My ast is 13 iu/l and alt 9 iu/l, it has gone down from the previous month (ast 20 iu/l, alt 17 iu/l). ab ultrasound normal. i have felt extremely foggy/fatigued for 6 yrs with no diagnosis. should i be concerned my ast/alt ratio is 1.44?

No. None of the lab data you provided are a cause for concern. Consult your doctor to ascertain if you are depressed. Regular exercise is essential for good health. For healthy diet: http://www.choosemyplate.gov/., exercise 30 minutes/day, drink enough water daily so your urine is mostly colorless, have safe sex, no tobacco alcohol weed or street drugs. Get HPV and Covid vaccines.

Your liver enzymes are normal and an alternate cause for your symptoms should be determined with the understanding that some diagnoses are made clinically as tests remain normal.