I went whole hog into the Dr Yasko belief that my CBS +/- could cause high ammonia mainly because of two things: The symptoms I have had for a long time were consistent with the high ammonia theory: Pain in the trapezius muscle exasperated by protein Blood tests with low eGFR, high creatnine, high chloride and high leukocytes in urine. Enlarged spleen She predicted my anxiety symptoms when starting MethylFolate and MeB12. So I have been taking many of the supplements that help with flushing ammonia and I feel great. Because of all the CBS confusion on this site, I decided to test my serum ammonia. I ate big protein for 3 days went off of the supplements specifically for ammonia and when I felt horrible I went and got my ammonia tested. It was 24 umol/L. Right in the normal range (9-33) Should I continue with the ammonia fighting program because it gives me energy and makes me feel better or should I get some more testing done to see what exactly is going on. My money is limited and my doctor may or may not be inclined to order the tests. The ammonia supplements will continue costing money though so the tests may save money in the long run.