Conversation: The conversation between human and AI assistant.
[|Human|] 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).
[|AI|]  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 complete set of liver tests and also immune studies to include ANA, Native DNA. Alpha fetoprotein,Anti-smooth muscle antibodies and Ashanti kitchen Chat Doctor.  If there is significant obstruction, your stool will be clay colored also. Your blood Alkaline phosphatase level Willie 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.