Amylase Test

An amylase test measures the amount of amylase in a sample of blood. The test is also known as the serum amylase test.

Amylase is an enzyme used to break down starch (a type of carbohydrate) into smaller molecules. Your pancreas and salivary glands produce most of the amylase in your body. It is also produced in small amounts by the small intestinal mucosa, ovaries, placenta, liver, and fallopian tubes. An excess of amylase is found in diseases of the pancreas, such as pancreatitis (inflammation of the pancreas) or pancreatic cancer. Therefore, doctors recommend this test for the early diagnosis and to guide the treatment of pancreatic conditions before they become serious.

The amylase test is advised if you are experiencing the following symptoms of a pancreatic disorder:

• Sudden or severe abdominal pain
• Abdominal tenderness
• Nausea
• Vomiting
• Fever
• Loss of appetite
• Bloating
• Unexplained weight loss
• Foul-smelling stools

The following categories of people are at high risk for abnormal amylase levels:

• Individuals with eating disorders – People who have eating disorders, such as anorexia nervosa and bulimia, have higher activity of salivary-type amylase, which leads to high levels of amylase in the blood (hyperamylasaemia).
• Individuals with alcohol use disorder – When someone drinks a lot of alcohol, the amount of pancreatic and salivary amylase may decrease or remain normal.
• Individuals with cystic fibrosis – Cystic fibrosis (CF) is a genetic disease that affects the lungs, intestines, pancreas, and other organs. People with CF and acute pancreatitis, may have higher levels of amylase. On the other hand, pancreatic insufficiency, which is commonly seen in CF, is associated with normal or low amylase levels.

Although the amylase test cannot directly diagnose any disorder, it can be used to monitor existing conditions, such as:

• Acute pancreatitis – This occurs when digestive enzymes are activated within the pancreas due to acute alcohol ingestion, poisoning or drug-induced pancreatic damage.
• Chronic pancreatitis – This refers to a long-term disease characterised by inflammation of the pancreas.
• Pancreatic cancer – Amylase levels usually increase more than 25 times in cases of pancreatic cancer, which is rarely seen in pancreatitis.
• Acute cholecystitis (inflammation of the gallbladder) – In this condition, the gallbladder swells due to obstruction caused by stones, leading to inflammation of the gallbladder and the areas near the pancreas, thus causing an increase in amylase levels.
• Macroamylasaemia – A rare benign condition in which the enzyme amylase in the blood binds to large molecules, accumulates in the bloodstream, and causes persistently elevated serum amylase levels.

What to Expect Before the Amylase Test

No fasting is required for a standalone Amylase test. You can eat and drink normally. However, if it is part of a broader package that includes fasting tests, your doctor may advise fasting for 8-12 hours. Avoid strenuous exercise for 24 hours before the test, as intense physical activity can temporarily raise amylase levels and affect interpretation. Always inform your doctor about any ongoing medications.

What to Expect During the Blood Collection

A phlebotomist cleans the skin with an antiseptic, then places an elastic band around your upper arm to make the veins easier to access. A small needle is inserted into the vein; you may feel a brief pinch. Blood is collected into a labelled tube in under a minute.

What to Expect After the Amylase Test

A small cotton swab and bandage are placed over the site to stop any minor bleeding. You can return to normal activities immediately. Minor bruising is normal and disappears quickly. If dizzy, sit and rest for a few minutes

In the amylase test, the primary parameter being measured is:

• The level of amylase in the blood.

The amylase test normal range is indicated in the table below.

Note: Amylase levels can be affected by medications. It is important to inform your doctor of any medicines that you are taking.

Like any other medical test, this test also has some risks and limitations.

Risks:

• The amylase test is generally safe. You might feel slight pain, bruising, or discomfort when the needle is inserted into your arm for collecting the blood sample. However, these symptoms are rare and usually heal quickly without treatment.

Limitations:

• You should not drink alcohol for 24 hours before taking an amylase test.
• Your doctor may advise you to fast for two hours before the test. You may also be asked to stop taking certain medications. Please consult your doctor before giving a blood/serum sample.

Depending on your symptoms and results, your doctor may recommend certain additional tests to better understand your condition. These may include:

• Serum lipase test
• Blood glucagon test
• CA 19-9 (tumour marker)
• Sweat chloride test for cystic fibrosis
• Endoscopic retrograde cholangiopancreatography (ERCP)