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Early physical symptoms of elevated blood ammonia include fatigue, muscle weakness, loss of appetite, nausea, vomiting, diarrhea, pain in the back, sides or abdomen, or other symptoms of liver and kidney damage.
Ammonia is a toxic compound that mainly damages the brain. The effects of an acute increase in plasma ammonia should be distinguished from chronic moderate increases. In the classical model of hepatic encephalopathy (secondary to liver cir-rhosis), ammonia plays a pivotal role in the genesis of neurological symptoms. Fac-