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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 one of the by-products of protein metabolism. Elevated blood ammonia levels have been associated with severe liver dysfunction such as hepatic encephalopathy, coma resulting from cirrhosis, severe hepatitis, Reye's syndrome, and drug hepatotoxicity. Also, elevated blood ammonia has been reported in cardiac failure, azotemia, and pulmonary emphysema.