Amylase levels in blood and urine

Amylase blood test

Amylase is an enzyme produced mainly by the pancreas and, to a lesser extent, by the salivary glands, mammary gland, ovaries and testes. This enzyme enters the pancreatic juice and, with it, the lumen of the digestive tract, where it breaks down polysaccharides (e.g. starch) into simple sugars, which are then absorbed from the small intestine. Amylase is one of the most important and most active pancreatic enzymes. Amylase is excreted from the body through the urinary and digestive systems.

The blood amylase concentration should be within the range of 25 – 125 U/L.

In people over 70 years of age, the reference range for amylase concentration is 20 – 160 U/L.

The normal amylase concentration in urine is 10-490 U/I

An indication for measuring serum amylase activity is upper abdominal pain accompanied by fever, nausea or vomiting, including in the following cases:

• suspected acute pancreatitis, with the following symptoms: severe abdominal pain with vomiting and diarrhoea
• suspected chronic pancreatitis, as well as persistent pain accompanied by weight loss, fatty stools and alcohol misuse or gallstones
• suspected salivary gland diseases such as inflammation or a tumour, which cause blockage of the salivary duct together with enlargement of the salivary gland
• suspected perforation (a hole) in the stomach, duodenum or intestine, as well as bowel obstruction or ischaemic changes in the bowel.

Increased amylase activity may be observed in:

• acute pancreatitis and flare-ups of chronic pancreatitis (in acute pancreatitis, amylase levels exceed the normal range by 3 to 20 times),
• pancreatic duct stones,
• stones in the gallbladder and bile ducts,
• inflammation of the gallbladder,
• a perforated stomach or duodenal ulcer,
• bowel obstruction,
• obstruction of the bile ducts and pancreatic ducts,
• appendicitis,
• peritonitis,
• salivary gland diseases and infections (e.g. mumps),
• chronic kidney failure,
• liver disease,
• alcohol dependence,
• certain malignant tumours – cancer of the bronchus, thyroid, liver, large intestine, ovary or prostate,
• macroamylasaemia – the presence of amylase in complexes with macromolecules,
• ectopic pregnancy,
• extensive injuries throughout the body,
• drug dependence (opiates, heroin).

An amylase level above the reference range does not always have to be associated with disease. Macroamylasaemia is a congenital increase in the concentration of this enzyme. As a result of amylase molecules joining together, the blood test shows levels significantly above the reference range, while the urine test gives no cause for concern (in most medical conditions, an increase in the enzyme level in the blood means increased excretion in the urine). The result report is issued in Polish.

Reduced amylase activity is associated with:

• extensive destruction of the pancreas (e.g. acute fulminant pancreatitis, advanced chronic pancreatitis, cystic fibrosis),
• severe liver damage (e.g. hepatitis, toxaemia of pregnancy, severe thyrotoxicosis, severe burns),
• the use of certain medicines (e.g. citrates and oxalates) that bind calcium.
• thyrotoxicosis (a group of symptoms caused by excess thyroid hormones)
• a heart attack
• extensive burns,
• elevated blood triglyceride levels, which may be accompanied by lower amylase levels (triglycerides have been found to inhibit amylase activity).

It is worth having your serum amylase level checked if you have recurrent and persistent abdominal pain of unknown cause. An amylase activity test helps assess the condition of the pancreas. You should attend the test on an empty stomach (at least 8 hours without eating or drinking); on the day before the test, you must not consume alcohol or take medicines that bind calcium (e.g. citrates, oxalates).

Amylase from the blood is excreted in the urine, so its concentration can be measured by testing either blood or urine.

An indication for measuring amylase activity in urine is band-like upper abdominal pain radiating to the lower back, accompanied by fever, nausea and vomiting. Amylase can be measured using a single urine sample or a 24-hour urine collection. It is sufficient to bring a urine sample collected in the morning to the laboratory.

* If your results are outside the reference range, we recommend consulting a doctor.

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