What causes a rise in liver enzymes?

Hello doctor,

I have MS and take Gilenya (Fingolimod) to treat it for 5 years now. My liver enzymes have raised over the last year and are currently GGT: 101.98, AST: 48.8, ALT: 74.1, and ALP: 99. I live in a country where doctors do not take my concerns seriously, including neurologists. My neurologist wants me to continue taking the Gilenya, prescribed me a plant supplement (milk thistle) to take in the meantime, and said we would get internal tests and another ultrasound on my liver to see if the cause is the Gilenya. I have actually been taking milk thistle supplements for the last six months. I am concerned to continue taking Gilenya. How fast can these enzymes cause damage to my liver? I have had two liver ultrasounds in the last year that detected a little bit of fat but it was healthy otherwise. Meanwhile, my enzyme levels have been rising for more than a year now. My concern is even if they somehow deduce that Gilenya is not the problem, how dangerous is it to continue taking Gilenya with these high enzyme levels? I am stressing out. Kindly suggest.

Hello doctor,

Last year my liver enzyme levels were AST: 28.92, ALT: 40.36, GGT: 34.19, and ALP: 112.2. At The start of this year my liver enzymes were AST: 36.14, ALT: 48.19, GGT: 37.79, ALP: ?. This year a month ago my liver enzymes were AST: 48.8, ALT: 74.1, GGT: 101.98, and ALP: 99. I do not drink alcohol. I already walk daily. I also stay under 1600 calories daily (around 2200 to 2300 total calorie burned per day). I have lost 40 pounds in the last year. But I only started avoiding fatty, oily foods in the last month. How bad are my current levels?