High Alkaline Phosphatase: Causes, Symptoms And Treatment

Alkaline phosphatase (FA) is an enzyme in the body whose main function is to eliminate phosphate groups, that is, the chemical groups with phosphorus that the molecules of the body have, such as nucleotides, proteins or alkaloids.

There are situations in which we find high alkaline phosphatase for various reasons that we will see later. When this happens, the person is in a situation of hyperphosphatemia, since, as there are more enzymes that eliminate the phosphate groups from the molecules, they pass into the blood, thus increasing their levels.

What exactly is alkaline phosphatase?

As we have mentioned, alkaline phosphatase is an enzyme, specifically a hydrolase, that moves through the body thanks to the blood system. However, it is in the liver, in the bile, in the growing bones, in the kidneys and in the intestinal system where it accumulates the most.

As its name indicates, alkaline phosphatase is more effective in an alkaline medium and its chemical name is orthophosphoric monoesterhydrolases . It comes from the normal breakdown of blood cells and other tissues.

Although it accumulates in all the structures mentioned above, it is in the bile and in the growing bones where there is the highest concentration of alkaline phosphatase, since they are the places where it is obtained. This enzyme fulfills a large number of biological functions. Among them we can highlight its ability to facilitate the diagnosis of diseases and different conditions that we will see later.

Furthermore, AF has an important role in the calcification of bones and cartilage. Although it is still being studied, it is believed that it participates in the bone resorption process by removing a layer of phosphate that is present in them.

However, its main function in the body is to carry out dephosphorylation, that is, to eliminate the phosphate group of various molecules in the body such as proteins.

Why are alkaline phosphatase levels elevated?

Research has recently pointed out that the reasons or events responsible for an increase in phosphataemia are increasingly numerous, a situation that is triggered when we have high alkaline phosphatase.

There are many causes that can cause the values ​​of this enzyme to rise. Sometimes these values ​​increase for reasons that have nothing to do with illnesses, but many others are due to previous illnesses.

These are some of the different situations that can trigger high alkaline phosphatase:

• Growth age : it is during the growth period when the increase in alkaline phosphatase levels is considered normal, since it is up to three or four times above the reference value. In people over 60 years of age, growth of up to 30% due to bone involution is also normal.

• Pregnancy : especially during the third trimester.

• Familial benign hyperphosphatasemia : is a rare disease characterized by the presence of high alkaline phosphatase in several members of the same family in the absence of a disease or known cause of hyperphosphataemia.

As for the diseases that can cause an increase in the levels of this enzyme, we can highlight:

• Rickets.
• Liver diseases : such as hepatitis, fatty liver or cirrhosis.
• Bone problems : tumors, fractures, Paget’s disease, osteomalacia or osteomyelitis are some of the examples of bone diseases that may be responsible for this increase in alkaline phosphatase levels.
• Neoplasms : sometimes tumors can cause tumor isoenzymes to be produced, which directly affects the increase in alkaline phosphate in the body.

Associated symptoms

The test that is usually done to know the levels of FA is a blood test prescribed by a doctor. This method is used to detect diseases linked to the bone marrow or liver, among others.

The normal levels of blood FA are 44 to 147 IU / L (international units per liter of blood). When these levels rise considerably is when problems appear. As in most cases the reasons why the levels of this enzyme increase are due to liver or bone problems, the symptoms are usually related to problems such as:

• Physical weakness
• Nausea and vomiting
• Deformation and fractures of the bones.
• Dark colored urine and light colored stools.

Apart from these symptoms, it is also common to observe in a patient with high levels of FA loss of appetite, fever, pain in the joints or jaundice (situation in which the mucous membranes and the eyes of the body stain a yellowish color) .

How do we lower alkaline phosphatase levels?

The first thing to do is detect the causes that are causing this increased concentration of the enzyme to be able to carry out the most appropriate treatment for the disease.

Medications to lower high alkaline phosphatase levels or vitamin D supplements are usually prescribed. In addition, the use of contraceptive pills should be reduced, since they affect bone development, anti-inflammatory drugs, antidepressants, psychotropic drugs and antihypertensives, among others.

On the other hand, diet should be controlled, as it is a factor that can greatly help lower alkaline phosphatase levels. For example, it is highly recommended to eat foods rich in vitamin D such as fish, milk or tuna, and those that contain copper, such as nuts, avocados or legumes.

Finally, physical activity and stretching exercises are very beneficial in cardiovascular and bone diseases, as well as sunbathing for approximately 20 minutes each day, as it is a great way to synthesize vitamin D.