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Ammonia



Why Get Tested

To detect an elevated level of ammonia in the blood that may be caused by severe liver disease kidney failure or certain rare genetic urea cycle disorders to help investigate the cause of changes in behavior and consciousness to support the diagnosis of hepatic encephalopathy or Reye syndrome

When To Get Tested

When someone with liver disease or kidney failure experiences mental changes or lapses into a coma when a newborn experiences frequent vomiting and increased lethargy or when a child has continuous vomiting and unusual sleepiness about a week after a viral illness such as the flu or chickenpox

Sample Required

A blood sample drawn from a vein in your arm

Test Preparation Needed

You should not smoke cigarettes prior to collection of the specimen




Common Questions


The ammonia test is used to detect an elevated level in the blood that can be caused by severe liver disease kidney failure Reye syndrome or a rare genetic disorder of the urea cycle for example The test may be used to help investigate the cause of an individual s changes in behavior and consciousness Ammonia is a waste product naturally produced in the body It primarily comes from the digestion of protein by bacteria in the intestines If not processed by the liver and cleared from the body appropriately excess ammonia can accumulate in the blood and pass from the blood into the brain where it is toxic An ammonia test may be ordered along with other tests such as glucose electrolytes and kidney and liver function tests to help diagnose the cause of a coma or to help support the diagnosis of Reye syndrome or hepatic encephalopathy caused by various liver diseases An ammonia level may also be ordered to help diagnose a rare urea cycle defect and to evaluate the severity of the condition For more on Reye syndrome hepatic encephalopathy and urea cycle disorders see the What is being tested

An ammonia test may be ordered when a newborn has symptoms that arise in the first few days after birth such as Irritability Vomiting Lethargy Seizures An ammonia test may be performed when a child develops these same symptoms about a week following a viral illness such as influenza or chickenpox or when a healthcare practitioner suspects that the child may have Reye syndrome When adults experience mental changes disorientation sleepiness or lapse into a coma and may have liver disease or kidney failure an ammonia level may be ordered to help evaluate the cause of the change in consciousness In people with stable liver disease an ammonia level may be ordered along with other liver function tests when a person suddenly becomes more acutely ill

A significantly increased concentration of ammonia in the blood indicates that the body is not effectively processing and eliminating ammonia and it may be the cause of the person s signs and symptoms In infants an extremely high level is associated with an inherited urea cycle enzyme deficiency or defect but may also be seen with hemolytic disease of the newborn Moderate short-lived increases in ammonia are relatively common in newborns where the level may rise and fall without causing noticeable symptoms For more about urea cycle disorders see the Related Pages tab An increased ammonia level and decreased glucose level may indicate the presence of Reye syndrome in symptomatic children and teens An increased concentration may also indicate a previously undiagnosed enzymatic defect of the urea cycle In children and adults an elevated ammonia level may indicate that severe liver or kidney damage has impacted the body s ability to clear ammonia and that the brain may be affected Frequently an acute or chronic illness will act as a trigger increasing ammonia levels to the point that an affected person has difficulty clearing the ammonia A normal blood ammonia level may mean that a person s signs and symptoms are due to a cause other than excess ammonia However normal concentrations of ammonia do not rule out hepatic encephalopathy Other wastes can contribute to changes in mental function and consciousness and brain levels of ammonia may be much higher than blood levels This can make correlation of a person s symptoms to ammonia blood levels difficult A decreased level of ammonia may be seen with some types of hypertension such as essential high blood pressure of unknown cause and malignant very high blood pressure that occurs suddenly and quickly

Increased levels of ammonia may also be seen with Gastrointestinal bleeding - blood cells are hemolyzed in the intestines releasing protein Muscular exertion - muscles produce ammonia when active and absorb it when resting Tourniquet use - ammonia levels can be increased in the blood sample collected Use of certain drugs including alcohol barbiturates diuretics valproic acid and narcotics Cigarette smoking Decreased levels of ammonia may be seen with the use of some antibiotics such as neomycin Ammonia tests can also be performed on arterial blood but this method is much less frequently used Some healthcare practitioners feel that arterial ammonia measurements are more clinically useful but there is not widespread agreement on this

Not generally In most cases ammonia acts locally burning or irritating whatever it comes in contact with but according to the Agency for Toxic Substances and Disease Registry ATSDR it does not usually act as a systemic poison Concentrated commercial ammonia in a liquid or vapor form can cause more severe burns than the more dilute liquid household ammonia but both can damage the eyes skin respiratory tract and if swallowed the mouth throat and stomach

It depends on why it was increased in the first place If you had a temporary condition then it is likely that the ammonia level will continue to be normal If you have a chronic condition then it is possible that it will increase again and your health status will likely need to be monitored Talk to your healthcare provider about what is best for you