Ammonia (NH3) and Liverdisease/Hepatitis
Ammonia is a product of amino acid breakdown. Increased levels of ammonia may be a sign of encephalopathy - an altered mental status associated with liver failure. (see chapter 6). Some doctors use ammonia levels to monitor the course of people with encephalopathy. However, since some studies have demonstrated a poor correlation between ammonia levels and degree of encephalopathy, its use for this purpose is controversial. Measurement of the ammonia level in people with liver disease is not recommended, as mild increases may occur with any liver disease and are not diagnostic of encephalopathy. Finally, there are multiple factors which can artificially elevate ammonia levels, thereby skewing interpretability. Such factors include- cigarette smoking, certain medications such as valproic acid (a medication used to treat seizures), accidentally mixing the patient’s perspiration with their blood sample during the blood draw, and laboratory delay in analyzing the blood sample.
Copyright © Melissa Palmer 2005-2012
All contents of this article are Copyright © Melissa Palmer, MD
Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. Prior to 2012, she maintained perhaps the largest medical practice devoted to liver disease in the United States. Dr. Palmer is Clinical Professor of Medicine at New York University Medical Center. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City.
Dr. Palmer is Board Certified in Gastroenterology and in Internal Medicine.
She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.
She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis. Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis.
Dr. Palmer has performed numerous clinical trials on various experimental medications for the treatment of hepatitis.
Dr. Palmer is currently available for lecturing, investor and hedge-fund consultations, consultations to industry, and media interviews and appearances-- including television. For such matters, she can be contacted through hepatitismedia@gmail.com.