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Ammonia levels
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Ammonia levels

  I am wondering if ammonia levels are always associated with liver function.  I am probably somewhat in denial here because I have a husband that is end stage and I am sure that I know what ammonia levels indicate in someone with cirrhosis.  Maybe if you can just say the words to me it will help.  I had ammonia levels of 50 the first time I was checked.  I was experiencing problems with getting lost when I was driving and confused other times.  Can't remember my PO box number, names numbers are difficult. Spelling is becoming quite challenging for me.  The next time I got them checked my ammonia was at 127.  Haven't gone back to have it checked again.  Anyway I guess I am just looking for more information about this subject.  I am not on any treatment as of yet for this due to lack of insurance.  But how high does your ammonia level have to be before seeing coma?  Just curious.
  Thanks for you time.
  Kendall
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Dear Kendall:
Thanks for you questions.  I can imagine just how concerned you are by your situation.  I understand you ammonia is elevated and you are having symptoms of confusion and forgetfulness.
First and foremost, to answer your first question, elevated blood ammonia levels are almost always due to liver disease.  There are some unusual circumstances in which someone can have an elevated ammonia and a normal liver.  If you do have a history of liver disease or reasons to believe your liver is damaged, I suspect your elevated ammonia is from liver problems.  
You ask some questions about how high the ammonia has to be to give a coma.  As you appreciate, as the liver fails, ammonia and other chemicals can rise in the blood and give confusion and lethargy.  We call this hepatic encephalopathy.  If hepatic encephalopathy is severe, patients can go into coma.  Surprisingly, the level of the ammonia does not always correlate with the severity of someone
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