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High ammonia - with gut dysbiosis

renski

Senior Member
Messages
338
Location
Honolulu
Hi,

I'm really suffering with insomnia, depression, anxiety and chronic fatigue at the moment, all of my symptoms are psychological/fatigue related. I'm seeing a few doctors at the moment but so far no one has really been able to help. Often when I try to take basic supplements like B12, I feel overstimulated and it makes my anxiety/insomnia much worse. I've used P5P on and off for a while, sometimes it helps me to relax other times I feel like it's adding to the over stimulation.

Some of the problems I have:
- High ammonia
- High oxalates
- Homocysteine is 6.1
- Low glutathione
- Neurotransmitters are high glutamate, low gaba/serotonin
- SIBO (streptococcus overgrowth, citrobacter), candida
- Thyroid - high reverse T3
- High cortisol
- B2, B6, Biotin deficiencies
- Mineral deficiencies (at least magnesium/selenium)

For CBS - I have CBS A360A+/+, but unaffected by - CBS C699T

Tests that I've had done can be viewed here: https://drive.google.com/drive/folders/0B20YfaNvgCdnLVhyZ1k5dndWSDg

I've tried to treat the SIBO/candida with probiotics and antifungals for 6 months but seen no improvement and I'm now at the point where side effects from antifungals are intolerable and have stopped using them. I've started to look into the ammonia issue, and have noticed when I used activated charcoal I felt much better, but am afraid to use it frequently. I've tried Ornithine, it gives me some relief for about an hour but then I get anxiety/anxious. I don't have constipation/bloating or anything like that, even when using the charcoal it passes through but takes 24 hours. I'm taking Pure encapsulations gi fortify, Lactobacillus GG, saccharomyces boulardii and a small dose of Bifidobacterium lactis and Lactobacillus rhamnosus. I suspect my body is toxic, I have cold hands/feet, my body generally feels cold all the time, my tongue is very white, my nails are very white. I'm kind of lost as to whether I should be focusing on reducing ammonia with things like Yucca, or somehow try to treat the gut (without antifungals) instead? I've ordered a methylation profile panel but don't have the results yet. My diet is steamed vegetables, salmon, salads, some chicken. It was previously high in beef/lamb etc, but have stopped that recently (didn't notice much improvement though). I don't think I have parasites but again stool test was only x1, so not 100% certain. I sometimes see relief with antifungals, but it's usually short term.

Appreciate any help..
 
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Misfit Toy

Senior Member
Messages
4,178
Location
USA
Butyrate cuts down on ammonia. You can take that everyday and it won't deplete you of minerals. Take charcoal like twice a week. I love charcoal. I agree, I feel better with it, too. Also, Yucca helps with ammonia and sulfur. Molybdenum may help to, but do this at a low dose.

Butyrate is used often but I never noticed a difference. Charcoal, I notice.
 
Messages
79
ideas...the CDSA doesnt look to good, right. Strep & citro. strep seems a real issue.
i would search online for strep food, natural treat, etc...and if you have a second source of strep in the body.
even not classified as pathogen Clostridia spp in CDSA can mess you up also. just an ideea to investigate.
but its curious >> clostridia increase in high ph while strep usually lower ph.

search here for e.coli culture or see Mutaflor product.

eosinophiles usually = parasites but also allergies.
do you feel your digestion is optimal?
allergy test showed a lot to be concerned of.
leaky gut >> could >> allergies right.

oh btw ornithine alone did the same to me.
try and search for LOLA maybe youll have better results. just read about it did not try it yet.
LOLA is not a user here :)

search a bit about histamine overload and see if it fits your simptoms...sometimes.
lot of gut bacteria produce histamine or amines...
 
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renski

Senior Member
Messages
338
Location
Honolulu
Ok will get some of that LOLA... thanks.

The problem is if I try to treat the gut with antimicrobials -> I get constipation -> which can only be overcome with stronger herbs (causes more side effects) -> also more depression/anxiety -> sleep problems.. and it just continues. I'm wondering whether I have some issue with my liver, and maybe my body isn't detoxing properly..
 

renski

Senior Member
Messages
338
Location
Honolulu
From my doctor on LOLA:

Be careful with this. While ornithine will remove ammonia from the brain, aspartate (bound to the ornithine) acts the same as glutamate on the NMDA receptors and overstimulate neurons. They possibly add it to increase absorption s aspartate is one of the few things that can cross the blood brain barrier, so they are correct in saying that it will work better (because it absorbs better), but the side-effects may be over-stimulation.
 

renski

Senior Member
Messages
338
Location
Honolulu
Side note, overall mood/energy improved after cutting out fats from my diet, no idea why but I seem to do better with carbs like vegetables/potatoes/grains/etc and no fats. Yesterday I had a salad with olive oil/avocado and it really seemed to tip me into a depressive and anxiety state about 2-3 hrs after eating (or maybe the histamine thing - avocados). Had no animal fats/protein all day either.
 
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renski

Senior Member
Messages
338
Location
Honolulu
eosinophiles usually = parasites but also allergies.
do you feel your digestion is optimal?
allergy test showed a lot to be concerned of.
leaky gut >> could >> allergies right.

oh btw ornithine alone did the same to me.
try and search for LOLA maybe youll have better results. just read about it did not try it yet.
LOLA is not a user here :)

search a bit about histamine overload and see if it fits your simptoms...sometimes.
lot of gut bacteria produce histamine or amines...

my digestion seems fine, I don't have any of the symptoms like bloating. I might get some gas sometimes but not that often. Have looked at histamine before and not sure about it.. but will look at it again.. thanks
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
I wash chasing high ammonia for many months. At some point it became clear that what I was left with, with same symptoms, was high peroxynitrite. I followed suggestions from Martin Pall, see my signature, and focused on antioxidants.

Before the peroxynitrite, when I was combating ammonia, I got a lot of help from this thread. I'd been using ornithine, arginine, citrulline, lysine, some or all of these daily. Plus butyrate w/ meals. Following that thread, I happily switched to malic acid instead. I now am not needing any of these.

I wrote a blog about seeking the sources of ammonia, which led to Candida and SIBO protocol, but it looks as if you've already done that. Hopefuly you've eliminated this source of ammonia.
 

renski

Senior Member
Messages
338
Location
Honolulu
Hi Caledonia,

I don't seem to do well with fat (even avocado or olive oil) and possibly protein (animal), so I guess that could explain the liver function? Last night I only had vegetables and some starches, was feeling OK up until dinner, then started to notice the anxiety/depression coming back a few hours after dinner. I had a glass of water and started to feel noticeably better, but it's not like I was dehydrated. Maybe this explains why I can't tolerate antimicrobials, and they make my anxiety/depression worse. I don't drink or anything, I was on a diet that had high animal protein/fat diet for a while but have since cut that back in the last few weeks. I'm 33 btw. I have low selenium, did try supplementing with it directly but was having a lot of sleep issues so haven't put it back in.

thanks
 

caledonia

Senior Member
Hi Caledonia,

I don't seem to do well with fat (even avocado or olive oil) and possibly protein (animal), so I guess that could explain the liver function? Last night I only had vegetables and some starches, was feeling OK up until dinner, then started to notice the anxiety/depression coming back a few hours after dinner. I had a glass of water and started to feel noticeably better, but it's not like I was dehydrated. Maybe this explains why I can't tolerate antimicrobials, and they make my anxiety/depression worse. I don't drink or anything, I was on a diet that had high animal protein/fat diet for a while but have since cut that back in the last few weeks. I'm 33 btw. I have low selenium, did try supplementing with it directly but was having a lot of sleep issues so haven't put it back in.

thanks

You can try lipase enzyme to assist fat digestion. I need to look at what might be the cause further, could be gut issues, low in bile salts, etc., it doesn't really seem to involve the liver.

You can try Brazil nuts for selenium if supplementation isn't tolerated.

FYI, on this forum, if you want to get someone's attention, you have to tag them, like this @renski
They will get a little red flag on the top of their page, so they know they got a message.
 

caledonia

Senior Member
Thyroid - high reverse T3 - Stop the Thyroid Madness -

High or low cortisol could be a cause - I think it would be good to retest your saliva cortisol to confirm high cortisol (see more comments below)
Low iron - iron, ferritin, etc. all look within range, so I think you can rule this out
low B12
Lyme
Chronic inflammation (you no doubt have chronic inflammation due to the gut issues)
Other health issues.
----------------

Pyrrole test looks positive, but kind of on the mild side. So you might have low zinc and B6 with high copper. If you have pyrroles suspect mercury toxicity.
-----------------

The leaky gut test is showing issues with leaky gut. If you have gut issues, suspect mercury toxicity.
----------------

The food allergy test is showing issues with wheat, dairy and more. I would definitely avoid everything that the test shows is an issue. Your SNPs also show many gluten markers (see the gluten section on the MTHFRsupport test). So genetically you don't tolerate gluten. I would be super strict with avoiding gluten.
----------------

Stool analysis - the analysis says the imbalanced flora doesn't need treatment. The dysbiotic flora (citrobacter farmeri) does. See the page on Bacterial Susceptibilities for what works against that (grapefruit seed extract, amoxicillin, etc.) I don't know what you were taking before, but maybe it just wasn't effective?

Your beneficial bacteria are low - you can take probiotics for that.

In general, you can do the 4R Gut Rebuilding Program which is a 4 step process for fixing the gut. You will likely have to do all 4 steps in order, and not skip anything to be successful with your gut. (I don't know if you did all 4 steps previously or not.) See my signature link for more info on the 4R Gut Rebuilding Program.
----------------

The cortisol test shows normal cortisol, but higher at night than is ideal. This could possibly contribute to insomnia.

The neurotransmitters show that all of the neurotransmitters are either low, or trending on the low side. This could contribute to insomnia and depression/anxiety.This could be due to the gut issues - this could also be a methylation issue. Some 5htp might be helpful for depression/anxiety and sleep.

Your glutamate is higher than your GABA - this would no doubt contribute to anxiety. Some GABA supplementation and also avoiding processed food (at least 50% of processed food contains glutamate).

It's a real minefield reading labels, as glutamate is hidden under various names. For simplicity I just avoid all processed food and make everything from scratch. In addition, the natural foods tomatoes (and tomato sauce, salsa, etc.), mushrooms, and Parmesan cheese also are high in glutamates. I think there is one more food, but I can't recall it right now. If you eat something and 15-20 minutes later you're anxious, suspect it was one of the foods you ate.
-------------------

Blood and urine tests - serum B12 is meaningless unless it's low. You could still be deficient.

Eight months later than the cortisol saliva test, your morning cortisol is high (whereas a few years ago it was normal). I think I would get another cortisol saliva test to confirm what is going on. If your saliva test is now running high, that would explain insomnia and anxiety as well as the reverse T3. It can be corrected with some Seriphos or Relora for about 8 weeks.

For example, my morning cortisol was normal, but my on my saliva test, my adrenals were deader than a door nail - almost a flat line.

Mild eosinophilia - could be due to the gut issues?

Low cholesterol and low homocysteine go together.
--------------------

The Bioscreen stool test shows high lactic acid bacteria which correlates with fat malabsorption. It also correlates with nervousness and sleep issues. Ampicillin/amoxicillin are supposed to be effective.

I haven't crossed check between the two stool tests, but that might be an informative thing to do.
----------------

Interestingly, your copper is not high. The zinc is trending low. I think I would get some zinc supplementation on board.

The iodine is moderately deficient. I would suggest to start using iodized salt. This could be linked to the thyroid issue.
 

renski

Senior Member
Messages
338
Location
Honolulu
ok have uploaded pictures of my tongue + nails. The tongue looks bad..

methylation/detox are up as well..

I have tried to treat the gut with probiotics/anti microbials but never really got anywhere, the first time I took a probiotic I remember feeling much better but it didn't last. Colostrum helps initially when I take it. The antimicrobials just give me constipation and bring on the depression, and I've been doing them for 5-6 months without seeing any real improvement. The probiotics I was taking earlier in the year might not be effective.. just don't know. I took a small dose (2 billion) of Bifidobacterium bifidum yesterday, seemed to tip me into a depressive state but it took about 4 hours to happen. I've taken this probiotic before, 30mins before my meals and haven't had this kind of reaction. Yesterday I took it about 40mins after eating a plate of vegetables, so I wonder if that acted as a prebiotic.. whatever it was it's a strong reaction because I still feel it this morning - depression isn't as bad, just a real foggy/slow feeling in the head.

My stool this morning was a mess and I had real strong urge to use the toilet this morning, so I guess something was flushed out.. usually my stool isn't messy like that. The problem is I was using other probiotics in the days before. Really have to stay consistent to see whats going on, it's hard when I can't sleep and any number of things can tip me into a depressive state.

On the cortisol readings - the high reading I had in the morning I think was due to all the supplements I was taking, the antimicrobials would create more inflammation in my body which would mean more cortisol is produced?
 
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renski

Senior Member
Messages
338
Location
Honolulu
--------------------

The Bioscreen stool test shows high lactic acid bacteria which correlates with fat malabsorption. It also correlates with nervousness and sleep issues. Ampicillin/amoxicillin are supposed to be effective.

I haven't crossed check between the two stool tests, but that might be an informative thing to do.
----------------

Hmm - would that explain why I think I do worse on meals with fat? Could the fat be feeding something?
 

renski

Senior Member
Messages
338
Location
Honolulu
You can try lipase enzyme to assist fat digestion. I need to look at what might be the cause further, could be gut issues, low in bile salts, etc., it doesn't really seem to involve the liver.

You can try Brazil nuts for selenium if supplementation isn't tolerated.

FYI, on this forum, if you want to get someone's attention, you have to tag them, like this @renski
They will get a little red flag on the top of their page, so they know they got a message.

Hmm, my doctor said something about bile as well when interpreting the methylation panel (haven't got this yet though):
  • We are checking your methylation profile. This is what it will tell me. Is your SAMe low or being inhibited? If so, then you are not making phospholipids. Phospholipids are SUPER IMPORTANT for bile production (this kills microbes in the gut and binds to toxins/die-off to move them out), brain function (makes acetylcholine to put you in deep sleep, also helps with concentration), healthy cell membranes (we already know there's an issue here due to your bad reaction to EPO), and many other things. If your SAMe PRODUCTION is low then we may need B12 or folate (depending on methionine). If your SAMe is fine but your SAH is high, then we look at your cystathione to see if inhibition is coming from your mitochondria or from CBS. If it's from CBS then we need to look at some sulfur nutrients with the B6. If from the mitochondria then maybe more magnesium or acetyl-carnitine. If we find a CBS upregulation then it indicates that there could be an ALDH issue as well (another die-off clearance enzyme). This is not all set in stone. I look at ratio's but this is to give you an idea.