53yo female on medifast diet. their food contains iron. yearly lipid, a1c cmp,cbc,ck, tsh all perfect except for alt of 39and bun/creatine ratio of 24 is more testing recommended? or could it be iron related? my alt last year was 19.

Retest in 1-2 months: Low grade elevations in transaminases (ALT/AST <5x upper limit of normal) are common, and there are many things that can cause them to go up. It's probably not related to dietary iron. I would suggest having your LFT's checked again in 1-2 months. If it is still elevated your PCP can do a workup for the most common causes of elevated Transaminases.