Hello, I had routine labs drawn recently that revealed an elevated ALP at 246. My PCP then ordered a GGT, Hep Panel, and AMA. The Hep panel was negative but my AMA & GGT were both elevated. I was referred to a Gastro doc but had to see his FNP. She did not seem concerned with my elevated enzymes but did order an ANA. She recommended I follow up in 6 months to repeat labs. She did not offer an explanation of why my enzymes would be elevated and I'm terribly concerned with the possibility of PBC. I feel I need a second opinion but since most specialist require referrals, I'm not sure what to do. Is waiting 6 months and repeating the labs seem fair and reasonable?