BCAA LOLA
BCAA (Branched chain Amino acids) are postulated to be decreased in cirrhotics due to alterations in protein metabolism resulting in a mismatch of BCAA and AAA. AAA preferentially overwhelms the L system resulting in BBB crossing and acts as substrate for false neurotransmitter generation. Also, BCAA is postulated toimprovs protein-energy malnutrition by improving utilization of glucose, also thought to facilitate ammonia detoxification by supporting synthesis of glutamine and stimulate the secretion of hepatocyte growth factor by hepatic stellate cells. Dosage estimated to be 12g per day (normal individual requirement 1-5g/day)
LOLA (L-ornithine-L-aspartate) provides critical substrates for both urea and glutamine synthesis, a key pathway for ammonia detoxification hence postulated to decrease ammonia level, one of the substrate blames on encephalopathy. It also is said to be able to regulate the relationship between BCAA and AAA. Dosage estimated to be 9-18g per day.