Blood draw
Amylase and Lipase
Pancreatic enzyme panel.
€ 32,00
All tests
Liver and pancreas · Blood
Amylase
A digestive enzyme from the pancreas and the salivary glands; strongly raised in acute inflammation of the pancreas.
At a glance
- Measured in blood
- In 1 test panel
- No special preparation
Explanation
Amylase: what is measured?
Amylase is an enzyme that helps digest starch and sugars from food. It is made by the pancreas and by the salivary glands. A small part enters the blood and is excreted by the kidneys in the urine. With inflammation of the pancreas, amylase in the blood rises quickly, within 12 hours according to the Dutch Society for Clinical Chemistry (NVKC), and after recovery it falls again within a few days.
What can it detect?
- Acute inflammation of the pancreas (acute pancreatitis), usually due to gallstones or alcohol
- Inflammation of the salivary glands, for example in mumps
- Reduced kidney function
- Macroamylasemia: a harmless abnormality in which amylase is attached to other proteins and therefore stays in the blood longer
Result
What does the result mean?
Amylase too high
A slightly raised amylase occurs with many disorders in the upper abdomen, with inflammation of the salivary glands such as mumps, and with reduced kidney function. Macroamylasemia also gives a raised value: amylase is then attached to other proteins in the blood and is poorly excreted by the kidneys; this causes no symptoms and is harmless. A strongly raised amylase, more than three times the upper limit, together with sudden severe pain in the upper abdomen fits acute inflammation of the pancreas; nausea, vomiting and fever also go with it. After recovery, the value falls within a few days.
Amylase too low
A low amylase usually has no meaning in healthy people. In long-term (chronic) inflammation of the pancreas, the value can fall over time, because the cells that make amylase become damaged. A low value in the blood is not a reliable test of how well the pancreas works; for that, elastase is measured in the stool.
After an abnormal result
With a strongly raised amylase and severe abdominal pain, assessment on the same day is needed. With a raised value without symptoms, the GP repeats the measurement together with lipase and kidney function; if lipase is normal, the laboratory can check whether it is macroamylase or amylase from the salivary glands.
Reliability
How reliable is the test?
Amylase is less specific than lipase, because it also comes from the salivary glands and rises in many other disorders, and it falls more quickly after inflammation of the pancreas. When acute inflammation of the pancreas is suspected, lipase is therefore preferred. According to the international definition, what counts is the combination of abdominal pain and an amylase or lipase raised more than three times; a raised amylase without symptoms is not inflammation of the pancreas. According to the Dutch Society for Clinical Chemistry (NVKC), a raised amylase therefore does not always point to a problem with the pancreas.
What can affect the result?
- Reduced kidney function and macroamylasemia raise amylase without the pancreas being diseased.
- Inflammation of the salivary glands, such as mumps, raises amylase.
- Some medicines can raise amylase slightly, including medicines for diabetes and overweight such as semaglutide and liraglutide.
- The result depends strongly on the measurement method; reference values differ per laboratory.
Who it is for
Who is the test useful for?
Useful for
Amylase is usually measured together with lipase. Useful for monitoring a previously raised value, after an episode of inflammation of the pancreas on the advice of the treating doctor, and as an addition to testing by the GP for symptoms in the upper abdomen. With sudden severe abdominal pain, a test by mail is not suitable, because a doctor then needs to assess you straight away. In healthy adults without symptoms, amylase adds little.
How common is it?
In 2005, acute inflammation of the pancreas occurred in about 1 in 6,800 people in the Netherlands, in about 60 in 100 cases due to gallstones and in 20 in 100 due to alcohol. A slightly raised amylase without symptoms is more common, due to the kidneys, the salivary glands or macroamylasemia, among other causes; how often is not well known.
Dutch Pancreatitis Study Group; NVKC
Drawbacks and risks
- A raised amylase without symptoms is often due to the kidneys, the salivary glands or macroamylasemia, but can lead to unnecessary worry and unnecessary testing of the pancreas.
- A test by mail only gives a result after a few days; with acute severe abdominal pain, this can wrongly lead to delayed care.
Get tested
Amylase: test panels
Amylase is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results