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I too have this elevated alt of 187 and right upper quad pain. I don't know where you go from here. I am in the same boat you are, they are just repeating my labs though, I haven't got the ultasound or hep screen done yet even. they say there are a lot of reasons for elevated alt's. I am a RN I am researching this thing since my labs came back on Friday and they mailed me these results, it sounds like a CT scan is next and the a liver biopsy, apperently just a needle thing not as bad as it sounds is next. If this is normal, then I don't know where you will go from here. Please cont to post I am interested in what you find. I do feel confident in telling you that you should continue to press for an answer but don't worry yourself to death. Also make sure you are not taking any meds that effect the liversearch meds liver damage on the net you will find lists.