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On a more subtle level, the effect of ammonia on the brain include reduced cognition, lack of focus, diminished motivation, loss of sense of self, heightened emotionality and extreme mental fog. All commonly found symptoms these days.
The liver normally converts ammonia into urea, which is then eliminated in urine. Ammonia levels in the blood rise when the liver is not able to convert ammonia to urea. This may be caused by cirrhosis or severe hepatitis. Take enough lactulose to have 3-4 bowel movements per day and your ammonia level will drop and you will feel better.