Amylase test

You do not need to do anything special before an amylase blood test. A healthcare professional will take a small sample of blood from a vein in your arm. 

In rare cases, your doctor may also request a urine sample. If so, they will tell you how to collect it. Tell your doctor about all medicines you are taking before the test, as some can affect the result. 

What the test measures 

Amylase is an enzyme — a protein that helps carry out chemical reactions in the body. Its main job is to help digest starch in food. The pancreas releases amylase into the digestive system, and the salivary glands in the mouth also produce it. 

Normally, only a small amount of amylase passes into the bloodstream. When the pancreas becomes inflamed or its duct is blocked — for example by a gallstone — damaged cells release much larger amounts of amylase into the blood. A urine amylase test can also detect this, as the kidneys filter excess amylase into the urine. 

Amylase rises quickly at the start of a pancreatitis attack and usually falls back towards normal within around two to three days. This timing can help your doctor confirm the diagnosis.

What your results mean 

If your amylase is high 

A raised amylase level — particularly one that is 3 to 10 times above the upper limit of normal — is a strong indicator of acute pancreatitis. However, the size of the rise does not tell your doctor how severe the pancreatitis is. 

Other conditions can also cause a raised amylase. These include: 

• gallbladder disease — including gallstones that block the pancreatic duct 
• a perforated peptic ulcer — a hole in the stomach or small bowel lining 
• intestinal obstruction — a blockage in the bowel 
• acute appendicitis 
• salivary gland inflammation — such as occurs with mumps 
• ectopic pregnancy — a pregnancy that develops outside the womb 
• pancreatic cancer — though amylase is not routinely used to diagnose this 

If your blood amylase is high but your urine amylase is normal or low, this may indicate macroamylase — a harmless condition where amylase attaches to other proteins in the blood and is not filtered into the urine as normal. Macroamylase is not a sign of disease, and your doctor can confirm it with further testing.

If your amylase is normal 

A normal amylase level makes acute pancreatitis less likely — particularly if the test was taken in the first day or two after symptoms started. However, amylase can return to normal quickly in some cases, so a normal result does not completely rule out pancreatitis. 

In chronic (long-term) pancreatitis, amylase levels may be only mildly raised, or they may actually be lower than normal. This can happen when the cells in the pancreas that produce amylase have been damaged or destroyed over time. 

If you are being monitored after a pancreatitis episode 

If you are already being treated for pancreatitis, your doctor may use repeat amylase measurements to track your progress. Falling levels suggest that the inflammation is settling. Levels that stay high or continue to rise may mean the condition is not improving as expected. 

If your amylase is significantly raised and you have symptoms of pancreatitis, you are likely to need further tests to confirm the diagnosis and find the cause. These may include a lipase test, an ultrasound scan, and in some cases a CT scan. 

Treatment for pancreatitis depends on how severe it is. Mild cases may be managed with rest, fluids and pain relief. More severe cases may require hospital admission, where you may be given fluids through a drip and your pancreas is given time to recover by avoiding solid food for a period. Medicines and surgery may sometimes be needed. 

If your amylase result is normal but your symptoms continue, your doctor will consider other causes and may arrange further tests. They will work with you to find the right answer. 

• Timing: amylase rises quickly at the start of a pancreatitis attack but usually falls within two to three days. If your blood is tested late in an episode, the result may have already returned towards normal. 
• Kidney function: the kidneys remove amylase from the blood. If your kidneys are not working well, amylase may build up in the blood even without a pancreatic problem. 
• Macroamylase: this harmless condition causes raised blood amylase with normal urine amylase. It is not a sign of disease. 
• Medicines: several medicines can raise amylase levels, including aspirin, some diuretics (water tablets), oral contraceptives, corticosteroids, indomethacin, and opioid painkillers. Tell your doctor about all medicines you are taking. 
• Ethnic background: people of African or Asian heritage may naturally have slightly higher amylase levels. This does not mean there is disease. 
• Chronic pancreatitis: in long-standing pancreatic disease, amylase may be only mildly elevated or even low, as damaged pancreatic tissue produces less amylase over time. 

Amylase is rarely used alone. Your doctor will usually consider it alongside other tests: 

• Lipase: another pancreatic enzyme that rises with pancreatitis and stays elevated for longer than amylase. It is often the preferred test for diagnosing acute pancreatitis. 
• Urine amylase: can help distinguish between true pancreatitis and macroamylase. It may be requested alongside or after a blood amylase test. 
• Liver blood tests and bilirubin: help identify whether gallstones or bile duct problems are involved. 
• Full blood count (FBC) and C‑reactive protein (CRP): used to assess whether there is significant inflammation or infection. 
• Ultrasound scan: often the first imaging test, used to look for gallstones and check the pancreas and bile ducts. 
• CT scan: gives a more detailed picture of the pancreas and surrounding tissue, particularly useful in severe or complicated pancreatitis. 

Pancreatitis is inflammation of the pancreas. It can be sudden (acute) or long-term (chronic). The most common causes are gallstones and alcohol. Acute pancreatitis is usually treated in hospital and most people recover fully. Chronic pancreatitis can cause lasting damage and ongoing symptoms. For more information, visit pancreatitis (NHS).