Alkaline phosphatase is an enzyme found inside all cells of the body. It is in higher concentration in certain tissues, however. Tissue damage from various diseases can release alkaline phosphatase into the blood, which can be detected on a blood test. Low levels of alkaline phosphatase are less common but also can provide clues to an underlying condition.
Vitamin and Mineral Deficiency
Low levels of certain vitamins and minerals can result in low levels of alkaline phosphatase measured in the blood. A deficiency of the minerals zinc or phosphorus can have this result. Low levels of vitamin C, especially if it is low enough to cause the connective tissue disorder scurvy, can lead to low alkaline phosphatase. Low levels of the vitamins folic acid, vitamin B12 and vitamin B6 can do the same.
Malnutrition
Malnutrition can also cause low alkaline phosphatase. This can be seen in its extreme form, starvation, or with more selective nutrient deficiencies. Excessively low calories can cause marasmus, a disease of starvation. In addition, adequate calories but inadequate protein can cause a condition called kwashiorkor that may also be associated with low alkaline phosphatase levels. A diet that leads to the vitamin or mineral deficiencies listed above can also cause low levels of the enzyme.
Digestive Problems
Certain digestive problems will also cause low levels of alkaline phosphatase, likely because they can lead to nutrient deficiencies. Celiac disease causes inflammation of the gastrointestinal tract, and this can interfere with absorption of nutrients. In pernicious anemia, the immune system attacks certain cells in the stomach, leading to decreased absorption of vitamin B12.
Hormonal Imbalances
Imbalances in some hormones can lead to low levels of alkaline phosphatase. For example, low levels of thyroxine, secreted by the thyroid gland, or low levels of parathyroid hormone, secreted by the parathyroid glands, can lead to low alkaline phosphatase.
References
- "Henry's Clinical Diagnosis and Management by Laboratory Methods"; Richard A. McPherson, et al.; 2006
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci, et al.; 2008
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