Ammonia clearance
Hepatic ureagenesis↑
Also searched as Hepatic ureagenesis.
You want it converted and excreted. This is one of the liver's oldest jobs.
In depth
Made by gut bacteria from protein, cleared by the liver into urea. A failing liver, or blood bypassing it through new veins, lets ammonia reach the brain. Blood levels help diagnose encephalopathy but do not track how severe it is.
What drives it
Gut barrier reduces it.
Ammonia is produced by intestinal bacteria from dietary protein and delivered to the liver by the portal vein — which is why the standard treatments named in the literature act on the gut: 'lactulose and RIFAXIMIN ARE the preferred treatments for hepatic encephalopathy' (pmc11299547), a non-absorbed sugar and a non-absorbed antibiotic. The evidence covers the therapeutic target is the gut, not the liver. That is a structural fact about this disease and it belongs on the map.
Liver reduces it.
10.1177/20543581251347154 — NBK513323 — The healthy liver converts ammonia to urea. This edge is inhibitory by definition of hepatic function and is asserted on physiology, not on a trial. The clinical corollary is in the same Merck source: tips, which diverts portal blood past the liver, 'is relatively contraindicated in patients with ... Hepatic encephalopathy' — bypassing the liver worsens it, which is the inhibition observed in reverse. doi 10.1177/20543581251347154
What it drives
It increases Mental clarity in liver health.
10.1371/journal.pone.0307899 — 10.3390/ijms27156739 — the most carefully scoped edge in this set. Merck Manual Professional: 'elevated serum ammonia level may help the diagnosis of hepatic enCEPHALOPATHY, but the level does not correlate well with the severity.' the edge is real and the dose-response is not. No copy may imply that lowering an ammonia number improves a person's cognition. doi 10.1371/journal.pone.0307899
Blends that modulate it
Each blend page names this pathway and carries the study behind its claim.
See it on the map
Open the causal map to follow this pathway upstream and downstream, arrow by arrow, each with its study.