High amylase levels in urine: what does it mean?

Hey Reddit,
Can anyone shed some light on elevated urinary amylase levels? I’m currently stuck on a month-long waiting list to see an internist.
Basically, my urine test shows amylase levels that are 3 to 4 times higher than the upper limit. My bloodwork looks totally fine—serum amylase is normal, bilirubin is fine, and my ALT and AST levels are all within range. Everything else in both my blood and urine tests came back perfectly normal too. My primary care physician is starting to suspect it might be pancreatitis.
I have been feeling some weird, minor abdominal pains lately.
Thanks!

Seriously, just go see a private doctor right away—don't sit around waiting two months for an appointment with some specialist when you might have esophageal inflammation...

I’d just wait out the twenty hours and then head straight to the ER with my test results in hand to tell them I’m in pain. You just have to brace yourself, grab some patience, and sit tight. Once they actually take you back, they’re required to give you a full workup. At least that’s how things work in Seattle.

So, uh, pancreas issues... uh, just these weird little abdominal pains... uh, amylase levels are up, but everything else looks fine... uh, uh....

Honestly, if your white blood cell count, CRP, or platelet levels are all normal, I wouldn't jump to conclusions about some major inflammation. It could be something chronic building up, but I don't think that's super likely here. Also, with pancreatitis, you usually see some spikes or drops in blood sugar because the pancreatic tissue that handles insulin gets hit hard, and you didn't mention anything about your glucose levels.

Look, this isn't groundbreaking medical advice, but you really need to get in front of a gastroenterologist. Beyond just the blood work, they’re definitely going to want an abdominal ultrasound, and maybe even a CT scan depending on what they find—mostly because we really need to rule out any kind of malignancy. That becomes especially important if you're over 40 or 50, or if there's any history of heavy drinking involved.

Look, I'll tell you since I've been dealing with this exact same mess for three years now. If your serum amylase levels are normal, your pancreas should be fine. Those urine levels just mean the function is off, even if there isn't full-blown inflammation yet. I went through doctor after doctor, ultrasounds, GI scans... did all five tests, and that number stayed high. I stuck to a strict gallbladder diet for six months and it finally dropped. But now? I've put on weight again, stopped watching what I eat, and the levels are back up... sitting around 750 right now.

Thanks for the advice, everyone,
Just for context, I don't really drink except for the occasional night out with friends every few months... and I don't smoke either.
My urine amylase levels were 259 U/l on 10/13/2005
and 439 U/l on 10/31/2005.
I just submitted another sample today and should get the results around 1:00 PM. If the numbers are spiking again, I'm heading straight to a private clinic to get checked out.
Looking back at some old labs from six years ago, my urine amylase was 214 U/l. Back then, that was considered totally normal because the reference range went up to 240 U/l (23-240 U/l), but now the standard range has tightened significantly to 23-91 U/l.
I'm 30 years old.
Best,

So, I’m back with my latest test results.
My urine amylase came back at 493 U/l, but here’s the kicker... they’ve changed the reference range on the report. It’s now listed as 23-400 U/l instead of the old 23-91 range I was used to. This means when my first result was 295 U/l, it actually fell within the "normal" window back then...
Honestly, I don't even know how to process this. Best,

What is he even supposed to say if your amylase levels jumped by almost 100 in just eight days!!!! 😲

RUN TO A SPECIALIST ASAP!

Mine hit around 960, I think... though I've seen people topping 1100. My guess is 400 is the baseline, and that 91 might be showing up in the serum. Not totally sure though, don't have my lab results handy. Just watch out, you gotta distinguish between the two—amylase in urine versus amylase in serum. The latter usually means the pancreas is totally shot.

I’m dealing with the exact same thing. When the pain hits, it’s a brutal ache right above the navel—enough bloating that I’ve had to head to the ER. This has been going on for two years now. I’ve had two endoscopic ultrasounds on my pancreas and an MRCP, but they came up completely clean. My blood work looks fine too; lipase, amylase, CBC, sedimentation, and CRP levels are all totally normal. The only outlier is my bilirubin, which sits around 27/39, though sometimes it drops back to a normal 14. It feels like a tiny stone is just wandering around in there somewhere, but even after ultrasounds and a HIDA scan, the only thing they ever found was a tiny 3 mm polyp in my gallbladder.

Lisa Moore7 said:Doctors couldn't figure out why my amylase levels were spiked. Everything seems fine, but they just stay high. It's probably just the extra weight... I don't get why they're showing up in my urine but not in my blood, though I guess the blood levels are what actually matter if there's some kind of issue with my pancreas.

Wait, if someone actually has Gilbert's syndrome, can they even gain weight?

Lisa Moore7 said:Mine hit around 960, I think... though I've seen people topping 1100. My guess is 400 is the baseline, and that 91 might be showing up in the serum. Not totally sure though, don't have my lab results handy. Just watch out, you gotta distinguish between the two—amylase in urine versus amylase in serum. The latter usually means the pancreas is totally shot.

Are you dealing with digestion issues, yellow stools, or anything like that?
Bloating. And I can't lose weight even though I barely eat anything.

Lisa Moore7 said:Look, I'll tell you since I've been dealing with this exact same mess for three years now. If your serum amylase levels are normal, your pancreas should be fine. Those urine levels just mean the function is off, even if there isn't full-blown inflammation yet. I went through doctor after doctor, ultrasounds, GI scans... did all five tests, and that number stayed high. I stuck to a strict gallbladder diet for six months and it finally dropped. But now? I've put on weight again, stopped watching what I eat, and the levels are back up... sitting around 750 right now.

Man, are you actually in pain with a level of 750?

Anonymous said:Hey Reddit,
Can anyone shed some light on elevated urinary amylase levels? I’m currently stuck on a month-long waiting list to see an internist.
Basically, my urine test shows amylase levels that are 3 to 4 times higher than the upper limit. My bloodwork looks totally fine—serum amylase is normal, bilirubin is fine, and my ALT and AST levels are all within range. Everything else in both my blood and urine tests came back perfectly normal too. My primary care physician is starting to suspect it might be pancreatitis.
I have been feeling some weird, minor abdominal pains lately.
Thanks!

Did you ever figure out what was causing those high amylase levels in your urine?