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A 2017 study by Qi and colleagues showed that chronic ammonia exposure (30 days) altered the composition of intestinal microbiota of crucian carp ( Carassius auratus ), while Yan et al (2021) established that ammonia exposure changed the abundance and evenness of intestinal microbes in hybrid grouper ( Epinephelus fuscoguttatus Epinephelus lanceolatu ), with increased relative abundance of Fusobacteria and a significant decrease the relative abundance of Gemmatimonadetes

10.1038/nchembio815 33 HolwerdaS

In the case of glucose scarcity, ketone bodies are used as a source of energy

We'd also encourage you to chat with your doctor about the options available, so they can help you make the best decision for your situation