Registered Dietitian

Answer: C - Branched chain amino acids (BCAA) might be helpful in treating the encephalopathy of end-stage liver disease, which is caused by accumulation of ammonia in the blood. Supplementation with branched-chain amino acids, such as leucine, isoleucine, and valine, might relieve the confusion and lethargy of encephalopathy of ESLD by blocking the action of aromatic amino acids, which act as neurotransmitters and may exacerbate the neurologic changes seen in ESLD. Although the herb milk thistle may help protect the liver, its effects on encephalopathy have not been tested.