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ALP

Arthritis Biomarker

Sample Needed

Collection Type: Blood

Body System

Related System: Arthritis

Overview

Alkaline phosphatase (ALP) is an enzyme present in liver, bone, placenta, intestine and kidney; the serum ALP test measures ALP activity in blood. It is used to detect and monitor conditions that increase bone turnover (Paget’s disease, bone healing, metastases) or cause cholestasis/hepatobiliary disease (bile duct obstruction, primary biliary cholangitis). Symptoms prompting testing include jaundice, dark urine, unexplained itching, bone pain, fractures, or persistent joint complaints. Normal ALP varies by age and physiologic state children and adolescents have higher values during growth, pregnant women show placental ALP elevations, and mild increases can occur with aging; men and nonpregnant women have similar adult reference ranges.

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Test Preparation

No special preparation is required

Why Do I Need This Test

Profile: included in Arthritis and liver/bone-related investigation panels.
Symptoms: bone pain, fractures, jaundice, pruritus, unexplained fatigue, persistent joint symptoms.
Conditions: detects/monitors cholestatic liver disease, bone diseases (Paget’s, osteomalacia, metastases), bone healing.
Reasons for abnormal levels: increased bone turnover or biliary obstruction; low levels from rare metabolic disorders.
Biological meaning: high ALP indicates cholestasis or increased osteoblastic activity; low ALP may reflect hypophosphatasia or malnutrition.
Lifestyle/family: heavy alcohol use, certain meds, rapid growth/pregnancy, family history of bone metabolic disorders warrant testing.

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Understanding Test Results

<44 U/L: low ALP is uncommon; may suggest hypophosphatasia (a genetic disorder), severe malnutrition, zinc deficiency, hypothyroidism, or certain medications clinical significance depends on symptoms and other tests.
44–147 U/L: normal adult range.
Note children/adolescents normally have higher values; pregnancy may modestly raise ALP.
148–300 U/L (≈1–2× upper limit): mild elevation often from bone growth/repair, recent fracture, bone disease in early stage, or early cholestasis; correlate with symptoms and other tests.
301–600 U/L (≈2–4× upper limit): moderate elevation suggests active cholestatic liver disease (bile duct obstruction, primary biliary cholangitis), Paget’s disease, or bone metastases further hepatic panel and imaging usually indicated.
>600 U/L (>4× upper limit): marked elevation commonly indicates significant biliary obstruction, metastatic or infiltrative liver disease, or severe Paget’s disease; urgent evaluation recommended.
To distinguish liver vs bone source, clinicians often check GGT (gamma‑glutamyl transferase) and/or ALP isoenzymes or bone-specific ALP.
Interpretation must consider age, pregnancy and clinical context.

Normal Range

44-147 U/L

FAQs

Q: What is the main cause of arthritis?

A: The most common cause of arthritis is wear-and-tear damage to joint cartilage—degenerative osteoarthritis—often from aging, repetitive use, injury, or excess weight. Cartilage breakdown leads to pain, stiffness, and reduced movement. Other forms are driven by immune-system inflammation (rheumatoid arthritis), infections, or crystal deposits (gout), but degeneration is the primary overall cause. Maintaining healthy weight and activity can slow progression.

Q: What are the first signs of arthritis?

A: Early signs of arthritis include joint pain and stiffness—often worse after rest or in the morning—reduced range of motion, swelling, warmth or redness around joints, and a grating or cracking sensation. Symptoms may be intermittent at first and can cause difficulty performing daily tasks; some types (like inflammatory arthritis) also cause fatigue, low-grade fever, or general malaise.

Q: Can arthritis be cured permanently?

A: Arthritis generally cannot be permanently cured. Many types especially osteoarthritis and autoimmune forms like rheumatoid arthritis are chronic, but symptoms can be well controlled with medication, lifestyle changes, physiotherapy, and surgery (joint replacement). Some reversible causes (e.g., infection-driven arthritis or gout when treated) can resolve. The care goal is symptom control, slowing progression, and preserving function.

Q: What foods are good for arthritis?

A: Foods that help arthritis include oily fish (salmon, mackerel) for omega‑3s; nuts, seeds (flax, chia) and olive oil for anti‑inflammatory fats; leafy greens, broccoli and other colorful vegetables; berries and cherries for antioxidants; whole grains and legumes for fiber; turmeric, ginger and garlic for anti‑inflammatory compounds; and low‑fat dairy for calcium and protein to support bone and joint health.

Q: What are the 3 common symptoms of arthritis?

A: Three common symptoms of arthritis are persistent joint pain that may worsen with activity, morning stiffness or reduced flexibility after periods of rest, and visible swelling or warmth around affected joints. These signs often limit range of motion, make daily tasks difficult, and can fluctuate in intensity over time depending on the type and severity of arthritis.

Q: What is the best treatment for arthritis pain?

A: The best treatment for arthritis pain is individualized: combine regular exercise, weight loss, physiotherapy and self-management with medications as needed. Use paracetamol or topical/oral NSAIDs for pain; topical capsaicin or topical NSAIDs for localized relief. For inflammatory arthritis, start DMARDs/biologics under specialist care. Corticosteroid or hyaluronic injections, joint replacement, heat/cold and assistive devices may help if severe.