Low Alkaline Phosphatase Symptoms: Signs, Causes, and When to Seek Help

Alkaline phosphatase (ALP) is an important enzyme in the body that plays a major role in liver function, bone health, and metabolism. When alkaline phosphatase levels drop significantly, it can indicate underlying health problems with certain symptoms. Though you may see mild symptoms initially, continuous low ALP levels can lead to severe symptoms. Understanding all the potential low alkaline phosphatase symptoms can help manage the cause and maintain overall health.

Explore the blog to learn about the key signs of low ALP levels and what they signal! But first, learn what alkaline phosphatase (ALP) actually is!

What is Alkaline Phosphatase? 

Alkaline phosphatase is an enzyme and a protein type that can accelerate chemical reactions in the body. It can be found scattered throughout the body and present primarily in the liver, kidney, and bones. It is also present in the placenta of pregnant females. 

This enzyme is helpful in:

• Bone calcification and mineralization process

• Cellular growth and movements in the cells

• Digestion in the gut microbe balance

• The breaking down of fats and specific vitamins

We need to know that alkaline phosphatase levels below 30 U/L are considered low, indicating underlying medical conditions.

6 Low Alkaline Phosphatase Symptoms 

Depending on the cause of the low alkaline phosphate, the following are the potential signs of low ALP levels:

• Fatigue: Low alkaline phosphate levels can lower energy, which can make you feel tired or weak constantly.

• Muscle Weakness: Since ALP is associated with muscle and bone health, its low levels in the body may lead to reduced muscle strength and discomfort.

• Brittle Bones and Frequent Fractures: Low ALP can contribute to bone mineralization issues, resulting in fragile bones and an increased risk of brittle bones and fractures.

• Joint Pain and Stiffness: Low ALP levels can cause a buildup of pyrophosphate, which prevents bone mineralization and leads to calcium pyrophosphate crystal disease, resulting in joint pain and stiffness.

• Dental Issues: Low ALP in severe cases can contribute to weak teeth, premature tooth loss, and enamel defects due to tooth mineralization and impaired bone.

• Skeletal Deformities: Low ALP can impair bone mineralization, which causes the bone to become fragile and soft, leading to skeletal deformities like rickets, short limbs, or bowed legs. 

Note: These symptoms are signals from your body that something isn’t right. It’s crucial to listen to them and seek medical help if you notice any of these signs.

Potential Causes of Low ALP Levels 

These are the low ALP causes that you need to be aware of to prevent further complications: 

1. Malnutrition

Malnutrition occurs when the body does not get enough nutrients, particularly protein. You could lose weight unintentionally, become weak, or feel unwell generally.

2. Zinc Deficiency

Alkaline phosphate depends on zinc for its function. Low zinc levels in the body can impair the activity of ALP, thus, lowering ALP levels.  

3. Magnesium Deficiency

ALP needs magnesium to activate. When there is a lack of enough magnesium in the body, it leads to decreased levels of alkaline phosphate. 

4. Pernicious Anemia

Research says that pernicious anemia (caused by vitamin B12 deficiency) can be a contributing factor to low ALP as it interrupts the activity of osteoblasts, the cells that are responsible for ALP synthesis and bone formation.

5. Hypothyroidism

Hypothyroidism can cause low ALP levels by reducing ALP synthesis by osteoblast cells that need thyroid hormones. This reduced osteoblast activity contributes to low ALP. 

6. Wilson Disease

Wilson's disease is marked by excessive copper accumulation in the body, especially in the brain, eyes, and liver. This condition can lead to low ALP levels because of a damaged liver and the incapability of the injured liver cells to release proteins like ALP.

7. Hypophosphatasia

Hypophosphatasia leads to low ALP levels as it includes mutations in the ALPL gene, which interrupts the function of the tissue-nonspecific alkaline phosphatase enzyme, resulting in a lack of this enzyme. This deficiency leads to reduced ALP activity, which is measured as low in blood tests.

Possible Complications Associated with Low ALP Levels

If left untreated, low ALP levels can lead to serious health issues like:

• Risks for bone diseases like rickets in children & osteomalacia in adults.

• Risk of liver conditions, such as Wilson's disease.

• Fat malabsorption

• Vitamin deficiencies

• Liver dysfunction

• Growth impairment & skeletal abnormalities like short stature, delayed motor development, and slow closure of fontanelles.

The risk necessitates the proper diagnosis and management to prevent long-term health issues.  

Should I Be Worried About My Low Alkaline Phosphatase Levels?

Though low ALP levels aren’t always an alarming sign, they can indicate the chances of some underlying conditions like malnutrition or certain genetic disorders that need to be addressed properly. The more cases of lower alkaline phosphatase can be due to modern lifestyles and modern agricultural practices. So, try to follow a nutritionally dense diet, and always for proper diagnosis and treatment.

Diagnostic Approach for Low ALP Levels

ALP blood tests will depend on the developed symptoms:

What is the ALP Blood Test?

• Measures the amount of alkaline phosphatase enzyme in the blood.

• Helps evaluate bone health, liver function, and overall metabolism.

Why is the ALP Blood Test Done?

• Diagnoses liver diseases like cirrhosis, bile duct issues, or hepatitis.

• Detects bone disorders such as osteoporosis or Paget’s disease.

• Check nutritional deficiencies of zinc, vitamin B6, or magnesium.

How is the ALP Blood Test Performed?

• A blood sample is taken by inserting a needle into a vein (generally in the arm).

• The blood is collected in the test tube, which is sent to labs for examination.

• No huge risks, just mild bruising or discomfort.

When to Expect the Test Results?

Within 1-2 business days or longer.

What Do the Test Results Mean?

• Normal ALP Levels: 30- 120 IU/L, showing no underlying health issues.

• Low ALP Levels: Below 30 IU/L may indicate these conditions: malnutrition, zinc deficiency, magnesium deficiency, hypothyroidism, or Wilson disease.

• High ALP Levels: Above 147 IU/L, indicating these conditions, liver cirrhosis, hepatitis, biliary obstruction, biliary atresia, cholestasis of pregnancy, mononucleosis, or bone metastasis.

How to Fix the Low Alkaline Phosphatase Symptoms?

Though it is easy to fix the low levels of alkaline phosphatase with just a well-rounded diet and a few lifestyle changes, let's have a look at these:

1. Correct Nutritional Deficiency

To correct malnutrition, eat foods rich in:

• Protein like eggs, beans, dairy products, fish, poultry, meat, nuts, and seeds.

• Vitamin B such as meat, leafy vegetables, eggs, beans, fish, grains, and dairy products.

• Zinc such as cereal products, meat and poultry, and milk products.

• Magnesium, including green leafy vegetables, nuts, fruits, and grains.

2. Address Underlying Conditions

Seek medical help to treat your underlying conditions like hypophosphatasia, thyroid disorders, or liver or kidney disease as they can be the potential cause of low ALP levels. 

3. Maintain Bone Health

Take vitamin D and calcium supplements to maintain your bone health. However, always ask the doctor before adding supplements to your diet. Additionally, practice weight-bearing exercises such as walking or strength training) that help strengthen bones and prevent bone loss issues. 

4. Make Lifestyle Adjustments

Stay hydrated and maintain a healthy weight through exercise and diet to support overall metabolic functions. In addition, make sure to avoid alcohol, smoking, and processed foods as they can worsen symptoms of low alkaline phosphate.

5. Get Regular Checkups

Go for regular blood tests to keep track of alkaline phosphate levels in the body. Also, carefully follow your personalized treatment plan provided by your doctor if your ALP levels remain low. 

6. Take Nutritional Supplements

Supplements are simple and powerful to concentrate on boosting all nutrition levels. Some of these supplements are:

• Vitamin essentials

• Mineral Essentials

• Thyroid boosters

• Vitamin B complexes

• Zinc

Have a handful of these supplements that can significantly speed up the ability to bounce back and restore the alkaline phosphatase levels to normal. 

Final Thoughts

Low alkaline phosphatase symptoms may include fatigue, muscle weakness, joint pain, brittle bones and fractures, dental issues, and skeletal deformities. Symptoms can arise from underlying medical issues like malnutrition, zinc and magnesium deficiency, Wilson’s disease, hypothyroidism, and hypophosphatasia. Hence, seek medical attention when you experience any symptoms of low ALP levels to address the issues timely. 

So, don’t wait—if something feels off, get it checked out. Early action can make a big difference in how you feel and how your body functions.

Read Also: What Foods to Avoid if Alkaline Phosphatase is High?