The 5 Most Common Causes Of Elevated Alkaline Phosphatase

Alkaline phosphatase is an enzyme found in our body. We find it, especially, in the liver and bone tissue.

In this article we detail the 5 causes of elevated alkaline phosphatase. We can discover some diseases that are related to this imbalance.

Alkaline phosphatase

Alkaline phosphatase is an enzyme found in most tissues in the body. However, it predominates in the liver, bile ducts, and bone tissue.

In addition, it is distributed in several ways. All these can be quantified separately if required through a blood test.

  • Normal values ​​are described in a range of 30 to 140 IU / L.
  • When these levels exceed the higher limit of normal, the presence of different diseases can be suspected.  Below we detail the causes that can raise it.

5 causes that increase alkaline phosphatase

1. Liver diseases

Liver disease increases alkaline phosphatase

Alkaline phosphatase values ​​can be altered and elevated as a consequence of different liver diseases, according to this study by Dr. J. Sánchez Rodríguez. This is the case, for example, of viral hepatitis, in which not only transaminases are increased but also this enzyme.  This is due to inflammation of the organ and the overproduction of bilirubin.

In the same way, it usually happens in other acute diseases, such as bile duct obstruction in cholecystitis. Also in chronic diseases such as liver cirrhosis or in the consequences of liver cancer.

2. Bone diseases

One of the bone diseases that points to elevated alkaline phosphatase is Paget’s disease, according to this study from Washington University in St. Louis, Missouri. In this pathology, the bones are characterized by progressively deforming and widening. However, as the pathology is controlled, the levels are regulated again.

This enzyme is also increased in certain types of cancers that metastasize or invade the bone. As in the previous case, if they have timely and effective treatment, the values ​​may return to their normal range.

3. Tumors

Tumors increase alkaline phosphatase

One of the tumors or neoplastic processes that affects the elevation of alkaline phosphatase is Hodking lymphoma. This is a characteristic tumor of the lymph nodes that increases the levels of this enzyme.

As part of the involvement of lymphoma, the imbalance in liver function is found. This causes alteration of alkaline phosphatase values.

However, this is a laboratory finding that begins to show itself in the advanced stages of the disease. Therefore, it implies that it is a sign of seriousness when one is in severe phases of this condition.

Other tumors that are producers of alkaline phosphatase are cancers of:

  • Lung.
  • Ovary.
  • Prostate.
  • Pharynx.
  • Testicles
  • Also leukemias, which come from lines similar to lymphoma.

4. Pregnancy

From the third trimester, the placenta in the mother is a producer of the enzyme alkaline phosphatase. This influences the general maternal values ​​and increases them above the normal range, even reaching 140 to 250 IU / L.

However, as it is a physiological condition, this increase in the enzyme is not a cause for alarm if it is treated from the beginning, since it usually disappears after delivery, according to this research carried out by the Ramón y Cajal University Hospital (Madrid). In this case, it is a substance required for the synthesis of proteins, and the calcification of bones and cartilage in the fetus.

The problem would be if after birth the levels of the enzyme persist in those high ranges. That is when we should find what other cause should cause it.

5. Specific drugs

Specific medications that cause an increase in alkaline phosphatase

Many of the medications that are indicated, even for day-to-day diseases, have the characteristic of increasing the visible alkaline phosphatase enzyme. Among the drugs that frequently have this effect as part of their action are:

  • Antacids such as ranitidine.
  • Antiepileptics and anticonvulsants such as phenytoin and carbamazepine.
  • Macrolide antibiotics such as erythromycin.
  • Calcium channel blocking antihypertensives, such as verapamil.

Therefore, when visiting the doctor, each patient must inform about the medications they take. In this way, the increase in alkaline phosphatase can be foreseen and not think about possible diseases that may be increasing such values. This is achieved with an adequate medical history and a good relationship between the doctor and the patient.

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