Amonia high - brain fog?

[Magnum]

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

[azpunky]

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.

[iStella]

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.

[DesparateMom939]

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.

[franke566]

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.

[Bill1954]

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

[Bill1954]

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