Ammonia levels lactulose
Common Questions and Answers about Ammonia levels lactulose
ammonia
Normav,
I'd encourage you to ask your father's doctors these questions. I know it's often difficult to get them to spend 5 minutes with you answering questions in language that you understand, but insist on it.
An ammonia level of 400 is extremely high. If your father has been in the hospital for 3 weeks with liver failure and his ammonia is still this high, it sounds pretty grim to me.
His condition has been unchanged for 3 weeks. I called and asked what his ammonia levels were last week. The nurse gave me the run around and said they were within normal limits. Without the limits in fornt of me I don't know what they are. My husband went to Utah 2 days after I called, and all of a sudden they were checking ammonia levels and trating him with Lactolose, which I know is the appropriate Tx.
He was advised to increase the lactulose to 30 ml twice a day for 5 days and then resume back to 15 ml twice a day. Is there any other medication for elevated ammonia? The side effects to lactulose are intolerable at times. He is experiencing depression, mood changes and personality changes. He did take the treatment of Ribavirin and Pegasys which was not effective.
My husband has cirrhosis and we have been told that the latest studies indicate people with cirrhosis actually really need the protein but they just have to keep their ammonia levels down by regularly taking enough lactulose. The amount varies per person by how many loose stools it causes...that is generally how it is dosed but you should get that information from your Dr. Some Dr's are so much more up to date than others.
He was pretty stable until last Christmas, and his health has seriously declined since then. We are having a really hard time keeping his ammonia levels under control, despite following his liver doctor's orders to the letter. He is normally on 3/x daily of 30 m/l lactulose, and when his ammonia ticks up (as we can tell from increased cognitive impairment, decline of motor skills, etc.), we provide it to him every 2-3 hours until symptoms improve. Except that they often don't.
Patients with liver disease are unable to process or detoxify ammonia so that ammonia levels can reach dangerously high levels. This is coupled by increased ammonia production of colonic bacteria, especially if one is constipated or has an irregular bowel movement. High protein intake can also lead to an incresed ammonia production. I suggest you talk about these possibilities with your doctors.
However if you choose a diet rich in fiber you may be able to skip that. It will depend on your ammonia levels which a blood test will reveal. You need to get to 3 good bowel movememnts a day to keep blood ammonia down, which is the largest cause of brain fog. If you treat for hep C with SOC you should also see a drop in this problem as your liver returns to normal function and enymes levels.
He has been in the hospital 3 times in the last month with high ammonia levels. He was just told he needed to be on a no protein diet and is taking the lactulose. The last time he was in the hospital his ammonia level was 250. He was not responding to anyone and it mimicked a stroke. He received IV therapy and a blood transfusion at this time also. Would increasing his lactulose on the onset of increased confusion (he is always slightly confused now) help clear some more of the ammonia out?
At the age of 36 she had to have a complete gastrectomy(entire stomach removed) due to massive polyps. One year ago she started developing high ammonia levels, range from upper 60's to 110. Massive headaches seem to accompany the elevated levels. She has had liver function tests and biopsies for years now and have determined the problem isn't her liver. They prescribed lactulose and Xifaximim(antibiotic given to liver disease patients, might have the spelling wrong).
Do an ultrasound, less dangerous. But I think most of your symps are post tx. I finished in May and still am not up to par. Post tx is an area were there just isn't alot of info. Definately no clinicial data. Since I completed tx(successfully) I've had an incredible cascade of symp's. I thought I had RA, low thyroid, low testosterone, OA, insulin resistance. This stuff wrecked my teeth, they are brittle and chip very easily. No one told me about any of this stuff.
The condition that happens when ammonia levels get too high. His doctor prescribed Lactulose. The liquid medication that does indeed increase the need for the bathroom. He is taking 3T. three times a day. In the beginning he would find himself rushing off the bathroom pretty frequently. Once the meds became established in his system (a month or so seems to be my recollection of how long it took) he now has 3-4 soft BM's a day and no longer feels chained to the bathroom.
After being told that there was nothing wrong with me for three years a geneticist discovered that my ammonia levels (reference range is 12-47 umol/L) were double and triple what they should have been after eating. I should also note that during that time I was having Ensure meal replacements as I thought this was a healthier option. After cutting down on protein, taking lactulose (30ml/3x/day) and starting Rifaximin (600mg/2x/day for the encephalopathy) my symptoms quickly started to improve.
He had numerous episodes with elevated ammonia levels and severe confusion before transplant. His ammonia levels continue to go up even after transplant. All on his blood tests, bioposy, ultrasound are shw normal lover functions. He has been hospitalized several times after transplant for confusion. His ammonia levels can be as little as 10 points above normal to 165. This makes it hard to do anything. He takes 9 Rifaximin a day and at first sign..if I catch it.. I give him lactulose.
My mother has cirrohsis and has ascites and is struggling with high ammonia levels. She is being treated with lactolose and for now it is bringing her levels down. She reached 102 a few days ago and the lactolose has returned her level to 54. I am trying to find out how how and ammonia level can go before it is considered toxic and will cause her to go into a coma? I am also wondering in advanced cirrohsis will the lactolose eventually be uneffective in bringing down the ammonia levels?
Has your appetite increased?
I'm trying to remember the stage of fibrosis you are since I can't really search the forum on my iPad but do you mean you are gaining while on treatment?
I guess first be sure it is not fluids or water retention and second among other things (ammonia and all that) as an osmotic laxative isn't Lactulose move your bowel? Hope this isn't TMI but I can look and feel pretty hefty if I am not regular if you know what I mean.
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