What is the Alkaline Phosphatase Test, and What Does It Check?

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The alkaline phosphatase test is a blood test that looks for the levels of the enzyme – alkaline phosphatase. This enzyme is found in the bone marrow and helps release calcium into the bloodstream, making it easier to extract from the bone. 

The enzyme alkaline phosphatase is found in other body parts, including the kidney, liver, and digestive systems. The function of alkaline phosphatase in each body part is different too. As such, it also helps with bone formation, digestion, reproduction, bile production, and growth. The abnormal alkaline phosphatase levels in your blood can also indicate certain diseases or disorders.

What is the Alkaline Phosphatase Test Used for?

The alkaline phosphatase test can be used to help doctors determine how well your body is working. It helps diagnose bone diseases like osteoporosis as well as some types of cancers. In addition, it can reveal potential problems in the liver and kidneys too. When used to track disease progression, an alkaline phosphatase test can help make treatment decisions in your best interest.

When Do Doctors Recommend an Alkaline Phosphatase Test?

Doctors may recommend an alkaline phosphatase test for a variety of reasons. It can be used to evaluate your condition or determine the cause of symptoms of diseases related to the liver or bones.

The symptoms of liver diseases for which doctors recommend an alkaline phosphatase test include:

  • Vomiting and nausea
  • Fatigue
  • Lack of appetite
  • Weakness
  • Abdomen pain or swelling
  • Frequent itching
  • Dark-colored urine or light-colored stool

The symptoms of bone diseases for which doctors recommend an alkaline phosphatase test include:

  • Pain in your bones
  • Broken bones
  • Arthritis or inflammation in your joints
  • Unshaped bones

What is the Normal Range for Alkaline Phosphatase?

The normal range of alkaline phosphatase is considered to be 44 to 147 IU/L. However, you should remember that the normal range for the alkaline phosphatase test can also change based on your age and medical history. If you want to know the exact amount of alkaline phosphatase in your system, then it would be better to consult a doctor.

What Do Elevated Alkaline Phosphatase Levels in Liver Indicate?

  • Liver cirrhosis

A higher amount of alkaline phosphatase in your liver can be caused by liver cirrhosis. This condition is marked by scarring of your liver. Whenever this happens, the ability of the body to remove waste products is lowered, which in turn increases alkaline phosphatase levels. 

  • Biliary atresia

The disease is marked by obstruction of normal bile flow, which in turn causes accumulation of bile in the liver cells. As a result, liver cells can get damaged and produce increased alkaline phosphatase.

  • Cholestasis of pregnancy

The condition is marked by the abnormal flow of bile from your liver to your small intestine. This happens when a pregnant woman develops an antibody that attacks certain proteins needed for bile production. The condition can cause severe itching, jaundice, and swelling in the abdomen.

  • Hepatitis

Hepatitis is marked by inflammation of the liver. Several factors, including drugs, alcohol abuse, certain viruses, or toxins, can cause it. With hepatitis, bile becomes trapped in the liver cells, leading to increased alkaline phosphatase levels.

  • Mononucleosis

Mononucleosis is marked by inflammation of the liver, resulting in the release of high levels of alkaline phosphatase into your blood. The condition can lead to swelling of the liver.

  • Biliary stricture

The narrowing of the bile duct marks the condition. When this happens, it can cause an accumulation of bile in your liver cells, which in turn leads to an increase in alkaline phosphatase levels.

What Do Elevated Alkaline Phosphatase Levels in Bones Indicate?

  • Osteomalacia

Osteomalacia is a disease that results in the softening of your bones. It is marked by a deficiency of vitamin D, which affects your body’s ability to deposit calcium into your bones. 

  • Osteogenic sarcoma

Osteogenic sarcoma is cancer that results in the formation of bone tumors. These tumors can cause bone pain and fractures.

  • Osteoporosis

Osteoporosis is marked by the weakening of your bones, making them more brittle and prone to fracturing. It is also marked by the loss of bone density, as well as low levels of calcium in your blood. 

  • Hyperthyroidism

Hyperthyroidism is marked by an increase in the production of thyroid hormones, which in turn can cause an increase in alkaline phosphatase levels.

  • Osteitis derformans

Osteitis derformans is a chronic condition that causes bone pain and inflammation. It occurs due to excessive or abnormal regrowth and breakdown in bones.

  • Bone metastasis

Bone metastasis is marked by the spread of cancerous cells to your bones. When cancerous cells spread to your bones, they can interfere with their normal function and, as a result, increase alkaline phosphatase levels in your blood.

What Do Lower Alkaline Phosphatase Levels Indicate?

Abnormally lower levels of alkaline phosphatase are rarely reported. And if it occurs, it can indicate the following:

  • Magnesium deficiency
  • Zinc deficiency
  • Hypothyroidism
  • Malnutrition
  • Rare genetic conditions like hypophosphatasia and Wilson disease


The alkaline phosphatase test is an important diagnostic test that can reveal various health concerns. It can be used to check the levels of alkaline phosphatase in your blood to detect liver or bone diseases, as well as various other medical conditions. You should consult your doctor for further information about the alkaline phosphatase levels in your body. The cost of an Alkaline Phosphatase Test varies per city. The average price of the test ranges from ₹80 to ₹220.

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