@deborahrb, ALP is a measurement of bone growth activity; it is highly concentrated in osteoblasts. Elevation is normal with romosozumab as a good indication that the medication is working effectively.
ALP is also elevated after a fracture when the bone begins healing. I only mention this because with osteoporosis we as sometimes on the verge of fracture. If you are having bone pain or muscle spasms be sure and let your provider know.