OK, time to update. Went to the PCP for the follow-up appointment on Friday the 27th. We decided to do another blood draw - and I got the results and they were a bit concerning - in less than 3 weeks, my ALT had gone up another 112 units (although AST stayed about the same). ALT (SGPT) 0-32 IU/L 274 Above High Normal (was 162 on 1/9) AST (SGOT) 0-40 IU/L 126 Above High Normal (was 136 1/9) So, I made an appointment to see a liver specialist, which happened today. I should note that the specialist is with a GI/Liver group, and I also needed to discuss some GI issues - I have GERD and three times this week, I have awakened in the middle of the night and barfed acid and then mostly dry-heaved, despite taking 2 Protonix/day. My PCP in CA had suggested five months ago that I should see a GI doc and maybe get another EGD, as it was happening occasionally back then - but 3x in a week is MORE than a little annoying (especially being the barfophobe that I am, waking up and trying to mentally overcome the feelings of needing to puke, and usually failing, is very disturbing). So, we discussed a variety of things, and came up with this plan: He wants me to stop taking my vitamin A and D for a week and retest My vit D3 level (taking 10 50K IU caps/week) is 100.0, with normal range 30.0-100.0 My vit A level (taking 3 25K IU caps/week) is 81, with normal range 26-82 As it happens, I haven't taken my tiny Adderall prescription for the last three days, and I was thinking about stopping taking it altogether (turns out to be a bigger PITA here in AZ to get refills, and I'm not sure I need it anymore anyway) He wants me to stop taking it too I'm going to do a trial of Dexalent once a day, before dinner, instead of Protonix, twice a day (which I've been taking after breakfast and just before bed, which he said was not the optimal way to take it - should be an hour BEFORE food, not after) And he's going to run some tests for various vital hepatitis types (I know I don't have HepC, or at least I didn't a couple of years ago), and some odd autoimmune diseases, when I get the bloodwork done in a week or so. He also reassured me that it is likely not much of anything, just a reflection of my mild steatohepatitis/fatty liver which was caused by years of obesity, and which didn't get better when I lost weight - plus getting older. Great :eyeroll: If things get worse, he'll do a fibroscan and maybe liver biopsy. I do NOT want to have to have the biopsy, that's for sure. Next up (in a while - I need to deal with this first) is making an appointment with a nephrologist for the kidney cyst.