Blood and body

What Are the Causes of low Alkaline Phosphatase?

Max. D Gray
By Max. D Gray. Updated: March 24, 2022
What Are the Causes of low Alkaline Phosphatase?

Alkaline phosphatase, also known as ALP, is an enzyme present in almost all tissues of our body, but we find it mostly in the liver, bile ducts and bones. It can also be found in the intestinal membrane, kidneys or placenta. This enzyme takes part in the so-called dephosphorylation, the process of getting rid of the phosphate groups of molecules.

There are a variety of types of alkaline phosphatase, called isoenzymes, which differ in structure and originate in different tissues, for example ALP1 is liver and ALP2 is bone. In this way, it is possible to evaluate them separately; their normal values in adults are between 30 and 140 IU / L. When a blood test shows a level lower than this, it is called hypophosphatasemia. At oneHOWTO we will look at causes low alkaline phosphatase.

You may also be interested in: How to Increase Alkaline Phosphatase


  1. Low alkaline phosphatase symptoms
  2. Possible causes
  3. Hypophosphatasia
  4. Liver disease
  5. Anaemia
  6. Leukaemia

Low alkaline phosphatase symptoms

Low alkaline phosphatase can produce symptoms such as those mentioned below:

  • fatigue
  • tachycardia (a pulse of more than 120 beats per minute)
  • shortness of breath
  • loss of your appetite
  • Jaundice
  • intolerance to cold
  • Itching
  • constipation
  • white stool, dark urine
  • major weight loss

Possible causes

There are a great number of possible causes of low alkaline phosphatase, which is why, before we go into further detail, we'd like to mention all of them:

  • Bone deformity as you grow old
  • Postmenopausal women who are given estrogen to protect against osteoporosis
  • Conditions such as coeliac disease, hypothyroidism, and enteritis
  • Deficiencies of magnesium, zinc, B12 or protein
  • Malnutrition
  • Genetic conditions such as Wilson's disease
  • In children it may be due to congenital diseases, such as cretinism and achondroplasia
  • Heart surgery


Hypophosphatasia is a genetic metabolic bone disease that even though it is very rare, is very serious. It can occur along with low levels of alkaline phosphatase and has different subdivisions (such as hypophosphatasia perinatal, odontohypophosphatasia or infantile hypophosphatasia) with different symptoms depending on the underlying cause of this disease. Symptoms are very variable depending on the form of this disease. However, the following general symptoms[1] include the following:

  • low mineralization of the bones
  • mild respiratory problems
  • progressive osteomalacia
  • easily broken bones
  • pseudogout
  • rapid weight loss
  • vomiting
  • weakness
  • The sufferer usually loses their teeth much sooner than expected

Liver disease

Alkaline phosphatase can also indicate a liver dysfunction or severe liver failure, which can be caused by cirrhosis (the condition in which the cells are destroyed by the liver), celiac disease, hepatitis (liver inflammation).

What Are the Causes of low Alkaline Phosphatase? - Liver disease


Both vitamin B12 and iron deficiency anaemia types often involve having low levels of alkaline phosphatase. Iron deficiency anaemia is when the body is unable to make enough new blood cells. Symptoms include fatigue, weakness and excessive blood loss. Most patients with iron deficiency anaemia often have low levels of alkaline phosphatase but don't know why.


Chronic myeloid leukaemia(CML) is a type of cancer that progresses at a slower pace compared to leukaemia. This disorder is also known as chronic myeloid leukaemia or chronic granulocytic leukaemia and usually affects older people, and rarely affects children.

In addition to reducing the levels of alkaline phosphatase, this disease increases your levels of white blood cells and enlarges the spleen (splenomegaly). But a spinal cord biopsy is necessary to diagnose it.

This article is merely informative, oneHOWTO does not have the authority to prescribe any medical treatments or create a diagnosis. We invite you to visit your doctor if you have any type of condition or pain.

If you want to read similar articles to What Are the Causes of low Alkaline Phosphatase?, we recommend you visit our Diseases & secondary effects category.


  • If you have any questions, please leave a comment or see your doctor.
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What did you think of this article?
cheryl kelley
Hypophosphotasia is misunderstood. It can be dominantly inherited, meaning only one gene from one parent can cause a disease state in offspring. This often leads to mild symptoms in children that go undiagnosed. It is very important to understand -- if you have LOW ALP you should not take calcium or phosphates and you are at risk for osteoporosis. As of 2015 low ALP is completely treatable. You will have to inform your doctor - most won't know. Don't take a brush off as an answer. Chronic Low ALP is a problem and it is treatable.
What can I eat to increase ALP?
OneHowTo Editor
Hi there Chris,

This article might help, it has all the information you need:

Hope this helps
Lawrence Ogwude
Alkaline phosphate is 58 Alkaline transfer 7 Asparete transferase 7 Total bilirubin 0.93 Direct bilirubin 0.12 What is the solution to this as the alkaline phosphate is low.
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What Are the Causes of low Alkaline Phosphatase?