You have undergone a pretty good initial evaluation for the elevated ALT. With a normal hepatitis screen and ultrasound, many of the major liver disorders may be present.
Alcohol can certainly play a role - you can recheck the liver function after a period of abstinence.
It is also possible that the Elavil could be playing a role - as evidenced by the improvement of the ALT after stopping the medication.
A liver biopsy would be the next step, however the levels aren't quite elevated enough to warrant this procedure.
You can discuss these options with your personal physician.
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