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07/05/2010 08:29 PM

Question about ammonia levels and liver disease??

Posts: 2
New Member

I have a very specific question that I'm not sure anyone will be able to answer...but here goes:

My husband has been a heavy drinker for at least 15 years. He was told by a liver specialist six months ago to stop drinking but he ignored the warnings. They suspected severe liver damage but my husband refused to allow a biopsy so we were left wondering.

Two weeks ago, he ended up in the hospital due to symptoms similar to dementia or a stroke. He went into alcohol withdrawals in the ER while he was being tested. Long story short, the dementia symptoms improved but he was hospitalized for severe alcohol withdrawal...which was horrible for about a week. He then was transferred to a rehab center. He has been there now for about five days and when he first arrived his ammonia level was very high (101)....and was started on medication to lower it. It has slowly lowered and is now in the 20s. Even though it is lower, he still seems a bit off to me as far as his personality. His thinking is slow and he gets information wrong a lot. So..that part is better than when he arrived but still not himself at all.

So...we don't know the extent of my husband's liver damage, as he has never been thoroughly tested other than liver blood panels, which are always high.

My question is this: IF my husband does have severe liver damage, will those ammonia levels go back up when he is taken off the medication used to lower it in the first place? I have been searching for the answer to this for days now.

Thank you in advance.


07/05/2010 08:44 PM
Posts: 9
New Member

If your husband has liver damage and this is what caused his ammonia levels to elevate, then without the medication it will go up again.

I spent 2 years fighting end stage liver disease and in the end I had to have a transplant. On 2 occasions I was taken to the hospital by paramedics because I was in a hepatic coma due to the elevated ammonia. The first was for 3 days and the second was for just over 1 but each time the doctors were not sure if I would make it. I also had at least 3 other incidents that I was taken by family to the hospital because of high ammonia levels, but it was caught while I was still conscious.

It will be especially important for your husband to stay off of the alcohol and follow the doctors orders, or his condition will get worse.

I will keep you in my prayers.

07/05/2010 09:40 PM
Posts: 3275
VIP Member
I'm an Advocate


Welcome to the group/. I know how scary this must have been for both of you.

The longer he stays away from alcohol the more his liver should improve, (depending on the damage)

It is not uncommon for patients with alcohol induced liver disease to improve enough to live normal lives. I know many that have recovered enough liver function to be removed from the transplant list.

This can take several months to a year or longer. Even if he doesn't improve he must remain alcohol free for 6 months to be listed for transplant.

The problem with ammonia is very different for each person. There are some that show no symptoms at very high level and others that do show symptoms at lower levels. He should remain on the medications

(Usually Lactulose and /or Rifaximin)It has not been long enough to know what his reaction would be. It's also important to know that there are other causes for the encephalopathy, Infections. Dehydration, Low sodium, Certain meds , (like narcotics)GI Bleeds.

I always suggest that you keep copies of ALL test results, Liver disease is a long road and you will use them more than you think. You can tell a lot about his Liver function with the following test results, Bilirubin, Albumin, INR, Creatinine,Platelets, Sodium. It is important to watch for changes in these test both for the good as well as the bad.

Give yourselves time to adjust to the changes in your lives but be proactive.He will never be able to drink again which is going to be a hard road But you will both be in my thoughts and prayers.

Again welcome to the group


07/06/2010 04:14 AM
Posts: 415

Hi Bluesun,

Welcome to the group! My huband has cirrhosis, too..dx'd nearly 4 yrs. ago w/end-stage C. He stopped drinking immediately, but had several strokes over a year later. He was prescribed Lactulose for the ammonia, and it helped a lot, as long as he took it.

Since he started drinking again, he stopped taking the Lactulose, and his ammonia levels are on a roller-coaster. He has hepatic encephalopathy very often; although at times it's hard to tell if it's HE or intoxication. As Gail said, there are other causes for HE: it's happened to dh when he was dehydrated, his sugar got too low, and when he's sick with anything.

You're both in my prayers.


07/06/2010 05:41 AM
Posts: 2286
Group Leader

Bluesun, the ammonia tests are really more of an indicator than anything else. To get a true ammonia reading of what is affecting the brain, ammonia in the brain cells would need to be checked. There are other toxins involved in the encephalopathy as well. During my first episode my ammonia was over 300. I was apparently so violent in the hospital the medical staff was unable to treat me. Only came through because my wife gave me lactulose a dropper at a time. We've since found that if my ammonia is much over 30 I'll start to have brain function problems. For me I have to stay on the lactulose or I'll start to forget it and that creates a cycle.

As for the alcohol, I quit 20 years ago because I thought living would be a better choice.


06/07/2012 12:34 PM
Posts: 148

My husband has non-alcholic cirrhosis and a diabetic. He is on lactulose to insure at least 3 bowel movements/day to lower the ammonia level and also on a low protein diet. I believe the doctors told us that beef breaks down into ammonia and if your liver is not filtering and working properly it goes back into blood stream and brain. My husband has been in the hospital 7 times, 6 of them with HE (hepatic encephalopathy) where he gets confused (not knowing date, date of birth, etc). I had to call 911 three of them. The hospital just gave him lactulose to get him back on track. My husband started ammonia level of 200+, been in the hospital at 107, 96 and released at 104. He is also on Xifaxin (he calls this his brain pill). I do the flap test on him, have him hold our his hands (stiff arm-football term)and see if his fingers are flapping. Another test is have him do a five point star with pencil and not lift the pencil.

I am not a doctor, but you can question your doctor on this.

We are all here for you.

I do hope he stops drinking, please!Smile


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