Alkaline phosphatase is an enzyme found in several tissues, including liver, bile ducts, and bone, and is measured in routine blood tests. Elevated alkaline phosphatase levels can indicate liver or bile duct disease, bone disorders, or normal growth and healing processes. In adults, significant or persistent elevation often prompts investigation for conditions such as cholestasis, hepatitis, metastatic bone disease, or other systemic illnesses. For insurers, alkaline phosphatase is one of several liver-related lab values used to screen for underlying disease, particularly in the context of abnormal AST, ALT, GGT, or bilirubin levels. Interpreting alkaline phosphatase requires considering age, medications, and other lab findings.

Underwriters review alkaline phosphatase results as part of the blood profile obtained during underwriting exams. Mild, isolated elevations may be accepted with little impact, especially if explained by benign conditions, while marked or unexplained elevations trigger requests for additional labs, imaging, or physician records. Elevated alkaline phosphatase paired with abnormal AST and ALT may suggest significant liver disease and result in ratings or declines. Advisors can help by encouraging clients with known liver or bone issues to obtain up-to-date evaluations and by providing underwriters with context for abnormal labs. Understanding alkaline phosphatase helps advisors interpret lab summaries, anticipate underwriting concerns, and reassure clients when isolated variations are not necessarily disqualifying.