Hello @cgm, I haven't seen any posts in the PMR group describing high alkaline phosphatase (ALP) levels but have seen some in other groups and discussions. Here's a search link that shows comments - https://connect.mayoclinic.org/search/comments/?search=alp%20levels.

Here's some information I found describing the topic if you haven't already seen it.
"High alkaline phosphatase (ALP) levels may be a sign of a liver problem or a bone disorder. Liver problems and bone disorders cause different types of ALP. But your test results can't tell which type of ALP is high."
-- Alkaline Phosphatase: MedlinePlus Medical Test:
https://medlineplus.gov/lab-tests/alkaline-phosphatase/
Were you able to discuss the elevated lab levels with your doctor?