<s>[INST] I have ALT levels around 74. I got an ultrasound for my liver and the doctor said it looked pristine. All three heptatitis's were checked for and the tests came back negative. They told me that I need to go see a specialist for liver functions. I'm also extremely tired all of the time. I can sleep ten hours at night and still take a 3-4 hour nap during the day (sometimes more) and still be tired. What could I have? [/INST] Thank you for posting query. presentation of slightly elevated liver enzymes and history of fatigue.all viral serology is negative so viral causes are ruled out. age, weight and height?not mentioned.history or present symptoms not mentioned.kindly do following blood test:1. CBC      2. TSH     3. ESR    4. CRPmeanwhile:- eat green vegetable- eat fruits or drink fresh fruit juice- eat liver (mutton)- drink fresh milkthe lab results of aforementioned blood tests maybe posted here or viist treating physician.wish you good health.hope to answer your concern.Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health.regards,Dr Tayyab Malik </s>