Cautions:
none.
Product
Description:
My introduction
to LOLA (l-ornithine l-aspartate) came when I was
suffering from meningitis. Pain so severe
that it re-defined my very notions of pain. I
had been clearing our newly bought and very over-grown
property in west marin. When you use a chainsaw
there is so much vibration that it’s difficult
to sense a small tick crawling on your skin. My
head was literally boggy, my brain like cotton
candy, my liver so inflamed that it made eating
difficult. Daniel Dunphy prescribed LOLA,
3 grams twice daily. It soothed my liver,
opening up my head to drain. So I was a believer
and I started using it with my patients.
Because buying LOLA was very expensive from germany especially as the dollar
kept dropping against the euro. I tried many other widely available ornithine
preparations with my patients, they did not work. So I turned to Stephen
Levine, as I knew Allergy Research was extremely innovative and asked him to
bring LOLA here. Convinced of its utility, its wide and safe use overseas, and
that very few people were using it here Stephen Levine was excited to make this
product available. In doing so Allergy Research has both reduced the cost
and taken all the fructose and flavorings out.
I run Alchemist Lab, a company that treats Hepatitis C. If I have a patient
with end-stage liver disease and I want to restore liver function I use LOLA. In
searching world-wide for answers to hepatitis I have found no better medicine
to soothe an inflamed liver, especially in the advanced cases. It
is safe and effective. In canvassing PubMed, LOLA is well studied and effective
for lowering ammonia levels, and improving mental status parameters without the
adverse events of using lactulose. Ammonia is a by-product of protein digestion,
normally the liver primarily clears ammonia through the urea cycle, also known
as the ornithine cycle. Poor liver function results in high levels of ammonia
causing encephalopathy, more commonly known to our patients as brain fog. All
the illnesses that complain of brain fog respond to using this product. We’re
not talking sleep deprived new mother who can’t find her keys, but the
lyme patients, the fungal overgrowth patients with liver inflammation, and the
EBV patients. LOLA for the neurotoxic conditions from biological
causes.
Steven
Finkbine L.Ac.
Background
and Aim:
An oral
glutamine load in cirrhotic patients awaiting liver transplantation
was shown to cause a rise in blood ammonia and psychometric
abnormalities which were reversed by hepatic transplantation.
L-Ornithine-L-aspartate (LOLA) has been shown to reduce
ammonia and improve psychometric function in patients
with hepatic encephalopathy. The aim of the present study
was to assess the effect of LOLA in healthy patients
with cirrhosis and no evidence of clinical encephalopathy
after challenging the central nervous system by administration
of oral glutamine. Hepatic encephalopathy remains a major
cause of morbidity and mortality in chronic liver disease.
Gut derived toxins bypass the liver or are inadequately
metabolised by the liver. The toxins then cause a complex
array of neuropsychiatric disturbances. A number of toxins
are implicated in the pathogenesis of encephalopathy,
with ammonia remaining the main candidate neurotoxin.1 Glutamine
is a non-essential neutral amino acid which is efficiently
absorbed from the jejunum when administered enterally.
An oral glutamine load has been shown to cause an increase
in venous ammonia and associated deterioration in psychometric
performance, and increase in mean amplitude of the electroencephalogram
(EEG) in cirrhotic patients awaiting transplantation.2 These
changes were reversed when patients were retested following
orthotopic liver transplantation. Conventional treatment
of hepatic encephalopathy entails restriction of dietary
protein and the use of non-absorbable disaccharides and
antibiotics. L-Ornithine-L-aspartate (LOLA) is the stable
salt of the amino acids ornithine and aspartic acid and
has been shown to reduce blood ammonia concentration
and improve psychometric performance in patients with
hyperammonaemia and hepatic encephalopathy when administered
intravenously.3-6 LOLA
acts to stimulate the urea cycle and glutamine synthesis
which are important mechanisms in ammonia detoxification.4-7 Transjugular
intrahepatic portosystemic shunts (TIPS) are an established
treatment in the management of variceal bleeding and
in a limited number of patients with refractory ascites.8 The
incidence of hepatic encephalopathy increases in the
presence of portosystemic shunts and in a recent meta-analysis,
104 of 265 (39%) patients randomised to receive
TIPS developed episodes of worsening or spontaneous encephalopathy
compared with 54 of 267 (20%) treated with
endoscopic sclerotherapy with or without beta blockade.9 The
aim of the present study was to evaluate the effect of
LOLA on blood ammonia, psychometric function, and EEG
amplitude in cirrhotic patients with and without TIPS
undergoing glutamine challenge in a double blind, placebo
controlled trial.
Patients
and Methods:
Eight
cirrhotics (Child's B or C) without transjugular intrahepatic
portosystemic shunts (TIPS) and seven with TIPS underwent
two oral glutamine (20 g) challenges, receiving
LOLA (5 g intravenously) on one occasion and placebo
on the other in random order. Psychometric tests, including
choice reaction time (CRT) and number connection test,
were performed before and after glutamine, together with
electroencephalography and blood ammonia.
Results:
Mean basal
ammonia was 27 (SEM 5) µmol/l in non-TIPS
and 76 (10) µmol/l in TIPS patients (p<0.05).
Basal CRT 2 was 0.643 (0.033) s in non-TIPS
and 0.825 (0.076) s in TIPS patients (p<0.02).
In non-TIPS patients, ammonia increased to 36 (10) µmol/l
when LOLA was administered and to 62 (13) µmol/l
with placebo (p<0.02). There was no alteration in
psychometric function in non-TIPS patients after glutamine
when LOLA was given but when placebo was given, glutamine
caused prolongation of CRT (p=0.02). Glutamine did not
affect psychometric function in TIPS patients with or
without LOLA.
Conclusion:
This study
showed that LOLA ameliorated the deleterious psychometric
effects of glutamine in Child's grade B and C patients
with cirrhosis without TIPS and supports its use in clinical
practice in hepatic encephalopathy.
