Other names: Bone-Specific Alkaline Phosphatase, BAP
Optimal Result:
6 - 22.7 ug/L.
Bone-specific alkaline phosphatase (BAP or BSAP) is an enzyme produced primarily by osteoblasts, the cells responsible for building new bone. It is a specific isoenzyme of the broader alkaline phosphatase (ALP) family, which includes enzymes from the liver, intestines, kidneys, and placenta.
Unlike total ALP, which reflects contributions from various organs, BAP directly reflects bone metabolism. Measuring BAP levels in the blood provides a more accurate picture of bone turnover, which is critical in diagnosing and monitoring bone-related conditions.
The Bone-Specific Alk Phosphatase test is used to:
Detect abnormal bone turnover
Monitor bone growth or bone loss
Help diagnose and manage metabolic bone diseases
Assess the effectiveness of osteoporosis treatment
Differentiate between bone- and liver-related causes of elevated total ALP
Since liver and bone ALP isoenzymes can overlap in standard testing, measuring bone-specific ALP provides more diagnostic clarity—especially when liver function tests are normal but ALP is elevated.
Elevated BAP levels typically indicate increased osteoblastic activity, meaning the body is actively building or remodeling bone. This can occur in:
Childhood and adolescence (due to rapid bone growth)
Healing from fractures
Recovery from orthopedic surgery
Paget’s disease of bone: abnormal bone remodeling and enlargement
Osteomalacia/rickets: soft or weakened bones due to vitamin D deficiency
Hyperparathyroidism: excess parathyroid hormone increases bone resorption
Renal osteodystrophy: bone changes caused by chronic kidney disease
Especially in postmenopausal women or individuals receiving antiresorptive or anabolic therapy (e.g., bisphosphonates or teriparatide)
BAP helps track treatment response and bone turnover rate
Certain cancers (e.g., breast, prostate) that spread to the bone may stimulate abnormal bone activity and raise BAP levels.
Low levels of BAP are less common but may suggest:
Hypophosphatasia: a rare genetic condition affecting bone mineralization
Severe malnutrition or zinc/magnesium deficiency
Hypothyroidism, in some cases
Your doctor may recommend this test if you:
Have unexplained bone pain, deformities, or fractures
Are being evaluated for osteoporosis or Paget’s disease
Have an elevated total ALP but normal liver function tests
Are undergoing treatment for bone disease and need to track changes
Have a history of cancer with potential bone involvement
Sample type: Blood (serum or plasma)
Preparation: No special fasting required, but let your provider know about any medications or supplements you take.
Often performed alongside other tests: calcium, phosphate, vitamin D, PTH, and total ALP
Hormonal status—particularly estrogen levels—has a major influence on bone metabolism and BAP levels. That’s why menopausal status is important when interpreting test results in women.
(Values may vary by lab and reporting units)
| Group | Bone-Specific ALP (µg/L or ng/mL) |
|---|---|
| Premenopausal women | ~5.0 – 22.0 µg/L |
| Postmenopausal women | ~7.0 – 30.0 µg/L |
Note: Some labs report BAP in U/L or IU/L. Always check lab-specific reference ranges.
Stable estrogen levels help maintain balanced bone remodeling.
BAP levels tend to be low to mid-normal unless there's an issue such as:
Osteomalacia
Vitamin D deficiency
Early-onset osteoporosis
Loss of estrogen leads to increased bone resorption, triggering higher osteoblast activity.
BAP levels are often elevated, especially during the first 5–10 years after menopause.
Persistently high levels may suggest:
High-turnover osteoporosis
Paget’s disease
Suboptimal response to antiresorptive treatments
BAP is a useful marker to track therapy outcomes in osteoporosis:
Antiresorptive drugs (e.g., bisphosphonates, denosumab) typically lower BAP over time.
Anabolic treatments (e.g., teriparatide) may initially raise BAP, reflecting stimulated bone formation.
A ≥25% change from baseline BAP is considered clinically meaningful during treatment monitoring.
Elevated BAP post-menopause is common but should be evaluated in context—especially if there's high fracture risk or declining bone density.
Low BAP in osteoporosis may indicate low-turnover bone disease, which can influence treatment choices.
Always consider BAP results alongside DEXA scans, vitamin D levels, PTH, and clinical history.
Bone-Specific Alkaline Phosphatase (BAP) is a vital marker for assessing bone formation and turnover, especially in women navigating menopause, individuals with bone diseases, and patients undergoing osteoporosis treatment. Unlike total ALP, BAP gives a clearer, bone-focused view of osteoblastic activity—supporting better diagnosis, monitoring, and treatment planning for a wide range of skeletal health conditions.
An elevated bone-specific alkaline phosphatase (BAP) level means that your body is experiencing increased bone formation activity, often due to active bone remodeling. This result reflects elevated activity of osteoblasts, the cells that build bone. While this can be a normal part of growth or healing, in adults—especially postmenopausal women—it may signal an underlying bone or metabolic condition that requires further evaluation.
Children and adolescents naturally have higher BAP levels due to rapid bone growth.
Healing fractures or post-surgical bone recovery can also cause temporary elevation in people of any age.
In postmenopausal women, declining estrogen levels lead to increased bone resorption. Osteoblasts respond by trying to rebuild bone, which raises BAP levels.
Elevated BAP in this context may suggest high-turnover osteoporosis and is often monitored to:
Assess fracture risk
Track treatment response to medications like bisphosphonates, denosumab, or teriparatide
A chronic condition where bones break down and rebuild excessively and abnormally.
BAP is often markedly elevated, making it a key diagnostic marker.
These conditions involve softening or weakening of bone due to vitamin D deficiency, calcium/phosphate imbalance, or kidney issues.
BAP levels rise as the body attempts to mineralize weakened bone.
An overactive parathyroid gland increases bone turnover.
BAP may be elevated along with calcium and parathyroid hormone (PTH) levels.
Some cancers (e.g., breast, prostate) can spread to bone and stimulate abnormal bone remodeling.
Elevated BAP in a patient with known cancer may prompt imaging to assess for bone involvement.
In advanced kidney disease, impaired calcium-phosphate balance alters bone metabolism, raising BAP levels.
Elevated BAP itself doesn’t cause symptoms, but underlying conditions may include:
Bone pain or tenderness
Increased fracture risk
Skeletal deformities (in Paget’s disease)
Muscle weakness or fatigue
Numbness or tingling (if related to calcium imbalance)
Elevated calcium, phosphate, or PTH levels on other blood tests
Don't panic. Mild elevation may be temporary, especially if you’ve recently had surgery or an injury.
Discuss with your doctor. Your provider will review your results in context with:
Age and menopausal status
Other lab markers (e.g., calcium, PTH, vitamin D, total ALP)
Bone density scans (DEXA)
Medical history and symptoms
Follow-up testing may include:
Total alkaline phosphatase
Liver function panel (to rule out liver ALP sources)
Vitamin D, calcium, phosphate
Bone imaging (DEXA, X-ray, or bone scan)
Cancer screening, if risk factors exist
For patients with osteoporosis, BAP is used to track medication effectiveness. A drop in BAP typically means the treatment is working.
In conditions like Paget’s disease, changes in BAP can help guide therapy decisions and disease progression.
Elevated BAP is more concerning if it’s:
Persistently elevated without a clear cause
Rising over time
Accompanied by symptoms like bone pain, fractures, or neurological changes
Found in someone with known cancer or chronic kidney disease
In such cases, early intervention can help prevent bone loss, fractures, or complications from progressive bone disease.
An elevated bone-specific alkaline phosphatase (BAP) level indicates increased bone-building activity, which may be normal in some cases (like healing or growth) or may point to an underlying condition like osteoporosis, Paget’s disease, or vitamin D deficiency. Interpreting BAP results alongside other lab tests, imaging, and medical history is key to understanding the cause and guiding treatment.
Import lab results from multiple providers, track changes over time, customize your reference ranges, and get clear explanations for each result. Everything is stored securely, exportable in one organized file, and shareable with your doctor—or anyone you choose.
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Our user-friendly form guides you through a quick, simple submission process, making it easy to enter your health metrics.
Add your results anytime with our easy entry form. It's quick, guided, and helps you stay organized — free for all members.
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Export Your Complete Lab History
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After collecting lab results from different providers, you can download your entire history combined into a single file.
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Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest. Complete plan members receive one report entered for free, then $15 per report after that. Unlimited plan members receive ten report entries for free, then $15 per report after that.
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Healthmatters is a personal health dashboard that helps you organize and understand your lab results. It collects and displays your medical test data from any lab in one secure, easy-to-use platform.
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Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
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If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you're on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
The Complete Plan ($15/month) is perfect for individuals who want ongoing access to their health data. It includes unlimited lab imports, visual tracking, custom ranges, result explanations, full account exports, and secure sharing — all with a simple monthly subscription. You can cancel anytime and restart your plan whenever you're ready — your data will still be there waiting for you. You can also upgrade to the Unlimited Plan at any time, with the cost prorated based on what you've already paid.
The Unlimited Plan ($250 one-time) is also designed for individuals but offers lifetime access with no ongoing subscription. You'll get all the same features as the Complete Plan, plus a larger initial data entry allowance (10 reports), making it a great choice if you prefer a one-time payment and long-term use without monthly fees.
In short:
There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines.
The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself.
Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
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All professional accounts allow you to import and onboard an unlimited number of clients and their lab results. The distinction between professional plans lies solely in the data entry service.
The Pro Monthly Plus plan is priced at $75 per month and includes a data entry service for five reports each month. Additional reports can be self-entered at no extra cost or, if preferred, you can use our data entry service for an additional fee of $15 per report.
The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report.
You also have the option to upgrade to higher monthly or to annual plans, which come with substantial discounts. All upgrades can be done directly from your account.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
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Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
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