Increased or decreased alpha amylase in the blood - causes and treatment

What is this enzyme and what is it for?

Amylase is a digestive enzyme that helps break down carbohydrates. However, for proper operation, its level must be within normal limits.

Amylase begins to be produced when the body consumes starchy foods. These are potatoes, rice, baked goods, etc. There are alpha, beta and gamma types.

Urine and blood are tested to determine amylase levels, and tests are performed on the same day to eliminate errors.

Blood is taken from a vein early in the morning on an empty stomach. When a person seeks medical help, tests are carried out at any time, but in such cases it is necessary to take into account the time of day and the food that the patient eats.

What is dangerous about changes in amylase levels?

In itself, the condition when amylase is elevated does not have clinical consequences for the body, however, it is an important marker of pancreatic damage. If an increase in the enzyme index is detected, the analysis is usually monitored within 24 hours, which makes it possible to assess the dynamics of the pathological process.

A decrease in the level of the enzyme against the background of deterioration in the patient’s well-being indicates severe destruction of pancreatic tissue.
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Standards for adults and children

Strict alpha-amylase levels are prescribed and vary depending on the age of the person. Based on these indicators, the efficiency of the digestive system is assessed. The following indicators are considered normal:

• In a child from birth to 2 years – 5 – 65 U/l.
• From 2 to 70 years – 25 – 125 U/l.
• After 70 - 20 - 160 U/l.

Women and men have the same standards. Slightly elevated levels of amylase in the blood do not cause much concern among doctors. However, if the deviation from the norm is double or more, this indicates a serious disruption of the body’s functioning.

An elevated index often results in abdominal pain, so your doctor will order special diagnostic tests, including alpha-amylase testing, to find out the cause and diagnose it.

Normal values

Total amylase by age

• 0-30 days (newborn): 0-6 units/l;
• 31-182 days: 1-17 units/l;
• 183-365 days: 6-44 units/l;
• 1-3 years: 8-79 units/l;
• 4-17 years: 21-110 units/l;
• after 18 years (adults): 26-102 units/l.

Pancreatic amylase by age

• 0-24 months: 0-20 units/l;
• 2-18 years: 9-35 units/l;
• after 18 years: 11-54 units/l.

(Please note that reference intervals may vary between laboratories, so for blood and urine tests please refer to the intervals listed on the report).

Reasons for high rates

A slight increase in the index by a few points is often a temporary phenomenon, does not affect the general condition of the patient and goes away on its own.

Total amylase in the blood may increase due to increased work of the pancreas. The enzyme quickly enters the bloodstream.

This may happen for the following reasons:

• A large amount of digestive fluid is produced, which enters the duodenum.
• There are obstacles that prevent him from moving normally in the sewer.
• Inflammatory reactions occur in the pancreas and surrounding systems. Subsequently, tissue destruction may occur, which is necrotic in nature.

This is due to factors such as:

• Acute pancreatitis is inflammation of the pancreas. Most often diagnosed in adults. The organ’s own enzymes are disrupted, which enter the blood in large quantities and become dangerous to human life. The pathology can progress to pancreatic necrosis - death of the pancreas (complete or partial), accompanied by an infectious process in general and an inflammatory process in the abdominal cavity. This usually occurs in patients with alcoholism when amylase levels become 8 times higher than normal. The mortality rate is about 10-15%.
• Chronic pancreatitis is a disorder of the pancreas. The excess can be from 3 to 5 times.
• Cancerous tumors, and more often the head of the gland is affected. The enzyme content is 4 times higher than normal.
• The presence of stones in the kidneys or gall bladder and its ducts. Blockage of the pancreatic duct by a stone, metastasis or tumor.
• Peritonitis is an inflammation of the parietal and visceral peritoneum, accompanied by a severe general condition of the body. High levels of amylase are observed as a result of irritation of the gland, which begins to actively work.
• Renal failure is a disorder of kidney function. The ability to produce and excrete urine is impaired, so enzymes are retained in the body.
• Diabetes mellitus is a metabolic disorder. The rate of action of amylase increases because it is not consumed properly.
• Mumps is a viral disease characterized by fever, general intoxication and the development of inflammation of the salivary glands (inflammation of the salivary glands). Affects glandular tissues of other organs and the central nervous system. After recovery, the level returns to normal.
• Ovarian cancer in women.
• Stomach ulcer.

High amylase levels can occur in conditions such as:

• Abdominal trauma.
• Intestinal obstruction.
• Herpes virus.
• Intestinal ischemia.
• Acute appendicitis.
• Ectopic pregnancy.
• Ruptured aortic aneurysm.
• Postoperative complications.
• Macroamylasemia is a disease characterized by the presence of macroamylase in the blood.
• Genetic predisposition—impaired penetration of amylase into urine.
• Stressful situations.

Poor diet and alcohol abuse also increase amylase levels. The cause may also be uncontrolled use of certain medications.

Treatment of disorders

The only way to normalize amylase concentrations is to identify and eliminate the cause of the condition. A single biochemical blood test is usually not enough to accurately determine the disease, so patients require a comprehensive study. It includes ultrasound of the abdominal cavity, general blood test, endoscopic examination of the digestive system (for example, gastroduodenoscopy).

Based on the results, the doctor draws conclusions and begins to treat the pathology.

In some conditions (tumors, blockage of the bile ducts, necrosis of pancreatic tissue, peritonitis), patients require immediate surgical intervention.

The treatment regimen depends on the disease, severity of symptoms, age and general condition of the patient. In case of disturbances in the functioning of the pancreas and inflammation of the tissues of the organ, antibiotics and drugs are prescribed that reduce the load on the organ, reduce blood circulation and suppress the excessive production of enzymes. For diabetes mellitus, renal failure, cholelithiasis and other pathologies, other treatment regimens are prescribed aimed at reducing unpleasant symptoms and eliminating pathological processes.

Symptoms

Excessive levels of this enzyme are diagnosed in diseases of the pancreas and other internal organs and require therapy. The disease is accompanied by symptoms:

• Pain in the hypochondrium and epigastrium on the right. This symptom worsens after eating. After defecation, the pain goes away.
• Impaired passage of stool, diarrhea is more common, stool is released in small quantities. The reason is a violation of the contractile function of the intestine.
• Apathy, drowsiness.
• Reduced performance.
• Deterioration in sleep quality does not bring increased strength.
• Attractive pain in the lower abdomen during pregnancy.

A patient's visit to a doctor with the above symptoms often leads to hospitalization. In this case, it is necessary to identify the root cause of the illness.

Amylase and its role in the body

Amylase (alpha-amylase) is an essential enzyme that is involved in digestive processes and ensures the breakdown of carbohydrates. With its help, nutrients entering the body break down into starches and polysaccharides, after which they are absorbed into the blood, supporting metabolism and vital processes. The production of the substance occurs in the pancreas and salivary glands, and an analysis to determine its content is prescribed if organ diseases are suspected. An increase in indicators may indicate dangerous disorders that require immediate medical attention.

When are tests ordered?

In various pathologies, an increase in amylase in the blood is observed, while the amount of the enzyme in saliva does not increase.

The most accurate determination of the level is possible with a biochemical blood test. Prescribed in the following situations:

• Inflammation of the parotid gland resulting from mumps, blockage, etc.
• Viral, infectious pathologies.
• Diabetes.
• Acute pancreatitis.
• Cystic fibrosis is an inherited disease caused by a gene mutation that affects cellular salt metabolism.

The examination is indicated for acute abdominal pain, which usually indicates a malfunction of the gastrointestinal tract.

Decreased amylase concentration

The reasons for the decrease in enzyme concentration are usually hepatitis, occurring in acute or chronic form. With such diseases, disruptions in carbohydrate metabolism occur, which causes an increase in the load on the fermentation system and changes in the parameters of a biochemical blood test. The second reason for the decrease in the level of the substance is neoplasms of the pancreas.

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Typically, tumor processes cause an increase in the concentration of amylase (especially in the initial stages), but after the degeneration of its tissues, the secretion of enzymes is disrupted. Due to organ injuries, intoxications of the body and poisoning, it is also possible for the enzyme concentration to change either down or up.

How to normalize an indicator

The production of amylase is an independent process in the body. In case of significant excess of its norm, it is necessary to carry out appropriate treatment, since this phenomenon negatively affects the patient’s condition and can be life-threatening.

Only an experienced specialist should prescribe the necessary therapy. Self-medication can not only be ineffective, but also lead to disastrous consequences.

Treatment measures can only be determined after research and an accurate diagnosis have been made. They should be aimed at eliminating the cause of the pathological condition.

To get rid of the underlying disease, a prescription for medications is written.

Treatment is prescribed individually, taking into account the age category, stage of the disease and the general condition of the patient.

Diet

For diabetes, pancreatitis, digestive tract disorders and other pathologies, you must follow a special diet. It is important to adjust your diet to reduce amylase levels.

The diet consists of the following elements:

• It is necessary to control the amount of protein entering the body.
• It is necessary to limit or exclude carbohydrates and fats from the diet as much as possible.
• It is important to avoid fried, spicy, salty, smoked, sour and alcoholic drinks. These products irritate the gastric mucosa.
• It is necessary to limit the intake of fiber into the body.
• It is not recommended to use marinades.
• You cannot eat onions, garlic and radishes.
• He should include in his diet a lot of fresh fruits and vegetables, natural juices and cereals.
• Fish and meat should be lean.

Food should be consumed in small portions 5-6 times a day.

Improper nutrition has a bad effect on the condition and function of the pancreas; following a diet can shorten the treatment period.

Prevention of amylase elevations

Prevention of pathologies associated with increased amylase involves proper lifestyle and diet. It is necessary to exclude spicy, fatty and fried foods, baked goods, coffee and alcohol from the diet. The menu should consist of cereal dishes, fruits and vegetables (with the exception of onions, garlic, radishes and sorrel), and boiled lean meat.

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Food should be boiled, baked without oil or cooked in a slow cooker, and eaten in small portions - at least four to five times a day, in small portions. The basic principle of nutrition when amylase levels are elevated is to avoid prolonged hunger, but not to overeat. In addition, it is recommended to quit smoking, reduce stress if possible and engage in light physical activity.

If you are prone to disorders of the digestive tract and other organs, during which disruptions in the production of enzymes occur, you need to regularly undergo preventive examinations with a doctor and take tests.

Consequences

If persistent disturbances in enzyme levels are detected, competent and, most importantly, timely therapy should be carried out.

Failure to comply with this rule can lead to the following complications:

• Pathologies of the gallbladder and the formation of cholelithiasis (more common in women).
• Metabolic disorders.
• Development of anemia (anemia).
• Weight loss.
• Dry skin.
• Increased fragility of hair and nails.
• Development of diabetes mellitus.

When the stomach and intestines are not functioning, food is less easily digested and absorbed, resulting in flatulence, abdominal pain and diarrhea.

If a high level of the enzyme is detected, treatment and diet are urgently required. Thanks to this, you will get rid of unpleasant symptoms and remain healthy for a long time.

What to do if amylase is low?

Low levels of the enzyme are much less common than high levels. Such changes in the analysis are typical for pancreatic failure, cystic fibrosis, severe liver damage (liver failure), pancreaectomy (removal of the pancreas).

Increased blood cholesterol levels can lead to low pancreatic amylase levels. In children of the first year of life, the level of the enzyme is much lower than in adults. This is due to the fact that the food they receive is devoid of sufficient amounts of complex carbohydrates.

Biochemical blood test / “9 months”

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No. 3, March 2008.

During 9 months of pregnancy, the expectant mother has to undergo a considerable number of tests. Why is this necessary and what do their results mean?

A biochemical blood test allows you to evaluate the functioning of many internal organs - kidneys, liver, pancreas, etc. In addition, a biochemical blood test shows which microelements are missing in a woman’s body. Since various changes associated with metabolic processes occur during pregnancy, assessment of biochemical blood parameters is important for the timely diagnosis of pathological conditions that may arise in the body of the expectant mother.

Let us list the main indicators of a biochemical blood test.

Total protein is an indicator of protein metabolism, reflecting the total content of all proteins in the blood serum. The normal concentration of total protein in the blood is 63-83 g/l. Plasma proteins are divided into groups with different structures and functions, which are called protein fractions. Among the protein fractions, albumins and alpha, beta, and gamma globulins are distinguished. Their definition and correlation allows a more accurate assessment of dysfunctions of internal organs. Physiological hypoproteinemia (decreased protein levels) can be observed in pregnant women (especially in the third trimester) and during lactation due to a decrease in the number of red blood cells in plasma associated with an increase in total plasma volume. A slight decrease in total protein (55-65 g/l) during pregnancy is not a pathology. An increase in protein concentration in the blood serum is observed due to pathology - dehydration and thickening of the blood due to fluid loss.

Lipids (fats) - there are 4 main groups of lipids in the blood: cholesterol (cholesterol), triglycerides, phospholipids, fatty acids. Cholesterol is the most important indicator of lipid metabolism, serves as a structural component of cell membranes, participates in the synthesis of sex hormones, bile acids, vitamin D. There are fractions of low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL) and some others, differing in composition and functions. The level of cholesterol in the blood largely depends on age. The normal level of cholesterol in the blood of a young woman is 3.15-5.8 mmol/l. During pregnancy, there is a physiological increase in the level of total cholesterol (up to 6.0-6.2), which is due to the increased formation of endogenous (produced in the liver) cholesterol, necessary for the construction of the vascular bed of the placenta and fetus. An increase in cholesterol levels in the blood is considered a factor predisposing to the development of atherosclerosis - the formation of specific plaques in blood vessels.

Carbohydrates are the main source of energy for the body.

Glucose is a source of energy and a component of the vital activity of any cell in the body. The normal blood glucose concentration in adults is 3.9-5.8 mmol/l. In healthy pregnant women, glucose levels may be slightly reduced (to 3.5-4.0 mmol/L) as the growing fetus consumes increasing amounts of glucose.

During pregnancy, the body's increased need for insulin (a pancreatic hormone that regulates carbohydrate metabolism) exceeds the functional capacity of pancreatic cells that produce insulin. This may result in insufficient secretion to maintain normal blood glucose levels. During this period, in some pregnant women, a relative lack of insulin can cause the development of gestational diabetes (pregnant diabetes), as evidenced by an increase in blood glucose. blood glucose testing is recommended for all expectant mothers between the 24th and 28th week . This analysis is carried out additionally, without examining other indicators of biochemical analysis.

specific proteins called enzymes participate as catalysts in all biochemical reactions . Each reaction involves its own specific enzyme, so their number is in the hundreds. In this case, only a few dozen enzymes have diagnostic value.

Alanine aminotransferase (ALT) - normally in women it is up to 32 U/l. The highest ALT activity is detected in the liver and kidneys. ALT levels increase when liver and kidney cells are damaged by viruses or chemicals.

Aspartate aminotransferase (AST) - normally in women it contains up to 30 U/l. AST is found in heart, liver, nerve, and kidney tissues; accordingly, it is determined in order to identify the pathology of these organs. During normal pregnancy, ALT and AST levels do not change. A slight increase in transaminases is observed with mild to moderate gestosis. A multiple increase in the activity of ALT (up to 100 IU/l) and AST (up to 160 IU/l) is observed with severe gestosis. This result indicates that the liver cannot cope with the load.

Alkaline phosphatase is present in almost all tissues of the body. The highest activity of alkaline phosphatase is found in the cells of bone tissue, liver, kidneys, intestinal mucosa and placenta. An increase in blood alkaline phosphatase activity is associated mainly with bone diseases and liver pathology. In pregnant women, especially in the third trimester, there is also a physiological increase in the activity of this enzyme; in this case, the placenta is an additional source of alkaline phosphatase. Normal values ​​of alkaline phosphatase in adults are up to 150 U/l. In pregnant women, this figure can increase to 240 U/l.

Pancreatic amylase is synthesized by pancreatic cells. Normally, adults contain up to 50 U/l. The level of pancreatic amylase in the blood increases with pathology of the pancreas.

Pigments are colored organic substances. Bile pigments (bilirubin and urobilinogen) and porphyrins (red pigments) are of diagnostic importance.

Bilirubin is a bile pigment that is formed as a result of the breakdown of hemoglobin, the pigment in red blood cells to which oxygen attaches. When hemoglobin breaks down, free bilirubin is initially formed, which is transported from the spleen to the liver in combination with albumin. Then, in the liver, free bilirubin binds to a special acid (glucuronic acid), resulting in the formation of direct, less toxic bilirubin, which is actively released into the bile ducts and excreted with bile. It is one of the main components of bile. Bilirubin is contained in blood serum in the form of two fractions : direct (bound) and indirect (free) bilirubin , together making up the total blood bilirubin . The normal level of total bilirubin, including during pregnancy, is 3.4-17.2 µmol/l. When the concentration of bilirubin in the blood increases (with accelerated breakdown of red blood cells, pathology of the liver or biliary tract), jaundice appears . This is due to the fact that in hyperbilirubinemia, bilirubin accumulates in the eyeball and skin.

Nitrogenous substances are the end products of the breakdown of proteins and nucleic acids - urea, creatinine, creatine, ammonia, uric acid. But in blood biochemistry, urea and creatinine are determined mainly.

Urea - serum urea levels, along with creatinine, are used to assess renal excretory function. The normal concentration of urea in the blood is 2.5-6.3 mmol/l. An increase in the concentration of urea in the blood is observed in various kidney diseases.

Creatinine - normal creatinine values ​​in women are 53-97 µmol/l. An increase in serum creatinine indicates a decrease in the level of renal filtration (decreased kidney function). Blood creatinine concentrations in pregnant women are physiologically reduced (by 40%) due to increased blood volume, increased renal plasma flow and filtration, especially in the second and third trimesters of pregnancy. For pregnant women, the normal creatinine level is 35-70 µmol/l.

Microelements are chemical substances whose content in the body ranges from a few micrograms to several nanograms. But, despite such a small amount, they play a significant role in all biochemical processes of the body.

Iron is a vital trace element involved in oxygen transport. The normal iron level in women is 8.95-30.4 µmol/l. Iron is part of erythrocyte hemoglobin, muscle myoglobin and some enzymes. With iron deficiency, iron deficiency anemia develops - the most common pathology of pregnancy, observed mainly in the second or third trimester due to insufficient satisfaction of the increased need of the mother and fetus for substances necessary for hematopoiesis. However, with normal hemoglobin levels, low iron levels may occur, which is an indicator of hidden iron deficiency anemia - which is why it is important to monitor iron levels in a biochemical blood test during pregnancy. The greatest loss of iron occurs during bleeding.

Sodium is the most important component of the extracellular space, which is associated with the regulation of water distribution in the body. The normal sodium concentration is 136-145 mmol/l. Sodium is involved in the mechanisms of excitation of nerve and muscle cells. A decrease in its level in plasma causes general weakness and can lead to the development of various neurological disorders. An increase in sodium concentration in the blood is observed when water intake is limited, vomiting, for example, during toxicosis of the first half of pregnancy or diarrhea (loose stools) without replacing fluid loss.

Potassium is the main intracellular microelement. The normal potassium level in adults is 3.5-5.5 mmol/l. Hyperkalemia is observed in renal failure and drug overdose. When potassium levels decrease, which can occur with diarrhea and vomiting, heart rhythm disturbances, muscle weakness, and decreased muscle tone develop.

Calcium is the main component of bone tissue. The normal calcium concentration in young women is 2.20-2.55 mmol/l. Calcium performs many functions in the body: it participates in the processes of muscle contraction, hormone secretion, regulation of the activity of many enzymes, and blood clotting. Calcium deficiency is observed during pregnancy, which is explained by the child’s need for building material for bones. If calcium in the analysis decreases, it is necessary to replenish its content with the help of medications.

Phosphorus - the main part of it is found in bone tissue in the form of calcium salts, the rest is mainly in soft tissues. The normal phosphorus concentration for an expectant mother is 1.0-1.40 mmol/l. An increase in its content in the blood is observed with an overdose of vitamin D. Decreased function of the parathyroid glands, renal failure.

The biochemical composition of the blood is examined twice during pregnancy: at the very beginning of pregnancy, when registering the pregnant woman, and at 30 weeks of pregnancy, if not required more often. Blood for biochemical analysis is taken from a vein in the morning on an empty stomach. At least 12 hours must pass since the last meal.

We have provided a list of the necessary, most frequently performed studies, but in each case the set of positions being studied is determined by the doctor. Based on necessity, in each specific case the number of indicators can be reduced or increased.

Nona Hovsepyan, doctor, INVITRO Independent Laboratory