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Alkaline phosphatases (ALP) are a group of isoenzymes located in the cell membrane. In the body, there are two types of ALPs, tissue-specific and tissue-nonspecific. While both can be found in plasma, tissue-nonspecific ALPs are the most abundant. Levels are highest during childhood and puberty due to bone growth and decline as we age. (source)
Low alkaline phosphatase levels can stem from physiological factors affecting liver function and bone health. Nutritionally, low alkaline phosphatase concentrations can stem from factors related to malnutrition, such as zinc or magnesium deficiencies. (source)
Prioritize zinc-rich foods: Low levels of alkaline phosphatase have been associated with low zinc. (source) Zinc has been shown to increase ALP activity by increasing the enzyme's half-life, as well as by reversing the effect of inorganic phosphate withdrawal. (source, source) Recommendation: Consume at least two servings of zinc-rich food a day.
One serving example: Oysters (3 oz), Beef (lean cuts) (3.5 oz), Crab (3 oz), Pumpkin Seeds (¼ cup), Lamb (3 oz)
Prioritize magnesium-rich food: Low levels of alkaline phosphatase have been associated with low magnesium. (source) Magnesium can affect the structure and function of ALP by increasing activity, as well as by controlling structural binding sites of the enzyme. (source) Recommendation: Consume at least two servings of magnesium-rich foods per day.
One serving examples: Chia Seeds (2 tbs), Pumpkin Seeds (¼ cup), Almond (1 oz), Cashews (1 oz)
Resistance training: Alkaline phosphatase, a marker of bone formation, has been shown to positively respond to resistance training. Resistance training increases the mechanical load on the skeleton, which stimulates osteogenesis, or bone formation (source, source, source, source) Recommendation: Follow a structured resistance training program with moderate to heavy loads at least two times a week. The final set of each exercise should be taken within two repetitions of failure.
Supplement with zinc: Low levels of alkaline phosphatase have been associated with low zinc concentrations. (source) Zinc has been shown to increase ALP activity by increasing the enzyme's half-life, as well as by reversing the effect of inorganic phosphate withdrawal. (source) Recommendation: Supplement with at least 5 mg of zinc daily.
Supplement with magnesium: Low levels of alkaline phosphatase have been associated with low magnesium concentrations. Supplementation with magnesium, which is a co-factor of ALP, has been shown to increase ALP activity through the interaction of structural sites on ALP to convert it into a more active form. (source, source) Recommendation: Supplement with at least 200 mg of magnesium daily.
Elevated alkaline phosphatase levels can often result from physiological factors linked to liver, kidney, and bone health. These increased levels can have wider implications as they are associated with obesity and metabolic inefficiencies. (source, source)
Prioritize foods high in vitamin D: Vitamin D concentrations in the blood are inversely correlated with ALP. (source) ALP plays a major role in bone mineralization and is released into the blood during states of high bone turnover. (source) Vitamin D influences parathyroid hormone concentrations, which are positively associated with bone turnover. (source) Adequate concentrations of vitamin D help maintain healthy parathyroid concentrations and support a healthy bone turnover, reducing ALP concentrations. Recommendation: Consume at least one serving of foods high in vitamin D daily.
One serving examples: Rainbow Trout (3 oz), Salmon (3 oz), Maitake Mushrooms (sliced) (1 cup), Fortified Milk (8 oz)
Avoid processed foods: Ultra-processed food consumption is associated with high ALP concentrations. (source) The body stores significant amounts of ALP in the liver. When the liver is stressed, ALP is released into the blood. (source) Processed foods have been shown to stress the liver and increase ALP concentrations. (source) Relieving liver stress helps to decrease ALP concentrations. Recommendation: Monitor the consumption of processed foods and limit or avoid them when possible.
Avoid smoking: Smoking has been associated with elevated ALP concentrations. (source, source) Smoking has been shown to stress primary ALP storage sites, like the liver. When these organs are stressed, ALP is released into the blood. (source, source) Relieving liver stress helps to decrease ALP concentrations. Recommendation: If a smoker, take the steps to quit. If not, avoid areas where secondhand smoke is present.
Get sun exposure: Low levels of serum vitamin D have been associated with elevated alkaline phosphatase levels. (source) Sun exposure increases vitamin D concentrations. (source, source) Vitamin D influences parathyroid hormone concentrations, which have been shown to be positively associated with bone turnover. (source) ALP is released into the blood during states of high bone turnover, a result of its role in bone mineralization. (source) Adequate concentrations of vitamin D help maintain healthy parathyroid concentrations and support a healthy bone turnover, reducing ALP concentrations. (source) Recommendation: Get at least 30 minutes of outdoor sunlight exposure with as much skin exposed as possible daily.
Supplement with vitamin D: Vitamin D concentrations in the blood are inversely correlated with ALP. (source) ALP plays a major role in bone mineralization and is released into the blood during states of high bone turnover. (source) Vitamin D influences parathyroid hormone concentrations, which are positively associated with bone turnover. (source) Adequate concentrations help maintain healthy parathyroid concentrations and support a healthy bone turnover, reducing ALP concentrations. Recommendation: Supplement with at least 2,000 IU of vitamin D daily during the spring, summer, and fall months. Increase supplementation to at least 4,000 IU during the winter months.
