This is topic Elevated Ammonia levels in forum Medical Questions at LymeNet Flash.


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Posted by TickTock4422 (Member # 12553) on :
 
Hello everyone,

It's been a long time since I've posted on the forum. But I'm glad to be back. I have a question I'm so concerned about, I thought I'd post and get more information and support for this topic.

My ammonia levels this past month is 175. My Lyme literate Physician is not too concerned about it and put me on L-Ornithine- L-Aspartate. I just so happened to see my Internist in the meantime and he freaked out about this level. He ordered another ammonia level, ultrasound of my liver, other lab tests for hepatitis, and tumor markers which freaked me out!!

Apart from Lyme Disease, I would like to check out my liver because of the bulk of medications I'm on including narcotics. I am also on a weight-loss diet and take in a high protein diet daily. From what I've read high-protein diets can also elevate ammonia levels apart from the above factors, Cirrhosis, and Hepatitis.

I've been having severe symptoms of extreme sleepiness daily to the point where I can't drive because I'm so drowsy and sleep a lot during the day and I also have episodes of shortness of breath and breathlessness. My internist told me he has patients with ammonia levels less than mine, who are comatose which is why he was SO concerned.

So, in essence, I am rather torn as to whether I should be extremely concerned as to any damage to my liver
due to the use of narcotics and all the medications that I take; versus the simple reversible causes of elevated protein in my diet OR Lyme. If anyone has any comments in regard to this area that can assist me/allay my fear of actually what could be going on here, it would be most appreciated.

Also, how long does it take for the L-Ornithine-L- Aspartate to lower my levels?
 
Posted by karenl (Member # 17753) on :
 
take lactulose and look at your genes as well, if it is genetic it will be forever
 
Posted by LisaK (Member # 41384) on :
 
my ammonia is crazy high. I had genetic testing done and it turned out I make gobs and gobs of ammonia and at the same time my system doesn't work to get rid of the ammonia,. this causes a lot of issues.

my gene person has me on several things to correct this.


some ups and downs that need tweaking. but overall seems to be helping. I am still out with the jury.

I agree with karenl- get genetics done. it was a HUGE eye opener for me.
 
Posted by Marz (Member # 3446) on :
 
I've been taking a proprietary blend of things to go after ammonia. The person recommending it thought ammonia is the cause for my insomnia and anxiety. My genes and organic acids test show I'd be high.

It hasn't made a difference though. I'm going to try yucca alone which is one of the ingredients and have heard some people use that alone.

I'm a little puzzled as to why people go into comas from excess ammonia or get sleepy like you ticktock. Smelling salts were used to bring people around who fainted. And why is this person saying it could be the reason for my insomnia.

Maybe the amount of it we have makes a difference?
 
Posted by GretaM (Member # 40917) on :
 
Hi there. My ammonia is high too. My doc says ammonia aggravates brain fog.
Activated charcoal capsules help me

So does yucca root tincture. And l arginine

I take the charcoal four hours away from everything else
 
Posted by Marnie (Member # 773) on :
 
“When BH4 supply is limited the body will prioritize detoxification of
excess ammonia

above production of neurotransmitters.”

http://tinyurl.com/pfnx9x9


Each turn of the folate cycle and
conversion of 5MTHF to THF produces 1 molecule of BH4.

MTHFR mutation...problematic!

Scroll down to this:

MTHFR A1298C

Here:

http://webcache.googleusercontent.com/search?q=cache:xMgi-Ta414MJ:http://geneticgenie.org/all-mutations/

Find BH4 mentioned here (into the search window, top left, type in BH4 and it will be highlighted):

http://webcache.googleusercontent.com/search?q=cache:1Sh8zyqOPlYJ:http://www.center4autism.org/therapyMETH.asp
 
Posted by ukcarry (Member # 18147) on :
 
That's a very helpful link, Marnie, thanks.
 
Posted by Marnie (Member # 773) on :
 
CBS (an enzyme which works with B6) can be upregulated -> high ammonia too!

I posted a link to a PICTURE several times that really explains how

***protein -> methionine -> homocysteine*** which is reduced primarily 2 ways:

1. Homocysteine is lowered via the "remethylation cycle" whereby we "recycle" methionine/methyls (CH3). That is where B9 - folate - and B12 and zinc (and other minerals...selenium (to make SAM - as in SAMe..., iron, etc.) come into play.

2. The "transsulfuration pathway" is where an enzyme called CBS works with B6 -> cysteine -> taurine + GSH + Sulfate. Taurine lowers cholesterol (my autistic son - low cholesterol). BUT...if CBS is upregulated, this can -> a lot of ammonia which is broken down by BH4 -> urea cycle (BH4 happens in the folate cycle).

So, can you see where if there is a MTHFR mutation, CBS (needs B6) might be upregulated to compensate - to drive homocysteine down?

Either way...too friggin much ammonia which will use up available BH4 ***at the expense of neurotransmitters*** (priority is to lower ammonia and incorporate it into the urea cycle).

Now...get this...!!!


"De novo BH4 production" is significantly increased in injured or hyperactive peripheral nociceptors,

as well as in a variety of immune cells, including T cells, macrophages and dendritic cells.

Our immune cells are MAKING BH4!!!

De novo looks to involve GTP, not ATP!!!

Picture here:

http://quartetmedicine.com/our-science/tetrahydrobiopterin-bh4-in-chronic-disease/

If BH4 is upregulated in a variety of our immune cells, aren't the immune cells “stealing” the precursors = general (rest of body) decrease of BH4 availability?

Smelling salts = ammonia to "wake up" (can't sleep)...ammonia using up available BH4 at the expense of neurotransmitters (including serotonin -> melatonin (!) as well as acetylcholine, etc...)

I never made that connection (ammonia, smelling salts), but certainly my son has sleep issues (with possible high CBS due to MTHFR mutation -> high ammonia.

My son had his first seizure at puberty when in boys especially, homocysteine levels go up.

Long story...many Rxs made a bad situation worse...we control his seizures - completely - with daily P5P (the active form of B6) in combination with B2 (riboflavin to help the mitochondria make FMN and FAD)+ Mg and Ca all in ONE P5P supplement - 50mg daily by Now (Brand Name).

But we still have a hard time countering depression and anxiety...working on it.

Genetic testing via 23andMe plus scheduled intake with FSU for genetic testing in Sept. is underway.

Then we will figure out additional "work-arounds".

Without protein as a methyl donor...kiss SAM (as in SAMe for depression) goodbye.

If you have been following the lithium post...

LiBH4 might happen? Impact?

Oddly...

Lithium borohydride is renowned as one of the highest energy density chemical energy carriers.
 


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