Your ALT was only 4 points too high? The rest were normal? I honestly would not think this is something to stress over. I had routine blood work a couple years ago and my ALT and AST were both elevated (more than 4 points!). My doctor, who was retiring, put me through a ridiculous amount of tests including an abdominal ultrasound and lots of bloodwork. All that came back was that I had a "slightly fatty liver," which is not unusual for someone my age. I also had had a beer the night before the test, which definitely can cause elevated enzymes. A month or so later, after being convinced I had liver disease and spending a month in massive stress, I met with my new doctor who retested me and my enzymes were back to normal. He said that they can fluctuate so easily - anything can cause elevation - alcohol (a biggie), tylenol, a recent cold or infection, lipitor, other meds. I think doctors look at all the bloodwork as a unit and not just one thing. What does your doctor say? Is he concerned?