Hi! There can be some concern when the ALT results are higher than the norm. Sometimes it can indicate issues with the liver. But there can be a number of things that can influence the changes in the liver enzyme number that don’t mean liver damage.
The doctor will look for trends and use that number along with other results such as AST and LDH to determine a problem. As an example, recently my ALT was elevated. But my AST and LDH were ok. After a little sleuthing, it was determined the problem was caused by a popular multivitamin for women that I had started taking a couple months before my last blood tests. The Vitamin A wasn’t being metabolize as it should and became a bit toxic to my liver. I stopped the supplements and subsequent tests have shown my numbers are back to normal. So that’s how touchy livers can be but they can regenerate quickly as well.

Your doctor seems to be taking all of this very seriously for you and ordering the appropriate tests. So try to relax and let him ‘do his thing’. When the biopsy reports return he may be able piece all of this together and find a cause for the excess red blood cell production. I’m sure you have him scratching his head with this mystery. 😉