Question: Here way go. Long story but hoping to get some insight/ideas and opinions.

Back in 2011 I became ill with some unknown virus. Possibly a reactivation of ebv. I developed elevated liver enzymes specifically alt which went as high 90 but came down rapidly over the course of a year. Eventually after a long period of time the number came down into the 20's and 30's. I also developed a high Bilirubin which was basically all the indirect fraction and with a negative hemolysis work up based on CNBC I found out I have Gilbert's syndrome as well. Actually looks back all off my labs have always had a near elevated total bilirubin level. I also had abdominal ultrasound which showed a totally normal liver and a slightly enlarged spleen.

In 2013 on my yearly physical we found the alt was elevated again. This time very mild at 53. Once again went for an ultrasound and the liver was normal and a slightly enlarged spleen. No change from previous ultrasound. Appear entry I have a slightly enlarged spleen that no one seems to be concerned with. Anyways 3 months later had a repeat lft done and the alt was down to 24. Everything else normal outside of the indirect bilirubin.

In September 2015 I had to get vaccinated against rabies due to possible exposure from a rabid raccoon. Within 3 weeks I had the worst reaction becoming very ill. I became highly hypertensive, developed cranial neuropathy, and extreme nausea. The hospital did blood work on me and showed liver enzymes elevated again with an Alt of 72. I was diagnosed with sensitivity reaction to the vaccine and was advised I would recover over time. 3 months later Alt level was 48 and than 3 months after that Alt 35. I had an ultrasound which showed the same results as previous, normal level and slightly enlarged spleen. Radiologist comments was a normal ultrasound.

I just want for my follow up to make sure everything is still good and Alt is back elevated again at 50. My doctor casually says you have mild fatty liver and the good news is there would be a medication out in the next few years to treat it. I realize fatty liver is common but how can he come up with this diagnosis when my ultrasounds are all normal. I would think that they would at least show some fatty infiltration. If this is fatty liver is this XXXXXXX or basic fatty liver that can be reversed? I also have crohn's and take humira and lialda. Maybe a med issue even though the GI says no? I am otherwise healthy. Normal BMI, blood pressure, and no diabetes. I do have high cholesterol but normal triglycerides.

What to do next? I have seen 2 doctors and they are handlin like this is no big deal. They kind of brush it off and it makes me feel like I am going crazy.

thanks. can mild XXXXXXX be cured through lifestyle changes?

thanks would supplements help? I was thinking Bouton adding omega 3 to my diet to boost hdl cholestrol a bit. is it safe to consume alcohol in moderation once it's cured?

thank you. last question. in regards to the spleen I have read that cirrhosis of the liver can cause an enlarged spleen. would an ultrasound show signs of there potentially being cirrhosis?