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Scary Test Result: Low Ammonia. Possible HE (hepatic encel...)

Messages
95
So, I got a test result of low Ammonia. Apparantly my liver isn't detoxing Ammonia. My doctor thinks I may have HE and maybe even cirrohis. I am going to a specialist on Monday.

Anyone have this and if so what were your treatments that worked?
 

Carl

Senior Member
Messages
362
Location
United Kingdom
Surely, if your liver is not detoxing ammonia then your blood ammonia would be high and not low like you say.

With CFS, the liver burden is very high from waste products entering the bloodstream from the digestive system. Doing as much as possible to optimize liver detox, supplying all necessary nutrients to support your liver function would be helpful. Milk thistle extract might also help and so would Fibre.

Ultimately, destroying the infection which is causing your CFS which would thereby eliminate your Increased Digestive Permeability would eliminate the burden on your liver which should help your liver to heal. There are bacteria which promote ammonia production by using an enzyme called Urease. Urease can help protect them. I myself have an infection by such a bacteria which I am attempting to destroy as soon as I get everything that I require.
 
Messages
95
Surely, if your liver is not detoxing ammonia then your blood ammonia would be high and not low like you say.

With CFS, the liver burden is very high from waste products entering the bloodstream from the digestive system. Doing as much as possible to optimize liver detox, supplying all necessary nutrients to support your liver function would be helpful. Milk thistle extract might also help and so would Fibre.

Ultimately, destroying the infection which is causing your CFS which would thereby eliminate your Increased Digestive Permeability would eliminate the burden on your liver which should help your liver to heal. There are bacteria which promote ammonia production by using an enzyme called Urease. Urease can help protect them. I myself have an infection by such a bacteria which I am attempting to destroy as soon as I get everything that I require.
Thanks! yes I believe getting rid of the hydrogen sulfide bacteria first is key. I am going to a doctor and hoping he will prescribe Rifamaximin and Lactulose together. That is standard treatment. The problem is I can't use herbs or lemons to detoxify liver due to Salycilate intolerance. Until I reduce my load no herbs. I have been using a-l-carnitine and ornithine which is helping a little.I just started coffee enemas. I want to eat leaky gut diet but the only foods that are low sulfur and low salycilate, that I can eat without symptoms are : Barley grass, celery, lettuce , white rice, potatoes and a little ghee. I know the rice and potatoes are affecting my gut but I cannot subsist on those three vegetables. What would you do in my situation? Should I just suck it up and juice cleanse on barley grass, celery and lettuce? Bad for my adrenals and no cooked foods to strengthen my spleen. I'm not in a good place and most of the doctors I've been to are not helping much. Seeing a functional medicine doctor in Feb. though.
 
Messages
95
Thanks! yes I believe getting rid of the hydrogen sulfide bacteria first is key. I am going to a doctor and hoping he will prescribe Rifamaximin and Lactulose together. That is standard treatment. The problem is I can't use herbs or lemons to detoxify liver due to Salycilate intolerance. Until I reduce my load no herbs. I have been using a-l-carnitine and ornithine which is helping a little.I just started coffee enemas. I want to eat leaky gut diet but the only foods that are low sulfur and low salycilate, that I can eat without symptoms are : Barley grass, celery, lettuce , white rice, potatoes and a little ghee. I know the rice and potatoes are affecting my gut but I cannot subsist on those three vegetables. What would you do in my situation? Should I just suck it up and juice cleanse on barley grass, celery and lettuce? Bad for my adrenals and no cooked foods to strengthen my spleen. I'm not in a good place and most of the doctors I've been to are not helping much. Seeing a functional medicine doctor in Feb. though.
No if you look up HE. Your ammonia is low due to it not detoxifying in the liver. It doesn't show up in the blood because it's all in the liver. It's a serious diagnosis.
 

Judee

Psalm 46:1-3
Messages
4,461
Location
Great Lakes
This Wikipedia article says that HE is, "believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver" and that "Lactulose is frequently used to decrease ammonia levels."

Sounds to me like ammonia levels would be too high then rather than too low. ???

It does sound pretty serious though. Hope you get some sound advice from your doctor.
 
Last edited:

Thinktank

Senior Member
Messages
1,640
Location
Europe
HE is caused by an elevation of ammonia in the blood which passes the BBB. It's when the liver can't degrade ammonia into urea (and glutamine?) that it will cause HE.

Maybe you misunderstood your doctor? If not then your doctor is seriously incompetent.
 
Messages
95
HE is caused by an elevation of ammonia in the blood which passes the BBB. It's when the liver can't degrade ammonia into urea (and glutamine?) that it will cause HE.

Maybe you misunderstood your doctor? If not then your doctor is seriously incompetent.
No HE is marked by low ammonia. It's because the ammonia is trapped in the liver thus it won't show via bloodtest. It's not circulating in the blood.
 

Thinktank

Senior Member
Messages
1,640
Location
Europe
No, it doesn't work like that. Can you please give me a source to backup your claim?

Hepatic encephalopathy (HE) is an altered level of consciousness as a result of liver failure.[2] Onset may be gradual or sudden.[2] Other symptoms may include movement problems, changes in mood, or changes in personality.[2] In the advanced stages it can result in a coma.[3]

Hepatic encephalopathy can occur in those with acute or chronic liver disease.[3] Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications.[4] The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver.[2] The diagnosis is typically made after ruling out other potential causes.[2] It may be supported by blood ammonia levels, an electroencephalogram, or a CT scan of the brain.[3]

There are various explanations why liver dysfunction or portosystemic shunting might lead to encephalopathy. In healthy subjects, nitrogen-containing compounds from the intestine, generated by gut bacteria from food, are transported by the portal vein to the liver, where 80–90% are metabolised through the urea cycle and/or excreted immediately. This process is impaired in all subtypes of hepatic encephalopathy, either because the hepatocytes (liver cells) are incapable of metabolising the waste products or because portal venous blood bypasses the liver through collateral circulation or a medically constructed shunt. Nitrogenous waste products accumulate in the systemic circulation (hence the older term "portosystemic encephalopathy"). The most important waste product is ammonia (NH3). This small molecule crosses the blood–brain barrier and is absorbed and metabolised by the astrocytes, a population of cells in the brain that constitutes 30% of the cerebral cortex. Astrocytes use ammonia when synthesising glutamine from glutamate. The increased levels of glutamine lead to an increase in osmotic pressure in the astrocytes, which become swollen. There is increased activity of the inhibitory γ-aminobutyric acid (GABA) system, and the energy supply to other brain cells is decreased. This can be thought of as an example of brain edema of the "cytotoxic" type.[10]