Overview of Alkaline phosphatase (ALP)

  • ALP is generally part of a routine lab testing profile, often with a group of other tests called a liver panel. It is also usually ordered along with several other tests if a patient seems to have symptoms of a liver or bone disorder.
  • High ALP usually means that the bone or liver has been damaged. If other liver tests such as bilirubin, aspartate aminotransferase (AST), or alanine aminotransferase (ALT) are also high, usually the ALP is coming from the liver. If calcium and phosphate measurements are abnormal, usually the ALP is coming from bone.
  • In some forms of liver disease, such as hepatitis, ALP is usually much less elevated than AST and ALT. When the bile ducts are blocked (usually by gallstones, scars from previous gallstones or surgery, or by cancers), ALP and bilirubin may be increased much more than AST or ALT. In a few liver diseases, ALP may be the only test that is high
  • In some bone diseases, such as a disorder called Paget’s disease (where bones become enlarged and deformed), or in certain cancers that spread to bone, ALP may be the only test result that is high.
  • Sometimes doctors don’t know why ALP is high, and they need to order other tests to determine the exact cause. In such cases, your doctor may order another enzyme, GGT, that is made by the liver in the same places as is ALP, but which is not made by bone.

Test: Alkaline phosphatase (ALP)
Specimen Required: Serum (clotted blood)
See also: Liver Function Tests
Reference Ranges: The normal range is 44 to 147 IU/L (international units per liter). 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.
Units: U/L

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