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Alkaline Phosphatase ALP Test

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Alkaline Phosphatase Test Overview

The enzyme alkaline phosphatase (ALP) is present in various forms and is increased in disease of liver, bone, intestine and kidney disorders.
The level of this enzyme increases in rickets, osteomalacia, obstructive liver diseases, hyperparathyroidism, post fracture and in malignant tumours

Liver disease may be genetic or it may be caused by several factors, including viral infection, obesity, or alcohol consumption. Over time scarring of the liver tissue occurs leading to cirrhosis, which may be life-threatening. Other medical conditions that may cause damage to the liver include liver cancer and bile duct blockage. Alkaline phosphatase (ALP) is an enzyme that comes from your liver and bones. Its levels in the blood increase when your liver does not function properly. Thus, doctors may measure your ALP levels to diagnose liver disease. Here's all you need to know about the Alkaline Phosphatase test.

What is alkaline phosphatase?

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.

Why is an alkaline phosphatase test done?

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

Who should do the alkaline phosphatase test?

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

What other tests are ordered along with the alkaline phosphatase test?

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
  • Alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST)
  • 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.

Written by: Dr Selvi Radhakrishnan, PhD in Biochemistry, Dept. of Biochemistry

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Alkaline Phosphatase ALP Test Price

Metropolis Healthcare is a leading diagnostics centre and pathology lab in India equipped with the latest state-of-the-art technologies that provides the Alkaline Phosphatase ALP Test with a clear pricing structure.

The Alkaline Phosphatase ALP Test Price in Mumbai is ₹ 260 .

We are committed to deliver accurate and quality results from the best labs in India with complete transparency regarding test cost and turnaround time. No matter where you are, we strive to offer patients high-quality service that is affordable and accessible.

Frequently Asked Questions

This test is done to diagnose liver diseases, biliary diseases and bone disorders.

An alkaline phosphatase test helps diagnose liver disease, bone disorders, and biliary disease. It is a part of a panel used for routine health check-ups. In the case of liver or bone issues, the ALP test helps determine if there is any improvement in the condition or if it has worsened

Alkaline phosphatase test measures levels of enzyme  ALP in blood

The alkaline phosphatase test measures the level of alkaline phosphatase in the blood coming from the liver and the bones.

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, those with hepatobiliary disease like bile duct obstruction, hyperparathyroidism,  chronic kidney disease, vitamin D deficiency, rickets, osteomalacia, bacterial infection and malignant tumour. ALP levels are not significantly increased in diseases affecting the liver parenchymal cells for e.g., viral hepatitis
Lowered levels of ALP are less common than elevated levels. 

Higher-than-normal levels of alkaline phosphatase are typically observed in

  • Childhood and puberty, during the active bone formation phase
  • In pregnant women, as ALP exists in the placenta

High levels of ALP indicate

  • Cirrhosis of the liver
  • Hepatitis
  • Biliary atresia (blockage in the ducts that carry bile from the liver to the gall bladder)
  • Biliary stricture (narrowing of bile ducts)
  • Biliary obstruction due to cancer
  • Mononucleosis (swelling of the liver due to an infection)
  • Chronic kidney disease
  • Vitamin D deficiency
  • Osteomalacia (softening of the bones)
  • Rickets (weakening of bones in children due to vitamin D deficiency)
  • Hyperparathyroidism (low levels of calcium due to excess thyroid hormone released by the thyroid gland)

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

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

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.

You may have to fast for 10 - 12 hours before the test. Your doctor may ask you to stop taking medications before the test. Please inform your doctor if you are pregnant, as pregnancy increases the ALP levels in the blood.

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.

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