Alkaline phosphatase is reduced in the blood. What does this mean in analysis for women, men, children

What is alkaline phosphatase

The human body contains many enzymes that take part in various processes. Such natural catalysts include alkaline phosphatase (ALP).

This group of enzymes is present in almost all tissues of the human body. Phosphatase got its name due to the fact that it acts only in an alkaline environment (with an acidity of at least 8.6).

A person eats foods that contain phosphoric acid, which is necessary for various metabolic reactions. Alkaline phosphatase separates this substance from organic compounds.

Based on its location, this group of enzymes can be liver, kidney, bone, placental, or intestinal.

The levels of these catalysts are not constant - depending on the age and gender of the person, alkaline phosphatase is elevated in different places.

For example, children and adolescents have the most enzyme in bone tissue, since their active growth is observed during this period.

In adults, alkaline phosphatase is mostly found in the liver. In any pregnant woman, placental alkaline phosphatase plays an active role.

Alkaline phosphatase is synthesized in cells, then, after their destruction, enters the blood. By monitoring the content of this enzyme, the doctor can diagnose certain diseases at an early stage.

Therefore, during a general blood test, alkaline phosphatase is checked without fail, especially during routine medical examinations or preparation for surgery.

The procedure itself is almost always carried out in the morning, because it is mandatory to fast for ten to twelve hours before collecting the material.

Foods, especially fatty, spicy and salty foods, can change the level of alkaline phosphatase in the blood, and the test results will be unreliable.

A few days before the procedure, it is better to stop drinking alcohol.

Alcohol has a detrimental effect on the body, causing certain chemical reactions, and can either lower or increase the content of certain substances in the blood.

As a result, the overall picture will be significantly distorted, and it will be quite difficult for the doctor to make an accurate diagnosis.

The situation is similar with taking medications. Regular use of medications affects the level of alkaline phosphatase in the blood, which greatly complicates the doctor’s work.

For this reason, a few days before the procedure, it is better to stop taking any medications, except in cases where a person’s life depends on it.

However, in such a situation, it is imperative to tell the doctor about this so that he can make the necessary adjustments to the analysis results.

What it is?

The term alkaline phosphatase (for brevity, many sources use the designation ALP) is used to designate a group of enzymes whose main function is to ensure the occurrence of dephospholation processes.

This reaction involves the separation of the phosphate group from organophosphorus compounds. Phosphatase acts as a reaction catalyst, that is, it ensures the occurrence of metabolic processes of calcium and phosphorus.

Advice! The enzyme received the name alkaline phosphatase because it is active only in an alkaline environment (pH level 9-10). There is also acid phosphatase, but other methods are used to determine its blood level.

This enzyme is found in different tissues, so several isoforms are isolated. However, there are mainly two isoforms present in the blood, one of them is found in liver tissue, the second in bone cells.

Alkaline phosphatase

Alkaline phosphatase (ALP)

Alkaline phosphatase (ALP) catalyzes the hydrolysis of organic phosphate esters in an alkaline environment. There are at least 5 isoforms of the enzyme: hepatic fraction (characteristic of the sinusoidal and tubular surface of hepatocytes), bone ALP, intestinal fraction (cells of the intestinal mucosa), placental ALP and ALP associated with tumor tissues, determined during separation. Placental and tumor-associated ALP may be resistant to heat inactivation. More than 96% of the total activity occurs in the bone and liver fractions (ratio ~ 1:1). The half-life of ALP is from 7 to 10 days.

Indications for examination

Alkaline phosphatase is determined as part of a biochemical blood test. Sometimes the doctor prescribes an assessment of individual liver enzymes - ALT, AST and alkaline phosphatase. The examination is carried out twice during pregnancy:

• at the first visit to the doctor;
• at 30 weeks.

According to indications, analysis is prescribed more often. The following conditions may be the reason for additional examination:

• diseases of the digestive tract (primarily the liver and biliary tract);
• pathology of the musculoskeletal system;
• complications of pregnancy;
• preparation for childbirth.

To assess the dynamics of enzyme levels, you need to take a blood test every 14 days or more often if indicated.

Why are enzyme levels low?

Reduced alkaline phosphatase in women can occur for a variety of reasons, the safest of which is poor nutrition.

Low levels of enzymes of this group appear with regular malnutrition and lack of sufficient protein in food.

In addition, the reasons may lie in a lack of vitamin C in the body (very often this develops scurvy, characterized by bleeding gums, fragility of blood vessels, skin rashes), B6, B12, and folic acid.

Microelements are no less important - a small amount of magnesium, zinc, phosphorus in the food consumed also leads to the fact that a woman’s alkaline phosphatase will be reduced.

An excess of vitamin D in the body can also reduce the level of alkaline phosphatase. In addition, the reasons for the decrease may lie in donation - anemia occurs quite often with regular blood donation.

The content of this group of enzymes can also be reduced in hypothyroidism - insufficient production of hormones by the thyroid gland.

For the same reason, a person experiences iodine deficiency (a small amount of iodine in the body). This disease leads to deviations in physical and mental development (cretinism), which also contribute to the emergence of a situation in which alkaline phosphatase is reduced.

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Another reason for the development of pathology may be related to the condition of the bones, which sometimes begin to deteriorate with age (osteoporosis develops).

Rare diseases such as kwashiorkor (a type of dystrophy that develops due to a lack of protein in food), achondroplasia (a hereditary disease that often leads to dwarfism), celiac disease (a disorder of the digestive processes caused by damage to the small intestine by certain drugs) can also lower the level of alkaline phosphatase. products).

In pregnant women, enzyme levels may be reduced due to insufficient development of the placenta.

Another fairly rare cause of low alkaline phosphatase is exposure to radiation.

If the level of alkaline phosphatase is low due to poor nutrition, the patient is prescribed a special diet designed to compensate for the lack of certain vitamins and microelements in the body.

If the cause of the pathology lies in some disease, then therapy is aimed primarily at eliminating this disease. It should be noted that any treatment must be carried out under the guidance of a qualified doctor.

Alkaline phosphatase is a group of enzymes in body tissues that perform specific functions.

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If the content of this catalyst is reduced, then quite often this means that a person develops certain diseases.

To return alkaline phosphatase levels to normal, you need to consult with your doctor and start timely treatment.

Alkaline phosphatase is reduced: reasons and ways to increase it

Low ALP can be caused by anemia

The reasons why alkaline phosphatase levels decrease are quite varied. The main doctors among them are the following:

• severe anemia;
• decreased activity of the thyroid gland;
• hypophosphatasia is a congenital pathology in which softening of the bones occurs;
• age-related osteoporosis;
• lack of vitamins C, B6 and B12;
• deficiency of zinc, magnesium and folic acid;
• cretinism.

During pregnancy, a decrease in enzyme levels may indicate the development of placental insufficiency.

Taking medications that affect the functioning of the liver can also cause a decrease in the level of the enzyme in the blood.

In a small percentage of patients, due to the individual characteristics of the body, the enzyme level is slightly reduced, but there are no pathologies. This feature is determined after the examination, if no health problems are detected during the examination.

What is it responsible for in the body?

Alkaline phosphatase (abbreviated as alkaline phosphatase or alkaline phosphatase) is an enzyme that accelerates chemical reactions. It plays a key role in transporting phosphorus across the cell membrane.

This is one of the main regulators that is responsible for the exchange of phosphorus and calcium. ALP is present in all tissues of the human body in varying concentrations.

Its maximum content is found in the liver, bile ducts, bone tissue, kidneys, and intestines.

The peak activity of this substance occurs when it finds itself in conditions of high alkali content. In the blood of a healthy person, this isoenzyme is present in minimal quantities and does not show its activity. If there is a blockage of the biliary tract, or disruption of the normal functioning of the gallbladder or liver, then alkaline phosphatase accumulates in the body, entering the bloodstream.

Based on the level of alkaline phosphatase, many pathologies that disrupt the functioning of the liver and biliary system can be diagnosed. And also the activity of the enzyme is overestimated when the metabolism of phosphorus and calcium is disrupted, which leads to destruction and deformation of bones, slowing down the recovery processes of the skeletal system.

Symptoms and signs of low ALP levels

Jaundice is not a specific sign of decreased alkaline phosphatase

Manifestations of a reduced level of alkaline phosphatase are also symptoms of the disease that provoked the disorder. In most cases, patients notice the following conditions:

• migraine-type headaches;
• joint pain;
• decreased mobility;
• pale skin;
• jaundice;
• stool disorders;
• pain in the liver area of ​​an acute, aching or spastic nature;
• a sharp change in weight up or down.

Usually, only some of the above symptoms are present. Even if only one of them occurs, this is a reason to seek medical help.

Attempts at self-medication pose a serious danger for the patient, since the pathology causing the symptoms will progress without proper therapy.

Determining indicator activity

The test requires blood from a vein, which is taken in the morning on an empty stomach. A day before diagnosis, fatty and spicy foods are excluded from the diet. The break in meals should be at least 10 - 12 hours. After this you can drink water. On the morning of the blood test, you are prohibited from drinking juice, coffee, or tea. You should not smoke for an hour, and you should avoid physical activity and stressful situations.

Drug therapy may lead to false-positive or false-negative results. Therefore, at least 3 days in advance, you need to agree with your doctor about stopping medications and dietary supplements, and you should avoid alcohol for a day.

Most laboratories use a reaction that changes the color of blood serum after adding a reagent (p-nitrophenyl phosphate) to it. Alkaline phosphatase cleaves phosphate from it, and nitrophenol in an alkaline environment gives the solution a yellow color. Depending on the intensity of the color, the activity of the enzyme is determined.

Watch the video about alkaline phosphatase in the blood and the analysis:

Analysis

One of the popular methods for determining alkaline phosphatase is kinetic calorimetry. To conduct the study, a small amount of blood is taken (venous or capillary).

The main rule for obtaining accurate data is preparing the body before donating biomaterial. To do this you need:

Do not eat 12 hours before;

If you smoke, do not smoke at least 30 minutes before donating blood;

Don't overexert yourself physically.

The study can be carried out every 3-5 days. It is during this time that the enzyme residues are half-removed from the body. Control blood sampling is carried out no more than once a week.

The laboratory technician needs to carry out the analysis with special care, since there are many factors that affect the indicator.

Reasons why you may receive incorrect data:

The patient did not know about pregnancy at the time of blood sampling;

There was damage to bone tissue;

Taking medications - antibiotics, aspirin or paracetamol.

Qualitative interpretation of the data obtained involves comparing ALP with the level of other enzymes and taking into account their ratio during diagnosis.

Reasons for increased and decreased alkaline phosphatase

As a rule, in medical practice, a patient, having looked at the slightest deviations from reference values, immediately begins to sound the alarm or worry in every possible way, but elevated/decreased values ​​are not always a consequence of pathology.
Physiological causes and characteristics of the body can never be written off, therefore a detailed examination and questioning of the patient is a necessary diagnostic measure that will avoid a false clinical picture. The final results depend on age, gender, diet, body type, previous injuries and fractures, etc.

from 45-148 units/l Significant increase in phosphatase

• Pathologies and diseases of the liver: obstructive jaundice, various hepatitis, cirrhosis, cancer of the pancreas, stomach and other gastrointestinal organs, scars on the liver tissue after surgery;
• Gallstones, blockage of the bile ducts with sand and stones, cholangitis, choleocystitis, etc.;
• Infectious mononucleosis (EBV), since the disease itself leads to disruption of the liver;
• Pathological changes in bone tissue: myeloma, bone metastases, osteomalacia, rickets, Paget's disease, etc.;
• Gastrointestinal diseases, intestinal infections, ulcerative colitis;
• Myocardial infarction;
• Physiological reasons.

In any case, the doctor must find out the reason for the inflated results.
Usually, for physiological reasons, people have increased phosphatase levels during pregnancy, childhood or adolescence, as a result of bone fractures, while taking antibacterial and hormonal drugs, etc. The doctor usually finds out such circumstances by asking in detail about the patient’s medical history and lifestyle, but a slight excess of this parameter against the background of other normal indicators will not be a pathology, but an individual norm.

To assess the clinical picture, the doctor analyzes the results of other laboratory tests to see correlations. Improper storage of biomaterial in the laboratory also causes distortion of the results, both upward and downward, but this factor is very difficult to verify.

Low alkaline phosphatase levels are considered less dangerous than high alkaline phosphatase levels, but they are most often observed in the following conditions:

• Anemia, including its malignant course;
• Magnesium and zinc deficiency;
• Blood transfusion or significant blood loss;
• Improper functioning of the thyroid gland;
• Hereditary autoimmune bone disease – hypophosphatosia;
• Placental insufficiency;
• Improper storage of biomaterial, hypothermia of blood;
• Cretinism;
• Achondroplasia is a serious bone disease associated with impaired bone growth.

There can be many reasons, but the main thing is to reliably find the cause of the disease, since the physiological causes of an increase/decrease in phosphatase do not require special treatment and care, and any pathology must be carefully diagnosed to avoid false interpretation of the results.

If there are symptoms in the form of pain in the right side, hypochondrium, deterioration in health, then elevated values ​​will be a consequence of liver disease, but in this case the liver fractions (direct, total, indirect bilirubin) will inevitably increase.

Very often, phosphatase is elevated in infectious mononucleosis, but to confirm this diagnosis, one such indicator is not enough, since for this you need to take all blood tests for Epstein Barr Virus (mononucleosis)

In addition, the doctor takes into account only a significant, diagnostic increase in phosphatase, along with other parameters that definitely deviate from the norm in various diseases. In this case, it is advisable to take a detailed biochemical blood test, since isolated phosphatase values ​​​​have little to tell the doctor

This will only prompt the doctor to prescribe additional tests, especially in cases where the patient has severe symptoms.

When is a test ordered?

The study is prescribed according to the indications and signs characteristic of the development of the pathology.

Indications for the study:

• general weakness and malaise of the body;

• change in the color and character of urine - darkening;
• digestive system disorders;
• development of neoplasms, tumors;
• diseases of the skeletal system, including trauma and bone damage;
• deforming changes in the skeletal system, including frequent fractures;
• preventive examination of workers working in hazardous conditions;
• routine diagnostics during pregnancy.

Enzyme levels in the blood

A healthy amount of alkaline phosphatase changes with age and depends on a person's gender. Indicators are measured in international units per liter of blood (IU/l, U/l).

For a newborn baby, the norm will be values ​​from 70 to 370 U/l. At five years of age, normal values ​​for boys range from 180 to 415 international units of alkaline phosphatase per liter of blood, and for girls - from 160 to 350. At the age of ten, the norms are as follows: 190 - 430 U/l and 215 - 475 U/l. l.

Since girls develop physiologically a little earlier, their highest levels of the enzyme are observed at eleven years of age - 175 - 520 international units per liter of blood. Subsequently, the norms begin to decrease in representatives of both sexes.

In sixteen-year-old adolescents, alkaline phosphatase in the blood should be in the following range: from 100 to 415 U/L in boys and from 65 to 265 U/L in girls.

Video:

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A healthy adult male has the following normal values: from 100 to 125 international units per liter of blood. In women from nineteen to sixty years old, the normal level should be 55 - 110 U/l.

With age, the normal level of alkaline phosphatase in the blood increases. For men over sixty, as throughout life, this rate is slightly higher than for women.

Representatives of the stronger sex normally have 180–190 U/l, while the weaker sex has 155–165 international units of alkaline phosphatase in one liter of blood.

A woman’s body is rebuilt for the entire period of bearing a child, since now it is necessary to provide food for two. In a healthy expectant mother, a normal blood test for alkaline phosphatase should show the following values: from 60 to 250 international units per liter.

If the study shows that a woman has low alkaline phosphatase, then the doctor should definitely be wary.

This phenomenon may indicate both poor nutrition and serious illnesses that require immediate treatment.

To make a more accurate diagnosis, additional examinations may be prescribed to detect the disease.

It should be borne in mind that if alkaline phosphatase is low, then this is not a disease as such, but only a sign indicating the development of other pathologies. As a rule, after the end of treatment, the content of this group of enzymes in the blood returns to normal by itself.

Reduced alkaline phosphatase in the blood: what does this mean, causes and treatment of low levels

Studying various analyses, conducting samples and all kinds of tests is an important part of diagnostic measures in identifying certain diseases.
It is the test results and the study of biological fluids that allow doctors to get a complete impression of the health status of a particular patient and make a specific diagnosis for the presence of diseases. It should be noted that both increases and decreases are causes for concern.

What is alkaline phosphatase

Phosphatase is essentially an enzyme that belongs to the category of hydrolases. This enzyme is necessary in the body because it participates in the dephospholation reaction and ensures its success. The reaction occurs at the molecular level and is the process of detaching phosphorus from certain organic substances.

Phosphatase transfers the resulting phosphorus through the cell membrane, while the levels of this substance in human blood are constant and serve to determine the level of phosphorus-calcium metabolic processes.

Alkaline phosphatase in medicine is one of the enzymes that occurs most frequently in the body, but the main mechanism of its action has not yet been fully understood. In the human body, this substance is present in almost any tissue, but it comes in several varieties, in particular, phosphatase can be placental, renal, bone, intestinal and liver.

In human blood serum, as a rule, the presence of bone and liver phosphatase is observed, while their amounts are almost always the same, and changes in one of the indicators may indicate the presence of disorders.

Indications for analysis

An analysis to determine the level of alkaline phosphatase is prescribed if certain diseases are suspected.

In most cases, the patient is referred for phosphatase testing if:

• Suspicion of jaundice.
• Vomiting and attacks of nausea, the causes of which are unknown.
• Discoloration of feces.
• Darkening of urine.
• Fatigue quickly for no apparent reason.

In the cases listed above, the patient is prescribed a study of the level of alkaline phosphatase, as well as gamma-glutamyltransferase (GGT), which allows to identify possible stagnation of bile.

In addition, the analysis is also prescribed during the treatment of certain diseases, when a person is taking drugs that can cause a state of cholestasis.

Research is also carried out if a person has diseases of bone tissue, as well as during treatment of these ailments to monitor the effectiveness of therapy.

Blood phosphatase levels in adults and children

The normal values ​​of this element can fluctuate within quite significant ranges, and on average the norm ranges from 44 to 147 IU/l. An important point for interpreting the study results is the patient’s age and gender.

In adolescents, as well as in women expecting a baby, the indicator of this element may be slightly increased, but this is not a pathology and does not indicate the presence of disorders.

In adolescents, this phenomenon is explained by hormonal instability and ongoing internal changes in the body, and in pregnant women, the increase occurs due to the appearance of the placenta and an increase in the volume of bone tissue (in the child developing inside).

In different laboratories, the indicators will be different, and this should be kept in mind when interpreting the results. Different clinics may use different reagents during the study, since standards for determining this indicator have not yet been developed. But, as a rule, the range of differences in norms is not significant.

Table of normal alkaline phosphatase levels:

Reasons for the decrease in the indicator

Any deviation from the norm is considered incorrect and this often hides some disease or pathology. What does a decrease in alkaline phosphatase mean in a biochemical blood test, what are the reasons for this phenomenon?

If the results of a biochemical analysis show that alkaline phosphatase is low, then you should consult a doctor as soon as possible.

This cannot be ignored, since a decrease in phosphatase levels may indicate certain diseases that can be very dangerous. In some cases, a decrease in this indicator may be no less dangerous than its increase.

Possible reasons for a decrease in phosphatase include:

• Conducting a large volume of blood transfusion.
• Disturbance in the functioning of the thyroid gland, and primarily its hyperfunction.
• Presence of cretinism.
• Various forms of severe anemia.
• Hypophosphatosia. This disease is very rare and usually congenital. It is a special pathology in which softening of bone tissue occurs.
• The presence of osteoporosis, which in most cases is an age-related disease.
• Lack of essential vitamins in the body, in particular folic acid, as well as B12 and B6.
• Insufficiency of certain elements in the patient’s body, in particular zinc and magnesium.
• Taking certain medications, since certain medications can affect the level of this element, leading to its decrease.

A decrease in alkaline phosphatase during pregnancy (normally it should be slightly elevated) may indicate serious placental insufficiency. This condition requires urgent help.

In order to adequately assess the patient’s condition and establish the exact cause of the decrease in phosphatase, the doctor will need to conduct a number of additional studies, and in some cases, consult other specialists. It is also important to remember that the boundaries of the range of normal values ​​are quite wide and almost always depend on the age of the patient.

In women, the level of alkaline phosphatase is usually slightly lower than that in men of the same age group, with the exception of periods of gestation, when the level of the element increases.

Since a decrease in phosphatase can be observed even in healthy people, it is important to take into account that it is impossible to make a specific diagnosis and draw conclusions about the presence of certain diseases based solely on studying the level of phosphatase, since such a diagnosis will be biased and inaccurate.

If a significant decrease in the indicator is detected, the doctor can only suspect the presence of some kind of illness, but to obtain a complete picture of the condition, more detailed and specific examinations are always required.

Treatment for low phosphatase levels

To return the indicators to normal values, it is necessary to carry out complex therapy for the underlying disease, which led to the appearance of a decrease in the level of this element.

If the reason for the decrease in alkaline phosphatase is a lack of vitamins and important minerals, then the patient is recommended to use vitamin complexes, as well as change the diet and diet.

It is important to add to your daily menu foods that contain large amounts of the missing vitamin or microelement, for example:

• If there is a lack of vitamin C, you should enrich your diet with citrus fruits, onions (raw), as well as fresh black currants.
• If you are deficient in B vitamins, it is important to include many types of fresh fruits and vegetables in your diet, as well as red meats.
• To increase your zinc content, you should eat fresh cheeses, poultry, a variety of seafood, and meat.
• If there is a lack of magnesium, you need to eat legumes, primarily beans, natural dark chocolate, lentils, as well as pumpkin and sunflower seeds.
• The lack of folic acid can be replenished by eating legumes, various types of cabbage and fresh, varied greens.

Source: https://vseanalizy.com/biohimicheskij-analiz-krovi/shhelochnaja-fosfataza/ponizhena.html

What may influence test results?

Speaking about the direct impact on the results, it should be understood that during normal pregnancy, alkaline phosphatase activity levels are increased because it is concentrated in the placenta. Another factor associated with a temporary increase in enzyme activity should be considered the time interval after the resulting fractures (both open and closed).

It should also be understood that in children and young people, phosphatase activity levels are higher than in adults, because they are the ones who experience growth in bone structures. According to experts, drugs such as aspirin, paracetamol, allopurinol, antibiotics and some others are quite capable of increasing the criteria for alkaline phosphatase activity. Another factor is the use of oral contraceptives. However, this does not always lead to aggravation of the activity indicators of the enzyme presented.

It is also noteworthy that the activity associated with alkaline phosphatase in the blood may be elevated if the blood is cooled after collection. Thus, in no case should the diagnostic significance of an enzyme such as phosphatase be neglected. It is she who demonstrates how normally the body works, namely organs such as the liver, stomach and some others

It is very important to know what the norm is for each specific age, and why it will change in one direction or another.

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   Can cancer be prevented?

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4. smoke don't smoke, nothing will happen
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    • broccoli

    hare or wood sorrel

13. cabbage white
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    • rectum

    stomach

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    sunscreen

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Increased values ​​in cardiovascular diseases

If alkaline phosphatase is increased, most often this indicates:

• Chronic heart failure;
• Acute tissue damage in the heart or lungs.

Congestive heart failure can cause acute liver failure. Low cardiac output syndrome with subsequent reduction in hepatic blood flow is a major factor and cause of liver disease.

In conditions of acute liver failure due to congestive heart failure, clinical signs of the latter may be absent , which requires an appropriate diagnostic approach. Against the background of severe heart failure, blood from the heart enters the inferior vena cava, which increases the pressure not only in it, but also in the hepatic veins.

If this pressure is high enough, the liver becomes overloaded with blood. Most patients with overload do not show any symptoms. In severe cases, the skin and whites of the eyes turn yellow - jaundice develops.

Fluid may accumulate in the abdomen, in which case a disorder called ascites . The spleen also tends to enlarge. If the congestion is severe and chronic, cirrhosis develops.

Most often, liver overload occurs in people with heart failure. In this case, the patient must take an extended blood profile test to determine how well the liver is functioning and assess blood clotting.

congestive hepatomegaly in the early stages , as it indicates the severity of the heart disease that occurs against its background.

At diagnosis, a blood test will show abnormally high levels of alkaline phosphatase, increased ESR, decreased total protein and protein fractions, fluctuating sodium and potassium concentrations, increased bilirubin, increased aspartate aminotransferase (an endogenous enzyme) or alanine aminotransferase.

Paget's disease is a localized bone disorder that begins with excessive bone resorption and enlargement. This means that the bones interfere with the body's normal recycling process, in which new bone tissue gradually replaces old bone tissue. Over time, the disease can cause deformed and brittle bones.

In severe cases of Paget's disease, the blood vessels inside the bone may become damaged . This means the heart has to work harder to pump blood throughout the body.

Sometimes the heart is not able to pump enough of it to meet the body's needs, so heart failure .

Symptoms include dyspnea (shortness of breath), increased fatigue and weakness, and swelling in the legs and ankles.

Heart failure due to Paget's disease is treated with a combination of medications designed to reduce the workload on the heart, helping it work more efficiently. In some cases, surgery is indicated to replace a damaged heart valve.

Patients with Paget's disease have calcium deposits in the blood vessels and heart valves. These problems are caused by an increase in calcium concentration in the body due to the breakdown of bone tissue.

When diagnosing the disease, a blood test will reveal a significant increase in phosphatase levels, increased urea levels in the blood, and increased concentrations of telopeptides (C and T).

Increased alkaline phosphatase activity is observed in giant cell arteritis. Such patients have an increased risk of developing cardiovascular diseases. Giant cell arteritis often precedes stroke and heart attack.

This condition must be diagnosed at an early stage to exclude relapses (including the development of thoracic aortic aneurysm, congestive heart failure, aortic dissection). When diagnosing the disease, a blood test will reveal a significant increase in ESR and elevated C-reactive protein.

Reasons for having a blood test

Normally, alkaline phosphatase has a constant activity level, since it is constantly involved in the transfer of phosphorus ions across the cell membrane. In the body it can be found in almost every tissue, but the most important are the kidney, liver, bone and placental tissues. In healthy people, the liver form is predominantly determined. The peculiarity of the enzyme is that it does not work in the blood, but appears in it only when cells are destroyed.

The analysis of alkaline phosphatase activity in blood serum is of greatest importance for studying liver function. This laboratory test is part of the biochemical analysis, namely in the group of liver tests. It is prescribed in the following cases:

• with complaints of general weakness, loss of appetite, nausea, bitterness in the mouth, pain in the right hypochondrium, yellowing of the skin, darkening of urine and discoloration of feces;
• for the diagnosis of hepatitis and cirrhosis of the liver;
• in order to detect cancerous degeneration of liver cells;
• patients with stagnation of bile in the bile ducts.

In traumatology and orthopedic practice, the study is prescribed for fractures, bone pain, suspected bone tumors or metastasis of cancer cells to the bones. A blood test helps detect kidney cancer. Monitoring the activity of alkaline phosphatase over time is indicated during drug therapy to assess its results. A referral for testing can be provided by the surgeon before the operation.

Diagnosis can be uninformative if you have recently eaten food, since the activity of the enzyme located in the intestines sharply increases. Insufficiently indicative results are found in children, since during the period of active bone growth, the bone protein fraction increases. Unreliable indicators are obtained against the background of intensive antibiotic therapy.

Biochemical blood test during pregnancy and its interpretation

During pregnancy, venous blood is necessarily taken for so-called liver tests (bilirubin, ALT, AST, GGT, alkaline phosphatase), since during this period there is a large load on the woman’s liver.

Also, a biochemical blood test allows you to determine the content of other blood markers, which is also necessary to know to determine the state of health of the mother’s body, because it is not enough to just carry the baby, she needs to be delivered and delivered, and a sick mother will not be able to do this.

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Standards for biochemical blood test indicators during pregnancy

Bilirubin is a blood pigment formed as a result of the breakdown of hemoglobin, the change in concentration of which is directly related to the condition of the liver and spleen.

Bilirubin comes in two types (fractions): direct (or bound) and indirect (free or unbound), and their sum gives a quantitative estimate of the total bilirubin in human blood. The norm for indirect bilirubin is 3.4-13.7 µmol/l, and for direct bilirubin – 0-7.9 µmol/l. Then the standard content of total bilirubin in the blood is in the range of 3.4-21.6 µmol/l.

As a rule, the results of a biochemical blood test display total and direct bilirubin, and their difference, accordingly, will be the amount of indirect bilirubin in a person’s blood.

For diagnostic purposes, the level of bilirubin is useful in determining jaundice, liver diseases, cholestasis, hemolytic anemia, and infectious mononucleosis. In these diseases, there is an increase in both direct and indirect bilirubin.

During pregnancy, there is often an increase in indirect bilirubin with normal readings of hemoglobin, ALT, AST, GGT and direct bilirubin, as well as with a good ultrasound of the liver and gallbladder. There is nothing wrong with this; this phenomenon is called Gilbert's syndrome - this is a congenital disease that persists throughout life and does not pose a risk for the development of the child.

It is recommended to take Essentiale Forte N 2 capsules 3 times a day (with meals) for 1-2 months and Enterosgel 1 tablespoon 3 times a day (1-2 hours before or after meals, with a few sips of water) for for 10 days to help your liver cope with the load, and also adhere to proper nutrition, you cannot starve!

Alanine transaminase or alanine aminotransferase (ALT or ALT) is an intracellular enzyme that is found to a greater extent in the liver and kidneys, and in smaller quantities in the heart muscle, lungs, pancreas and spleen.

The normal level of the ALT enzyme in a woman’s blood is up to 31 U/ml.

When the cells of these organs are destroyed, a significant release of ALT into the blood is observed, which occurs with hepatitis, fatty liver hepatosis, jaundice, toxic liver damage, pancreatitis, heart disease and other serious diseases.

With late toxicosis (preeclampsia) during pregnancy, a slight increase in ALT may be observed.

Aspartate aminotransferase (AST) is an enzyme that, like ALT, is involved in the metabolism of amino acids and is found in the cells of various human organs.

The norm of AST in the blood of women is up to 31 U/ml.

An increase in the level of this enzyme most often indicates problems with the heart (in particular, with the myocardium), as well as liver disease.

There are hepatic causes of increased ALT and AST - liver ischemia, viral hepatitis, liver hepatosis, and non-hepatic causes - hemolytic anemia (hemolysis), obesity, etc.

A slight increase in ALT and AST enzymes in the first and second trimester of pregnancy is not a consequence of the disease.

Creatinine is a metabolic product of creatine phosphate, which is involved in the process of providing energy to human muscles.

Creatinine is filtered in the kidneys, and if their function is impaired, an increase in creatinine in the human blood is observed.

The normative concentration of creatinine in a woman’s blood is 53-97 µmol/l.

During pregnancy (usually in the 1st and 2nd trimesters), a decrease in this indicator by 40% is observed due to an increase in blood volume, increased kidney function, i.e. the creatinine content during pregnancy decreases to 35-70 µmol/l, which is physiologically normal.

If a pregnant woman has an overly thin physique or follows a vegetarian diet, this figure can also be reduced, which in this case is not a good sign; it is necessary to gain weight by adjusting and balancing the diet.

Urea is a nitrogen-containing product, which, along with creatinine, makes it clear how the excretory system of the kidneys works.

The normal level of urea in the blood of an adult is 2.5-7.1 mmol/l, but during pregnancy a decrease in this indicator is considered normal due to increased protein synthesis and increased renal filtration, provided that liver markers are normal.

Cholesterol (or cholesterol) is an important building component of the cells of our body, most of which is produced in the liver, the rest is obtained from food.

Cholesterol is also involved in the production of sex hormones, so monitoring cholesterol levels and maintaining them at normal levels is an important task during pregnancy.

Cholesterol norms according to a woman’s age, mmol/l: With normal general blood counts, a twofold increase in cholesterol during pregnancy is normal, that is, each indicator in this table must be multiplied by 2. This increase is due to the active release of certain hormones into the woman’s blood, necessary for the formation of the placenta .

An increase in cholesterol values ​​(namely, on average, with readings of more than 12-13 mmol/l) is observed in liver diseases, cholestasis, pancreatitis, renal failure, coronary heart disease, diabetes mellitus, obesity, etc.

High cholesterol is an extremely undesirable phenomenon for both the baby and the mother, so it is necessary to take measures to reduce it: change the diet to a lower calorie one, do exercises for pregnant women, etc.

Indeed, with an excess of cholesterol, the risk of intrauterine anomalies in the development of the cardiovascular system in the fetus increases, and the mother herself may suffer from a decrease in the strength of blood vessels, their blockage and the formation of blood clots; with a deficiency, the risk of spontaneous miscarriage or premature birth increases, and a pregnant woman with reduced cholesterol experiences deterioration of health.

Glucose is the main blood marker for determining diabetes mellitus in humans. The normal level of glucose in the blood is 3.89-5.83 mmol/l, but during pregnancy in healthy women this figure is often reduced, because the fetus is growing and needs more glucose, which it consumes from the mother’s body.

Also, during the period of bearing a child, pregnant women are faced with gestational diabetes mellitus, which disappears after childbirth. These phenomena are considered within normal limits, since they are caused by the active release of glucose by the mother’s body and its consumption by the developing fetus.

An increase in blood glucose indicates diabetes mellitus, kidney and liver diseases, and pancreatitis.

A decrease in glucose can also occur with endocrine pathologies, for example, with adrenal insufficiency.

Diastase (or alpha-amylase) is an enzyme that is synthesized in the pancreas and salivary glands, present in small quantities in the liver and intestines, therefore this blood marker is used primarily for diagnosing diseases of the pancreas and inflammatory processes in the salivary glands, well and of course to confirm diseases of the liver and gastrointestinal tract.

The norm for an adult is 25-125 U/l.

An increase in the level of diastase in the blood is observed with pancreatitis, cholecystitis, renal failure, diabetes mellitus, etc.

And a decrease in the level of diastase is associated with toxicosis, hepatitis, and pancreatic insufficiency.

Gamma glutamyl transferase or gamma glutamyl transpeptidase (GGT (GGTP) or GGTP) is an enzyme that accumulates in the kidneys, liver and pancreas.

The GGT norm for women is up to 36 U/ml.

During the second trimester of pregnancy, GGT may be slightly increased, which is within normal limits.

In diseases of the liver and biliary system (cholestasis, for example), a significant increase in the enzyme in the blood serum is observed. GGT may also increase in diabetes mellitus.

Alkaline phosphatase (ALP) is an enzyme primarily involved in bone growth.

The normal level of alkaline phosphatase in women is 40-150 U/ml. An increase in this enzyme during healing of fractures is considered normal.

Pregnant women in the second and third trimester may experience an increase in alkaline phosphatase, which is due to the active growth of fetal bone tissue.

Also, an increase in alkaline phosphatase may indicate the presence of bone or liver disease (for example, with hepatic cholestasis, hepatitis).

Also, with infectious mononucleosis, an increase in alkaline phosphatase is observed in the first week of illness.

Taking antibiotics, magnesium, large doses of vitamin C, and insufficient consumption of foods rich in calcium and phosphates also increases the level of alkaline phosphatase in human blood.

K+ (potassium), Na+ (sodium), Cl- (chlorine), Mg (magnesium), P (phosphorus), Fe (iron) are the main inorganic substances that play an important role in the functioning of the whole organism.

Each of them is responsible for certain important processes: muscle contractions, conduction of nerve impulses, metabolism in the human body, maintaining somatic pressure, maintaining acid-base balance, functioning of the nervous system, oxygen transmission, etc.

The normal content of potassium in the blood is 3.4-5.3 mmol/l, sodium - 135-155 mmol/l, chlorine - 98-107 mmol/l, magnesium - 0.85-1.15 mmol/l, phosphorus – 0.87-1.45 mmol/l, iron – 7.2-25.9 mmol/l.

Both an increase and a decrease in the content of macro- and microelements in the body of a pregnant woman leads to health problems for both the mother and the unborn child, so it is important to maintain these indicators at normal levels by taking specially designed vitamin and mineral complexes for pregnant women.

A biochemical blood test must be taken only in the morning and on an empty stomach, and the last meal should be 8-12 hours before the test.

Berezhnaya A.S.

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Level of indicator during pregnancy

The physiological norm is considered to be an increase in alkaline phosphatase during pregnancy.
This is primarily due to the development of the fetus and placenta, and during such a period the body begins to work hard “for two”, releasing a lot of enzymes and hormones. This does not require medical adjustment or treatment, and increased phosphatase is not a threat to pregnancy. However, if a woman had chronic diseases of the liver, gastrointestinal tract, and bones before conception, then this indicator will have diagnostic value, and the enzyme results will need to be constantly monitored in order to avoid intrauterine and birth complications. A significant increase in phosphatase requires medical supervision and diagnosis, as during pregnancy you can get hepatitis and other ailments.

sufficient oxygen

High levels: what does the increase mean?

Elevated alkaline phosphatase may be due to congestion or obstruction of the biliary tract , this phenomenon occurs in the liver and in the ducts leading to the gallbladder or in the duct leading from the gallbladder through the pancreas and then into the duodenum.

We list the most likely causes of the increase associated with liver disease:

• Cholestasis;
• Constant use of contraceptives;
• Obstructive pancreatitis;
• Hepatitis C;
• Fatty liver degeneration;
• Mononucleosis;
• Cytomegalovirus infection;
• Bacteria, viruses, tuberculosis;
• Malignant formations.

An increase in alkaline phosphatase indicates bone problems such as rickets, tumors, Paget's disease, and increased levels of hormones that control bone growth (parathyroid hormone). Elevation of the enzyme can be caused by fracture healing, acromegaly, myelofibrosis, leukemia and rarely myeloma.

Alkaline phosphatase is commonly used as a tumor marker in the body and to monitor the body's response to treatment for Paget's disease or therapy to correct vitamin D deficiency.

The most likely reasons for the increase in relation to bone and hormonal diseases:

• Paget's disease;
• Shingles;
• Hyperthyroidism;
• Excessive activity of the parathyroid glands (primary hyperparathyroidism, secondary hyperparathyroidism, osteomalacia, malabsorption syndrome);
• Rickets - vitamin D deficiency;
• Osteogenic sarcoma - very high concentrations of the enzyme indicate osteogenic bone cancer;
• Hyperfunction of the adrenal glands.

Alkaline phosphatase also increases in other diseases not related to the liver and bones:

• Amyloidosis;
• Granulation of the affected tissue;
• Gastrointestinal inflammation (Crohn's disease, erosion, ulcerative colitis);
• Systemic infections (sepsis);
• Sarcoidosis;
• Kidney carcinoma;
• Gilbert's syndrome;
• Rheumatoid arthritis;
• Long-term alcohol intake (in chronic alcoholism, bilirubin and ESR concentrations are increased);
• Some types of cancer such as Hodgkin's lymphoma, gynecological malignancies.

Elevated alkaline phosphatase almost always requires further testing to determine the origin of the condition.
For example, liver enzyme tests to check the integrity of the liver, as well as x-rays if bone abnormalities are noted. Most often, against the background of increased phosphatase and in the presence of liver disease, the following changes are observed: decreased albumin and total protein, low urea concentrations in the blood, decreased glucose concentrations, high cholesterol and triglycerides. In the presence of bone diseases: increased levels of inflammatory markers (globulins and immunoglobulins), increased ESR.

Deviations from the norm

The physiological reason for an increase in alkaline phosphatase in children or a decrease in its activity is the intensive growth of bones or the cessation of their growth due to the person’s age. But there are also pathological reasons for changes in the concentration of these enzymes.

Elevated alkaline phosphatase

An increase in alkaline phosphatase in the blood serum can occur due to diseases of the organs that contain these enzymes. Alkaline phosphatase is elevated in the following diseases:

Liver pathologies - hepatitis, parenchymal necrosis, cirrhosis, drug intoxication, toxic type, damage to the organ by parasites, etc.

Pathologies of the biliary tract and gallbladder - cholecystitis, mechanical jaundice, adhesions.

Infectious mononucleosis;

Multiple myeloma.

Cytomegaly.

severe acute intestinal infections;

Lymphogranulomatosis.

Quite often, pathologically elevated alkaline phosphatase in children occurs due to bone diseases. This may be a tumor process localized in bone tissue, rickets, metabolic disorders, during the rehabilitation period after severe bone fractures. When bones heal after fractures, a high level of alkaline phosphatase is always recorded.

The tumor process in the body also causes a rapid increase in this indicator. If the concentration of these enzymes has increased to very high values, this may indicate a malignant tumor.

In children and adolescents, alkaline phosphatase in the blood is increased if the body grows too rapidly, leading to various pathological conditions or due to pathologies of the endocrine system.

Taking certain medications may also increase serum alkaline phosphatase levels. For example, this is paracetamol, erythromycin, antibiotics of the penicillin group, etc.

Safe deviation from the norm

High concentrations of enzymes in a child’s body can be safe for the child. According to statistics, in 1-5% of children this occurs at an early age. This condition is called transient hyperphosphatasemia. Most often, this condition is observed in children under 5 years of age.

This can only be diagnosed by chance, during a preventive examination, since such deviations do not show symptoms, since they do not indicate pathologies of the liver or bones. Transient hyperphosphatasemia in children is a temporary condition. That is, after several weeks, and in some cases several months, the normal level of alkaline phosphatase is restored. In this case, there will be no negative consequences for the child’s health.

Reduced alkaline phosphatase

Alkaline phosphatase levels in children decrease when the body does not receive the required amount of minerals and vitamins. Namely, phosphorus, magnesium and zinc. This occurs if the child has malnutrition.

In rare cases, children experience conditions such as:

hypophosphatasia;

a genetic disorder in which there is an abnormality in phosphatase metabolism.

Reduced ALP levels are very dangerous for children under 6 months. Since such a deviation causes developmental delay, calcium in the body increases pathologically, and bones become deformed. Often this pathology leads to death. For older children, a decrease in alkaline phosphatase levels is not as dangerous. But everything can lead to deformations of bone tissue and frequent fractures. Also these children will grow slowly.

Alkaline phosphatase is reduced in men for reasons. Increased alkaline phosphatase in the blood - what does this mean?

The study helps to identify at an early stage various abnormalities and disorders in the body, even in the absence of any symptoms characteristic of the development of diseases. In most cases, diagnostics allows us to assess the condition of the liver and its tissues, bile ducts, and the skeletal system.

The study also helps determine the presence of serious pathological abnormalities in the internal organs, including congenital anomalies and genetic mutations associated with the production of the isoenzyme.

When is a test ordered?

The study is prescribed according to the indications and signs characteristic of the development of the pathology.

Indications for the study:

• general weakness and malaise of the body;
• change in the color and character of urine - darkening;
• digestive system disorders;
• development of neoplasms, tumors;
• diseases of the skeletal system, including trauma and bone damage;
• deforming changes in the skeletal system, including frequent fractures;
• preventive examination of workers working in hazardous conditions;
• routine diagnostics during pregnancy.

Diagnosis can be made by monitoring the condition and assessing the degree of effectiveness of treatment aimed at eliminating diseases caused by failures in enzyme production.

Treatment

An increase in the enzyme in medicine is considered as a symptom, but not as a separate disease. At the moment there is no clearly developed course for normalizing the level, since this is impossible. It is necessary to determine the cause and, based on the information received, select treatment.

When diagnosing, it is important to consider that there are a number of natural factors that increase the concentration of ALP even in completely healthy people. Therefore, if necessary, the attending physician will prescribe additional studies.

After studying the results of the examination, conducting an examination and collecting an anamnesis, the therapist refers the patient for consultation to specialists of a narrower profile. This could be an endocrinologist, surgeon, oncologist or orthopedist.

Norms of indicators

Levels of phosphatase isoenzymes vary depending on the patient's age. Unit of measurement – ​​U/l.

Among women

From 18 years of age to 25 years of age, normal levels range from 40 to 140 U/L. 25-40 years – more than 80 U/l. For women over 45 years of age, the normal value is 40 U/l.

Alkaline phosphatase is reduced during pregnancy. In this case, indicators may deviate from established norms depending on the gestational age. Thus, in the 1st trimester the value varies between 20-90 U/l, in the 2nd trimester – from 40 to 130 U/l, in the 3rd – 60-240 U/l.

In men

The normal level of alkaline phosphatase in men is considered to be from 100 to 190 U/l. From 18 to 45 years, the value varies between 100-120. From 45 to 70 years of age, indicators may increase and range from 120 to 145 U/l.

Over 70 years of age, the enzyme level increases to 195 U/l.

In children

The level of the enzyme in the blood of children is significantly higher than that of adults. This phenomenon is due to various changes in the child’s body caused by the formation of the immune and hormonal systems.

How to prepare for research

The study and determination of alkaline phosphatase levels is carried out by drawing blood from a vein. To display correct results, you must follow some preparation rules.

Recommendations:

• The last meal should occur no later than 8-10 hours before the start of the procedure. It is allowed to drink water without gases.
• 24 hours before the test you must avoid physical activity and exercise.
• It is recommended to stop drinking alcoholic beverages for 2-3 days.
• Situations that can provoke the development of stressful conditions should be avoided.
• It is recommended to stop smoking a few hours before the procedure.
• It is necessary to inform the treating specialist several days in advance about possible medications taken during this period.

In this case, the maximum period of abstinence from food should be taken into account. It should not exceed 14 hours.

Decoding analysis responses

When deciphered, alkaline phosphatase is denoted by the generally accepted abbreviation ALP.

At the end there is an additional letter indicating the region of decrease in the isoenzyme:

• I – intestinal region.
• L – liver or kidney tissues, skeletal system.
• P – disruptions in the production of the substance were found in the placenta.

Reasons for deviations from the norm

Alkaline phosphatase can be reduced for various reasons.

Possible diseases:

• The development of hypothyroidism – swelling of the mucous membranes, mental and physical underdevelopment.
• Severe anemia.
• The formation of intestinal enzymopathy is celiac disease.
• Anomalies in the structure of the skeletal system.

Other causes of pathology:

• Lack of vitamins in the body, especially vitamins B and C.
• Lack of useful macro- and microelements - zinc, magnesium.
• Increased production of vitamin D.
• Reduced protein formation and, as a consequence, the development of dystrophy.
• The formation of placental insufficiency during pregnancy.
• Beginning of menopause.
• Kidney failure.
• Diabetes.
• Abuse of hormonal drugs containing high levels of estrogen.
• Previous bypass surgery or blood transfusion.

Among cardiovascular pathologies, the development of tachycardia, heart failure, increased cholesterol levels, and blood vessel diseases are noted.

It is extremely rare that the cause of pathology is congenital hypophosphotization. The process is caused by hereditary or genetic factors. The condition poses a high risk to the patient’s life, is accompanied by disruptions in the mineralization of bone tissue, breathing problems and requires immediate treatment.

In more rare cases, the cause of low enzyme levels may be improper storage conditions for the patient's blood serum or incorrect display of test results.

Causes of increased alkaline phosphatase

An increase in the concentration of the isoenzyme can occur for various reasons, including drug abuse (barbiturates, sulfonamides, nicotinic acid). Increased levels can also be observed in cases of alcohol poisoning during pregnancy.

Pathology often develops against the background of internal diseases. In this case, several main groups are distinguished: liver disorders, changes in the skeletal system, and other forms of diseases.

Liver disorders, bile duct disorders:

• The development of cirrhosis is the inhibition of most liver functions, the replacement of damaged tissue with scar tissue.
• Hepatitis formation - the activity of the isoenzyme increases 3 times.
• The presence of tumor processes (cancer) - metastases move from other organs.
• Cholangitis is an extremely rare occurrence and is characterized by inflammatory processes in tissues.
• Development of biliary cirrhosis - pathology is formed due to complications caused by cholangitis. In this case, an increase in the enzyme by more than 4 times is noted.
• An infectious form of mononucleosis - the process affects all liver tissues, a change in the properties of the blood is noted.
• Stagnant processes of bile – cholestasis.
• Damage to the biliary system. The formation of stones that provoke stagnation and outflow of bile.

Disorders in the skeletal system:

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Alkaline phosphatase level in blood serum

The unit of measurement for protein activity in the blood is international units – IU/l. Depending on age, there are differences in physiological parameters. Adults also have differences in gender.

In men

Indicators corresponding to the norm can be determined from the table.

Some laboratories carry out measurements in units/l. Therefore, there may be differences in the boundaries of reference (normal) values.

Among women

In addition to age-related fluctuations in the level, pregnancy can also cause changes, as placental alkaline phosphatase increases.

In children

The highest rates occur after one year and up to 8 years – 350 IU/l. In newborns, the average value is 250 IU/l. From the age of ten, gender differences begin to appear - boys have a normal level of 270, and girls 280 IU/l.

What causes the increase?

A high enzyme content is not always a sign of any pathology; it can also be a consequence of natural physiological causes or the body’s reaction to taking certain medications.

For example, it increases due to:

• bone growth due to age-related reasons;
• formation of new bone tissue after injuries;
• puberty, hormonal “changes”;
• age-related degenerative-dystrophic processes in the bone structure;
• intensive sports training;
• vitamin deficiency as a result of poor nutrition and dieting;
• alcohol and nicotine addiction;
• excess weight, excess fat deposits;
• low physical activity;
• excess vitamin C;
• taking medications containing acetylsalicylic acid, paracetamol, as well as medications classified as antibiotics;
• protection from pregnancy by taking oral contraceptives;
• taking drugs that have a negative toxic effect on liver tissue (sulfonamides, methotrexate, tetracycline).

An increase in alkaline phosphatase levels in women does not necessarily mean the presence of diseases of the internal organs. There are two main physiological causes that are not caused by any pathology - pregnancy and lactation.

However, enzyme values ​​above normal often signal the presence of serious diseases. In severe forms of pathologies, the level of alkaline phosphatase can reach up to 2000 U/l.

Diseases that provoke a sharp increase in alkaline phosphatase levels form three conditional groups.

Pathologies of the liver and biliary tract

This enzyme is considered a marker of bile stagnation, which is observed in the following ailments:

• cholestasis;
• cholangitis;
• liver cirrhosis (its biliary variant);
• Infectious mononucleosis;
• hepatitis of various origins (viral, drug, toxic);
• oncological diseases of the liver and biliary tract;
• the formation of stones blocking the outflow of bile;
• mechanical, cholestatic jaundice (due to long-term use of female sex hormones).

Bone damage

The enzyme is actively produced in osteoblasts - new bone-forming cells that arise from the destruction of old ones. The higher their activity, the more pronounced the concentration of alkaline phosphatase will be.

Among the diseases that destroy bone tissue are:

• Paget's disease (inflammatory skeletal damage);
• osteomalacia (deviation in the process of mineralization, leading to unnatural flexibility, fragility and softness of bones);
• osteosarcoma (malignant lesion of bone-forming cells).

Other diseases

A large number of diseases affecting various body systems cause an increase in ALP:

• pathologies of the cardiovascular system - chronic heart failure, myocardial infarction, damage to cardiac muscle tissue;
• hormonal disorders - hyperthyroidism (thyrotoxicosis), pathologies of the adrenal glands (hyperfunction), hyperparathyroidism (Burnet's syndrome), diffuse toxic goiter (Graves' disease);
• congenital disease of the urinary system (osteonephropathy or “renal” rickets);
• rickets in children of the first year of life caused by a lack of vitamin D;
• miliary tuberculosis;
• pathologies of the gastrointestinal tract - the formation of through damage in the wall of the stomach, cancer of the gastrointestinal tract, nonspecific ulcerative colitis (UC), inflammatory process of the intestinal mucosa (Crohn's disease);
• malignant lesions of the blood (leukemia), lymphatic tissue (lymphoma);
• inflammation of the internal genital organs, ovarian, endometrial, cervical cancer;
• damage to bone marrow cells (multiple myeloma) and others.

ASLO antistreptolysin, which means an increase in ASLO in the blood. The connection between ASLO and rheumatism.

Antstreptolysin O (ASLO) is a group of antibodies directed against toxins (streptolysin type O) of
streptococcal .
The ASL-O analysis is a diagnostic procedure that determines the presence in the blood of a person being examined of antibodies against group A streptococcus. An increase in the level of ASLO is observed if the patient has recently suffered an infection caused by group A streptococcus (for example, tonsillitis, pharyngitis, etc. .).

Basically, this analysis is used in the diagnosis of post-streptococcal complications - acute rheumatic fever ( rheumatism ) and
glomerulonephritis .
ASLO levels are highest 4-6 weeks after the last episode of streptococcal infection. The value of ASLO does not give any idea about the possibility of developing rheumatism.

The ASLO test determines the amount of antistreptolysin O (ASL-O) in the blood. ASL-O is a special antibody that our body produces against streptolysin O. Streptolysin O is a toxin secreted by the bacterium group A streptococcus.

Group A streptococcus (Streptococcus pyogenes) is a bacterium that causes streptococcal sore throat (scarlet fever). If a sore throat is not detected and treated appropriately, specific post-streptococcal complications may appear, namely acute rheumatic fever (rheumatism) and glomerulonephritis, etc. see also Complications of scarlet fever.

Very often, an increase in ASLO levels is observed in patients suffering from chronic tonsillitis.

How is ASLO tested? Preparation for analysis.

To test for ASLO, blood is taken from a vein. 6 hours before the test, you must refrain from eating (as a rule, the test is taken in the morning, on an empty stomach).

Why is ASL-O analysis done?

An ASL-O test is done to determine whether the patient has recently had a streptococcal infection.

In cases where long-term streptococcal infection is asymptomatic and/or is not treated appropriately, some patients (especially children and young adults) may develop post-streptococcal complications, in particular acute rheumatic fever and glomerulonephritis. Accordingly, an ASLO test is prescribed if the patient has symptoms of rheumatic fever or glomerulonephritis, and if he has recently had a sore throat or has been suffering from chronic tonsillitis for a long time.

Sometimes the test is ordered twice over a period of 10-14 days to determine if antibody levels are rising, falling, or remaining the same.

What diseases are we talking about and what are their symptoms?

We can talk about a wide range of diseases. This:

• Liver pathologies: infectious hepatitis, toxic hepatitis. In these diseases, inflammation of the liver occurs. Much less common is cirrhosis of the liver: massive death of organ cells with their replacement by scar tissue. Symptoms: pain in the right side, swelling of the extremities, change in stool color (yellowish or white), the appearance of spider veins, weakness, a feeling of heaviness in the right hypochondrium.
• Diseases of the musculoskeletal system. Most often we are talking about arthritis, arthrosis, osteoporosis. Alarming manifestations: pain in large joints, bone fragility, deformation of musculoskeletal structures, a feeling of stiffness in movements, numbness of the arms and legs.
• Decreased functional activity of the thyroid gland. Manifested by decreased intelligence, weakness, and rapid fatigue. Cognitive functions do not always decline, but only when the disease begins in childhood.
• Intestinal pathologies. This includes Crohn's disease and colitis of various etiologies. These diseases manifest themselves as wandering abdominal pain, stool disorders, blood, pus, and mucus in the stool structure. If such manifestations are noticed, it means that it is time to consult a doctor.
• Low levels of alkaline phosphatase are observed with a decrease in hemoglobin. Weakness, fatigue, and low blood clotting appear.

Knowing the symptoms, you can suspect that you have a particular disease, but under no circumstances should you self-medicate. Any suspicions are grounds for visiting a doctor.

Reduced phosphatase index in the blood

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

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

• Osteoporosis of old age,
• Thyroid myxedema,
• An excess of radioactive isotopes in bone tissue,
• Severe 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.

You can increase the presence of alkaline phosphatase in your blood serum using 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 herbs,
• Foods rich in magnesium molecules are seeds, legumes, soybeans, nuts of all kinds.

Foods rich in magnesium molecules

What causes the decline?

A decrease in ALP levels in the blood may indicate that there are diseases in the body that require treatment:

• deficiency of thyroid hormones (hypothyroidism), as a consequence, the development of myxedema (mucoedema), retardation in mental and physical development (cretinism);
• severe anemia;
• intestinal enzymopathy (celiac disease, celiac disease);
• congenital anomalies of skeletal development (achondroplasia, hypophosphatasia).

In addition, ALP may be below normal as a result of:

• deficiency of vitamins – groups C and B (B6, B9, B12);
• lack of elements - zinc and magnesium;
• excess vitamin D;
• severe dystrophy due to protein deficiency (kwashiorkor);
• donor blood transfusion, coronary artery bypass surgery;
• placental insufficiency during pregnancy;
• menopause;
• taking hormonal medications containing estrogen.

Among the cardiovascular reasons why phosphatase may be reduced is chronic heart failure, which leads to enlargement of the heart chambers and their pathological expansion.

Along with low ALP levels, high cholesterol levels, tachycardia and blood vessel diseases are often diagnosed.

Conclusion: if the alkaline phosphatase level is above 150 U/l, you should pay attention to the state of your own health, especially if you already have chronic diseases of the liver and biliary tract.

The following symptoms may indicate a metabolic disorder: nausea, feeling tired, fatigue, poor appetite, joint pain, unpleasant aching sensations in the area under the right hypochondrium. If pathologies are excluded, then it is worth retaking the test a week after the first test, and following all recommendations regarding preparation for the test procedure.

Alkaline phosphatase is found in all tissues of the body. It is especially abundant in cell membranes. It enters the blood of a healthy person in sufficient quantities due to the natural death of “old” cells and the physiological activity of osteoblasts (bone tissue cells).

“Champions” for the production of alkaline phosphatases: - epithelium of the bile ducts and membranes of liver cells, - bone tissue, - as well as: placenta (in pregnant women), intestinal epithelium and renal tubules.

Content:

What values ​​are considered low?

The level of alkaline phosphatase in the blood can change with age and also depends on gender.
Therefore, low rates are appropriate to consider for certain categories of patients. In men, the following analysis results are reduced:

• 18-35 years – less than 45 units/l;
• 35-45 years – less than 40 units/l;
• 45-65 years – less than 38 units/l;
• over 65 – less than 37.5 units/l.

For women, the following values ​​are considered deviations from the norm:

• 18-25 years – less than 48 units/l;
• 25-35 years – less than 45 units/l;
• 35-45 years – less than 44 units/l;
• over 45 years old – less than 40 units/l.

For older people over 66 years of age, the lower limit rises significantly; accordingly, low values ​​are indicators that are below 150 units/l.

In childhood, alkaline phosphatase is considered low at the following levels :

• newborns and children of the first year of life - less than 85 units/l;
• 1-5 years – less than 68 units/l;
• 5-10 years – less than 65 units/l;
• 10-15 years – less than 80 units/l.

At the time of pregnancy, the level of phosphatase increases significantly, since molecules synthesized by the placenta are added to the total amount of the enzyme.

Therefore, during this period of time, it is important to ensure that phosphatase does not decrease, which can lead to the development of negative consequences for both the mother and the child.

Anna Poniaeva. Graduated from the Nizhny Novgorod Medical Academy (2007-2014) and Residency in Clinical Laboratory Diagnostics (2014-2016).Ask a question>>

Alkaline phosphatase is a specific enzyme that belongs to the group of hydrolases. This enzyme can be observed in all parts of the human body.

This enzyme is especially widespread in osteoblasts, the intestinal mucosa, the mammary gland, the placenta, and the walls of the bile ducts.

Treatment for low phosphatase levels

To return the indicators to normal values, it is necessary to carry out complex therapy for the underlying disease, which led to the appearance of a decrease in the level of this element.

It is important to add to your daily menu foods that contain large amounts of the missing vitamin or microelement, for example:

• If there is a lack of vitamin C, you should enrich your diet with citrus fruits, onions (raw), as well as fresh black currants.
• If you are deficient in B vitamins, it is important to include many types of fresh fruits and vegetables in your diet, as well as red meats.
• To increase your zinc content, you should eat fresh cheeses, poultry, a variety of seafood, and meat.
• If there is a lack of magnesium, you need to eat legumes, primarily beans, natural dark chocolate, lentils, as well as pumpkin and sunflower seeds.
• The lack of folic acid can be replenished by eating legumes, various types of cabbage and fresh, varied greens.

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Preparation for analysis and its implementation

The alkaline phosphate test is performed by drawing venous blood from the patient. To determine the concentration of the enzyme in the resulting biological material, a chemical method called colorimetry and a set of reagents are used.

To obtain a reliable result, you should follow simple recommendations before donating blood:

1. It is better to donate blood early in the morning, on an empty stomach. The fasting period should be at least 8-10 hours and no more than 14, while drinking water without gas is allowed.
2. The day before donating blood, you should avoid physical activity and intense training.
3. Avoid drinking alcohol two to three days before the test.
4. The emotional state should be calm; if possible, limit exposure to factors that cause a stress reaction.
5. If you smoke, refrain from smoking before donating blood. The break should be at least half an hour.
6. Warn your doctor about the medications you took a couple of days before the test.

In the forms of results of biochemical blood tests, ALP is designated by the common abbreviation ALP. An additional letter after this designation will indicate the place where this enzyme fraction was formed. For example, ALPI - in the intestines, ALPL - in the tissues of the liver, bones, kidneys, or it is also called nonspecific alkaline phosphatase, ALPP - in the placenta.

When detecting deviations of the alkaline phosphatase level from the norm, the following indicators are additionally analyzed to clarify the reasons:

• ALT and AST enzymes;
• bilirubin;
• balance of calcium and phosphorus;
• GGTP or GGT.

The price of an analysis (in 2020) to determine the level of alkaline phosphatase in Moscow, excluding the cost of the blood drawing procedure, averages 250 - 270 rubles.