Re: Thinking about trying Lactulose. Ammonia from Protein.

It seems that I'm dealing with similar ammonia issues - or at least I've strongly suspected as much. For the better part of six months, now - I've intermittently investigated ways to lessen/eliminate my ammonia burden. I haven't gotten very far as far as resolving the problem (assuming that there is one) - but don't let that discourage you. You might respond differently. Besides - I haven't been very persistent with the supposed remedies - I've usually stopped taking the supplement shortly after noticing certain adverse effects. I just haven't been sure how wise "pushing through" an adverse reaction was - and I may have certain unique "roadblocks" that prevented the product from having the desired effect right away.

For example - with the ornithine - I think I tried one type of ornithine supplement two or three times, and a different ornithine supplement once - and I quit each trial because I thought I noticed a depressive effect. It may have been helping with the ammonia - but I seemed to have an immediate (or almost immediate) reaction that didn't seem positive. It seemed to rob me of energy (physical and mental), and have that depressive effect. But perhaps my expectations were a bit unrealistic - I mean, was that immediate depressive effect something that I should have "waited out", or was that a legitimate sign that ornithine was not the right supplement for me? It can be hard to sort-out those things. But I'm glad that it's working for you better.

Alpha ketoglutaric acid has also been recommended for ammonia issues. This is another one that I've only taken a scant handful of times. Again, it may have helped with the ammonia - but I stopped taking it before I could really be certain that it was working for me because it seemed to make me too "acidic", and give me a vague unpleasant feeling (which may have been because of the acidity - not sure). But you may have better, more immediate luck with this supplement.

Other things that are purported to help are probiotics - for they supposedly re-balance your intestinal bacteria in a way that crowd out the "bad bacteria" - the ammonia-producing bacteria. (It may also alter the pH of the intestinal environment in a way that discourages ammonia-production - I may have read this somewhere.) This was a supplement that also seemed to show some promise - at first. Then the supposed "die-off" reaction arrived - well, I wasn't sure if it was actually "die-off", or my body's inflammatory response to the probiotics themselves. "Die-off" (or the reaction that is hyped to be "die-off") often seems to cause the very thing that we are trying to get rid of - as though the brain/body were under another "ammonia attack". To hear the experts/probiotic-proponents tell it - this reaction is due to the bad-bacteria "dieing off", and releasing its toxins in the process (such as ammonia). What is eventually supposed to happen is that the "die off" reaction eventually fades, your gut-flora is re-balanced, and you have less ammonia in the system because the "bad guys" are gone - or at least greatly reduced in number. Some caution is in order - at the very least, take things slow and easy. (I often have a tendency to impatiently rush things a bit - which may have caused me harm.) And I want to be sure that the purported "die-off" reaction is really die-off before I fully commit to this remedy.

Another suggestion would be improving your digestion; for example, making sure that you're producing enough stomach acid, or increasing your stomach acid/digestive enzymes. The more thoroughly your stomach digests these proteins - the less "material" the bad bacteria has downstream to feast on and produce the ammonia or ammonia compounds. It has been suggested that digestive bitters are a safer long-term option for increasing stomach acid than is betaine hcl. Before trying the bitters or betaine hcl - you might want to make sure that your body has sufficient zinc levels, as zinc is essentially involved in the production of stomach acid. (Certain B vitamins are also important.) Personally - I've just started taking digestive bitters while also trying to take more B vitamins/zinc (there has been evidence that I'm zinc deficient). I'm in the process of sorting out a possible problem with the digestive bitters - I think I need to switch to an alcohol-free digestive bitters formula.

I've recently come across suggestions from Peter D'Adamo - author of those "Eat Right For Your Type" books (he advocates a diet that restricts certain foods based on one's blood-type). Although he doesn't mention ammonia specifically (or maybe he does?) - he does focus on foods/supplements that might lower one's indican/indole levels. Indicans and indoles are ammonia/nitrogen compounds that are produced by intestinal bacteria whose effects - at least at excessive levels - may be similar to those of ammonia (ammonia may be involved in their formation). If you have excess ammonia - you may also have an excess of indolic compounds.

But to decrease indoles, he suggests sticking to foods that are appropriate for your bloodtype. He also suggests a supplement called Larch Arabinogalactan - it is some type of polysaccaride that may work in a similar fashion as lactulose. I've been sort-of mulling over whether or not to give it a try.

D'Adamo also suggests these foods to lower indoles:

-walnuts

-green tea

-dark-blue, purple or red-pigmented fruits such as blueberries, cherries, and elderberries (I'm guessing that blackberries fall into this category as well)

-pomegranate, plantains, guava (though blood-types AB & B should avoid pomegranate, and types A & O should avoid plantains)

-onions, dill, tarragon, broccoli leaves, garlic

-curcumin and tumeric

I'm not sure how well I could stick to a blood-type-specific diet, but I do plan to try out some of these foods he suggests.

Oh - my source for these suggestions is D'Adamo's book "Live Right 4 Your Type". Google Books doesn't give the page numbers - but if you go to Google Books and type in "stomach acid" and "indican" - the book should come up (to further ensure this - you could try typing "Peter D'Adamo" in the "author" field).

I've also read that the amino acid lysine, and branched-chain amino acids (leucine, iso-leucine, valine) could help in indirect ways. From my experience, lysine was well-tolerated (and seems to help some) - while the branched-chain amino acids seemed to produce the same "depressive" effect as the ornithine. Again - you can try these yourself - there's a more-than-decent chance that your experiences will be different.

By the way, I have not tried lactulose at all - as you need a prescription for that, and I don't feel like jumping through hoops to try to get one.

Also - I've considered the possibility that I could have some form of Lyme disease; it is said that Lyme bacteria produce ammonia. I've been tentatively considering incorporating some of the treatments/remedies that are recommended for Lyme sufferers. (I've heard that Lyme disease can be extremely difficult to detect by the available testing methods.) Even if I don't have Lyme outright - I may benefit from some of the treatment methods.

I apologize for the length - hopefully there is something in this post that may be of some help. Sorry that I cannot answer all of your questions.

P.S. - from what I understand, it can be difficult to tell from TSH alone whether or not you're hypo. TSH is released in sort-of a feedback-loop (if your hypothalamus is working correctly) - it can vary substantially from day-to-day, or from hour-to-hour. Ideally - if your body has "enough" thyroid hormones, TSH-production is lowered....if your body senses insufficient thyroid hormone - TSH-production is revved-up. Your TSH indicates that your body is not calling out much for more thyroid hormone - so you might be o.k. - but as I said, TSH-alone might not tell the whole story. Your Free T3 levels might be the best indicator of whether or not you have enough thyroid hormones - Free T3 is the "active" thyroid hormone that represents how much physiologically-active thyroid hormone is available to the body's tissues.
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