Well, i finally went to see the hepatologist and it didn't go well, unfortunately. First of all, he said i had to do a liver biopsia, which i already knew, but by laparoscopy so i must get general anesthesia. I have never in my life had general anesthesia, but it concerns me a little bit. A few weeks ago a had an abcess in my finger, to drain it the doctor inyected anesthesia in my hand and i was closed to throw up and pass out. I didn't but it was not a good experience. Any advice about the general anesthesia of something i should tell the doctor? Then i told him about my symptoms and he told me that they had nothing to do with the PBC, but instead depression and anxiety. So, the best hepatologist here doesn't know anything about fatigue and PBC. Sigh. I had with me an study that links autonomic dysfunction with PBC but i didn't dare to give it to him because he was a little arrogant. And finally i mention the possibility of taking LDN and he said NO! But then he added something interesting: "we only use naltrexone in patients with late stage PBC to control the itchiness" really? So, they do use naltrexone in PBC. Now i don't know if i should do my LDN experiment. If they use naltrexone 50 mg in people with severe damage in the liver, i think that low dose should not be a problem for me, since i am in an early stage apparently. I would appreciate your opinion and Dr Edwards. Thank you.