Ammonia

Too much ammonia is often a problem for many Lyme patients so I thought I would try to explain what is going on. Although the root cause of why excessive ammonia is produced may not be known, there are several plausible scenarios that could be the reason for concern.
1. Bacterial dysbiosis - Increased ammonia production is mostly associated with gram negative anaerobes. These are nitrogen fixing bacteria and thrive when animal protein or increased nitrogen containing foods are eaten. Examples of these bacteria are E coli, Salmonella, Yersinia, etc. These are pathogenic bacteria for the most part. There are also other bacteria that are big ammonia producers and they include Clostridia, Enterococcus, and the non-spore forming gram positive anaerobes. Modest ammonia producers include Streptococcus and the Micrococci. Very little ammonia is produced by Lactobacillus and various yeasts like Saccharomyces. So if you have too much ammonia, more than likely, you have too many of the ammonia producing bacteria.
2. Intestinal pH issues - If you have dysbiosis caused by a toxin producing pathogen or eating improper foods, then your intestinal pH can be altered. More ammonia is produced at a pH of 7 than a pH of 5, so increasing bacteria like H pylori that lower pH can be beneficial by reducing intestinal pH. Yes, even the harmful H pylori can be beneficial in some scenarios. But the intestinal pH swings upwards also. If the pH goes too high, say a pH of 9, this can favor unwanted bacterial growth like Enterococcus. Increasing ammonia production can then alter pH and decrease Enterococcus and other unwanted bacterial growth. Increasing Candida growth could be beneficial in someone with too much ammonia. Saccharomyces overgrowth can occur in this situation also. It should be noted that eating is the most important indicator of intestinal pH and is the ultimate factor in GI pH management.
3. We know that carbohydrate fermentation decreases ammonia production. This could be due to multiple factors. There is a spacial component to our GI tract that is often overlooked. Our villi, (the finger-like projections on the interior surface of our GI tract), are responsible for our absorption of nutrients. The villi have a pH change from the tip to the base that allows for different compounds and nutrients to be modified so that they can be absorbed through the tight junctions which are located between each finger-like projection. If dysbiosis causes an altered pH change on the villi, this can alter absorption of nutrients. It can also increase absorption of ammonia through the portal vein and it has been shown that up to 40 grams of ammonia can be absorbed through the portal vein per day.
4. Glutamine is the most abundant amino acid in the body. It has been shown that glutamine transfers nitrogen between the tissues. This would be very important for ammonia production. Glutamine has also been shown to regulate protein synthesis and is a substrate for renal ammonia production. One of its main roles is to serve as a key fuel for the intestinal mucosa. It has been shown that intracellular compartments of glutamine and glutamate can increase dramatically causing "Glutamine and Glutamate Pools." A dysfunction in the glutamine-glutamate cycle can lead to increase ammonia levels as glutamine is made from glutamate and ammonia. Leucine and alanine may play a key role in this and there are many factors that can play a role in this cycle.

I hope this post helps you understand what is happening and possibly why it is happening.

Quin said...
Intestinal bacteria might contribute, but bartonella henselae is capable of producing ammonia all by itself.

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc348914/

Excellent article. Bartonella phage induction is caused most likely by ammonia accumulation and it would be self limiting. This article clearly shows that Bartonella limits its own production which would be an excellent evolutionary survival mechanism. It also shows that physiological growth at a pH of 7.4 is reduced. This strengthens my theory that Bartonella is a secondary infection and not the primary cause of disease in people who are not immunocompromised. Only when infection lowers synovial and interstitial pH does Bartonella thrive. Other infections lower immune response and allow Bartonella to be problematic. We just don't see Bartonella causing devastating problems in people that don't have other severe issues.
Bartonella is not the reason for ammonia accumulation in Lyme patients.

Bartonella is a blood borne vector and utilizes red blood cells to replicate and thrive. They should never really come in contact with synovial fluid but do deal with the serum of the blood. The reason a lower pH in the synovum or interstitially allows Bartonella to thrive is because that means that other immune resources are being used in those areas. If they are used there, then the person's immune response may not be able to cover everything and Bartonella becomes a problem. The same occurs with Borrelia in Lyme. Lyme isn't supposed to thrive in the blood stream, it wants to hide in places that make it harder to find and kill. Lyme can flourish in the blood if the patient's immune response is spread thin and can't cover everything.

Our main problem is that our GI bacterial ratios are not what they should be. The cause can be Borrelia or it could be something completely different. Finding out what is causing it is a huge problem.

Also test your vitamin B6. Bartonella loves to produce that too.

Thank you for that information, I can not believe how intelligent the members on this board are! I still have a lot to learn but am gaining more information everything I visit this site. I am wondering if I have high levels of ammonia and glutamate in my brain would somthing like NAC help with my depersonalization feelings?

Thank you girlie, I will look into LOLA!