Test your ALP and 100+ other biomarkers for $190

Alkaline Phosphatase

Normal range: 44 – 147 U/L (lower is better)

ALP is an enzyme produced by the liver, bile ducts, and bone. A blood test for ALP helps detect problems with bile flow from the liver or increased bone turnover. Because it comes from two different sources, an elevated reading requires context: your doctor will look at other liver and bone markers to figure out which organ is driving the change.

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How much does an ALP test cost?

ALP isn't sold on its own. It comes in a comprehensive metabolic panel, about $40. A fuller workup adds Vitamin D ($75), hs-CRP ($69), ApoB ($50), and ApoA1 ($50). You can test ALP and 100 other biomarkers for $190 as part of an Empirical membership.

Empirical is FSA/HSA eligible, so you can pay with pre-tax dollars. Fast for 8-12 hours beforehand for the most accurate lipid and metabolic results, and expect results in days rather than weeks.

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ALP is an enzyme produced by the liver, bile ducts, and bone. Elevated ALP from the liver usually indicates bile duct obstruction. Elevated ALP from bone indicates increased bone turnover (Paget’s disease, healing fractures, vitamin D deficiency). Pregnancy and adolescent growth spurts are normal causes of elevation.

What is a normal ALP by age?

In NHANES 2021-2023, the median ALP was about 77 U/L for adults aged 18-29 and 83 U/L for adults aged 70 and older. The chart below shows the full distribution by age and sex.

Median and 10th to 90th percentile ALP by age and sex, NHANES 2021-2023 Median ALP by age and sex, with the 10th to 90th percentile band. Source: NHANES 2021-2023 (weighted estimates).

What can cause high ALP?

A normal ALP is 44 – 147 U/L. Lower is better.

Elevated ALP from the liver usually indicates bile duct obstruction, whether from gallstones, tumors, or drug-induced cholestasis. Elevated ALP from bone indicates increased bone turnover: Paget's disease, healing fractures, vitamin D deficiency, or hyperparathyroidism.

Pregnancy (from placental ALP) and adolescent growth spurts (from bone growth) are normal, harmless causes of elevation. Very low ALP can occur in hypothyroidism, zinc deficiency, or a rare genetic condition called hypophosphatasia.

Several medications can raise ALP, including certain antibiotics, anti-seizure drugs, and some cholesterol medications. Getting enough vitamin D and calcium supports healthy bone metabolism and may help keep bone-derived ALP in range. If elevated ALP is from the liver, reducing alcohol and managing any underlying liver conditions are the priority.

Biomarkers related to ALP

ALP is most highly correlated with High-sensitivity C-reactive Protein and ALT. Here are the top biomarkers correlated with ALP, based on 500,000 tests done by Empirical Health.

1 hs-CRP
+20%
2 ALT
+16%
3 MCV
−16%
4 Triglycerides
+15%
5 HDL
−14%
6 eVLDL
+11%
7 Glucose
+11%
8 ApoB
+11%
9 Anion Gap
+10%
10 MCH
−10%

The percentage shows how strongly two biomarkers move together. A higher number means the relationship is stronger. Green = rises and falls together. Orange = one rises as the other falls.

Frequently asked questions about ALP

Where to get an ALP test near you

ALP is drawn at 2,200+ Quest and BioReference patient service centers across the US, so there's usually one within a short drive. Browse the full directory to find the one closest to you.

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