Ammonia Toxicity: How to Resolve Brain Fog and Anxiety with L-Ornithine

Psoriasis is usually just a one symptom of bad health even though it may be the most ugly. One of the least known toxicity which causes a lot of problems including psoriasis is Ammonia toxicity – which puts a lot of burden on liver and nervous system, especially brain! I believe that hyperammonemia is present in many people with psoriasis and places additional burden on liver performance as well as health of nervous system and adrenal glands.

Ammonia is a strong neurotoxin and even worse it is produced constantly in our intestines by bacteria decomposing protein in food. Ammonia is also produced in most cells in our bodies as metabolic waste so if there is some defect in detoxification of ammonia there may be a whole set of problems. Especially brain disorders since brain is very sensitive to ammonia toxicity.

Symptoms of ammonia toxicity not only in psoriatics

Nausea, loss of appetite, back pain, muscle cramps are common physical symptoms caused by higher amount of ammonia in our bodies.

Anxiety, insomnia, irritability, confusion and depression are just some of the mental symptoms of ammonia toxicity. Less recognized effects of ammonia toxicity are brain fog, low motivation, inability to focus,… all the symptoms people are complaining about nowadays but almost nobody talks about ammonia as cause of these problems.

Ammonia toxicity may cause serious physical changes in the brain which are long-term and even irreversible.[2]

The body has evolved while keeping this ammonia toxicity issues “in mind” so liver is supposed to detoxify the ammonia via the conversion of ammonia to Urea.

Urea levels are usually tested in basic blood test by most doctors so getting the test ordered by your doctor is not difficult.

The problem is the evaluation of the tests results. If Urea levels are normal the doctors usually do not suspect any problems with ammonia toxicity or detoxification pathways.

However, when creatinine levels which is a waste metabolite of muscle cells are high and urea levels are normal or low normal then there may be some problems with detoxification of ammonia, too.

High creatinine is present very often in kidney problems. But you can experience increased creatinine levels in blood if you have a lot of muscle tissue and/or take the creatine supplement. It is possible to calculate your own ratio of urea or blood-urea-nitrogen to creatinine levels.

There is also a specific test for blood ammonia levels but it is not a part of standard tests so there is a chance you have not had any tests done yet.

A lot of people with psoriasis have increased ammonia levels in their blood, low or normal urea and high creatinine. I believe that many of them might benefit from optimization of their urea cycles. Especially when they experience mental symptoms like anxiety, brain fog and insomnia.

L-Ornithine helps detoxify the ammonia

L-Ornithine may greatly help in detoxification of ammonia since L-Ornithine plays an important role in Urea cycle.

L-Ornithine may help anxiety, insomnia, inability to focus and psoriasis of course.

L-Ornithine may help anxiety, insomnia, inability to focus and psoriasis of course.

Another easy to buy amino acids which are significantly involved in Urea cycle are L-Arginine and L-Citrulline.

Always take amino acids on empty stomach in order to improve the absorption into the blood. Amino acids are usually not hard on stomach so most people won’t have any negative effects like nausea.

L-Ornithine is especially useful for detoxification of ammonia from the brain due to absence of  some ornithine related enzymes in brain compared to other parts of the body.

L-Ornithine effects on anxiety

People may feel the effects of L-Ornithine fairly quickly like in 1-2 hours after oral intake.

If ammonia toxicity is the problem and there is a culprit in Urea cycle involving ornithine deficiency then you may feel significantly calmer than usual. It is not a sedation type of calmness like when taking drugs like Xanax.

It is more like being yourself without anxiety, low self esteem or nervousness.

People describe the feeling like “that is what I was missing since I remember”.

No wonder because those who are living with anxiety caused by ammonia toxicity for years or decades can not even remember how it is to feel normal.

Some say it is a feeling of confidence they get from L-Ornithine.

The word “confidence” we can exchange for the term “no anxiety” so even the social skills are greatly improved. Would you believe that all that is possible in 2 hours just by taking one natural non-essential amino acid?

Oral lactulose for ammonia detoxification

Ammonia toxicity in hospitals is usually treated with lactulose which is a form of sugar that body can not break down so it passes to the small and large intestine where it gets fermented by bacteria.

There it is decomposed by bacteria which produce lactic acid. This causes the pH in the intestines to decrease. This makes ammonia (NH3) convert to ammonium (NH4+) ions which are not absorbed into the blood.

bacteria

Inappropriate species in colon and overgrowth of bacteria in the small intestine significantly affect the amount of ammonia production and diffusion through the intestinal wall. This is one way how bad bacteria overload the liver and eventually cause symptoms of neurotoxicity like anxiety and psoriasis.

Here you can clearly see how important it is to have healthy gut and right bacteria in the intestines. Lactic acid producing bacteria are commonly found in probiotic supplements and that is why they are called Lactobacillus species.

Also SIBO (small intestinal bacterial overgrowth) may significantly worsen the ammonia toxicity since production of ammonia from ingested protein is commonly present also in small intestine which if it were (almost) sterile there would be not such a problem like excess of ammonia production by bacteria.

SIBO may lead also to protein malnutrition/malabsorption due to bacterial decomposition of ingested protein before its assimilation by human body.[1] The same goes about the bile acids and fat soluble vitamins like vitamin A, vitamin K and vitamin E. Bacterial degradation of bile acids interfere with assimilation of fat soluble nutrients and vitamins.

Dosage of L-Ornithine

According to studies the dosage of 2-3 grams of L-Ornithine twice daily is the average effective dose.

The amino acids like L-Ornithine, L-Arginine and L-Citrulline are commonly used by athletes and especially bodybuilders in much higher amounts without negative side effects.

L-Ornithine helps remove ammonia during heavy exercise.

L-Ornithine helps remove ammonia during heavy exercise.

Athletes may adjust the dosage according to the smell of their sweat. If the sweat smells like ammonia then there is a problem with Urea cycle.

Without any extra help in ammonia detoxification it is common that during heavy anaerobic exercise the sweat smells like ammonia. And not just like ammonia; it is actually ammonia excreted in sweat because after the glycogen stores get depleted then the body uses the muscles (protein) as fuel. And as you already know protein digestion even if it is our own muscles produces ammonia as waste material.

 

References:

1) Jan Bures, Jiri Cyrany, Darina Kohoutova, Miroslav Förstl, Stanislav Rejchrt, Jaroslav Kvetina, Viktor Vorisek, and Marcela Kopacova.Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010 Jun 28; 16(24): 2978–2990. – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890937/

2) Braissant O, McLin VA, Cudalbu C. Ammonia toxicity to the brain. J Inherit Metab Dis. 2013 Jul;36(4):595-612.

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2 Responses

  1. Lisa says:

    Need help… Going in for a TIPS procedure Thursday. Brain fog, can’t sleep, can’t sleep enough ?.. WTF? No one in my family “gets it”!

    • John says:

      I am not a doctor so I can not recommend you anything!

      If I were you I would ask my doctor for explanation of my health status.

      If you are scheduled for TIPS (Transjugular intrahepatic portosystemic shunt) you may have some serious symptoms as you already mentioned.

      Liver health and performance is ESSENTIAL for overall well-being and reduced liver performance = brain fog, anxiety, depression, anger, “autoimmune” diseases…

      About 1 in 3 patients experience post-operative hepatic encephalopathy which is basically which is basically general toxicity due to liver malfunction. In hepatic encephalopathy the liver does not function well which means that toxins including ammonia causes mental symptoms – brain toxicity.

      This means that after TIPS procedure some people experience temporary worsening of their symptoms. So I would strongly ask the doctor to monitor the post-operative time period and perhaps use some drugs/supplements to decrease the ammonia (nitrogen compounds) absorption or to improve ammonia detoxification.

      L-Ornithine and L-Citrulline is one of them. Yucca root is another natural supplement. Lactulose (not lactose – milk sugar!) is usually prescribed by doctors to treat hepathic encephalopathy.

      It is also recommended to decrease intake of high-protein foods in order to decrease the amount of ammonia produced in the gut by bacteria.

      But ASK your DOCTOR about all of these if you can take some of those supplements! I CAN NOT tell you, but your doctor knows your health history and risks so only the doctor can tell you.

      Best wishes!

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