BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuALP isoenzyme testAlkaline phosphatase isoenzyme testAlkaline phosphatase (ALP) is an enzyme found in many body tissues such as liver, bile ducts, bone, and intestine. There are several different structural 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 ALP test is a related test.ALP testAlkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blo...ImageRead Article Now Book Mark Article 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. Drawn from a veinVenipuncture is the collection of blood from a vein. It is most often done for laboratory testing.ImageRead Article Now Book Mark Article How to Prepare for the Test 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 medicines without talking to your provider 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 ALP test result is high, you may need to have 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 or monitor:Bone disease Liver, gallbladder, or bile duct disease LiverThe term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain or swelling...ImageRead Article Now Book Mark Article Pain in the abdomen Parathyroid gland disease Vitamin D deficiencyVitamin D deficiencyRickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.ImageRead Article Now Book Mark Article It may also be done to check liver function and to see how medicines you take may affect your liver. Normal Results The normal value for total ALP is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (µkat/L). ALP isoenzyme testing may have differing normal values.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 or 835 µKat/L. For this reason, the test is usually not done in children, and abnormal results refer to adults.ALPAlkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blo...ImageRead Article Now Book Mark Article 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 provider 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 HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Hyperparathyroidism HyperparathyroidismHyperparathyroidism is a disorder in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).ImageRead Article Now Book Mark Article Hyperthyroidism Leukemia Liver disease Lymphoma Osteoblastic bone tumors Osteomalacia Paget disease of bone Paget diseasePaget disease is a disorder that involves abnormal bone destruction and regrowth. This results in deformity of the affected bones.ImageRead Article Now Book Mark Article Sarcoidosis Lower-than-normal levels of ALP:Hypophosphatasia Hypothyroidism Malnutrition MalnutritionMalnutrition is the condition that occurs when your body does not get enough nutrients.ImageRead Article Now Book Mark Article Pernicious anemia Protein deficiency ProteinProteins are the building blocks of life. Every cell in the human body contains protein. The basic structure of protein is a chain of amino acids. ...ImageRead Article Now Book Mark Article Wilson disease Wilson diseaseWilson disease is an inherited disorder in which there is too much copper in the body's tissues. The excess copper damages the liver and nervous sys...ImageRead Article Now Book Mark Article Zinc deficiencyLevels that are only slightly higher than normal may not be a problem unless there are other signs of a disease or medical problem.Other conditions for which the test may be done:Alcoholic liver disease (hepatitis/cirrhosis) Alcohol use disorder Biliary stricture Gallstones Giant cell (temporal, cranial) arteritis Multiple endocrine neoplasia (MEN) II Pancreatitis Renal cell carcinomaOpen ReferencesReferencesFogel EL, Sherman S. Diseases of the gall bladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.Korenblat KM, Berk PD. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier ; 2020:chap 138.Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier ; 2020:chap 137.Weinstein RS. Osteomalacia and rickets. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 231.AllVideoImagesTogBlood test - illustration Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.Blood testillustrationBlood test - illustration Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.Blood testillustration Tests for ALP isoenzyme test ALP isoenzyme testALP - blood testRelated Information ALP - blood test(Medical Test)Enzyme(Special Topic)Bile duct obstruction(Condition)Liver disease(Condition)Rickets(Condition)Hepatitis(Condition)Osteomyelitis(Condition)Paget disease of the bone(Condition)Bone tumor(Condition)Osteomalacia(Condition)Hepatitis - InDepth(In-Depth)Anemia - InDepth(In-Depth)Alcohol use disorders - InDepth(In-Depth) Review Date: 6/20/2023 Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. 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ALP isoenzyme testAlkaline phosphatase isoenzyme testAlkaline phosphatase (ALP) is an enzyme found in many body tissues such as liver, bile ducts, bone, and intestine. There are several different structural 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 ALP test is a related test.ALP testAlkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blo...ImageRead Article Now Book Mark Article 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. Drawn from a veinVenipuncture is the collection of blood from a vein. It is most often done for laboratory testing.ImageRead Article Now Book Mark Article How to Prepare for the Test 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 medicines without talking to your provider 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 ALP test result is high, you may need to have 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 or monitor:Bone disease Liver, gallbladder, or bile duct disease LiverThe term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain or swelling...ImageRead Article Now Book Mark Article Pain in the abdomen Parathyroid gland disease Vitamin D deficiencyVitamin D deficiencyRickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.ImageRead Article Now Book Mark Article It may also be done to check liver function and to see how medicines you take may affect your liver. Normal Results The normal value for total ALP is 44 to 147 international units per liter (IU/L) or 0.73 to 2.45 microkatal per liter (µkat/L). ALP isoenzyme testing may have differing normal values.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 or 835 µKat/L. For this reason, the test is usually not done in children, and abnormal results refer to adults.ALPAlkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blo...ImageRead Article Now Book Mark Article 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 provider 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 HepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Hyperparathyroidism HyperparathyroidismHyperparathyroidism is a disorder in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).ImageRead Article Now Book Mark Article Hyperthyroidism Leukemia Liver disease Lymphoma Osteoblastic bone tumors Osteomalacia Paget disease of bone Paget diseasePaget disease is a disorder that involves abnormal bone destruction and regrowth. This results in deformity of the affected bones.ImageRead Article Now Book Mark Article Sarcoidosis Lower-than-normal levels of ALP:Hypophosphatasia Hypothyroidism Malnutrition MalnutritionMalnutrition is the condition that occurs when your body does not get enough nutrients.ImageRead Article Now Book Mark Article Pernicious anemia Protein deficiency ProteinProteins are the building blocks of life. Every cell in the human body contains protein. The basic structure of protein is a chain of amino acids. ...ImageRead Article Now Book Mark Article Wilson disease Wilson diseaseWilson disease is an inherited disorder in which there is too much copper in the body's tissues. The excess copper damages the liver and nervous sys...ImageRead Article Now Book Mark Article Zinc deficiencyLevels that are only slightly higher than normal may not be a problem unless there are other signs of a disease or medical problem.Other conditions for which the test may be done:Alcoholic liver disease (hepatitis/cirrhosis) Alcohol use disorder Biliary stricture Gallstones Giant cell (temporal, cranial) arteritis Multiple endocrine neoplasia (MEN) II Pancreatitis Renal cell carcinomaOpen ReferencesReferencesFogel EL, Sherman S. Diseases of the gall bladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.Korenblat KM, Berk PD. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier ; 2020:chap 138.Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier ; 2020:chap 137.Weinstein RS. Osteomalacia and rickets. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 231.