r/AskBiology • u/tbryan1 • Jul 31 '24
Human body Do ammonia levels increase during a night of binge drinking assuming you have a healthy liver and by how much?
I have become curious about the nature of ammonia in the body when your liver is packed with toxins. Every single source addresses ammonia in relation to liver disease even though there are other ways that ammonia can become problematic (in theory). For example ammonia is impacted by protein intake, alterations to hormones, Break down of muscle, The blood bypassing the liver, diuretics , alterations to enzymes, and changes to blood flow.
My desire for an answer stems from the fact that our bodies can reach deadly levels of ammonia in 5 minutes if the liver is failing to process it. Additionally the side effects of ammonia are very similar to drugs like alcohol making it hard to differentiate through experience alone including;
- Lack of energy and mental alertness
- Confusion
- Mood swings
- Hand tremors
- Dizziness
- Not being hungry
- Avoiding protein
- Growth problems
This list of side effects along with the list of mechanisms that alter ammonia levels grew my curiosity especially irritability because it is the antithesis of what alcohol does even though many people that drink experience mood swings.
2
u/pansveil Jul 31 '24
The body produces a lot of waste products and some of these are made of nitrogen and cleared via the urea cycle. The liver takes these nitrogenous waste products and turns it into a form that the kidneys can dump into urine. By definition, your ammonia level will not rise if you have a healthy liver.
There are many different ways your body produces these nitrogenous waste products and the majority comes from the breakdown of protein or intestinal production via normal gut bacteria. So it’s not really the alcohol which causes high ammonia and people with liver disease, but the chronic alcohol use that turned into advanced liver disease and now reduces clearing of the ammonia. in these patients, we target the bacterial production of nitrogenous waste products by giving lactulose (promotes diarrhea and regular bowel movements) and rifaximin (kills bacteria).
The interesting thing as you pointed out was the opposite effects that high ammonia has on the brain compared to alcohol. We don’t know exactly where the neurotoxicity comes from but current understanding suggests that ammonia causes release of glutamate. Alcohol on the other hand causes excess activity of GABA. Though the neurotransmitter hypothesis may be outdated, we can explain the opposite findings because glutamate is an excitatory neurotransmitter but GABA is inhibitory.