Alkaline phosphatase 30. Alkaline phosphatase in a biochemical blood test: increased, normal

Alkaline phosphatase refers to a specific enzyme that can be found in many body tissues. It is present in bones, biliary tract cells, liver and placenta.

With the help of alkaline phosphatase (AP), reactions associated with the elimination of phosphate from organic compounds are activated in the body. The enzyme belongs to hydrolases, which means it converts biochemical substrates by adding water elements. It contributes to the unhindered movement of phosphorus throughout the body.

The peak of alkaline phosphatase activity is fixed in the pH medium, therefore, “alkaline” is present in its name.
The level of the enzyme reflects the state of the bone tissue and the hepatobiliary system (gall bladder and bile ducts, liver). Also, according to its content in the blood, one can judge the compliance of phosphorus-calcium metabolism with the needs of the body.

An increased content of the enzyme is observed both in physiological conditions of the body and in severe pathologies.

Symptoms of an increase in alkaline phosphatase

An increase in the amount of alkaline phosphatase compared to the norm can be manifested by the following symptoms:

• feeling tired;
• pain in the right hypochondrium;
• loss of appetite;
• bouts of nausea;
• pain in the bones and joints.

Such manifestations signal an unhealthy state of the body. They are characteristic of many diseases, so it is simply necessary to conduct a study of the composition of the blood. The results of the analysis will provide information on the content of the enzyme.

Alkaline phosphatase is increased: causes

An increase in the concentration of alkaline phosphatase is observed in relatively healthy people in the following cases:

• alcohol poisoning;
• long-term use of medications. Their list is quite extensive and contains several hundred items. Especially dangerous are drugs that can cause the so-called hepatotoxic effect. This means that their long-term use will easily disrupt the structure and functions of the liver;
• pregnancy.

An increase in the level of the enzyme associated with pathologies most often occurs with the development of diseases that damage bone tissue, liver and kidneys.

Three groups of such ailments can be distinguished.
I. Liver damage, its destruction (destruction) and bile flow problems:

• Cirrhosis is a painful process in which normal organ tissue is replaced by scar tissue. All liver functions are inhibited.
• Hepatitis, most often viral and autoimmune. With this disease, the content of alkaline phosphatase exceeds the norm three times.
• Primary tumor in the liver and secondary cancer - the penetration of metastases of neoplasms that have arisen in other organs.
• Cholangitis sclerosing primary - chronic illness liver, resulting in inflammation, development of liver failure and portal hypertension. The disease is rare.
• Primary biliary cirrhosis is a consequence of a previous disease. A day or two after the onset of the disease, the level of alkaline phosphatase increases four times and does not decrease even after recovery. It will take at least a week before the enzyme content returns to the normal range.
• Infectious mononucleosis is an acute viral disease. The liver is affected, peculiar changes in the composition of the blood occur.
• Cholestasis is the stagnation of bile.
• Extrahepatic obstruction bile ducts stones that interfere with the flow of bile.

Festive video recipe:

II. Pathological changes bone tissue:

• Paget's disease is a chronic and complex disease. The mechanism of bone repair is damaged, which leads to their increased destruction, deformation and weakening.
• Osteomalacia - systemic disease skeleton, which is accompanied by softening and deformation of the bones. The disease disrupts mineral metabolism, and phosphoric acid, calcium salts and vitamins leave the body.
• Osteogenic sarcoma is a malignant primary bone tumor. It originates and develops directly in their depth.
• Metastases that have penetrated into the bone structure from other organs.
• Increased metabolism in bone tissue. It occurs during the healing of fractures.

III. Other diseases:

• Primary hyperparathyroidism is a disease endocrine system caused by overactive parathyroid glands. It is accompanied by a pronounced violation of the exchange of phosphorus and calcium.
• Heart attack.
• Ulcerative colitis.
• Intestinal perforation.

Medical statistics inform that in more than half of patients, the excess of alkaline phosphatase is caused by liver pathologies.

Features of increasing alkaline phosphatase in men and women

The normative amount of alkaline phosphatase in men is higher than in the fair sex, by 20-25 units. Over the years, it changes in both sexes and tends to increase.

An abnormal amount of natural alkaline phosphatase is manifested as a result of:

• excessive or intense physical activity;
• avitaminosis and nutritional errors.

In the fair sex, the level of the enzyme increases:

• during the period of bearing crumbs, mainly in the third trimester;
• during breastfeeding;
• after menopause.

Women who take contraceptives with hormones are more likely to develop a disease such as cholestatic jaundice or intrahepatic cholestasis.

And men who are already 50 years old often suffer from Paget's disease. This disease can be inherited.

Features of the growth of alkaline phosphatase in children

The amount of the enzyme and its activity in children is always higher than in adults.

This situation can continue until the onset of puberty. All this is natural and is explained by the peculiarities of the physiology of children, because they have vigorous growth of bone tissue.

At the same time, data on the content of alkaline phosphatase help to diagnose liver pathologies, which are accompanied by insufficient supply of bile to the liver. duodenum. The level of the enzyme in such ailments often rises and becomes much higher than the normal value.

An increased amount of alkaline phosphatase in children signals the possible development of such diseases:

• rickets;
• hyperparathyroidism;
• Infectious mononucleosis;
• intestinal infection;
• damage to bone tissue, including malignant tumors;
• Paget's disease.

For the timely diagnosis of rickets, fixing the level of alkaline phosphatase is invaluable. An increase in the content of the enzyme during the development of this disease occurs much earlier than the first symptoms appear.

Alkaline phosphatase above normal: what to do?

First of all, do not self-medicate. The growth of the enzyme is not a disease, but only a symptom that accompanies a specific ailment.

It must also be taken into account that elevated level ALP may be of a natural nature. Excess activity of the enzyme is sometimes observed in healthy people. In these cases, it is a consequence physiological characteristics and processes in the human body.

Therefore, only a specialist can find out the real reasons for the increase in the level of the enzyme. He will appoint additional research, according to the results of which he accurately diagnoses the disease and determines the therapy.

In order for the level of alkaline phosphatase to normalize, it is necessary to cure the underlying disease. Simply adjusting the indicator to the optimal limits will not work.

Alkaline phosphatase(AP) is an enzyme that belongs to the group of hydrolase molecules. It is necessary for the dephosphorylation reaction in the body.

The success of this splitting of phosphorus is due to alkaline phosphatase.

The splitting of phosphorus molecules and organic substances occurs through the movement of phosphorus ions through the cell membrane by phosphatase.

The concentration of alkaline phosphatase in blood plasma has a constant coefficient, which shows the norm in phosphorus metabolism in the body. Alkaline phosphatase is most active in an environment of pH from 8.60 to 10.10.

What is alkaline phosphatase?

Alkaline phosphatase is the most abundant enzyme in the body, but it functional responsibilities not fully explored.

Alkaline phosphatase is present in all cells of all organs of the body and has its own variety:

In serum, alkaline phosphatase is present in isoenzymes.

They are in almost the same percentage:

• Bone enzyme is present in osteoblasts;
• Liver enzyme - in hepatocytes.

If the balance is disturbed, and there is a destruction of molecules in the cells (with a bone fracture), or pathology in the liver, then there is a jump in the alkaline phosphatase index in the blood plasma.

There are enzymes that biochemical analysis are included in the indications of alkaline phosphatase, in the body they have certain functional responsibilities.

The duties of many enzymes include the breakdown of phosphoric acid into essential organic compounds, which leads to the normalization of phosphorus-calcium metabolism.

The activity of this enzyme

The activity of this enzyme in serum has properties to change depending on the metabolic process. This activity is a marker for detecting bone disease (osteoporosis) at an early stage of pathology development, and this coefficient is also used for screening study of blood serum composition.

Processes in the genital female organs lead to an increase in placental phosphatase, and in the biochemical analysis it will be reflected as an increased activity of the general index of alkaline phosphatase.

According to the placental change, neoplasms in the female genital organs (malignant tumor of the cervix) can be detected.

The activity of the ALP enzyme in a child's body is normally higher than in an adult body by 1.5-2 times. Depends on the physiological processes that occur in the body of children - this is the intensive formation of all systems and organs, their intensive growth. During the period of intensive growth, the alkaline phosphatase index can be - 800 U / l.

Such an indicator in children is not a pathology, but the norm, since both enzymes are involved in the process of growing up of the body: liver type and bone.

When the growth of the bones of the skeleton is completed, then the bone enzyme ceases to show its activity and only the hepatic isoenzyme affects the activity of alkaline phosphatase.

Activity during pregnancy

The phosphatase isoenzyme increases in women during childbearing, and especially in the 3rd trimester of fetal development. Also very high activity enzyme in children who were born prematurely, because they have to catch up with their peers in development.

Such indicators are physiological, and are not considered deviations from the normative indicators.

There are results of biochemistry, if alkaline phosphatase is underestimated, then this is an indicator of underdevelopment of the placenta, and is an indicator during pregnancy.

Why study the enzyme phosphatase?

Phosphatase testing will be prescribed in order to detect at an early stage the development of pathology in the liver, as well as diseases of the musculoskeletal system.

Also, an increase in the alkaline phosphatase index occurs with violations of the gallbladder, with clogging of the bile ducts, as well as stones that are in the bladder and in the ducts.

The activity of alkaline phosphatase also increases with malignant neoplasms in the organs of the endocrine system - in the pancreas.

Testing for gamma-glutamyl transferase together with the test for alkaline phosphatase is carried out during the diagnostic check of diseases that provoke pathologies in the process of excretion of bile into the body - biliary cirrhosis (primary form), as well as primary sclerosing cholangitis.

Biochemical analysis for the ALP coefficient is carried out in order to identify pathologies in bone cells, because any changes in the bones increase the activity of alkaline phosphatase.

At this point, it is possible to identify neoplasms of a malignant type and help ensure that this focus of oncology does not go beyond the bone.

The delivery of biochemistry is repeated to monitor the activity of alkaline phosphatase and the development of pathology, as well as to adjust the medical therapeutic or surgical treatment.

Under what circumstances is a study ordered?

Laboratory testing for alkaline phosphatase is standard in biochemical analysis, and is used in preparation for surgery in the body. Also, this test is carried out with liver tests.

Analysis for alkaline phosphatase is prescribed when the patient has pronounced symptoms:

• General weakness of the body;
• Decreased appetite;
• Nausea that turns into vomiting;
• Pain in the upper abdomen that ricochets to the right side under the ribs;
• Yellowing of the skin with jaundice;
• Darkening of urine;
• Change in color of feces;
• itchy skin;
• Pain in the bones;
• Joint pain.

Alkaline phosphatase testing is also always done for frequent bone fractures.

Normative index of the enzyme in the blood

The normative coefficient of alkaline phosphatase has a fairly wide range of coefficients. Its range is from 44.0 IU / l to an index of 147 IU / l.

When determining the standards, the gender of the person, as well as the age category, is of great importance.

Women who carry a child have an overestimated ALP index, and also a slightly higher coefficient in adolescents in the puberty phase. Such high index readings are not considered a pathology in the body, but are physiological deviations from the normative coefficients.

Also, the indicators may fluctuate in different directions, depending on the reagents used by the laboratory, because there is currently no standard scheme for the use of drugs in biochemistry.

Table of normative indicators in the blood composition of alkaline phosphatase:

Enzyme activity is determined by various methods, as well as under different temperature conditions. The norm given in the table is calculated at a laboratory temperature of 37 degrees.

In order to avoid confusion when deciphering the discrepancies of various clinical laboratories, there are reference values ​​​​in the test for alkaline phosphatase in laboratory results. These values ​​can be used to determine whether the coefficient of the test blood is within the normative range, or whether there are deviations from the norm.

Reference value norm table:

Patient's age	Reference value (unit U/l)
newborns up to 5 days old	up to 550.0
from 5 days to six months of age	1000
from 6 calendar months - up to one year	1100
from one year to 3 years of age	670
from 3 to 6 calendar years	650
from 6 years - up to 12 years of age	720
girls from 12 to 17 years of age	450
women over 17 calendar years old	720
boys from 12 to 17 years of age	930
men over 17	270

To be sure of the normal index of your test results, you should consult about your results in a clinical laboratory, or at an appointment with your doctor.

At what diseases the index is increased?

In addition to the physiological etiology of an increase in alkaline phosphatase, pathologies in the body affect the increase in the activity of this enzyme:

Treatment to reduce enzyme activity is carried out with medications and balanced nutrition of the patient:

• drug Azathioprine;
• The drug Clofibrate;
• Oral contraceptives;
• Drugs that normalize the functioning of the liver;
• Use infusions of medicinal plants that have a positive effect on the liver;
• Diet with foods rich in calcium;
• A diet that has the maximum presence of phosphorus in foods is fish, seafood, dairy products, meat, beef liver.

Decreased phosphatase index in the blood

Less release of isoenzymes into the blood serum provokes a decrease in the ALP index.

Alkaline phosphatase is lowered, which means that the following pathologies occur in the body:

• Osteoporosis of old age;
• Myxedema of the thyroid gland;
• An excess of isotopes of a radioactive nature in bone tissue;
• Pronounced anemia;
• scurvy or vitamin C deficiency;
• An excess of vitamin D in the body. This indicator is a consequence of non-compliance with the dosage of medications for rickets.

To increase the presence of alkaline phosphatase in the blood serum, you can use a diet that can saturate the body with essential vitamins:

• Foods high in vitamin C - citrus fruits (especially lemon), onions, garlic, black currants, rose hips;
• Products containing B vitamins - meat, legumes, beef liver, fatty fish, garden greens;
• Food rich in magnesium molecules - seeds, legumes, soybeans, nuts of all kinds.

Do not confuse alkaline phosphatase with acid phosphatase

In addition to alkaline phosphatase, in the analysis of blood biochemistry, there is also an indicator - acid phosphatase. This index shows the condition of the prostate gland in men.

An increase in the level of an acidic enzyme indicates that a tumor is present in the gland or metastases have sprouted in cancer of other organs.

Acid phosphatase is a prostate-specific antigen and also a marker of neoplasm in the prostate (PSA).

Conclusion alkaline phosphatase

In order to identify pathology in the body, it is not enough just to study the blood composition for the concentration of alkaline phosphatase. Since the normative range of this enzyme is quite wide, and depends on the age category.

For an accurate diagnosis, a number of additional diagnostic tests must be performed.

Based on the alkaline phosphatase index and on the results of additional studies, the doctor sees a complete picture of the pathology and can establish the correct diagnosis.

Synonyms: alkaline phosphatase, ALP, ALKP

Alkaline phosphatase (AP) is an enzyme that can be found in many body tissues, including the liver, bones, intestines, and placenta. Depending on the location of the enzyme, it is divided into several fractions, which are called isoenzymes. In the blood serum, the total activity of alkaline phosphatase is usually determined, that is, the total amount of all isoenzymes in the blood, but if necessary, an analysis can be made for a specific isoenzyme. In adults, alkaline phosphatase is represented mainly by hepatic and bone isoenzymes in approximately equal amounts. Other isoenzymes are present in small amounts.

Alkaline phosphatase testing is usually performed to diagnose conditions associated with the hepatobiliary system (gall bladder, liver, and bile ducts) or bone disease. Diseases that destroy the cells of organs containing alkaline phosphatase lead to the release of alkaline phosphatase into the blood, and, accordingly, an increase in the level of alkaline phosphatase in the blood.

An increase in the level of alkaline phosphatase in the blood occurs with all forms of cholestasis (stagnation of bile in the liver tissues and a decrease in its flow into the duodenum), especially with obstructive jaundice.

Alkaline phosphatase in bone is produced by special cells called "osteoblasts" that are involved in bone formation. Any condition that affects bone growth or causes increased bone cell activity can affect blood levels of ALP. An alkaline phosphatase test can be used, for example, to detect cancer that has spread to the bone, or to help diagnose Paget's disease (a skeletal disease in which one or more bones are damaged as a result of abnormal bone remodeling). Also, an ALP test can sometimes be used to monitor treatment for Paget's disease or other bone conditions such as vitamin D deficiency.

Norms of alkaline phosphatase in the blood

Normally, a small amount of alkaline phosphatase is present in the blood due to constant cell renewal. However, when a large number of cells die, the level of alkaline phosphatase rises significantly.

The norms of alkaline phosphatase may differ depending on age, gender, method of determining alkaline phosphatase. When deciphering the analyzes, one should rely on the standards of the laboratory that did the analysis.

Alkaline phosphatase is elevated

An increase in blood alkaline phosphatase is most often associated with liver disease or bone disease. The level of alkaline phosphatase in the blood can be greatly increased, for example, with blockage of the bile ducts. A less significant increase in ALP is possible with cirrhosis of the liver, hepatitis, taking drugs that are toxic to the liver, or liver cancer. Any condition that causes excessive bone formation, including Paget's disease, as well as other diseases such as rheumatoid arthritis and fractures, can lead to an increase in alkaline phosphatase levels.

If, in addition to alkaline phosphatase, bilirubin is elevated in the blood, and then usually an increase in alkaline phosphatase is associated with the liver. A simultaneous increase in ALP and , also indicates the hepatic origin of enzymes in the blood, but if normal, then ALP can be increased due to the bone fraction. An increase in the level of calcium and phosphorus in the blood in parallel with alkaline phosphatase also indicates damage to bone tissue.

The level of alkaline phosphatase increases during pregnancy due to the placental isoenzyme. Children and teenagers usually have higher blood levels of ALP because their bones are still growing.

Alkaline phosphatase is lowered

A low level of alkaline phosphatase is much less common than an elevated one. A decrease in the level of alkaline phosphatase in the blood can be caused by a deficiency of zinc and magnesium in the body, a rare genetic bone disease - hypophosphatasia, with malnutrition and protein deficiency in the body.

Alkaline phosphatase is elevated - the causes of this condition can only be determined after a thorough examination. An increase in the level often indicates pathological processes occurring in the body.

But first you need to find out what it is, what are the indicators of the norm and what do they depend on? Are there specific symptoms and what are their causes? What can laboratory tests reveal?

The value and indicators of the norm

Alkaline phosphatase is the most important enzyme present in the cells of all internal organs and takes part in exchange processes. It is the main element in the exchange of phosphorus and calcium, producing the cleavage of phosphate molecules in organic compounds.

The highest activity of the enzyme was noted in the pH present in the human body.

According to the location of the enzyme, several of its types are distinguished:

• hepatic or hepatobiliary phosphatase (ALPL-1);
• ostaznaya (ALPL-2);

• renal (ALPL-3);
• intestinal (ALPI)
• placental (ALPP).

Determine the level of the indicator in the blood using biochemical analysis. However, the indicators will be general, not divided by type. There are methods for determining the amount of each individual enzyme, but they are used extremely rarely. When making a diagnosis, specialists use general diagnostic data and clinical picture diseases. These factors are enough to make a diagnosis.

Normal indicators of alkaline phosphatase concentration tend to vary depending on the age of the person. In children, alkaline phosphatase in the blood will be increased compared to adults. During the growth and development of the child, this enzyme takes an active part in the formation of the skeleton and the growth of internal organs.

Therefore, the average indicators indicating the norm are interpreted as follows:

• children up to a year - not higher than 450-460 U / l;
• from 1 to 3 years - up to 280 IU / l;
• from 4 to 6 years - up to 270 IU / l;
• from 7 to 12 years - up to 300 IU / l;
• girls from 13 to 17 years old - up to 185 U / l;
• boys from 13 to 17 years old - up to 390 IU / l;
• women - 40-130 IU / l;
• men - 35-105 IU / l.

It is necessary to take into account the method by which a particular laboratory conducts research. Values ​​may vary. When deciphering the result of the analysis, reference values ​​are taken into account, which are necessarily indicated in the standard form.

An increase or decrease in the indicator indicates a leak pathological processes, the nature of which must certainly be clarified and eliminated the causes of the disease.

Symptoms and preparation for a blood test

An increase in alkaline phosphatase may be asymptomatic in the early stages or not be felt by any specific signs.

However, there are a few to watch out for:

These symptoms occur in many diseases, but a blood test will help determine the alkaline phosphatase in the blood. If necessary, additional studies will be assigned to establish an accurate diagnosis.

Absolutely healthy person an increased level of the indicator may be noted in the following cases:

• excessive alcohol consumption, which can lead to alcohol intoxication;
• taking some medical preparations having a hepatotoxic side effect;
• pregnancy, especially the third trimester.

From this we can conclude that a blood test to determine the level of phosphatase requires preparation:

• before taking the biomaterial (venous blood), do not eat for at least 8 hours;
• do not drink alcohol even in small quantities and even low-alcohol drinks 2-3 days before the analysis;
• do not smoke for at least an hour before donating blood;
• restrict physical exercise, sports per day.

If you accept any medications or oral contraceptives, be sure to notify the specialist who will decipher the analysis and the attending physician about this.

Causes of an increase in the level of alkaline phosphatase

There are various reasons for an increase in alkaline phosphatase in the blood. They are physiological and pathological.

Consider natural factors that can increase the rate:

1. Growth, development and sexual changes. In women, this condition is noted at the age of 20 years, in men - up to 30 years. A high (in certain limits) content of the enzyme decreases spontaneously after the completion of the processes of formation and growth of skeletal bones.
2. Late childbearing period future mother the enzyme is above the norm due to the active growth of the placenta (placental alkaline phosphatase is detected).
3. During the recovery period after surgery or healing of fractures. The enzyme will increase, in particular ostasis, as bone tissue is renewed.
4. Taking medications that have a negative effect on the liver. This action is distinguished by antibiotics, paracetamol, aspirin, some contraceptives and other drugs that have a hepatotoxic effect. Due to their long-term use, irreparable damage can be caused to the liver.
5. Age indicators also affect the level of alkaline phosphatase. In a growing child, in a woman during menopause, and in the elderly, when bone mass decreases, the concentration of the enzyme increases.
6. Addictions: smoking, drinking alcohol.
7. Hypodynamia, lack of physical activity.
8. Irrational nutrition, oversaturated with fatty, fried and spicy foods, frequent use of fast food.
9. High body mass index, obesity.

An increase in alkaline phosphatase occurs with certain pathologies.

Significantly increased alkaline phosphatase occurs in such cases:

1. Cirrhosis is the replacement of healthy liver tissue with scar tissue.
2. Hepatitis causes an increase in the enzyme at times.
3. Tumor processes, more often malignant, of the organ itself. Metastasis of cancer of various localization in the liver.
4. Primary sclerosing cholangitis is a rare liver disease characterized by inflammatory processes that cause liver failure and dysfunction.
5. Cholestasis - stagnation of bile in gallbladder, bile ducts and its accumulation in the organ.
6. Infectious mononucleosis. A blood test will show not only elevated alkaline phosphatase, but also changes in the overall blood picture.
7. Cholelithiasis.

If alkaline phosphatase is elevated, then the bone tissue undergoes the following changes:

• Paget's disease is a pathology that damages the repair mechanism in the bones. This leads to weakening and destruction of bone tissue.
• Osteomalacia is a systemic pathology characterized by softening and deformation of the bones of the skeleton. Mineral metabolism is disturbed, which leads to excessive excretion of important elements.
• Osteogenic sarcoma is a malignant tumor that arises and develops in bone tissues.
• Cancer metastasis various etiologies into bone tissue.

Other diseases that are characterized by an increase in the concentration of alkaline phosphatase in the blood:

1. endocrine disorders, especially thyroid gland. One of the most common diseases in such cases is called hyperparathyroidism. There is a failure in metabolic processes regarding phosphorus and calcium.
2. pre-infarction conditions and the infarction itself.
3. ulcerative colitis.
4. intestinal diseases.

Statistics say that in almost 60% of the increase in alkaline phosphatase is due to liver damage.

ALP in children

The concentration of the indicator in children is much higher. This is due to the active growth and development of the child.

A high level of the enzyme will be observed until adolescence, when the production of hormones begins that affect all metabolic processes.

But sometimes even such a high figure can be exceeded at times, which indicates the presence of serious pathologies in the child's body.

It can be:

• hepatic pathologies, which are characterized by stagnation of bile and its insufficient secretion into the duodenum;
• rickets. When this disease occurs, the ALP index plays a key role for early diagnosis and initiation of treatment - the level rises long before the manifestation obvious signs illness;

• infectious mononucleosis, which childhood may be asymptomatic, but cause serious complications;
• intestinal infection, which in its manifestations is similar colds, but requires a completely different approach to treatment;
• bone pathologies, including malignant neoplasms;
• congenital pathologies and diseases that threaten to develop into a chronic form.

Something About Healing

Before we talk about the measures that need to be taken to reduce the level of phosphatase, we need to pay attention to something else.

Alkaline phosphatase has a clear corridor of normal limits. We already know enough about increasing the level and activity. And here reduced level could it be and why is it dangerous?

In fairness, it should be noted that a reduced level of the enzyme is a rather rare phenomenon, but it is evidence of no less serious pathology than an increased one.

The reasons for the decline may be the following conditions:

• transfusion of a large volume of blood or its preparations;
• pathologies of the thyroid gland caused by inhibition of its functions;

• severe anemia of various etiologies;
• deficiency of trace elements: magnesium, zinc, calcium, phosphorus and some others;
• hypophosphatasia - a congenital pathology that leads to softening of the bones;
• if a decrease in alkaline phosphatase is diagnosed during the period of bearing a child, this may indicate placental insufficiency.

If a biochemical analysis revealed an increase in alkaline phosphatase, which is much more normal indicators you need to seek qualified help. The local therapist, if necessary, will send to a narrow-profile doctor who will clarify the diagnosis and prescribe adequate therapy.

No one can give universal recipes for reducing or increasing the level of the enzyme. It is not the symptom that needs to be treated (in this case, it is the concentration and activity of alkaline phosphatase that will be a symptomatic indicator), but the cause itself, that is, the disease.

Alkaline phosphatase is an informative criterion in a biochemical blood test. In some cases, an increase in the level is observed long before the manifestation clinical symptoms. And if we talk about such indicators in children, then the treatment of rickets in the early stages leads to a complete elimination of the pathology, eliminating all the consequences.

Alkaline phosphatase (AP) is an enzyme involved in the metabolism of phosphoric acid, splitting it and ensuring the distribution of phosphorus throughout the body. When alkaline phosphatase is elevated, it means that not everything is in order in the body.

What is this substance responsible for and what analysis shows its level

ALP is part of the cell membranes of most tissues of the body, while it is most actively manifested in the liver, bones, intestinal mucosa, kidneys, placenta, and also the mammary gland during lactation.

Phosphoric acid enters the body with food, but is not completely absorbed. ALP separates it from other elements and breaks it down. Getting into the blood, it performs the function of a catalyst, due to which phosphorus enters the tissues and supports metabolic processes on cellular level. Against the background of pathologies, the absorption of phosphorus is slower, the level of enzymes becomes abnormally high, and metabolism is disturbed. To find out the quantitative indicator of alkaline phosphatase, a biochemical blood test is prescribed.

What is the rate of alkaline phosphatase in the blood

Below are the data on the indicators of alkaline phosphatase, which are considered normal.

Table 1. Norms in children and adults

Table 2. Norms in pregnant and non-pregnant women

What the increase says: common reasons

There are different conditions that cause a jump in ALP. They are classified into:

• physiological;
• pathological.

The first group includes:

1. Human growth and maturation, including changes hormonal background due to puberty. In women, this occurs before the age of 20, and in men it ends by the age of 30. The amount of HF decreases naturally as soon as the formation and growth of the bones of the skeleton ends.
2. Pregnancy. In the later stages, an increase in the enzyme is due to active development placenta, which releases its own alkaline phosphatase in the third trimester.
3. Postoperative period or the process of healing of fractures. The enzyme increases due to the need to restore bone tissue.
4. Taking medications that adversely affect the liver. We are talking about antibacterial, contraceptive and other drugs that have a hepatotoxic effect. Due to their long use, the condition of the liver worsens, its functionality suffers.

Among other things, they increase alkaline phosphatase:

• smoking and addiction to alcohol;
• sedentary lifestyle with a lack of physical activity;
• a diet with a predominance of fatty and spicy foods, as well as fast food;
• obesity.

The level of alkaline phosphatase is also affected by age. In menopausal women and older men, the volume of the enzyme becomes larger.

The pathological causes of the increase in the enzyme will be discussed later.

In adults

So, in addition to age, pregnancy and bad habits, the reasons for increasing the level of alkaline phosphatase in adults are:

1. Liver pathologies:
   • tumors in her parenchyma (body), benign and malignant;
   • the appearance of cancer metastases in connection with processes localized in other organs;
   • cholestasis - a condition caused by a violation of the outflow of bile from the gallbladder;
   • mononucleosis of infectious origin;
   • cholelithiasis.
2. Bone pathologies:
   • Paget's disease, which disrupts the regenerative ability of bones, and also leads to their gradual weakening and destruction;
   • osteomalacia - a systemic lesion that causes softening of the bones, as well as their deformation;
   • osteogenic sarcoma - a malignant process in the structures of the skeleton;
   • metastasis of cancer cells to bone tissue.
3. Other diseases:
   • hyperparathyroidism - endocrine pathology;
   • myocardial infarction and the condition preceding it;
   • peptic ulcer of the intestine.

When upper bound ALP norms are exceeded by 5 times or more, among the most likely causes will be:

• Paget's disease;
• cirrhosis of the liver;
• cholestasis;
• osteomalacia and rickets.

To find out exactly why alkaline phosphatase is elevated, a biochemical blood test alone is not enough, a comprehensive examination will be required.

In children: infants, adolescents

High levels of alkaline phosphatase in children are explained by the rapid growth and development of the body, as well as changes in the hormonal background and related processes during adolescence.

When the already high numbers increase many times, the development of:

• liver diseases caused by stagnation of bile and its deficiency in the intestines;
• rickets. With this violation, the ALP indicator has an important diagnostic value, since it is observed even before the first manifestations of the disease;
• infectious mononucleosis, which does not give bright symptoms in childhood, but causes terrible complications;
• infectious lesions of the intestine, which symptomatically resemble a common cold, but are treated differently;
• pathologies of bone tissue, including malignant nature;
• other diseases.

In case of deviations from the norm of indicators of a biochemical blood test in children, the pediatrician prescribes an additional examination.

How to downgrade

It was said above that the factors causing the growth of alkaline phosphatase include bad habits, including food. Unfortunately, in order to normalize the indicator, it is not enough just to stop smoking, drinking strong drinks and junk food. In any case, this will be a useful solution, but in order to put the body in order and normalize the level of alkaline phosphatase, it will be necessary to cure the pathologies caused by the wrong lifestyle.

An increase in alkaline phosphatase in the blood is a reason for a full examination, unless it is caused by physiological reasons. Timely diagnosis It will allow to identify health problems and start treatment at an early stage.