Elevated Ammonia Levels

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olivesqueeze
New Member


Date Joined Aug 2012
Total Posts : 6
   Posted 8/24/2012 7:22 PM (GMT -6)   
Hi. My dad has the early stages of cirrosis not caused from drinking. He can't seem to get his ammonia levels down and he is taking lactulose and xiafaxin. He is not eating any red meat, no seafood. Basically, going vegetarian. He did get his ammonia levels down as far as 124 and then it shot back up to 187 and now it is down to 185? I know they want it down to about 40. He is loosing weight. My mom and I can tell, but he is still having a lot of fluid build up in his abdomen. He had a CT Scan, but it did not show anything else. What else could be causing all this? He does not have the energy like he used to either and he sweats big time doing the smallest amount of work even if it is inside the house.

susie_sassafrass
Regular Member


Date Joined Jun 2010
Total Posts : 311
   Posted 8/24/2012 8:23 PM (GMT -6)   
How much lactulose does he take daily? He may need to up his dosage.

I take lactulose and Xifaxan and my ammonia averages 100-130. I am able to function at this level. I do have some memory lapses, have trouble finding words, and slight tremors . I have not driven in about a year because my reflexes are slow. I don't get mean like some people with HE but am highly emotional.

In 2010, my HE was worse and I was falling and I could not concentrate to have a phone conversation. My personality was flat. I had to have a tips procedure to remove a portal vein clot in 2011. Often, tips make HE worse and I was worried. I am one of the few lucky ones whose HE improved after the procedure.

olivesqueeze
New Member


Date Joined Aug 2012
Total Posts : 6
   Posted 8/24/2012 9:37 PM (GMT -6)   
The GI doctor had him at 60CC 4x a day and a few weeks ago said he should be taking 45CC a day 4x a day. What is TIPS? Other than being very tired, having no energy, and retaining fluid in the abdomen that is all the he is experiencing. Just the ammonia levels are way up there.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 8/24/2012 10:51 PM (GMT -6)   
Hi, Olivesqueeze, and welcome to the forum. I am sorry your dad is ill. A Transjugular Intrahepatic Portosystemic Shunt (TIPS) is for uncontrolled ascites.

Anyone with liver disease is going to experience ongoing fatigue. Your dad should be seeing a hepatologist for care. Does your dad know what caused his liver disease?

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

Liver transplant recipient, Oct. 27, 2011, at Mayo Hospital, Jacksonville, FL

Post Edited (hep93) : 8/25/2012 12:11:45 PM (GMT-6)


healthynow
Veteran Member


Date Joined Oct 2010
Total Posts : 1720
   Posted 8/24/2012 11:23 PM (GMT -6)   
Hi Olivesqueeze,

Welcome to the forum. I too, am sorry that your dad is so sick. How old is he? How long has he been experiencing symptoms?

The more you can share with us, the more information forum members can share. Please post back.

Emma

olivesqueeze
New Member


Date Joined Aug 2012
Total Posts : 6
   Posted 8/25/2012 8:01 AM (GMT -6)   
He is 71. The high ammonia levels just began in May. His liver disease is hepatitis C caused from a blood transfusion from when he was in his 20s when he was really really sick and needed many pints of blood given to him. He did not know he had Hep C until years and years later until he went to dontate blood and then confirmed it with the doctor. He along with a couple of other people were told their blood had come in contact with Hep C.

Charlie92
Regular Member


Date Joined Jul 2009
Total Posts : 191
   Posted 8/25/2012 8:10 AM (GMT -6)   
Hi Olivesqueeze,
During my wife's four year battle with this disease her hepatologist prescribed 220 mgs of Zinc sulfate in addition to Xifaxan and lactalose to control her ammonia. Until the last few months before she passed, she never had a really bad episode of HE. Her hepatologist told us the Zinc, in addition to the other meds helped to keep the ammonia under control.
 
Just something you might want to ask your husband's doctor about.
 
Like Connie said your dad needs to be treated by a Hepatologist and not a GI doc. They have much more training and experience in treating liver disease.

In memory of Janie Johnson
AIH/PBC
August 3, 1950
August 16, 2012

olivesqueeze
New Member


Date Joined Aug 2012
Total Posts : 6
   Posted 8/25/2012 10:57 AM (GMT -6)   
Thanks Charlie for letting me know this. I will let my dad know and my mom know and we will contact a Hepatologist for him to see. Yeah, I don't think anyone has mentioned Zinc sulfate in addition to the other stuff he is taking. Will be checking into that for sure too.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 8/25/2012 1:19 PM (GMT -6)   
"He along with a couple of other people were told their blood had come in contact with Hep C."

At the blood donation center that day or overall? Because LOTS of people end up with hep C as a result of needing transfusions back when they didn't have a screening test for hep C. Our member, David, contracted it that way.

Hep C doesn't have symptoms for many, many years. I contracted it in the late 60s and didn't have symptoms until '92, when I suddenly experienced fatigue which has only gotten worse with time.

Does your dad have symptoms of HE (hepatic encephalopathy) along with the high ammonia?

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

Liver transplant recipient, Oct. 27, 2011, at Mayo Hospital, Jacksonville, FL

Post Edited (hep93) : 8/25/2012 1:26:37 PM (GMT-6)


olivesqueeze
New Member


Date Joined Aug 2012
Total Posts : 6
   Posted 8/25/2012 1:32 PM (GMT -6)   
When he received over 20 pints of blood back in his early 20s because he was very sick is when he got Hep C. He did not even know it until late in life either. If it would not have been going to donate blood and them telling him his donated blood was not good, he would not have known. Yes, he has symptoms of HE along with his high ammonia.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 8/25/2012 2:35 PM (GMT -6)   
He would've found out eventually that he has hep C, just from the symptoms of fatigue, etc., which would lead to specific blood work. When I first experienced extreme fatigue, I went to my PCP with my complaints. The blood work showed the liver enzymes to be a little elevated. The doc blew it off, saying it was from smoking or hormones (was in perimenopause), etc. Then I got a new doc in '93 and the first thing she did was to test for mononucleosis and viral hepatitis. That's when I found that I had hep C and had also had hep B, but my immune system had kicked the hep B out. PCP sent me to a GI doc for a consult and he said to determine if the hep C was chronic active, I would need a liver biopsy. I had this about a month later and the sample showed chronic active hep C.

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

Liver transplant recipient, Oct. 27, 2011, at Mayo Hospital, Jacksonville, FL

olivesqueeze
New Member


Date Joined Aug 2012
Total Posts : 6
   Posted 8/28/2012 10:22 AM (GMT -6)   
My dad went back to the Dr on Monday and he prescribed Neomycin. Hopefully the ammonia levels will go down with this since the other stuff is not working. They did tell him now he has to cut out Protein from animals. He is going to refer him to UAB's Kirkland's Clinic so we can talk to them about a living donor transplant.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 8/28/2012 1:30 PM (GMT -6)   
Thanks for the update, Olive. I hope that the Neomycin will work for your dad. I saw a new PA at Pain Clinic yesterday and he mentioned zinc tablets help with healing. (I have 2 leg ulcers that just opened up for no known reason.) Having had a transplant and being immunosuppressed, it takes a long time for wounds to heal, even tiny cuts.

Hugs,
Connie
hep93
Forum moderator - Hepatitis


"But that was yesterday, and I was a different person then."

Lewis Carroll, Alice in Wonderland

Liver transplant recipient, Oct. 27, 2011, at Mayo Hospital, Jacksonville, FL
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