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(3) renal â glutamine break down in proximal tubule (combines with H+ -> NH4+ and eliminated) CAUSES OF HYPERAMMONAEMIA. Overproduction of ammonia. Protein/ amino acid load. gastrointestinal hemorrhage. gastric bypass. multiple myeloma. allogeneic stem cell transplantation.
The third major cause of unexpected ammonia and nitrite spikes is old tank syndrome. This arises when tanks are not given regular partial water changes and are simply topped up instead when water evaporates. Over time nitrates build up, carbonates deplete and the water acidifies.