Summary

Alkaline phosphatase (ALP) is an enzyme located mainly in the liver, bile ducts, bones, and kidneys, and it's instrumental in processes involving protein metabolism.

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Overview

Increased levels of ALP in the bloodstream often point towards possible liver or bone diseases. Certain conditions such as liver cirrhosis, gallstones, bone disorders, or kidney disease can lead to a surge in ALP levels as the enzyme leaks from the affected cells into the bloodstream. 

In liver diseases, ALP is often used with other liver function tests to assess liver function and identify conditions like cholestasis or biliary obstruction. If high ALP levels are caused by liver problems, the liver function tests will be abnormal. If ALP is elevated and other liver tests are normal, the problem may be a bone disorder. However, additional tests are required for the proper diagnosis. Certain medications and excessive alcohol consumption can also cause an elevation in ALP levels.^[1,2]

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What should you know about this biomarker?

Each laboratory uses different machines and protocols, so the results might vary in terms of the reference ranges or used units of measurement. In Macromo blood tests we use µkat/l (microkatal per liter).

Optimal ALP levels may vary depending on age, sex, and individual characteristics and can also be affected by medications and other factors. Normal ALP levels for healthy adults typically range up to 2.15 µkat/l (microkatal per liter).^[3] 

Your blood test could indicate one of several potential outcomes:

• When your ALP levels are lower, it is usually not something to worry about, however, if you notice unusual symptoms, do reach out to your healthcare provider. Low ALP levels are less common but may indicate zinc deficiency, malnutrition, pernicious anemia, thyroid disease, Wilson disease, or hypophosphatasia.
• When your ALP levels are within the reference range, this is a good sign. 
• When your ALP levels are above the reference range, it could signify issues with your bones or liver, like cirrhosis, hepatitis, bile duct obstruction, Paget disease, etc. Please get in touch with your healthcare provider for a comprehensive evaluation. 

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Genetics

Previous studies have shown that mutations in certain genes can lead to abnormal levels of ALP, resulting in various health conditions.
Mutations in the ALPL gene can lead to several bone diseases like hypophosphatasia, characterized by abnormally low levels of ALP. Other genes, such as those involved in liver function or bone growth, can also affect ALP levels.^[4] 

Moreover, twin and family studies have revealed that genetic factors can account for a substantial portion of the variation in serum ALP levels. While lifestyle and environmental factors also play a role, these findings affirm that genetics is a significant determinant of ALP levels in the human body.^[5,6]

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Recommendations

If alkaline phosphatase (ALP) levels are outside the optimal range, it may indicate several health conditions. Elevated levels of ALP can indicate liver disease, bile duct obstruction, or bone disorders.^[1]:

• Routine liver function tests can help monitor ALP levels and detect any anomalies that might indicate a problem early.
• A balanced diet rich in vitamins and minerals, particularly Vitamin D and calcium, can support bone health and help maintain normal ALP levels.
• Over-consumption of alcohol can damage the liver and cause elevated ALP levels. It's important to drink in moderation or abstain altogether.
• High cholesterol can lead to bile duct obstruction, which may result in increased ALP levels. Regular cholesterol checks and a diet low in saturated fats can help control cholesterol levels.

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The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.