Patients with chronic liver disease often have elevations in plasma levels of aromatic amino acids, including tyrosine, phenylalanine, and tryptophan, as well as methionine, glutamate, aspartate, and ornithine; branched-chain amino acids, leucine, isoleucine, and valine, are usually depressed.1,2 Fischer Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.