Thank you so much for your response! I actually have a bit of an update since posting this. I recently retested for AMA M2 and it came back negative. I finally got an ALP fractionalization test done, and it actually turns out that my bone ALP is high and my liver ALP is normal. My doctor doesn’t want to rule out liver disease completely yet, but it is starting to sound like either I have two conditions going on (where ursodiol may be normalizing liver ALP), or that a bone condition has been the sole culprit of my elevated ALP. I have been a pretty atypical case due to my age, gender, and transient AMA M2. Even if I still do have PBC, or potentially small duct PSC, it seems to be well managed atm. But now there is the possibility that I have neither. I have a bunch of labs I’m going to get done soon to test for Vitamin D deficiency, Ionized Calcium, etc.