Ammonia – study, standards. Symptoms of ammonia in the blood

Proven content

Ammonia is formed in the lumen of the digestive tract as a result of protein metabolism by the bacterial flora present here. It is absorbed into the blood, enters the liver, where it is transformed into urea and in this form is excreted from the body. Ammonia is also a source of nitrogen ions for the synthesis of certain amino acids. Serum ammonia testing helps diagnose liver damage.

What is ammonia?

Ammonia is produced in the human body as a result of metabolic changes of amino acids found in food. The process of ammonia formation takes place in the lumen of the digestive tract. In order for it to occur in the digestive tract, there should be a physiological bacterial flora. Ammonia is formed when the amino group is removed from an amino acid. Then it is synthesized in the liver into urea and in this form it is transported to the kidneys and finally removed from the body with urine.

Ammonia is usually in the form of NH4 + ions (the physiological pH of the body is necessary), and its increase occurs as a result of urea metabolism disorders. Usually, the human body uses ammonium ions immediately, while ammonia itself only to a certain extent comes from the cells of the body.

See also: Liver function – what is the role of the liver in the body?

Discovery of ammonia

The first description of an ammonia compound, more precisely ammonium chloride (ammonium chloride), occurred around 332 BC and was obtained from camel excrement near the Temple of Amun in the oasis of Siwa in what is now Egypt. It is from the Egyptian deity Amun that the name “ammonia” is derived from, which is used in various forms in most of the world’s languages.

In medieval times, ammonium chloride was well known by the alchemists of the time, even Albert the Great at the beginning of the XNUMXth century wrote about it. In turn, in the XNUMXth century, the German alchemist Basilius Valentinus obtained ammonia by treating this salt with a base. The composition of ammonia was established by Claude Louis Berthollet.

Ammonia in the blood

Ammonia can cross the blood-brain barrier. It accumulates in the brain when it is not metabolized properly by the liver and removed as urea. This is when encephalopathy develops, characterized by confusion, neurological and cognitive impairment.

In many cases, encephalopathy causes drowsiness and, consequently, coma, which ultimately leads to death.

To get rid of ammonia in the blood faster, support your liver with HepaDr. And in tablets – a dietary supplement that you can buy on Medonet Market.

Find out more: Arginine – sources and role in the body

Ammonia in the blood – symptoms

In addition to encephalopathy, which limits the functioning of the brain. Ammonia in the blood causes in patients:

1. somnolence,
2. entanglement,
3. confusion
4. rapid or deep breathing,
5. agitation / aggression,
6. headaches,
7. muscle tremors
8. cognitive impairment.

Ammonia and hyperammonaemia

Based on the causes of hyperammonaemia (the presence of ammonia in the blood), two forms are distinguished:

1. primary – arising as a result of a gene mutation or inborn errors of metabolism. In this form, the process of metabolism and removal of ammonia from the body may be disturbed because the activity of enzymes operating in the urea cycle is reduced;
2. secondary – its most common cause is liver failure and its improper work, which in a significant way interferes with the conversion of ammonia into urea. As a consequence, the presence of ammonia in the blood is disturbed. This may be due to heavy smoking and excessive alcohol consumption, the use of certain medications, or infections caused by the bacterium with ureosis.

Also check: Digestive enzymes – description, supplementation, precautions

Ammonia testing – when do we do?

Blood ammonia level testing is performed in the following cases.

1. Impaired liver function (suspicion of acute and chronic liver failure leading to impaired liver function).
2. In patients with portal hypertension, liver cirrhosis with suspected vascular fistula between the portal and systemic circulation.
3. Hepatic encephalopathy (impaired consciousness in people with liver disease) and controlling encephalopathy treatment.
4. Suspicion of intensification of putrefactive processes in the intestine.
5. Metabolic disorders in newborns.
6. The process of decomposition in the intestines.
7. Assessment of the metabolic block in the urea cycle.

Ammonia test – the course of the test

The primary purpose of ammonia testing is to assess the efficiency of the liver parenchyma.

1. Ammonia test material: serum.
2. Preparation for the ammonia test: on an empty stomach (at least 8 hours).
3. The course of the study: one-time blood sampling from a vein in the arm (inside of the upper limb). In children, the skin is cut with a lancet, and the blood that flows out is placed in a test tube. The downloaded material is sent further for analysis.
4. Time to wait for the result: 1 Day.
5. Standard: 47-65 micromol/l (80-110 microg/dl).

Comments: It is suspected that ammonia is responsible for damage to the central nervous system in people with hepatic insufficiency, with impaired detoxification processes.

Are there any complications with the test?

Actually no. Of course, as with any venous blood test, you may experience prolonged bleeding. Therefore, the injection site should be pressed for a long time, especially in people with blood clotting problems. Another unsightly effect of blood donation can be a hematoma, which is most often formed due to an incorrect vein puncture.

Find out more: Basic blood tests – meaning, interpretation

Blood ammonia test – standards and interpretation

The test results are analyzed separately for men and women.

1. women: 19–87 µg/dl, (11-51 µmol/l),
2. men: 27–102 µg/dl, (16-60 µmol/l).

High levels of ammonia in the blood are most often caused by liver disease and its poor functioning. In people with hepatic insufficiency, the conversion of ammonia into urea is impaired, which causes its increase in the blood.

Findings:

1. over 150 µg / dl – indicates severe liver damage accompanied by encephalopathy,
2. over 300 µg / dl – indicates hepatic coma.

Increased blood ammonia can also be caused by:

1. genetic defects leading to enzyme deficiencies (in newborns, the deficiency may be congenital),
2. kidney malfunction (acute or chronic kidney disease) – insufficient kidney elimination of urea, which causes ammonia to accumulate in the body,
3. Reye’s syndrome (a dangerous disease) with a high mortality rate. In its course, there is diffuse damage to the mitochondria. In addition to the presence of high levels of ammonia, there is a high level of lactate, hypoglycemia and an increase in transaminases,
4. smoking,
5. alcohol abuse,
6. excessive exercise (muscles produce ammonia),
7. proteins released in the gut when blood cells are broken down from bleeding into the gastrointestinal tract).

We very rarely deal with low blood ammonia levelswhich usually indicates problems with abnormal blood pressure. Ammonia below the lower limit of normal can appear in the case of essential hypertension (cause unknown) or in the presence of malignant hypertension.

See also: Toxic liver damage

Ammonia in the blood – treatment

If hyperammonaemia is suspected, blood ammonia and glutamine levels are measured. Appropriate treatment is initiated based on the obtained test results. The main task of patients is to follow a diet that is low in protein but high in calories.

In addition, the patient is prescribed preparations aimed at lowering the level of ammonia in the blood, as well as intravenous lipids and glucose. In the treatment of hyperammonaemia, drugs containing glycerol phenylgutyrate, ammonul and sodium phenylbutyrate are used.

In addition to diet and medication, patients should remember to drink plenty of fluids to keep their body hydrated. In some cases, doctors order to remove toxins and other harmful substances from the blood by means of hemodialysis.

Liver diet – what does it look like? Nutrition rules for damaged liver

Ammonia poisoning

Certain rules must be followed to prevent ammonia poisoning. If we work in a place where we come into contact with ammonia, it is extremely important that we follow the health and safety rules.

The same applies to any chemicals with which we come into contact. Read the labels carefully and follow the instructions on them. We should also remember about the proper protection of chemicalsso that they do not fall into the hands of children.

Read more: Ammonia poisoning

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