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
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