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Alkaline Phosphatase (ALP)

Liver
Normal range
44–147 U/L
☎ When to call

Escalate the obstructive picture (jaundice, clay stools, dark urine, RUQ pain), not the isolated enzyme.

What you do
  • High ALP + high bilirubin + jaundice = obstructive picture — anticipate imaging
  • Isolated high ALP with normal GGT points at bone, not liver
Causes of HIGH alkaline phosphatase
Biliary obstruction (with high bilirubin)Bone disease, fractures, metsPregnancy (placental — normal)
Causes of LOW alkaline phosphatase
Not clinically significant
Source: Pagana, Mosby's Manual of Diagnostic and Laboratory Tests, 7th ed.Reference only — verify against your facility's policy.

Related cards

AST10–40 U/L (values vary by lab)ALT7–56 U/L (values vary by lab)Bilirubin0.3–1.0 mg/dLAlbumin3.5–5.0 g/dLAmmonia10–80 µg/dL (lab-specific)
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