What level of Alkaline Phosphatase is Dangerous?

What level of Alkaline phosphatase is dangerous?

Alkaline phosphatase (ALP) is an enzyme that is present in the various tissues of the body such as liver, bones, intestines, placenta and kidneys. The major role of ALP is to maintain the physiological processes such as bone mineralization, liver and intestinal functions. To understand what level of Alkaline phosphatase is dangerous, let’s see the discussion below.

Normal Range of Alkaline Phosphatase Levels

Alkaline phosphatase ALP levels are determined by blood tests. The international reference values for alkaline phosphatase can vary among the laboratories, and it depends upon factors like age, sex, and overall health of an individual. The normal range of ALP is between 20 to 140 international units per liter (IU/L). 

Factors Affecting the Normal Levels of ALP.

Alkaline phosphatase (ALP) levels are influenced by various factors. Liver and bone disorders, such as hepatitis or osteoporosis, can elevate ALP. Medications, pregnancy, and age also impact levels. Malnutrition and certain cancers may decrease ALP. Understanding these factors aids in interpreting ALP levels for accurate health assessments.

i. Age and Sex

In children and adolescents, Alkaline phosphatase levels are naturally higher due to bone growth. Pregnant women may also experience a temporary increase. Older adults have slightly elevated levels as bone turnover increases with age.

Dangerous Levels of ALP

The alkaline phosphatase levels are dangerous once it exceeds 300 (IU/L). This is of serious concern which may indicate certain medical conditions such as liver disease, liver cancer, bone disease, bone cancer, kidney cancer and certain other ailments.

Interpreting Alkaline Phosphatase Levels

To interpret what level of alkaline phosphatase levels is dangerous you should not solely depend on absolute values of ALP, but it also involves a comprehensive assessment of the individual’s overall health and clinical picture. However mild, moderate and severe level of ALP can be seen in different ailments.

i. Mild Elevation

A mild increase (up to 1.5 to 2 times the upper limit of normal) can be present in conditions such as pregnancy, adolescence, or mild liver or bone disorders.

ii. Moderate Elevation

Moderate increases (2 to 5 times the upper limit of normal) may signal liver diseases such as hepatitis, cirrhosis, or biliary obstruction. Bone disorders like Paget’s disease.

iii. Severe Elevation

Levels exceeding 5 times the upper limit of normally indicates bone or liver tumors, advanced liver disease, or other significant health issues.

Conditions Associated with Elevated Alkaline Phosphatase

Conditions associated with elevated alkaline phosphatase levels include liver diseases such as hepatitis, cirrhosis, and liver tumors. Bone disorders like Paget’s disease, bone fractures, and bone cancer can also contribute. Intestinal conditions, such as celiac disease, and certain medications may elevate alkaline phosphatase. Timely medical evaluation is crucial for accurate diagnosis and management.

i. Liver Disorders

Acute Hepatitis usually presents with symptoms like jaundice-yellowing of sclera, vomiting, loss of appetite, yellow colored urine and abdominal pain. Lab values of ALP are elevated in this condition. 

However, a chronic medical ailment such as a patient with anti-HCV positive may have developed Hepatic cirrhosis with increased ALP levels.

ii. Bone Disorders

Elevated ALP level is a sign of bone disease like Paget’s disease, bone tumor or certain other bone disorders.

iii. Intestinal Issues

Inflammatory bowel diseases-IBS patient presents with altered bowel habits with increase in the alkaline phosphatase ALP levels in blood. 

iv. Gallbladder Stones

Inflammation of gallbladder—Cholangitis, patient presents with pain in the right upper quadrant of abdomen, vomiting, fever. Lab values show raised ALP levels.

Similarly, Choledocholithiasis is a condition of stones in your gallbladder or bile duct. Lab values show raised ALP levels in blood. However, your healthcare professional will perform ultrasound to confirm the presence of stones in the gallbladder before cholecystectomy—surgical removal of gallbladder.

v. Medications

Certain medicines such as anti-seizures may increase the ALP levels in blood.

When to Seek Medical Guidance

Elevated alkaline phosphatase levels can be dangerous when exceeding 300 IU/L, it’s necessary to seek medical guidance as soon as you come to know about the elevated alkaline phosphatase levels. The absolute level alone may not determine the severity of a medical condition. Other factors such as the overall clinical picture, additional liver function tests LFTs, and diagnostic information are crucial for accurate assessment.

If you or your healthcare provider notice significant deviations from the normal range, further investigations, including imaging studies and other lab tests, may be warranted to identify the root cause.


Alkaline phosphatase is a valuable enzyme reflecting the health of the liver and bones. Interpretation of its levels and a thorough evaluation by a healthcare professional is essential for accurate diagnosis and appropriate management. Never self-diagnose or self-treat based solely on lab results; always seek guidance from qualified medical professionals for a comprehensive understanding of your health status.

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