Alkaline phosphatase, sometimes abbreviated as ALP, is a group of enzymes that exist normally in the liver and bone, although the kidneys, intestines and placenta also contain ALP. Serum levels of ALP measures the amount of ALP in the blood. Normal serum levels of ALP range from 44 to 147 International Units per liter, or IU/L. To lower ALP, you need to address the cause of the elevated level. In some cases, an elevated ALP is part of a normal process.
Step 1
Determine the cause. The most common causes of elevated ALP are liver and bone disease, because these tissues contain the highest levels of ALP. An abnormal ALP always requires testing to find the cause, unless it's obvious, such as a bone fracture. An elevated ALP is normal towards the end of pregnancy; children growing rapidly may also have an elevated ALP. In these cases, the ALP will normalize on its own.
Step 2
Check for and treat liver disease. Because tissues in the liver and bile ducts contain high amounts of ALP, any injury to these structures causes ALP levels in the blood to rise. Blockages in the bile ducts or liver disease such as fatty liver or fibrosis, the presence of scar tissue, can raise ALP levels. If your alcohol intake is causing liver damage, quitting drinking may help lower your ALP levels. Treating liver disease may require seeing a hepatologist, a gastroenterologist who specializes in the liver.
Step 3
Look for bone disease. A number of bone diseases can also raise your ALP levels. Rickets, which is caused by vitamin D deficiency, may raise ALP levels. Taking vitamin D supplements will help lower your ALP level in this case. People with Paget's disease, which causes abnormal breakdown and turnover of bone, may need to take bisphosphonates -- drugs that inhibit bone breakdown -- which will lower ALP levels. Bone cancers may also cause bone breakdown and elevated ALP levels. Treating the disease will decrease ALP levels..
Step 4
Assess your medications. Medications that can cause liver problems may be a source of an elevated ALP level. Birth control pills, anti-inflammatory medications such as steroids, male hormones, narcotic pain medications, tranquilizers and tricyclic antidepressants can also cause a rise in ALP. Stopping the medications or switching to a comparable drug that doesn't affect the liver will lower ALP levels
Step 5
Search for other causes. If the liver or bones aren't the source of high ALP levels, more testing may be necessary. Other causes of elevated ALP include diseases that cause inflammation of the gastrointestinal tract such as inflammatory bowel disease, Crohn's disease or ulcerative colitis. Autoimmune diseases such as sarcoidosis and rheumatoid arthritis can also raise ALP levels. Treating the causes will help decrease elevated ALP levels. Damage to the heart muscle from a myocardial infarction or lung tissue damage can also release excess amounts of ALP into the bloodstream. Parathyroid disease, which raises the amount of calcium in the blood, can also raise ALP levels. Drugs that lower elevated calcium levels may also lower ALP levels.
Tips and Warnings
- Although tests for specific enzymes aren't done often, elevated ALP-1 levels indicate liver disease while elevated ALP-2 levels indicate bone disease.
- An elevated ALP level can indicate a serious disease process. Always search for the cause and don't ignore it.
