When I was first diagnosed with liver disease, I didn’t understand why my doctor kept talking about something called “ammonia levels.” Honestly, I was thinking about pine cleaners and how the kitchen smelled when mom did the spring cleaning! But after going through some scary symptoms due to my Hepatic Encephalopathy or HE, I got some answers because with severe HE, I realized how important it is to understand this part of my health. So I hope it helps you too if you or a loved one have ammonia on the brain with cirrhosis.
What Are Ammonia Levels Anyway?
Ammonia is a waste product your body makes when you digest protein (like meat, eggs, and beans). Normally, your liver takes care of that ammonia and turns it into something called urea. Then your kidneys flush it out through your pee. This process is called the urea cycle.
But if your liver isn’t working properly—like in liver disease—ammonia can start to build up in your blood. This can be super dangerous because ammonia is toxic to your brain. High levels can cause memory problems, confusion, and even coma. The medical name for this is hyperammonemia. Big word, but it basically means “too much ammonia in the blood.” I was hyper for sure and I survived with the correct treatments.
Why Did I Need the Test?
Mine started long before I knew about the lurking liver disease. It was hidden and almost strange symptoms—things like feeling confused, super tired, moody, and unsteady on my feet. Some days I’d forget where I was, fall asleep in my car, or forget what I was doing. When I was hospitalized after ascites came up and my belly bloated, he ordered an ammonia blood test to help figure out what was going on.
This test doesn’t take long. They just draw a small sample of blood, usually from a vein in your arm. Sometimes they might take blood from an artery if they need more exact results. Just to say though. This is not an exact science and my doctor told me early on that ammonia was not always the most reliable way to detect HE.
What Do the Results Mean?
If your ammonia levels are normal, that’s great news. But if they’re too high, it means your body isn’t getting rid of waste the way it should. Liver disease is the most common reason, but it can also be caused by:
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Kidney problems
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Certain rare genetic conditions (called urea cycle disorders)
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Reye syndrome (a rare condition mostly in children after a viral illness)
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Some medications
What Symptoms Should I Watch For?
Everyone is different, but some common signs of high ammonia levels are:
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Feeling tired or confused
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Headaches or throwing up
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Mood swings
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Trouble walking or talking
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Seizures
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In kids, not growing well or missing developmental milestones
If you or someone you love has liver disease, it’s important to know these symptoms. Don’t wait to get help if something feels off.
What Helps?
Treatment depends on the cause, but your doctor may recommend medicine, diet changes, or even hospital care if levels are too high. They’ll likely repeat the ammonia test to see if your treatment is working.
Also, a few quick tips: Before the test, don’t smoke or drink alcohol. You may also need to skip heavy exercise or certain meds—but only if your doctor says so.
Ammonia on the Brain with Cirrhosis
I know this stuff can feel overwhelming for you and your caregiver who can help you with hepatic encephalopathy. But understanding it is a big step in taking care of yourself. You’re not alone in this. I’m walking this road too, and I’m cheering for you every step of the way. xo Karen
