Discussion: I am not focused and have difficulty driving; I have chronic fatigue. I was told to ask the doctor and check if I do not have liver encephalopathy.

Hepatic encephalopathy is when a high level of ammonia in the blood (a breakdown product of any protein) penetrates through the brain's barriers and causes side effects that affect alertness and cognitive ability. Ammonia is a potent toxin that the liver should eliminate after synthesis and excrete through the kidneys. High ammonia levels in the blood and hepatic encephalopathy may indicate liver failure and require a comprehensive liver-kidney function examination.