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BUN Urea verses Ammonia Levels in Blood Testing

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markymarc
markymarc

I had a quick question if anyone is well versed in CBC and Differential blood markers and tests.

If my BUN (Urea), Creatine, and GFR are all in normal ranges I can assume my kidney function is fine, but I was curious about the correlation between BUN levels and Ammonia levels. 

If the liver is converting Ammonia to Urea at normal levels can I assume that my Ammonia level is normal? I think not and can't find any studies or articles on this. I read if BUN is low that means the hepatic conversion of Ammonia to Urea is compromised as one cause and ammonia can be raised, conversely if the BUN is very high it could mean the kidneys are not filtering BUN out of the blood or ammonia is also very high.

My last blood test was all normal and I asked my GI to add ammonia but he said not necessary despite me telling him I had 2 brief (one whiff) nostril smells of chlorine in the past 6 months that happened for a second and then didn't reoccur. I don't have any symptoms outside of occasional insomnia and constant anxiety about my health. I have had a couple brief relapses with alcohol over the past year which raised my AST and ALT slightly but nothing else. 

I have moderate fatty liver from ALD but no/or mild scarring and no cirrhosis that I am aware of from testing over the past year. I am trying to convince myself that HE and high ammonia are most frequent with advanced disease and decompensated cirrhosis. But when you smell that chlorine/ammonia smell in your nose even once, all rational thought goes out the window.

I know smoking, exercise, malnutrition or fasting, and high protein diets can also raise ammonia and BUN levels.

My last bloods were:

AST - 17

ALT - 38

ALP - 52

GGT - 38

Bili Total - 0.7

Albumin - 4.5

Globulin - 2.3

Platelets - 270

INR/PT Time - 1.0 and 10.50 respectively 

BUN - 18

Creatine - .85

GFR - 118 (> 60)

Sodium - 142

Potassium - 3.9

Red and White Blood Cell Markers - All normal

Every other marker normal or close to it. 

 

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