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High ammonia levels

nothuman

Featured Member / Kilo Klub
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Long shot but has anyone had their ammonia levels checked before and were they ever high? Possibly from eating too much protein for a prolonged period of time? Any symptoms?

It's not routinely checked, but I figured I'd ask just in case.
 
NH you still taking stabs at trying to figure out what’s going on with you or is this just curiosity?
 
Ammonia->uric acid->urea so a BUN test should cover this as far as I know.
 
Ammonia->uric acid->urea so a BUN test should cover this as far as I know.

what if ammonia is extremely high but uric acid and BUN are optimal?
 
I have taken a sleeping tablet but just a quick comment. When eating high amounts of protein and low other macros it's common for that breakdown of protein to increase ammonia. It will be noticeable when sweating and urinating.

A simple change in diet can change this quickly. Supplementing with citrulline or/with ornithine and arginine will also help with ammonia detoxification. Why do you think you might have high ammonia levels?
 
I have taken a sleeping tablet but just a quick comment. When eating high amounts of protein and low other macros it's common for that breakdown of protein to increase ammonia. It will be noticeable when sweating and urinating.

A simple change in diet can change this quickly. Supplementing with citrulline or/with ornithine and arginine will also help with ammonia detoxification. Why do you think you might have high ammonia levels?


this is correct.

i have had high ammonia levels. i had wicked brain fog. felt completely disconnected from the world around me
 
NH you still taking stabs at trying to figure out what’s going on with you or is this just curiosity?

It's still bad enough that I can barely function. I've been so focused on thyroid but now I'm wondering if the primary symptoms are from ammonia toxicity.

I have taken a sleeping tablet but just a quick comment. When eating high amounts of protein and low other macros it's common for that breakdown of protein to increase ammonia. It will be noticeable when sweating and urinating.

A simple change in diet can change this quickly. Supplementing with citrulline or/with ornithine and arginine will also help with ammonia detoxification. Why do you think you might have high ammonia levels?

Because I do! It was 217 with a range of 0-72. Also I have the severe brain dysfunction symptoms I'm reading about it.

Really impressed you know a lot about this. I was just doing a bunch of research on it and I'm reading to do the things that you're suggesting. I would have asked you earlier had I known.

200-300g protein every single day for 16 years is apparently not a good idea. How low do you think I should drop it? Like, 120g or so?
 
this is correct.

i have had high ammonia levels. i had wicked brain fog. felt completely disconnected from the world around me

Holy cow, there are more like me! What did you do to fix this problem? How are you now? Please tell me everything. I have suffered 2 1/2 years with this. I just want my life back.
 
What do your liver and kidney numbers look like ??
If your ammonia is that high then I'd suspect that it is due to a liver or kidney issues not processing the ammonia down so it can be excreted properly.

This could potentially be a very serious issue , figure out the cause and treat that rather than just treating symtoms.
 
What do your liver and kidney numbers look like ??
If your ammonia is that high then I'd suspect that it is due to a liver or kidney issues not processing the ammonia down so it can be excreted properly.

This could potentially be a very serious issue , figure out the cause and treat that rather than just treating symtoms.

They’re pretty much perfect, which I don’t understand. All kidney numbers are mid range with eGFR above 100. ALT and AST below 20. GGT is 11. Yet my ammonia is 217. I had the ammonia tested non fasted after eating a lot of protein though, so I wonder if it acutely elevated from that. I have the symptoms of it though.

I read a study where ammonia levels went up by 59% on a high protein diet, which is still less protein than I’ve been eating all these years. I’m pretty sure this is the cause.
 
Holy cow, there are more like me! What did you do to fix this problem? How are you now? Please tell me everything. I have suffered 2 1/2 years with this. I just want my life back.


i started taking high doses of citrulline, 10-20g and sure enough, it cleared right up.

what has your doctor said? have you considered seeing a neurologist?
 
i started taking high doses of citrulline, 10-20g and sure enough, it cleared right up.

what has your doctor said? have you considered seeing a neurologist?
Straight citrulline? Or citrulline malate? Could malic acid help this?
 
i started taking high doses of citrulline, 10-20g and sure enough, it cleared right up.

what has your doctor said? have you considered seeing a neurologist?

He said absolutely nothing. He was nothing more than a salesman and could hardly qualify as a doctor.

I made an appointment with a liver specialist but you're saying I should see a neurologist instead? It would have been nice if the neurologist I saw two years ago actually tested my ammonia level.

Looks like I'm jacking up the citrulline dose.

How long did it take to clear up? Did you reduce your protein intake?
 
Lactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease.

https://www.google.com/search?q=lac...=chrome..69i57j69i59&sourceid=chrome&ie=UTF-8

Not saying you have liver disease but you need to have a workup including imaging to cover all of your bases.

Read this and check out the link...

"Primary causes of hyperammonemia include congenital enzymopathies in the urea cycle, such as deficiencies of ornithine transcarbamoylase and argininosuccinate lyase. These disorders can lead to varying degrees of hyperammonemia depending on the enzyme affected and on whether the genetic deficiency is heterozygous or homozygous. Secondary hyperammonemia occurs commonly in the presence of hepatic disorders leading to portosystemic encephalopathy, but can occur in the absence of hepatic dysfunction in disorders like Reye's syndrome, ureterosigmoidostomy, and infection in a neurogenic bladder. Drug toxicity as a result of disruption of mitochondrial pathways by drugs like cyanide, carbamazepine, valproic acid, iron, and cytotoxics can also cause secondary hyperammonemia, and this is thought to be the main mechanism by which nonhepatic or noncirrhotic hyperammonemia can occur in people exposed to these drugs (2, 49)."

"Noncirrhotic hyperammonemia as a cause of altered mental status remains a diagnosis of exclusion. In our patient, the elevated blood ammonia level and the rapid resolution of symptoms coupled with the reduction of his blood ammonia level led us to suspect that hyperammonemia may have accounted for his presentation. His clinical presentation and subsequent clinical course were similar to those of patients described in prior case reports of noncirrhotic/nonhepatic hyperammonemia (28)."

"The diagnosis of hyperammonemia may be challenging and requires a high index of suspicion. However, it should be considered when a clear cause of altered mental status is not obvious after basic investigations. As an initial step, it is advisable to exclude hypo- or hyperglycemia, azotemia, liver failure, electrolyte imbalance, sepsis, structural and vascular pathologies like stroke, and central nervous system involvement by cancers. Thereafter, the evaluation can be expanded to consider less common etiologies."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569228/
 
Even if you're able to reduce the level and clear up some of the brain fog, definitely follow through with seeing the doctor to make sure there isn't any underlying disease. Keep us posted!
 
He said absolutely nothing. He was nothing more than a salesman and could hardly qualify as a doctor.

I made an appointment with a liver specialist but you're saying I should see a neurologist instead? It would have been nice if the neurologist I saw two years ago actually tested my ammonia level.

Looks like I'm jacking up the citrulline dose.

How long did it take to clear up? Did you reduce your protein intake?


i would explore all avenues when it comes to medical experts.

when i started taking the high doses of citrulline, my mind cleared in a matter of hours. i did not decrease my protein intake
 
Lactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease.

https://www.google.com/search?q=lac...=chrome..69i57j69i59&sourceid=chrome&ie=UTF-8

Not saying you have liver disease but you need to have a workup including imaging to cover all of your bases.

Read this and check out the link...

"Primary causes of hyperammonemia include congenital enzymopathies in the urea cycle, such as deficiencies of ornithine transcarbamoylase and argininosuccinate lyase. These disorders can lead to varying degrees of hyperammonemia depending on the enzyme affected and on whether the genetic deficiency is heterozygous or homozygous. Secondary hyperammonemia occurs commonly in the presence of hepatic disorders leading to portosystemic encephalopathy, but can occur in the absence of hepatic dysfunction in disorders like Reye's syndrome, ureterosigmoidostomy, and infection in a neurogenic bladder. Drug toxicity as a result of disruption of mitochondrial pathways by drugs like cyanide, carbamazepine, valproic acid, iron, and cytotoxics can also cause secondary hyperammonemia, and this is thought to be the main mechanism by which nonhepatic or noncirrhotic hyperammonemia can occur in people exposed to these drugs (2, 49)."

"Noncirrhotic hyperammonemia as a cause of altered mental status remains a diagnosis of exclusion. In our patient, the elevated blood ammonia level and the rapid resolution of symptoms coupled with the reduction of his blood ammonia level led us to suspect that hyperammonemia may have accounted for his presentation. His clinical presentation and subsequent clinical course were similar to those of patients described in prior case reports of noncirrhotic/nonhepatic hyperammonemia (28)."

"The diagnosis of hyperammonemia may be challenging and requires a high index of suspicion. However, it should be considered when a clear cause of altered mental status is not obvious after basic investigations. As an initial step, it is advisable to exclude hypo- or hyperglycemia, azotemia, liver failure, electrolyte imbalance, sepsis, structural and vascular pathologies like stroke, and central nervous system involvement by cancers. Thereafter, the evaluation can be expanded to consider less common etiologies."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569228/

I was reading about lactose yesterday actually and ordered some online, just in case I’m unable to secure a prescription on Thursday with a liver specialist. Thanks for the added reading material though. This is excellent and helpful information! I hope it works to lower ammonia even though I don’t think that I have a liver problem.


I’m going to do:
glutamine 20g daily
A combo supplement of arginine/ornithine/lysine
Extra citrulline
Lactulose when I receive it
 
I meant to say lactulose*
 
I think you are over-reacting to this, especially if you are eating in a hypocaloric state, low carbs, and higher protein(?). Both your BUN and liver enzymes are normal. Higher ammonia comes with the territory I described above. Lactulose, glutamine and citrulline may/will help, but your ammonia levels will rise and fall throughout the day. Foggy headedness can be a result, but unless you have any type of liver disease, I feel you have nothing to worry about.
 

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