From the Guidelines
Your Alkaline Phosphatase (ALP) level of 47 U/L is normal, falling within the reference range of 40-120 U/L, and no action is required. ALP is an enzyme found primarily in the liver, bones, and placenta, and normal levels indicate proper functioning of these organs [ 1 ]. This test is commonly used to evaluate liver and bone health. Elevated levels might suggest liver disease, bone disorders, or certain medications affecting these systems, while significantly low levels (below 40 U/L) could indicate conditions like malnutrition, certain genetic disorders, or zinc deficiency.
Key Points to Consider
- The normal result suggests your liver is functioning properly and there are no significant bone metabolism issues [ 1 ].
- If you experience symptoms like bone pain, jaundice, or fatigue despite this normal result, consult your healthcare provider for further evaluation.
- Regular monitoring of ALP as part of routine bloodwork is recommended, especially if you have existing liver or bone conditions.
- Pathologically increased levels of ALP may occur in cholestatic liver disease, such as primary biliary cholangitis, primary sclerosing cholangitis, intrahepatic or extrahepatic bile duct obstruction, and drug-induced cholestasis [ 1 ].
- Measurements of GGT can indicate whether pathologically elevated ALP is of hepatic or nonhepatic origin [ 1 ].
From the Research
Alkaline Phosphatase (ALP) Levels
- The given ALP level is 47 U/L, which falls within the reference range of 40-120 U/L.
- According to the study 2, elevated ALP levels in postmenopausal women are mainly caused by high bone turnover.
- The same study 2 found that ALP levels decreased to normal range levels after bisphosphonate therapy, suggesting a strong correlation between ALP and bone metabolic markers.
Association with Cardiovascular Disease
- A prospective cohort study 3 found that elevated levels of serum ALP are associated with an increased risk of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke.
- The study 3 also found that higher ALP levels, even within the normal range, were significantly associated with increased risks of CVD in a dose-dependent manner.
Evaluation of Abnormal Liver Chemistries
- The American College of Gastroenterology clinical guideline 4 states that hepatocellular injury is defined as disproportionate elevation of AST and ALT levels compared with alkaline phosphatase levels.
- Cholestatic injury is defined as disproportionate elevation of alkaline phosphatase level as compared with AST and ALT levels 4.
- The guideline 4 recommends that an elevated alkaline phosphatase level of hepatic origin should be further evaluated with testing for primary biliary cholangitis and primary sclerosing cholangitis.