Alkaline phosphatase is an enzyme produced by the liver and by the bone. In order to find out the best investigation would be a bone specific alkaline phosphatase. There are conditions which cause elevation of alkaline phosphatase especially bone specific alkaline phosphatase such as Paget’s disease in which the bone specific alkaline phosphatase. Even if a single bone is involved, there is elevation of alkaline phosphatase. But it is not a mild increase, but a marked increase. So your 90 IU per ml is because of bone alkaline phosphatase increase secondary to Vitamin D deficiency. So you may see that the calcium, phosphorus, these minerals which are from the bone, those are normal, but alkaline phosphatase maybe at times elevated. Vitamin D deficiency is a very common reason for elevated alkaline phosphatase. If gamma GT or bilirubin is elevated, then liver disease could be the cause of the alkaline phosphatase elevation.
