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& Ranjha, N

27th International Thyroid Cancer Survivors Conference

CONTENTS Intro: Hyperammonemia is a serial killer Clinical presentation & diagnosis Causes Investigation & monitoring Management [1] Neurocritical care of hyperammonemia [2] Reduced enteral ammonia absorption [3] Basic nutritional manipulations [4] Discontinue potentially offensive medications [5] Consider treatment for infectious etiologies [6] Consider zinc supplementation [7] Consider carnitine supplementation [8] Consider additional vitamins [9] Consider L-arginine administration [10] Support renal clearance & consider CRRT [11] Sodium phenylacetate plus sodium benzoate (Ammonul) hyperammonemia is a serial killer hyperammonemia is a serial killer Nonhepatic hyperammonemia behaves like a serial killer

Ah Mew N, Payan I, Daikhin Y, Nissim I, Nissim I, Tuchman M, Yudkoff M

Results continue to build through the three-month mark when paired with proper nutrition and consistent dosing