Brain Fog, hepatic encephalopathy and relationship with Ammonia

Hi

The link between Brain Fog, Nitrogen/Ammonia and Taking ES (Epson Salt) for magnesium.

http://www.healingwell.com/community/default.aspx?f=30&m=854537

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Conditions that can increase ammonia levels include:

Liver failure
Severe congestive heart failure
Erythroblastosis fetalis
Gastrointestinal (GI) bleeding - usually in the upper GI tract
Genetic diseases of the urea cycle
Leukemia
Pericarditis
Reye's syndrome
Certain drugs
An ammonia test measures the amount of ammonia in the blood.

In healthy people, the liver converts ammonia into urea which is then eliminated in urine. People infected with lyme and other bacterial diseases usually have an overload of ammonia because protein is broken down by bacteria in the intestines forming ammonia. Levels of ammonia rise when the liver is not able to convert ammonia to urea.

People infected with lyme are known to have raised liver enzymes and left untreated, can have liver disease:

HE (hepatic encephalopathy) remains a complex clinical problem, the precise mechanism of which is unknown. The premise of most pathophysiologic theories is that ammonia accumulates in the central nervous system producing alterations of neurotransmission that affect consciousness and behavior. These "ammonia toxicity" theories have been supported by studies demonstrating increased ammonia levels in patients with both fulminant hepatic failure and chronic liver disease. The lack of strong correlation between serum ammonia levels and stage or degree of encephalopathy has been used in the argument that hyperammonemia may not be the sole factor in HE pathogenesis.

Most ammonia is produced in the intestine by both colonic breakdown of nitrogenous compounds and enterocytic catabolism of amino acids. Other sources of ammonia are the kidneys and skeletal muscle. Normally ammonia is metabolized in the liver (by its conversion to urea) and is excreted through the kidneys or colon. Another means of detoxifying ammonia is through the formation of glutamine from glutamate in the liver and brain. Impaired liver function, the shunting of blood around the liver and increased muscle wasting all lead to increased serum ammonia levels in cirrhotic patients.4

Ammonia interferes with brain function at many sites. Ammonia crosses the blood-brain barrier and directly depresses central nervous system functioning by inhibiting postsynaptic potentials.5 There is also evidence that hyperammonemia may facilitate the brain's uptake of tryptophan, a substance with neuroactive metabolites such as serotonin.6 Excess ammonia may reduce levels of brain adenosine triphosphate resulting in impaired cerebral energy.7 Lastly, the metabolism of ammonia to glutamine in the brain increases the intracellular osmolarity of astrocytes, inducing both astrocyte swelling and vasodilation.8 Increased astrocyte hydration without overt increased intracranial pressure is currently considered a major factor in the development of HE in patients with chronic liver disease.9

Toxins other than ammonia have also been implicated in the pathogenesis of HE. Excesses of neurotoxic short-chain fatty acids and mercaptans have received attention in the past.10 Patients with cirrhosis have also been shown to have decreased branched-chain amino acid-to-aromatic amino acid ratios. It has been postulated that the increased aromatic amino acid in the cirrhotic patient's brain may competitively inhibit normal neurotransmitters such as dopamine and norepinephrine. Cirrhotic patients with HE have greatly increased serum manganese levels. Manganese may deposit directly in the basal ganglia and induce extrapyramidal symptoms. Manganese may also act synergistically with ammonia to activate peripheral-type benzodiazepine receptors and the GABA-ergic neuroinhibitory system.
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http://www.extension.iastate.edu/nutrition/supplements/magnesium.php

Magnesium is necessary for the proper function of over 300 enzymes essential for actions such as the transmission of nerve impulses, muscle contraction and the heart beat. Magnesium is required for protein synthesis and for releasing energy from the body's carbohydrate stores in the liver. Magnesium also helps in bone building and in the release of energy from food.

http://www.gkproducts.com/compmagnesium.html

Magnesium is essential in the production of energy and performs a critical role in the activation of four of the nine enzymes in the Tri-carboxylic Acid Cycle (TCA cycle). This cycle is at the very center of all cellular metabolism involving protein, fat and carbohydrate metabolism. Its role is crucial in the external and internal cell membranes and has a regulating effect upon the nervous system, exerting an overall relaxing effect. It exerts a stabilizing effect on the electrical potential of cell membranes in the muscular and nervous tissues thus reducing sudden depolarization of cell membranes, which can lead to epileptic fits, cardiac arrhythmia and spasms. Magnesium is vital for regular and strong contractions of the cardiac muscle fibers. Magnesium relaxes smooth muscle in the blood vessel walls thus reducing blood pressure.

MAGNESIUM USEFUL FOR:
Anxiety and stress related disorders
Panic attacks
Recurrent headaches & migraines - preventative
Muscular cramps
Fibromyalgia
Back pain
Epilepsy
Cardiac arrhythmia
Cardiomyopathy
Congestive cardiac failure
Prolonged use of diuretic drugs
Hypertension
Chronic fatigue

http://www.home-remedies-for-you.com/askquestion/8632/remedies-and-cure-to-re...

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Remedies to reduce ammonia level in blood

Formation of ammonia in the body is directly related to the breaking down of protein in the intestines. The liver then converts this ammonia into urea, which is then excreted in urine. Ammonia levels are generally checked to check the functioning of the liver in cases of extreme drowsiness and come or even to check for cirrhosis of liver. Reye's syndrome, a disorder found amongst children is also related to increased levels of ammonia in the blood and thus this is one of the first tests conducted to diagnose Reye's syndrome correctly. Finally it is also tested when a person is on a high nutrient intravenous diet.

The best and most effective way to reduce ammonia levels in the blood, is to increase intake of water. Since ammonia is a nitrogenous substance, which is toxic, the kidney clears it out from the body. Drinking water induces frequent urination which in turn facilitates flushing out of ammonia from the system. In addition, you should consume a lot of herbal teas and juices to help keep the system clean. Grapefruit seeds and lemon help the liver to breakdown toxins. If the liver is functioning efficiently, it breaks down the ammonia into urea, and thus prevents building up of ammonia in the system.
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IMO What follows is a Drastic way to treat HE

http://en.wikipedia.org/wiki/Hepatic_encephalopathy

http://en.wikipedia.org/wiki/Lactulose

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Hepatic encephalopathy

In treating hepatic encephalopathy, lactulose helps "draw out" ammonia (NH3) from the body.

The effectiveness of lactulose is somewhat controversial, and whether or not its effects are through ammonia is controversial as well. Lactulose is metabolized in the colon by bacterial flora to short chain fatty acids, acidifying the colonic contents. This favors the formation of the nonabsorbable NH4+ from NH3, trapping NH3 in the colon and effectively reducing plasma NH3 concentrations.

Side effects

Common side effects are abdominal cramping, gas, borborygmus and flatulence. Less common side effects are nausea and vomiting. Excessively high dosage can cause explosive and uncontrollable diarrhea. Overdose is considered uncomfortable, but not life threatening.

In sensitive individuals, such as the elderly or people with reduced kidney function, excess dosage can result in dehydration and high sodium levels.
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Cheers

WIEL

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