00:00Alkaline phosphatase is an enzyme that is found in varying amounts in various organs
00:07in the body.
00:08What if your alkaline phosphatase is high?
00:12Should you be worried?
00:13What if it is low?
00:16If you recently had blood work and noticed that your alkaline phosphatase result was
00:21outside the normal range, this video will help you understand what that number might
00:27mean.
00:27Here are a few general rules you need to know to decide whether there is a cause for
00:34concern.
00:36By the end of this video, you will understand where alkaline phosphatase comes from, why
00:43it rises, and how doctors interpret the result.
00:48Before I give you a simple rundown on alkaline phosphatase and how to make sense of its results,
00:55let's first look at where this enzyme actually comes from.
01:00First of all, alkaline phosphatase is not just a single enzyme.
01:05It actually exists in several slightly different forms, known as isoenzymes.
01:11These forms originate in different organs of the body.
01:17For example, there is a form found in the liver, another in the bones, and one in the bowel, as
01:25well as one in the kidney.
01:27And there is even one in the placenta.
01:31There are additional forms of this enzyme as well, but these do not concern us here.
01:38Now, here is an important point.
01:41About 80% of the alkaline phosphatase circulating in your blood comes from just two organs, the
01:50liver and the bones.
01:52This means that when alkaline phosphatase is elevated, the cause most often comes from one
02:00of these two sources.
02:03So let's start with the liver.
02:05In liver disease, alkaline phosphatase most commonly rises when the bile ducts become blocked
02:14or when bile flow slows down.
02:18Bile ducts may be blocked inside the liver or outside the liver.
02:23For example, gallstones can block the bile ducts outside the liver.
02:29Inside the liver, diseases that infiltrate the liver, such as lymphoma, can interfere with
02:36bile flow and raise alkaline phosphatase levels.
02:41But obstruction is not the only cause.
02:44Certain medications, herbal remedies, and even some foods can slow the flow of bile through
02:51the liver.
02:53When this happens, alkaline phosphatase levels may rise in the blood.
02:59A good example is amoxicillin clavulanic acid, a commonly prescribed antibiotic that is well
03:07known to cause this type of liver reaction in some individuals.
03:12In rare cases, alkaline phosphatase may also rise because of more serious conditions affecting
03:19the liver or because certain tumors produce alkaline phosphatase outside of the liver.
03:28Fortunately, these causes are much less common.
03:31Now that we've looked at the liver, let's turn to the second major source of alkaline phosphatase,
03:39the bones.
03:41Bone alkaline phosphatase increases when there is increased bone formation or bone repair.
03:49In other words, when bone cells become more active.
03:54This can occur in several situations.
03:58For example, bone turnover increases in vitamin D deficiency, in overactive thyroid disease, or
04:07when a fractured bone is healing.
04:10Because children experience rapid bone growth, alkaline phosphatase levels are naturally high in
04:17childhood, levels usually decline during adulthood and may begin to rise again later in life as
04:25own metabolism changes.
04:28These variations are normal.
04:31So this raises an important question.
04:36How high does alkaline phosphatase have to be before doctors become concerned?
04:43Physicians usually interpret alkaline phosphatase results based on how much they exceed the upper
04:49limit of normal.
04:50A mild elevation, usually less than two times the upper limit of normal, can often be monitored
04:58and repeated because these values sometimes return to normal on their own.
05:05A moderate elevation, between two and four times the upper limit, is considered nonspecific.
05:15This means it does not immediately identify the cause.
05:20But if the elevation persists, it may indicate liver or bone disease and usually requires further
05:29evaluation.
05:31However, when the bile ducts are significantly obstructed, alkaline phosphatase levels often
05:39rise to four times the upper limit of normal or even higher.
05:44Now, another important question arises, how do doctors determine whether the alkaline phosphatase
05:52in the blood is coming from the liver or from the bones?
05:55The first step is usually to measure other enzymes associated with liver disease.
06:03Two commonly tested enzymes are GGT, which stands for gamma-glutamyl transpeptidase, and 5-nucleotidase.
06:15These enzymes are much more specific for liver problems.
06:19If alkaline phosphatase is elevated and one of these enzymes is also elevated, it strongly
06:28suggests that alkaline phosphatase is coming from the liver.
06:33One caveat is important to remember.
06:37A normal 5-nucleotidase level does not completely exclude liver disease because these enzymes do
06:45not always rise together.
06:48If there is still uncertainty, doctors could perform a more specialized test called an alkaline
06:56phosphatase electrophoresis.
06:59This test separates the different forms of alkaline phosphatase and can indicate which organ is
07:06producing the enzyme.
07:07There is also an interesting detail many people are unaware of.
07:15Individuals with blood types O and B can experience a temporary increase in alkaline phosphatase after
07:24eating a fatty meal.
07:27In these cases, the alkaline phosphatase originates from the intestine.
07:32For this reason, fasting before an alkaline phosphatase test may help eliminate these temporary elevations.
07:42Finally, what about the low alkaline phosphatase level?
07:48Low alkaline phosphatase is less common and can be a little trickier to interpret.
07:55It may occur in zinc deficiency or magnesium deficiency or in certain hereditary conditions that affect
08:04bone metabolism.
08:06So when doctors interpret an alkaline phosphatase result, they usually look for three broad patterns.
08:14First, a mild elevation which often resolves on repeat testing.
08:21Second, a persistent elevation which may suggest liver or bone disease and requires further investigation.
08:31And third, very high levels which may indicate significant problems with bioflow in the liver.
08:42Understanding these patterns helps doctors determine whether an alkaline phosphatase result
08:48is something to monitor or something that requires further evaluation.
08:56I hope you enjoyed the video.
08:58If you did, like and share the video with your friends and family.
09:02You can support this channel by subscribing.
09:05Until the next video, stay healthy and stay safe.
09:09the things you've been Hostet boosted by doing ______
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