Hello Dr. I am 60 yr/old male and have been diagnosed with fatty liver disease approximately 30 years ago. my weight fluctuates between 220 lbs and 26% body fat to 325 lbs. and 48% body fat over a repeating 3 or 4 year cycle. I am Bi-Polar; and my weight fluctuates depending on what medications I am able to take and the amount of sleep I am receiving, due to severe sleep apnea ( I have a Bi- Pap unit but only within the past 9 months (new model) in the past 10 years have I been able to use it due to nasal and palate restriction in my airways complicated with central sleep apnea. I do not have any history of even moderate alcohol use and I have never done drugs. Should I be looking for a more aggressive treatment for protecting and or helping my liver to regain any potentially lost function. When I take Liv 52 4 caps per day my liver functions (ALT AST) come back normal; when I don t they are elevated. my weight is currently on the losing curve and I am down to 269 lbs and 36% body fat. I am fairly stable with 1 amitriptyline 25mg and 1 2mg klonopin a day. Is metadoxine a possibility. Thank You