Is my Liver linked to my fatigue, dehydration, etc?

I've been sick for a while.  General malaise stuff--my body just seems down.  Three times in the past two years, I've spiked fevers of around 103, become severely dehydrated, had tachycardia and dizzyness, and had trouble breathing.  All three times, I was hospitalized, and several hours to about a day and a half later--with oxygen and saline--came out fine,.

Here are the significant tests so far:

ALT continues to rise every time I see a doctor.  It is currently at 84.
AST is currently at 44.
GGT has been elevated (I don't remember the number)
ASMA is positive.
Ultrasound is compatible with fatty liver.

I rarely drink, and my diet is not high in fat.  I'm 6'7", and weigh 240 lbs., mostly muscle (a little fat around the middle)

My GI says it's nothing to worry about.  He wants to keep checking levels every three months or so, and possibly do a biopsy sometime down the road.  I'm wondering if he isn't being a little too cavalier...

So what could be causing this?  Should I get a second opinion?  Are my symptoms in line with the testing?  

I'm tired of feeling this way.  Any help would be appreciated.

[Kevin Pho, MD]

Liver disease can cause fatigue and some of the symptoms you describe.  

Imaging the liver should be done in light of the elevated liver enzymes.  If the ALT continues to rise, a liver biopsy should be considered.

I would also test for viral hepatitis via blood test and obtain an ANA level to evaluate for autoimmune causes of the elevated enzymes.

These options can be discussed with your personal physician, or in conjunction with another opinion.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com