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High alkaline phosphatase (ALP) level in the blood

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High alkaline phosphatase (ALP) level in the blood

What is high alkaline phosphatase (ALP) level in the blood called?

  • Hyperphosphatasemia

What is the normal alkaline phosphatase (ALP) level in the blood?

If you need to know which are the alkaline phosphatase (ALP) reference ranges or you require more information about the role of alkaline phosphatase (ALP) in the blood you can visit: Normal alkaline phosphatase (ALP) level in the blood

What does a high alkaline phosphatase (ALP) level in the blood mean?

Alkaline phosphatase (ALP) high level in the blood may indicate problems related to the liver, a biliary colic or bone disorders. Occasionally, the alkaline phosphatase (ALP) can be high with no medical issue associated.

* In this document, we show the reference ranges for adults measured in U/L. In children, reference ranges are different. The alkaline phosphatase (ALP) in the blood can also be measured in ukat/l. In both cases we recommend you to visit the respective reference tables. Hyperphosphatasemia or a high alkaline phosphatase ALP level in the blood mean:

  • Mild hyperphosphatasemia (120 - 300 U/l in adults):

    Your alkaline phosphatase (ALP) level in the blood is a bit high. About 95% of people with mild hyperphosphatasemia, with no symptoms and no other alteration in a blood test, do not have any disease in the next two years.

    Take a new blood test in the following months and it is probable that your alkaline phosphatase (ALP) level will be in the normal range.

  • Moderate hyperphosphatasemia (300 – 600 U/l in adults):

    Moderate hyperphosphatasemia with a high level of GGT in the blood may be a first sign of a liver damage or gallstones in the gallbladder.

    If the GGT in the blood is within the normal range a bone disorder may be suspected. It is a common sign of a fracture healing or maybe also a sign of suffering from osteomalacia.

    Anyway, you should visit your doctor and he will decide if it is necessary to do any additional screening test.

    Important: The alkaline phosphatase (ALP) may have these values in children and adolescents in the growth stages. Please, see the reference table of alkaline phosphatase (ALP) for children.

  • Marked hyperphosphatasemia (600 – 1200 U/l in adults):

    If the alkaline phosphatase (ALP) is very high and the GGT in the blood is also high it may suggest a liver damage such as cirrhosis or a bile duct obstruction. If your skin and the whites of your eyes turn yellowish, what is called jaundice, you should visit your doctor to provide you the proper treatment.

    If the alkaline phosphatase (ALP) is very high but the GGT in the blood is within the normal range it can be a sign of a bone disorder. The worst scenario would be a metastatic cancer that is destroying the bones. You should ask your doctor and he will try to find the cause in your case.

  • Severe hyperphosphatasemia (> 1200 U/l in adults):

    Severe hyperphosphatasemia along with the GGT in the blood high may suggest a serious liver damage. It is advisable that you visit your doctor as soon as possible. He will recommend you the next steps to avoid chronic liver diseases.

    Severe hyperphosphatasemia with the GGT within the normal range usually suggest a bone disease such as Paget`s disease. Paget`s disease is a chronic disease with causes softer bones or enlarged bone growth. Trauma and orthopedic surgeon are the best professional to treat this condition.

Which factors can raise your alkaline phosphatase (ALP) level in the blood?

There are some medical conditions or drugs than can elevate your alkaline phosphatase ALP level in the blood:

  • Alcohol
  • Vitamin D deficiency
  • Pregnancy
  • Growth stages (puberty)
  • Drugs
    • Androgen
    • Antibiotics
    • Antiepileptic drugs
      • Carbamazepine
    • Antituberculars
      • Aminosalicylic acid
    • Barbiturate
    • Bromocriptine
    • Captopril
    • Uricosuric
      • Allopurinol

Which diseases can raise your alkaline phosphatase (ALP) level in the blood?

There are many diseases why the alkaline phosphatase (ALP) level in the blood can be higher than normal:

  • Anemia
  • Cholestasis
  • Cholangitis
  • Hepatic cirrhosis
  • Hepatitis
  • Hyperparathyroidism
  • Thyrotoxicosis
  • Osteomalacia
  • Paget's disease
  • Bone tumor
  • Prostate cancer
  • Osteosarcoma
  • Leukemia
  • Prostatitis
  • Rickets
  • Ulcerative colitis

What can I do to lower the alkaline phosphatase (ALP) level in the blood?

If your alkaline phosphatase (ALP) level in the blood is slightly high, you can follow the next tips:

  • Increase your vitamin D intake. Food rich in vitamin D includes:
    • Milk
    • Fish (tuna, sardines, mackerel, salmon)
    • Eggs
    • Mushrooms
  • Reduce the intake of food high in zinc. Food rich in zinc includes:
    • Seafood
    • Oysters and clams
    • Lamb meat
    • Beef meat
  • Sunlight exposure is a good way to get vitamin D.

Where can I find more information about alkaline phosphatase (ALP) level in the blood?

You can visit our pages about:

Which values are considered a high alkaline phosphatase (ALP) level in the blood?

The following values are considered to be above the normal range:

IMPORTANT: These levels are expressed in U/L. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

Normal ranges of alkaline phosphatase (ALP) in the blood in children and in pregnancy are very different at the values presented here. In that case you must use the respective reference tables.

Alkaline phosphatase
Mild hyperphosphatasemia
121 U/L122 U/L123 U/L124 U/L125 U/L126 U/L127 U/L128 U/L
129 U/L130 U/L131 U/L132 U/L133 U/L134 U/L135 U/L136 U/L
137 U/L138 U/L139 U/L140 U/L141 U/L142 U/L143 U/L144 U/L
145 U/L146 U/L147 U/L148 U/L149 U/L150 U/L151 U/L152 U/L
153 U/L154 U/L155 U/L156 U/L157 U/L158 U/L159 U/L160 U/L
161 U/L162 U/L163 U/L164 U/L165 U/L166 U/L167 U/L168 U/L
169 U/L170 U/L171 U/L172 U/L173 U/L174 U/L175 U/L176 U/L
177 U/L178 U/L179 U/L180 U/L181 U/L182 U/L183 U/L184 U/L
185 U/L186 U/L187 U/L188 U/L189 U/L190 U/L191 U/L192 U/L
193 U/L194 U/L195 U/L196 U/L197 U/L198 U/L199 U/L200 U/L
201 U/L202 U/L203 U/L204 U/L205 U/L206 U/L207 U/L208 U/L
209 U/L210 U/L211 U/L212 U/L213 U/L214 U/L215 U/L216 U/L
217 U/L218 U/L219 U/L220 U/L221 U/L222 U/L223 U/L224 U/L
225 U/L226 U/L227 U/L228 U/L229 U/L230 U/L231 U/L232 U/L
233 U/L234 U/L235 U/L236 U/L237 U/L238 U/L239 U/L240 U/L
241 U/L242 U/L243 U/L244 U/L245 U/L246 U/L247 U/L248 U/L
249 U/L250 U/L251 U/L252 U/L253 U/L254 U/L255 U/L256 U/L
257 U/L258 U/L259 U/L260 U/L261 U/L262 U/L263 U/L264 U/L
265 U/L266 U/L267 U/L268 U/L269 U/L270 U/L271 U/L272 U/L
273 U/L274 U/L275 U/L276 U/L277 U/L278 U/L279 U/L280 U/L
281 U/L282 U/L283 U/L284 U/L285 U/L286 U/L287 U/L288 U/L
289 U/L290 U/L291 U/L292 U/L293 U/L294 U/L295 U/L296 U/L
297 U/L298 U/L299 U/L300 U/L    
Moderate hyperphosphatasemia
301 U/L302 U/L303 U/L304 U/L305 U/L306 U/L307 U/L308 U/L
309 U/L310 U/L311 U/L312 U/L313 U/L314 U/L315 U/L316 U/L
317 U/L318 U/L319 U/L320 U/L321 U/L322 U/L323 U/L324 U/L
325 U/L326 U/L327 U/L328 U/L329 U/L330 U/L331 U/L332 U/L
333 U/L334 U/L335 U/L336 U/L337 U/L338 U/L339 U/L340 U/L
341 U/L342 U/L343 U/L344 U/L345 U/L346 U/L347 U/L348 U/L
349 U/L350 U/L351 U/L352 U/L353 U/L354 U/L355 U/L356 U/L
357 U/L358 U/L359 U/L360 U/L361 U/L362 U/L363 U/L364 U/L
365 U/L366 U/L367 U/L368 U/L369 U/L370 U/L371 U/L372 U/L
373 U/L374 U/L375 U/L376 U/L377 U/L378 U/L379 U/L380 U/L
381 U/L382 U/L383 U/L384 U/L385 U/L386 U/L387 U/L388 U/L
389 U/L390 U/L391 U/L392 U/L393 U/L394 U/L395 U/L396 U/L
397 U/L398 U/L399 U/L400 U/L401 U/L402 U/L403 U/L404 U/L
405 U/L406 U/L407 U/L408 U/L409 U/L410 U/L411 U/L412 U/L
413 U/L414 U/L415 U/L416 U/L417 U/L418 U/L419 U/L420 U/L
421 U/L422 U/L423 U/L424 U/L425 U/L426 U/L427 U/L428 U/L
429 U/L430 U/L431 U/L432 U/L433 U/L434 U/L435 U/L436 U/L
437 U/L438 U/L439 U/L440 U/L441 U/L442 U/L443 U/L444 U/L
445 U/L446 U/L447 U/L448 U/L449 U/L450 U/L451 U/L452 U/L
453 U/L454 U/L455 U/L456 U/L457 U/L458 U/L459 U/L460 U/L
461 U/L462 U/L463 U/L464 U/L465 U/L466 U/L467 U/L468 U/L
469 U/L470 U/L471 U/L472 U/L473 U/L474 U/L475 U/L476 U/L
477 U/L478 U/L479 U/L480 U/L481 U/L482 U/L483 U/L484 U/L
485 U/L486 U/L487 U/L488 U/L489 U/L490 U/L491 U/L492 U/L
493 U/L494 U/L495 U/L496 U/L497 U/L498 U/L499 U/L500 U/L
501 U/L502 U/L503 U/L504 U/L505 U/L506 U/L507 U/L508 U/L
509 U/L510 U/L511 U/L512 U/L513 U/L514 U/L515 U/L516 U/L
517 U/L518 U/L519 U/L520 U/L521 U/L522 U/L523 U/L524 U/L
525 U/L526 U/L527 U/L528 U/L529 U/L530 U/L531 U/L532 U/L
533 U/L534 U/L535 U/L536 U/L537 U/L538 U/L539 U/L540 U/L
541 U/L542 U/L543 U/L544 U/L545 U/L546 U/L547 U/L548 U/L
549 U/L550 U/L551 U/L552 U/L553 U/L554 U/L555 U/L556 U/L
557 U/L558 U/L559 U/L560 U/L561 U/L562 U/L563 U/L564 U/L
565 U/L566 U/L567 U/L568 U/L569 U/L570 U/L571 U/L572 U/L
573 U/L574 U/L575 U/L576 U/L577 U/L578 U/L579 U/L580 U/L
581 U/L582 U/L583 U/L584 U/L585 U/L586 U/L587 U/L588 U/L
589 U/L590 U/L591 U/L592 U/L593 U/L594 U/L595 U/L596 U/L
597 U/L598 U/L599 U/L600 U/L    
Marked hyperphosphatasemia
601 U/L602 U/L603 U/L604 U/L605 U/L606 U/L607 U/L608 U/L
609 U/L610 U/L611 U/L612 U/L613 U/L614 U/L615 U/L616 U/L
617 U/L618 U/L619 U/L620 U/L621 U/L622 U/L623 U/L624 U/L
625 U/L626 U/L627 U/L628 U/L629 U/L630 U/L631 U/L632 U/L
633 U/L634 U/L635 U/L636 U/L637 U/L638 U/L639 U/L640 U/L
641 U/L642 U/L643 U/L644 U/L645 U/L646 U/L647 U/L648 U/L
649 U/L650 U/L651 U/L652 U/L653 U/L654 U/L655 U/L656 U/L
foto de Dr. Javier Muga Bustamante
Written by

Dr. Javier Muga Bustamante

Last update: 03/04/2020

Bibliography

  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 523.
  • Moss DW, Henderson RA. Clinical Enzymology. In: Burtis CA, Ashwood ER, eds. Tietz textbook of clinical chemistry. Philadelphia:WB Saunders Company, 1999; 676-684. ISBN 9780721656106.
  • Tietz NW, Rinker D, Shaw LM. IFCC methods for the measurement of catalytic concentration of enzymes Part 5. IFCC method for alkaline phosphatase. J Clin Chem Clin Biochem 1983;21:731-48.
  • Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0.Published: November 27, 2017. U.S. Department of health and human Services. Disponible en: https://ctep.cancer.gov
  • Severity grading in drug induced liver injury. U.S. National Library of Medicine. Disponible en: https://livertox.nih.gov

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