<s>[INST] just recently after a routine blood test ive been informed my alt level is borderline..two years ago i had the same results and after a ultrasound was informed i have a fatty liver ..i was advised to loose a little weight and that was that ..i did loose weight two stone but ive put it back on again [/INST] Hi thanks for asking question. Here are few possibility.1. First fatty liver might not be recovered fully, and it can lead to elevated liver enzyme. Ultrasound will be helpful.2. Second it could be viral hepatitis chronic case or carrier. Do serum viral marker for that.3. Third besides liver rule out whether you have any muscular problem or heart problems as they can elevate liver enzyme.4. If you have digestive problem with sensitivity to gluten then celiac disease also can elevate enzymes.5. If still condition worsening then liver biopsy helpful for rule other forms of hepatitis. Maintain green leafy vegetables and fruit diet without disappointment. Regularly do 30 minute exercise. Cumin seed with water and licorice with honey seems to be useful. Take garlic in diet also. Avoid alcohol. I hope my suggestion will help you. </s>