Autism & Ammonia – Exciting!
I recently wrote an article entitled Stinky People & Odor Sensitivities. It covers the basics of ammonia toxicity and detoxification of ammonia. While it may be a humorous title, in the average person ammonia can wreak havoc. When additionally combined with ASD it can be even more problematic. I wanted to cover a little more in detail some of the nuances that exist in the ASD adult or child that may be affected by elevated ammonia.
For ammonia toxicity basics along with detoxification please reference my previous article.
Most people that are in search of answers and doing all they can to help with ASD avoid things like casein and gluten because they are well versed in the concept of excitotoxins. But, I haven’t seen anyone talking about the excitotoxic nature of ammonia.
Like many other factors, ammonia frequently affects the brain of those with ASD. The way it does this is because excess ammonia (NH3+) is able to cross the blood brain barrier and combine with a-ketoglutarate. This brings us a three-fold problem.
- The first problem is obvious as more excitotoxins and excessive glutamate are never good for ASD.
- The second problem is that because of the excess ammonia, a-ketoglutarate chooses to combine with ammonia and it leads to the depletion of a-ketoglutarate. A-ketoglutarate is a big word, pronouncing it isn’t important, but knowing that it is a critical biochemical step in the citric acid cycle is. The citric acid cycle is the process by which we produce a lot of ATP or energy for our cells. Trying to get the citric acid cycle functioning properly is one of the reasons why so many people are using B complex vitamins. But even with B vitamins, without adequate a-ketoglutarate, the citric acid cycle can’t function optimally. Without adequate ATP, cells die, nerves die, etc. This may be a primary problem or there still may be a third problem.
- The third problem could be the decreased formation of GABA due to the increased formation of glutamine. Ammonia pushes the conversion of glutamic acid to glutamine instead of to GABA. This may be a little confusing as both glutamate and glutamine can both be beneficial or detrimental all dependent upon the proper balance. Glutamate and glutamine act as the major buffering molecules for ammonia.
If you look at the 3 examples above you, the one thing they have in common is high ammonia levels that are making things shift and change to compensate. Ideally the urea cycle in the liver should be the one detoxifying the majority of ammonia. So if you can discover what is driving you excess ammonia, the real root cause, then that would be the best way to resolve and balance the system.
Why So Much Ammonia?
Arguably the most common reason for elevated ammonia in the ASD is due to dysbiosis or stealth infections and their co-infections. It is very common for me to find fungal dysbiosis in my patient population. One of the major byproducts of fungal overgrowth is ammonia. Other types of dysbiosis can lead to ammonia accumulation and the liver can only handle so much. So now the vicious cycle begins where you have excess ammonia, an overburdened liver and overproduction of glutamate. In addition with the citric acid cycle functioning below optimal, it doesn’t produce adequate CO2 to fuel the urea cycle.
The easiest way to know if you are dealing with dysbiosis is simply observing symptoms such as irregular bowel movements, acid reflux (GERD), loss of appetite, picky eating, abdominal cramping or pretty much anytime you are aware that you are digesting food, you probably could benefit from looking into dysbiosis. Most people should be able to eat food and digest it without really even feeling anything happening.
Just as a review of a few of the neurological symptoms, you may observe:
- Slurring of speech
- Blurred vision
- Nausea (decreased appetite)
- Neurological deficits
- Intellectual disability
One of the most common findings in traditional lab work that is associated with elevated ammonia is high blood urea levels or high BUN. It doesn’t seem to catch every case of elevated ammonia, but if you have the blood work already, then it is worth looking at. In my office I use manual muscle testing to get a real time picture of ammonia sensitivity. The patient simply smells some ammonia and if there is a neurological muscle response, then I further investigate why ammonia may be elevated and how to properly detoxify it.
For the detoxification of ammonia, please reference this article. There are definitely emergency precautions that can be taken if blood ammonia is severely elevated, but the typical patient in my office is not in a life threatening situation.
Obviously proper supplementation is going to depend on you discovering the root problem. If you are just buying supplements from a list of products that detox ammonia, it can get expensive quickly. You will save a lot of money if you find a physician to help you identify the correct diagnosis and the correct remedy.
Just because it is so common, if you determine dysbiosis to be the primary contributor to your ammonia toxicity, then a powerful natural antimicrobial is likely necessary.
My most commonly used supplements are Chinese Coptis, Cistus Incanus & Noni Berry. For difficult fungal and candida related issues addition of molybdenum and biotin may be helpful. Its is very common for molybdenum to be depleted in chronic fungal infections.
Discovering root causes for why the brain is overexcited is critical in attempting to reverse autism. Ammonia can be a critical piece especially in those with ASD. I believe that biological treatments for autism are critical in order to gain ground on a condition that can be overwhelming and misunderstood.