What is alkaline phosphatase (ALP)?
Alkaline phosphatase (ALP) is an enzyme that’s found throughout your body. An enzyme is a type of protein in a cell that acts as a catalyst and allows certain bodily processes to happen. There are thousands of enzymes throughout your body that have important functions.
Even though researchers know the function of several other types of enzymes and have studied alkaline phosphatase for decades, they don’t yet know the exact function of ALP. However, researchers believe it’s important for multiple different processes.
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ALP is often considered a liver enzyme because it’s primarily found in your liver. However, it also exists in the following places:
- Your bile duct.
- Your bones.
- Your kidneys.
- Your intestines.
- The placenta in pregnant people.
Abnormal levels of ALP in your blood can reflect damage to tissue or disruption of normal bodily processes.
What is an alkaline phosphatase (ALP) blood test?
An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. Although ALP exists throughout your body, the two main sources of ALP in your blood are your liver and bones. High levels of ALP may indicate liver disease or certain bone disorders, but an ALP test alone cannot diagnose a condition.
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There are two main types of alkaline phosphatase (ALP) blood tests: a general ALP (the more common test) and an ALP isoenzyme test.
A general ALP test is usually included in a blood test known as a comprehensive metabolic panel (CMP) and a liver panel (HFP or LFT).
Whereas an ALP test just measures the level of ALP in your blood, an ALP isoenzyme test can differentiate between types of alkaline phosphatase based on where they originated in your body.
Your healthcare provider may have you undergo an ALP isoenzyme test as a follow-up if you had an abnormal ALP level on a previous test. While an isoenzyme test can provide more detailed information, it’s more technically challenging and expensive, and some laboratories may not offer it.
Why do I need an alkaline phosphatase blood test?
Your provider may order an alkaline phosphatase (ALP) blood test to help screen for, monitor or help diagnose liver and biliary diseases, bone disorders and other health conditions.
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Screening means checking for potential health issues before you experience symptoms. An ALP test is often included in a comprehensive metabolic panel (CMP) and liver panel. Healthcare providers often use these panels as part of a routine check-up to screen for a wide range of potential health problems.
If you have a liver or bone condition or another type of condition, your provider may order an ALP test, often as part of a panel, to monitor your condition to see if it’s improving, worsening or staying the same with or without treatment.
Your provider may use an ALP test for diagnostic purposes when you have signs of possible liver or bone problems. An ALP test can also help diagnose the cause of more general symptoms, such as fatigue, when it’s included in a liver panel or CMP. While providers can’t diagnose a condition based solely on ALP levels, it can be an important part of the diagnostic process. The degree to which the ALP level is elevated or lower than usual may indicate the type or severity of a condition.
Signs and symptoms of liver disease include:
- Jaundice — a condition that causes your skin and the whites of your eyes to turn yellow.
- Abdominal (belly) pain and/or swelling, especially on your right side.
- Bruising easily.
- Nausea and/or vomiting.
- Having dark-colored pee and/or light-colored poop.
- Unexplained weight loss.
- Tiredness (fatigue).
- Swelling in your arms or legs (edema).
Signs and symptoms of bone disorders include:
- Bone pain and/or joint pain.
- Enlarged and/or abnormally shaped bones.
- Increased frequency of bone fractures.
How is an alkaline phosphatase (ALP) test different from a liver panel or comprehensive metabolic panel (CMP)?
A panel blood test involves more than one measurement from a blood sample. Because of this, a liver panel or comprehensive metabolic panel (CMP) provides more information than a test for just alkaline phosphatase. While you can undergo a blood test that just measures your ALP, it’s most often included in a panel with other measurements, such as liver enzymes, to get a more complete picture of your liver’s health.
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