Hi. I went through your concerns regarding your condition of fatty liver and a high ALT level. It s a condition in which triglycerides are deposited in the liver. In 20% of patients which causes inflammation in the liver and high ALT level, the condition is called NASH. NASH is more dangerous than fatty liver. 20% of patients with NASH will develop cirrhosis of liver. Your condition is NASH. It is a control able condition. The first line management is achieving weight loss by life style n dietary modification. You should avoid junk foods, oily foods and sweets. you should continue combination of capsule ursodeoxycholic acid 250-300 mg once a day and capsule Vitamin E 200-400 mg once a day. This combination has shown promising effect in clinical trials. Ursodeoxycholic acid is a safe drug. It has narrow spectrum of side effects like nausea, vomiting, diarrhea, headach, dizziness and dyspepsia. But most of patients tolerate it very well. Clinical data has also shown proven role of metformin which you are already taking. You have been prescribed appropriate treatment for your condition (NASH). You should continue this treatment regimen and try to lose weight. you should continue Zyloric which is for your high uric acid. But it has no definite role in fatty liver/NASH. I wish you good luck.