5 Causes of Elevated Alkaline Phosphatase

When the levels of alkaline phosphatase are no longer within the normal parameters, it's possible that it is due to some type of complication or special situation
5 Causes of Elevated Alkaline Phosphatase

Last update: 09 January, 2019

Alkaline phosphatase is an enzyme that’s in the majority of the body’s tissues. But, alkaline phosphatase is more prominent in the liver. Also, it appears in the biliary tract and the bone tissue.

So, it is found distribute in various forms, known as isoenzymes originally from the liver and bones.

All of these can be quantified separately with a blood test, if necessary.

  • Normal levels are from a range of 30 to 140 UI/L
  • And, when these levels pass the larger normal limit, the presence of distinct diseases may show. Many of them are the cause of the elevated levels.

5 causes for the increase of alkaline phosphatase

1. Liver disease

Man experiencing abdominal pain

Alkaline phosphatase levels can change and increase as a consequence of different liver diseases.

This is the case, for example, for viral hepatitis. Not only do the transaminases increased, but also this enzyme. This is due to the inflammation of the organ and the overproduction of bilirubin.

Also, it usually occurs in other acute diseases. For example, the obstruction of the biliary tract in cholecystitis, and in chronic diseases, like hepatic cirrhosis. Or, it can occur as a consequence of liver cancer.

2. Bone disease

  • One of the bone diseases that is known for elevating alkaline phosphatase if Paget’s disease.

Basically, in this pathology, the bones progressively deform and widen. However, by controlling the disease, the levels return to normal.

  • This enzyme can also be seen increasing as a result of certain types of cancers that metastasize or invade the bone

And, similar to the previous case, if they have timely and effective treatment, the values may return to their normal range.

3. Tumors

Cancer cells

One of the tumors or neoplastic processes that affects the elevation of alkaline phosphatase is the Hodgkin’s lymphoma. 

Additionally, this tumor characteristic of the lymph nodes determines the increase of the levels of this enzyme through blood tests.

As a part of the lymph node condition, a change occurs in the hepatic functions. Basically, the levels of the alkaline phosphatase change.

However, this is a laboratory finding that can be noticed in the advanced stages of the disease, so it demonstrates the severity of the situation when one is in more serious stages of this condition.

Other tumors that can cause alkaline phosphatase are cancers of:

  • Lungs
  • Ovarian
  • Prostate
  • Pharynx
  • Testicular

Also, the leukemias, that come from lines similar to lymphoma.

4. Pregnancy

After the start of the third trimester, the placenta in the mother is a producer element of the alkaline phosphatase enzyme.

This influences the general maternal values and increases them to above their normal range. Generally, the range is between 140 and 250 UI/L.

However, as with the physiological condition, this enzyme increase is not a reason for alarm. This is because it’s a required substance for protein synthesis, as well as the calcification of the bones and the cartilage of the fetus.

If enzyme levels stay at this elevated range after birth, it may be that there is something else causing it.

5. Specific medications

Injection with alkaline phosphatase

Many everyday medications have a characteristic that increases the visible levels of alkaline phosphatase through a blood test.

Among the medications that commonly have this effect are:

  • Antacids like ranitidine
  • Anti epileptics and anti convulsants like phenytoin and carbamazepine
  • Macrolide antibiotics like erythromycin
  • Antihypertensive calcium channel blockers, like verapamil

Therefore, when visiting your doctor, every patient should inform them of the medications that they usually take.

And, this way, they can anticipate the increase of the alkaline phosphatase and they will not directly think about possible illnesses that could be increasing the levels.

Finally, this is possible with a full clinical history and a good doctor-patient relationship.

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