How to Treat High Alkaline Phosphatase

Co-authored by Marsha Durkin, RN and Amber Crain

Last Updated: October 13, 2023 Fact Checked

Alkaline phosphatase (ALP) is an enzyme naturally found in your liver, digestive system, kidney, and bones. A high ALP may indicate health conditions including liver damage, liver disease, bone disease, or a blocked bile duct. In most instances, high ALP is a temporary and non-serious concern. Children and teenagers, in particular, may have a higher ALP than adults. ALP rates can be lowered through a combination of medication, dietary changes, and lifestyle modifications. Talk to your doctor about whether further testing is needed.^{[1]
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Method 1

Method 1 of 3:

Managing Medications and Health Conditions

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1
Control the disease or condition that is causing your high ALP. ALP is typically the symptom of a different health condition. So, to reduce your ALP, you’ll need to control the underlying condition. High ALP can be caused by conditions as varied as a vitamin D deficiency and bone disorders.^{[2]
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- For example, if your doctor figures out that your high ALP rates are being caused by liver disease, they’ll prescribe you a medication to deal with the liver disease. The high ALP will normalize on its own after the liver disease has been dealt with.
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Figure out if medications are causing high levels of ALP. Certain prescription medications have a side effect of raising ALP levels. Your doctor will likely ask you to stop taking one or more of these medications for a pre-determined amount of time (e.g., a week), and then to come back to the office for another blood test. If your ALP levels have not decreased, you may need to take a week off from a different medication, to see if that has an effect on your ALP. Medications that can lead to high ALP levels include:^{[3]
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- Birth control pills and hormonal drugs.
- Antidepressants and anti-inflammatory medicines.
- Various steroids and narcotics.
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3
Stop or switch out your medications as necessary. In some cases, you may not be able to safely stop taking a prescription medication altogether. If you and your doctor have determined that a specific medication is giving you high ALP, work with your doctor to find an effective replacement medication. Many prescription medications require you to slowly reduce your dosage over time. Stopping cold turkey may result in unpleasant side effects.
- For example, if your current antidepressant is raising your ALP levels, ask your doctor if they can write you a prescription for a different antidepressant.
- On the other hand, your doctor will probably recommend that you stop using steroids and narcotics altogether. If you’re taking these products for pain management, ask your doctor to recommend a safe alternative that will not impact your ALP levels.
- Whether you’re stopping medications temporarily or permanently, be sure to only do so under a doctor’s supervision.

Method 2

Method 2 of 3:

Treating High ALP through Dietary and Lifestyle Changes

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Eliminate foods high in zinc from your diet. Zinc is a structural element of the ALP enzyme. Consequently, cutting out zinc-rich foods from your diet will automatically decrease the amount of ALP in your body. Read the “Ingredients” list on a food product if you’re not sure how much zinc it contains. Foods that contain large amounts of zinc include:^{[4]
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- Lamb and mutton.
- Beef and pumpkin seeds.
- Oysters and spinach.
- Adult women should avoid consuming more than 8 milligrams (0.0080 g) of zinc daily, and Adult men should avoid consuming more than 11 milligrams (0.011 g).^{[5]
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Eat foods that are high in copper. Copper is important in regulating the body’s enzyme levels, and has been shown to help decrease high levels of ALP. Foods that are rich in copper include:^{[6]
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- Sunflower seeds and almonds.
- Lentils and asparagus.
- Dried apricots and dark chocolate.
- Adults over 19 years of age should avoid consuming more than 900mcg of copper daily.^{[7]
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Incorporate foods that will help control enzyme levels. Certain types of food will encourage a healthy ALP level in your body. Speak to your doctor if you have any dietary concerns or restrictions, or would like more information about which foods can help moderate ALP levels in your body. Eat foods that will help regulate your body’s enzyme levels and that contain low levels of ALP. These include:^{[8]
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- Dairy products like milk, eggs, yogurt, and cheese.
- Fish like herring, tuna, and mackerel.
- Alfalfa and mushrooms.
4
Increase your exposure to sunlight. Since vitamin D deficiency is one of the most common causes of high ALP, your doctor will likely ask you to find a way to raise your vitamin D levels. When your skin comes into contact with sunlight, your body produces vitamin D. Try to spend at least 20 minutes in the sun on a daily basis to help lower your ALP.^{[9]
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- This could mean taking bi-weekly trips to the swimming pool, or sunning yourself on the beach or your lawn. Or, wear short sleeves and take a 30-minute walk when the sun is shining.
- It’s always a good idea to wear sunscreen when spending time in direct sunlight. The sunscreen will not interfere with the amount of vitamin D that your body produces.
- If you live in an area where it’s inconvenient to receive direct sun exposure (or if it’s winter), your doctor may suggest that you take vitamin D capsules.
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Incorporate an exercise routine into your weekly agenda. Living a healthy lifestyle, including regular exercise or work-outs, will help prevent or diminish the type of health conditions that will give rise to high ALP.^{[10]
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- You can start exercising by taking a 30-minute walk or jog each day. Also consider joining a local gym, or finding a nearby spin or yoga class to take.
- Conditions that lead to high ALP and can be improved through exercise include a fatty liver and conditions related to liver inflammation and bile blockage.
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Tailor your exercise program to fit your physical abilities. For many people with high ALP, the condition is caused by a serious illness like diabetes, heart or bone disease, or hypertension. People with these conditions may not be physically able to perform regular gym workouts or other strenuous tasks. While it’s still important to have an exercise regimen, tailor this to your physical abilities.^{[11]
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- For suggestions about viable types of exercise, talk to your doctor. Your doctor can also advise you as to whether or not your body is healthy enough for a specific type of exercise.
- In some cases, your doctor may refer you to work with a physical therapist.

Method 3

Method 3 of 3:

Diagnosing High ALP and Contributing Conditions

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Tell your doctor about any bone pain or weakness. Many of the underlying causes of high ALP are related to problems with your bones. Symptoms of these conditions include continual pain in your bones, or multiple bone fractures. Bone conditions that can lead to high ALP include:^{[12]
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- Osteomalacia: a medical condition which causes the bones to weaken.
- Renal osteodystrophy: a condition in which bones lack sufficient mineralization.
- Malignant bone tumors.
2
Schedule an appointment for blood work to measure your liver enzymes. In the blood test, your doctor will use a syringe to draw a small amount of blood from your arm. The blood will then be sent to a laboratory for enzyme-level testing. This will allow your doctor to detect high ALP.^{[13]
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- Ask your doctor if there are any ways you can prepare beforehand for the liver-function test. Your doctor will likely ask you to avoid certain foods or medications. The results for your bloodwork should take several days, maybe up to a week.
- Physical symptoms that indicate you may need to receive a liver screening include severe abdominal pain, dark urine or bloody stool, frequent nausea or vomiting, and yellow-looking skin and eyes.
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Ask your doctor about undergoing a cancer screening. If your high ALP isn’t related to a medical issue with your bones or liver disease, it may be caused by a form of cancer. Your doctor may be able to detect cancer through blood work. In most cases, however, you’ll need to undergo a biopsy in order to determine if you have a form of cancer. Types of cancer that can cause high ALP include:^{[14]
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- Breast or colon cancer.
- Lung or pancreatic cancer.
- Lymphoma (cancer of the blood cells) or Leukemia (cancer of bone marrow).

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The normal ALP level for adults is anywhere between 44 and 147 units per Liter.^{[15]
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In some cases, high levels of ALP can also be observed in children going through growth spurts and in women who are pregnant.^{[16]
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