Alkaline phosphatase (ALP) is a type of enzyme found in many areas of your body, including your liver, digestive system, and your bones.
High levels of alkaline phosphatase can be an indicator of many different health issues, so you’ll need to work with your healthcare provider to determine the most likely root cause if your ALP is high.
This can include ordering additional blood tests and other diagnostics such as imaging (scans, X-rays, etc).
In this article, we’ll review some of the more common causes of high ALP, as well as foods to eat and avoid for these common causes.
What foods to avoid if alkaline phosphatase is high
Alcohol
One of the potential causes of high alkaline phosphatase (ALP) is liver damage. This includes liver cirrhosis, which is commonly caused by alcohol abuse.
If you have liver cirrhosis from alcohol abuse, you’ll need to abstain from alcohol to help heal your liver.
Avoid alcohol in all forms, including beer, wine, hard alcohol, alcoholic seltzers, and mixed drinks.
High-fat foods
Eating high-fat foods can worsen blockages of the common bile duct from gallstones. The reason is that your body produces more bile in response to a high-fat meal (bile helps digest fatty meals).
If bile is already backed up and causing high ALP, then producing more bile isn’t going to help the situation.
Eating some healthy fats such as olive oil, salmon, nuts, seeds, and avocados is generally considered okay, but if your healthcare provider suggests that you avoid all types of fat, then you should exclude them from your diet until further notice.
Examples of less nutritious high-fat foods to avoid for gallbladder issues causing high alkaline phosphatase include:
- Beef (primarily non-lean cuts with marbled fat or non-lean [20% fat] ground beef)
- Butter
- Cheese
- Coconuts (including coconut oil)
- Ice cream
- Lamb
- Lard and cream
- Non-lean cuts of pork
- Palm oil and palm kernel oil (common ingredients in processed foods)
- Poultry with the skin on
- Processed meats like sausage, hot dogs, and salami
- Some baked and fried foods including ingredients like lard and butter
Get your FREE bladder diary
- Daily bladder diary
- Better understand your urinary symptoms
- Step-by-step guide
Refined sugar
While eating a high-refined sugar diet doesn’t cause high alkaline phosphatase levels, it’s still recommended to avoid high-sugar foods.
High-sugar foods and drinks can contribute to liver problems over time, such as non-alcoholic fatty liver, which can eventually lead to liver disease.
Most Americans consume way too much refined sugar, which is the type found in processed foods and drinks like:
- Soda
- Sweetened tea and coffee beverages
- Energy drinks
- Desserts
- Candies
- Sweetened foods like breakfast cereals, granola bars, flavored yogurt, etc.
- Condiments, salad dressings, marinades, etc.
Aim to keep your intake of added sugar (not counting the natural sugar in fruits, vegetables, etc) to 32 grams per day for women and 36 grams per day for men.
That boils down to 6 and 9 teaspoons of added sugar per day for women and men, respectively.
Foods to eat with high ALP
Fruits & vegetables
Fruits and vegetables are packed with nutrients and antioxidants that can help ease inflammation.
They are also low in fat (minus avocadoes), which means they aren’t likely to worsen gallbladder problems.
Aim for a variety of fruits and vegetables in different colors, which indicates that you’re getting a variety of antioxidants and phytochemicals (the compounds that give fruits and veggies their color).
Whole grains
Whole grains are rich in fiber, which impacts your liver health. Fiber helps reduce inflammation in the liver and reduces the risk of liver injury, according to a study!
Whole grains are healthier than their refined counterparts, like white bread and white rice. Some examples of whole grains include:
- Oatmeal*
- Barley
- Whole grain corn*
- Whole wheat bread, tortillas, pancakes, etc.
- Bulgur
- Millet*
- Farro
- Brown rice*
- Spelt
- Buckwheat*
*=gluten-free
Beans and lentils
Beans and lentils are a lean (low-fat) source of protein and are also packed with beneficial fiber to support liver health (remember that high alkaline phosphatase can often be linked with liver problems).
Not only are beans and lentils a great plant-based source of protein, but compared to meat, they are much more budget-friendly.
Lean protein
Since high-fat foods aren’t generally recommended for high alkaline phosphatase levels (high-fat foods can worsen gallstones, a common cause of high ALP), you’ll need to focus on lean (low-fat) protein sources in place of fatty meats, sausages, etc.
Some examples of lean protein sources include:
- Skinless poultry
- Lean cuts of beef and pork, such as lean ground beef and pork loin
- Eggs
- Soybeans (tofu, tempeh, etc)
- Low-fat dairy products
- Seafood, e.g., shrimp, crab, white meat fish like tilapia, etc.
Low-fat dairy
Some sources of dairy products are high in fat, like cheese and butter. If you need to be on a low-fat diet for issues like gallstones, can you still eat dairy?
The good news is that dairy products come in a variety of fat concentrations, ranging from nonfat to full-fat.
Nonfat or low-fat dairy products offer protein, calcium, and other nutrients while sparing the fat.
For a low-fat diet, opt for nonfat, low-fat (1% milkfat), or reduced-fat (2% milkfat) dairy products such as milk and yogurt.
For cheese, white cheese like mozzarella and cottage cheese are lower in fat than darker cheeses like cheddar.
What causes high alkaline phosphatase?
There are several potential causes for a high alkaline phosphatase level. We’ll review some of the more common causes next, but know that there are other potential reasons your alkaline phosphatase might be high.
Choledocholithiasis (most common cause)
Choledocholithiasis is the medical term for the presence of gallstones in your common bile duct.
Your liver produces bile, a substance that helps digest foods. It’s excreted from your liver into your intestines through a structure called the common bile duct, which passes through your pancreas and into your small intestine.
If the common bile duct is blocked with a gallstone, it can cause a backup of bile and lead to high alkaline phosphatase levels.
Liver damage
Alkaline phosphatase is an enzyme that is produced in your liver. High levels of alkaline phosphatase can indicate liver problems, such as hepatitis (the inflammation of your liver) and cirrhosis (liver scarring).
High alkaline phosphatase levels can also indicate a buildup of pressure within your liver. This can happen when substances produced by your liver (like bile) can’t effectively exit your liver, causing a buildup of pressure.
Your healthcare provider can help determine the potential cause of your liver problem if you have one and whether it’s acute (short-term) or chronic (long-term).
Bone disorders
Alkaline phosphatase is found in your liver and digestive system but is also found in other areas of your body, like your bones.
High levels of alkaline phosphatase in your bones can be an indicator of a bone disorder such as Paget’s disease, which causes weak, easily broken bones.
If you have a bone disorder, your alkaline phosphatase level would likely be high without your liver enzymes also being high, which can help to rule out digestive causes of high ALP.
What symptoms does high alkaline phosphatase cause?
Having a high alkaline phosphatase level isn’t likely to cause symptoms on its own because it’s usually a symptom of something else.
If you have gallstones (a common cause of high alkaline phosphatase levels), you might have symptoms such as:
- Steady, severe pain in your upper abdomen increasing in intensity over 30 minutes to several hours
- Pain between your shoulder blades or in your right shoulder
- Nausea
- Vomiting
- Fever
- Chills
- Jaundice (yellowing of your skin or eyes)
- Abdominal bloating
- Intolerance of fatty foods
- Belching or gas
- Indigestion
If you have liver problems, such as hepatitis or cirrhosis, some of the symptoms that might occur include:
- Feeling tired and weak
- Loss of appetite (which may result in unintentional weight loss)
- Low libido (low sex drive)
- Jaundice (yellowing of the whites of your eyes and/or skin)
- Itchy skin
- Feeling sick
What can I do to lower my alkaline phosphatase?
The main way to lower high alkaline phosphatase is to treat its root cause. While there are many potential causes of high alkaline phosphatase (some common and some rare), we’ll outline common treatments for the more common causes of high alkaline phosphatase.
| Common cause of high ALP | Potential treatment |
| Gallstones | Cholecystectomy (removal of gallbladder)Medications to dissolve gallstonesLow-fat diet |
| Liver disease (e.g., cirrhosis, hepatitis) | Alcohol cessation (if caused by alcohol abuse)Medications (antiviral medications for certain types of hepatitis) |
Conclusion
- High levels of alkaline phosphatase (ALP) can be an indicator of many different health issues, but among the more common causes are gallbladder problems (gallstones blocking the common bile duct) and liver disorders.
- Foods to eat for gallbladder and liver problems causing high ALP include lean protein, fruits, vegetables, and whole grains, while foods to avoid with high alkaline phosphatase include high-fat foods, alcohol, and large amounts of refined sugars.
Explore More
