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<h1>Ammonia Levels</h1>
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<section><div class="mp-content"><h2>What is an ammonia levels test?</h2>
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<p>An ammonia levels test measures the amount of ammonia in a sample of your blood. Ammonia is also called NH3. It is a normal waste product in your body. Healthy bacteria in your intestines make ammonia when you digest protein in the foods you eat.</p>
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<p>Normally, your liver changes ammonia into another waste product called urea. Your kidneys get rid of urea in urine (pee). This process is called the urea cycle.</p>
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<p>When you're healthy, the urea cycle prevents ammonia from building up in your blood. This is very important because ammonia is toxic (poisonous) to your brain. Even small increases in the level of ammonia in your blood can cause permanent brain damage, <a data-tid="5559" href="https://medlineplus.gov/coma.html">coma</a>, and even death.</p>
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<p><a data-tid="310" href="https://medlineplus.gov/liverdiseases.html">Liver disease</a> is the most common cause of high ammonia levels. Other causes include <a data-tid="302" href="https://medlineplus.gov/kidneyfailure.html">kidney failure</a> and <a data-tid="33" href="https://medlineplus.gov/geneticdisorders.html">genetic disorders</a> called urea cycle disorders.</p>
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<p>The medical term for high ammonia levels is hyperammonemia.</p>
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<p>Other names: NH3 test, blood ammonia test, serum ammonia, ammonia; plasma</p></div>
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</section>
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<section><div class="mp-content"><h2>What is it used for?</h2>
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<p>An ammonia levels test may be used to help diagnose high ammonia levels in people who have symptoms. The test alone can't diagnose conditions that increase the amount of ammonia in your blood. But it may be used with other tests to help find the cause.</p>
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<p>Ammonia levels testing can help diagnose conditions such as:</p>
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<ul>
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<li><strong>Hepatic encephalopathy.</strong> This condition happens when toxins (poisons), including ammonia, build up in your brain because your liver is unable to break them down. It can cause memory loss, confusion, loss of consciousness, and coma.</li>
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<li><strong><a data-tid="385" href="https://medlineplus.gov/reyesyndrome.html">Reye syndrome</a>.</strong> This rare disease damages the brain and liver. Without treatment, it causes death. It mostly happens in children younger than 15 who have had a <a data-tid="454" href="https://medlineplus.gov/viralinfections.html">viral infection</a> that causes a <a data-tid="511" href="https://medlineplus.gov/fever.html">fever</a>, such as <a data-tid="182" href="https://medlineplus.gov/chickenpox.html">chickenpox</a> or the <a data-tid="299" href="https://medlineplus.gov/flu.html">flu</a>. Taking aspirin during a viral illness may increase the risk of Reye syndrome.</li>
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<li><strong>Urea cycle disorders</strong> (UCDs)<strong>.</strong> This is a group of rare genetic conditions that you inherit from your parents. If you have a UCD, you lack enzymes that help change ammonia into urea. An enzyme is a protein that speeds up certain chemical reactions in your body. Symptoms may show up shortly after birth or later in life. Newborns are tested for certain UCDs as part of routine <a data-tid="4041" href="https://medlineplus.gov/newbornscreening.html">newborn screening</a>. Your child's health care provider can explain more about which UCD screening tests are used in your state.</li>
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</ul>
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<p>Ammonia levels testing is also used to monitor conditions that cause high ammonia levels and to check if treatment is working.</p></div>
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</section>
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<section><div class="mp-content"><h2>Why do I need an ammonia levels test?</h2>
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<p>You may need this test if you have symptoms that could be from too much ammonia in your blood. The symptoms depend on how high your ammonia levels are and your age. Symptoms in children and adults may include:</p>
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<ul>
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<li>Feeling irritable</li>
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<li>Lack of energy and mental alertness or being very sleepy</li>
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<li><a data-tid="489" href="https://medlineplus.gov/nauseaandvomiting.html">Vomiting</a></li>
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<li><a data-tid="273" href="https://medlineplus.gov/headache.html">Headache</a></li>
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<li>Loss of muscle coordination that may cause difficulties with <a data-tid="5673" href="https://medlineplus.gov/walkingproblems.html">walking</a> or <a data-tid="409" href="https://medlineplus.gov/speechandcommunicationdisorders.html">speech</a></li>
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<li>Changes in behavior</li>
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<li>Confusion, including not being sure about the time and/or where or who you are</li>
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<li>Mood swings</li>
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<li><a data-tid="396" href="https://medlineplus.gov/seizures.html">Seizures</a></li>
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</ul>
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<p>Other symptoms in children may include:</p>
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<ul>
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<li>Not growing taller or gaining weight as expected</li>
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<li>Lack of muscle tone (limp muscles)</li>
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<li>Developmental delays in <a data-tid="185" href="https://medlineplus.gov/childdevelopment.html">children</a> or <a data-tid="1548" href="https://medlineplus.gov/infantandnewborndevelopment.html">infants</a></li>
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</ul>
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<p>Newborn babies may develop symptoms of high ammonia levels within three days after birth. Symptoms in newborns include the above symptoms and may also include fast breathing and/or making grunting sounds when breathing. If your baby or child has any symptoms of high ammonia levels, contact their provider right away.</p>
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<p>If you have a family history of genetic urea cycle disorders, you or your child may need this test even if you don't have symptoms.</p>
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<p>If you've been diagnosed with high ammonia levels, you may need this test to see how well your treatment is working.</p></div>
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</section>
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<section><div class="mp-content"><h2>What happens during an ammonia levels test?</h2>
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<p>In most cases, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.</p>
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<p>In certain cases, the blood sample may be taken from an artery, which is a blood vessel that carries blood from your heart to the rest of your body. Some providers think blood from an artery may provide more accurate results. The blood is taken from an artery in your wrist, arm, or groin using a needle attached to a syringe.</p>
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<p>Taking blood from an artery tends to be more uncomfortable than blood tests that use a vein. So, numbing medicine may be applied to your skin first. Afterwards, the site will be bandaged, and pressure will be applied for at least five minutes to stop bleeding. You may be told to avoid lifting heavy objects for 24 hours after the test.</p>
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<p>To get a blood sample from a newborn, a provider will clean the baby's heel with alcohol. Then the provider will stick the baby's heel with a small needle to collect a few drops of blood. The heel will then be bandaged.</p></div>
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</section>
|
||
|
||
<section><div class="mp-content"><h2>Will I need to do anything to prepare for the test?</h2>
|
||
<p>Your provider will give you specific instructions about how to prepare for an ammonia levels test. You should not smoke for several hours before the test. You may be asked to avoid strenuous exercise and alcohol for a period of time.</p>
|
||
<p>You may also need to <a data-pid="858" href="https://medlineplus.gov/lab-tests/fasting-for-a-blood-test/">fast</a> (not eat or drink) for several hours. Your provider may tell you to stop taking certain medicines, including diuretics (water pills) and opioid pain medicines. But never stop taking any prescription medicines without talking with your provider first.</p>
|
||
<p>Babies do not need any special preparations before the test.</p></div>
|
||
</section>
|
||
|
||
<section><div class="mp-content"><h2>Are there any risks to the test?</h2>
|
||
<p>There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.</p>
|
||
<p>If your blood sample was taken from an artery, you may also have some bleeding where the needle was put in. Very rarely, the needle may damage a nerve or the artery.</p></div>
|
||
</section>
|
||
|
||
<section><div class="mp-content"><h2>What do the results mean?</h2>
|
||
<p>Your provider will use your test results, symptoms, and medical history to understand what your ammonia levels say about your health. Normal levels vary with age, but in general, low levels are normal and healthy.</p>
|
||
<p><strong>If your test results are normal</strong>, your provider will order other tests to find out what's causing your symptoms.</p>
|
||
<p><strong>If your test results show ammonia levels that are higher than normal</strong>, it usually means that your body is having trouble getting rid of ammonia. Many types of health conditions can cause high ammonia levels, including:</p>
|
||
<ul>
|
||
<li>Liver diseases, such as <a data-tid="190" href="https://medlineplus.gov/cirrhosis.html">cirrhosis</a> or <a data-tid="109" href="https://medlineplus.gov/hepatitis.html">hepatitis</a></li>
|
||
<li>Hepatic encephalopathy</li>
|
||
<li><a data-tid="91" href="https://medlineplus.gov/kidneydiseases.html">Kidney disease</a> or kidney failure</li>
|
||
<li>Certain genetic disorders, including urea cycle disorders</li>
|
||
<li>Reye syndrome (most common in in children and teens)</li>
|
||
<li>Taking certain medicines</li>
|
||
</ul>
|
||
<p>If the results of an ammonia levels test are high, more tests will usually be done to diagnose the cause. Treatment will depend on the condition that's causing the problem. If you have questions about your test results or treatment, talk with your provider.</p>
|
||
<p>Learn more about <a data-pid="806" href="https://medlineplus.gov/lab-tests/how-to-understand-your-lab-results/">laboratory tests, reference ranges, and understanding results</a>.</p></div>
|
||
</section>
|
||
|
||
<section><div class="mp-content"></div>
|
||
</section>
|
||
|
||
<section><div class="mp-refs mp-content"><h2>References</h2>
|
||
<ol>
|
||
<li>Ah Mew N, Simpson KL, Gropman AL, et al. Urea Cycle Disorders Overview. 2003 Apr 29 [Updated 2017 Jun 22; cited 2023 Apr 19]. In: Adam MP, Mirzaa GM, Pagon RA, et al., editors. GeneReviews(r) [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2023. Available from: <a href="https://www.ncbi.nlm.nih.gov/books/NBK1217/#!po=42.5926" target="bibliowin">https://www.ncbi.nlm.nih.gov/books/NBK1217/#!po=42.5926</a></li>
|
||
<li>Ali R, Nagalli S. Hyperammonemia. [Updated 2022 Aug 8; cited 2023 Apr 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: <a href="https://www.ncbi.nlm.nih.gov/books/NBK557504/#_article-23094_s7_" target="bibliowin">https://www.ncbi.nlm.nih.gov/books/NBK557504/#_article-23094_s7_</a></li>
|
||
<li>American Liver Foundation. [Internet]. New York: American Liver Foundation; c2023. Diagnosing Hepatic Encephalopathy (HE); [updated 2023 Mar 16; cited 2023 Apr 17]; [about 9 screens]. Available from: <a href="https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/hepatic-encephalopathy/diagnosing-hepatic-encephalopathy/#what-are-the-symptoms" target="bibliowin">https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/hepatic-encephalopathy/diagnosing-hepatic-encephalopathy/#what-are-the-symptoms</a></li>
|
||
<li>Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2023. Ammonia Levels; [reviewed 2022 Apr 11; cited 2023 Apr 18]; [about 10 screens]. Available from: <a href="https://my.clevelandclinic.org/health/articles/22686-ammonia-levels" target="bibliowin">https://my.clevelandclinic.org/health/articles/22686-ammonia-levels</a></li>
|
||
<li>Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2023. Hyperammonemia; [reviewed 2022 Aug 24; cited 2023 Apr 18]; [about 18 screens]. Available from: <a href="https://my.clevelandclinic.org/health/diseases/24065-hyperammonemia" target="bibliowin">https://my.clevelandclinic.org/health/diseases/24065-hyperammonemia</a></li>
|
||
<li>Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2023. Urea Cycle Disorder; [reviewed 2022 Jul 11; cited 2023 Apr 18]; [about 17 screens]. Available from: <a href="https://my.clevelandclinic.org/health/diseases/23470-urea-cycle-disorder" target="bibliowin">https://my.clevelandclinic.org/health/diseases/23470-urea-cycle-disorder</a></li>
|
||
<li>Hinkle J, Cheever K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Ammonia, Plasma; p. 40.</li>
|
||
<li>Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2023. Hepatic Encephalopathy; [reviewed 2023 Jan; cited 2023 Apr 17]; [about 2 screens]. Available from: <a href="https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/hepatic-encephalopathy" target="bibliowin">https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/hepatic-encephalopathy</a></li>
|
||
<li>National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: disorientation; [cited 2019 Jul 17]; [about 4 screens]. Available from: <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/disorientation" target="bibliowin">https://www.cancer.gov/publications/dictionaries/cancer-terms/def/disorientation</a></li>
|
||
<li>National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: Lethargy; [cited 2023 Apr 17]; [about 1 screen]. Available from: <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/lethargy" target="bibliowin">https://www.cancer.gov/publications/dictionaries/cancer-terms/def/lethargy</a></li>
|
||
<li>National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: Reye syndrome; [cited 2023 Apr 17]; [about 1 screen]. Available from: <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/reye-syndrome" target="bibliowin">https://www.cancer.gov/publications/dictionaries/cancer-terms/def/reye-syndrome</a></li>
|
||
<li>National Center for Advancing Translational Sciences/Genetic and Rare Diseases Information Center [Internet]. Gaithersburg (MD): U.S. Department of Health and Human Services; Urea cycle disorders; [updated 2023 Feb; cited 2023 Apr 18]; [about 12 screens]. Available from: <a href="https://rarediseases.info.nih.gov/diseases/7837/urea-cycle-disorders" target="bibliowin">https://rarediseases.info.nih.gov/diseases/7837/urea-cycle-disorders</a></li>
|
||
<li>National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Definition & Facts for Cirrhosis; [updated 2018 Mar; cited 2023 Apr 19]; [about 4 screens]. Available from: <a href="https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/definition-facts" target="bibliowin">https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/definition-facts</a></li>
|
||
<li>National Institute of Neurological Disorders and Stroke [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Hypotonia; [reviewed 2023 Jan 20; cited 2023 Apr 18]; [about 3 screens]. Available from: <a href="https://www.ninds.nih.gov/health-information/disorders/hypotonia" target="bibliowin">https://www.ninds.nih.gov/health-information/disorders/hypotonia</a></li>
|
||
<li>National Institute of Neurological Disorders and Stroke [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Reye's Syndrome; [reviewed 2023 Jan 20; cited 2023 Apr 18]; [about 3 screens]. Available from: <a href="https://www.ninds.nih.gov/health-information/disorders/reyes-syndrome" target="bibliowin">https://www.ninds.nih.gov/health-information/disorders/reyes-syndrome</a></li>
|
||
<li>Testing.com [Internet]. Seattle (WA): OneCare Media; c2023. Ammonia Test; [modified 2022 Mar 18; cited 2023 Apr 17]; [about 13 screens]. Available from: <a href="https://www.testing.com/tests/ammonia/" target="bibliowin">https://www.testing.com/tests/ammonia/</a></li>
|
||
<li>UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2023. Ammonia blood test: Overview; [reviewed 2021 Jan 24; cited 2023 Apr 17]; [about 2 screens]. Available from: <a href="https://ufhealth.org/ammonia-blood-test" target="bibliowin">https://ufhealth.org/ammonia-blood-test</a></li>
|
||
<li>University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2023. Health Encyclopedia: Ammonia; [cited 2023 apr 17]; [about 2 screens]. Available from: <a href="https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=ammonia" target="bibliowin">https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=ammonia</a></li>
|
||
<li>UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2023. Health Information: Ammonia Test; [updated 2022 Sep 8; cited 2023 Apr 17]; [about 4 screens]. Available from: <a href="https://patient.uwhealth.org/healthwise/article/en-us/hw1768" target="bibliowin">https://patient.uwhealth.org/healthwise/article/en-us/hw1768</a></li>
|
||
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<li><a href="https://medlineplus.gov/lab-tests/what-you-need-to-know-about-blood-testing/">What You Need to Know About Blood Testing</a></li>
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"headline": "Ammonia Levels",
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"description": "An ammonia levels test measures the amount of ammonia in a sample of your blood. Ammonia is also called NH3. It is a normal waste product in your body. Healthy bacteria in your intestines make ammonia when you digest protein in the foods you eat. Normally, your liver changes ammonia into another waste product called urea. Your kidneys get rid of urea in urine (pee). This process is called the urea cycle. When you're healthy, the urea cycle prevents ammonia from building up in your blood. This is very important because ammonia is toxic (poisonous) to your brain. Even small increases in the level of ammonia in your blood can cause permanent brain damage, coma, and even death. Liver disease is the most common cause of high ammonia levels. Other causes include kidney failure and genetic disorders called urea cycle disorders. The medical term for high ammonia levels is hyperammonemia. Other names: NH3 test, blood ammonia test, serum ammonia, ammonia; plasma",
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