Aa
Amonia high - brain fog?
Got bloodwork results yesterday that were read by my primary. He stated that the Amonia levels in my body were higher than normal. He then stated that this can effect the thinking pattern and/or clarity of the brain being able to concentrate and think normally.
I personally don't feel like I'm disabled in that capicity. Anyone else have this? Has anyone else been told by their doctor that they have high Amonia which can relate to thinking problems?
I have to say this must be related to the last volatile and near death over-dosed treatment, as I never had high Amonia before...
Magnum
I personally don't feel like I'm disabled in that capicity. Anyone else have this? Has anyone else been told by their doctor that they have high Amonia which can relate to thinking problems?
I have to say this must be related to the last volatile and near death over-dosed treatment, as I never had high Amonia before...
Magnum
I have hep c, cirrhosis, and a very,very low platelet count and a blood clot in my Portal vein leading to my liver. My blood screen came back with an ammonia level of 177 (60 is supposed to be the limit before brain fog starts). I have days where everything is 'pretty' good, and some where I sleep all day. No energy, and no balance. I know what it's like, HAVEN'T COME UP WITH A SOLUTION YET, BUT I BELIEVE I'M ONLY A FEW MONTHS/YEARS UNTIL I DEVELOP LIVER CANCER. TO ALL OF THOSE IN MY SITUATION, KEEP YOU HEAD UP AND KEEP READING ABOUT WAYS TO CLEANSE YOUR LIVER.
I have hep c, cirrhosis, and a very,very low platelet count and a blood clot in my Portal vein leading to my liver. My blood screen came back with an ammonia level of 177 (60 is supposed to be the limit before brain fog starts). I have days where everything is 'pretty' good, and some where I sleep all day. No energy, and no balance. I know what it's like, HAVEN'T COME UP WITH A SOLUTION YET, BUT I BELIEVE I'M ONLY A FEW MONTHS/YEARS UNTIL I DEVELOP LIVER CANCER. TO ALL OF THOSE IN MY SITUATION, KEEP YOU HEAD UP AND KEEP READING ABOUT WAYS TO CLEANSE YOUR LIVER.
I am suffering quite a lot from brain fog. Lactulose did not work at all. Rifaxin has. It is quite costly, but the pharmacy I am required to use sent me many months too much once and that helps. I lived by my mind consorting with the queen of the sciences.
Hepatic encephalopathy was another insult to a brain ravaged by HEP C's assault. I have some of the best medical help in the world, but there is nothing you can do in those moments when you are out of it. On a good day I would merely became lost when trying to think through a moderate calculation; on a bad day I would get lost getting dressed. Some daysI was a different person.
Rifaxin cannot return all that HEP C has stolen, but it has helped enormously. Consistent low 200's to 50-80. It is all the difference in the world. While still unable to do what I would like to I am no longer wandering around without a clue.
The West Haven criteria is a good way to see what may happen.
Excerpted from http://en.wikipedia.org/wiki/Hepatic_encephalopathy
West Haven Criteria
The severity of hepatic encephalopathy is graded with the West Haven Criteria; this is based on the level of impairment of autonomy, changes in consciousness, intellectual function, behavior, and the dependence on therapy.[1][7][8]
Grade 1 - Trivial lack of awareness; euphoria or anxiety; shortened attention span; impaired performance of addition or subtraction
Grade 2 - Lethargy or apathy; minimal disorientation for time or place; subtle personality change; inappropriate behaviour
Grade 3 - Somnolence to semistupor, but responsive to verbal stimuli; confusion; gross disorientation
Grade 4 - Coma (unresponsive to verbal or noxious stimuli)
[
Hepatic encephalopathy was another insult to a brain ravaged by HEP C's assault. I have some of the best medical help in the world, but there is nothing you can do in those moments when you are out of it. On a good day I would merely became lost when trying to think through a moderate calculation; on a bad day I would get lost getting dressed. Some daysI was a different person.
Rifaxin cannot return all that HEP C has stolen, but it has helped enormously. Consistent low 200's to 50-80. It is all the difference in the world. While still unable to do what I would like to I am no longer wandering around without a clue.
The West Haven criteria is a good way to see what may happen.
Excerpted from http://en.wikipedia.org/wiki/Hepatic_encephalopathy
West Haven Criteria
The severity of hepatic encephalopathy is graded with the West Haven Criteria; this is based on the level of impairment of autonomy, changes in consciousness, intellectual function, behavior, and the dependence on therapy.[1][7][8]
Grade 1 - Trivial lack of awareness; euphoria or anxiety; shortened attention span; impaired performance of addition or subtraction
Grade 2 - Lethargy or apathy; minimal disorientation for time or place; subtle personality change; inappropriate behaviour
Grade 3 - Somnolence to semistupor, but responsive to verbal stimuli; confusion; gross disorientation
Grade 4 - Coma (unresponsive to verbal or noxious stimuli)
[
I did not know that Ammonia could cause such disaster until my mom was misdiagnosed 4 times in the hospital then finally a Neurologist did some test and found out that her ammonia level was sky high. She was totally confused and did not even knew who I was, she was uncontrollable and the first thing every one suggested was to put her in a mental institution. Turns out that she had a Chronic UTI and Cardiac failure. There are no abnormalities with her liver and so no one has been able to figure out what is causing the high ammonia... she is taking lactulose, but if she ever misses a dose she goes totally confused. Today i feel really depressed, she is tired of taking the lactulose and has given up because she forgot an entire day because she missed a dose of lactulose... High ammonia is nothing to play with. Hope one day I can find a real cure for her
I am so sorry for your loss......
Thank you for your time and caring in writing here and educating all of us who read about your husband's illness and symptoms.
I logged on tonight to read about brain fog and found a lot of good information, including what you have just written this month.....and I started reading from the beginning - in 2007!
Being related to family members who drank too much, I am familiar with some of the things you write about. It does make me pause and wonder if possibly the illnesses both of my family members are experiencing (different symptoms, though) may be related to the liver problems you talk about. I will start tomorrow with a new view and check out those things you mention. Thank you for your help and take good care of yourself now!
Kindest regards.......
Thank you for your time and caring in writing here and educating all of us who read about your husband's illness and symptoms.
I logged on tonight to read about brain fog and found a lot of good information, including what you have just written this month.....and I started reading from the beginning - in 2007!
Being related to family members who drank too much, I am familiar with some of the things you write about. It does make me pause and wonder if possibly the illnesses both of my family members are experiencing (different symptoms, though) may be related to the liver problems you talk about. I will start tomorrow with a new view and check out those things you mention. Thank you for your help and take good care of yourself now!
Kindest regards.......
Longstoryshort, if your have issues with high ammonia levels, you need to take a serious, honest pause and consider _why_ your ammonia is high. If you are a heavy drinker, you should realize that treating the symptom with lactulose - while required - will not save you.
If you are a heavy drinker and you have high ammonia levels, you likely have liver damage. It's the liver's job to neutralize ammonia. If you keep drinking, there won't be enough good liver left to perform any sort of bypass of the cirrhosis.
If you are a heavy drinker and you start bruising easily, you likely have liver damage. The bruising is from too little protein in your bloodstream. Your thin blood doesn't clot properly.
If you are a heavy drinker and your feet and/or belly start swelling, you likely have liver damage. The proteins being rejected by your liver are pooling in the cavities of your body. The accumulating fluid puts pressure on all your other organs, including heart and kidneys.
I and my husband were living in a grand delusion - the swollen feet were from sitting in the office chair wrong, the swollen belly was just fat, the easy bruising was blamed on taking too many aspirin for the aching back. And on and on...
Sorry for the loooong posts, but I feel the need to share the information.
If you are a heavy drinker and you have high ammonia levels, you likely have liver damage. It's the liver's job to neutralize ammonia. If you keep drinking, there won't be enough good liver left to perform any sort of bypass of the cirrhosis.
If you are a heavy drinker and you start bruising easily, you likely have liver damage. The bruising is from too little protein in your bloodstream. Your thin blood doesn't clot properly.
If you are a heavy drinker and your feet and/or belly start swelling, you likely have liver damage. The proteins being rejected by your liver are pooling in the cavities of your body. The accumulating fluid puts pressure on all your other organs, including heart and kidneys.
I and my husband were living in a grand delusion - the swollen feet were from sitting in the office chair wrong, the swollen belly was just fat, the easy bruising was blamed on taking too many aspirin for the aching back. And on and on...
Sorry for the loooong posts, but I feel the need to share the information.
My husband just passed away yesterday from alcohol related cirrhosis. In his case, it was the build-up of ammonia that killed him. He did not go to the doctor and was not taking lactulose. For several months he had become sleepy all the time, he lost his appetite, and seemed to think slower. In his final month, I noticed he had started walking and gesturing very slowly. To my knowledge, he was not really aware of the issue in any alarming way. I did not know what I was looking at (symptoms of cirrhosis), but I could clearly see that something was wrong.
There is another point to be made though. I've seen several posts here that seem to put too much comfort in lactulose, particularly if the person is continuing to drink. In addition to my husband's ammonia build-up, he had blood unable to enter the destroyed liver, which backed up into his veins. His cirrhosis went untreated until last week when one of the backed-up veins in his esophagus burst, causing him to vomit about a quart of blood, resulting in a 911 call, to the ER. They were unable to stop the bleeding with meds in the IV, and so had to do an endoscopy (camera/tool down the throat) to put bands to close the actively bleeding veins. This procedure required him to be anesthetized. If the procedure hadn't been done, he would have bled to death. He never woke up from that, he instead fell into a sort of deep sleep. So, cirrhosis isn't just about ammonia build-up.
Oh, there's also the major symptom of ascites - fluid build-up in the belly - which is also deadly. With ascites, the fluid is rich with proteins that are supposed to go into the bloodstream, but don't, because the liver is unable to process. This results in the blood being very, very thin, and unable to congeal (meaning when he started bleeding, they couldn't stop it. This symptom actually showed up about a year earlier in his regular doctor's bloodwork results as anemia.
In the end, all the medicine in the world isn't going to help if the liver is damaged, because liver damage is irreversible. Cirrhosis is the curse of alcoholism, unfortunately. I just hope others get more time with their alcoholic loved ones than I did - mine was 45 years old.
There is another point to be made though. I've seen several posts here that seem to put too much comfort in lactulose, particularly if the person is continuing to drink. In addition to my husband's ammonia build-up, he had blood unable to enter the destroyed liver, which backed up into his veins. His cirrhosis went untreated until last week when one of the backed-up veins in his esophagus burst, causing him to vomit about a quart of blood, resulting in a 911 call, to the ER. They were unable to stop the bleeding with meds in the IV, and so had to do an endoscopy (camera/tool down the throat) to put bands to close the actively bleeding veins. This procedure required him to be anesthetized. If the procedure hadn't been done, he would have bled to death. He never woke up from that, he instead fell into a sort of deep sleep. So, cirrhosis isn't just about ammonia build-up.
Oh, there's also the major symptom of ascites - fluid build-up in the belly - which is also deadly. With ascites, the fluid is rich with proteins that are supposed to go into the bloodstream, but don't, because the liver is unable to process. This results in the blood being very, very thin, and unable to congeal (meaning when he started bleeding, they couldn't stop it. This symptom actually showed up about a year earlier in his regular doctor's bloodwork results as anemia.
In the end, all the medicine in the world isn't going to help if the liver is damaged, because liver damage is irreversible. Cirrhosis is the curse of alcoholism, unfortunately. I just hope others get more time with their alcoholic loved ones than I did - mine was 45 years old.
yes to high ammonia levels and brain fog. I am have more brain fog (I call it mind spacing) than in the past. My gastro RX'd lactulose a few months ago, I didn't take it as prescribed at first because it made me nauseaus but am doing better in taking it as requested. However, it doesn't seem to be helping my mind spacing out so much (dr. also said lactulose could help with concentration and more energy as well as helping to lower the ammonia levels. I am anxious to know where or to what this problem leads and am feeling kind of scared about it.
my daughter did not have such a quick recovery from lactulose. it has been 10 months and she has improved somewhat, but rolling in excruciating pain each time i give it to her.
thank you for your comments. i truly wish you well, and my heart goes out to you and family.
i think she needs a new specialist, and fast.
to all who have sent me some help, i am so greatful.
i am having a difficult time getting to know my way around this site; but i am learning.
i don't seem to be able yet to respond to those people listed in my emails? but i will get it. so little time lately.
God bless you all.
working on new doctor.....this girl needs some tests!
on it Again tomorrow am.
thank you for your comments. i truly wish you well, and my heart goes out to you and family.
i think she needs a new specialist, and fast.
to all who have sent me some help, i am so greatful.
i am having a difficult time getting to know my way around this site; but i am learning.
i don't seem to be able yet to respond to those people listed in my emails? but i will get it. so little time lately.
God bless you all.
working on new doctor.....this girl needs some tests!
on it Again tomorrow am.
I hope I spell this right MENTAL ENCEPHALAPATHY is a waking coma and can be caused by high ammonia levels. I had this more than once and Lactulose (enulose is the generic name) brought me right out of it. I have to take this syrup daily. I have no memory of the event but last Easter with my wife and children, grandchildren, I ate an easter egg-shell and all They rushed me to the emergency room because of this and the fact they would ask me a question and I would just say What-over and over again.
I had just finished a high protein breakfast-eggs, sausage, bacon and went into this strange coma.
I had just finished a high protein breakfast-eggs, sausage, bacon and went into this strange coma.
Here is some info about management of hepatic encephalopathy, including a little bit on intolerance of Lactolose:
“There are also concerns regarding the cost-effectiveness of the medication. At the author's institution, one day's treatment with lactulose (30 g PO qid) costs $2.20; one day's treatment with rifaximin (400 mg PO tid) costs $18.42. However, the differential in cost of medication might be overcome if it was determined that rifaximin decreased the incidence of significant medication-related adverse effects (eg, severe abdominal cramping) or reduced hospital stay.”
http://emedicine.medscape.com/article/186101-overview
Bill
“There are also concerns regarding the cost-effectiveness of the medication. At the author's institution, one day's treatment with lactulose (30 g PO qid) costs $2.20; one day's treatment with rifaximin (400 mg PO tid) costs $18.42. However, the differential in cost of medication might be overcome if it was determined that rifaximin decreased the incidence of significant medication-related adverse effects (eg, severe abdominal cramping) or reduced hospital stay.”
http://emedicine.medscape.com/article/186101-overview
Bill
I believe there are a number of options that are available for managing encephalopathy; ask her doctor about rifaximin as well as spirolactolone (sp?). There are also antibiotics that can be used too. So sorry to hear about your daughter’s troubles; do you know why she hasn’t been evaluated for transplant yet?
Bill
Bill
I just read up above and see people have been asking my advice. I need to tell you I'm just a guy with a wonky liver who takes lactulose once in a while and pokes fun at the GI problems it generates. I know a lot more about farting than doctoring, if you get my drift.
There a prebiotic called inulin that may have a similar effect - you can buy that over the counter. But I would not be the one to advise you to go against the doctors orders - and I don't think it's as powerful as lactulose. You might try smaller doses of lactulose and work up.
There's a drug currenty in trials - I heard it's approved in Japan. You could maybe participate in a trial, but not if your in the backwoods. http://www.oceratherapeutics.com/content/pipeline/ast120.htm
Also, limiting protien intake can reduce amonia.
Good luck. I'm soory to hear of you situation.
There's a drug currenty in trials - I heard it's approved in Japan. You could maybe participate in a trial, but not if your in the backwoods. http://www.oceratherapeutics.com/content/pipeline/ast120.htm
Also, limiting protien intake can reduce amonia.
Good luck. I'm soory to hear of you situation.
i have a 43 year old daughter with ending stage of liver disease. she has hep c.
she has brain fog and high ammonia level, and after months of agony will not take lactulose again! she gets severe gas pain and can't pass it. she is literally rolling in pain and crying.
i have to agree that her life with lactulose is hardly worth living. i don't know why this terrible pain, but her dr says take more!
i don't know what to do anymore. can't get on transplant list yet. her dr is unconcerned. we live in the back woods. no specialists around. her pac told me she won't care for her unless she gets psychiatric help?
i want my daughter to live, but not in extreme pain.
is anyone else having a prob with lactulose and is there an alternative drug?
please.
she has brain fog and high ammonia level, and after months of agony will not take lactulose again! she gets severe gas pain and can't pass it. she is literally rolling in pain and crying.
i have to agree that her life with lactulose is hardly worth living. i don't know why this terrible pain, but her dr says take more!
i don't know what to do anymore. can't get on transplant list yet. her dr is unconcerned. we live in the back woods. no specialists around. her pac told me she won't care for her unless she gets psychiatric help?
i want my daughter to live, but not in extreme pain.
is anyone else having a prob with lactulose and is there an alternative drug?
please.
my dad has cirohsis of the liver. He has a high amonia level so the doc gave him lactose. First it was 4 a day and then dad cut it down to 2 a day after about 2 weeks due to going to the potty too much. The blood test was just done again and his level is not down. He has probally been taking the lactose for a month now. The doc called and told mom the level was still high and to take three doses a day of the lactose. My dad says it makes his stomach hurt and wont increase his dose. He takes 100 mg a day of diuretics, and one other that is for his stomach holding fluids. He is 78 and just sits in his chair now and wont do anything much at all. So far he seems pretty clear headed but, if he doesn't increase his lactose dose do you think the amonia will just never go down at all? He is stubborn but, I would like to know the bare facts. He sees a stomach doc that is also a liver doc. Should he be seeing a different kind of specialist? Thanks for your time and consideration...
I am Certified Lymphedema Therapist with a patient who has cogenital Severe lower extremity lymphedema. She recently over the past few months has been having these "brain fogs" and went into a hepatic encephalopathy coma state. She came out of it. The physician wanted treatment to restart, now her amonia levels are climbing. Through Manual Lymphatic Drainage treatment and moving of the lower extremity lymph flow upwards; is this I am assuming adding to her ammonia problems?? I have stopped treatment and on the web researching. Thanks for any advise. Lori
My pleasure. I don't see how exploding farts could not be funny. They just are, like water's wet.
To all those that think high ammonia levels cause "brain fog" I've got just one thing to say..... Dang, I forget now what I was going to say :)
LOL - Keep the faith
LOL - Keep the faith
Oregon is supposed to have a shorter wait for livers. I recently saw that fact in the news. For what it's worth.
Just checked out on ammonia level . To find a totally GoofyDad. You really are Goofy. Well I went for a colonoscopy while taking lactulose and fortunate or unfortunately did'nt blow the Dr. away. Lactulose is a prescribed drug. I've been taking it for about a year now and still haven't figured out the right dosage for me. Believe me there are times when your traveling or have an appointment and you just can't take it. If you go to long without it a You get as everyone say BRAIN FOG never knew what that ment till now.The Dr. have their own word for it encepalopathy. Luckly the Dr. said I could'nt overdose on it so there are occations when I try to compensate and end up sitting in the thinking chair for a very long time.I try to take a higher dose in the evening so I don't spend the entire day in the bathroom. And of course they did say you could go into a coma if your not careful. Someone also asked about transplant I'm not on the list yet but have gone for an eveluation. Looks like I'm still going to be at the bottom of the list because I have no significant symptoms MELD score is at 10 and should be much higher in order to go up on the list . I am according to biopsy at end stage. So whom ever asked Your husband needs to get an eveluation at a liver transplant center before they tell him he can not get a transplant. Goofydad you made my day . Made me smile for awhile and these days its rare. Thanks!!!!!!!!!!!!!!!!!!! cat33
ahh the joy of it all....everybody else is planning their holiday meals and here we all are decribing the blue flaming meanies,,,,,,which after t-day we'll skip the yardstick and grab the Stanley 16 ft-er to measure trajectories......rolleyes
is a prob-biotic more fun than a preb-boitic?? (jk)
Goofydad....you've changed forever my image of a surgical masked doctor,,,,,saying "smokin"...
you did jim carey proud.
is a prob-biotic more fun than a preb-boitic?? (jk)
Goofydad....you've changed forever my image of a surgical masked doctor,,,,,saying "smokin"...
you did jim carey proud.
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
