Lemme say this is not a request for medical advice. I have a diagnois and and treatment (lactulose).
But…for godsake I have ammonia in my system??? Apparently it’s a result of being mean to your liver. Which I have been. But ammonia??? That and having an IV shunt put in my arm when I was in the hospital, I had serious ideas that I was becoming a Borg.
I asked all the questions I could but DR. can be slippery mutherfuckers. Anyone have experience with this?Anyone else have experience with this.? Any one can tell me how your body can generate ammonia of all things?
Ammonia is produced in the body as a byproduct of amino acid metabolism (protein breakdown). The liver is supposed to convert it to urea, a less harmful substance, so that it can be excreted in the urine. If you have liver problems, the conversion process can be impaired, letting ammonia levels build up.
It’s normal to have some ammonia in your blood, because it helps keep your acid/base balance in check. When levels get too high, though, it’s called hyperammonemia. That’s not good for you because, well, ammonia is pretty toxic. I’m sure your docs have things under control, though.
I don’t know anything about the treatments for hyperammonemia, so I can’t help much there. I just know how to measure how much is in the blood.
It’s usually a sign of very significant liver disease when the ammonia levels start to rise.
I’ve a number of patients with this condition, also known as hepatic encephalopathy. When the ammonia levels rise, the brain doesn’t work too hot anymore.
That’s why it is important for my patients to take their lactulose and avoid all other hepatotoxins, particularly alcohol (which is the primary cause of the trouble in about 90% of the cases I see). Once the hepatotoxins are removed, and the patient is on a low protein diet, sometimes the liver can recover a bit.
Lactulose is not a cure, it merely helps the body rid itself of excess ammonia. Kind of like a bucket to help bail out a leaky boat.
I can’t stress enough to my patients who have this condition the absolute need to avoid all alcohol. Not “cut back”, not “just on special occasions”. Adding alcohol to a dysfunctional liver that cannot properly metabolize ammonia anymore is like pouring gasoline on a smouldering fire.
I had a patient just last week with asterixis. AKA liver flap. AKA waving bye-bye.
I should correct myself and note that elevated ammonia levels don’t automatically equal hepatic encephalopathy, but the former generally does lead to the latter. Sooner if proper treatment is not instituted, and much later and maybe never if it is caught early, or reversible causes are found.
nitrogen is the part of the amine in amino acid. When you metablolize protein for fuel you strip and discard this group. there’s plenty of hydrogen in the body, et voila, NH3. Lactulose favors certain bacterial activity in the gut that helps get more out of your system by the back door. If your levels get high enough to affect your brain you qualify for the encephalopathy moniker. Be advised, lactulose is likely to give you the runs.
My father’s increased asterixis would be a sign that he needed to go back to the hospital. He was was waiting for a liver transplant. By the time he’d have asterixis, he wouldn’t be making any sense.
Thanks everyone. Not surprised the SD fills in a few blanks my doc didn’t. The lactulose seems to be kicking ass. If you look at (oh lord please don’t) some of my posts for a few weeks ago, I was definitly running on toxins. Much better now.
Low protien diet? Now that’s something my Doc didn’t mention but I’ll keep it in mind.
Probably not, the concentration is surely too low to be an effective cleaner (any more effective than plain non-ammoniated spit, anyhow).
I would, however, recommend you give up the Clorox Smoothies, just in case…
Gots a more serious question on the treatment though: I remember lactulose from the days when that was the med of choice for my son’s encopresis (he was, quite literally, “full of it”) - it helped soften/bulk up his stools and he was much less likely to soil his underwear. so if you’ve been having any, er, problems like that you get to kill 2 birds with one stone
How does it address the ammonia issues? What’s the mechanism there? Does the increase in poopage somehow help pull out the poisons better or something?
Lactulose acts as an osmotic agent, pulling fluids into the bowel. This speeds transit time thru the large intestine, and doesn’t allow the bacteria there as much time to digest the bowel contents’ protein and break it down into ammonia-type compounds which the intestine then absorbs into the blood.
d’oh! I knew I should have read the whole thread :smack:. Outlierrn answered that very question just above the one about saliva’s inefficiency as a floor cleaner.
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