Alkaline Phosphatase elevations

Although its role in human physiology is cloudy, alkaline phosphatase is an enyme which is tested to evaluate liver function.   Since the liver is not the only organ containing alkaline phosphatase, other systems can emit this enzyme during pathological processes or normal growth (in case of children).

Elevated alkaline phosphatase (2-3 x the upper limit of normal or higher) may be an indication of disease or dysfunction in the body.

Here are some examples:

Liver:

• obstructed gall bladder
• fatty liver disease
• alcoholic hepatitis
• drug toxicity
• liver cancer
• liver cyst

Bone:

• Paget’s disease
• bone cancer or metastasis
• osteomalacia

Endocrine conditions:

• increase thyroid or parathyroid activity

Drugs can also increase alkaline phosphatase including some examples:

• carbamazapine
• erythromycin
• allopurinol
• estrogen

For increased alkaline phosphatase, a complete history and physical examination is needed to determine the cause.  Other testing may be needed including imaging of the gall bladder,  liver, bones or thyroid and further lab testing:

Liver function testing

• AST
• ALT
• GGT
• albumin
• prothrombin time
• bilirubin

thyroid testing:

• TSH
• free T4
• thyroid antibody

parathyroid testing:

• calcium
• vitamin D levels
• parathyroid hormone (PTH)
• phosporous
• albumin