To answer your questions:
1) An ultrasound would be the most reasonable initial test. It can suggest cirrhosis. However, the only way to be sure would be via a liver biopsy.
2) The biopsy will be more accurate. However, with the ferritin at your level, hemochromatosis is less likely.
3) You are correct in that ferritin is an unreliable marker of iron stores. Despite that, that level, as well as the transferrin saturation, are the principal ways currently used to measure response to phlebotomy.
If the studies for iron stores are non-revealing, biopsy and genetic testing can be considered if hemochromatosis is still in question.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Addition: Prothrombin time normal at 10.0, INR normal at 1.0
No diabetes or anemia.
OK, I know I've already posted about a million questions on my thread, but am curious if fibrosure might be an alternative to biopsy even though I don't have HCV? My understanding is it is good at distinguishing none/mild fibrosis from severe/cirrhosis but is rather gray inbetween.