.

Alkaline phosphatase (hereinafter referred to as “ALP”) is a group of enzymes responsible for separating phosphates from organic molecules such as nucleic acids. Let's talk more about what alkaline phosphatase is and what deviations from the norm indicate today.

ALP in biochemical blood analysis

The name of the enzyme is due to the fact that it exhibits the greatest activity in an alkaline environment, for which the acidity pH is at least greater than seven. The highest concentration of alkaline phosphatase is concentrated in bone, liver, kidney, placental tissue, and bile duct. But alkaline phosphatase is also found in all other human tissues.

Despite the fact that this enzyme does not function in the blood, a certain amount of it is constantly present in the bloodstream. However, if the level of alkaline phosphatase in the blood increases significantly, that is, we are talking about an increase in alkaline phosphatase in the blood, the causes can be determined by the destruction of liver cells or serious deformation of bone tissue.

Norm

The indicator accepted as the norm may vary for the described enzyme. Its level in the blood is influenced by age, gender, pregnancy status, puberty, and even the research method used in a particular laboratory.

However, reference values for different ages and genders are available in the reference data.

Norm for alkaline phosphatase in children (in units/l):

From birth to two weeks: 84-249;
Two weeks - 1 year: 123-470;
Year – 10 years: 143-336;
11-13 years: 130-418;

Starting from the period of adolescence, which usually occurs between 13 and 15 years, the level of alkaline phosphatase in women differs from that of men. For women (units/l):

Up to 15 years: 58-255;
15-17 years: 50-118;
17-19 years old: 46-87;
Over 19 years old: 36-106.

Alkaline phosphatase is elevated during pregnancy, this is due to increased growth of the placenta. The tissues of the placenta also contain large amounts of this enzyme.

Alkaline phosphatase level in men (units/l):

13-15 years: 117-469;
15-17: 83-332;
17-19: 56-150;
Over 19: 40-130.

In order to avoid inaccuracy of the analysis and unjustified discrepancies with the alkaline phosphatase norm, you should prepare for donating blood. And although this preparation is no different from that typical for any blood test, some neglect even these simple principles. Firstly, blood is donated on an empty stomach, at least 12 hours after the last meal. Secondly, half an hour before donating blood, you should refrain from smoking and avoid physical and emotional stress.

To test blood for alkaline phosphatase, you can examine capillary or venous blood. Such an analysis is usually prescribed routinely, when a disease is suspected, in preparation for any surgery, or when determining the level of liver health.

What are the reasons that alkaline phosphatase is elevated?

A significant increase in alkaline phosphatase in the blood most likely indicates a violation of the integrity of bones, liver or bile ducts, as well as their involvement in pathology. To clarify a specific diagnosis, the doctor prescribes additional studies. For example, if elevated alkaline phosphatase in the blood is observed together with high ALT and AST, liver disease is diagnosed. If an excessive amount of Ca and P is added to the excess enzyme, further study of the patient’s bone tissue is necessary.

However, elevated alkaline phosphatase may not be due to disease. We have already mentioned pregnancy and adolescence as a factor in increasing the enzyme in the bloodstream. In addition to them, taking medications from a list of more than 250 items (including oral contraceptives, aspirin and antibiotics) can affect the fact that alkaline phosphatase is elevated. Laboratory errors can also influence enzyme overestimation. So, if after a patient donates blood, the sample is refrigerated before analysis, the result will be an elevated level of alkaline phosphatase.

If alkaline phosphatase is elevated in a child, the doctor may suspect rickets. In general, the values of this enzyme in children are higher than in adults, but without additional tests it is not possible to accurately diagnose any disease. So if alkaline phosphatase is elevated in a child, only a pediatrician can determine the reasons after studying other results of a biochemical blood test or other examinations.

Diseases that provoke an increase in alkaline phosphatase:

Jaundice (a disease caused by the accumulation of bilirubin in tissues, manifested by yellowing of the skin and whites of the eyes);
Lack of calcium;
Myocardial infarction (death of a section of the heart muscle as a result of ischemic disease);
Stones in the bile duct (a disease whose likelihood increases with age, it is dangerous due to its complications);
Osteomalacia (softening and deformation of bones due to lack of minerals and vitamin D);
Consequence of surgery on the biliary tract;
Osteosarcoma (malignant bone tumor that can spread to adjacent tissue);
Paget's disease (the growth of alkaline phosphatase can exceed the norm by 15-20 times, the disease is characterized by abnormal growth of bones and a violation of their integrity in some areas);
Cancer of the liver, pancreas, stomach;
Ulcerative colitis (rare inflammation of the colon mucosa);
Liver cirrhosis (replacement of healthy organ cells with scar tissue);
Rickets (a disease characteristic of children with impaired metabolism and vitamin D deficiency, accompanied by muscle sagging and other symptoms);
Intestinal perforation (a sufficient amount of the enzyme is also found in the cells of the intestinal tissue);
Hepatitis (accompanied by an increase in alkaline phosphatase several times);
Bone fracture;
Infectious mononucleosis (in addition to an increase in alkaline phosphatase, there is an increase in body temperature and inflammation of the lymph nodes);
Calcium leaching from bones (may occur as a result of hormonal imbalance - hyperparathyroidism);
Multiple myeloma (malignant disease);
Etc.

Even completely healthy people may have elevated levels of this enzyme in a blood test.

Reasons why alkaline phosphatase is low

Diseases observed when the enzyme in the blood decreases can be no less dangerous than when it increases. These include:

Anemia;
Hypothyroidism (decreased performance of the thyroid gland);
Hypophosphatasia (softening of bone tissue, congenital phenomenon).

Also, the low concentration of the enzyme in the blood is influenced by volumetric blood transfusion and deficiency of Zn and Mg in the diet.

If alkaline phosphatase in the blood is low, this may indicate insufficient placental growth in the patient.

Just as with an increase in the enzyme, if alkaline phosphatase is low, this does not necessarily indicate any of the diseases listed above. The doctor who prescribed the test for you, and this may be a therapist, hematologist, surgeon, gastroenterologist or endocrinologist, should continue your examination by comparing the data obtained with a general examination.

If you have any questions about this topic, leave your comments below.