The liver usually has to be 70% damaged for the ALT to be elevated on a routine blood test. A bile acid test would have to be done. I don't want to scare you though. It may not be that but the disorientation is strange. She never presses her head into heard objects, walks in circles, shakes AFTER meals, has UTIs, is a picky eater..., right?
By the way, those symptoms don't have to be present. They do occur quite a bit though.
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