I would get the reading for your liver ultrasounds and find out what bloodwork has been done. Many of the meds cause problems with the liver, and also "fatty liver" can be a real problem--often a part of diabetes or obesity. It can cause an up and down in enzymes as well. There may be a reason they do the ultrasounds besides just elevated enzymes. Many docs don't really note fatty liver, thinking it is benign and that there is nothing you can do about it, but there are meds that are very effective in treating it and stabilzing the enzymes.
Of 85 patients with liver cancer studied recently, 35 had severe fatty liver with insignificant fibrosis, proving for the first time th fatty liver alone, without progressing to cirrhosis, can cause liver cancer, therefore it is not just benign. Many docs haven't got the memo yet. It frequentlygoes undiagnosed.
Since I have liver disease and have had it slowly mess with my body, I urge people with repeatedly elevated enzymes to see a hepatologist, notjust a gi guy or rheumatologist. A hepatologist can do some special bloodwork to make sure that something else isn't going on.
On e lfts, mine go up and down and actually I feel best when my ALT is elevated, as my liver is newly repaired and being repaired (the ALT doesn't measure damage, but the amount of repair taking place). When they go high and then very low, or just very low, I get fibrosis(scarring), the liver is not able to repair itself, fibrosis is the stage before cirrhosis (permanent damage). Most important is the MELD score, there are calculators online. Lots of people with liver disease gripe because liver function tests don't show much about how the liver is functioning in many cases, we laugh when docs get happy because the ALTs are so low,mine were zero for a while when Igot most of my permanent damage.
The almost all the rest of the enzymes are not just markers of liver problems, but kidney, heart etc. so you don't really know what part is getting damaged. With me, I started wth ALTs high with he onset of my autoimmune problems, then ALTs down to zero and I felt like crap, and now the other ones go up too, not just the ALT anymore.
There is much a healthy diet and care with meds can do. Im glad your doc is watching it so close and I'm sorry you are having his on top of the rest. Hopefully it is something that a medication adjustment can fix.
Ills--Sjogrens-Lupus cond., AI polygland. dysfunction 2, hyper/hypopigment, scoliosis,kyphosis,stenosis, deg.,O.A.,spine surgeries, salivary/lymphectomies, NASH, COPD, RLS, UT/GI bleeds, hystero, brain/nerve damage,TB
Meds--INH,Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, HRT and Lidocaine patchs, Voltaren gel, Klonopin, Vicodin, Restasis, Albuterol, steroids