ALP reference ranges
| Group | Normal Range |
|---|---|
| Adults | 44–147 IU/L |
| Children / adolescents | Up to 500 IU/L (bone growth) |
| Pregnancy (3rd trimester) | Up to 3x normal (placental ALP) |
What does high ALP mean?
Liver vs bone origin
ALP comes from both liver and bone. Raised ALP with raised GGT points to a liver or bile duct cause (cholestasis, bile duct obstruction, primary biliary cholangitis). Raised ALP with normal GGT points to a bone cause — Paget's disease, bone metastases, healing fractures, or hyperparathyroidism. In children, ALP is naturally high during growth spurts and is not a cause for concern.
Causes of raised ALP
| Cause | Category |
|---|---|
| Bile duct obstruction (gallstones, cancer) | Liver/biliary |
| Primary biliary cholangitis (PBC) | Liver/biliary |
| Paget's disease of bone | Bone |
| Bone metastases | Bone |
| Hyperparathyroidism | Bone |
| Healing fractures | Bone |
| Pregnancy (3rd trimester) | Physiological |
Questions to ask your doctor
- Is my raised ALP from the liver or bone?
- Should I have a GGT to help distinguish the cause?
- Do I need a liver ultrasound or bone scan?
Medical Disclaimer: For educational purposes only. Always consult a qualified healthcare professional for diagnosis and treatment.