For those of you that use gregs extended alto tuning, how does it compare to the standard alto tuning? Do i need to change the strings and setup on my alto to switch to this tuning?

Mark

I had both tunings on my Alto. Extended is a full step higher of course, so if you don't think you'll miss that low b on the melody side give it a try. You won't need to mess with the setup much, maybe lower the c# string adjustment screw a half turn at the bridge, to accommodate for it being thinner than the b.
I prefer the standard alto tuning over extended, just enough low end on the b string to satisfy.

I use the extended Alto tuning. The only warning I would give you if you're moving from standard Alto tuning is the highest string. The extended Alto highest string gauge is a 6. Anything heavier than that and you run a high risk of breakage.