This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.
There are 12 references cited in this article, which can be found at the bottom of the page.
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Ammonia is a normal byproduct of digestion that is usually removed from the body by the liver. If you have elevated ammonia levels, it is typically due to a problem with your liver function. However, there are ways to decrease your ammonia levels and to improve your liver function. These include taking medication, supplementing your diet, and changing what you eat. With a combination of these methods, you can lower the ammonia levels in your body.[1]
Steps
Consult with your doctor. Most people that know they need to lower their ammonia levels find this out from their doctors. This problem is usually associated with another health problem, so controlling your ammonia levels will be part of an overall treatment plan.[2]- High ammonia levels are a common symptom of advanced liver disease, known as cirrhosis, Reye's syndrome, and severe cases of hepatitis. If you have one of these diseases, it is likely that you will need to work on reducing your ammonia levels.
Have your ammonia levels tested. Before taking medication for high levels of ammonia, you need to verify the problem. Ammonia tests measure the amount of ammonia in the blood, so a blood sample will be required.[3]Advertisement
Take Lactulose. Lactulose is a constipation medication that is used to treat high levels of ammonia in the blood. Lactulose works by removing ammonia from the blood and moving it into the colon. Once in the colon, the ammonia is eliminated from the body when you go to the bathroom.[7]- Follow your doctor's instructions for timing and dosage amount for ammonia removal. Typically, 2–3 tablespoons (30–45 mL) of Lactulose are taken 3 to 4 times a day.[8]
- Lactulose is a liquid typically taken by mouth. However, if you have extremely high levels of ammonia and are hospitalized, it may be administered with an enema directly into the digestive system.
- Lactulose is the only medication used to lower ammonia levels in the body. However, it is sold under a variety of brand names, including Duphalac, Enulose, Generlac, Constulose, and Kristalose.[9]
Manage the side effects. While Lactulose does reduce ammonia in the blood, it also causes several side effects, including diarrhea, gas, and nausea. It was developed to treat constipation, so it pulls water out of the body and into the stool. This causes loose stools and other digestive complications. Talk to your doctor about what you can do to minimize these side effects.[10]- Be sure to hydrate regularly when taking Lactulose. The medication will pull a lot of water out of your body, so you should replace that liquid in order to avoid dehydration.
- If your side effects are severe and impacting your quality of life, tell your doctor. This could signal that you need your dosage adjusted.
Add probiotics into your diet. Probiotics are beneficial bacteria that help you digest foods and protect you from disease. These bacteria can help your gut to digest and eliminate ammonia more effectively. Some common foods that add probiotics into your diet include fermented dairy products, such as kefir, and fermented foods, such as sauerkraut.- For example, try to eat a serving of yogurt every day. Yogurt is very high in probiotics and it can help your digestion, as well as your overall health.[11]
Reduce your intake of animal protein. Red meat protein is more likely to increase the ammonia in your blood than other types of animal proteins. If you know you have high ammonia levels, it's best to eat other types of meat, such as chicken.[12]
Consider eating a vegetarian diet. Vegetable protein, such as that in beans, digests more slowly than protein that comes from animals. Therefore, your body has more time to dispose of the ammonia created while it is digested. With this in mind, it's best to choose vegetable proteins if you are working to keep your ammonia levels low.- Eating a vegetarian diet also provides more dietary fiber and amino acids, which both help balance your ammonia levels.
Limit protein after symptom flareups. Ammonia is a byproduct of protein digestion in the body. Because of this, it is important to limit your protein intake if you are experiencing particularly high levels of ammonia in the blood. High levels of ammonia are usually identified due to an increase in symptoms.[13]- For example, if you have liver disease and you are experiencing abnormal brain function, it's a good idea to limit your protein intake as you recover.
Take zinc supplements. Zinc can play an important role in increasing the amount of ammonia that your body is able to excrete. Talk to your doctor about whether a zinc supplement could help your ammonia levels decrease.[14]- Those with liver disease tend to have lower levels of zinc. Since zinc is an important part of normal ammonia disposal, supplementing zinc can help someone with high levels of ammonia get rid of it.[15]
Talk to your doctor about a multivitamin that you can take. When you have high ammonia levels in the body, it is a signal that your body systems are not working correctly. This can cause a variety of health problems due to lack of essential vitamins and minerals. To offset this risk, talk to your doctor about taking a daily multivitamin that can give you many of the nutrients that you need.- Having your doctor approve your exact multivitamin and dosage will minimize the chance of you taking something that could have a negative impact on your liver function and ammonia levels. For instance, vitamin A in very high doses has been known to cause liver toxicity.[16]
Take glutamine supplements. Glutamine supplements have been shown to decrease ammonia levels in endurance athletes. Talk to your doctor about whether taking this supplement might help manage your ammonia levels.[17]- Glutamine supplementation can be dangerous in people with liver failure. It’s important to discuss any supplements with your doctor before taking them.[18]
Expert Q&A
Tips
Warnings
- It is important to reduce ammonia levels that are above normal. Having too much ammonia in the blood can cause severe health problems, such as decreased brain function.[19]Thanks
References
- ↑ https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatic-encephalopathy/
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=ammonia
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=ammonia
- ↑ https://medlineplus.gov/ency/article/003506.htm
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/18059593
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=ammonia
- ↑ https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatic-encephalopathy/
- ↑ https://www.healthline.com/health/lactulose-oral-solution#dosage
- ↑ https://www.drugs.com/mtm/lactulose.html
- ↑ https://www.healthline.com/health/lactulose-oral-solution#about
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/18542039
- ↑ https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatic-encephalopathy/
- ↑ https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatic-encephalopathy/
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/11779097
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/1505922
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496761/
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/18059593
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777432/
- ↑ https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatic-encephalopathy/
About This Article
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
Increased ammonia levels in your body can be the result of your liver not functioning properly, but by making dietary changes and taking medication, you can reduce them. Probiotics contain good bacteria that help your body digest food, so try eating foods high in probiotics, like yogurt or sauerkraut. You could also try eating more vegetables, like beans carrots, and broccoli, instead of red meat, since vegetable proteins release ammonia more slowly because they take longer to digest. High levels of ammonia can often be linked to medical conditions, like liver disease or hepatitis. That’s why it’s important to consult with your doctor, who will test your ammonia levels and make a treatment plan. They may prescribe you lactulose, which is a medication that can help your body get rid of ammonia. For tips from our Medical co-author on how to use supplements to reduce your ammonia levels, keep reading!
Reader Success Stories
"My father has been having health problems. He seems to go into a confused state where he can't remember his name and stares right through you. He is 80 years old. At first, I believed it was from dehydration. He had a seizure a few nights ago. Took him to the hospital where they tested and said he had high ammonia levels. He is now very confused and has cognitive issues. Looking back on it now he had every symptom of high ammonia levels. This article was very helpful!"..." more
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