The ALP test measures alkaline phosphatase, an enzyme made mainly in liver and bone, with smaller contributions from the gut and, in pregnancy, the placenta. Practitioners read it with GGT to tell a bile duct signal from bone turnover, and follow persistently low results that may reflect zinc or magnesium shortfall. Pregnancy, adolescent growth and recent fractures raise it. Practitioners can order it through the Vively practitioner platform.
| Test type | Measured in a blood sample |
|---|---|
| Measurements required | ALP only |
| Sample and collection | Blood draw at a collection centre |
| Preparation | Fast for 8 to 12 hours before your collection, water only. The Baseline Health Check is a fasting test anyway. |
| Turnaround | 3 to 5 business days |
| Available through | Liver Function Tests, part of the Baseline Health Check. Also in: Full Body Health Check, Weight Management Test. |
| Pricing | Included in the $99 Baseline Health Check |
| Results | Returned in the Vively practitioner platform, beside your client's other markers |
What are the ALP reference and optimal ranges?
| Typical lab reference | Vively optimal | |
|---|---|---|
| Adults | 30 to 110 U/L | 45 to 100 U/L |
Labs differ, and ranges are age-specific through the teens and early twenties, so read the client's result against their report (RCPA guidance). The optimal range is a long-term adult target, not a diagnostic cut-off.
Check a client's ALP result
Enter the value from your client's lab report to see where it sits against the typical lab range and the Vively optimal range.
A guide only, not a diagnosis. One result is a starting point: read it with symptoms, history and a repeat test. Labs differ, so check the result against the range on your client's report. Nothing you enter is stored or sent.
How do you arrange ALP testing through Vively?
- Get verified. Practitioners with a recognised qualification or membership (ATMS, NHAA, ANTA, Dietitians Australia, NSA, CMA or Ahpra registration) can request free practitioner access.
- Choose a panel. Log in to the practitioner platform and pick a panel that includes ALP, or build your own. It is included in the $99 Baseline Health Check.
- Client collects. Your client collects at a partner collection centre, with their request on their phone or printed.
- Review results. Results come back to you in the practitioner platform, beside your client's other markers, ready for the follow-up consult.
Which Vively panels include ALP?
Log in to the practitioner platform to view a panel in full, or build and save your own from 100+ tests and panels.
- Baseline Health Check74 markers across 11 lab groups$99
One fasting blood draw.
Full Blood CountUrea, Electrolytes & CreatinineLiver Function TestsCalcium, Phosphate & MagnesiumLipid StudiesDiabetes & Glycaemic StudiesIron StudiesThyroid Function Tests+3 moreLog in to view this panel - Weight Management Test27 markers · Heart & metabolicPrice on sign-upALPTotal CholesterolLDL CholesterolHDL CholesterolNon-HDL CholesterolTriglyceridesFree testosteroneSHBG+19 moreLog in to view this panel
- Log in to view this panelFull Body Health Check87 markers · Health checksPrice on sign-up
Why does the optimal range sit there?
Our optimal range trims both ends of the lab range for different reasons: possible vascular risk at the top, diet, absorption and thyroid status at the bottom.
Tonelli and colleagues (Circulation, 2009) linked higher ALP, including values inside the normal range, with higher mortality after a heart attack, possibly through vascular calcification. 100 U/L is a cautious step below the lab limit and is not a proven threshold.
ALP depends on zinc and magnesium, so values under 45 U/L prompt a look at diet, absorption and thyroid status. Persistently very low ALP with musculoskeletal symptoms raises hypophosphatasia, which needs medical work-up.
What should ALP be read with?
- HighHigh ALP with high GGT
Liver or bile duct source, such as cholestasis, fatty liver or a medicine effect.
- HighHigh ALP with normal GGT
Bone source: growth, fracture healing, low vitamin D or, less often, Paget's disease.
- LowLow ALP with low zinc or magnesium
Nutritional shortfall, from low intake or malabsorption.
- LowLow ALP with high TSH
Hypothyroidism lowers ALP; recheck once thyroid function is treated.
- HighHigh ALP in the second or third trimester
Placental ALP; expected in pregnancy.
What can affect a ALP result?
- Pregnancy: placental ALP can lift the level to around twice the adult limit by late pregnancy.
- Adolescent growth and recent fractures.
- A fatty meal in people with blood group O or B.
- EDTA contamination of the sample, which binds zinc and magnesium and falsely lowers ALP.
- Anticonvulsants raise it; oral oestrogen and bisphosphonates can lower it.
When should you refer the client to their GP?
- ALP above about twice the upper limit (around 220 U/L) in a non-pregnant adult.
- Raised ALP with raised GGT or bilirubin, or with jaundice, itch or right upper abdominal pain.
- Raised ALP with bone pain, unexplained fractures or high calcium.
- ALP persistently below 30 U/L without a clear cause.
How should a client prepare for a ALP test?
Copy or print this to send to your client.
Preparing for your ALP test
- Fast for 8 to 12 hours before your collection, water only. The Baseline Health Check is a fasting test anyway.
- Fasting matters here because a fatty meal can raise ALP for several hours, mainly in people with blood group O or B.
- Take your pathology request to any of 4,000+ collection centres. Bring it printed or on your phone.
- Keep taking prescribed medicines as usual unless your doctor tells you otherwise.
- Results usually take 3 to 5 business days and come to your practitioner. Book your results appointment for after that.
How do practitioners use ALP with clients?
For a low ALP, check zinc and magnesium intake and status, protein intake and thyroid markers first. For a high-normal ALP, look at GGT, vitamin D and alcohol; vitamin D repletion decisions should involve the client's GP where levels are low.
ALP FAQs
Can a naturopath, nutritionist or dietitian order ALP through Vively?
Yes. Add it to a client panel on the Vively practitioner platform. It is part of Liver Function Tests in the $99 Baseline Health Check, and is also in Full Body Health Check and Weight Management Test. No account yet? Request free access.
How do I tell whether a high ALP is liver or bone?
Check GGT first. A raised ALP with a raised GGT points to the liver or bile ducts; a raised ALP with a normal GGT points to bone. If the picture is still unclear, the client's GP can request ALP isoenzymes or bone-specific ALP, along with calcium, phosphate and vitamin D.
Is a low ALP worth following up?
Yes, when it persists. A single low-normal result often reflects diet. ALP below 30 U/L on repeat tests, with no sample issue, prompts a look at zinc, magnesium, protein intake and thyroid function, and a GP review for hypophosphatasia if the client has early tooth loss, poorly healing fractures or muscle and joint pain.
How does pregnancy change how I read ALP?
A high ALP in the second or third trimester is expected, because the placenta produces its own ALP. By late pregnancy the level can reach around twice the adult limit. Read the adult range with that in mind, and look at GGT, bilirubin and symptoms such as itch or right upper abdominal pain before attributing a rise to the placenta alone.
Can a sample problem falsely lower ALP?
Yes. EDTA contamination of the sample binds zinc and magnesium, which ALP needs, and falsely lowers the result. Before chasing a low value, check the collection was clean. A true low ALP is worth reading with zinc, magnesium, protein intake and TSH, as hypothyroidism can lower it. Oral oestrogen and bisphosphonates can also lower it.