Can Apple Cider Vinegar Increase Serum Alkaline Phosphatase?
Yes, apple cider vinegar can increase serum alkaline phosphatase levels, but this occurs only at specific doses and is associated with hepatotoxicity rather than any beneficial effect.
Evidence from Animal Studies
The only direct evidence examining apple cider vinegar's effect on alkaline phosphatase comes from a controlled animal study that demonstrated dose-dependent effects 1:
- At moderate doses (0.51 ml/kg body weight daily), liver alkaline phosphatase (ALP) was notably elevated in mice after 4 weeks of treatment 1
- At lower doses (0.17 ml/kg) and higher doses (1.02 ml/kg), no significant changes in ALP were observed 1
- The ALP elevation at moderate doses was accompanied by concerning pathological findings including vacuolated hepatocytes, erosion of gastric mucosa, and duodenal villus blunting 1
Clinical Interpretation
This ALP elevation represents hepatotoxicity, not a desirable physiological response. The mechanism appears to be:
- Direct liver injury causing release of hepatic ALP isoenzymes 1
- Damage to the gastric and intestinal mucosa, potentially affecting nutrient absorption and metabolism 1
- The dose-response pattern (elevation only at intermediate doses) suggests a narrow toxic threshold 1
Important Clinical Caveats
When evaluating any patient with elevated ALP, remember that multiple factors unrelated to vinegar consumption affect baseline levels 2:
- Age and sex: ALP is highest in adolescence, drops after bone growth completion, and shows sex-specific patterns (higher in males until age 50, then higher in females) 2
- Body weight: Greater weight correlates with higher ALP concentrations 2
- Smoking: More cigarettes per day associates with higher enzyme levels 2
- Height: Taller individuals tend to have lower ALP 2
The hepatotoxic effects observed in the animal study occurred alongside histopathological liver damage, making any ALP elevation from apple cider vinegar a marker of harm rather than benefit 1.