The most important aspect of the initial evaluation is to try to determine the cause of the elevated liver enzymes. Common causes include a variety of different forms of hepatitis, although you have been tested for the common forms, alcohol, fatty infiltration of the liver, medications affecting the liver, autoimmune
inflammation of the liver, hemochromatosis, or metabolic diseases. Many people with elevated liver enzymes will have spontaneous improvement while undergoing the evaluation, probably because of a non-specific viral
infection that has resolved. It is important that you inform the doctor of any associated symptoms that may be present and any use of alcohol, medicines, or recreational drugs. After a history and physical examination is completed, it would be appropriate to ask what are the findings and initial impression from the physical, what further testing will be done, including any risks associated with the evaluation, and what, if any interventions
should be performed. In many cases, the patient is recommended to avoid any substances that potentially will adversely affect the liver, such as alcohol and acetaminophen.