Ammonia, Plasma

The Ammonia, Plasma test contains 1 test with 1 biomarker.

IMPORTANT - The specimen for this test must be collected at a patient service center that can collect, store and transport frozen samples as outlined below.  

IMPORTANT: Before ordering this lab test, check and confirm with the selected patient service center to ensure that they can collect, store and transport frozen samples as outlined below.

Preferred Specimen(s) 

2 mL frozen plasma collected in an EDTA (lavender-top) tube

Collection Instructions 

Collect blood from stasis-free vein of patient (e.g., no tourniquet). Patient should not clench fist during collection, as muscular exertion often increases venous ammonia levels. Patient should avoid smoking prior to phlebotomy since smoking increases plasma ammonia levels. Tubes should be filled completely and kept tightly stoppered at all times. Place immediately on ice. Separate plasma from cells within 20 minutes and freeze plasma immediately.

Transport Temperature 


Specimen Stability 

Room temperature: Unstable
Refrigerated: Unstable
Frozen -20° C: 72 hours
Frozen -70° C: 7 days

Reject Criteria 

Hemolysis • Lipemia • Received thawed • PPT Potassium EDTA (white-top) tube

Description: Ammonia Plasma is a blood test that checks for ammonia levels in your blood’s plasma, and is often ordered by physician’s after sever illness and/or mental changes in a patient to check for ammonia toxicity.

Also Known As: NH3 Test, NH3 Plasma Test, Ammonia Blood Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

When is an Ammonia test ordered?

An ammonia test may be required if an infant exhibits any of these symptoms within the first few days after delivery:

  • Irritability
  • Vomiting
  • Lethargy
  • Seizures

A medical professional may order an ammonia test if a child exhibits these symptoms a week after a viral infection like the flu or chicken pox or if they think the child might have Reye syndrome.

An ammonia level may be requested to help determine the source of the change in consciousness when individuals exhibit mental changes, disorientation, tiredness, or slide into a coma and may have liver disease or renal failure. When a person suddenly becomes more acutely ill, an ammonia level as well as other liver function tests may be requested in patients with stable liver disease.

What does an Ammonia blood test check for?

A byproduct of the breakdown of protein in the intestines, ammonia is largely produced by bacteria. Excess ammonia can build up in the blood if it is not properly digested and eliminated from the body. This examination calculates the blood's ammonia level.

Normally, ammonia travels through the blood to the liver, where it is transformed into the compounds urea and glutamine. Once at the kidneys, the urea is removed through the urine. Ammonia builds up in the blood and can enter the brain if this "urea cycle" does not completely break down the ammonia.

The brain is poisonous to ammonia. For instance, ammonia and other substances processed by the liver can build up in the brain and induce a condition known as hepatic encephalopathy when liver function is considerably impaired as a result of diseases like cirrhosis or hepatitis.

Mental and neurological abnormalities brought on by hepatic encephalopathy can result in confusion, disorientation, tiredness, eventually a coma, and even death.

Children and infants with elevated ammonia levels may vomit often, get agitated, and become progressively more sluggish. If untreated, they could develop respiratory problems, suffer seizures, or fall into a coma.

Lab tests often ordered with an Ammonia test:

  • Hepatic Function Panel
  • ALT
  • AST
  • ALP
  • Glucose
  • Electrolytes Panel
  • Renal Panel
  • Comprehensive Metabolic Panel

Conditions where an Ammonia test is recommended:

  • Liver Disease
  • Kidney Disease
  • Cirrhosis
  • Hepatitis

How does my health care provider use an Ammonia test?

The ammonia test is used to identify blood levels of ammonia that are elevated and may be brought on by conditions such severe liver illness, kidney failure, Reye syndrome, or a rare hereditary defect of the urea cycle. The test may be employed to aid in determining what is causing a person's changes in behavior and consciousness.

Ammonia is a waste product that the body naturally produces. It primarily results from bacteria in the intestines digesting protein. Excess ammonia can build up in the blood and travel into the brain, where it is poisonous, if the liver is not properly cleansed from the body and processing it.

In order to determine the etiology of a coma or to support the diagnosis of Reye syndrome or hepatic encephalopathy brought on by different liver illnesses, an ammonia test may be requested along with additional tests like glucose, electrolytes, kidney, and liver function tests. A uncommon urea cycle malfunction may also be diagnosed and the severity of the condition assessed using an ammonia level.

There is still debate over the clinical usefulness of the ammonia test for hepatic encephalopathy treatment monitoring among healthcare professionals. Blood ammonia levels do not accurately predict the severity of hepatic encephalopathy since the illness can be brought on by the accumulation of several poisons in the blood and brain.

What do my Ammonia test results mean?

The signs and symptoms of the individual may be brought on by an ammonia level in the blood that is much higher than normal. This signals that the body is not adequately removing and digesting ammonia from the body.

An abnormally high level in newborns can also be a sign of newborn hemolytic illness in addition to a hereditary urea cycle enzyme deficit or abnormality. Newborns frequently experience moderate, brief elevations in ammonia levels, which can rise and fall without manifesting any symptoms.

When children and teens with symptoms have elevated ammonia levels and low glucose levels, Reye syndrome may be present. A higher quantity can also be a sign of an unidentified urea cycle enzymatic malfunction.

An increased ammonia level in both children and adults may signal significant liver or renal impairment that has compromised the body's capacity to eliminate ammonia and that the brain may be harmed. Acute or persistent illnesses frequently act as triggers, raising ammonia levels to the point that a patient has trouble excreting the ammonia.

If a person's blood ammonia level is normal, it's possible that something other than too much ammonia is to blame for their signs and symptoms. Normal ammonia levels do not, however, rule out hepatic encephalopathy. Ammonia levels in the brain may be significantly greater than those in the blood, and other wastes may also play a role in modifications to mental processes and consciousness. This can make it challenging to relate a person's symptoms to ammonia blood levels.

With some types of hypertension, such as essential and malignant, the quantity of ammonia may be reduced.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: Ammonia Plasma

Ammonia (P)

*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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