Hello,

Thank you for your response! My INR is 1.1 with the reference range: Reference Range 0.9-1.1, Moderate-intensity Warfarin Therapy 2.0-3.0, and Higher-intensity Warfarin Therapy 3.0-4.0. My albumin was 4.3 with reference range 3.6-5.1 g/dL.

The two days before I went to the ER with the above mentioned symptoms, I had been taking ibuprofen for the migraines. I took 400mg for 2 days in a row. The blood work with the high ALT/AST was 10 days after I had gone to the ER. I asked the doctor if that could've triggered it, (as I know those things are harsh on your liver), and he said no. I'm not on any other medications, drugs, or supplements.

Also, is it possible to be autoimmune related and still have be negative on an ANA?

I'm definitely going to seek a second opinion (HMO makes that process super fun :/), so I feel more comfortable with the decision to spend that money on the biopsy! Thank you again!