A dietitian’s guide to navigating high alkaline phosphatase

Key Points

• High ALP is a symptom, not a disease. Think of elevated alkaline phosphatase as a marker of a potential liver or bone issue; it’s not a diagnosis on its own.
• Foods don't directly lower your ALP, but a healthy diet supports your liver and bone health, which can help your ALP levels get back to normal.
• The right food plan depends on why your ALP is high. An eating plan for liver support looks pretty different from one designed for bone health.
• Always work with your healthcare provider to figure out the cause of your high ALP and create a full treatment strategy.

Seeing an out-of-range number on your lab report can be unsettling. If your recent blood test showed high alkaline phosphatase (ALP) levels, you’re probably wondering what it means and, more importantly, what you can do about it. It’s totally natural to look for solutions in your daily habits, especially your diet.

You might be searching for a simple list of foods to eat (and not eat) with high ALP, but the story behind high ALP is a bit more complex. The truth is, no specific food directly raises or lowers your ALP levels. Instead, high ALP is a signal – a clue that there might be an underlying issue with your liver or bones.

The best way to think about your diet isn't about targeting the number itself. It's about supporting the health of the organ system that’s waving the red flag. This guide will walk you through what high ALP means and how you can use food to support your body right where it needs it most.

What exactly is alkaline phosphatase (ALP)?

Before we get into food, let's quickly cover what ALP is. Alkaline phosphatase is an enzyme found all over your body. Enzymes are basically little protein helpers that make chemical reactions happen, and ALP is involved in a lot of them.

“ALP is an enzyme that’s found in cells throughout the body,” explains Leann John, RD. “Typically, 80% of the ALP reflected in blood testing comes from the liver and bone. Notable intestinal presence of this enzyme could also correlate elevated ALP levels to impaired gut health and integrity.” 

It’s most concentrated in your:

• Liver: Specifically, in the cells that line your bile ducts
• Bones: Where it helps with bone growth and repair
• Intestines and kidneys: It has a smaller role here, but generally modulates renal function

Because it’s in a few different places, a high ALP level on a blood test points your doctor toward a problem, but it doesn't tell them the exact issue. Your medical provider will use other tests, like a GGT test or an ALP isoenzyme test, to figure out if the source is your liver, your bones, or somewhere else.

Leann John, RD, says that the functional nutrition question to ask is: Where did elevated ALP levels originate? Functionally optimal ALP levels are 70-100 U/L vs the conventional range of 25-120 U/L. A marginally elevated ALP of 100-130U/L is more reflective of impaired intestinal health vs. direct liver or bone concerns. Regardless, a healthy gut is essential to liver and bone health. 

Why is my alkaline phosphatase high?

Think of a high ALP reading like the check engine light in your car. It tells you something needs attention, but you need a mechanic to run diagnostics and find the real problem. The most important first step is working with your doctor to understand the root cause.

Here are some of the common reasons why ALP might be elevated:

Common liver-related causes

If other liver enzymes (like ALT and AST) are also high, it often points to a liver issue. When liver cells are damaged or when bile flow gets blocked, they can release more ALP into your bloodstream.

Common causes include:

• Non-alcoholic fatty liver disease (NAFLD): A condition where extra fat builds up in the liver
• Hepatitis: This is just inflammation of the liver, which can be caused by viruses, alcohol, or autoimmune conditions
• Bile duct obstruction: Blockages from things like gallstones
• Cirrhosis: Scarring of the liver tissue

Common bone-related causes

If your other liver tests look normal, the high ALP might be coming from your bones. This usually happens when there's a lot of bone cell activity.

Common causes include:

• Healing fractures: Your body makes more ALP to help rebuild the bone
• Paget's disease of bone: A chronic condition that makes bones grow larger and weaker than they should be
• Vitamin D deficiency: Being really low in vitamin D can lead to bone-weakening conditions that raise ALP.
• Bone cancers or cancers that have spread to the bone

Other normal reasons for high ALP

Sometimes, high ALP isn't a sign of a problem at all. It’s perfectly normal for ALP levels to be a bit higher in kids and teenagers, who experience rapid bone growth, as well as pregnant women. The placenta makes its own ALP, so levels naturally go up during the third trimester.

Can diet really lower high alkaline phosphatase?

Here’s the most important thing to remember: You don’t eat to lower a number on a lab report; you eat to support the health of the organ that’s causing the trouble.

Your diet is a powerful tool for reducing inflammation, getting essential nutrients, and easing the overall workload on your body. The right food choices can help you manage the underlying condition, and as that improves, your ALP levels will likely follow and return to a normal range.

So, let's break down the food strategies based on whether the issue is with your liver or your bones.

Foods to ease up on for a happier liver

If your doctor figures out that your high ALP is liver-related, the goal is to reduce the strain on your liver. Think of your liver as your body's main filter. If you overload it with hard-to-process stuff, you can make inflammation and damage worse.

Here are the key things to limit or avoid to give your liver a break:

1. Saturated & trans fats

Foods loaded with these unhealthy fats can contribute to fat building up in your liver, which is the main issue in NAFLD. When your liver is overwhelmed with unhealthy fats, it just can't do its job efficiently.

Foods to limit: Fried foods (French fries, fried chicken), fatty cuts of red meat, processed meats (sausages, bacon), full-fat dairy, and store-bought baked goods made with partially hydrogenated oils.

2. Added sugars & refined carbs

Your liver has to deal with all the sugar you eat. A diet high in added sugars, especially high-fructose corn syrup, forces the liver to turn that sugar into fat. This process is a huge driver of NAFLD. Consuming too much high-fructose corn syrup promotes liver inflammation and fat accumulation.

Foods to limit: Sugary drinks (sodas, sweet tea, most fruit juices), candy, pastries, cakes, white bread, white pasta, and sugary cereals.

3. High-sodium processed foods

Sodium itself doesn't directly attack the liver, but foods that are high in sodium are usually also highly processed and generally unhealthy. Some research even suggests that a high-salt diet might contribute to liver cell damage and fibrosis (scarring).

Foods to limit: Canned soups, frozen dinners, processed meats, fast food, and salty snacks like chips and pretzels.

4. Alcohol

This one is big. If your high ALP is from any kind of liver inflammation or damage, alcohol is one of the most important things to avoid. Your liver is in charge of metabolizing alcohol, and that process creates nasty byproducts that can damage liver cells. For anyone with a liver condition, abstaining from alcohol is a critical step toward healing.

What to eat to support your liver

Now, for the more positive side of things! The foods that can help your liver are delicious, nourishing, and easy to build a healthy lifestyle around.

The power of a plant-forward, Mediterranean-style diet

Instead of obsessing over individual "superfoods," it's more helpful to think about your overall eating pattern. The Mediterranean diet is a rockstar for liver health. It's packed with antioxidants and anti-inflammatory compounds that protect your liver.

This way of eating is all about:

• Fruits and veggies: Aim for a rainbow of colors
• Whole grains: Things like oats, quinoa, brown rice, and whole-wheat bread
• Legumes: Beans, lentils, and chickpeas are your friends
• Healthy fats: Think olive oil, avocados, nuts, and seeds
• Lean protein: Fish, chicken, and plant-based proteins

Coffee's surprising role in protecting your liver

Coffee drinkers, great news! Tons of studies show that regular coffee drinking is linked to a lower risk of liver disease and lower liver enzymes. It seems that compounds in coffee help reduce liver inflammation and scarring. So go ahead and enjoy your black coffee or coffee with a splash of milk – just try to skip the sugar and heavy creams.

Key nutrients for your liver

• Vitamin E: This antioxidant has been shown to help reduce inflammation and damage in people with NAFLD. You can find it in almonds, sunflower seeds, and spinach.
• Omega-3 fatty acids: Found in fatty fish like salmon and sardines, as well as walnuts and flaxseeds, these healthy fats can help reduce fat in the liver and calm inflammation.

What if it's a bone issue? 

If your doctor determines that the high ALP is coming from your bones, your diet plan will look completely different. In this case, the goal is to give your body all the building blocks it needs for strong, healthy bones.

You'll want to focus on foods that are rich in these key nutrients:

• Calcium and Vitamin D: This is the classic bone-building team. Calcium provides the structure, and Vitamin D helps your body actually absorb it.
  • Calcium sources: Low-fat dairy (yogurt, milk), fortified plant-based milks, leafy greens (kale, collards), and tofu.
  • Vitamin D sources: Fatty fish (salmon, mackerel), fortified milk, and good old-fashioned sunlight. Many people, especially if they have a deficiency, might need a supplement, but talk to your doctor about that.
• Magnesium and Vitamin K: These are the essential supporting players. Magnesium helps turn Vitamin D into its active form, and Vitamin K helps send calcium straight to your bones.
  • Magnesium sources: Nuts, seeds, whole grains, beans, and dark leafy greens.
  • Vitamin K sources: Leafy green veggies like kale, spinach, and broccoli.

Final thoughts: your diet is a tool, not a cure

Seeing a high alkaline phosphatase level can be a wake-up call to pay a little more attention to your health. While changing your diet is a powerful and proactive step, it’s important to remember its role in the bigger picture.

Your diet is a tool to help your body's healing process, but it can't replace a medical diagnosis or a treatment plan from your doctor. The first step is always to work with your healthcare team to find the root cause of your high ALP. From there, a registered dietitian can help you turn these ideas into a personalized, sustainable eating plan that works for your life – whether you need to focus on liver health, bone health, or just overall wellness.

Frequently asked questions

What is considered a dangerously high level of alkaline phosphatase?

There isn't a single "dangerous" number, because it all depends on the context of your overall health, age, and other lab results. Generally, if your levels are several times higher than the normal range (which is usually around 140 IU/L for adults), your doctor will want to investigate more urgently to rule out serious issues like a blocked bile duct or a bone disorder.

Can dehydration cause high alkaline phosphatase?

Dehydration doesn't directly cause high ALP. However, if you're severely dehydrated, it can make your blood more concentrated, which might make the levels of everything, including ALP, appear a little bit higher. This is usually a temporary thing that fixes itself once you rehydrate. It's not considered a primary cause of a truly high ALP reading.

How long does it take for ALP levels to go down?

How long it takes for ALP to go down really depends on the underlying cause and how it's being treated. For something temporary like a healing bone fracture, your levels will probably get back to normal over a few weeks or months. For chronic conditions like fatty liver disease, you might start seeing improvements over several months of consistent lifestyle changes.

What is the best drink for high alkaline phosphatase?

The right drink depends on the root cause. If it's a liver issue, your best bets are water (it helps your liver do its job) and black coffee (which has been shown to be protective for the liver). Adding lemon to your water can be a good boost, too, according to Leann John, RD. Green tea is also a great choice because it's full of antioxidants. If it's a bone issue, milk or fortified plant-based milks are great because they give you calcium and vitamin D. Either way, it's a good idea to steer clear of sugary drinks and too much alcohol.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.