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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.
Dehydration causes your urine to be more concentrated and may have a stronger smell than normal, as do high-protein foods like meat and eggs. Menopause, some sexually transmitted diseases, and certain metabolic disorders may also increase the ammonia smell.