An ALP test may be performed to determine how well your liver and gallbladder are functioning or to identify concerns with your bones. Checking ALP levels in the blood is a routine part of liver function and gallbladder tests. Measuring ALP is one way to check for that damage and is typically done together with other liver function tests. The ALP test can be helpful in the diagnosis of bone concerns such as :. ALP testing may also be helpful in investigating the presence of cancer tumors, unusual bone growth, or vitamin D deficiency.
It can also be used to check the progress of treatment for any of the above conditions. Having blood drawn for an ALP test is routine. You may have to fast for 10 to 12 hours before the test. Eating can interfere with your ALP levels. Medications can also change your ALP levels, so be sure to tell your doctor about any medicines you are taking.
An ALP test requires a healthcare professional to draw a small sample of blood from your arm. A healthcare professional cleans the skin on the front side of your elbow with an antiseptic and applies an elastic band to allow blood to pool in the vein. They then insert a needle into the vein to draw blood into a small tube.
The process is quick and typically causes little pain or discomfort. The blood sample is collected in a tube and analyzed by a laboratory. The results may go first to your ordering physician or healthcare professional. This typically takes 1 to 2 days. Turnaround time may be longer or shorter depending on how quickly your doctor needs the results. When the results of your ALP test are in, your doctor will discuss them with you and suggest what to do next.
ALP is found in all tissues of the body but, not surprisingly, is found in its highest concentration in the liver, bones, kidneys, and intestines as well as the bile ducts that drain bile from the liver and gallbladder that stores bile.
Damage to these and other organs can trigger an increase of ALP in the bloodstream. By contrast, certain diseases or conditions can impair ALP synthesis and lead to a drop in the blood concentration. Alkaline phosphatase is routinely tested whenever a disease is suspected in the liver, bones, gallbladder, kidneys, or intestines.
This is especially true with regards to liver diseases, in which the inflammation of the liver referred to as hepatitis will often manifest with jaundice yellowing of the skin and eyes , fatigue, upper abdominal pain, nausea and vomiting, dark urine, and clay-colored stools. ALP tests play an important role in the diagnosis of liver disease. Similar symptoms can occur with gallbladder diseases. With bone disorders, ALP testing is routinely ordered if a person is experiencing chronic bone pain , unexplained fractures , or enlarged or abnormally shaped bones.
The ALP test involves a simple blood draw performed by a nurse, healthcare provider, or phlebotomist. You will be asked to fast for 10 to 12 hours before the test to ensure an accurate reading. Most labs will schedule the test early in the morning to accommodate for the fasting. There are certain drugs that can interfere with the results.
Advise your healthcare provider or the lab if you take any of the following:. If your ALP levels are modestly raised, it may due to the drugs you are taking rather than an underlying disease or medical condition. Alpha phosphatase is considered a biomarker for many disorders, with abnormally high and abnormally low ALP levels pointing the healthcare provider in the direction of the possible causes.
Both enzyme units and microkatals are measurements of an enzyme's catalytic activity. The normal range of values of ALP differs by age and pregnancy status.
ALP values are higher in children because their bones are actively growing, while the ALP values increase during pregnancy in tandem with the development of the placenta and the approach of childbirth. ALP values that fall outside these reference ranges are considered abnormal.
On their own, abnormal ALP values are not diagnostic but can provide a clue as to the underlying cause. Abnormally high ALP values may be the result of:. Abnormally low ALP values may be the result of:. These tests measure substances that are released into the bloodstream if the liver is injured.
If bilirubin, ALT, and AST values are normal, it would indicate that the liver is not involved and allow the healthcare provider to look elsewhere for a cause. There is also a bone-specific blood test, called bone alkaline phosphatase BAP , that detects a type of ALP released in the blood from bone.
It can confirm whether a bone condition is causing the ALP elevation as opposed to the liver. People with HPP have soft, fragile bones that fracture easily and heal slowly. They also tend to lose baby teeth prematurely and can have skeletal deformities such as bowed legs. The severity of HPP varies widely, from no or mild symptoms to life-threatening. You don't need any special preparations for an alkaline phosphatase test. If your health care provider has ordered other blood tests, you may need to fast not eat or drink for several hours before the test.
Your health care provider will let you know if there are any special instructions to follow. There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
High alkaline phosphatase levels may mean there is damage to your liver or that you have a type of bone disorder. Liver damage creates a different type of ALP than bone disorders do. If the test results show high alkaline phosphatase levels, your health care provider may order additional tests to find out where the extra ALP is coming from. High alkaline phosphatase levels in the liver can indicate:. There are several other types of blood tests that check your liver function.
If these results are normal and your alkaline phosphatase levels are high, it may mean the problem is not in your liver. Instead, it can indicate a bone disorder, such as Paget's Disease of Bone , a condition that causes your bones to become abnormally large, weak, and prone to fractures.
Moderately high levels of alkaline phosphatase may indicate conditions such as Hodgkin lymphoma , heart failure , or a bacterial infection.
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