MooBear, what a cool experience to hike the Appalachian Trail.
Welcome to the forum!
Are you comfortable with your doctor's level of experience with Lyme? It's a very specialized area, sadly, so finding someone with real expertise is important, especially early on while you try to figure out what's going on. Mold toxicity also isn't something mainstream doctors are going to know how to handle.
WalkingbyFaith has given you great advice and resources. I would echo everything she says, including that your c4a is extremely high, which can be the result of Lyme or mold - and quite possibly both. I also would recommend Neil Nathan's book Toxic, which is a great resource for helping people with mold toxicity, Lyme, and other environmentally-acquired illnesses figure out where to begin. It's important to have a smart plan for which things to address first, as so many treatments can be destabilizing initially.
I'm sure you also are trying to be extra careful with your liver issues. Feel free to post separately about
that, if you want thoughts on that. Folks here have a lot of success supporting their livers with supplements such as milk thistle and D-limonene.
It sounds like you have a lot of inflammation going on, which of course feels awful. Would you like to share more about
your symptoms? What is your treatment plan so far?
By the way, "Lyme-literate" doctors (you'll see the term LLMD a lot here) consider Lyme to be a clinical diagnosis - based on signs and symptoms, not just testing - because Lyme and co-infection testing is notoriously inaccurate, especially the ELISA. Many of us with Lyme have had more than one negative test. I would assume with your hiking history, c4a, and multiple positive test bands, that you almost certainly have tick-borne infections.
Epstein-Barr virus, which can be transmitted by ticks or can be a dormant virus that becomes reactivated by tick-borne disease, also can cause spleen issues, widespread inflammation, and many chronic issues very similar to Lyme. Have you been tested for EBV?
Good luck! I know this can feel so overwhelming and scary.