What are the causes of low alkaline phosphatase?

The alkaline phosphatase is a single name that brings together a whole catalytic enzyme family which is responsible for mediating the displacement of phosphate groups in alkaline environments of multiple tissues of the body, being particularly active in the liver, kidneys, bile ducts, intestines, bones, and very especially, in the placenta of pregnant women and in the white blood cells.

When should the alkaline phosphatase test be done?

The blood test is performed to routinely verify the liver function viability and the possible bone injuries as a diagnostic method, or also, if the treatments in these injured organs – as a process to overcome some of their diseases – are being developed in an ideal way. Typically, an alkaline phosphatase test is indicated as a routine diagnostic test if:

  • The patient has permanent pain in the bones, deformations in them or an atypical bone fracture.
  • Exhausted.
  • Weightloss.
  • Difficulty breathing.
  • Cold intolerance
  • Dark urine and light stools.
  • Constipation.
  • Jaundice.
  • Pain in the right flank of the trunk and sustained distention of the abdomen.
  • Generalized itching

The development of a specialized isozyme analysis It is commonly indicated as a complement to the metabolic evaluation related to alkaline phosphatase, thus being able to comprehensively evaluate the activity of this enzyme in the various tissues.

Normal serum alkaline phosphatase values

The measured values ​​for alkaline phosphatase can be somewhat variable, and are dependent on the age, sex, and general condition of the patient; this is especially true in most children and pregnant women. Reference standards may also vary slightly from laboratory to laboratory. The reference table for normal alkaline phosphatase values ​​is reflected below:


  • 46 – 120 IU / l

Children and teenagers

  • Infants under 2 years: 85 – 235 IU / l
  • From 2 to 8 years: 65 – 210 IU / l
  • From 9 to 15 years: 60 – 300 IU / l
  • From 16 to 21 years: 30 – 200 IU / l

The highest values ​​occur during the sudden growth of children that occurs in stages close to adolescence (where the enzyme can increase to values ​​of 500 IU / l); It can also be increased during pregnancy, related to the development of the baby and the intense metabolic activity that takes place in the placenta.

Due to the oscillations and situations outside the standardized pattern that occurs in these cases, normally in both physiological periods it is not usually requested regularly that this test be performed, except in cases where it is necessary to verify normal placental activity.

Deviation from normal results in alkaline phosphatase values

The alteration of the normally expected results can include both an increase and a decrease in the normal values ​​of alkaline phosphatase, called hypophosphatasemia, which is a careful metabolic condition. This is considered present when laboratory values ​​are verified below 30 IU / l (International Units / liter).

Pathologies related to low levels of alkaline phosphatase

Although it is not usually very common, hypophosphatasemia is the indicator of certain organic disorders, such as:

  • Malnutrition and malnutrition.
  • Congenital deforming hypophosphatasia (PPH; it is a disease that causes a defect in the mineralization capacity of the bones, and especially, the teeth).
  • Pernicious anemia (congenital anemic disorder, derived from the inability of the intestine to properly absorb vitamin B12).
  • Aplastic anemia (severe inability of the bone marrow to make enough blood cells, particularly red blood cells).
  • Chronic myeloid leukemia (known as chronic granulocytic leukemia, it is a serious cancer in which due to a spontaneous mutation that occurs in maturity, the regulation function of the spontaneous formation of cells in the bone marrow is lost, generating uncontrolled proliferation).
  • Myelofibrosis (a blood disorder that causes scar tissue in the bone marrow).
  • Polycythemia vera (cancer in which the bone marrow produces excess red blood cells).
  • Essential thrombocytosis (a condition that causes a disorder in the activity of platelet formation in the marrow, causing frequent bleeding and a tendency to thrombosis).
  • Zinc deficit consumption.
  • Magnesium deficiency.
  • Vitamin B6 deficiency.
  • Vitamin C deficiency (associated with the development of scurvy).
  • Folic acid deficiency.
  • Poor protein intake (as in poorly balanced vegetarian diets).
  • States immediately after heart surgery, a bypass or a transfusion.
  • Some thyroid conditions, particularly hypothyroidism.
  • Cretinism (congenital hypothyroidism with chronic manifestations, such as deficit in growth rate, delayed psychic maturation, metabolic problems, delayed intellectual development).
  • Achondroplasia (Chronic, very painful pathology, caused by premature calcification of bones and cartilage, which generates malformations in the development of cartilage and prevents bones from growing and developing their final size and shape, causing deformations and overcalcifications that often impede mobility) .
  • Severe diarrhea (enteritis).
  • Celiac disease.

As well as other factors related to:

  • Toxicity and side effects of some medications.
  • Tamoxifen
  • Contraceptives oral
  • Corticosteroids, particularly the prednisone
  • Substitute therapies to prevent osteoporosis in postmenopause

Consumption tips to improve alkaline phosphatase values

The best way to recover the normal values ​​of this family of enzymes is to ensure a permanently balanced diet, and enrich it with foods that provide Zinc to the diet, among which we can name:

  • Seafood
  • Mollusks (such as oysters and clams)
  • Crustaceans
  • Veal
  • mutton
  • Pork
  • Cow liver
  • Bird meat
  • Eggs
  • Cheese, milk and butter
  • Beer yeast
  • Dark chocolate
  • Integral rice
  • Nuts (almonds, walnuts, hazelnuts)
  • Pumpkin seeds
  • Cooked soybeans and tofu
  • Chickpeas

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