Alkaline Phosphatase High in Pregnancy - How to Reduce It?

Medically Reviewed by Dr. Arti Sharma
Written by Sangeeta Sharma, last updated on 6 September 2023
Alkaline Phosphatase High in Pregnancy - How to Reduce It?

Pregnancy is a beautiful phase in which a woman's body prepares to carry a whole new life. Some transitions are pleasingly overwhelming. However, a few may bring discomfort, initiating illnesses that, at times, could be life-threatening. Such changes are marked by the fluctuations in the body components, such as enzymes, Alkaline Phosphatase.  

Alkaline Phosphatase or ALP is an enzyme produced by cells of various body organs, i.e. liver, kidney, and bone. Also, it is found in the cells of the small intestine and placenta, with progressively increasing levels found in the bloodstreams of pregnant women. However, high alkaline phosphatase in pregnancy is common. Its extremely high levels are a kind of indicator of upcoming adversity. 

Continue reading this blog to understand and learn more about alkaline phosphatase in pregnancy, its role, symptoms and how to reduce alkaline phosphatase during pregnancy.

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Role of Alkaline Phosphatase in the body

Alkaline Phosphatase is found in different organs of the body and thus has a significant role to play in bodily functions, such as: 

  1. Breaking down complex protein molecules into simpler ones.
  2. Development of bone and liver. Thus, it is required to be maintained at adequate levels in the body.
  3. Membrane transport in the placental metabolism.

The full functionality of this enzyme is not entirely known, but it is usually found that its abnormal levels are proven to be harmful to the body. ALP is expected to exist in its prescribed normal range in the bloodstream as its high levels are potent at causing devastation in the major organs. 

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Causes of High Alkaline Phosphatase

There are several reasons why Alkaline Phosphatase levels could go high in the blood. Abnormal levels of ALP are due to:

  1. Impaired functioning of organs such as the liver or gallbladder
  2. Body's malnutrition status
  3. Threat to bone health
  4. Problems with kidney 
  5. Alterations in the placenta's functions can raise ALP in pregnancy. 

Symptoms of High Alkaline Phosphatase

Below are some of the symptoms exhibited by the body when the levels of ALP are high in the blood.

  1. ALP is a potential indicator of the function of the liver and the gallbladder. When their functioning is disturbed, one could notice warning signs such as 
    1. Jaundice (skin and eyes turning pale)
    2. Stomach Pain
    3. Weakness
    4. Vomiting
    5. Inflammation
    6. Itching on the skin
    7. Changes in the urine or stool appearance
    8. Loss of appetite
  2. When there is high alkaline phosphatase in pregnancy, the above-mentioned symptoms have the least chance of appearing. This is because the symptoms of high alkaline phosphatase in pregnancy are usually different and, in most cases, are not evident. 
  3. High ALP in pregnancy can even result in Preeclampsia in pregnant women.That is, accompanied by: 
    1. High blood pressure
    2. Nausea or vomiting
    3. Proteinuria (release of proteins in the urine)
    4. Frequent severe headaches
    5. Shortness of breath
    6. Problems with vision

What if Alkaline Phosphatase is High in Pregnancy?

In pregnant women, alkaline phosphatase high in the third trimester are usually on the higher side and is a normal sign. The reason behind this is the production of ALP by the placenta. The cell name syncytiotrophoblasts of the plasma membrane are responsible for the secretion of ALP.

The ALP production in pregnant women is found to trigger between the 15th to 26th gestational week. Also, the serum of pregnant women consists of increased levels of ALP. Though the levels are normally high, awfully high levels are not desired for good maternal health.  

Extremely high levels of placental origin ALP are suspected to be troublesome to pregnant women and the fetus. Given below are some of its complications:  

Placental dysfunction or placental insufficiency is one of the relevant damages that the raised levels of ALP do to pregnant women. This condition is marked by:
  1. Oedema
  2. Thrombus on the placental entities
  3. Placental infarction
  4. Complications at the time of delivery
High ALP in pregnancy can cause HELLP syndrome. Increased levels of placental origin ALP were found to be related to the development of HELLP syndrome in pregnant women. The syndrome is typically characterised by intricacies such as:
  1. Hemolysis
  2. Low platelet levels
  3. Elevated liver enzyme levels (one of which is alkaline phosphatase).  

Abnormally elevated alkaline phosphatase levels can also be linked with IUGR (Intrauterine Growth Restriction). This can lead to:

  1. Poor development of the foetus 
  2. Preterm labour results in premature babies with low weight at birth and similar complications.
Aside from the placental origin, ALP levels can also be raised due to the shortcoming of other body organs. This can lead to:
  1. Diseases of the liver or bone
  2. Intrahepatic cholestasis
  3. Episodes of malignancies

Ways to Reduce Alkaline Phosphatase during Pregnancy?

There are ways to overcome or put an end to the complications caused by ALP. For this, finding ways to reduce abnormally high ALP levels becomes integral. Given below are a few of them: 

  1. Spend more time in the sun: As the poor status of bone health or vitamin D deficiency contributes to the high levels of ALP, getting more vitamin D will eventually reduce ALP. 
  2. Eat a balanced diet: Eating a balanced diet will support the body's vital organs and also control the high levels of ALP. Taking care of the liver becomes crucial, thus, one must consume more food that improves liver functions. 
    1. Green vegetables such as broccoli help improve hepatic abnormalities. Thus, it's always better to fill the plates more often with these vegetables to keep the ALP levels in the normal range. 
    2. One must also be aware of the nutrients that trigger or suppress ALP, i.e. avoiding the food that has more zinc, as it results in shooting ALP.
    3. Incorporating food that has high copper content is beneficial in bringing the ALP levels down. 
  3. Taking care of bone health: Taking good care of bone health and maintaining the vitality of other organs is crucial for a healthy body. This is possible by eating healthy and catching up with all the necessary activities to sustain a healthy pregnancy. 
  4. Watch the medicines: Medicines can also play a role in increasing ALP levels. Certain steroids, birth control pills, antidepressants or anti-inflammatory drugs, etc, are found to contribute to increasing the ALP levels in the body. To detect this kind of condition, doctors usually ask the patient to withdraw that particular drug for at least a week to notice changes. 
  5. Disease control: Raised ALP, in a way, is a symptom of a diseased condition that also accommodates altered levels of other body enzymes, hormones, or minerals. It is valuable to control these conditions to have stable levels of ALP in the body. Some of the conditions that can increase ALP levels are:
    1. Osteomalacia: A condition causing bone weakening.
    2. Renal osteodystrophy: A condition causing bones to lack sufficient mineralisation.
    3. Malignant bone tumours.


Alkaline Phosphatase is an enzyme that takes part in different body functions; however, its abnormally elevated levels are equally responsible for invading the smooth functioning of the body. Measures must be taken at the right time when the body features the relevant symptoms before the damage evolves intensely.  

Though ALP levels during pregnancy are usually higher, it should be discerned that they do not elevate more than their permissible limit. The extreme incline in ALP during the gestational stages is riskier because the threat here is posed to 2 lives. In such conditions, constant monitoring of ALP in the maternal serum backed with necessary medication is required. 

Either in the presence or absence of symptoms, the elevated levels of ALP in pregnancy should be responded to with proper medical assistance. HexaHealth is a reliable and exceptionally apt health tech platform comprising experienced and highly qualified medical practitioners. 

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Frequently Asked Questions

What is alkaline phosphatase (ALP)?

Alkaline Phosphatase, or ALP, is an enzyme released by the cells of different body organs, and it plays a role in various bodily functions.   

What is an alkaline phosphatase (ALP) blood test?

The alkaline Phosphatase (ALP) blood test is a kind of liver function test that is also a significant indicator for assessing the kidneys' efficiency.  

When is ALP required?

Alkaline Phosphatase (ALP) levels are required for screening, monitoring, or diagnosing potential disorders related to bone, liver, and gallbladder.  

Do I need to fast for an alkaline phosphatase blood test?

No, the Alkaline Phosphatase blood test need not require a body's fasting state. 

When can I expect the results of my alkaline phosphatase (ALP) test?

Alkaline phosphatase (ALP) test results are usually available within a day or two depending upon the laboratory in which you are getting tested. 

What do alkaline phosphatase (ALP) blood test results mean?

For a normal or healthy individual, the alkaline phosphatase (ALP) levels in the blood are expected to be within the prescribed normal range. 

High levels could suggest conditions such as: 

  1. Liver Cirrhosis
  2. Problems in the bile duct, such as blockage 
  3. Hepatitis 
  4. Swelling of the liver 

Low levels could be suggestive of the following: 

  1. Deficiency of nutrients 
  2. Thyroid abnormality 
  3. Inherited disorders of the bone 
  4. Wilson's disease (copper accumulation in the body) 

Also, its extremely high levels in pregnant women could imply severe complications such as congenital disabilities.  

What is the normal range for alkaline phosphatase (ALP)?

The normal range for alkaline phosphatase (ALP) is 20 to 140 IU/L; however, this range could slightly vary depending upon the laboratory standards. 

What does it mean if my alkaline phosphatase (ALP) is high?

High Alkaline Phosphatase or ALP levels could suggest complications associated with the liver, kidneys, bone, and small intestine. 

What does it mean if my alkaline phosphatase (ALP) is low?

Low levels of ALP could suggest nutrient deficiency, thyroid abnormalities, and other rare genetic disorders. 

Are there any risks of the ALP test?

ALP test is performed from the serum, i.e. the patient would need to undergo a procedure where the phlebotomist would puncture the vein and draw the blood sample from which the serum gets extracted. Most of the time, there is no harm. However, in rare cases, the patient could suffer the following:

  1. Hematoma 
  2. Damage to the artery in proximity to the vein 
  3. State of shock or coma 

Is the liver disease common during pregnancy?

A healthy pregnancy is expected to be free of any kind of complication; however, about 3% of pregnant women were found to be affected by liver diseases during the gestational stage and the postpartum period.

Can ALP gets raised during pregnancy?

Yes, ALP or Alkaline Phosphatase levels are usually high during pregnancy; however, extremely high levels could have adverse effects on the body.  

What is the reason for raised ALP during pregnancy?

The reason behind raised ALP in pregnancy is the extra production from the placental source, i.e. from the syncytiotrophoblastic membrane of the placenta. 

Can be raised ALP levels pose any threat to the fetus?

Alkaline Phosphatase high in pregnancy can threaten the fetus in a few ways, such as restricting its growth in the womb, resulting in premature delivery, low-weight birth, etc. 

What may happen if ALP is high during pregnancy?

High ALP in pregnancy is capable of causing harm to the mother and the fetus, namely, IUGR, placental infarction, and so on.

Can liver disease be prevented during pregnancy?

Yes, liver diseases can be prevented during pregnancy by switching to healthy habits strengthened with cautious medical assistance. For example, you can switch to eating more green veggies, such as broccoli, as it helps prevent liver abnormalities.

How to control raised ALP levels during pregnancy?

Raised alkaline phosphatase during pregnancy can be controlled by constant monitoring and seeking proper treatment from a healthcare provider. 

Updated on : 6 September 2023


Dr. Arti Sharma

Dr. Arti Sharma

MBBS, DNB Obstetrics and Gynaecology, Diploma In Cosmetic Gynaecology

8 Years Experience

Dr Arti Sharma is a well-known Obstetrician and Cosmetic Gynaecologist currently associated with Aesthetica Veda in Bengaluru. She has 8 years of experience in Obstetrics and Cosmetic Gynaecology and worked as an expert Obstetrician...View More


Sangeeta Sharma

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)

6 Years Experience

She has extensive experience in content and regulatory writing with reputed organisations like Sun Pharmaceuticals and Innodata. Skilled in SEO and passionate about creating informative and engaging medical conten...View More

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