Amylase and Lipase Tests
One of the causes of severe abdominal pain is inflammation of the pancreas. A few blood tests can help determine the cause of abdominal pain. C...

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What Are Amylase and Lipase Tests?

Amylase and lipase are key digestive enzymes. Amylase helps your body break down starch. Lipase helps your body digest fats. The pancreas, a glandular organ that sits behind the stomach, produces both of these enzymes.

Inflammation of the pancreas, also called pancreatitis, commonly causes high levels of amylase and lipase in the bloodstream. Amylase and lipase tests are used to detect this. These tests measure the amount of these enzymes circulating in your bloodstream. They’re typically done when you have symptoms of acute pancreatitis or another pancreatic disorder and your doctor wants to confirm the diagnosis.

Symptoms of pancreatitis may include:

  • severe abdominal pain
  • back pain
  • fever
  • nausea
  • vomiting
  • loss of appetite

There are many other potential causes of abdominal pain besides pancreatic problems. Other causes include appendicitis, ectopic pregnancy in women, and intestinal blockage, among others. Checking amylase and lipase levels is important to help determine if the cause of these symptoms is pancreatitis, or something else.

What Are Normal Levels of Amylase and Lipase?

Enzymes are proteins produced by the body to do a particular job. The pancreas produces amylase to break down the carbohydrates in food into simple sugars. The pancreas makes lipase to digest fats into fatty acids. Sugars and fatty acids can then be absorbed by the small intestine. Some amylase and lipase can also be found in saliva and in the stomach, but most of it is made in the pancreas and released into the small intestine.

In a healthy individual, a normal blood amylase level is 23-85 units per liter, (U/L). Although, some lab results for amylase go up to 140 U/L.

A normal lipase level is 0-160 U/L.

If the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal. Amylase levels more than four times normal levels, or greater than 450 U/L, and lipase levels greater than 400 U/L, are likely to mean there’s damage to your pancreas or pancreatitis.

What Causes Abnormal Amylase Levels?

There are many reasons why a patient might have abnormal levels of amylase in their blood. These include:

  • acute pancreatitis, which is a sudden inflammation of the pancreas
  • chronic pancreatitis, which is a long-term inflammation of the pancreas
  • pancreatic pseudocyst, which is a fluid-filled sac in the abdomen
  • pancreatic cancer
  • cholecystitis, which is an inflammation of the gallbladder
  • ectopic pregnancy, which is an egg implantation in the fallopian tube
  • mumps
  • salivary gland blockage
  • intestinal blockage
  • bile duct blockage
  • macroamylasemia, which is the presence of macroamylase in your blood
  • perforated ulcer

If the amylase level is too low, it may indicate certain pancreatic cancers, kidney disease, or toxemia of pregnancy.

There are some medications that can increase the amount of amylase in your blood without any illness present:

  • aspirin
  • some birth control pills
  • corticosteroids
  • some chemotherapy drugs, including asparaginase
  • cholinergic drugs, including pilocarpine and neostigmine
  • methyldopa
  • thiazide diuretics
  • simvastatin
  • opiates, including codeine and morphine

What Causes Abnormal Lipase Levels?

Lipase levels may be at abnormally high levels if a patient is experiencing:

  • acute pancreatitis, which is a sudden inflammation of the pancreas
  • chronic pancreatitis, which is a long-term inflammation of the pancreas
  • pancreatic cancer
  • severe gastroenteritis, or “stomach flu”
  • cholecystitis, which is an inflammation of the gallbladder
  • celiac disease, which is an allergy to gluten
  • duodenal ulcer
  • macrolipasemia

Abnormal levels of lipase may also exist in patients with familial lipoprotein lipase deficiency.

Drugs that may affect the levels of lipase in your blood include:

  • some birth control pills
  • cholinergic drugs, including pilocarpine, neostigmine, and bethanechol
  • thiazide diuretics
  • loop diuretics
  • opiates, including codeine and morphine
  • meperidine

Amylase and Lipase During Pregnancy

Acute pancreatitis is rare during pregnancy. However, it can lead to problems with your baby if it does occur.

Research suggests that serum amylase and lipase levels are unchanged during pregnancy. In other words, what is considered a normal level of amylase and lipase is about the same in pregnant women versus women who aren’t pregnant. Increases in serum amylase and lipase activities during pregnancy should be considered the same way they are in non-pregnant women.

How Should You Prepare for an Amylase and Lipase Test?

There’s no special preparation necessary for an amylase and lipase blood test. You may want to wear a loose fitting or short-sleeved shirt so your doctor can easily access the vein on your arm.

What to Expect During an Amylase and Lipase Test

There are many reasons why you might be experiencing abdominal pain or other symptoms. Amylase and lipase tests are just a piece of the puzzle. Your doctor will first take a medical and family history and perform a physical examination. They will also ask if you’re taking any medications.

An amylase and lipase test requires a health professional to take a small amount of blood from your vein. The test is typically administered as follows:

  1. A health professional will clean the area of skin around a vein in your elbow or on the back of your hand with an antiseptic.
  2. An elastic band will be applied around your upper arm to apply pressure and allow your blood to fill the vein.
  3. A needle is inserted into the vein.
  4. Blood is removed and put into a vial or small tube. Collecting the blood should only take a minute or two.
  5. The elastic band is removed.
  6. The blood is sent to a laboratory for analysis.

A small amount of pain and bruising is possible at the site of insertion. Excessive bleeding, fainting, lightheadedness, and infection are rare but also possible. Since high amylase levels also may be associated with decreased kidney function, your doctor may order a urine amylase test in addition to the blood test.

What Do the Test Results Mean?

When levels of lipase and amylase are higher than normal, it may indicate a pancreatic injury or another disease. Researchers can’t agree on a cutoff value for amylase and lipase levels. Most studies show that levels of greater than three to five times the upper limit of normal can usually lead to a diagnosis of pancreatitis, according to guidelines from the American College of Gastroenterology (ACG). Lipase levels can’t be used to determine the severity of an acute pancreatitis attack.

Elevated amylase levels show your doctor that there’s a problem, but that problem may not necessarily involve your pancreas. Lipase levels, however, are usually more specific for pancreatic disorders. Evaluating the results of the two tests as well as your symptoms together can help your doctor diagnose or rule out pancreatitis or other conditions of the pancreas.

If you experience severe abdominal pain, see your doctor immediately. Based on the results of an amylase test, a lipase test, and your medical history, your doctor can decide if additional tests are needed or determine what specific type of treatment is needed. 

Written by: Christine Case-Lo and Jacquelyn Cafasso
Edited by:
Medically Reviewed by: The Healthline Medical Review Team
Published: Oct 5, 2015
Published By: Healthline Networks, Inc.
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