A reader wrote: “I got some new results one that is really “exciting” is that I have very high Ammonia in my blood. What do you make of it? Normal range ends with 3, I have 7 Ammonia.”

According to WebMd, “An ammonia test measures the amount of ammonia in the blood. Most ammonia in the body forms when protein is broken down by bacteria in the intestines . The liver  normally converts ammonia into urea, which is then eliminated in urine.”

The same protein intake will produce different amounts of ammonia in different people because what the protein is broken down to is determine by the bacteria.  Think of it this way, protein is like trees — people break them down and the outcomes are not the same: it may be houses, furniture or paper.  It depends on the people (bacteria) involved.

The best assumption is hyper-ammonia producing bacteria. [2004] identifies Klebsiella and Pseudomonas as ones. High Klebsiella was reported in the 1998 study of CFS Microbiome.

• “The largest amounts of ammonia were generated by gram-negative anaerobes, clostridia, enterobacteria, and Bacillus spp.” [1980] High enterobacteria was also reported  in the 1998 study of CFS Microbiome.
• “The effect of lactulose in reducing ammonia concentration is attributed to its role as a bacterial substrate in either increasing bacterial assimilation of ammonia or reducing deamination of nitrogenous compounds. The effect of low pH in reducing generation of ammonia appears to be part of a general reduction in bacterial metabolism.” [1978]
  • Low pH means more ACID. My post speculating on the cause of CFS sites that a shift to high pH (Alkaline) was part of the process.
  • Lactulose is a non-absorbable sugar used in the treatment of constipation

Bottom Line

High ammonia level in the blood has not been reported as a dominant CFS lab result  [1994]. It is unclear how often it is tested for when a CFS diagnosis is given.

It has been associated with Sjögren syndrome[2013] [2008]. Ammonia is a neurotoxin [2014] (thus may be a factor for brain fog) . This article cites some specific treatments (which likely would be helpful to many CFS patients):

• “The nonabsorbed antibiotic rifaximin, when added to conventional therapy with lactulose, increases the rate of total reversal …” [2014]
• “A combination of B. longum and FOS⁸² or a cocktail of four freeze-dried, nonurease-producing bacteria (Pediacoccus pentoseceus, Leuconostoc mesenteroides, Lactobacillus paracasei ssp. paracasei, and Lactobacillus plantarum) mixed with beta glucan, inulin, pectin, and resistant starch⁸³ had similar effects. [2014]