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Alkaline phosphatase is an enzyme found in all tissues in the human body. In balance, it protects your gut against harmful bacteria and aids digestion. However, high blood levels usually point to liver or bone problems. Read on to understand the symptoms and causes of high alkaline phosphatase and how to reduce it naturally.

What Does High Alkaline Phosphatase Mean?

The normal range of alkaline phosphatase in the 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 [1].

Values above 130 U/L are usually considered to be high.

Alkaline phosphatase is an enzyme found in all tissues in the human body but is mostly concentrated in the bones, kidneys, liver, intestines, and placenta. It exists in different forms, depending on where it originates [1].

Its major function is to protect your intestinal tract against bacteria, aid in digestion, breakdown fats and some B vitamins, and promote bone formation [1].

High levels of ALP in the blood may indicate bone, liver, or bile duct disease.

ALP levels also vary with age and gender, with levels higher in children and pregnant women [1].

Higher ALP levels can occur in people with blood group B or blood group O [2].

In balance, ALP supports good health. In excess or deficiency, this enzyme can lead to a broad range of diseases [3].

When the liver is not functioning properly, ALP is released into the bloodstream. Additionally, any condition that affects bone growth or causes the increased activity of bone cells can increase ALP levels in the blood. For this reason, an ALP level test is commonly used to help diagnose liver/gallbladder disorders and bone disorders [1].

High alkaline phosphatase (above 130 U/L) may point to liver, gallbladder, or bone disorders.

Symptoms of High Alkaline Phosphatase

When caused by liver disease, symptoms of high ALP include [4, 5]:

  • Itching
  • Nausea and vomiting
  • Weight loss
  • Fatigue
  • Weakness
  • Jaundice
  • Swelling and pain in your stomach
  • Dark-colored urine and/or light-colored stool

Symptoms caused by bone disorders include [6]:

  • Bone or joint pain
  • Enlarged or abnormally shaped bones
  • Higher frequency of bone fractures
Symptoms of high alkaline phosphatase depend on your underlying health condition–such as liver disease or bone disorders.

Causes of High 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 [7].

Additionally, lifestyle factors, medication, and certain supplements can raise alkaline phosphatase levels.

1) Birth control pills

Birth control pills can increase alkaline phosphatase to many times the level of a normal range [8].

2) Exercise

Exercise increases bone alkaline phosphatase levels after thirty and fifty minutes of moderate to intensive exercise in male cyclists, but it quickly returns to normal [9].

3) Thyroid Hormones 

Thyroid hormones stimulate alkaline phosphatase [10, 11]. Increased alkaline phosphatase levels are also correlated with hyperthyroidism [12].

Taking birth control pills, having high thyroid hormones, and exercising shortly before doing a blood test can increase your alkaline phosphatase levels.

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 [13].

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 [14].

An anti-HIV drug (efavirenz) and the herb Cissus quandrangularis both increase alkaline phosphatase.

6) 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 [15].

Estrogen is also able to regulate the growth and expression of this enzyme in human bone marrow cell culture [16].

High levels of estrogen and testosterone breakdown products may increase the activity of alkaline phosphatase without affecting its blood levels.

7) 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 [17].

8) Colon Cancer

Alkaline phosphatase levels are frequently high in patients with metastatic colon cancer. Increasing alkaline phosphatase levels are correlated with an increased cancer stage and may indicate that cancer has spread to the liver [18].

9) 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 [19, 20].

10) 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 [21].

People with blocked bile flow and various types of cancers are more likely to have high alkaline phosphatase levels.

11) 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 [22].

12) 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 [23, 23].

13) 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 of vitamin D deficiency [24].

Alzheimer’s disease, Paget’s disease, and vitamin D deficiency may all underlie high alkaline phosphatase levels.

14) Heart Disease

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

In a prospective study of more than 3,000 elderly men, the higher alkaline phosphatase levels predict higher risks of heart attacks, strokes, and increase mortality [25].

15) 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 [26].

Heart disease and liver damage from celiac disease have been linked with high alkaline phosphatase levels.

16) 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 [27, 28].

In patients with sickle cell disease, higher levels of alkaline phosphatase are associated with vaso-occlusive crises involving the bones [28].

17) Epilepsy

Epileptic children have higher alkaline phosphatase levels compared to children without the disorder [29].

People with sickle cell anemia and children with epilepsy are more likely to have high alkaline phosphatase levels.

18) Genetic Factors

Different genes encode human alkaline phosphatases, i.e. [1]:

  • 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 your genes can influence your alkaline phosphatase levels.

Your genes may have an effect on your alkaline phosphatase levels, though more research is needed to determine their impact.

SelfDecode is a sister company of SelfHacked. The proceeds from your purchase of this product are reinvested into our research and development, in order to serve you better. Thanks for your support!

How to Reduce Alkaline Phosphatase

1) Support Your Liver

If your alkaline phosphatase levels are high because you have liver damage, look into natural ways to support the health of your liver. Your liver has the capacity to regenerate. Read our 6-step protocol for liver regeneration. In a nutshell, you should take targeted liver-protective herbs and nutrients while adapting your diet and reducing alcohol intake.

Consider liver-protective supplements like:

Vegetables like broccoli [30], onions [31], dandelion greens, cabbage, cauliflower and Brussels sprouts [32] also have a cleansing effect on the liver.

Here is a list of all foods and supplements that are good for your liver.

If your alkaline phosphatase is high due to a liver disorder, the number one step you should take is to protect and support your liver with nutrients and antioxidants like milk thistle, NAC, and vitamin C.

2) Starvation and Fasting

Starvation and fasting reduce intestinal alkaline phosphatase. Intermittent fasting is a great way to get the benefits of fasting without making many sacrifices [33].

3) 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 [34].

4) Stop Smoking

Stop smoking, as it can increase ALP levels [35].

To lower your alkaline phosphatase levels, stop smoking, get more omega-3s in your diet, and consider intermittent fasting.

5) Drink More Coffee

Drink more coffee. It is linked to lower ALP levels [36].

6) Cinacalcet

Cinacalcet, a drug for chronic kidney disease, can reduce blood alkaline phosphatase levels by more than twenty percent in patients after 26 weeks of administration. This drug should be prescribed by a doctor [37].

7) Resistance Exercise

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 [38].

8) Sun Exposure/Vitamin D

Since vitamin D deficiency has been linked with high alkaline phosphatase, be sure to check your levels. If you are deficient, get more sun and/or take vitamin D supplements. Sun exposure is a better way to increase your vitamin D levels than supplements.

Get more sun, exercise, and consider upping your coffee intake to lower your alkaline phosphatase.

Learn More

Irregular Alkaline Phosphatase Levels?

LabTestAnalyzer helps you make sense of your lab results. It informs you which labs are not in the optimal range and gives you guidance about how to get them to optimal. It also allows you to track your labs over time. No need to do thousands of hours of research on what to make of your lab tests.

This post contains links from our sister companies, SelfDecode and LabTestAnalyzer. The proceeds from your purchase of these products are reinvested into our research and development, in order to serve you better. Thank you for your support.


Alkaline phosphatase is an enzyme that helps you digest food and maintain strong bones. It’s concentrated in the liver, kidneys, gut, and bones. High levels may point to problems with these organs.

Your alkaline phosphatase is high if your blood levels surpass 130 U/L.

High alkaline phosphatase doesn’t cause any symptoms directly. Your symptoms will depend on your underlying health issue–such as liver or bone disorders.

If your levels are high due to liver disease, make sure to take supplements and nutrients that will help your liver regenerate. Some good options include milk thistle, NAC, taurine, B vitamins, and vitamin C.

Additionally, get enough sun, exercise, omega-3 fatty acids, and coffee. Reduce alcohol, stop smoking, and give intermittent fasting a try–all of these lower alkaline phosphatase levels and support good health.

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