What is Amylase? What Causes High and Low Amylase?

by Abbas Jahangir · June 22, 2024

Amylase is a type of enzyme used in the digestion of carbohydrates. This enzyme, which has a protein structure, is also present in the blood in small amounts. Amylase levels may exceed normal ranges due to certain health problems, especially pancreatic diseases. The amylase test, used to investigate diseases that may cause this condition, is a type of examination that can be performed in the form of a blood or urine test. When low or high amylase levels are detected as a result of this test, the results are examined by the physician and, if deemed necessary, more detailed diagnostic tests related to the underlying health problem are applied.

What is Amylase?

Amylase, a digestive enzyme, is found in digestive secretions in the mouth and small intestines. This enzyme, produced in both the salivary glands and the pancreas, works together with other digestive enzymes to help convert carbohydrates into glucose, the smallest building block, and make them available for energy. The pancreas is responsible for the production of approximately 40% of the amylase enzyme in the body.

The remaining part is produced by the salivary glands. Very low or very high levels of amylase enzyme, which is normal in small amounts in blood or urine, may be caused by pancreas and salivary gland diseases, infections or some medications used. Amylase enzyme, which is especially used in the investigation of pancreatic diseases, can reach very high levels in the case of acute or chronic pancreatitis. Apart from this, some other diseases such as ectopic pregnancy, stomach ulcers (peptic ulcers), appendicitis, digestive system tumors and alcohol use may also be among the causes of high amylase in the blood.

Therefore, in cases where diseases related to the pancreas, salivary glands or digestive system are suspected, amylase testing is very useful in evaluating the possibilities of these diseases. In patients applying to health institutions,

Abdominal pain and swelling,
Nausea and vomiting,
Swelling in the area under the ear where the salivary glands are located,
In case of complaints such as loss of appetite, fever and diarrhea, it is useful to include amylase enzyme in the diagnostic tests to be performed.

How is Amylase Test Done?

Amylase testing can be performed in two different ways. The first of these is the amylase test in blood and the other is the amylase test in urine. One or both of these tests can be applied to investigate common pancreatic diseases and, in some cases, other diseases that affect the amylase enzyme level mentioned above. Generally, lipase, trypsinogen, hematocrit tests and liver function tests are also performed along with amylase enzyme.

In this way, clearer information can be obtained regarding digestive system diseases or any problems that may affect enzyme levels. Performing medical imaging examinations such as computed tomography (CT) or ultrasound also helps in conducting further research. For urine amylase testing, it is sufficient to take a urine sample. However, in some cases, your doctor may ask you to collect urine for 24 hours.

Blood amylase test, just like other blood tests, is performed by examining a blood sample taken into a tube from the arm veins with the help of a thin needle. In either case, results are usually available the same day or the next day the sample is collected. Patients who receive test results must show their results to their physicians.

Causes of High Amylase

The question of what the amylase value should be is one of the issues that many patients who have undergone this test are curious about. The normal value of amylase can be stated as 19-86 U/L for adults and healthy individuals. This value is the common and approximate value range used by laboratories. However, since reference ranges may vary from laboratory to laboratory, it is useful to take into account the reference range specified in the test result.

Reference ranges may change for infants and children, adolescents, elderly people, during pregnancy or during periods of various diseases. Apart from these situations, amylase levels being above reference values may be due to the use of alcohol or certain drugs, and may also indicate various health problems. Some of these are those:

Acute and chronic pancreatitis
pancreatic cancer
ovarian cancer
Lung cancer
mumps disease
Infections affecting the salivary gland
Ectopic pregnancy
Obstructions in the pancreas and bile ducts
cholecystitis
peptic ulcer
Gastroenteritis
prostate tumors
burns
Inflammatory bowel diseases
Eating disorders such as anorexia and bulimia nervosa
Diabetes disease and diabetic ketoacidosis

Causes of Low Amylase

Apart from high amylase in the blood, low amylase may also indicate certain health problems. Some of these are those:

Chronic pancreatitis disease, which can cause permanent damage to the pancreas
excessive alcohol use
cystic fibrosis disease
Liver and kidney diseases
Preeclampsia that can occur during pregnancy

Apart from the above situations, some medications used continuously may also cause low amylase in the blood. For this reason, it is very important to provide information about the medications used to the physician who orders the amylase test or evaluates the results. In cases where the amylase value is slightly below the reference value, it may be recommended to repeat the test after a while before any disease is suspected. In some cases, slight changes in enzyme levels may occur due to reasons such as starvation or infectious diseases. For this reason, it is beneficial to act in accordance with the doctor’s recommendations for mild low and high heights.

How Does Amylase Value Decrease?

If the amylase level in the blood is above the upper limit of 86 U/L, various disease possibilities arise, especially pancreatic diseases and especially pancreatitis. In evaluating the possibilities, other test results such as levels of other pancreatic enzymes such as lipase, liver function tests and blood counts should also be examined. If the results obtained raise suspicion of any disease, further diagnostic tests should be carried out.

Detailed research on organs can be carried out, especially with computerized tomography, ultrasound and magnetic resonance (MR) imaging. If the presence of a tumor is detected, a biopsy can be performed to determine whether the tumor is malignant or not. Endoscopy can be used to examine digestive system diseases. After detecting the underlying health problem with the help of such applications, amylase values can be returned to normal by starting the treatment protocol for the disease.

Pancreatic damage can be prevented with early diagnosis and treatment of pancreatitis, which is among the common causes of elevated amylase. In this way, pancreatitis is quickly brought under control and amylase enzyme levels can be reduced to normal ranges. In patients who develop high amylase levels depending on the medications used, amylase levels can be monitored by switching to different drug alternatives. If there is alcohol use, this habit should definitely be stopped. In some cases, amylase testing may also be performed as part of routine health checks. If, as a result of such a test, the enzyme level is found to be outside the normal range, further diagnostic tests may be required, taking into account the patient’s existing diseases. Since early detection of pancreatic diseases is very important for the success of treatment, it is recommended that tests measuring the levels of amylase and other enzymes be repeated at regular intervals. In addition, since the risk of pancreatitis increases in the presence of bile duct obstructions and gallstones, it is useful to monitor amylase levels in these patients during the preoperative period.

If you notice that your amylase enzyme level is outside the normal range as a result of your blood test, you can consult your doctor and get information about the reasons for this situation. If your doctor deems it necessary, you can get information about your possible health problems by having different diagnostic tests and start the recommended treatment as soon as possible.