From the Guidelines
Elevated ALKP levels on lab results should prompt further evaluation by a healthcare provider to determine the underlying cause, which could be related to liver disease, bone disorders, or other conditions, as indicated by the most recent study 1. ALKP, or alkaline phosphatase, is an enzyme found primarily in the liver, bones, intestines, and placenta. Elevated ALKP levels can indicate liver disease or bone disorders, among other conditions. Normal ALKP ranges typically fall between 44-147 IU/L for adults, though reference ranges may vary slightly between laboratories.
Possible Causes of Elevated ALKP
- Liver disease, such as cirrhosis, chronic hepatitis, or cholestatic liver disease
- Bone disorders, such as Paget's disease, bony metastases, or fracture
- Biliary obstruction, which can be caused by choledocholithiasis, malignant obstruction, or other conditions
- Certain medications or drugs
- Pregnancy or bone growth in children
Next Steps
If ALKP is elevated, the following steps should be taken:
- Follow up with a healthcare provider for further evaluation
- Mild elevations may require monitoring, while significant elevations warrant additional testing, such as:
- Liver function tests
- Imaging studies, such as ultrasound or CT scan
- Bone-specific alkaline phosphatase measurements to determine the source of the elevation
- Understanding ALKP results in context with other lab values and clinical symptoms is essential for proper diagnosis, as suggested by 1 and supported by 1.
Importance of Further Evaluation
Further evaluation is crucial to determine the underlying cause of elevated ALKP levels, as it can have significant implications for morbidity, mortality, and quality of life. For example, if the elevation is caused by a liver disease, prompt treatment can help prevent progression of the disease and improve outcomes, as indicated by 1.
From the Research
ALKP on Lab Results
- ALKP, or alkaline phosphatase, is an enzyme found in various tissues throughout the body, including the liver, bone, and intestines 2.
- In the context of liver health, elevated ALKP levels can indicate cholestatic injury, which is defined as a disproportionate elevation of alkaline phosphatase levels compared to AST and ALT levels 3.
- A study on primary biliary cholangitis found that normal ALKP levels in patients treated with ursodeoxycholic acid were associated with better long-term outcomes, including a significant absolute complication-free survival gain at 10 years 4.
- The evaluation of an ALKP elevation determined to be of hepatic origin should include testing for primary biliary cholangitis and primary sclerosing cholangitis 3.
- ALKP levels can also be influenced by other factors, such as bone health and intestinal function, and can be measured in serum to assess overall health 2.
Possible Causes of Elevated ALKP
- Cholestatic injury, such as primary biliary cholangitis or primary sclerosing cholangitis 3
- Bone disorders, such as osteomalacia or Paget's disease 2
- Intestinal disorders, such as inflammatory bowel disease 2
- Liver diseases, such as hepatitis or cirrhosis 3
Clinical Significance of ALKP
- Elevated ALKP levels can indicate liver damage or disease, and can be used in conjunction with other liver function tests to diagnose and monitor liver health 3
- Normal ALKP levels can indicate a better prognosis for patients with primary biliary cholangitis 4
- ALKP levels can also be used to monitor response to treatment and adjust therapy as needed 4