Imagine waking up with a sharp pain in the upper belly that bores straight through to your back. You feel sick, you can't eat, and lying flat makes it worse. At the hospital, one of the first things the doctor orders is a blood test with two names you may never have heard before: lipase and amylase.
These two enzymes are small, but they can tell doctors a lot about what's going on inside your pancreas. Let's look at what they are, what the numbers mean and why a high result isn't something to ignore.
What Is the Lipase and Amylase Test?
The pancreas is an organ shaped like a leaf which is situated behind the stomach. The pancreas produces digestive enzymes and hormones such as insulin which regulates the blood sugar level.
Amylase is responsible for digestion of starch, which is the carbohydrate present in roti, rice, and potato. Amylase is secreted mainly by the pancreas, and it is also secreted by the salivary glands. Lipase is involved in the digestion of fats and is secreted mainly by the pancreas.
Usually, small quantities of these enzymes are present in the blood. In case of inflammation and injury of the pancreas, these enzymes leak in larger quantities, and the amylase lipase test detects this. This test requires a small quantity of blood sample.
Amylase Normal Range and Lipase Normal Range
Enzymes are proteins that are made in the body to perform one specific task. Amylase is produced by the pancreas to facilitate the breakdown of carbohydrates into sugars. The enzyme lipase, which breaks fats into fatty acids, is produced by the pancreas.
Some amounts of amylase and lipase may be present in saliva and the stomach. Most enzymes produced in the pancreas are discharged in the small intestine.
- Amylase normal range: roughly 25 to 85 U/L
- Lipase normal range: roughly 0 to 160 U/L, though some labs use a lower upper limit
The presence of digestive enzymes in the blood is a sign of damaged pancreas. If the levels of amylase and lipase are more than thrice the normal levels, this means that there could be inflammation of your pancreas.
Lipase vs Amylase: Which One Matters More?
Both of them are tested together, but lipase is usually regarded as the more accurate test of the two in cases of pancreatic disorders. The specificity of lipase is higher because the enzyme remains elevated for a longer period of time, usually for 8-14 days. Moreover, lipase levels are not influenced by other organs.
Amylase increases rapidly, within hours, but returns to normal in several days. Amylase can also increase in cases of salivary gland disorders, such as mumps or salivary duct stones, that are not related to the pancreas at all. This is why many physicians use only lipase test or both tests together.
Symptoms That Lead Doctors to Order the Test
The test is usually ordered when someone has signs that point to a pancreas problem:
- Severe pain in upper abdomen
- Back Pain
- Nausea
- Fever
- A swollen, tender belly
- Yellowing of the eyes and skin, if a gallstone is blocking the duct
If you have this kind of pain, please don't wait it out at home. Acute pancreatitis can become serious quickly.
What a High Lipase and Amylase Test Means: Common Causes
The most common reason for high levels is acute pancreatitis, which is sudden inflammation of the pancreas. The presence of increased amylase indicates that there is something wrong, but the problem may not necessarily be related to the pancreas. In most cases, the comparison between lipase and amylase values will be more specific in terms of diseases of the pancreas. Analysis of test results and patient’s symptoms will help your doctor to identify or exclude pancreatitis. The usual triggers are:
- Gallstones blocking the duct that drains the pancreas
- Heavy alcohol use
- Very high triglycerides in the blood
- Certain medicines
- Infections, injury to the belly, or a procedure involving the bile duct
But high levels don't always point to pancreatitis. Other causes include:
- Chronic pancreatitis flare-ups
- Blocked pancreatic or bile ducts, or pancreatic tumours
- Gallbladder inflammation
- Bowel obstruction or a perforated ulcer
- Kidney disease, because the kidneys clear these enzymes
- Diabetic ketoacidosis
- Salivary gland problems (affects mainly amylase)
One more thing worth knowing: the number alone doesn't show how severe the problem is. Someone with a very high level may have a mild illness, while someone with a modest rise can be quite unwell. Your doctor reads it with your symptoms and scans.
Can Lipase and Amylase Be Low?
Yes, although it is less common and less pressing. It can be found in longstanding chronic pancreatitis, where much of the pancreas has been destroyed, and in diseases such as cystic fibrosis. Low levels by themselves don't mean much, but your doctor will use them along with your symptoms, such as fatty stools and weight loss.
Other Tests Doctors Order Alongside
To find the cause, you'll often have more than the amylase and lipase test:
- Liver function tests, which can show a gallstone blockage
- Triglycerides and calcium
- Blood sugar
- Complete blood count and CRP, for signs of infection and inflammation
- Kidney function tests
- Ultrasound or CT scan of the abdomen, to see the pancreas, gallbladder and bile ducts
How to Prepare for the Test
A serum amylase test or lipase blood test usually needs no special preparation, but some labs ask for a few hours of fasting, so follow the instructions you're given. Tell your doctor about any medicines you take, and avoid alcohol before the test if you've been advised to.
Treatment and Prevention
The treatment depends on the underlying condition. The treatment of acute pancreatitis usually involves hospital admission, fluid therapy, pain relief and dietary management, while treating the underlying condition, like removal of gallstones. Medication will not be a miracle cure, so do not attempt to cure yourself of severe abdominal pain.
There are several ways to reduce your risks. You should avoid drinking, maintain your weight and triglyceride levels, stop smoking and examine any gallstones.
Reference: https://www.healthline.com/health/amylase-and-lipase-tests
