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Ammonia blood test
Serum ammonia
The ammonia test measures the level of ammonia in a blood sample.
How the Test is Performed
A blood sample is needed.
Blood sample
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
How to Prepare for the Test
Your health care provider may ask you to stop taking certain drugs that may affect test results. These include:
- Alcohol
- Acetazolomide
- Narcotics
- Valproic acid
You should not smoke before your blood is drawn.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.
Why the Test is Performed
Ammonia (NH3) is produced by cells throughout the body, especially the intestines, liver, and kidneys. Most of the ammonia produced in the body is used by the liver to produce urea. Urea is also a waste product, but it is much less toxic than ammonia. Ammonia is especially toxic to the brain. It can cause confusion, lethargy , and sometimes coma.
Lethargy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
This test may be done if you have, or your provider thinks you have, a condition that may cause a toxic buildup of ammonia. It is most commonly used to diagnose and monitor hepatic encephalopathy , a severe liver disease.
Hepatic encephalopathy
Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy. This problem may occ...
Normal Results
The normal range is 15 to 45 micrograms per deciliter (mcg/dL) or 10.71 to 32.13 micromoles per liter (micromol/L).
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
Abnormal results may mean you have increased ammonia levels in your blood. This may be due to any of the following:
-
Heart failure
Heart failure
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Gastrointestinal (GI) bleeding
, usually in the upper GI tract
Gastrointestinal (GI) bleeding
Gastrointestinal (GI) bleeding refers to any bleeding that starts in the gastrointestinal tract. Bleeding may come from any site along the GI tract, ...
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- High body temperature (hyperthermia)
- Leukemia
- Liver failure
-
Low blood potassium level
Low blood potassium level
Low potassium level is a condition in which the amount of potassium in the blood is lower than normal. The medical name of this condition is hypokal...
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A high-protein diet can also raise the blood ammonia level.
Risks
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
References
Nevah MI, Fallon MB. Hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, and other systemic complications of liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 94.
Pincus MR, Tierno PM, Fenelus M, Bowne WB, Bluth MH. Evaluation of liver function. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 21.
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Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
-
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
Review Date: 2/8/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
