Treatments for high ammonia levels aim to reduce the amount of ammonia in the blood and manage complications.
High ammonia levels, also known as hyperammonemia, often occur due to issues with the liver. The liver is responsible for processing ammonia and turning it into urea that the body then releases in urine.
In some people, infections or issues with the urinary cycle can also cause ammonia levels in the blood to increase.
Hyperammonemia can lead to acute or chronic neurological symptoms. Left untreated, it can lead to potentially life threatening complications.
Treatment targets ammonia levels and helps address complications. A person may also receive treatments for any underlying condition causing the elevated levels.
This article reviews the goals of treatment, as well as the available treatment options for people with high ammonia levels.
The primary goals of treatment for high ammonia levels involve
Doctors may use certain medications to lower ammonia levels in the blood directly. However, there is uncertainty as to whether these medications are beneficial.
Lactulose is a synthetic sugar that
Lactulose may cause mild side effects, which can include:
Lactitol is another synthetic sugar that is similar to lactulose. It can also reduce ammonia levels by
Similar to lactulose, lactitol may also cause gastrointestinal side effects, such as:
Rifaximin is an antibiotic. Some people may have high ammonia levels due to ammonia-producing bacteria. As such, rifaximin can help reduce the number of these bacteria. A doctor may use a
Potential side effects of using rifaximin may include:
- stomach pain
The side effects of sodium benzoate may include:
- impaired mental status
Glycerol phenylbutyrate works in the pancreas. It
Though generally well-tolerated, glycerol phenylbutyrate can cause some side effects, such as:
L-ornithine phenylacetate contains both L-ornithine and phenylacetate in the form of salt. It
Doctors may recommend it for people with liver scarring or other conditions that affect the liver.
Possible side effects can include severe stomach cramping and diarrhea.
However, the researchers note that additional studies are necessary to fully determine its safety and effectiveness for reducing ammonia levels.
Spherical carbon adsorbent (AST-120) may help absorb ammonia levels in the blood in people with hepatic encephalopathy.
According to a 2019 review, AST-120 was more effective at removing ammonia from the blood than a placebo.
However, the authors note that all of the studies included in the review were of low quality. They recommend additional studies to help determine whether AST-120 can help people with advanced liver disease.
Liver or stem cell transplants may help people with high blood ammonia levels. Both
Both types of transplants come with possible side effects. These
- transplant rejection
- liver cells contaminating the blood
- portal vein thrombosis
In addition, a person may have difficulty finding a donor, making a transplant less viable than other treatment options.
For some people, support from an artificial liver
Artificial live support options include:
- AMC bioartificial liver
Read more about artificial liver support systems.
The main potential side effect of artificial liver support is bleeding. Additionally, it may only reduce ammonia levels by a
High ammonia levels in the blood often indicate a problem with the liver, but other underlying conditions can also be responsible.
A doctor can help determine whether an underlying condition is causing high ammonia levels and provide treatment for both the elevated levels and any underlying condition.