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ALP isoenzyme test

Alkaline phosphatase (ALP) is an enzyme found in all body tissues. There are many different forms of ALP called isoenzymes. The structure of the enzyme depends on where in the body it is produced. This test is most often used to test ALP made in the tissues of the liver and bones.

The ALP isoenzyme test is a lab test that measures the amounts of different types of ALP in the blood.

The alkaline phosphatase test is a related test.

Alternative Names

Alkaline phosphatase isoenzyme test

How the test is performed

A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand.

How to prepare for the test

You should not eat or drink anything for 10 to 12 hours before the test, unless your doctor tells you to do so.

Many medicines can interfere with blood test results.

  • Your health care provider will tell you if you need to stop taking any medicines before you have this test.
  • Do not stop or change your medications without talking to your doctor first.

How the test will feel

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

Why the test is performed

When the alkaline phosphatase (ALP) test result is high, the doctor may order the ALP isoenzyme test. This test will help determine what part of the body is causing higher ALP levels.

This test may be used to diagnose:

  • Bone disease
  • Liver , gallbladder, or bile duct disease
  • Pain in the abdomen 
  • Parathyroid gland disease
  • Vitamin D deficiency

It may also be done to check liver function and to see how medicines you take may affect your liver.

Normal Values

The normal value is 20 to 140 IU/L (international units per liter).

Adults have lower levels of ALP than children. Bones that are still growing produce higher levels of ALP. During some growth spurts, levels can be as high as 500 IU/L. For this reason, the test is usually not done in children, and abnormal results refer to adults.

The isoenzyme test results can reveal whether the increase is in "bone" ALP or "liver" ALP.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The example above shows the common measurement range for results for these tests. Some laboratories use different measurements or may test different specimens.

What abnormal results mean

Higher-than-normal ALP levels:

  • Biliary obstruction
  • Bone disease
  • Eating a fatty meal if you have blood type O or B
  • Healing fracture
  • Hepatitis
  • Hyperparathyroidism
  • Leukemia
  • Liver disease
  • Lymphoma
  • Osteoblastic bone tumors
  • Osteomalacia
  • Paget's disease
  • Rickets
  • Sarcoidosis

Lower-than-normal levels of ALP:

Levels that are only slightly higher than normal may not be a problem unless there are other signs of a disease or medical problem.

References

Afdhal NH. Diseases of the gall bladder and bile ducts. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 158.

Berk P, Korenblat K. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 149.

Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 148.

Weinstein RS. Osteomalacia and rickets. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 252.

Updated: 5/5/2013

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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