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ALP

Liver Unit: U/L

Biliary and bone marker

Also known as: Alkaline Phosphatase

Reference Ranges

Clinical Reference 44.0 – 147.0 U/L
Optimal Range 44.0 – 100.0 U/L
Critical Range > 500.0 U/L

Also elevated in bone disease; age-dependent

Related Conditions

Liver Disease High
Bile Duct Obstruction High
Bone Disease High

Food & Lifestyle Recommendations

🍎 Food Ensure adequate vitamin D intake — deficiency can elevate ALP from bone turnover Vitamin D deficiency increases bone ALP as calcium metabolism is disrupted
🍎 Food Limit alcohol to protect liver function Alcohol-induced liver damage can elevate liver ALP isoenzyme
🍎 Food Include calcium-rich foods: dairy, sardines, leafy greens Adequate calcium intake reduces bone turnover and bone-derived ALP
🍎 Food Include zinc-rich foods: oysters, beef, pumpkin seeds ALP is a zinc-dependent enzyme; deficiency can cause low ALP levels

Evidence-Backed Supplements

When High

  • Milk Thistle Tier A May Decrease

    Moderate evidence; silymarin may reduce ALP in cholestatic liver disease. Meta-analyses show modest benefit.

    Silymarin extract (70–80%) 140–210 mg silymarin 2–3x/day With meals
    PMID 40552569 PMID 37816677 PMID 40738719
  • Curcumin Tier A May Decrease AYURVEDA

    Limited evidence; curcumin may reduce ALP in primary sclerosing cholangitis. Small trials show benefit.

    Curcumin with piperine or phytosome 500–1000 mg/day With meals
    PMID 34017975 PMID 31423805 PMID 38542668
  • Vitamin D Tier A May Decrease

    Limited evidence; vitamin D deficiency is associated with elevated ALP. Supplementation may normalize ALP if deficiency is the cause.

    Vitamin D3 (cholecalciferol) 1000–2000 IU/day Morning
    PMID 19370554 PMID 24414552 PMID 24729336
  • Nac Tier A May Decrease

    Limited evidence; NAC may support liver function and modestly reduce ALP in some contexts.

    N-Acetyl Cysteine 600–1200 mg/day Morning or divided doses
    PMID 30746681 PMID 39349461 PMID 33294991

When Low

  • Zinc Tier A May Increase

    Limited evidence; zinc deficiency can cause low ALP since ALP is a zinc-dependent enzyme. Supplementation may normalize levels.

    Zinc picolinate or bisglycinate 15–30 mg/day Evening, away from iron/calcium
    PMID 33724446 PMID 36994923 PMID 27996088

Questions to Ask Your Doctor

  • Could my elevated ALP be from liver or bone issues, and how can we tell the difference? ALP isoenzyme testing can distinguish liver vs bone origin. GGT helps confirm liver source.
  • Could my low ALP indicate a zinc deficiency? Low ALP can indicate zinc deficiency since ALP is a zinc-dependent enzyme.

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