Alkaline Phosphatase (ALP) Test

An alkaline phosphatase test is done to diagnose

• Liver disease (Cirrhosis)
• Liver cancer
• Hepatitis (Inflammation of the liver)
• Bone disease
• Cancer that has spread to the bones
• Biliary disease (a disease that affects the gall bladder and the bile duct)
• Health conditions due to a vitamin D deficiency

Alkaline phosphatase test measures levels of enzyme ALP in blood.

Alkaline phosphatase test requires a blood sample. A tourniquet (elastic) band is placed tightly on the upper arm. The patient is then asked to make a fist. This helps in the build-up of blood filling the veins. The skin is disinfected before needle insertion and the blood sample is collected in vacutainer.

High levels of ALP are seen in children during active bone formation, pregnant women, and those with hepatobiliary diseases like bile duct obstruction, hyperparathyroidism, chronic kidney disease, vitamin D deficiency, rickets, osteomalacia, bacterial infection and malignant tumour. 

Low levels of ALP are less common. It could indicate:

• Magnesium deficiency
• Zinc deficiency
• Malnutrition
• Hypothyroidism
• Rare genetic conditions

A normal alkaline phosphatase level ranges between 44 and 147 International Units per litre (IU/l). Normal levels often differ from laboratory to laboratory. They also vary based on age and sex.

Biliary disease is a disease that affects the bile ducts, the gallbladder, and other organs that produce and transport bile. The liver produces bile, which aids in digestion. If left untreated, the biliary disease can cause infection in the gallbladder and gangrene in the gallbladder tissue.

Alkaline phosphatase (ALP) is an enzyme present in your body. An enzyme is a protein that prompts several processes in your body. ALP is mainly found in your liver. It is also found in other parts, such as bones, kidneys, intestines, the bile duct, and the placenta.

Abnormal levels of the ALP in your blood mean damage to the above organs or tissues or changes in specific bodily processes.

Doctors advise the alkaline phosphatase test for people with liver disease or bone disorder symptoms.

Symptoms of liver disease are:

• Nausea and vomiting
• Fatigue
• Loss of appetite
• Jaundice
• Abdominal pain
• Swelling in the arms, legs, or ankles
• Change in the colour of urine and stools
• Persistent itching

Symptoms of bone disorder are:

• Inflammation
• Arthritis in the joints
• Bone pain
• Frequent bone fractures
• Abnormally shaped or enlarged bones

The alkaline phosphatase test is a part of a package of tests called, Comprehensive Metabolic Panel. The other tests in this panel include:

• Glucose
• Calcium
• Sodium, potassium, carbon dioxide, and chloride
• Albumin
• Total protein
• Alanine transaminase (ALT)/ SGPT
• Aspartate aminotransferase (AST)/ SGOT
• Bilirubin
• Blood urea nitrogen (BUN) and creatinine

If your blood test shows higher levels of ALP, then your doctor may advise you to do the following tests:

• ALP isoenzyme test: This test helps detect the part that is making the ALP.
• Liver function test: This test measures the function of your liver.

• ALP Test
• ALK PHOS
• ALK Test

In the case of high levels of ALP, your doctor may advise you to:

• Eliminate foods high in zinc, such as mutton, lamb, pumpkin, oysters, and spinach
• Include foods high in copper, such as almonds, sunflower seeds, and lentils
• Reduce coffee consumption
• Quit smoking
• Get regular exercise
• Get enough sunlight
• Make healthy lifestyle changes