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Do you know your A1C? One of the biggest causes of liver issues is NASH (fatty liver disease). It's an epidemic actually, a disease of carbs and affluenza. Do you know that only 2% of Americans at 60 years or above are metabolically healthy? And below 60 only 12% of Americans are. My wife has NASH, and her ALT and AST were above the reference range. Mine was close to being over-reference as well. For the last 13 months we've been on Keto, my wife has lost 22lbs and I've lost 46lbs. Our liver values are nice and centered in range now. It also helps with ED and morning wood.