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How to interpret ALP results?
ALP results should be interpreted according to other tests in the liver panel or the signs and symptoms of the patient.
In most cases, ALP is not the only abnormal result of the liver panel, and this contributes to trace the problem. However, in some cases, ALP is the only one biochemical test that is raised or it may be disproportionally elevated. In these cases, it might be useful to determine which isoform of ALP is found at such high levels in the blood. There are different isoforms in different tissues, so that will help us trace the source of the problem.
We usually find high ALP levels in cholestatic liver disease. In this case, ALP levels go up 4 times as normal, and this happens to 75% of people with cholestasis. When levels are moderately elevated, the test is nonspecific and does not necessarily point out cholestasis. It can be viral hepatitis, chronic hepatitis, cirrhosis, and many other disorders. Even non-hepatic diseases can trigger moderately high levels of ALP.
Mild elevations (lower than 50% high) of ALP are not alarming. However, these patients are recommended to stay under observation with periodic monitoring to determine the cause of the elevation.
On the other hand, low levels of ALP are also significant to diagnose certain liver and non-liver diseases. Wilson disease with fulminant hemolysis may lead to low levels of ALP because zinc is displaced by copper. Low levels of ALP are also common in zinc deficiency, hypothyroidism, and pernicious anemia.
