What are attainable ammonia levels?

[Crafter1950]

I’m new here. I have shared about my 42 year old daughter who takes Lactulose (2 doses per day) and Xifaxin (2 per day). Now we don’t believe that her first 4 lab tests at an outsider were correct because the blood draw was not chilled. Now we know that it should be and have a hospital outpatient lab do the draw. They won’t draw until the technician has a cup of ice to chill it.

My question today is what ammonia level # are your doctors concerned with and what numbers are good? The first lab says under 87 and she was never lower than 122 from that lab. Only one test was after taking one dose of Lactulose and it was 158. The first lab draw at the hospital lab with only one dose of Lactulose was 73!! Xifaxin was added and then a second dose of Lactulose was added. The hospital wants it under under 51 and she has never been lower that 59. ( last time 64).

The second dose of Lactulose and theXifaxin haven’t moved the needle much. I believe the Lactulose is messing with her diabetes. I will check with her doctor again but am interested in personal accounts so I understand what is possible.

[carllovatt]

we are not doctors. but you should be able to tell if her ammonia levels are ok just by her demner good bad high low but mainly OK or not.

apart from the pills, lactulose and vitamins. what she eats has a huge effect on the hepatic encephalopathy [H,E] and salt

look on the british liver trusts website for more info.

[Crafter1950 in reply to carllovatt]

Thank you for your reply. Our daughter has no symptoms of HE, just that a doctor decided to test for ammonia because one of her seizure meds is known to cause increase ammonia. No one tested her for the first 30 of the 32 years she has taken it. She may have been high in ammonia with no other symptoms for many years. Since new meds for this were introduced, her blood glucose numbers are higher. I will address this with her GI doctor. She was diabetes meds free for 12 years and since May back on them with not much change in BG numbers. I just like personal input to help me present our concerns to him. Thanks again.

[Hidden]

Hi Crafter1950

Are you in the UK? if you are not, then it is very possible that the reference ranges may be completely different in another country so no one on the forum can really safely advise.

Here in the UK, the ranges can also vary from one lab to another.

We would suggest that you discuss ammonia levels with the clinicians who ordered the tests to ensure you get accurate feedback.

Best wishes

Trust1

[Crafter1950 in reply to Hidden]

Thank you for your reply. I am in the U.S. so yours was a good qualifying question. I hadn’t thought of that. It is all frustrating because I kept telling the neuro who prescribed the first dose of Lactulose that we would go to any lab and he said it didn’t matter and yet he would say that the range numbers were different than he was used to. Only when he referred us to a GI at a hospital complex did we get the proper tests at the hospital. Since the GI added the Xifaxin and the second dose of Lactulose that haven’t changed the numbers, we want a med free blood test to see if she really needs meds that present their own set of problems.

Thanks again.