High Ammonia Levels In The Blood: Causes, Symptoms & Treatment

Having high levels of ammonia in the blood is a metabolic condition that needs to be managed promptly. Ammonia in the blood comes chiefly from bacterial decomposition of unabsorbed dietary protein in the intestines. Intestinal ammonia travels to the liver, via the blood and gets converted to urea. Urea subsequently is eliminated through urine.

Prompt diagnosis and timely treatment greatly reduce the risk of potentially life-threatening complications. Increased amounts of ammonia going into the brain is a chief cause of neurologic disorders, such as – hepatic encephalopathy, congenital deficiency of urea cycle enzymes, and Reye syndrome.

Symptoms Of High Ammonia Levels In The Blood

Symptoms of high levels of ammonia in the blood in newborns and children are:

  • Irritability
  • Fatigue
  • Poor feeding
  • Vomiting
  • Gasping and hyperventilation
  • Convulsions

Signs and symptoms in adults:

  • Intellectual impairment
  • Intermittent headaches
  • Vomiting
  • Sporadic ataxia
  • Abnormal gait
  • Slurring of speech
  • Behavioral disturbances
  • Sleep disturbances
  • Epilepsy
  • Protein avoidance

What Causes High Ammonia Levels In The Blood?

Ammonia is a product of metabolism of proteins and is needed to synthesize various vital cellular compounds. On the other hand, 10 fold increase in the levels of ammonia in the blood triggers toxic effects with huge changes in the functioning of the central nervous system.

A test to detect the amount of ammonia in blood will be done which measures the amount of ammonia in your blood. Ammonia forms in your body when protein gets broken down by bacteria in your bowels. Normally, the liver converts the ammonia into urea that gets eliminated via urine.

You will have high levels of ammonia in your blood when the liver fails to convert ammonia to urea. This may occur due to hepatitis or cirrhosis. The liver produces ammonia which contains nitrogen. Nitrogen combines with other elements, – hydrogen, carbon and oxygen, to form urea, which is a waste product. Urea goes from the liver to the kidneys via the blood. Healthy kidneys filter urea and remove other waste products from your blood.

Cirrhosis and liver failure leads to increasingly severe metabolic and chemical disturbances in the body. The chemicals which are normally detoxified by the liver, buildup in the blood and disturb normal function of the brain.

An elevated blood ammonia level is typically seen in individuals having Reye’s syndrome. Ammonia toxicity associated with Reye’s syndrome causes confusion, seizures and drowsiness.

Gastrointestinal bleeding is a cause for raised levels of ammonia in the blood. RBCs contain a high concentration of protein. Profuse bleeding, particularly in the upper part of the GI tract, increases the protein load in the intestine and the synthesis of ammonia. Increased ammonia from the intestine makes it difficult for the liver to break down the chemical, more so, in case you have an existing liver disorder.

Treatment For High Ammonia Levels In The Blood

The chief goal in patients with high levels of ammonia in the blood is to remedy the biochemical anomalies and ensure that you get sufficient nutritional intake. The treatment also consists of giving compounds which increase the elimination of nitrogen wastes.

Drugs that are used in the treatment of hyperammonemia include the following:

  • Urea cycle disorder treatment drugs.
  • Anti-emetic agents to manage the nausea and vomiting.
  • Stopping or reducing the intake of protein and / or nitrogen.
  • Hemodialysis.
  • Supportive care with parenteral intake of calories.
  • Surgery may be recommended by your health care provider in extreme cases such as – liver transplantation to correct the metabolic error. Discuss your options with your doctor.