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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Amonia Odor, Itchy Skin, Nausea, Dizziness. Elevated Billirubin. Is This Lever Disease?

I have an ammonia odor emanating from my body (whether I sweat or not) as well as dizziness, itchy skin, nausea and cold finger tips. I have elevated billirubin (40) but otherwise all blood test were negative. The odor is embarrassing (urine smell). Is this liver disease ( I am 43, non smoker, drink moderately and lead an active lifestyle).
Fri, 12 Apr 2013
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Gastroenterologist 's  Response
Hello, Lwdownham,
Your high bilirubin count and itchy skin indicates that you have some
sort of obstruction to the bile duct , the channel that brings the bile
produced in the liver to the intestine. You could have primary liver
disorder which might have affected the smaller ducts (Hepatic ducts)
that carry the bile or you could have the main duct called the common
bile duct blocked by a stone or scar tissue from repeat inflammation.
What you need is a sonogram of the liver and gallbladder first. You need
a complete set of liver tests and also immune studies to include ANA,
Native DNA. Alpha fetoprotein,Anti smooth muscle antibodies and also
Anti mitochondrial antibodies. If there is significant obstruction , your
stool will be clay colored also. Your blood Alkaline phosphatase level will
be very high.
Hope you can discuss these with your doctor and get tested properly
before they can decide on the treatment.
I wish you the very best.
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General Surgeon Dr. Dr. Ivan Romich's  Response
Hi and welcome to HCM.
Yes , this is liver disorder. YOu just need to find right cause. Bilirubin elevation is common found in many disorders must most usualy is alcoholic, viral, autoimmune or toxic liver damage. The most common liver disorders is fatty liver which can be found in healthy people, but usually is resulting from alcohol, elevated blood lipids, overweight and elevated blood sugar.YOu must do ultrasounds to see is there serious liver damaga, biliary obstruction or something else. Your symptoms are serious and you must evaluate this and do further tests. Beside ultrasounds you should check viral markers.
Also you should treat it by changing dieatary and lifestyle habbits. Do exercise, avoid alcohol,smoking, fats,fast food and carbonated drinks. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be presribed, but I suggest to do ultrasounds first and then go step by step.
Wish you good health.
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Have Amonia Odor, Itchy Skin, Nausea, Dizziness. Elevated Billirubin. Is This Lever Disease?

Hello, Lwdownham, Your high bilirubin count and itchy skin indicates that you have some sort of obstruction to the bile duct , the channel that brings the bile produced in the liver to the intestine. You could have primary liver disorder which might have affected the smaller ducts (Hepatic ducts) that carry the bile or you could have the main duct called the common bile duct blocked by a stone or scar tissue from repeat inflammation. What you need is a sonogram of the liver and gallbladder first. You need a complete set of liver tests and also immune studies to include ANA, Native DNA. Alpha fetoprotein,Anti smooth muscle antibodies and also Anti mitochondrial antibodies. If there is significant obstruction , your stool will be clay colored also. Your blood Alkaline phosphatase level will be very high. Hope you can discuss these with your doctor and get tested properly before they can decide on the treatment. I wish you the very best.