I am new to this site, just a month, but have found it to be very helpful. I am 51 and last month my ALP came back high (215) during routine blood work. My family doctor suspected PBC and ordered AMA which came back negative. I have been referred to a liver specialist which I imagine will involve further testing to determine if I have PBC or something else. I feel fairly good most of the time despite sleep issues as a result of menopause. In retrospect, I have experienced episodes of fatigue during the day as I can become very sleepy and struggle to stay awake at times. This has been happening since my 30s, not a daily thing and doesn't last too long (an hour or so), never really thought much of it. Seems like it may take a while to confirm a diagnosis. Just curious as to others experience when first informed of PBC.