How Is Low Serum Ammonia Related To Hypertension?

[yerrag]

I was reviewing my blood tests from a few years back, and I caught something that I missed before:

my serum ammonia tests less than 9 umol/L (with range being 9-30)

I did a search, and only came up with a remark from labtestsonline.org that says low ammonia is related to hypertension

I couldn't get any more useful search results. Note that most search results talk about high ammonia. Even searches that would seem to answer the question of low ammonia turn out discussing about high ammonia.

Does anyone know? @haidut @Mito @aguilaroja

 

[yerrag]

I did a few more searches and am just trying to connect the dots from what I'm finding:

low ammonia
hypertension
urea cycle - produces arginine out of ammonia on the way to becoming urea
arginine - used to make vasopressin
vasopressin - anti-diuretic hormone (ADH), used to regulate urination; too low ADH results in excess urination and hypovolemia
hypovolemia - low blood volume

Low ammonia leads to low arginine to low vasopressin, leading to excess urination. Excess urination leads to hypovolemia. Hypovolemia leads to high blood pressure.

 

[Ella]

Do you have results for serum ammonia and urea?

Were you eating adequate protein when urine test was done? You may have started the high fruit diet perhaps and the higher potassium may explain low ammonia.

High potassium intake reduces ammonia excretion while depleted potassium cause high excretion levels of ammonia in urine.

The connection between low ammonia in urine and hypertension has to do with kidneys have difficulty in excreting ammonia causing high levels in blood; it crosses blood brain barrier rapidly where it is extremely toxic. It can cause headaches which are common with hypertension.

Dr Peat advocates the beneficial use of the potato water and fruit due to their high keto acids. These ketoacids are able to recycle the excess ammonia into amino acids for the body to use. If this is the situation with you, the low ammonia may not be an issue. This would be a positive outcome. If you are free of headaches then it may very well be the case. However, if headaches are a common occurrence with the hypertension; I would seek to mop up excess ammonia from the system. Calcium has a role here.

By including fruit and potato ketoacids in your diet, you would have reduced need for heme protein.

Look forward to your blood pressure coming down.

 

[yerrag]

It's actually my serum ammonia being low, not urine ammonia. I only noticed it being low, but the test was taken 2 years ago and I wasn't on a fruit diet.

I'll take another serum ammonia test tomorrow to see if the last test was in error.

 

[aguilaroja]

before:
serum ammonia tests less than 9 umol/L (with range being 9-30)
/QUOTE]
As with other lab tests, context counts for a lot, despite some recent physician if-this-then default conditioning. It is probably hard to know what, if anything, the value represented two years ago, especially if there were no pressing health issues.
Low serum ammonia would not be on a list of common lab findings for investigating hypertension.

 

[yerrag]

Do you have results for serum ammonia and urea?

Feb 6: BUN was 4mmol/L (range 2.18-8.33).

As with other lab tests, context counts for a lot, despite some recent physician if-this-then default conditioning. It is probably hard to know what, if anything, the value represented two years ago, especially if there were no pressing health issues.
Low serum ammonia would not be on a list of common lab findings for investigating hypertension.

I overlooked this piece of seemingly trivial data 2 years ago, but I already had hypertension then.

It's either I was producing too little ammonia, or I was clearing too much ammonia.

I don't know if I should be making anything out of my BUN being on the low side of range and my creatinine being on the high side of range: Creatinine 103 umol/L (range 59-104)

 

[Ella]

A result from 2 yrs ago has no relevance on current health status. Damage to liver can result in low BUN result and high creatinine, kidneys not working optimally. You may have been dehydrated when test was done. Proper hydration has a huge impact on physiology, blood pressure and blood volume. Individuals experiencing peeing in the early hours tend to reduce their fluids in an attempt to stop the noctural trips to the loo which results in extreme dehydration.

Do you drink mineral water throughout the day? Choosing one rich in calcium will add to your calcium intake. Check label and stay away from the iron rich ones.

 

[yerrag]

A result from 2 yrs ago has no relevance on current health status. Damage to liver can result in low BUN result and high creatinine, kidneys not working optimally. You may have been dehydrated when test was done. Proper hydration has a huge impact on physiology, blood pressure and blood volume. Individuals experiencing peeing in the early hours tend to reduce their fluids in an attempt to stop the noctural trips to the loo which results in extreme dehydration.

My state may be different from 2 years back, but what's common is that I still have hypertension. The BUN and creatinine values are current though, and the BUN/Creatinine Ratio, at around 40, is out of range, as based on Dr. Weatherby's reference and optimal range, reference being from 7-14, and optimal being 13-17. But that should be seen in the context of me having a high creatinine value of 103, with the reference and optimal ranges being at 53.0- 132.6 and 70.7-97.2, respectively.

If based strictly (and this may be wrong) on the BUN-Creatinine Ratio, I don't have renal disease, but eat either a low-protein diet or have posterior pituitary dysfunction. But I have never been on low protein except for 2 weeks of being on a fruit fast just a month ago.

I'm attaching Dr. Weatherby's blood chemistry cheat sheet that has been very helpful.

 

[Ella]

What is your current GFR? Since you have been dealing with uncontrolled hypertension for some time, I would stop with the what ifs on blood tests and have kidneys, heart and liver investigated by ultrasound. Especially with the elevated LDH. This will show if there has been damage done. Your dr will probably have a fit re your reluctance to take bp medications, but I am sure you can find a dr who is prepared to work with you. If damage is found, your focus can be diverted to regeneration and repair.

 

[yerrag]

What is your current GFR? Since you have been dealing with uncontrolled hypertension for some time, I would stop with the what ifs on blood tests and have kidneys, heart and liver investigated by ultrasound. Especially with the elevated LDH. This will show if there has been damage done. Your dr will probably have a fit re your reluctance to take bp medications, but I am sure you can find a dr who is prepared to work with you. If damage is found, your focus can be diverted to regeneration and repair.

I would rather not spend on ultrasound and rely on doctors' interpretations, which I don't trust tbh. They would just uncover artifacts that they would blow up to a major issue, making a mountain out of a molehill, as that is their business model.

My eGFR is at 65, which isn't good. But it's an "e" which is based simply on creatinine, which is derived from an oversimplification based on race, sex, and age, which is done out of convenience at the expense of accuracy.

I'll take a 24hr urine collection to get a better estimate, and compare it to an eGFR that incorporates both creatinine and cystatin C.

I know ultrasound is safe, but after spending a sum on it, its accuracy is still subject to technician skill as well as the skill of the interpreter. It's basically an expensive black box, for which I have to entirely put my trust on a system that has failed a lot. I like to know what's going on, and this is the reason I shy away from shamans, and even TCM, even if they merit consideration. It's just that there are a 100 shamans for every skilled shaman. I don't want to play dice.

I have identified relatively inexpensive markers in ammonia, BUN, and creatinine, that point strongly to a problem with ammonia and urea being low. I could be more amenable to a test for ADH or vasopressin, which is costly at $160, but this still gives me more information that an ultrasound. As my objective is to find the root cause, there's little that an ultrasound can do in this respect.

I've been to many doctors, both conventional and naturopathic, and there's a snowball's chance in hell I can find one that's free of mechanically following to the script. They only end up giving me false leads and harming me, both in health and in finance.

 

[Ella]

My eGFR is at 65, which isn't good. But it's an "e" which is based simply on creatinine, which is derived from an oversimplification based on race, sex, and age, which is done out of convenience at the expense of accuracy.

Kidneys are only performing at 65 capacity. Your goal is to get the blood pressure under control as not only kidneys have been compromised but also heart and those tiny vessels at the back of the eye. I like ultrasound for kidney as this gives an in vivo on how efficiently kidneys are filtering - there is no guessing or estimating. Same with the heart, we want to see the structural integrity of the heart, chambers, aorta, values etc. and pumping capacity. Just don't talk or distract the technician when they are doing their measuring and calculations :)

incorporates both creatinine and cystatin C

Including cystatin C would be interesting as it is not only a marker for kidney function but more importantly also heart and cardiovascular disease. It has been found that even in patients with > 60 gfr a high cystatin C is a high risk for heart failure and death. However it too similar to creatinine, is variable as it is now known that cystatin C level may be affected by factors other than kidney function, including sex, race, obesity, greater height, current cigarette smoking, thyroid function, inflammation, glucocorticoid function, and malignancy. It is expressed in all cells with a nucleus and found in virtually all tissues and body fluids. It prevents the break down of protein by proteinases outside the cell. If gfr is low, ldh high, uric acid high, then I am hedging my bets on cystatin C will come in a tad on the high side unless you are guzzling heaps of coffee.

Again focus should be on regeneration. Pulse rate needs to be kept at the higher end 90+. Walter Kempnar's rice and fruit diet originally was designed to treat malignant hypertension. As the name implies; hypertension that kills. Valter Longo's Fasting Mimicking Diet is also impressive when it comes to regeneration and increasing stem cells.

If cystatin C comes in high, it will open up another can of worms.

When you go to the dr, you can take the script but you don't have to take the meds. If you are able to keep bp at 140/90, you should not have to go lower than this and dr can't force you. Yes I know they bully and get paranoid, they are under a lot of pressure to stick to standard protocol and yes they can sack non-compliant patients. You need to pander to their insecurities, try not to argue, you need them just in case. Look for a good one and pray they don't die on you. I don't know your age but in my earlier days in the hospital (decades ago) it use to be your age + 100. I have the opposite problem to you, I have to work hard to get my bp to 140/90 and I am much older than 40. I don't feel energetic when it is below 120/70.

Work on taming adrenaline by eating every 3 hrs and focus on improving liver function and its ability store glycogen, preventing blood sugar drops. I know its hard work and people always underestimate how much effort it takes but if you want be be around a long time it is worth it.

Aspirin and beta blockers have been associated with lower Cystatin C. Coffee also can lower it and increase gfr.

https://www.hindawi.com/journals/jnme/2011/146865/

 

[yerrag]

Kidneys are only performing at 65 capacity. Your goal is to get the blood pressure under control as not only kidneys have been compromised but also heart and those tiny vessels at the back of the eye. I like ultrasound for kidney as this gives an in vivo on how efficiently kidneys are filtering - there is no guessing or estimating. Same with the heart, we want to see the structural integrity of the heart, chambers, aorta, values etc. and pumping capacity. Just don't talk or distract the technician when they are doing their measuring and calculations :)

I'm not so sure it's at 65% as the eGFR value is based on a flawed model, being that it relies solely on creatinine to determine eGFR. I've done creatinine clearance computations using 24hr urine collection and the value I get is 105 instead of 65. So, I'd have to get an eGFR using creatinine and cystatin C to get a clearer picture of my GFR.

It would be interesting to get an ultrasound, but I'm more disposed at the moment to see my high blood pressure as a matter of hypovolemia:

Work = Force x Distance; Force= Pressure x Area; Work = Pressure x Area x Distance; Volume = Area x Distance;
therefore :

Work = Pressure x Volume

Work1 = Work2; P1V1 = P2V2;

If V2 < V1; P2 > P1

V1 represents normovolemia (or normal blood volume) while V2 represents hypovolemia; under hypovolemia, pressure (P2) is higher.

Why am I hypovolemic, that should be the question. The signs point to hypovolemia being the cause of my high blood pressure. My high RBC, hemoglobin, and hematocrit point to dehydration, which is in this context the same as being hypovolemic. Low ammonia, and a low BUN/Creatinine ratio point points to a posterior pituitary dsyfunction. How do I test for a posterior pituitary dysfunction? If I can't, how can I increase my serum ammonia? What are the implications of a low serum ammonia? Would I lose having ammonium as a cation in pairing with acidic anions to be secreted in urine, as part of the kidney's role to achieve acid-base balance? What will substitute for ammonium in this role? Will it be electrolyte cations such as potassium, magnesium, calcium, and sodium? If so, will I be constantly losing these electrolytes through urine? Is this why I have to urinate so often (regardless of whether I am deficient in arginine and vasopressin)? And if I'm constantly losing these electrolytes, would it then result in me losing the osmolarity needed to build blood volume?

Perhaps I should do a 24hr urine collection and test for how much electrolytes and ammonia I'm urinating. This would be a verification of my suspicions.

 

[Ella]

How do I test for a posterior pituitary dysfunction?

I have provided the solution many times and you keep skirting around it. Dr Peat has guided you and you keep wanting to going down rabbit holes.

Let's tackle it from the belief you may be deficient in vasopressin?

Do you know which ion controls the release of vasopressin? If so, it may be the reason you are low in vasopressin. If you are low in vasopressin you will also be low in many other glandular secretions because this ion is the master controller of all secretions. There need be no damage to the gland, only lack or deficiency of the signalling ion.

If you test for vasopressin in a state of deficiency, you will naturally be low in vasopressin. Then what do you do? Supplement vasopressin?? What about all those other secretions which are controlled by this ion for example; secretion of HCL, secretion of insulin, secretion of saliva, thyroid, parathyroid, neurotransmitters, too many, its the mother of all secretions.

If you understand which ion it is, then you can test to see if posterior pituitary is faulty. Increase the ion and see what happens. Test vasopressin in depleted state and then test in replete state. You need some understanding of electrophysiology or electrochemistry as we are body electra and our cells function as batteries.

Now if there is a master ion of secretion, then there must exist an opposing ion which can inhibit secretion. Perhaps under some misunderstanding you may be massively supplementing this inhibiting ion because it has been relegated to super star status. So you inadvertently go inhibiting all manner of secretions. So is the problem with the gland or is it with upsetting the delicate balance?
https://www.physiology.org/doi/full/10.1152/advan.90213.2008

 

[yerrag]

My state may be different from 2 years back, but what's common is that I still have hypertension. The BUN and creatinine values are current though, and the BUN/Creatinine Ratio, at around 40, is out of range, as based on Dr. Weatherby's reference and optimal range, reference being from 7-14, and optimal being 13-17. But that should be seen in the context of me having a high creatinine value of 103, with the reference and optimal ranges being at 53.0- 132.6 and 70.7-97.2, respectively.

If based strictly (and this may be wrong) on the BUN-Creatinine Ratio, I don't have renal disease, but eat either a low-protein diet or have posterior pituitary dysfunction. But I have never been on low protein except for 2 weeks of being on a fruit fast just a month ago.

Just to recap on my Ammonia, BUN, Creatinine, and BUN/Creatinine Ratio:

Ammonia: <9 umol/L (range 9-30)
BUN: 11.20 mg/dL (range: 5-25; optimal: 10-16)*
Creatinine: 1.15 mg/dL (range: 0.6-1.5; optimal: 0.8-1.1)*
BUN/Creatinine: 9.74 (range:7-18; optimal: 10-16)*

*Based on Dr. Weatherby's cheat sheet

I had to recap as I got some some values and consequently my conclusions were affected. There's actually not much wrong with my BUN, Creatinine, and BUN/Creatinine readings. The only issue I have is my having very low serum ammonia. So I have to lower my DEFCON Alert level

This makes my conclusion on the possibility of posterior pituitary dysfunction weaker, as I only have the low serum ammonia to stand on. And if the coming test to confirm my low serum ammonia from 2 years back fails to do so, then out goes that possibility.

I have provided the solution many times and you keep skirting around it. Dr Peat has guided you and you keep wanting to going down rabbit holes.

I'm not skirting around. I'm being open to another possibility.

Do you know which ion controls the release of vasopressin? If so, it may be the reason you are low in vasopressin. If you are low in vasopressin you will also be low in many other glandular secretions because this ion is the master controller of all secretions. There need be no damage to the gland, only lack or deficiency of the signalling ion.

You refer to calcium. It may be the reason I am low in vasopressin, as you say. But it could also be I am low in vasopressin because I am low in arginine. And because arginine is produced in the urea cycle, I also have to have sufficient ammonia as an input reactant. If I'm low in ammonia, I won't produce enough arginine, and I won't have enough vasopressin. As indicated earlier, my serum ammonia is less than 9 umol/L (reference is 9-30).

If you test for vasopressin in a state of deficiency, you will naturally be low in vasopressin. Then what do you do? Supplement vasopressin?? What about all those other secretions which are controlled by this ion for example; secretion of HCL, secretion of insulin, secretion of saliva, thyroid, parathyroid, neurotransmitters, too many, its the mother of all secretions.

I could supplement vasopressin, or its precursor arginine, or I could also take urea.

The other secretions are doing just fine. I have no blood sugar issues, have no hypochlorydia, have no digestive enzyme deficiency, am euthyroid, etc.

If you understand which ion it is, then you can test to see if posterior pituitary is faulty. Increase the ion and see what happens. Test vasopressin in depleted state and then test in replete state. You need some understanding of electrophysiology or electrochemistry as we are body electra and our cells function as batteries.

I've begun supplementing calcium and drinking more milk. Today I observed higher heart rate in the mid80s, but along with that my blood pressure shot up. Maybe the body was jolted. I'll wait for it to come to a steady state condition to properly gauge its effect.

Now if there is a master ion of secretion, then there must exist an opposing ion which can inhibit secretion. Perhaps under some misunderstanding you may be massively supplementing this inhibiting ion because it has been relegated to super star status. So you inadvertently go inhibiting all manner of secretions. So is the problem with the gland or is it with upsetting the delicate balance?

Since you prefer to be cryptic, let me unpack it for you. Are you referring to my use of magnesium. I don't know how you got the impression magnesium became a superstar, or perhaps that is your way of being sarcastic? It depends on how you see my intake of magnesium. I see it as serving 2 purposes - first, ridding the body of lead toxicity, along with vitamin C, and if your calcium came late into the game I apologize. And secondly, to address a deficiency in magnesium stores. I now realize I should have taken more calcium as well, thanks to your untiring efforts.

But I must remind you that my issue with hypertension preceded my past 2 years of magnesium intake, and my hypovolemic condition (as seen in my high RBC, HGB, and HCYT numbers from way back) goes further back.

I hope you are right though, that my calcium deficiency is at the root of it, and that it also extends far back.

Thanks for the big help!

 

[Ella]

Today I observed higher heart rate in the mid80s, but along with that my blood pressure shot up. Maybe the body was jolted. I'll wait for it to come to a steady state condition to properly gauge its effect.

Mid 80s is impressive As mentioned previously, you need to get over 90 to increase regeneration of tissue damage. In the low 60s your are going to achieve ***t; well actually no ***t - slow transit. With a sudden input of calcium, you need to expect some equilibrating of the other alkaline minerals; sodium, potassium and magnesium along with the flushing out of more lead, cadmium, aluminium and god knows what else. Heavy metals are ambiquitous in the environment, not just in your supplements. Bones take 7 years to completely renew, so calcium needs to be in the diet in order to displace lead from taking its position in bone. Also to protect against radioactive elements. There is no fear of heavy metals if we are eating a mineral rich diet. The body, enzymes will grab the heavy metals or an inferior metal to see it through drought times but they are not ideal for optimal function and deleterious long term.

If you were dealing with high lead levels in the past, it indicates a lack of calcium and perhaps a catabolic state as the lead may have been coming from bones. Again indicating insufficient calcium in the diet. How do you know you actually got rid of the lead? Lead is able to take up position in bone marrow and stimulate the production of RBCs. We see similar with aluminium. In your attempt to rid the body of lead, you may have redistributed the lead to different compartments. Just putting it out there because I see this all the time. What is stimulating the increased production of RBCs?

Are you referring to my use of magnesium. I don't know how you got the impression magnesium became a superstar, or perhaps that is your way of being sarcastic? It depends on how you see my intake of magnesium.

I was not referring to you specifically, it is just what everyone does. They all supplement with magnesium paying little attention to their calcium needs and little importance on the balance of other minerals. Of course its a super star. Magnesium has its own superhero; Magnesium Man Morely, Caroline Dean has given it miracle status with her own brand Miracle Magnesium, ReMag.

Dr Peat comes along and says sodium can exchange for magnesium in maintaining alkalinity. Drink coffee, it is rich in magnesium, drink water from leafy greens a couple times a week and eat lots of juicy fruit high in magnesium and its buddy potassium. More importantly he tells us the root cause of why we lose so much magnesium; if you are having such a difficult time hanging onto magnesium then perhaps your thyroid needs optimising. Peat knocks magnesium off its throne, reminding us that magnesium is not the star player. His coffee is a milk coffee + sugar being mindful of balancing magnesium with its buddy calcium. His OJ is salted, again mindful of the balance between potassium, sodium and magnesium. OJ is balanced with equal amounts of milk/cheese. Peat thinks very deeply but I don't think many understand the importance of his reasoning. People will adopt the bits and pieces that appeal, then experience problems and blame Peat because it does not work for them. Everyone who has bp knows to supplement magnesium paying little attention to the balance of other alkaline minerals. Yet potassium, calcium and sodium also have equally important roles.

Dr Peat does equal amounts of OJ and milk and people miss the reasoning why. I don't favour calcium over the other minerals but from my experience in working in this area, I have never seen a case of optimal calcium. Calcium dysregulation is rampant. Usually, anyone with high bp is on up to 3 bp medications and still struggle, believing, it is the curse of their genes. All the family has high bp, grandma had it or uncle harry has it. No ******* wonder, they are all eating the same SAD diet, terrified of milk and fruit, skimp and skipping meals, exercising like hell and guzzling coffee with a drop of milk if any. Yes, they are cutting sugar because they know very well; sugar is bad for their bp and diabetes is next for them.

I have witnessed amazing changes in people's health conditions from anxiety, low energy states, bp, sleep problems, hormonal and fertility, behavioural problems in children and adults, digestive problems, endotoxemia, rescuing catabolic states in the elderly, protection from heavy metals as well as ridding the body of these metals. Don't get me wrong; its not that I place less importance on magnesium; each of the alkaline minerals have their role to play and they are equally important. It is when we focus on one over its buddies that we create imbalances.

to address a deficiency in magnesium stores.

I was not singling you out and had no idea whether you where supplementing magnesium or not. However, if vasopressin is low; then you have to rule out magnesium supplementation. Magnesium inhibits the secretion of vasopressin and calcium is required to release it. I think we have known this since before 1960s. Your PTH is on the high side, so calcium and high phosphate are implicated. The high phosphate increases your calcium needs unless you are doing lots of fruit and sugar. High phosphate is problematic for kidneys. I recall you were having 1 cup of milk + calcium carbonate; which begs the question whether you are getting adequate calcium in the background of magnesium supplementation and high phosphate. Yes, the sarcasm was intended and make no apologies for it. One more thing, if you have reduced kidney function, supplementing with magnesium will cause you to accumulate too much due to kidneys inability to filter it.

If you have difficulty in hanging onto magnesium and you are doing coffee , OJ, lots fruit and juices; perhaps thyroid may require further optimisation. We don't have rT3; so it brings thyroid hormones into question.

You can't be serious about arginine. I could not think of a more problematic solution than arginine and don't understand why you would even want more ammonia since it is extremely poisonous to cells. High ammonia kills. If you are truly concerned in the protection of tissues and organs then you would not want to promote more ammonia and nitric oxide. Perhaps you are extremely efficient at removing ammonia. May be you have lots of CO2 at your disposal. As you said there is nothing wrong with your BUN/creatinine, so ammonia is being dealt with efficiently.

Remember, those ranges are based on the average population. Not on an optimised healthy population who avoid high arginine foods like grains, nuts and seeds. Meat and diary contain arginine and should provide adequate. If serum ammonia is low, then you must be doing something right. I don't know which population studies this dr who created the cheat sheet based his normal and optimised ranges on.

There are conditions that can result in arginine deficiency and I will only discuss the most likely. If you are of Asian background, African, Arabic or Italian then you need to rule out sickle cell anemia and whether you are a carrier for the gene SNP which makes you resistant to malaria parasite. If so, your needs for riboflavin will be higher, as it is required to activate B1, B3, B6, B12 and folate. If you supplement the others and neglect riboflavin, supplementing with the others will place you in a deficient state for B2. If this is the case, then you will experience higher levels of ROS = equals tissue damage and so much more.

What did your blood smears reveal? Why were you supplementing B12? Deficiency? Were you ever diagnosed with hemolytic anemia?

There are conditions in which an arginine-deficient state may be desirable. For example, some tumor cells are auxotrophic for arginine and undergo cell cycle arrest and apoptosis in response to arginine deprivation. Thus, intravenous administration of pegylated derivatives of recombinant mammalian arginase or microbial arginine deiminase to create arginine deficiency is being explored as part of therapeutic strategies for some types of cancer (e.g., [46, 47].

Ammonia, like nitric oxide, inhibits respiration, and can increase the Crabtree effect (with aerobic glycolysis stimulated by increased glucose, inhibiting respiration). This suggests an important role for it in cancer in general, and especially in liver cancer. In the uncontrolled glycolysis of cancer, ammonia can be used to form amino acids from the lactate and pyruvate produced by glycolysis, supporting growth of the tumor at the expense of the normal tissues that are producing ammonia by protein degradation.”

Nitric oxide, associated with unbalanced excitation, is involved in the nerve damage of epilepsy, amyotrophic lateral sclerosis, Parkinson’s disease, Alzheimer’s disease, and Huntington’s disease. An energy deficit increases excitation and cellular calcium uptake, increasing nitric oxide synthesis (Schulz, et aI., 1997). Nitric oxide increases the ratio of glutamate to GABA (“the excitotoxicity index”), (Demchenko & Piantadosi, 2006), while lowering mitochondrial energy production.

“Stress increases nitric oxide, and an excess of that poisons mitochondrial energy production, making stress worse. The right amount of coffee inhibits nitric oxide and so improves energy efficiency. Nitric oxide increases parathyroid hormone and aldosterone, which increase blood pressure. Vitamin D and vitamin K lower those.”

“A localized stress or irritation at first produces vasodilation that increases the delivery of blood to the tissues, allowing them to compensate for the stress by producing more energy. Some of the agents that produce vasodilation also reduce oxygen consumption (nitric oxide, for example), helping to restore a normal oxygen tension to the tissue. Hypoxia itself (produced by factors other than irritation) can induce vasodilation, and if prolonged sufficiently, tends to produce neovascularization and fibrosis.

“Lactate, glutamate, ammonium, nitric oxide, quinolinate, estrogen, histamine, aminolevulinate, porphyrin, ultraviolet light, polyunsaturated fatty acids and endotoxin contribute to excitatory and excitotoxic processes, vasodilation, angioneogenesis, and fibrosis.”

“PTH (like estrogen) causes mast cells to release promoters of inflammation, including histamine and serotonin. Serotonin and nitric oxide contribute to increasing PTH secretion.”

“Substances such as PTH, nitric oxide, serotonin, cortisol, aldosterone, estrogen, thyroid
stimulating hormone, and prolactin have regulatory and adaptive functions that are essential, but that ideally should act only intermittently, producing changes that are needed momentarily. When the environment is too stressful, or when nutrition isn’t adequate, the organism may be unable to mobilize the opposing and complementary substances to stop their actions.”

I don't know why the hesitation of doing ultrasound investigation of kidney, liver and heart. If you have been dealing with the same issue for a long time, then I would investigate further. The high uric acid is from dna damage which implies tissue damage. and not just hemolysis of rbcs.

I suggest the organic acid test to explore for b-vitamin status and other nutritional markers like vitamin C + other metabolites to gain an in depth insight. Plus investigation of blood smears if this has not be done to date. If nutritional deficiencies are found, you need to ask, for what reason are you not able to get from your diet. Is your diet restrictive, inadequate or is there ongoing damage, inflammation that is causing the malabsorption of these nutrients. Is there damage to liver, gallbladder, spleen, pancreas which is preventing absorption of specific vitamins. What about gut flora, are they stealing nutrients, favouring pathogens, producing toxic metabolites, parasites etc.

You said your digestion was fine. Why supplement B12? You eat plenty heme protein, liver, shellfish, then why can't you absorb B12. Brings us back to calcium being the master controller of secretions; is required to secrete intrinsic factor to absorb B12. Magnesium will inhibit the release of intrinsic factor. The more I write this, the more I am starting to think conspiracy against calcium. So I should stop and go tend to my orchard.

I am not saying calcium will fix whatever is wrong with you but you want to get the basics right before looking at the scarier scenarios. However adhering to that golden ratio of calcium to phosphate goes a long way in preventing scary outcomes.

 

[yerrag]

Mid 80s is impressive As mentioned previously, you need to get over 90 to increase regeneration of tissue damage. In the low 60s your are going to achieve ***t; well actually no ***t - slow transit. With a sudden input of calcium, you need to expect some equilibrating of the other alkaline minerals; sodium, potassium and magnesium along with the flushing out of more lead, cadmium, aluminium and god knows what else. Heavy metals are ambiquitous in the environment, not just in your supplements. Bones take 7 years to completely renew, so calcium needs to be in the diet in order to displace lead from taking its position in bone. Also to protect against radioactive elements. There is no fear of heavy metals if we are eating a mineral rich diet. The body, enzymes will grab the heavy metals or an inferior metal to see it through drought times but they are not ideal for optimal function and deleterious long term.

If you were dealing with high lead levels in the past, it indicates a lack of calcium and perhaps a catabolic state as the lead may have been coming from bones. Again indicating insufficient calcium in the diet. How do you know you actually got rid of the lead? Lead is able to take up position in bone marrow and stimulate the production of RBCs. We see similar with aluminium. In your attempt to rid the body of lead, you may have redistributed the lead to different compartments. Just putting it out there because I see this all the time. What is stimulating the increased production of RBCs?

I'm going to say that I'm crossing out tissue damage as a cause of my high LDH. My LDH is not high as in cancer-level high. It's just getting in and out of high range. And it's looking like it's the result of high RBC, being that RBC uses the anaerobic glycolysis pathway for energy production, and relies of LDH enzyme to catalyze the process.

I'm also going to assume that lead isn't the primary driver of my hypertension. When it was determined that l have lead toxicity, it had to take a provoked test to make that determination. A provoked challenge test is needed to draw out lead that's stored in fat tissue, where it's not creating harm. I had been focused on lead toxicity as the primary driver for my hypertension, and this misplaced focus has kept me away from eploring other causes.

That I had and have been calcium-deficient is true. I wasn't a heavy milk drinker, nor cheese eater, nor have the habit of eating huge amounts of cooked greens. It's only been a year since I began eating plenty of cooked greens, and I'm still not drinking more than 1 cup of milk each day. But to say my hypertension is primarily driven by low calcium may once again lead me on a detour. If calcium deficiency were such a factor for hypertension, there would be much more people suffering from it. But it's entirely possible, as you say, that low calcium made me prone to collect lead in my body, and this can't be ruled out. So it is that I would keep true to increasing my calcium intake (food plus supplementation) and decreasing phosphate intake. The latter I've already been on for at least a year. Am continuing to log my results and hopefully i'll see a gradual and significant reduction in my blood pressure.

Everyone who has bp knows to supplement magnesium paying little attention to the balance of other alkaline minerals. Yet potassium, calcium and sodium also have equally important roles.

Guilty as charged, but have been a recovering with my Magnesium Anonynous group. I'm now getting my magnesium mostly from cooked greens, potassium for fresh fruit juice. And leaving sodium as is, with enough salt incorporated in my cooked foods (which is salty enough as is). With calcium, I had been mixing eggshell calcium with food such as my sunny-side up egg, and drinking a glass of milk, as well as in eating cooked greens. That may not be enough still, so I started with taking 1600 mg calcium from eggshell powder with water to chase it down, but now I'm reacting the eggshell powder with acetic acid to convert it to calcium acetate, and then just mixing it with my fruit juices.

I'm hoping that's balanced enough. Will see how this works out.

Dr Peat does equal amounts of OJ and milk and people miss the reasoning why. I don't favour calcium over the other minerals but from my experience in working in this area, I have never seen a case of optimal calcium. Calcium dysregulation is rampant. Usually, anyone with high bp is on up to 3 bp medications and still struggle, believing, it is the curse of their genes. All the family has high bp, grandma had it or uncle harry has it. No ******* wonder, they are all eating the same SAD diet, terrified of milk and fruit, skimp and skipping meals, exercising like hell and guzzling coffee with a drop of milk if any. Yes, they are cutting sugar because they know very well; sugar is bad for their bp and diabetes is next for them.

My siblings don't have high bp, yet I'm pretty sure they're ****88 up calcium-wise. Yet, with my extreme hypertension, I'm doing better than all of them health-wise. Not that any one of us has cancer, nor take any maintenance drugs.

I was not singling you out and had no idea whether you where supplementing magnesium or not. However, if vasopressin is low; then you have to rule out magnesium supplementation. Magnesium inhibits the secretion of vasopressin and calcium is required to release it. I think we have known this since before 1960s. Your PTH is on the high side, so calcium and high phosphate are implicated. The high phosphate increases your calcium needs unless you are doing lots of fruit and sugar. High phosphate is problematic for kidneys. I recall you were having 1 cup of milk + calcium carbonate; which begs the question whether you are getting adequate calcium in the background of magnesium supplementation and high phosphate. Yes, the sarcasm was intended and make no apologies for it. One more thing, if you have reduced kidney function, supplementing with magnesium will cause you to accumulate too much due to kidneys inability to filter it.

I could probably do a kidney ultrasound to gauge my kidney health, but then again I'll want to defer on it. I should get an eGFR based on cystatin C and creatinine to get a bigger picture, as I've expressed how the creatinine-based eGFR could give me a false positive on kidney dysfunction. I also question the use of the urine albumin/creatinine ratio as a measure of chronic kidney disease. I suspect that high albumin urinary excretion could be due to the albumin excreted being oxidized albumin. In a state of chronic bacterial infection, albumin, as an antioxidant, gets oxidized. Since oxidized albumin has an opposite charge to albumin, it can easily get excreted instead of being reabsorbed in the kidney tubules. Once again, another false positive that could throw us off into never-never land.

Last week, my serum albumin test got me a surprisingly high albumin reading. Two years ago it was at 38 (really low of range), and lately it has hovered around 42. Last week, it was 46.5, which is near the high range of 50. The last time I had a reading this low was 17 years ago, when my blood pressure was normal. What changed? I no longer have a chronic bacterial infection, since my periodontal issues were resolved 3 months ago.

One more thing, if you have reduced kidney function, supplementing with magnesium will cause you to accumulate too much due to kidneys inability to filter it.

That was said of potassium. I didn't know it applies also to magnesium. And this is good news. Because I was taking 1000mg magnesium a day for a spell last year, and I was taking a lot of potassium from bananas and from fruit juices, and I wasn't feeling any worse for it. This kind of makes for a stronger case that my kidney's demise is exagerrated.

If you have difficulty in hanging onto magnesium and you are doing coffee , OJ, lots fruit and juices; perhaps thyroid may require further optimisation. We don't have rT3; so it brings thyroid hormones into question.

I'm okay holding on to magnesium. I'm not getting loose bowels either. Nor am I suffering from arrhythmia.

No rT3, but is that still needed when I had said countless times that my temperature is right up there. And my ECG gives me a QTc of less than 440 msec, and that I pass the Achilles tendon reflex test. Is it wise to spend on an rT3 when all the physical indications tell me I'm euthyroid. One thing about this forum is that everyone except me just like using the numbers from a lab instead of relying on observation. This is nuts.

You can't be serious about arginine. I could not think of a more problematic solution than arginine and don't understand why you would even want more ammonia since it is extremely poisonous to cells. High ammonia kills. If you are truly concerned in the protection of tissues and organs then you would not want to promote more ammonia and nitric oxide. Perhaps you are extremely efficient at removing ammonia. May be you have lots of CO2 at your disposal. As you said there is nothing wrong with your BUN/creatinine, so ammonia is being dealt with efficiently.

You're being very harsh on ammonia, looking at it as some kind of monster. In the universe, there is duality. There's the good and the bad in the same object. People say high cholesterol is bad, yet they don't ever say low cholesterol is bad. Why is that? You're just as guilty saying high ammonia is bad, and then saying very low ammonia is good. Isn't it true that ammonia is produced from glutamate, and that this ammonia is used to pair with acidic anions such as chloride and phosphate, so that these acids can be excreted through urine? How then is ammonia bad in this specific context?

Remember, those ranges are based on the average population. Not on an optimised healthy population who avoid high arginine foods like grains, nuts and seeds. Meat and diary contain arginine and should provide adequate. If serum ammonia is low, then you must be doing something right. I don't know which population studies this dr who created the cheat sheet based his normal and optimised ranges on.

Unfortunately, ammonia wasn't included in the cheat sheet of Dr. Weatherby. I just used the lab's reference range. My serum ammonia is below range. I don't think I should outright congratulate myself on that. It sticks out, and I'd like to know why it's that low because it's an anomaly. I smell a rat when someone offers me something that's too good to be true. When there's too much of a good thing, I run.

There are conditions that can result in arginine deficiency and I will only discuss the most likely. If you are of Asian background, African, Arabic or Italian then you need to rule out sickle cell anemia and whether you are a carrier for the gene SNP which makes you resistant to malaria parasite. If so, your needs for riboflavin will be higher, as it is required to activate B1, B3, B6, B12 and folate. If you supplement the others and neglect riboflavin, supplementing with the others will place you in a deficient state for B2. If this is the case, then you will experience higher levels of ROS = equals tissue damage and so much more.

What did your blood smears reveal? Why were you supplementing B12? Deficiency? Were you ever diagnosed with hemolytic anemia?

There are conditions in which an arginine-deficient state may be desirable. For example, some tumor cells are auxotrophic for arginine and undergo cell cycle arrest and apoptosis in response to arginine deprivation. Thus, intravenous administration of pegylated derivatives of recombinant mammalian arginase or microbial arginine deiminase to create arginine deficiency is being explored as part of therapeutic strategies for some types of cancer (e.g., [46, 47].

Ammonia, like nitric oxide, inhibits respiration, and can increase the Crabtree effect (with aerobic glycolysis stimulated by increased glucose, inhibiting respiration). This suggests an important role for it in cancer in general, and especially in liver cancer. In the uncontrolled glycolysis of cancer, ammonia can be used to form amino acids from the lactate and pyruvate produced by glycolysis, supporting growth of the tumor at the expense of the normal tissues that are producing ammonia by protein degradation.”

I'm not big on b supplementation. I find that my varied diet keeps me well supplied with nutrients. If I do take supplementation, it's for therapeutic purposes.

I'm not sure what you mean by blood smears. I was supplementing B12 occasionally. Since I realized that I don't really have much need for methylated B-vitamins, I've not been keen on B12.

Ammonia can be all that - in excess. But from where I'm coming from, from being low on it, I would not be loading up on it to go to the other end of the pendulum.

Nitric oxide, associated with unbalanced excitation, is involved in the nerve damage of epilepsy, amyotrophic lateral sclerosis, Parkinson’s disease, Alzheimer’s disease, and Huntington’s disease. An energy deficit increases excitation and cellular calcium uptake, increasing nitric oxide synthesis (Schulz, et aI., 1997). Nitric oxide increases the ratio of glutamate to GABA (“the excitotoxicity index”), (Demchenko & Piantadosi, 2006), while lowering mitochondrial energy production.

“Stress increases nitric oxide, and an excess of that poisons mitochondrial energy production, making stress worse. The right amount of coffee inhibits nitric oxide and so improves energy efficiency. Nitric oxide increases parathyroid hormone and aldosterone, which increase blood pressure. Vitamin D and vitamin K lower those.”

“A localized stress or irritation at first produces vasodilation that increases the delivery of blood to the tissues, allowing them to compensate for the stress by producing more energy. Some of the agents that produce vasodilation also reduce oxygen consumption (nitric oxide, for example), helping to restore a normal oxygen tension to the tissue. Hypoxia itself (produced by factors other than irritation) can induce vasodilation, and if prolonged sufficiently, tends to produce neovascularization and fibrosis.

“Lactate, glutamate, ammonium, nitric oxide, quinolinate, estrogen, histamine, aminolevulinate, porphyrin, ultraviolet light, polyunsaturated fatty acids and endotoxin contribute to excitatory and excitotoxic processes, vasodilation, angioneogenesis, and fibrosis.”

I can see how nitric oxide can work against us. But nitric oxide has its good side. It's used to kill pathogens by macrophages. It's also used to dilate blood vessels. It has to be in supply and be ready to be used when needed by the body to maintain homeostasis. If it's not available, there won't be homeostasis.

“PTH (like estrogen) causes mast cells to release promoters of inflammation, including histamine and serotonin. Serotonin and nitric oxide contribute to increasing PTH secretion.”

“Substances such as PTH, nitric oxide, serotonin, cortisol, aldosterone, estrogen, thyroid
stimulating hormone, and prolactin have regulatory and adaptive functions that are essential, but that ideally should act only intermittently, producing changes that are needed momentarily. When the environment is too stressful, or when nutrition isn’t adequate, the organism may be unable to mobilize the opposing and complementary substances to stop their actions.”

Hopefully, with increased calcium intake, PTH as well as calcitriol can go down to much better levels, and this will contribute to lowering stress.

I don't know why the hesitation of doing ultrasound investigation of kidney, liver and heart. If you have been dealing with the same issue for a long time, then I would investigate further. The high uric acid is from dna damage which implies tissue damage. and not just hemolysis of rbcs.

I'm more keen on an investigative style of problem-solving than relying on visual aids that can't fully explain to me relationships of cause and effect. They can barely give me a complete picture. I still have to rely elsewhere for the how's and why's. I should also ask you why women need mammograms instead of relying on serum tests.

I beg to differ on the view on uric acid. Many people with cancer show low uric acid levels. Uric acid is a part of the body's primary antioxidant system. When it's high, it's because it's needed to deal with a stress situation. So it's better to find what's causing the stress, than shift the blame to the antioxidant that's helping deal with the situation.

I suggest the organic acid test to explore for b-vitamin status and other nutritional markers like vitamin C + other metabolites to gain an in depth insight. Plus investigation of blood smears if this has not be done to date. If nutritional deficiencies are found, you need to ask, for what reason are you not able to get from your diet. Is your diet restrictive, inadequate or is there ongoing damage, inflammation that is causing the malabsorption of these nutrients. Is there damage to liver, gallbladder, spleen, pancreas which is preventing absorption of specific vitamins. What about gut flora, are they stealing nutrients, favouring pathogens, producing toxic metabolites, parasites etc.

I appreciate your ideas on approaching my hypertensive condition, but I have a fairly good lay of the land as far as my body goes. My funds are limited, and this is a good thing. It forces me to be efficient dealing with my issue. It forces me to narrow my scope. The body is a complex and intricate web of relationships. I can get overwhelmed and lost prying into every lock and key. But I feel it to be prudent to focus on where the evidence points to.

Twenty years ago, I began to shift away from relying on conventional doctors and I didn't realize getting better doesn't stop with going to naturopathic doctors. But the process of learning has given me a better understanding of what ails me. It's a slow process of identifying problem areas and of eliminating these problems. This is what I mean when I say I have better understanding of the lay of the land. Your ideas are very helpful, but from my vantage point, some tests are not needed anymore as they would just tell me what I already know.

 

[yerrag]

I got my serum ammonia results today. It's 14 umol/L (range: 9-30). My serum ammonia is now within range, thankfully. I won't ever understand what changed, or what made it so low before. If it ever was related to hypertension, it isn't anymore. Perhaps the ammonia was being used before to pair with acidic anions for urine excretion, when I was possibly acidemic. With acidic loads from eating a lot of meat (sulfates and phosphates), and lactic and keto-acids from my metabolism. That could cause ammonia to be used up quickly. Or it could be that I didn't have enough of the electrolyte minerals to pair up with the acidic anions during urine excretion.

Got another serum albumin reading today as well. I got another result today. Feb 2, it was 41.5. Feb. 6, it was 46.6. Feb 11, today, it's 42.36. Is this how variable serum albumin is? Or is the lab not giving me repeatable results?

Next thing for me to do is to take a serum osmolality test. It would tell me if indeed I have high serum osmolality, and that would strengthen my suspicion that I have low blood volume. It's not cheap at $50, but it's better than shelling $160 for a vasopressin test.

I inquired on an ultrasound for liver/kidneys/spleen/pancreas etc., I was surprised it only cost $50. I may go with that, but I'll still need to have a doctor to interpret the results for me. But rather than spend on the ultrasound, I'm more inclined to spend on a 24 hr urine collection test to get the creatinine clearance and an eGFR based on it, as my interest here is to see how well my kidney is doing, as far as GFR goes. This will run me $12.50 only. I'll use what's left over from a $50 bill to get a urine ACR (albumin-creatinine ratio) - $36.50.ca

Since my liver has recently tested to be in great shape (pretty much all values are in optimal range), and if my kidney is found to be doing well (I may still do an ultrasound just to be sure), I would at least be in a better position to arrive at the cause of my hypertension - by the process of elimination.

And if the increased calcium intake does wonders with lowering my PTH, and the lowered PTH gets my posterior pituitary to secrete more ADH, and I get to build blood volume, then I could just as easily see my blood pressure go down.

One thing about getting the ultrasound - it would be interesting to see if there is fibrosis. And if so, I may have to press the order button for some systemic enzymes such as serrapeptase.

 

[yerrag]

Including cystatin C would be interesting as it is not only a marker for kidney function but more importantly also heart and cardiovascular disease. It has been found that even in patients with > 60 gfr a high cystatin C is a high risk for heart failure and death. However it too similar to creatinine, is variable as it is now known that cystatin C level may be affected by factors other than kidney function, including sex, race, obesity, greater height, current cigarette smoking, thyroid function, inflammation, glucocorticoid function, and malignancy. It is expressed in all cells with a nucleus and found in virtually all tissues and body fluids. It prevents the break down of protein by proteinases outside the cell. If gfr is low, ldh high, uric acid high, then I am hedging my bets on cystatin C will come in a tad on the high side unless you are guzzling heaps of coffee.

I got my eGFR panel results yesterday. And again, you were right about my cystatin C levels: 1.19 mg/L (reference 0.41-0.99). Serum creatinine at 115.70 umol/L (range 64.0-104.00). eGFR computed at 61 mL/min/1.73 m2. This is just barely above 60, which is considered to be a cutoff point for CKD.

This compares well to the eGFR result based from creatinine only, from earlier: 62.76 ml/min/1.73 m2

These results confirm that I have a low glomerular filtration, and my kidneys could stand to be improved.

 

[Texon]

I would rather not spend on ultrasound and rely on doctors' interpretations, which I don't trust tbh. They would just uncover artifacts that they would blow up to a major issue, making a mountain out of a molehill, as that is their business model.

My eGFR is at 65, which isn't good. But it's an "e" which is based simply on creatinine, which is derived from an oversimplification based on race, sex, and age, which is done out of convenience at the expense of accuracy.

I'll take a 24hr urine collection to get a better estimate, and compare it to an eGFR that incorporates both creatinine and cystatin C.

I know ultrasound is safe, but after spending a sum on it, its accuracy is still subject to technician skill as well as the skill of the interpreter. It's basically an expensive black box, for which I have to entirely put my trust on a system that has failed a lot. I like to know what's going on, and this is the reason I shy away from shamans, and even TCM, even if they merit consideration. It's just that there are a 100 shamans for every skilled shaman. I don't want to play dice.

I have identified relatively inexpensive markers in ammonia, BUN, and creatinine, that point strongly to a problem with ammonia and urea being low. I could be more amenable to a test for ADH or vasopressin, which is costly at $160, but this still gives me more information that an ultrasound. As my objective is to find the root cause, there's little that an ultrasound can do in this respect.

I've been to many doctors, both conventional and naturopathic, and there's a snowball's chance in hell I can find one that's free of mechanically following to the script. They only end up giving me false leads and harming me, both in health and in finance.

This may be a long shot, but have you looked into histamine issues at all such as this?
https://healinghistamine.com
Plus, how does one improve gfr? I am 67, and my last labs said gfr= 60. @haidut...thoughts?

 

[yerrag]

In my case, I think it has to do with the kidney capillaries being filled with arterial plaque. It's more of a vascular problem with the kidneys being negatively impacted as kidneys have plenty of capillaries, and capillaries are far more significantly affected by plaque than major arteries. I'm going to try using proteolytic enzymes to try to lyse away the plaque. I have two bottles of ZymEssence on order and I'll update you in 2-3 months how it goes.