# Hyperammonemia

Category: Conditions

The presence of too much ammonia in the blood.

11 passages · 3 authors · 2013–2024 · Most-cited: [Georgi Dinkov](https://bioenergeticoracle.com/md/voices/georgi-dinkov/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/hyperammonemia

## Synthesis

**Hyperammonemia** is a state of elevated ammonia in the blood, which Ray Peat and Georgi Dinkov describe as a highly toxic condition resulting primarily from the inefficient metabolism of protein when *carbon dioxide production is insufficient* to detoxify it into urea. [Source 4, 9] Dinkov has written that ammonia is a true waste product generated when amino acids are deaminated for fuel rather than used for tissue synthesis, a process that becomes pathological when metabolic rate is low. [Source 9] Peat argued that the smell of ammonia on a person's breath or skin is usually a sign of insufficient thyroid function, though he noted it could also stem from kidney problems or bacterial action on sweat. [Source 1]

The primary driver of hyperammonemia is the catabolic use of protein as an energy source, which occurs when carbohydrate intake is inadequate or stress hormones are elevated. Dinkov explains that consuming more than roughly 30 grams of protein in a single meal without sufficient carbohydrates forces the body to deaminate the excess amino acids, cleaving the amino group and releasing **ammonia** as a byproduct. [Source 10, 11] This process is amplified by **cortisol**, the master catabolic hormone, which shreds muscle tissue and floods the bloodstream with amino acids, upregulating gluconeogenesis and overwhelming the liver's capacity to convert ammonia into urea. [Source 11] Roddy and his guest Kyle Mamounis have discussed how even subclinical reliance on gluconeogenesis from a low-carbohydrate diet chronically elevates ammonia production, and that the urea cycle is saturable, meaning the body cannot simply upregulate detoxification to match a high protein intake. [Source 7]

The toxicity of ammonia is systemic, but it is *most damaging to the brain*, where it can cause conditions ranging from insomnia, fatigue, and mania to **hyperammonemic encephalopathy** and coma. [Source 4, 8, 9] Dinkov notes that this is the typical cause of death in advanced liver failure, as the damaged liver can no longer process ammonia, leading to a hyperammonemic coma of hepatic origin. [Source 4] Peat's framework emphasizes that the detoxification of ammonia into benign urea is directly dependent on **carbon dioxide**, which combines with ammonia in a reaction that requires a robust oxidative metabolism. [Source 4, 9] Therefore, any factor that suppresses metabolic rate—such as hypothyroidism, estrogen excess, or a deficiency of B vitamins like **riboflavin**—predisposes an individual to ammonia accumulation. [Source 2, 3]

Dinkov has extended this view by identifying specific interventions that can chelate or excrete ammonia. He points to *Ceylon cinnamon* as a practical remedy, explaining that it metabolizes into benzoic acid and conjugates with ammonia to form hippuric acid, which is then excreted in urine, mirroring the mechanism of the pharmaceutical drug Ucephal. [Source 8] He also notes that the hyperammonemia observed in some viral infections may be an adaptive, antiviral response, and that substances like **adamantane** can functionally oppose the estrogen-driven excitotoxic systems that ammonia toxicity exacerbates. [Source 5] The bioenergetic perspective thus frames hyperammonemia not as an isolated pathology but as a direct consequence of a low metabolic rate where the protective, anabolic use of protein has been supplanted by a toxic, catabolic one. [Source 6, 9]

## People also ask

### How does low metabolism cause ammonia buildup?

Peat and Dinkov described that a low metabolic rate reduces carbon dioxide production, which is needed to detoxify ammonia into urea, while also promoting the catabolic deamination of amino acids for fuel instead of tissue synthesis.

### Why does eating too much protein at once raise ammonia?

Dinkov explained that consuming over roughly 30 grams of protein without enough carbohydrates forces the body to deaminate the excess amino acids, releasing ammonia as a byproduct that can overwhelm the saturable urea cycle.

### What remedy does the bioenergetic view suggest for ammonia toxicity?

Dinkov pointed to Ceylon cinnamon, which metabolizes into benzoic acid that conjugates with ammonia to form hippuric acid for urinary excretion, mirroring the pharmaceutical drug Ucephal.

## Related concepts

- [Free fatty acid theory of insulin resistance](https://bioenergeticoracle.com/md/concepts/free-fatty-acid-theory-of-insulin-resistance/index.md)
- [Anemia](https://bioenergeticoracle.com/md/concepts/anemia/index.md)
- [Autophagy](https://bioenergeticoracle.com/md/concepts/autophagy/index.md)
- [Beef](https://bioenergeticoracle.com/md/concepts/beef/index.md)
- [Biotin](https://bioenergeticoracle.com/md/concepts/biotin/index.md)
- [Caffeine](https://bioenergeticoracle.com/md/concepts/caffeine/index.md)

## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Lost Conversations with Ray Peat #3: Israel, Iron, Formative Ether, HAARP, Jeffrey Epstein, Topical Vitamins, Temperature, and Joseph Stalin

Ray Peat (with Danny Roddy) · Interview · Aug 26, 2019 · https://dannyroddy.substack.com/p/lost-conversations-with-ray-peat-e42

> **Danny Roddy:** Okay, so based on your understanding of science, this seems far fetched.
>
> **Ray Peat:** Yeah.
>
> **Danny Roddy:** Okay. Can I ask you some logistical questions?
>
> **Ray Peat:** Sure.
>
> **Danny Roddy:** If somebody smells like ammonia, is that a surefire sign that they are not taking enough thyroid?
>
> **Ray Peat:** Usually. It could just be that they have a kidney problem and they're dripping. In rest homes, a lot of the people smell of ammonia and sometimes people who sweat a lot, their skin bacteria will produce ammonia, so there are different causes. Sometimes it can actually be in the breath, that's when they're very sick, but a very healthy, sweaty person can have enough bacteria growing that their skin will develop an ammonia smell.
>
> **Danny Roddy:** If it was a kidney problem, would there be some direct course of action that would be fruitful?
>
> **Ray Peat:** If it's coming out of your breath, yeah. Getting enough sugar and thyroid and of the essential vitamins and minerals.
>
> **Danny Roddy:** If a person does significantly better on a combination of T3 and T4 than T3 alone, does that mean they have a very high-functioning pituitary?

### Source 2 — Rosacea, inflammation, and aging: The inefficiency of stress

Ray Peat · Article · 2013 · https://raypeat.com/articles/articles/rosacea-inflammation-aging.shtml

> If the problem is prolonged, the conjuctiva becomes chronically blood-shot, hyperemic, and larger more visible blood vessels grow, surrounding the cornea, or even invading the cornea. Many people, especially women, experienced problems of this sort from wearing contact lenses, especially when the lenses were made of materials very impermeable to oxygen (Dumbleton, et al., 2006).
>
> Sunlight, and mechanical obstruction of the cornea, produce very localized effects, but those local effects are more likely to be harmful when there is a systemic nutritional deficiency or excess of estrogen. When the systemic problem is very severe, the cheeks, nose, and eyes might not be the first tissues to experience a functional disturbance.
>
> The mitochondrial inhibition produced by the action of the parasympathetic nervous system (occurring in simple blushing) can occur wherever those nerves act, and blood vessels in all parts of the body are responsive to the acetylcholine secreted by those nerves. Sleep typically involves a shift of dominance in the autonomic nervous system toward the parasympathetic nerves, with vasodilation. Nosebleeds, especially in children, commonly occur during sleep (Jarjour & Jarjour, 2005: high incidence in sleep, and association with migraine).
>
> A 3 year-old child who had been having an average of 3 nosebleeds every day, during a nap and at night, for several months, also had an extreme behavior problem. He became angry and sometimes violent when he went a little longer than normal between meals. After an oral dose of about ten milligrams of riboflavin, he was able to sleep without having another recurrence of the nosebleeds, and his tantrums became rare. Apparently, the nerve-regulated vasodilation produced by sleep, combined with a riboflavin deficiency, had been enough to produce nosebleeds. The energy deficit resulting from a systemic riboflavin deficiency had probably been causing him to be abnormally sensitive to glycogen depletion, producing sudden anger. In another individual, the energy problem might have taken the form of a memory problem, or of a hemorrhage in the brain or other essential organ.
>
> A 37 year old slightly alcoholic man with a bright red nose and cheeks was an amateur fiction writer, but he was having trouble with his memory for words, and for everyday events. Even conversationally, he had to struggle for relatively familiar words.

### Source 3 — Herb Doctors: Diabetes I

Ray Peat · Interview · Feb 21, 2014 · http://l-i-g-h-t.com/files/herb-doctors-diabetes-I.mp4

> **Ray Peat:** And in hyperglycemia, what you have is the body’s adjustment to the inability of cells to get enough energy, because they can’t oxidize glucose, because the fats are blocking it. That’s been known since the 60’s, called Randle cycle, in which free fatty acids block the use of glucose. So, the thyroxine, the body tries to overcome that poisonous effect of the free fatty acids by increasing glucose production. And so it kind of get around the block just by stuffing more glucose into the blood. So, to a great extent, the rise in blood sugar shouldn't be thought in itself the cause that interferes with the use of glucose, it shouldn’t be concentrated on. And when cells can’t get enough glucose, that not only turns on the stress hormones it turns off the production of thyroid hormone. And so, in all diabetics (if the cell isn’t able to take up and use glucose) the liver becomes unable to activate the pre thyroid hormone, turning it into the active T3. So, supplementing the active T3 thyroid hormone will cure lots of the so-called effects of diabetes. I had an old friend whose toes were basically rotting (because of what was diagnosed as diabetes degenerative nerve and circulation problems in the legs and feet), and 2 weeks after he had started using Armour thyroid, his feet recovered completely. His toes had been black with ulcerated sores going right into the bones, but they completely healed up on thyroid. But we went through 3 cycles in which his doctor said the Armour thyroid is going to increase his blood sugar and make his diabetes worse, so he would tell him to stop it and his feet would start to rotting again. So, it wasn’t just a coincidence: we did it 3 times.

### Source 4 — [EP.18] Georgi Dinkov - on Keto Acids, PUFA, and Kompirin

Georgi Dinkov · Interview · Feb 14, 2022 · https://www.youtube.com/watch?v=gk7dvEWTSlA

> **Georgi Dinkov:** And when this happens, this process releases ammonia. In other words, sick and old people have high levels of ammonia in the blood. Ammonia is known to be extremely toxic. It is also a reductant, a reducing agent. It can cause schizophrenia, mania, depression, recidivism, madness. There is no such diagnosis, but generally, I mean, it can make a person inadequate. And if ammonia levels rise above certain levels, the person dies from the so-called, first falls into the so-called hyperammonemic coma, that is, the ammonia level is very high, and if nothing is done to reduce the ammonia in the blood, at some point metabolism in the brain stops and the person is gone. Usually this is the end; this is the way most chronic alcoholics die. May Ivan Laskin rest in peace; he is perhaps a classic example, as is Batashov, I do not know if you remember, both of them were in the hospital for some time before they passed, but while they were in the hospital they were in a state of so-called hyperammonemic coma of hepatic origin. That is, the liver is what can process ammonia and bind it, I mean, and produce, and if there is enough carbon dioxide, ammonia and carbon dioxide bind and produce a compound called urea, about which Ray Peat also writes, and it is sold everywhere, it can be used as fertilizer, it can be used as medicine, and it is stable. But, so, in order to get rid of ammonia, if you have an excess of ammonia in the tissues, that means you need carbon dioxide; otherwise there is no way to get rid of it. And if your metabolism is not working, then there is no way to get rid of this thing naturally; ammonia accumulates and at some point this person is gone. This happens in people with, in practice, cirrhosis of the liver, or another type of damaged liver, from drugs or something else.

### Source 5 — IdeaLabs Forum Q&A — Diamant

Georgi Dinkov · Forum Q&A · Mar 15, 2017

> **Georgi Dinkov:** There is evidence that the hyperammonemia state often seen in hepatitis and other viral infections is an adaptation with an anti-viral goal. But I digress. A more liphophillic intracellular environment inhibits both the binding of the estrogen to the ER and its translocation to the nucleus. So, the overall effects of adamantane would be functional estrogen antagonism as a result of structural water change, change in cellular pH and change in affinity for water. That is probably the main cause behind its anti-viral effects you mentioned, and also its anti-excitoxic, anti-serotonin, anti-histamine, and anticholinergic effects. The NMDA receptor, histamine, and the cholinergic system are the main mediators of estrogen's effects inside the cell (as Peat has mentioned many times) and the adamantane derivatives have been shown to oppose all of these without any direct interaction. Memantine is marketed as an NMDA antagonist but there is no evidence that it actually binds to and antagonizes that receptor. Same for the opposition to glutamate, acetylcholine and promotion of dopaminergic activity - i.e. none of these have been shown to be directly engaged by any of the adamantane derivatives. I think this is one of the reasons we are not seeing more human trials and approvals - there is no clearly established genomic mechanism of action for any of the adamantane derivatives, and pharma companies do not like to sell a chemical whose mechanism of action is a mysterious "stabilization" of the cell (not sure if they even accept such process to exist). Perhaps more importantly, if adamantane and its derivatives are indeed functional anti-estrogens then this will make them even less palatable to the pharma shills. [references]

### Source 6 — Episode 272 - Carnivore vs. Carbs Debate: Dr. Anthony Chaffee and Georgi Dinkov!

Georgi Dinkov · Interview · Jul 21, 2023 · https://www.youtube.com/watch?v=k_LFfSyUADQ

> **Brian Gryn:** And Georgi, maybe a little bit about the bioenergetic viewpoint.
>
> **Georgi Dinkov:** I think it actually overlaps quite a bit with what Dr. Chaffee just said. For some reason, people think that the bioenergetic or the pterian diet is somehow anti-meat. It is not. In fact, we think it's better to probably eat a meat-based diet as long as you factor in a couple of things. Number one, some insoluble fiber in order to stimulate intestinal motility. When you're eating a high protein, high meat diet, you certainly don't want your digestion to slow because... the microbiome can produce some pretty toxic compounds from meat, such as putrescine, cadaverine. Just the names are basically kind of telling you that these are kind of toxic amines that can be produced from meat if your digestion is not fast enough. And the bioenergetic view basically says you eat all the meat you want as long as you ensure that your digestion is quick so you process the meat properly. Number one, number two, make sure you're eating sufficient amount of carb because the protein... If you're not eating a sufficient amount of carbohydrates, protein is very insulinogenic, at least the one that is in meat is. So it's going to raise your insulin. And basically, once the blood glucose drops, you're going to get a stress reaction. And also, if you don't eat sufficient amount of carbohydrates with the meat... part of that protein will get metabolized into glucose through the process of gluconeogenesis. And we don't want that because the process of deamination of a lot of these amino acids that are in the meat is actually pretty toxic. And you're going to be producing a lot of ammonia. In fact, there are several studies published on the fact that if you eat too much meat and not enough carbs, you could get into a hyperammonemic state, which I think Dr. Chaffee would agree is certainly not optimal. So the biology review, really, it can be kind of...

### Source 7 — #02: Zero-Carb and Carnivore Diet Critique with Ex-Carnivore Kyle Mamounis

Danny Roddy · Interview · May 17, 2019 · https://open.spotify.com/episode/5ngFPotpHRqRbU6OmcHpbB

> **Danny Roddy:** Just to beat a dead horse, but you're saying from your reading, like increasing the hypothalamus, pituitary and adrenal systems because you are artificially restricting carbohydrate. Like, is it good to be chronically running on these systems in your estimation?
>
> **Kyle Mamounis:** Doesn't seem that way.
>
> **Danny Roddy:** What would be some of the detrimental effects? Like you mentioned, even at a subclinical level, you're going to be producing more ammonia, correct? Because of the gluconeogenesis, et cetera.
>
> **Kyle Mamounis:** Yeah. I mean, that's a real long-term kind of problem. But eventually, although for some people, like one of the last AHSs I went to, Chris Masterjohn gave a talk about dangers of protein and there's a couple of genetic disorders where if like people you know just they didn't even know they had it and then they ate like a really high protein low carb meal and just died from that meal because their urea they were like missing one of the enzymes to make urea so their ammonia just went up so high that they you know went into a coma um but yeah for normal people it's just there's no benefit to have basically there's no benefit to having ammonia in the system it's not being made into urea So, and the urea production system is saturable, you know, at a point beyond which you can't, I mean, maybe there's some drug you could take or whatever, but in the, in the like normal natural situation, you can only make so much urea and it doesn't really get upregulated that much if you eat a ton of protein and oxidize that protein and release the ammonia. So that, you know, that could be a problem. I don't really think it's that big of a deal, though.

### Source 8 — Georgi Dinkov and I Discuss Weight Problems | Insulin Resistance

Georgi Dinkov · Interview · Jul 19, 2023 · https://www.youtube.com/watch?v=P02QAZz15CA

> **Georgi Dinkov:** Yeah, one thing, one remedy that works really well if you're already like in a hyperammonemic state is eating Ceylon cinnamon, but specifically the Ceylon type. So it chelates ammonia and converts it into something called hipuric acid, which can be excreted by urine. But basically it's used, the ingredient, it metabolizes the body into something called benzoic acid. And it's actually a proof drug for treating hyperammonemia and brain damage caused by hyperammonemia in children. The drug is called Ucephal, U-C-E-P-H-A-L. But it's really, you can get the exact same effects by eating just, you know, half of a teaspoon of Ceylon cinnamon. And this also will tell you if you have too much, to have an ammonia. Ammonia causes issues with insomnia, with fatigue, with basically muscle pain, kidney pain. If you take the Ceylon cinnamon... And suddenly you feel great. Like basically like your world is a new means you were, you know, either catabolizing too much protein or eating too much.
>
> **High Carb Regenerator:** Oh, well, there's a good test for that. Now you said something about greens, I guess, in the last video and people were asking if it's better to juice greens or eat them.

### Source 9 — The Myths of Supplementation with Giorgi Dinkov

Georgi Dinkov · Interview · Oct 9, 2024 · https://www.youtube.com/watch?v=bHQnx-5PjFM

> **Georgi Dinkov:** It's not. It turns out it's not. It's basically the body rarely generates waste products unless it is under stress. An example of a true waste product would be ammonia. Basically, when you're consuming a lot of protein and you're not utilizing the amino acids for building new tissues, which is what their primary function is and should be. then any excess that the body cannot utilize for building tissues or rebuilding tissues is going to get oxidized as fuel. But in order to get oxidized as fuel, the amino acids first need to have their amino group removed. And then this is the process called deamination. and when you're deaminating amino acids in other words when you're preparing to use them as fuel which is not how they it's not their physiological function then you're generating a waste product ammonia and ammonia is highly toxic to every organ that it touches um and people with liver disease have high levels of ammonia people with kidney disease have high levels of ammonia ammonia itself can damage both of these organs but it's above all most toxic to the brain um You can get into something called hyperammonemic encephalopathy and basically can damage your brain, make you demented or even insane simply because there's a buildup of ammonia because either the liver or the kidneys are not screening properly. But if you're producing sufficient amounts of carbon dioxide, ammonia combines with carbon dioxide and forms urea, which is not only benign, but it's actually helpful. It has a lot of good physiological functions in the body. So since the production of carbon dioxide depends on the metabolic rate very directly, very direct relationship, right? The less carbon dioxide you're producing, by definition, the more ammonia floating around you'll have and the worse things will be.

### Source 10 — 001 Pro-Metabolic Hormones with Georgi Dinkov

Georgi Dinkov · Interview · Feb 27, 2021 · https://open.spotify.com/episode/55VW3kJaaOjlJrxlkh7XFF

> **Host:** Love it. Yeah, it's sort of like when you give your body all of the right things, it can keep everything in its right place. Where sugar is the fuel and protein is the structure. I'm chuckling here because I'm thinking about all the time that I spent trying so hard to lift weights and work out when I was doing carnivore. And I would be absolutely tired. I would need minutes and minutes and minutes and minutes in between my sets. And then I would finally get to the end of my workout, pull myself out of this hypometabolic slump and cook myself a big platter of meat and no carbs. And I would eat this big platter of meat, probably loaded with PUFA. And then I would just, I became so habituated to just feeling awful and totally hypoglycemic afterwards. And of course, now I'm smiling because I'm happy to, you know, be downing milk and maple syrup. That's my favorite right now. A whole bunch of maple syrup with a couple, you know, like maybe a cup and a half of milk. It's awesome.
>
> **Georgi Dinkov:** So a couple of things that I'll add to that. So why the carnivore that usually, it may work initially, but why eventually does not work for bodybuilding? First, without the carbs, a good portion of that extra protein you're eating will get converted to glucose because the body can only utilize, and that's probably a good thing to mention here, the optimal dosage of protein per portion is no more than 30 grams. Anything more than that will get deaminated and I emphasize the word deaminated, which means the amino acids will have their amino group stripped and turn into ammonia. So if you're overdoing the protein, you will be in a state of hyperammonemia, which is not only highly toxic for your brain, but one of the primary effects of that is chronic fatigue. And there are actually drugs on the market that bodybuilders and now actually athletes are starting to abuse, parentheses, abuse, right? And those drugs help you excrete the ammonia more efficiently or chelate it. And it's been shown that these drugs improve cognitive function, improve sleep, improve athletic performance, precisely because ammonia is such a toxic molecule for almost any cell in the body. Now, yes.

### Source 11 — Does sugar cause insulin resistance and make you fat? Ray Peat Criticisms Part 2 with Georgi Dinkov

Georgi Dinkov · Interview · Jun 8, 2021 · https://www.youtube.com/watch?v=yRcXtTjfb-M

> **Georgi Dinkov:** every doctor will tell you if you have a problem with ammonia that's not good it may ruin your kidneys it will poison your brain in fact people they haven't they have a liver issue they usually die like if it's a very advanced liver failure and they don't get a transplant they die for something called hyperammonemic hepatoencephalopathy in other words too much ammonia that the liver could not handle uh is build up and is basically poisoning their brain and because ammonia is toxic um you know it's good for plants but definitely not for us it's a it is a byproduct of our of our metabolism so if you if you if you're eating too much protein in uh instead of carbs and and um and fats then some of that protein actually most of it will actually end up getting metabolized as fuel not it's not going to go some of it will go to building muscle bone etc etc renewing cells but if you're eating too much protein without matching with carbs you actually the body will say okay that's the fuel you're giving me that's the fuel i'll use and then it will try to oxidize these extra amino acids by first cleaving the the ammonia group the amino group and creating ammonia right and then it will still oxidize these sugar to the process of gluconeogenesis which is a very wasteful process it occurs in the liver and in fact it is a process that is upregulated in virtually every chronic disease including diabetes cardiovascular disease cancer and neurodegenerative diseases to the point where now doctors are looking for drugs to block selectively the process of gluconeogenesis hoping that that is a pathway which would cure some of these diseases but i think it's too myopic it's actually they should be looking at why is gluconeogenesis increased it's and the reason is because of elevated cortisol which shreds the muscle provides too many amino acids into the bloodstream and the body has to dispose of them somehow and the the only way that the body knows of other than being them out in your in your urine which is what happens in diabetes another test for diabetes what do you have protein in your blood i'm sorry in your urine then the other thing that about it is only two things you know oxidize them as fuel or excrete them through the urine um and basically so but why again why is gluconeogenesis upregulated cortisol directly upregulated it also provides it with that fuel uh from by shredding your soft tissues and bones pretty much everything cortisol is the master catabolic hormone among among other things even though it's anti-inflammatory So basically if you have upregulated gluconeogenesis, chances are your cortisol is high, which is corroborated by those human studies with a cortisol blocker, which essentially cured their type two diabetes and drastically reduced gluconeogenesis.

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