I was very fatigued, having bouts of itchiness, belching and having upper right quadrant pain. The pain reminded me of when I had gallstone blockages. I knew something was really wrong. When I went to see a gastroenterologist, my bloodwork showed that my ALT, AST, BILI were elevated and ALB was decreased. AMA was then ordered and was elevated. Because ALK PHOS wasn't elevated, he said I did not have PBC, even though my liver biopsy showed lymphocyte infiltration. It also showed I have a fatty liver which he was more concerned about. When I argued that a positive AMA is the hallmark test for PBC, then he prescribed ursodial for me.
I went to see a hepatologist next. Again, since my ALK PHOS wasn't elevated, he didn't believe that I had PBC and told me to stop taking ursodial. I believe that I have it and the reason ALK PHOS isn't elevated is because I am in the beginning stages of the disease and the hepatic cells aren't severely damaged yet.