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Alkaline phosphatase is a group of very important enzymes, including intestinal alkaline phosphatase, tissue non-specific alkaline phosphatase, and placental alkaline phosphatases. Read this post to learn more about the roles of alkaline phosphatase and how you can optimize this enzyme.

People go to their doctor to get their alkaline phosphatase tested as part of a standard panel. Almost always, the results are not scrutinized, even though we know that you can be healthier and live longer when your results lie within optimal ranges. When I used to go to doctors and tried to discuss my results, they had no clue what these meant from a health perspective. All they cared about was whether I was gonna die in the next year.

This is why we created Lab Test Analyzer, a tool that easily lets you know which lab results you need to be concerned about, and how to bring these in the optimal range.

Our Lab Test Analyzer can help you keep your alkaline phosphatase in the optimum range by allowing you to keep track of your levels, identifying causes of low or high levels, and giving you evidence-based lifestyle, diet, and supplement recommendations.

Contents

Introduction

Alkaline phosphatase is an enzyme that dephosphorylates (removes phosphate groups from) other molecules such as proteins and nucleotides. They are found in all body tissues in the human body but are mostly concentrated in the bones, kidneys, liver, intestines, and placenta (R).

There are different forms of the enzyme. The bone form is involved in bone calcification.  The intestinal form plays a role in the transport of phosphate into intestinal cells (epithelial) (R).

The correct balance of alkaline phosphatase is required for healthy functioning, too much or not enough can cause a broad range of diseases (R).

Alkaline phosphatase play an important role in the development of bones and teeth, because it is essential for mineralization. Mineralization is when minerals, like calcium and phosphorus, are deposited in bones and teeth to help them become strong (R).

Alkaline phosphatase is used in ongoing research on stem cells, cancer, and other diseases (R).

Normal Range for Alkaline Phosphatase

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Generally, the total alkaline phosphatase (ALP) test is run to find all types of ALP in the blood to diagnose bone and liver disorders.

If ALP comes back high, the doctor may order the ALP isozyme test to see which specific type of alkaline phosphatase is elevated. The ALP isozyme test can distinguish between the bone and liver ALP.

The normal range of alkaline phosphatase in blood is 20 to 140U/L, although this can vary from lab to lab. Children and pregnant women can have significantly higher levels of the enzyme in their blood (R).

However, the normal range is not the optimal range. Our Lab Test Analyzer can help you determine if you’re in the optimal range, and how to get it there if you’re out of the optimal range.

Conditions With Decreased Alkaline Phosphatase

Reduced levels are correlated with certain diseases (R).

1) Hypophosphatasia, Achondroplasia, and Cretinism

Low levels of alkaline phosphatase can cause hypophosphatasia, an inherited disorder that causes defective bone mineralization. Without the enzyme, children can have early loss of teeth and seizures while adults can have dental problems and weakened bones (R).

Achondroplasia is a type of dwarfism, and cretinism is a condition with severely stunted growth. In children with these disorders, their alkaline phosphatase levels are lower than normal range (R).

2) Wilson’s Disease

Wilson’s disease is an inherited disorder where copper is accumulated in the organs. Wilson’s disease patients have low blood alkaline phosphatase activity. They also had a significantly lower alkaline phosphatase to bilirubin ratio (R).

3) Malnutrition

Malnutrition can also cause lowered alkaline phosphatase levels in the blood. In a review of 130 patients with low enzyme levels, 12% suffered from malnutrition (R).

Benefits of Decreased Alkaline Phosphatase

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1) Better Attention and Memory Abilities

Decreased alkaline phosphatase levels predicted better scores on a brain test in patients who have undergone weight loss surgery. This suggests that a lower level of enzyme activity can predict better attention and memory abilities. However, this does not prove that the enzyme is harmful to the brain (R).

2) Lower Cholesterol (correlation)

Pregnant women have higher blood alkaline phosphatase activity. Both triglyceride and total cholesterol levels increased in parallel with alkaline phosphatase, so cholesterol levels are correlated with enzyme activity (R).

Conditions with Increased Alkaline Phosphatase

While alkaline phosphatase may not necessarily cause harm to the body itself, elevated levels are associated with cancer, bone, liver, and kidney diseases (R).

1) Biliary Obstruction and Liver Cancer

High liver alkaline phosphatase levels are associated with bile duct obstruction and liver cancer. The presence of liver alkaline phosphatase in patients may indicate the presence of a tumor in the bile duct (R).

2) Colon Cancer

Alkaline phosphatase levels are frequently high in patients with metastatic colon cancer. Increasing alkaline phosphatase levels are correlated with increasing cancer stage and may indicate that the cancer has spread to the liver (R).

3) Breast Cancer

Women with breast cancer had elevated levels of alkaline phosphatase compared to normal healthy women. The increase of enzyme activities also indicates that the cancer is metastatic and spread to either the bone or liver (R, R).

4) Leukemia

Leukemia patients, especially untreated ones, have high alkaline phosphatase levels. The placenta alkaline phosphatase level is a useful biomarker to help diagnose and treat leukemia (R).

5) Alzheimer’s

Alzheimer’s patients have higher tissue-nonspecific alkaline phosphatase levels compared to healthy patients. The higher the alkaline phosphatase activity, the lower the brain function (R).

6) Hyperthyroidism

Increased alkaline phosphatase levels are also correlated with hyperthyroidism (R). Thyroid hormones stimulate alkaline phosphatase (R, R).

7) Paget’s Disease

Paget’s disease is a common disorder that affects bone strength and formation. Abnormally high levels of bone alkaline phosphatase can be an indicator of bone turnover, so while the enzyme does not cause the disease, it can be a helpful indicator (R, R).

8) Vitamin D Deficiency

Vitamin D deficiency is usually accompanied by elevated levels of total alkaline phosphatase in the blood. However, it is not the best indicator for vitamin D deficiency (R).

9) Heart Disease

Elevated alkaline phosphatase levels are associated with a higher risk for heart disease.

In a prospective study of more than 3000 elderly men, the higher alkaline phosphatase levels predict higher risks of heart attacks, strokes, and increase mortality (R).

10) Liver Problems Associated with Celiac Disease

Celiac disease is an autoimmune condition where the immune system attacks the gut lining upon gluten consumption. In cases of uncontrolled celiac disease where the patients continue to consume gluten, other liver and biliary tract disorders can occur. Elevated alkaline phosphatase levels are associated with these two disorders (R).

11) Sickle Cell Anemia

Sickle cell anemia is associated with high levels of alkaline phosphatase. The higher alkaline phosphatase levels correlate with worsened bone and other tissue damage in sickle cell anemia patients (R, R).

In patients with sickle cell disease, higher levels of alkaline phosphatase are associated with vasocclusive crises involving the bones (R).

12) Epilepsy

Epileptic children have higher alkaline phosphatase levels compared to children without the disorder (R).

Benefits of Increased Alkaline Phosphatase

If you’re confused about ALP, Lab Test Analyzer is your digital health advisor that helps you understand your lab tests and makes recommendations based on your results.

Alkaline phosphatase helps with bone and teeth mineralization (R).

A genetic mutation in bone alkaline phosphatase results in defective bone mineralization, leading to early loss of teeth, frequent dental problems and weakened bones.

Without this important enzyme, children can have early loss of teeth while adults can have dental problems and weakened bones. The most severe cases of hypophosphatasia can cause seizures or infant deaths (R).

Alkaline phosphatase is important for the development and survival of embryos (R). It causes fetal and embryonic cell growth (R).  Mice with mutated embryonic alkaline phosphatase had a smaller litter size, fewer embryonic cells, and grew more slowly (R).

Factors that Increase Alkaline Phosphatase

Everyone is different, and our bodies are complex. If you want to increase your levels, it’s best to put them in Lab Test Analyzer so that it can compute based on this and your other results what you can do to become optimal.

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1) Birth control pills

Birth control pills can increase alkaline phosphatase to many times the level of a normal range (R).

2) Exercise

Exercise increases bone alkaline phosphatase levels after thirty and fifty minutes of moderate to intensive exercise in male cyclists, but it quickly returning to normal (R).

3) Thyroid Hormones 

Thyroid hormones stimulate alkaline phosphatase (R, R). Increased alkaline phosphatase levels are also correlated with hyperthyroidism (R).

4-5) Efavirenz and Cissus quadrangularis

Efavirenz, an anti-HIV drug, is associated with increased alkaline phosphatase levels in HIV patients. The high enzyme levels also associated with increased bone turnover and Vitamin D deficiency (R).

Cissus quadrangularis, a type of plant from the grape family, significantly increases alkaline phosphatase activity in cell culture. It also increases bone mineralization, which is likely due to the increased enzyme function (R).

Estrogen and Testosterone Metabolites

Estrogen, 5 alpha-DHT, and dehydroepiandrosterone (different types of hormones) can increase the enzyme’s activity (not the level in the blood) in human endometrial cancer cell lines (R).

Estrogen is also able to regulate the growth and expression of this enzyme in human bone marrow cell culture (R).

Factors that Decrease Alkaline Phosphatase

Everyone is different, and our bodies are complex. If you want to decrease your levels, it’s best to put them in Lab Test Analyzer so that it can compute based on this and your other results what you could do to become optimal.

1) Starvation and Fasting

Starvation causes the loss of intestinal alkaline phosphatase (R).

2) Omega-3 Fatty Acids

Omega-3 fatty acids reduce the levels of intestinal alkaline phosphatase, whereas omega-6 fatty acid increases the level of intestinal alkaline phosphatase in the gut (R).

3) Cinacalcet

Cinacalcet, a drug for chronic kidney disease, can reduce blood alkaline phosphatase levels by more than twenty percent in patients after 26 weeks administration (R).

4) Magnesium Deficiency (decreases activity)

Magnesium deficiency can lower alkaline phosphatase activity levels in the body because The enzyme needs magnesium to activate. In a study done on female rats, the rats with a magnesium-deficient diet had only half the alkaline phosphatase activity compared to the controls. Magnesium supplementation significantly restores enzymatic activity, but it did not return to normal levels (R).

5) Resistance Exercise (decreases activity)

In untrained male subjects, one single bout of resistance exercise can cause bone ALP activity to significantly decrease two and three days after the exercise (R).

6) Protein-Free Diet (decreases activity)

Rats fed a protein-free diet have reduced intestinal alkaline phosphatase activity (R).

8 Benefits of Intestinal Alkaline Phosphatase

Current animal studies have demonstrated very important roles of the intestinal alkaline phosphatase that is naturally present in the gut. The enzyme interacts with the gut, the food we eat, and the microbes found in our body.

In addition, several animal studies and human trials have demonstrated the effectiveness of supplementation with alkaline phosphatase. However, currently, there is no alkaline phosphatase supplement available for sale.

Unlike other types of alkaline phosphatases, intestinal alkaline phosphatase is mostly tied to the gut lining, with 1 – 2% may be present in the bloodstream (R).

Curcumin increases intestinal alkaline phosphatase activity levels in gut cells (R).

1) Protects Against Bacteria Infection in the Gut

Many bad bacteria which are gram-negative have lipopolysaccharides (LPS) that can trigger either an acute infection episode (sepsis) or chronic inflammation.

Intestinal alkaline phosphatase can remove phosphate groups from LPS, which reduces its inflammatory effects (R).

In addition, intestinal alkaline phosphatase also prevents the bacteria like Salmonella typhimurium and Clostridium difficile from traveling to the lymph nodes in the gut (R).

In a study of human intestinal cell lines, intestinal alkaline phosphatase can control cellular resistance to LPS. The presence of LPS in the blood can stimulate inflammation in the body (R).

2) Helps Restore Gut Bacteria After Antibiotics

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Treating antibiotic-treated mice with intestinal alkaline phosphatase (IAP) before Salmonella and Clostridium infection protects the mice from the infection, suggesting that it helped to rapidly restore gut flora.

In mice, oral supplementation with calf intestinal alkaline phosphatase during antibiotic treatment had fewer infections and a lower mortality rate compared to mice with no supplementation (R).

3) Helps Repair Leaky Gut in Cystic Fibrosis Patients

Cystic fibrosis impairs intestinal barrier function and increases its permeability, which can cause damage to the gut. This also causes reduced activity of intestinal alkaline phosphatase (R).

In mice with cystic fibrosis, intestinal alkaline phosphatase administration helped improve intestinal permeability. It also reduced small intestinal bacterial overgrowth by more than eighty percent (R).

4) Helps Remove Toxic Microbial Chemicals

Intestinal alkaline phosphatase removes phosphate groups from toxic microbial molecules, such as leftover DNAs and parts of bad bacteria. This helps protect against inflammation (R).

5) Slows Down Fat Absorption

Mice without intestinal alkaline phosphatase absorb fat very fast. As a result, these mice have higher blood cholesterol and gain weight faster than normal mice (R).

6) Helps Treat Kidney Injuries

In humans with severe bacterial infection, the administration of alkaline phosphatase through the blood helped improve overall kidney function (R).

Because alkaline phosphatase can reduce inflammation by removing phosphate groups from certain toxins, it can protect organs from bacterial damage (R).

7) Protects Against Type 2 Diabetes

Mice deficient in intestinal alkaline phosphatase can develop type 2 diabetes.

Oral supplementation of intestinal alkaline phosphatase prevents metabolic syndrome in mice fed with high-fat diet (R).

Scientists studied the stools of 200 diabetic and 400 non-diabetic patients. They found that compared to the controls, diabetic patients had lower intestinal alkaline phosphatase activity levels (R).

Intestinal alkaline phosphatase was also protective against type 2 diabetes even in obese patients (R).

8) Helps Reduce Gut Inflammation

Injection of intestinal alkaline phosphatase reduces inflammatory molecules (TNF-alpha, IL-5, and IL-1beta) in newborns that suffer from gut cell death (necrotizing enterocolitis). However, the injection did not cure the necrotizing enterocolitis (R).

Genetics of Alkaline Phosphatase

Different genes encode human alkaline phosphatases, i.e. (R):

  • ALPP for the alkaline phosphatase in the placenta
  • ALPL (also called TNAP for Tissue Non-Specific Alkaline Phosphatase) for the alkaline phosphatase in the liver, bone, and kidney

Go to SelfDecode to learn how to get your own genetic information evaluated for alkaline phosphatase risk.

Lab Test Analyzer: The Future of Personalized Health

If you ever felt like you should be getting more out of your lab results, now you can. Using Lab Test Analyzer, you can get up-to-date scientific information about your lab results. In addition, you get both lifestyle tips and natural solutions to help you optimize your health. You can also rely on our science-based Optimal Ranges to prevent potential health issues and maximize your overall wellbeing.

If you got your blood test results and you’re not sure what to make of them, you need to use our cutting-edge tool: Lab Test Analyzer.

We built this tool to do the heavy lifting for you. No need to do thousands of hours of research on what to make of your blood tests.

People don’t realize that their blood results contain a gold mine of information that is waiting to be unearthed. Unfortunately, layers usually need to be dug to uncover this information gold.

But we make it super-simple so that even if you don’t have any background in science, you will understand what your results mean, and what you can do to get them in the optimal range.

Everything written in Lab Test Analyzer is backed by science and researched by a team of PhDs, professors, and scientists.

By using Lab Test Analyzer, you will learn how to optimize your health, tailored to your unique biology.

We’re all unique, so we deserve therapies that treat us that way.

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28 COMMENTS

  • John Alcott

    The center of the ALP molecule is zinc. Whenever I take pumpkin seed oil my ALP goes from about 65 to 81. Great for prostate health.

  • Hariom Verma

    Meri mom ki gall ballder me stone he aur unaka
    Alkaline phosphate laval 456 iu/ltr. He
    Aur unka s.bilirubin 10.mg/dl he
    Plz. Koi upaay btaye help me mujhe email par sujhab de plz.

  • Donna Mills

    My husbands alkaline phosphates are 603! He’s getting an MRI soon. What do I have to worry about.

  • Michael Edwards

    My levelels of alkaline phosphatase was 198 can u tell me if that is very high because it sounds like it. Please email me back as soon as u can because i have to make a apointment this week for something else and id like to give my dr a heads up incase i need tests

  • ranjana

    my ALP level is 87 kau/dl is it normal or high because i am confuse in units

  • Kuljeet singh

    I often feel pain in on my heel while I walk after leaving bed. But after 30-40step it becomes normal. What cause of it. What should we do.

  • Kuljeet singh

    I found my ALP level at higher 160 in my blood test of LFT
    What do you suggest me, how do I decrease this level. And which decease symptoms cause of it.
    Also the AST(SGPT) level is 51 that is 1 point high according to Dr. Lady’s path lab. How can I decrease it.

  • Linda Jackson

    My ALP has been consistently high for one year. It is 177 now. All other liver function factors are normal. Should I see a gastroenterologist?

  • Amy

    My 18 month old daughter recently had the flu and we were waiting at docs office when she had a seizure. We immediately went to hospital and stayed over night. They determined her seizure was in fact due to flu/fever, but also found in her blood work that she had abnormally crazy high alkaline levels..like in the 2000s. They said that everything else tested ok so for whatever reason hers were just really high, and to get them retested again in the next few weeks to see where they’re at. In November we moved to the country and are on a well/septic system now. Is it possible that our well water would have anything to do with her alkaline levels? Any ideas or input is appreciated!

  • robin long

    Could you tell me what this reading is on my alkaline phosphatase 63 reading

  • Reshma

    my Alkaline Phosphatase level is 8 u/l. is this too low? and what can be the cause?

  • Girish Kumar Baswal

    I have high alkaline phosphate 137 by blood report so pls suggest me what I do so it would normal

  • Imran Ahmed

    This article help me in one of my university presentation. thanks

  • Idna

    Would Magnesium supplementation elevate ALP values? I take 400 mg a day, but I also take NDT for hypothyroidism and I’m diagnosed with osteoporosis and gallstones. There’s no pain with gallstones so surgery isn’t necessary right now. My ALP 143 IU/L with a range of 39-117. OTher blood values are normal.

  • SONDRA H.

    I HAVE A LOW ALKALINE HOSPHATASE ON MY LAST BLOOD TEST. I AM NOT SURE I HAVE EVER HAD THIS CHECKED ON PREVIOUS BLOOD TEST. SHOULD I BE CONCERNED? MY DOCTOR WILL LOOK AT THE RESULTS.

  • Christina

    There are several studies on Pub Med linking low ALP to zinc deficiency.

  • Olatunji Ayodele

    My laboratory gives ALP normal range of 70_ 460 U/L. and. my result as 509U/L.
    Are these readings realistic?

  • Khendra

    Add me to the list of those with Hashimoto’s thyroiditis plus low Alk Phos levels (I test around 17 U/L every time I go to the doctor’s; they have never been concerned about the levels — I discovered them myself by accessing my test results online, and wondering if it meant anything meaningful).

  • Cindi Anderson

    I should add, at the same time my MCV/MCH normalized for the first time in my life (I always previously had macrocytosis which wasn’t helped from the normal things), and I attribute that to taking folinic acid instead of just 5 methyl folate. I started that after realizing I had an SNP that often needs more folinic acid.

    I had also heard alkaline-phosphatase could be from low zinc or high P5P. But I’ve been taking zinc for a long time, and P5P on and off with no change.

  • Cindi Anderson

    I have been low for many years. Recently my levels came up to normal range, but around the same time my creatinine dropped below normal for the first time. Thoughts? I eat fairly high fat/low carb and intermittent fast, but was doing that before these changes. I’ve also been putting on more muscle than before.

  • Scott F.

    Surprised not to see zinc and KPU mentioned. Those are important factors with low ALP and their absence makes this article feel lacking.

    1. Nattha Wannissorn, PhD

      We have a post on KPU, but a lot of literature about this disease are so old. Do you have any citations to share?

  • Kathy P.

    I’d like to hear your response to the previous comment/question from ADAM C. I have the same situation – consistently low ALP level (10 years +) and Hashimoto’s thyroiditis. I also have low vitamin D even though I take a D3 supplement daily.
    Are all of these things related? And what can I do to raise my ALP?

  • Adam C

    I consistently have below range ALP. I also have Hashimoto’s thyroiditis. What can I take to raise my ALP? Will N-acetyl Cysteine help? Thanks

  • Alice Aman

    If I’m reading this right (and I scanned it quickly), seems that high ALP in some cases is very good and in other cases is very bad. Kind of confusing. Wish you had some kind of matrix or something that had rows of “conditions/diseases” and columns of “desirable level” i.e. high or low?

    1. Nattha Wannissorn

      Thanks for the comments, Alice. Gut ALP is very important, so it’s important to have enough.
      Whereas, liver ALP and non-tissue specific ALP is typically only elevated where there is liver and tissue damage. We’ll definitely consider including a table for this post and the next ones. ~Nattha @ Team SelfHacked

  • pamojja

    Though can’t remember where, heard a consistent ALP below 70 would indicate Zinc deficiency. In my case seems could be the case, since recent intake above 50mg/d correlated with an ALP of about 90, while below 50 mg/d of Zinc it averaged at 70 for many years.

    1. Nattha Wannissorn

      Is that for yourself or from a study?

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