What is Ammonia?

Although we might not realize it, we all have a certain amount of ammonia in our bodies. It is a natural by-product of the digestive process. When we ingest dietary protein, bacteria in the gut break this down. Ammonia is formed as a result of the breakdown of protein. This ammonia is a nitrogen waste product and is converted into harmless substances – urea and glutamine – by the liver. The urea is then is transported to the kidneys before being excreted in the urine. A healthy urea cycle is necessary to maintain normal ammonia levels in your body.

Figure 1 Ammonia molecule

Figure 1 Ammonia molecule


The Dangers of High Ammonia Levels

Severe health problems occur when the liver does not convert ammonia into urea. This malfunctioning of the urea cycle is often attributed to other conditions such as cirrhosis or extreme hepatitis. Whatever the cause, this results in high ammonia levels in the blood – a metabolic condition referred to as hyperammonemia.

High ammonia levels pose a significant health risk. Since ammonia is a waste product, if allowed to accumulate in the blood stream, its toxicity will poison your system, affecting your whole body. This is because ammonia is able to pass through the blood-brain barrier.

When Should you Consider Getting your Ammonia Levels Checked?

There are a few instances where a medical investigation or diagnosis requires a blood test to check your ammonia levels. These instances include:

  • The diagnosis of extreme liver disease.
  • The diagnosis of genetic disorders of the urea cycle.
  • To confirm a diagnosis of Reye’s Syndrome.
  • To confirm a diagnosis of hepatic encephalopathy.
  • The investigation of the causes of behavioural changes.
  • The investigation of the causes of changes in consciousness (e.g. coma).

As a caveat, it must be mentioned that ammonia levels can be elevated by other causes. Some examples of these causes include:

  • Smoking. (It is therefore important that you refrain from smoking prior to an ammonia test.)
  • Exertion of muscles.
  • Gastrointestinal bleeding.
  • After using a tourniquet.
  • Ingestion of alcohol or certain drugs (e.g. diuretics, barbiturates, narcotics, valproic acid).

Treatment for Hyperammonemia

The treatment of this condition can take several forms, depending on the severity.

Ultimately the aim is to establish normal ammonia levels in the patient. Therefore, possible courses of treatment include:

  • Medication to treat urea cycle disorders
  • Antiemetic medications    (Medications that are effective against nausea and vomiting.)
  • Reduction of protein intake
  • Reduction of nitrogen intake
  • Haemodialysis
  • Kidney transplant
  • Liver transplant
  • Liver cell transplant

Encephalopathy can be Caused by Liver Disease

When left untreated, hyperammonemia translates into elevated levels of ammonia that will then accumulate in the brain, leading to a condition called hepatic encephalopathy. Essentially this means a disruption in brain function. It is important to note that although the symptoms are neuropsychiatric in nature, the cause is dysfunction of the liver rather than brain disease.

Possible Signs and Symptoms to look out for

This illness has a range of neurological and mental symptoms including:

  • Disorientation
  • Confusion
  • Delirium
  • Epilepsy
  • Sleepiness
  • Personality changes
  • Mood swings
  • Loss of fine motor coordination
  • Slurred speech  
  • Coma (which can lead to death)

The list of possible symptoms is slightly different in the case of newborns. Here, symptoms can include:

  • Irritability
  • Lethargy
  • Vomiting
  • Difficulty feeding
  • Hyperventilation
  • Seizures

The severity of symptoms differs significantly from patient to patient. Accordingly, this type of encephalopathy is classified according to five levels, referred to as Grade 0 to Grade 4 with Grade 0 being the least severe classification.

Acute Versus Chronic Hepatic Encephalopathy

This condition can be either acute or chronic, depending on the causal factors. Liver disease, such as hepatitis or Reye’s syndrome, is responsible for acute cases of hepatic encephalopathy. Severe cirrhosis leads to a recurrent condition. It is very rare for a patient to develop a permanent condition that does not respond to treatment.

Other causes of Encephalopathy

It is important to note that hepatic encephalopathy can be caused by a range of factors. In addition to the liver and kidney problems discussed above, other possible causes of this condition include:

  • Dehydration
  • Infections
  • Low oxygen levels
  • Medications that suppress the immune system
  • Medications that suppress the central nervous system
  • An electrolyte imbalance (especially a potassium deficiency)
  • Recent surgery
  • Excessive intake of dietary protein

Practice Self-Healing through Prevention

Through preventative measures you can reduce your risk of developing this potentially debilitating and even life-threatening illness. The most effective preventative plan is to avoid developing liver disease or, in cases where liver disease has been diagnosed, effective maintenance of the condition. Steps that can be taken include:

  • Avoid all alcohol, or only drink alcohol in moderation
  • Avoid drug use
  • Avoid sharing needles
  • Do not eat foods that are high in saturated fat
  • Lose any excess weight
  • Live a healthy lifestyle and maintain a healthy weight
  • Liver Detox  

Additional steps can be taken to avoid contracting viral hepatitis:

  • Avoid immediate contact with anyone who has viral hepatitis
  • Avoid sharing needles
  • Wash your hands thoroughly after using the toilet
  • Wash your hands thoroughly after changing a diaper
  • Wash your hands after using the restroom or anything that will create contact with disease pathogens.


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Author: Esateys Stuchiner

Esateys (pronounced Ee sáh teez) is an International Life Transformational Speaker, Author, Master Facilitator, Life Coach and Expert in the Human condition. She is a Nationally and Board Certified Nurse Practitioner. For over 30 years, she has practiced, taught and lectured extensively in the allopathic and alternative medicine field.

Esateys is known for her groundbreaking work in the areas of personal empowerment and health restoration using mindset and inner connection as the catalyst for all change.

Esateys describes herself as the ‘Architect of the New You’ and has dedicated her life and professional career to helping her clients create “New Beginnings” by facilitating self empowerment, economic freedom and restored health.

For more information, go to esateys.com.

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