Should a liver biopsy be done for elevated liver enzymes and fatty liver?
Patient: I am a 63 yr old woman. My doctor has been checking my LFT s for a few months since only my ALT went up to 43 after two months of taking more tylenol then I usually take but not even considered a lot. After staying off Tylenol and alcohol for 3 wks, we retested and my ALT was down to 40 but she recommended a liver ultrasound. Results today show mild fatty liver. I am normal BMI and all other testing on blood for other causes is negative. All of my blood tests were normal in Feb, 2018. I also take 4mg of Testoterone daily and Fosomax 70mg once a week. Have started Fosomax in March, 2018, Testosterone taking for over a year. Should I have a liver biopsy considering there is not a logical reason for a fatty liver? I usually drink 7 drinks a week but am willing to cut back or stop. My doc wants to recheck blood in three months and said I can drink my 7 drinks a week. Thoughts? Doctor: Hi,  I don't think that biopsy is required. it would be better to do MRI Scan.   Hope I have answered your query. Let me know if I can assist you further.  Take care  Regards, Dr Iven Romic Rommstein, General Surgeon