Amylase and Lipase Tests

What are amylase and lipase tests?

Amylase and lipase tests are basically tests for the enzymes amylase and lipase. Both enzymes are very important to the digestive system. Amylase helps in starch catabolism. Lipase helps in digestion of fats. These enzymes are produced by the pancreas, a glandular organ, lying behind the stomach. The pancreas also produces other enzymes besides amylase and lipase.

The levels of amylase and lipase in the bloodstream are increased when the pancreas is inflamed. This condition is known as pancreatitis. Learn more about acute pancreatitis here

Pancreatitis can be detected through amylase and lipase tests.  These tests detect the concentration of these enzymes in your blood stream. Your physician will check the levels of these enzymes when you exhibit symptoms of acute pancreatitis or any other disorder of the pancreas and when your physician wants to confirm the diagnosis.

Symptoms associated with pancreatitis include:

Abdominal pain also has a host of potential causes. These include ectopic pregnancy in women, appendicitis, and blockage of the intestine, among others. Amylase and lipase tests are important because they help determine if these symptoms are as a result of pancreatitis, or something else.

Amylase and lipase tests
Photo Credit: Healthline

What are the normal levels of amylase and lipase?

The glands of the body produce enzymes to carry out a specific task. This implies that each is enzyme has a unique function. Amylase, for instance, is produced by the pancreas to catabolize carbohydrates into simple sugars. On the other hand, lipase is produced by the body to help digest fats into fatty acids. The small intestine then absorbs the sugars and fatty acids. Some amylase and lipase are present in the saliva and in the stomach. However, a greater quantity of these enzymes produced by the pancreas is released into the small intestine.

  Amylase levels
Normal 23-85/L (some lab results go up to 140 U/L)
Pancreatitis suspected >200 U/L

In healthy individuals, normal level of amylase in the blood is around 23-85 units per liter (U/L). However, some laboratories peg their range up to 140U/L.

Depending on the laboratory, normal levels of lipase may range from 0-160 U/L.

If the pancreas is diseased or damaged, the concentrations of these enzymes will be elevated. Pancreatitis is damaged when amylase and lipase tests show a result more than three times normal. In rare cases, however, the levels of amylase and lipase may remain normal even in the presence of significant damage to the pancreas. In these cases, abdominal pain manifests as the most common symptom. In the initial stage of pancreatic damage, amylase or lipase levels may also be normal.

What causes abnormal amylase and lipase levels?

There are a number of reasons why this may happen. These include:

  • A sudden inflammation of the pancreas, referred to as acute pancreatitis
  • Pancreatic cancer
  • Chronic pancreatitis, prolonged inflammation of the pancreas
  • Cholecystitis (inflammation of the gallbladder)
  • Pancreatic pseudocyst
  • Mumps
  • Ectopic pregnancy
  • Blockage of the salivary gland
  • Intestinal blockage
  • Perforated ulcer
  • Macroamylasemia
  • Eating disorders
  • Kidney problems
  • Medications

If the levels of amylase are lower than normal, then it may be an indication of severe pancreatic injury, prediabetes, or diabetes and high triglycerides.

Certain medications can elevate the concentration of amylase in your blood even in the absence of illnesses. These include:

  • Medications used for the treatment of psychiatric conditions
  • Corticosteroids
  • Birth control pills
  • Some chemotherapeutic drugs
  • Methyldopa
  • Medications used for the control of blood pressure
  • Thiazide diuretic
  • Some antibiotics
  • Antiviral medications

Levels of lipase in the blood may rise astronomically if a person is experiencing:

  • Pancreatic cancer
  • Acute pancreatitis
  • Chronic pancreatitis
  • Severe gastroenteritis or stomach flu
  • Inflammation of the gallbladder (cholecystitis)
  • Macrolipasemia
  • HIV infection
  • Duodenal cancer

People experiencing familial lipoprotein lipase deficiency may also have abnormal levels of lipase.

Medications that affect the levels of amylase in the blood also affect the levels of lipase.

Amylase and lipase during pregnancy

Acute pancreatitis does not occur commonly during pregnancy. However, if it does occur, it may cause problems with your baby. Studies suggest that levels of amylase and lipase in the serum do not change significantly during pregnancy. What this implies is that the levels of amylase and lipase in pregnant women are the same as that in non-pregnant women. Hence, increases in serum amylase and lipase levels during pregnancy should not be considered the same way they are in non-pregnant women.

Preparing for amylase and lipase tests

No special preparation is required for amylase and lipase tests. You may put on a short-sleeved shirt or a loose fitting shirt so that your physician may have easy access to a vein in your arm.

What should I expect during amylase and lipase tests?

If you are experiencing abdominal pain, you should not jump to the conclusion that you have acute pancreatitis. Abdominal pain has many causes. Amylase and lipase tests are just pieces of the puzzle. Your physician will first ask of your medical and family history, conduct a physical examination, and then inquire from you if you are taking any medications.

To conduct amylase and lipase tests, a health professional will perform the following procedure:

  • An antiseptic will be used to clean the area of skin around a vein on the back of your hand or elbow.
  • An elastic band will be wrapped around your upper arm to facilitate pooling of blood into your vein.
  • A needle will be inserted into the vein
  • Blood will be drawn and put into a small tube or vial. It takes at most two minutes to get the blood.
  • The elastic band is removed while the blood is sent to the laboratory for analysis.

You may experience some pain and bruise at the site of insertion. Infection, excessive bleeding, and fainting may occur, but it rare. Because high amylase levels are associated with decreased kidney function, your physician may order for a urine amylase test or other blood tests.

What do amylase and lipase test results mean?

If your level of amylase and lipase are higher than they should be, then it may be an indication of pancreatic disease or any other disease. Studies have shown that if the levels of amylase and lipase are three times greater than normal, then a diagnosis of pancreatitis is imminent, according to guidelines from the American College of Gastroenterology (ACG). Lipase levels are not the sole determinant of the severity of acute pancreatitis. Abnormal amylase and lipase tests result may warrant the conduct of other tests such as endoscopy, MRI scan, CT scan, and ultrasound.

A high amylase level tells your physician that you’ve got a problem. However, it may not necessarily involve your pancreas. It should be noted that lipase levels are usually more specific for pancreatic disorders, compared to amylase levels. Evaluating the results of both amylase and lipase tests can help your physician rule out or diagnose pancreatitis and other pancreatic conditions.

If you have severe abdominal pain, please consult your physician immediately. Based on the results gotten from amylase and lipase tests, and your medical history, you physician will decide whether or not you need an additional test or what kind of treatment you need.