### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Yes... I had a liver enzyme test on June 14th which indicated: ALP 179 ALT 72 AST 68 then I had another test on August 21st which indicated: ALP 174 ALT 55 AST 56 Apparently my liver enzymes have been high since last year. I have Multiple Sclerosis and have been injecting with copaxone for 15 years. Since copaxone is a man made drug I am under the impression that would not elevate liver enzymes. My MS Neuro does not think my other meds are causing any problems. Two family members (on my mother s side) died from liver cancer . My Aunt was 60 and my Grandfather was 80. This is my question: should I pursue additional testing. Symptoms: dark circles under eyes, rough brown bumby rash on upper legs, veins popping out of my hands, feeling sick to stomach during and after meals, bloated belly and a feeling of something is larger on the right upper chest area. My MS Neuro ordered a ultrasound: Impression: 1) No evidence of cholelithiasis or cholecystitis , 2) there was not pain focal to the gallbladder however pain was noted in the right ribs during exam, 3) technicially difficult exam secondary to bowel gas. A probable hepatic hemangloma and cyst noted on prior CT examinations were not visualized. Was never told about #3.

### output:

Hi, Thank you for contacting Chat Doctor. You have elevated liver enzymes, which has been confirmed on two occasions, but as per your description, they have been high for over a year. As you corrected suspected, Copaxone (Latimer acetate) used for treating multiple sclerosis (MS), does not lead to elevated liver enzymes. MS per se is a disease of central nervous system (affecting brain, spinal cord and optic nerves); liver is not affected in MS. In view of a positive family history of liver cancer, you possibly should further pursue the abnormality in liver function tests. However, based on Ultrasound exam, your liver is absolutely normal, and it is a great relief. Best wishes, Chat Doctor. 