ALT liver test result fluctuating - Liver ultrasound or wait for repeat?

hi All,
Since last year i've been having this issue of ALT number fluctuating. Normal range is 32. However, last year it went from 44, 68, 80 in 3 months( repeat test every month). We've been through all the HEP and autoimmune blood tests and all clear. I didn't have an ultrasound of the liver though because after that, my number went down to 29. that was when I was with Kaisers.

A year later, annual blood test, my ALT is at 48. Doctor Repeated 1 month later, it went down to 40. She was going to give me an ultrasound if the number raise from 48. it went down but still not in normal range. this time i'm with Standford.

She asks me to retest in 3 months, saying that it's not significant elevated and the fact that it is going down signal that i can wait. I shall keep up with my excercise, diet and apple vinegar+honey daily dose.

Shall i wait 3 months or pay extra to get the liver ultrasound? I know if i get the ultrasound booked, I'll be going through a super-anxious state and my dream vacation is only 2 weeks away.

thanks