@mayblin, Thanks so much for this Pubmed study. The results of this give me encouragement that the .4 increase in my second Echolight T score after 10 months may be valid and not a fluke. I've been reviewing my ALT, AST, ALP total bilirubin and Gamma GT results, you asked about, back to January of 2020. The rise of my ALP appears to be independent of my raised ALT and AST. The ALT, AST and Gamma GT were out of range in January, 2020. The ALP began creeping up in September, 2020 and went out of range in December, 2020 until two weeks ago. My bilirubin was always at a good low level, never out of range. My high level Gamma GT correlated with the ALP and AST high levels. All these liver test results were down within range as of February 28, 2025. I'm not sure what the pattern of these results means. I would need further testing, such as a BALP, for definitive answers I imagine. I know I was rapidly losing bone between November, 2019 and November, 2023 with DEXA spine T score plummeting from -2.8 to -3.5. I was also on high dose Prednisone from February 2020 until September, 2020. Have your liver enzymes stayed within normal range? Thanks again Mayblin for all your input.