Alkaline phosphatase is elevated: symptoms, causes of an increase in adults and children, treatment. Alkaline phosphatase - a normal level in a biochemical blood test in children and adults

Alkaline phosphatase (AP) is an enzyme that belongs to the group of hydrolase molecules. It is necessary for the dephosphorylation reaction in the body.

The success of this splitting of phosphorus is due to alkaline phosphatase.

The splitting of phosphorus molecules and organic substances occurs through the movement of phosphorus ions through the cell membrane by phosphatase.

The concentration of alkaline phosphatase in blood plasma has a constant coefficient, which shows the norm in phosphorus metabolism in the body. Alkaline phosphatase is most active in an environment of pH from 8.60 to 10.10.

What is alkaline phosphatase?

Alkaline phosphatase is the most abundant enzyme in the body, but it functional responsibilities not fully explored.

Alkaline phosphatase is present in all cells of all organs of the body and has its own variety:

In serum, alkaline phosphatase is present in isoenzymes.

They are in almost the same percentage:

Bone enzyme is present in osteoblasts;
Liver enzyme - in hepatocytes.

If the balance is disturbed, and there is a destruction of molecules in the cells (with a bone fracture), or pathology in the liver, then there is a jump in the alkaline phosphatase index in the blood plasma.

There are enzymes that biochemical analysis are included in the indications of alkaline phosphatase, in the body they have certain functional responsibilities.

Many enzymes are responsible for breaking down phosphoric acid on essential organic compounds, which leads to the normalization of phosphorus-calcium metabolism.

The activity of this enzyme

The activity of this enzyme in serum has properties to change depending on metabolic process. This activity is a marker for detecting bone disease (osteoporosis) at an early stage of pathology development, as well as given coefficient used for screening study of the serum composition of the blood.

Processes in the genital female organs lead to an increase in placental phosphatase, and in the biochemical analysis it will be reflected as increased activity general index alkaline phosphatase.

According to the placental change, neoplasms in the female genital organs (malignant tumor of the cervix) can be detected.

The activity of the ALP enzyme in a child's body is normally higher than in an adult body by 1.5-2 times. Depends on physiological processes that occur in the body of children is the intensive formation of all systems and organs, their intensive growth. During the period of intensive growth, the alkaline phosphatase index can be - 800 U / l.

Such an indicator in children is not a pathology, but the norm, since both enzymes are involved in the process of growing up of the body: liver type and bone.

When the growth of the bones of the skeleton is completed, then the bone enzyme ceases to show its activity and only the hepatic isoenzyme affects the activity of alkaline phosphatase.

Activity during pregnancy

The phosphatase isoenzyme increases in women during childbearing, and especially in the 3rd trimester of fetal development. Also, very high activity of the enzyme in children who were born prematurely, because they have to catch up with their peers in development.

Such indicators are physiological, and are not considered deviations from the normative indicators.

There are results of biochemistry, if alkaline phosphatase is underestimated, then this is an indicator of underdevelopment of the placenta, and is an indicator during pregnancy.

Why study the enzyme phosphatase?

Phosphatase testing will be prescribed in order to detect at an early stage the development of pathology in the liver, as well as diseases of the musculoskeletal system.

Also, an increase in the alkaline phosphatase index occurs with disorders in the gallbladder, with clogging of the bile ducts, as well as stones that are in the bladder and in the ducts.

The activity of alkaline phosphatase also increases with malignant neoplasms in the organs endocrine system- in the pancreas.

Testing for gamma-glutamyltransferase together with an ALP test is performed at diagnostic test diseases that provoke pathologies in the process of excreting bile into the body - biliary cirrhosis (primary form), as well as primary sclerosing cholangitis.

Biochemical analysis for the ALP coefficient is carried out in order to identify pathologies in bone cells, because any changes in the bones increase the activity of alkaline phosphatase.

At this point, it is possible to identify neoplasms of a malignant type and help ensure that this focus of oncology does not go beyond the bone.

The delivery of biochemistry is repeated to monitor the activity of alkaline phosphatase and the development of pathology, as well as to adjust the medical therapeutic or surgical treatment.

Under what circumstances is a study ordered?

Laboratory testing for alkaline phosphatase is standard in biochemical analysis and is used in preparation for surgical intervention in organism. Also, this test is carried out with liver tests.

Analysis for alkaline phosphatase is prescribed when the patient has pronounced symptoms:

General weakness of the body;
Decreased appetite;
Nausea that turns into vomiting;
Pain in the upper abdomen that ricochets into right side under the ribs;
Yellowing skin with jaundice;
Darkening of urine;
Change in color of feces;
itchy skin;
Pain in the bones;
Joint pain.

Alkaline phosphatase testing is also always done for frequent bone fractures.

Normative index of the enzyme in the blood

The normative coefficient of alkaline phosphatase has a fairly wide range of coefficients. Its range is from 44.0 IU / l to an index of 147 IU / l.

When defining standards great importance has a person's gender, as well as an age category.

Women who carry a child have an overestimated ALP index, and also a slightly higher coefficient in adolescents in the puberty phase. Such high index readings are not considered a pathology in the body, but are physiological deviations from the normative coefficients.

Also, indicators can fluctuate in different side, depending on the reagents used by the laboratory, because the standard scheme for the use of drugs in biochemistry on this moment missing.

Table of normative indicators in the blood composition of alkaline phosphatase:

Enzyme activity is determined by various methods, as well as at different temperature regime. The norm given in the table is calculated at a laboratory temperature of 37 degrees.

In order to avoid confusion when deciphering the discrepancies of various clinical laboratories, there are reference values in the test for alkaline phosphatase in laboratory results. These values can be used to determine whether the coefficient of the test blood is within the normative range, or whether there are deviations from the norm.

Reference value norm table:

Patient's age	Reference value (unit U/l)
newborns up to 5 days old	up to 550.0
from 5 days to six months of age	1000
from 6 calendar months - up to one year	1100
from one year to 3 years of age	670
3 to 6 calendar years	650
from 6 years - up to 12 years of age	720
girls from 12 to 17 years of age	450
women over 17 calendar years old	720
boys from 12 to 17 years of age	930
men over 17	270

To be sure of the normal index of your test results, you should consult your results in a clinical laboratory, or at an appointment with your doctor.

At what diseases the index is increased?

In addition to the physiological etiology of an increase in alkaline phosphatase, pathologies in the body affect the increase in the activity of this enzyme:

Treatment to reduce enzyme activity is carried out with medications and balanced nutrition of the patient:

drug Azathioprine;
The drug Clofibrate;
Oral contraceptives;
Drugs that normalize the functioning of the liver;
Use medicinal infusions medicinal plants that positively affect the liver;
Diet with foods rich in calcium;
Diet, which with the maximum presence of phosphorus in foods - fish, seafood, dairy products, meat, beef liver.

Decreased phosphatase index in the blood

Less release of isoenzymes into the blood serum provokes a decrease in the ALP index.

Alkaline phosphatase is lowered, which means that the following pathologies occur in the body:

Osteoporosis old age;
Myxedema of the thyroid gland;
An excess of isotopes of a radioactive nature in bone tissue;
Pronounced anemia;
scurvy or vitamin C deficiency;
An excess of vitamin D in the body. This indicator is a consequence of non-compliance with the dosage of medications for rickets.

To increase the presence of alkaline phosphatase in the blood serum, you can use a diet that can saturate the body with essential vitamins:

Foods high in vitamin C - citrus fruits (especially lemon), onions, garlic, black currants, rose hips;
Products containing B vitamins - meat, legumes, beef liver, fatty fish, garden greens;
Food rich in magnesium molecules - seeds, legumes, soybeans, nuts of all kinds.

Do not confuse alkaline phosphatase with acid phosphatase

In addition to alkaline phosphatase, in the analysis of blood biochemistry, there is also an indicator - acid phosphatase. This index shows the status prostate in men.

An increase in the level of an acidic enzyme indicates that a tumor is present in the gland or metastases have sprouted in cancer of other organs.

Acid phosphatase is a prostate-specific antigen and also a marker of prostate neoplasm (PSA).

Conclusion alkaline phosphatase

In order to identify pathology in the body, it is not enough just to study the blood composition for the concentration of alkaline phosphatase. Since the normative range of this enzyme is quite wide, and depends on the age category.

For an accurate diagnosis, a number of additional diagnostic tests must be performed.

Based on the alkaline phosphatase index and on the results additional research, the doctor sees the full picture of the pathology and can establish the correct diagnosis.

Alkaline phosphatase is an indicator that often appears in a comprehensive biochemical blood test. This enzyme is responsible for the functions of many organs, primarily the liver and the musculoskeletal system. It got its name because it is the most active in alkaline environment where the pH is between 8 and 10. Normal concentrations of this substance are in a fairly large range, so only significant deviations acquire clinical significance. For the correct interpretation of this analysis, it is necessary to have an idea about the function of the enzyme and its norms by age.

What is alkaline phosphatase used for?

Alkaline phosphatase is an enzyme from the group of hydrolases. Under its influence, dephosphorylation reactions occur in the body - the elimination of phosphates from bioorganic compounds at the molecular level. According to localization, several types of phosphatases are distinguished:

intestinal;
hepatic;
placental;
bone;
renal.

In laboratories, the overall level of alkaline phosphatases of the body is determined, which reflect the functions of the liver and bone tissue. The enzyme transfers phosphorus between molecules and cell membranes, and therefore, participates in the regulation of phosphorus-calcium metabolism along with parathyroid hormone and calcitonin.

Alkaline phosphatase is synthesized in osteoblasts - structural units of bones, as well as in hepatocytes - cells that form the stroma of the liver. When the activity of these cells increases, or when they are destroyed, the production of the enzyme increases and its concentration in the blood increases.

Regulation of phosphorus-calcium metabolism. Alkaline phosphatase works in all organs involved in it.

The dominant site of enzyme production is the liver. After its synthesis by the cells of this organ, the enzyme, together with bile, enters the intrahepatic ducts, through which it flows out of the liver into the common bile duct, which flows into the duodenum.

If there is an obstruction to the outflow of bile, then alkaline phosphatase rises simultaneously with other components of bile synthesized in the liver, such as cholesterol. This condition is called cholestasis, in which alkaline phosphatase in the blood will always be elevated.

In second place in importance is alkaline phosphatase of bones. It plays a role in bone renewal and regeneration. If the bones grow or fuse after fractures, then the activity of alkaline phosphatase increases and this is the norm.

Giardia in children symptoms and treatment

Normal values of the enzyme in the blood

Fluctuations in alkaline phosphatase in the blood normal phenomenon. Depending on the laboratory, enzyme values can range from 43 to 148 IU/L (international units per liter). The results of the analysis may be higher, and this will be the norm.

The level of alkaline phosphatase in the blood depends on the person's age and gender. In women during pregnancy, the enzyme is sometimes slightly higher than the average values, but this will be within the normal range. In children, the rates are often higher than in adults. Such changes are explained by the peculiarities of hormonal and other vital systems in a certain period of life.

The results also depend on the reagents used in the laboratory: standardized universal method there is no definition for alkaline phosphatase. The table shows the average values of the alkaline phosphatase norm by age and gender.

For getting reliable results needed proper preparation to research:

12 hours before the study, do not eat or drink water;
exclude 2 hours before the study physical activity and stress;
do not smoke one hour before the examination.

Causes of an increase in alkaline phosphatase

If the patient has complaints such as fatigue, loss of appetite, discomfort, or pain syndrome in the right hypochondrium, bone pain or nausea, then the level of alkaline phosphatase should be determined - in these situations it is often elevated. The most significant result will be for the diagnosis of diseases of the bones and liver.

Revealing high values enzyme is also found in the absence of any symptoms, for example, during a routine medical examination or during preparation for surgical operations. To clarify the activity in this case, you can take the analysis a second time, a repeated high result shows that there is a deviation.

An increase in alkaline phosphatase is assessed in a complex way: if other liver enzymes (AST and ALT) increase along with it, then this indicates diseases of the liver and gallbladder, but if calcium and phosphorus values deviate from the norm along with the enzyme, then it is necessary to examine the bones and parathyroid gland .

There are 4 main groups of conditions that can lead to an increase in alkaline phosphatase:

1. Changes in the system of the liver, biliary tract and pancreas. Variants of pathologies include obstructive jaundice with gallstones or with cancer of the head of the pancreas or stomach, cancer and cirrhosis of the liver, viral and autoimmune hepatitis. Infectious mononucleosis, leading to an increase in the liver, also contributes to an increase in the enzyme.
2. Diseases of the bones and steam thyroid gland. These diseases include any parathyroid gland with changes in calcium and phosphorus metabolism, osteomalacia, rickets, myeloma. Less common is Paget's disease, in which the bone structure. Metastases of any cancer to the bone can also cause an increase.
3. Other causes associated with diseases. Myocardial infarction, ulcerative colitis and Crohn's disease, hematological diseases - all of them can lead to an increase in alkaline phosphatase, but quite rarely. It is impossible to rely in the diagnosis of these diseases only on an increase in this enzyme.
4. Non-painful conditions. These include pregnancy, childbirth and teenage years when an increase in alkaline phosphatase is physiological. The level of the enzyme is also affected by the intake of certain medicines- antibiotics, combined oral contraceptives and some others. After the end of treatment with these drugs, the enzyme level returns to normal.

Reasons for the decline

A decrease in alkaline phosphatase is much less common. This can either indicate dangerous diseases or be a sign of minor deviations from the norm, so a visit to the doctor should not be neglected. A decrease in the enzyme occurs in the following conditions:

hemotransfusion in a large volume, large blood loss;
hypofunction of the thyroid gland and its diseases;
severe anemia with hemoglobin below 90 g/l;
deficiency of magnesium and zinc;
hypophosphatasia - congenital deficiency alkaline phosphatase, which is clinically manifested by softening of bone and dental tissue;
placental insufficiency in pregnant women.

Deformation of the bones of the skeleton with hypophosphatasia

Treatment

For a qualitative assessment of changes in the concentration of alkaline phosphatase in the blood, any doctor needs some additional methods examinations. This:

general and detailed biochemical blood test;
general urine analysis;
ultrasound examination of the liver and biliary tract;
x-ray of bones and joints, if they have complaints.

Only after that the doctor will be able to prescribe adequate treatment.

Treatment of an increase in alkaline phosphatase is carried out in accordance with the detected pathology. If the liver suffers, then hepatoprotective and detoxification therapy, supported by choleretic agents.The drugs used in the treatment are:

1. Heptral.
2. Essentiale forte.
3. Hofitol.
4. Gepamerz.
5. Alfanormix.
6. Ursodeoxycholic acid.
7. Trimedat.

The listed drugs are included in different pharmacological groups, only the doctor is engaged in the selection of the dosage, their independent use is unacceptable. Folk remedies (decoctions and infusions choleretic herbs- immortelle, wormwood, tansy, dandelion) are justified only if they reinforce the main drug therapy. At complex treatment reduce alkaline phosphatase as quickly as possible.

If problems with the bones are identified, then the treatment is prescribed by a traumatologist or rheumatologist. Usually used drugs that stimulate bone growth and vitamin D3. If hematological disorders are detected, the patient is referred to a hematologist. Treatment by a hematologist is specific, drugs are not sold in the pharmacy network, folk methods treatments are only detrimental to health.

Thus, if elevated alkaline phosphatase is detected, a thorough additional examination is necessary to establish correct diagnosis and proper treatment.

And some secrets...

A healthy liver is the key to your longevity. This body performs a huge number of vital functions. If the first symptoms of the disease were noticed gastrointestinal tract or liver, namely: yellowing of the sclera of the eyes, nausea, rare or frequent stool you just have to take action.

It consists in the transfer of phosphorus across the cell membrane.

Phosphatase is a component of cell membranes of almost the entire organism. It is an important indicator, since its variability depends on various diseases organs and systems. Blood alkaline phosphatase is also elevated in physiological conditions such as pregnancy.

In women and girls under 20 years of age, the level of the enzyme is slightly increased due to the active growth of bones.

Types of alkaline phosphatase

In the human body, it is present in almost all tissues, and is provided in 11 varieties (isoenzymes). The most common and clinically significant are the following:

Bone LPL is formed in osteoblasts (young bone cells). In case of violations of bone integrity (fractures), bone deformities, rickets, alkaline phosphatase from the cell enters the blood, respectively, its level in the blood rises (the most active).
Hepatic (ALPL-located in liver cells (hepatocytes) and, when they are destroyed, enters the blood.
Renal (ALPL is an isoform of alkaline phosphatase found in the renal tubules.
Enteric (ALPI) in the intestinal mucosa.
Placental (ALPP) is synthesized in the placenta. Her performance increases physiologically during pregnancy. Especially a lot of it is secreted by the mammary gland during the lactation period.
Oncological phosphatase is an isoenzyme that is released from malignant neoplasms.

Revealing advanced level this enzyme indicates changes in many organs and systems, so this indicator is often checked. The enzyme is quite variable, as it can change depending on gender, body temperature, and even the mood of the patient. severe stress can cause an increase in enzyme levels.

What you need to know about alkaline phosphatase

An increase in alkaline phosphatase is more typical for older people - due to a decrease in bone mass.
This enzyme contains zinc, therefore, with a lack of zinc in food, the phosphatase index will be lowered. Zinc-containing foods: watermelon seeds, cocoa powder, chocolate, beef, lamb, peanuts, oysters.
It is necessary to take an analysis on an empty stomach, so as not to get a false overestimation. Because after drinking fatty foods in persons with I and III blood groups, the intestinal form of alkaline phosphatase increases.

How to know the level of alkaline phosphatase

Its content is determined not only in the blood, but also in the mucous membranes of the intestines and even in saliva. A biochemical blood test is generally accepted. At healthy people, in the blood serum, the hepatic or bone isoform of alkaline phosphatase usually circulates, but not in high numbers. Common designations are ALKP, alkaline phosphatase, or simply ALP. In the case of high activity of alkaline phosphatase, liver diseases are likely, which are accompanied by obstruction of the biliary tract. Alcohol abuse (since it destroys hepatocytes). In bone diseases, calcium-phosphorus metabolism is disturbed, and the activity of this enzyme increases. Therefore, phosphatase is one of the markers for the early detection of pathology. skeletal system women in menopause (osteoporosis), and in children (rickets).

Causes of increased phosphatase

Physiological reasons for the increase in the enzyme:

active growth of bone tissue (possibly a 20-fold increase in children, as well as after fractures);
pregnancy U/l;
lactation.

Bone disease: osteoporosis, osteomalacia, osteopetrosis, osteosarcoma, bone metastases, rickets. In the latter, an increase in the enzyme level 4-6 weeks before the onset of symptoms.
Diseases of the liver and biliary tract:

obstruction or obstruction of the biliary tract, a 3-5 times increase in the level of phosphatase;
hepatitis of different etiology (viral, toxic) U/l;
oncopathology (hepatocarcinoma, liver metastases) U/l;
cirrhosis, alcoholic hepatitis;
kidney disease;
chronic renal failure;
malignant tumor of the kidney.

Paget's disease (deforming osteitis);
hyperparathyroidism;
lymphogranulomatosis;
mononucleosis;
sepsis;
ischemia of the intestinal wall;
Crohn's disease, ulcerative colitis;
acromegaly;
vasculitis.

Causes of a decrease in alkaline phosphatase

alimentary;
placental insufficiency;
hypothyroidism;
hypophosphatasemia;
deficiency of vitamin B12 or folic acid;
lack of growth hormone in children.

Details about some diseases and their impact on alkaline phosphatase levels.

Osteoporosis

In menopause, women begin an active "washout" of calcium from the bones, therefore, the bones become more fragile and brittle, which means that they lead to an increase in the level of alkaline phosphatase. Even before the development of the clinical picture, the biochemical parameters of the blood increase. Therefore, the increase in this enzyme can be regarded as early sign osteoporosis and used as a screening.

Liver disease and impact on performance.

An increase in the hepatic isoenzyme of phosphatase with a slit occurs due to the death of hepatocytes. The reason for this may be hepatitis, both viral and toxic, cirrhosis of the liver, alcohol poisoning, while taking hepatotoxic drugs (tetracycline, paracetamol, salicylates, etc.).

There is also a cholestatic reason for the increase in the enzyme. Cholestasis or obstruction of the outflow of bile, possibly with extrahepatic obstruction bile ducts, damage or narrowing of the ducts, or impaired transport of bile through the small bile ducts.

Given the data of scientists in 65% of cases, the rise in alkaline phosphatase is due to liver disease.

The effect of oral contraceptives on the level of the enzyme in the blood

Oral contraceptives that contain estrogen and progesterone may alter phosphatase levels.

Oncological diseases

Cervical cancer is able to produce placental phosphatase. Osteogenic sarcoma sharply increases the activity of the enzyme. Metastases in bone tissue, liver, kidneys, lymphogranulomatosis with bone lesions, multiple myeloma also contribute to an increase in phosphatase.

indicators during pregnancy. Normally, during pregnancy, starting from the 16th week, the level of the placental phosphatase isoenzyme increases in the woman's body. In the case of a decrease in the level of the enzyme in the blood, placental insufficiency can be suspected.

Reasons to measure alkaline phosphatase

Since the causes of an increase in alkaline phosphatase are found in almost every organ, then specific symptoms, which indicate an increase in this particular enzyme, no. However, some of them can be noted:

headache;
bitterness in the mouth;
jaundice, subicteric sclera, It's a dull pain in the right hypochondrium, pruritus, discoloration of feces, darkening of urine, general weakness nausea (indicates stagnation of bile);
bone disease, frequent fractures, bone pain;
sudden loss of body weight.

How to bring your scores back to normal

When the patient's condition stabilizes, biochemical parameters also normalize. For the prevention of osteoporosis, it is necessary to remember about taking calcium supplements with vitamin D in the postmenopausal period and women after 50 years of age. Moreover, vitamin D is required, since after 50 in the body, under the influence of sun rays on the skin, it is no longer synthesized, unlike children and young people.

Alkaline phosphatase should be assessed in conjunction with other tests, such as: ALT, AST, GGT, LDH, bilirubin, creatine kinase with alkaline phosphatase. Given these data, liver function can be easily assessed.

We are the masters of our own health. It is our duty to ourselves and those close to him to follow and cherish. At slightest symptoms diseases do not rely on the almighty "self-pass", but hurry to go to the doctor. Be healthy!

The information on the site is provided for informational purposes only and is not a guide to action. Do not self-medicate. Consult with your physician.

Alkaline phosphatase is the norm in women after 50 years

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Alkaline phosphatase is an active enzyme that is found in human blood, and allows you to enrich the body with organic compounds due to the breakdown of phosphoric acid. There is also a huge concentration of this enzyme in organs that affect blood purification: liver, bone tissue, kidneys. The level of alkaline phosphatase is the basis of the correct diagnosis in case of suspicion of any diagnosis of diseases of the internal organs. That is why it is important for everyone to know, especially for people of respectable age, how to reduce alkaline phosphatase in the blood at home.

What does alkaline phosphatase show

Most of the enzyme is found in cells biliary tract and liver. It actively affects the biochemical reactions of the body and is the only catalyst for the breakdown of phosphoric acid. During the process of splitting, the contents enter the bloodstream and are distributed to all cells of the body. That is why the enzyme can be found in almost any cell.

With it, you can determine the deviation in the body. It is noteworthy that it is impossible to detect deviations in the removal of bile from the child's body.
In elderly people, there is a decrease in alkaline phosphatase, since the enzyme is found in bone tissues. And as you know, in older people there is a decrease in bone mass.
If there are violations, then it is necessary to take tests at the level weekly. The thing is that more than half of the enzyme can leave the body within 3-5 days.
The main reason for the increase in alkaline phosphatase in the blood is zinc deficiency, since it is the main component.
Before the analysis, it is not recommended to eat fatty foods. This moment is especially important for the 1st and 3rd blood groups.

With the help of an enzyme, harmony and normal metabolism reign in the body. In addition, this applies to all organs and tissues. But if any part of the body is damaged, its cells enter the bloodstream and cause an imbalance of phosphatase. This situation is especially noticeable in lesions of bone tissue, kidneys and liver. Another striking cause of imbalance is the formation of a malignant tumor.

Also, a variety of drugs can affect phosphatase levels. Especially: halothane, furosemide, papaverine.

The main reasons for the abnormal indicator:

thyroid disease;
rickets;
unbalanced diet;
the period of breastfeeding;
third trimester of pregnancy;
avitaminosis;
menopause;
infectious diseases;
inflammatory processes;
excessive physical activity;
heart attack;

What is alkaline phosphatase in biochemical analysis and why do tests

As a rule, an analysis for the level of this enzyme is prescribed in combination with other analyzes of a clinical trial. Be sure to donate blood patients who suffer from diseases of the bone tissue, digestive system, liver and kidneys.

The main symptoms of an abnormal enzyme indicator:

liquid stool;
nausea;
cholestasis;
suspicion of Paget's disease;
yellowing of the eyes;
severe pain in the abdomen.

The rate of alkaline phosphatase in women after 50 years of age differs from that of other ages. More detailed information is given in the table:

It is also worth remembering that the enzyme tends to rise or fall, regardless of whether you are healthy or sick. This can be influenced by short-term factors that change very quickly. Changes in the indicator of enzymes do not always indicate the presence of terrible diseases or pathologies.

The examination may be ordered by the following specialists:

Enzyme normalization

So, we figured out what elevated alkaline phosphatase means and what are the reasons. It remains to determine how to bring the enzyme back to normal and what treatment to choose.

Important! You should not make any decisions on your own during pregnancy, violation of the integrity of the bone tissue or during the rehabilitation period. We have already said that with the growth of bone tissue, the level of the enzyme increases significantly. This is normal. The indicator will return to normal over time.

There is no specialized treatment for restoring phosphatase levels. Do not self-medicate. The doctor will look at the tests, determine the cause of the increase in the indicator and, if necessary, prescribe treatment or additional tests.

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Alkaline phosphatase is normal in women

Alkaline phosphatase - the norm

Alkaline phosphatase is a protein that ensures the normal course of many chemical reactions in the body. The deviation of the indicator from the norm often indicates the development of certain pathologies associated with a violation of phosphorus-calcium metabolism.

The norm of alkaline phosphatase in the blood

In order to identify compliance or deviation from the norm of the content of alkaline phosphatase, a biochemical blood test is performed. It should be noted that the rate of alkaline phosphatase is associated with age, gender, and in some cases, the physiological state of the patient. So, in children, this indicator is three times higher than in adults, and in women, the level of alkaline phosphatase in the blood is normally lower than in men.

In addition, it should be taken into account that the indicators of the alkaline phosphatase norm also depend on which reagents were used in the blood test. Here are the average figures.

Blood ALP norms in biochemical analysis (constant time method):

in children and adolescents - 1.2-6.3 μkat / l;
in men - 0.9-2.3 mkat / l;
the norm of alkaline phosphatase in women is 0.7-2.1 mkat / l.

from birth to 1 year - units / l;
from 1 to 9 years - units / l;
from 9 to 15 years - units / l;
from 15 to 18 years old - units / l.

A significant increase in the average ALP in children under 9 years of age is not a pathology and is associated with intensive bone growth.

The norm of alkaline phosphatase in blood plasma in women (by age):

from 19 to 45 years old /l;
from 45 to 55 years - units / l;
from 55 to 70 years - units / l;
after 70 years - units / l.

It is normal to change the level of the enzyme during pregnancy. This is due to the formation of the placenta in the body of the expectant mother.

Pathological causes of changes in alkaline phosphatase

Together with others laboratory tests and instrumental studies, the identification of the level of alkaline phosphatase is of decisive importance in the diagnosis of certain diseases. Biochemical analysis is prescribed for patients with pathology of the endocrine system, digestive tract, liver, kidneys. IN without fail this study performed with pregnant women and patients who are being prepared for surgery.

As a result of damage to the tissues of an organ or system, the level of alkaline phosphatase changes. Contribute to this disease:

liver (cirrhosis, viral hepatitis, obstructive jaundice);
bile ducts;
bone tissue (rickets, osteosarcoma, osteomalacia, etc.);
malignant tumors;
rheumatoid arthritis;
myocardial infarction;
severe renal failure;
ulcerative colitis and intestinal infections accompanied by diarrhea;
thyroid disorders.

Rules for conducting biochemical analysis

To get the most accurate data, you must follow the following rules:

The day before the analysis, it is forbidden to engage in intense physical labor or sports.

At least 24 hours in advance, it is recommended not to drink alcohol and not to use drugs that help change the level of alkaline phosphatase.

The analysis is done on an empty stomach in the morning period of time.

Blood sampling from a vein for analysis is done in a volume of 5-10 ml.

Additionally, in order to clarify the diagnosis, tests of urine, feces, intestinal juice can be prescribed, as well as liver, intestinal, bone, placental, alkaline phosphatase isoenzymes.

Alkaline phosphatase: norm and pathology

What is alkaline phosphatase?

Alkaline phosphatase is a group of enzymes that provide biochemical processes in the body, resulting in the breakdown of phosphoric acid monoesters. By chemical structure phosphatase is a protein whose molecule has complex structure and contains several zinc atoms.

In the biochemical processes occurring inside the cell, alkaline phosphatase plays the role of a catalyst, its highest activity is determined in an alkaline environment, with a ph value of 9 to 10. Total alkaline phosphatase is not homogeneous in structure and consists of isoenzymes similar in structure, the main sources of which are:

Normally, all alkaline phosphatase in the blood is represented by the liver and bone isoenzyme, approximately in equal parts, the remaining fractions may be present in small quantities. However, under certain pathological and physiological conditions, the quantitative ratio of ALP isoenzymes in blood plasma can change significantly.

Why does the level of alkaline phosphatase in the body change?

Alkaline phosphatase ensures normal metabolism in all tissues human body. Therefore, when the cells of any of the organs of a mechanical, inflammatory, degenerative or neoplastic nature are damaged, some of the enzymes from the damaged tissues enter the bloodstream, and an increase in the activity of alkaline phosphatase in the blood plasma is determined. Most often, the following conditions contribute to this:

diseases of the liver and biliary tract: obstructive jaundice, cirrhosis of the liver, viral hepatitis, Gilbert's syndrome;
bone tissue diseases: Paget's disease, osteogenic sarcoma, rickets, osteomalacia, bone fusion after fractures;
malignant tumors of the testicle, prostate, kidney, ovary, uterus, pancreas and lung;
with other pathologies: hyperparathyroidism, hyperthyroidism, myocardial infarction, ulcerative colitis, chronic renal failure, rheumatoid arthritis, etc.;
how side effect when taking medications: phenobarbital, furosemide, ranitidine, papaverine, halothane, etc.

An increase in the level of alkaline phosphatase in the blood can also be observed in healthy people with a significant increase in the metabolism of certain organs and tissues caused by certain functional states, the main ones being:

active process of digestion, after eating;

in women during pregnancy (especially later dates) and breastfeeding;

in children during periods of intensive bone growth.

Much less common pathological conditions, in which the activity of alkaline phosphatase decreases, and its indicators in the blood are determined at a very low level. Deficiency of alkaline phosphatase is caused by the following pathologies:

hypovitaminosis and beriberi (especially with a lack of vitamins of groups B and C);
lack of trace elements in the body: zinc, magnesium, phosphorus (occurs during starvation and poor nutrition);
hypervitaminosis D (with excessive consumption of foods containing large amounts of vitamin D);
hypothyroidism with severe dysfunction of the thyroid gland;
taking medications: statins, sulfonamides.

When is an alkaline phosphatase blood test performed?

IN clinical practice the level of alkaline phosphatase acquires an important diagnostic value only in combination with other laboratory and instrumental studies. Therefore, patients are usually prescribed a biochemical blood test, which includes the determination of the content of alkaline phosphatase. This study is indicated for all outpatients and inpatients with pathology of the liver, kidneys, digestive and endocrine systems. At present, in most cases, it is limited to the definition general level ALP, since fractional analysis, although more informative, is very expensive and is performed only in specialized laboratories.

How is the analysis for ALP done?

To obtain the correct result of the study, you must adhere to the following rules:

blood sampling is performed in the morning from the cubital vein in the amount of 5-10 ml;
the analysis should be performed on an empty stomach and it is best not to eat for at least 12 hours before taking blood;
one day before blood donation, one should not engage in heavy physical labor and sports involving intense loads;
refrain from drinking alcohol and taking medications that increase the level of alkaline phosphatase.

What is the rate of alkaline phosphatase in the blood?

Normal levels of alkaline phosphatase in blood plasma vary depending on the age and sex of the person. The norm in children is:

In adults, ALP indicators slightly differ depending on gender, the norm for women per liter is lower than for men of the same age:

20-30 years - 85 - 105 units / l;
30-45 years - 95 - 115 units / l;
45-55 years - 100 - 125 units / l;
55-70 years - 130 - 145 units / l;
over 70 years old - 165 - 190 units / l.

Alkaline phosphatase is elevated

Alkaline phosphatase is a group of enzymes that is present in almost all tissues of the body. The greatest localization of enzymes is in the liver, bones and placenta. Phosphatases located in cells take part in the reactions of cleavage of the phosphoric acid residue from its organic compounds.

The norm of alkaline phosphatase

In the blood of a healthy person, the content of alkaline phosphatase is quite natural, since the cells are constantly updated. However, if many cells die, then the level of these enzymes can increase, sometimes by several times. Depending on age, the norm of the content of these enzymes in the blood also changes, and the norm for men and women also varies. So, for example, at the age of 4 years in boys, the norm of the alkaline phase is 104 # 8212; 345 U / l, in girls of the same age, the norm is slightly higher - 108 # 8212; 317 U/l. With age, the amount of alkaline phosphatase decreases, and in boys the blood already contains from 74 to 390 U / l, for girls of the same age the norm is 50 # 8212; 162 U/l. With the onset of 18 years, these indicators in men and women, these indicators are compared and remain unchanged - from 30 to 120 U / ml.

As you can see, in the blood of a healthy person, the content of alkaline phosphatase is minimal. To determine the amount of alkaline phosphatase, a blood test, urine, feces, intestinal juice is used. Sometimes alkaline phosphatase isoenzymes are determined, such as hepatic, intestinal, bone, placental, Regan and Nagayo isoenzymes in blood serum, in amniotic fluid. Taking a blood sample for alkaline phosphatase takes a couple of minutes. Before taking the test, it is recommended to refuse food and drink, because in some people eating produces alkaline phosphatase, which can distort the results of the analysis. Modern laboratories are able to provide test results within a couple of hours. Exceeding the permissible values in most cases indicates a disease.

Causes of elevated alkaline phosphatase

The main reasons for an increase in alkaline phosphatase are:

1. Damage to the liver and biliary tract.

Obstructive jaundice due to obstruction of the bile ducts.

Bile duct stones, bile duct scars caused by surgery.

Tumors of the bile ducts of various origins.

Cancer of the head of the pancreas.

Gastric cancer with mechanical compression of the common bile duct, through which bile enters the duodenum.

Metastases in the liver of malignant tumors of internal organs.

Hepatitis of any origin. Traditionally, this disease exceeds the ALP value by 3 times the norm.

Infectious mononucleosis. The symptoms of this acute viral infection are not only fever, inflammation of the pharynx and swollen lymph nodes, but also elevated values of alkaline phosphatase.

Primary biliary cirrhosis and primary sclerosing cholangitis.

At times, the level of alkaline phosphatase can increase in Paget's disease. This disease is accompanied by pathological growth of bones and a violation of their structure.

Metastases of tumors in the bone.

Osteomalacia is a softening of the bones due to a lack of calcium.

Hyperparathyroidism is a hormonal disorder in which parathyroid glands provoke excessive formation of parathyroid hormone, as a result, calcium is washed out of the bones.

Third trimester of pregnancy.

Congestive heart failure.

Breast cancer with metastases.

Lymphoma and leukemia.

Lung cancer with metastases.

Prostate cancer.

Agree, dear visitors to our portal, not so much is known about alkaline phosphatase, as we suppose, about the same bilirubin, the increase in which in the blood also indicates problems with the liver. However, in no case do not neglect the treatment and do not ignore the treatment if the norm is exceeded at times, since the consequences of this can be extremely sad. We will be grateful if you tell us what you know about alkaline phosphatase in the comments to this article.

The norm of alkaline phosphatase in women and deviations from the norm

What is alkaline phosphatase, the norm in women different ages. Serious importance in metabolism is played by alkaline phosphatase (especially calcium and phosphorus metabolism), which is found in many tissues of the body of any person. The amount of this enzyme in the blood stream allows you to obtain information about a particular disease of any internal organ or human systems. Conducting a special blood test aimed at determining the amount of alkaline phosphatase helps to diagnose various diseases including the presence of cancerous tumors.

Alkaline phosphatase - what is it for

This medical term is the modern name for the enzymes involved in the body's exchange of calcium and phosphorus in cells. Each of these enzymes has its own function - in alkaline phosphatase it is the transport of phosphorus through cell membranes organism. To ensure this, phosphatase helps separate phosphoric acid molecules from the compounds with which it entered human tissues. Thanks to the function of alkaline phosphatase, phosphorus freely enters the cells of the body, contributing to normal metabolism.

Phosphatase is one of the most important indicators human health, because its amount directly depends on pathologies various systems organism. She may have elevated reduced values which is most commonly seen during pregnancy. It is also worth knowing that an increase in the amount of phosphatase today is most often observed in the elderly, which is due to a decrease in bone mass.

Since zinc is part of this enzyme, if it is deficient in the diet, the level of phosphatase will have reduced results.

cocoa;
peanut;
any kind of chocolate;
watermelon seeds;
oysters;
fresh meat (lamb, beef).

In order for the test results to be correct and reliable, it is important to donate blood on an empty stomach. The fact is that in people with blood groups 1 and 3, when eating fatty foods, there is an increase in intestinal phosphatase, which will certainly affect the test result.

Varieties of alkaline phosphatase

In the human body, phosphatase is found in many tissues and organs, while having 11 varieties - isoenzymes.

The most famous and of diagnostic value are the following:

Bone LPL - is located in the bone tissue, or rather, its cells. If there is a deformation in the bone, alkaline phosphatase quickly penetrates into the blood from the bone tissue cells, while increasing its level in the blood stream.
Renal ALPL - This type is located in the tubules of the kidneys.
Hepatic ALPL - is located in the liver cells, in violation of the integrity of which it quickly penetrates into the blood.
Intestinal ALPI is found in the intestinal mucosa.
Placental ALPP - found in the placenta. The indicators and results of alkaline phosphatase increase rapidly during pregnancy for physiological reasons of the body, while a lot of it is secreted by the mammary gland during lactation.
Oncological - this isoenzyme penetrates into the human body as a result of the formation of malignant and life-threatening neoplasms.

The level of this enzyme in the blood of women and men is evidence of pathology in some tissues, even if certain and characteristic symptoms diseases are absent or strongly lubricated.

Why you need to regularly measure the level of the enzyme

Since alkaline phosphatase is found in many organs of the human body, a variety of reasons affect the increase in its norm in the blood, therefore there are no pronounced symptoms indicating an increase in the amount of this enzyme. However, some signs can be distinguished, the presence of which explains the blood test for phosphatase.

These include:

bitterness in the oral cavity before and after eating;
severe and not passing pain in the head;
itching on the skin, resembling an allergic reaction;
jaundice;
nausea;
weakness of the body even without performing physical exertion;
darkening of urine and the acquisition of an unpleasant odor;
discoloration of feces;
pain in the hypochondrium, which can be called aching;
frequent fractures;
diseases of bones and joints;
drastic weight loss.

High levels of phosphatase in women

This indicator is observed much more often than a low level, and it tells the doctor a lot. Often high test results are explained by the fact that any kind of pathological process that occurs in the female body is accompanied by death. a large number cells. This leads to the penetration of phosphatase into the woman's blood from cell membranes.

If high study results are accompanied by sharp increase the amount of other enzymes in the body, then the doctor can safely say that the patient has problems with the liver, even if she does not feel any symptoms of a particular disease.

A simultaneous increase in calcium, phosphorus and this enzyme indicates pathologies of bone tissue.

It is also worth knowing that the increase in alkaline phosphatase - the norm in women and men, can be influenced by the gender, temperature and psychological mood of the patient. The rise in test results can be provoked by constant stress and fatigue.

If the level of phosphatase is increased in some cancerous tumors, this is due to the ability of their cells to synthesize this enzyme.

All reasons for the increase in test results can be divided into several groups:

Pathology of the liver. The increase in indicators is affected by liver diseases, its malignant tumors, as well as metastatic lesions, which include cancer, tumors and disruption of some internal and genital organs.
Violation of the integrity of bone tissue. This includes a lack of calcium in the body, and the development of a disease such as rickets. Also, the level of phosphatase is affected by osteomalacia, characterized by the destruction of tissues in the bones. Fractures, tumors, cancer that have spread to the bone tissue can cause a lot of diseases, which include cancer of the prostate and breast, disruption of the kidneys, lungs and other organs.
This includes diseases that are not associated with diseases of the above organs. Most often, the main cause is myocardial infarction, colitis and disruption of the intestines, which develops as a result of lower scores enzyme in a woman's blood.
This group includes the patient's conditions that cannot be associated with pathologies of the body. In this case, the level of phosphatase is often increased in women who are carrying a child, adolescents, boys in adulthood, and also in girls who have not reached the age of 20.

Decreased phosphatase values and blood biochemistry

This condition is much less common - in this case, the patient needs to undergo a complete diagnostic examination to determine the cause of the low enzyme level.

It is worth knowing that this condition is associated with dangerous and serious diseases, which include:

zinc deficiency in a woman's body;
deterioration and disruption of the thyroid gland;
anemia;
hypophosphatosis;
protein deficiency - sometimes occurs as a result of a low-protein diet for kidney disease.

To determine the level of enzyme activity in the blood, the method of colometry is used, during which various reagents are alternately added to the blood serum. The current equipment in laboratories allows physicians to obtain data on a wide variety of blood enzymes, and the results obtained are referred to as international units per liter of blood (IU/l).

When conducting biochemistry, blood from a vein is used, which is taken only on an empty stomach, since the presence of food dramatically increases the level of the enzyme in the liver. Cigarette drinkers should refrain from smoking for at least 30 minutes prior to testing.

Norms of alkaline phosphatase in the blood in women

In a healthy person, this level is directly related to gender, body condition and age, so the indicators of this enzyme often differ from each other.

In men normal values are considered (in IU / l):

aged 1-10 years;
at the age of departure;
at the age of departure;
at the age of 19 years.

In women, these indicators are somewhat different, the alkaline phosphatase rate is as follows (IU / l):

aged 1-10 years;
at the age of departure;
at the age of departure;
at the age of 19 years.

It can be seen that normal performance in women differ significantly from the norm in men.

This is due to several factors, the main ones being:

The onset of pregnancy. During the bearing of a child in a woman’s body, in addition to the presence of ordinary or “standard” isoenzymes, a placental or, as doctors call it, a new one also appears.
In women, a constant increase in the enzyme often occurs when taking contraceptives.
High levels of this substance in the blood are also caused by preeclampsia of pregnant women, which is considered dangerous disease for the expectant mother and child. For such patients, the gynecologist will constantly prescribe blood donations to monitor the state of the body.

An increase in alkaline phosphatase in the blood can cause both physiological changes in the body, and serious diseases. What are the symptoms of an increase in this enzyme and how to behave when receiving such an analysis?

Symptoms

On the early stages the change in metabolism in the liver and the associated rise in the level of alkaline phosphatase goes unnoticed by the patient. Over time, the body gives signals about a change in state. The first signs are the following:

Nausea;

Decreased appetite;

Rapid fatigue and fatigue;

Weakness all over the body;

Aching pain under right rib;

Pain in bones and joints.

A similar clinical picture is characteristic of many diseases, a biochemical blood test will accurately determine the level of alkaline phosphatase, but this will only direct diagnostic search in the right direction. There are many diseases that occur with an increase in alkaline phosphatase.

Preparing and conducting analysis

Alkaline phosphatase can also be elevated in healthy people. Such cases include:

Consumption of alcoholic beverages, which caused alcohol intoxication organism;
Pregnancy, last trimester;
Drugs with hepatotoxic side effects.

What does it mean? First of all, before passing the analysis, you need to take measures to prepare the body. This is the only way to trust the results. These activities include:

Abstinence from food for at least 8 hours;
Exclusion of alcohol and alcoholic beverages from the use of products for 2-3 days;
Do not smoke 30 minutes before the delivery of the biomaterial;
Avoid physical overexertion, including sports for 24 hours.
If you can not stop taking drugs, then you should report them. health worker, which picks up the analysis. The attending physician should also be notified.

They will take blood from a vein for testing.

What causes an increase in enzyme levels?

Causes of elevated alkaline phosphatase may be natural or pathological.

Natural causes include:

Physiological features of the body, characteristic of a certain period of life (pregnancy);

An increase associated with external influences on the body (diet, physical activity, taking medications).

Alkaline phosphatase is elevated - causes that relate to the physiological characteristics of the body:

growth, development, puberty cause an increase in alkaline phosphatase. When a certain age limit is reached, the level of the enzyme in the blood begins to spontaneously fall. And female body reaches this mark much earlier (up to 20 years) than men (up to 30 years);

Before giving birth, the baby in the womb develops and grows more actively. This process causes an increase in the concentration of placental alkaline phosphatase in the blood of the expectant mother;

In the postoperative period or in the recovery period after significant fractures;

Medicines have an effect on the body different action. There are medicines long-term use in which alkaline phosphatase is elevated. These drugs include: antibiotics, contraceptives, paracetamol, aspirin, drugs with a hepatotoxic effect;

Bad habits: smoking, alcohol;

Age features. In children during the period of active growth increased concentration enzymes in the blood. A similar situation is observed in women during menopause. In older people, the bones become lighter and more brittle, and the alkaline phosphatase in their blood is higher than normal;

lack of physical activity;

Obesity;

Wrong diet. The menu is dominated by fatty, spicy and fried foods.

The level also increases with pathological changes in the cells of the placenta, liver, and bones. In order for the enzyme molecules to enter the bloodstream, the destruction of liver cells and bones must occur.

Pathological processes, a symptom of which is high alkaline phosphatase, can be divided into 3 categories:

Liver dysfunction and biliary tract problems. Such ailments include:

Viral and autoimmune hepatitis. An increase in the level of alkaline phosphatase by about 3 times;

Cirrhosis. With a biliary variety of the disease, the level of alkaline phosphatase can increase by 4 times and remain at the reached limit;

Infectious mononucleosis;

Cholangitis sclerosus - chronic autoimmune disease causing high pressure in the portal vein;

Stagnation of bile;

Blockage of the bile ducts by stones. As a result, the outflow of bile is produced in small quantities or there is no exit at all.

Bone diseases:

Severe destruction and deformation (Paget's disease);

Cancer with bone metastases;

Osteomalacia is a systemic skeletal lesion in which the bone deforms and becomes soft. As a result, phosphoric acid, vitamins and calcium are excreted, and the bones of the skeleton soften;

Osteogenic sarcoma - a tumor forms and develops directly in the depth of the bone tissue;

Rehabilitation after fractures;

Diseases of a different nature:

heart attack;

Ulcerative colitis is a chronic inflammation of the mucous membrane of the large intestine;

Intestinal perforation - a through hole in the large intestine through which the contents of the intestine enter the abdominal cavity;

Hyperparathyroidism - pathological changes endocrine system, provoking intensive work of the parathyroid glands.

According to statistics, 50% of cases with high concentration alkaline phosphatases have been triggered by liver disease.

Features of the increase in adults

There are a number of nuances that need to be considered when deciphering the results of an alkaline phosphatase blood test. First, in men, the content of isoenzymes in the blood is always higher than in women. The difference is about 20-25 points. With age, the amount of alkaline phosphatase increases in everyone. This means that the concentration given element depends on the age and gender of the person.

The most popular natural causes high content enzymes in the blood of adults are:

The list of possible reasons for the increase in the level in women is supplemented by the following "moments":

Pregnancy, the period before the birth of a baby;
Breast-feeding;
Climax;
Reception of contraceptives on a hormonal basis. At long-term use complications in the form of diseases are possible, for example, cholestatic jaundice and intrahepatic cholestasis.

Read more about changes in phosphatase levels during pregnancy in the article.

Alkaline phosphatase is a group of enzymes found in almost all tissues of the body, with a predominant localization in the liver, bones and placenta. Phosphatases in cells are involved in the reactions of cleavage of the residue of phosphoric acid from its organic compounds. The activity of total alkaline phosphatase increases in a number of diseases accompanied by tissue damage to the liver, bones, kidneys and other organs.

Russian synonyms

Phosphatase is alkaline.

English synonyms

ALK PHOS, ALP, ALKP, alkaline phosphatase.

Research method

Kinetic colorimetric method.

Units

U / l (unit per liter).

What biomaterial can be used for research?

Venous, capillary blood.

How to properly prepare for research?

Do not eat for 12 hours before the test.
Eliminate physical and emotional overstrain 30 minutes before the study.
Do not smoke for 30 minutes prior to the study.

General information about the study

Alkaline phosphatase is an enzyme that is found in the cells of the liver and biliary tract and is a catalyst for certain biochemical reactions in these cells (it does not work in the bloodstream). When these cells are destroyed, their contents enter the bloodstream. Normally, some of the cells are renewed, so a certain activity of alkaline phosphatase is found in the blood. If many cells die, it can rise very significantly.

Bile is produced in the liver cells and excreted through the system of intrahepatic bile ducts. They then combine to form the hepatic ducts, which extend beyond the liver to form the common bile duct, which flows into the small intestine.

Bile is necessary for the absorption of fats from food. Also, some medicinal substances. It is formed constantly, but enters the intestine only during and after meals. When not needed, it accumulates in the gallbladder.

The activity of alkaline phosphatase is greatly increased when bile flow is obstructed, for example, stones in the bile ducts. This stasis of bile is called cholestasis.

In bones, alkaline phosphatase is formed in special cells - osteoblasts, which play important role in the formation and renewal of bone tissue. The higher the activity of osteoblasts, the higher the activity of alkaline phosphatase in the blood, therefore, in children and those who have suffered bone fractures, the activity of alkaline phosphatase is high.

Alkaline phosphatase is also found in the cells of the intestine and placenta.

What is research used for?

Usually given test prescribed to detect diseases of the liver or bones. In addition, alkaline phosphatase is elevated in diseases that affect the bile ducts, so this analysis helps confirm blockages in the bile ducts in bile duct stones or pancreatic tumors.

The test for alkaline phosphatase as well as gamma-glutamyl transferase is performed in order to diagnose diseases that affect the biliary tract: primary biliary cirrhosis and primary sclerosing cholangitis.

Any condition that involves bone growth or increased activity bone cells, increase the activity of alkaline phosphatase. Therefore, an alkaline phosphatase test can be used, for example, to determine that a tumor has spread beyond the primary focus to the bone.

Re-administration of alkaline phosphatase is used to monitor the activity of diseases in which it is elevated, or to evaluate the effectiveness of treatment.

When is the study scheduled?

The alkaline phosphatase test may be part of the standard diagnostic panels that are used for routine medical examinations and preparing the patient for surgical intervention. It is also usually included in "liver tests" used to evaluate liver function.

This study is carried out when the patient complains of weakness, fatigue, loss of appetite, nausea, vomiting, abdominal pain (especially in the right hypochondrium), jaundice, darkening of urine or lightening of feces, skin itching.

In addition, the analysis is prescribed for symptoms of bone lesions: pain in the bones, their deformation, frequent fractures.

What do the results mean?

Reference values

Age, gender		Reference values
		83 - 248 U/l
15 days - 1 year		122 – 469 U/l
		142 - 335 U/l
		129 - 417 U/l
		57 - 254 U/l
		116 - 468 U/l
		50 - 117 U/l
		82 - 331 U/l

		55 - 149 U/l
		35 - 105 U/l
		40 - 130 U/l

If other tests such as bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) are also elevated, then an increase in blood alkaline phosphatase may be due to liver damage. If the levels of calcium and phosphorus are changed, the most probable cause increased alkaline phosphatase is a pathology of bone tissue. An increase in alkaline phosphatase activity almost always means damage or involvement in pathological process liver, bile ducts or bones.

Increased activities of gamma-glutamyl transpeptidase (GGT) and 5-nucleotidase indicate that the increase in ALP is due to damage to the biliary tract.

Causes of increased activity of alkaline phosphatase

1. Damage to the liver and biliary tract.

Obstructive jaundice associated with obstruction of the bile ducts.
- Bile duct stones, bile duct scars after surgical interventions.
- Tumors of the bile ducts.
- Cancer of the head of the pancreas, cancer of the stomach with mechanical compression of the common bile duct, through which bile enters the duodenum.
Liver cancer, metastases of tumors of other organs in the liver.
Cirrhosis of the liver is a pathological process during which normal hepatic tissue is replaced by scar tissue, which inhibits all liver functions.
Hepatitis of any origin (usually alkaline phosphatase because of it becomes 3 times more than normal).
Infectious mononucleosis is an acute viral infection, manifested by fever, inflammation of the pharynx and enlarged lymph nodes. In this case, the liver is often involved in the pathological process.
Primary biliary cirrhosis and primary sclerosing cholangitis are rare diseases, which occur in adults and are associated with autoimmune damage to the bile ducts. Accompanied by extremely high activity of alkaline phosphatase and gamma-glutamyl transferase.

2. Damage to the bones.

Particularly high activity of alkaline phosphatase (15-20 norms) is noted in Paget's disease. This is a disease that is accompanied by pathological growth of bones and a violation of their structure in certain places.
Osteosarcoma.
Metastases of other tumors in the bone.
Osteomalacia is a softening of the bones caused by a lack of calcium.

3. Other reasons.

Hyperparathyroidism is a hormonal disease associated with over-education parathormone by the parathyroid glands, which leads to the leaching of calcium from the bones.
Myocardial infarction.
Ulcerative colitis, intestinal perforation (since alkaline phosphatase is also found in intestinal cells).

Causes of a decrease in alkaline phosphatase activity

Severe anemia.
Massive blood transfusions.
Hypothyroidism is a condition in which the function of the thyroid gland is reduced.
Lack of magnesium and zinc.
Hypophosphatasia - rare congenital disease leading to softening of the bones.
A pronounced decrease in alkaline phosphatase in pregnant women is a sign of placental insufficiency.

What can influence the result?

During pregnancy, the activity of alkaline phosphatase is normally increased, since it is contained in the placenta.
A temporary increase in ALP activity is observed after fractures.
In children and young men, the activity of alkaline phosphatase is higher than in adults, so they have bone growth.
Aspirin, paracetamol, allopurinol, antibiotics and a number of other drugs can increase the activity of alkaline phosphatase.
Taking oral contraceptives sometimes leads to a decrease in alkaline phosphatase activity.
The activity of alkaline phosphatase may be overestimated if the blood was cooled after taking.

Important Notes

The activity of alkaline phosphatase is sometimes increased in healthy individuals, this does not necessarily indicate any pathology. In order to correctly interpret the change in ALP activity, a comprehensive assessment of the results of other tests, as well as other medical data, is needed.