Elevated Liver Enzymes in Toddler

Hi,
My daughter has had elevated liver enzymes a few times in the past 8 months. She was recently seen by a GI dr and had more blood tests done. Those tests showed her enzymes went down. She has had two of her 3 HEP B vaccines, however, she tested Negative on her bloodwork meaning she is not taking to the vaccine. I'm happy her levels are back down, but where do we go from here? She just turned 2 and is very irritable and tired most of the day. She sleep great at night and takes an afternoon 3 hour nap, so she shouldn't be so sleepy. Any thoughts?! Please help. My dr just wants her to have her 3rd hep b vaccine and be done with it, but we are concerned could it be hurting her liver?

[Paderla Anitha, DNB]

Hello and hope you are doing well.

If her liver function tests are normal, she should have her third dose of the vaccine. Anti Hbs levels above 10 IU/L are considered to be protective. So, have these levels assessed after the vaccination. Check to see if she is anemic with blood tests. Discuss this with your consulting doctor.  

Hope this helped and do keep us posted.