What causes increased liver enzymes?

Hello doctor,

I am not really sure where to start here. It is going to be a long one. Two years ago, I went to the doctor because I could not stay awake at work. Even sleeping all day I am exhausted. They ran a lot of tests. My liver enzymes were elevated (have been for 11 years that I know of) and I had smooth muscle antibodies. These antibodies have pretty consistently stayed between the initial two to three years when the elevated liver enzymes were diagnosed. The test says anything more than 20 U/L is positive. My doctors dismissed the whole thing as me being overweight. I lost 130 pounds yet liver enzymes got worse. I was told that it is because of fatty liver. I was diagnosed with idiopathic hypersomnia with a sleep latency of three minutes. My liver enzymes have continued to be high since then. My alkaline phosphatase reached 230 U/L then lowered by itself around five months ago. I have lost 130 pounds and I am down to 175 pounds but it is still being blamed on my weight. I had a biopsy and I found that ongoing mild hepatic injury and venous outflow compromised. I had an echo and my heart was fine. This was all six months ago. I recently had my laboratory tests done. I have not seen my hepatologist yet and I am considering switching because things just keep getting worse and not taken seriously. My GGT (gamma-glutamyl transferase) was 259 U/L (ref range 3 to 50) alkaline phosphatase 154 U/L ( ref range 31 to125) AST 35 U/L (10 to30) ALT 75 (6 to 29). My smooth muscle antibody also increased to 35 U/L and my IGG (immunoglobulin) is 1749 U/L (600 to1640). I just feel like something is wrong. This cannot be just because of being a little overweight. I am so exhausted. Should I be worried about these numbers? There is a particular specialist I want to see but I do not know if I should take the next available place where I can get in or if I can or should potentially wait months for an appointment with the doctor I want to see.

I am currently taking medications like tablets Breo, Singulair, Abilify, Effexor, Crestor, Wegovy, and Humira. Please help me with your suggestion.

Thank you.