Autoimmune Hepatitis

This is where the immune system decides to attack the liver.

The treatment is heavy doses of steroids for 2 months, gradually easing down until a minimum dose controls the problem.

Side effects are weight gain, puffiness, hair growth and hyper-activity

Are there any ways of combatting the weight gain. I understand the puffiness will go once the dosage is decreased.

Current exercise is gym 6 days a week, walking 6kms 7 days a week, zumba class once a week and pilates twice a week.

If the steroids are not taken then cirrohsis of the liver will result.

This is in a non-drinker, non-smoker.

Any advice greatly appreciated

I have no idea from a medical point of view... but I would assume that if weight gain is only related to taking steroids, then it probably reverse once lower doses were being taken.

Apart from that, plenty of frest fruit and veges... freshly squeezed vege juice in the mornings and salmon oil (or similar) normally help the immune system.

THe other thing to think about is that in some autoimmune diseases, like chronic fatigue, aerobic exercise can actually be a contra-indication, because it can stimulate some of the hyperactive immune responses. So, it may be better to cut back on the exercise a bit.

But obviously, that would all need to be checked with a Dr... which I'm not!!

Overall, I would have thought getting the immune system up and running would be more important than trying to control weight at this stage.

You will not be able to significantly reduce the weight gain until you get your prednisone under 10mg preferably around 7.5mg. I take it you're sitting on 50+mg.

If this is the first flare up they will probably attempt to withdraw the steriods at some time in the future but there's an odds on chance it will flare up again within 2 years.

A liver biopsy can determine the level of cirrohsis.

Diet is probably the most important at this stage because your immune system is being surpressed you're more likely to pick up infections. If you are staying on the prednisone long term look at taking some calcium supplements.

I seem to be hearing more & more people saying they have it including socceroo Harry Kewell.
Thankyou both.

I have absolutely no symptoms, problem turned up in annual blood tests and I had to see a liver specialist within 24 hours.

The liver biopsy is next week. Specialist said he will give me massive doses of steroids for 2 months then test and hopefully should be able to reduce level gradually but I will have to stay on minimum level forever.

Specialist has said my diet is good and exercise level can be maintained.

He also said I will be very hungry, so it will be necessary to watch food intake. Puffiness will be the result of the steroids which will disapear as soon as level reduced but weight gain will result as wanting to eat more food.

Thanks again for advice

I don't want to know the answers, but contemplate these questions regarding autoimmune triggers:

- what's your natural hair color?
- your skin tone? very pale, pale, very freckly, smooth, dark, dry/oily etc.
- have you been sleeping well for the last 3-5 years?
- do you remember a lot of dreams after waking, good or bad?
- do you sweat in your sleep noticeably?
- do you sweat easily with exercise?
- are your extremities extra sensitive to the cold?
- have you been more easily angered in the last few years?
- have you traveled overseas in the last 2 years, and suffered a flu like illness?
- has your blood pressure changed in the last few years, up or down?
- urinary tract infections?
- change in diet when overseas? more protein, fat, starch, or simple sugar than usual?
- psychological stress/shock?
- menopause?
- new partner?
- tender points in limbs or generalized aching?
- recent course of antibiotics?
- gut health? increase in flatulence, irritable bowel.
- increased fatigue, sugar attacks?
- increased appetite prior to prednisone meds or similar?
- unusually high intake of vitamins or health products?
- tolerance for fatty foods?
- allergy type symptoms? stuffy sinuses and nasal passage?
- fuzzy headedness?
discomfort in abdomen anywhere?
- lower back pain history?

It would be wise to reduce the work of the liver while it is inflamed.
This could include
- not overeating
- eating less simple sugars
- reducing aerobic exercise from strenuous to moderate for less than 4 hours a week.
- doing yoga to help the autonomic nervous system balance.
- ensuring adequate hydration.
- reducing stimulants like caffiene, fast tempo music.
- calming the mind and body from 8pm if not a shift worker.
- meditating and self awareness courses.

To help counter the hunger pangs associated with prednisone class drugs, split your three meals into 2 sessions, so that you are eating something every 2.5-3 hours. Drink a glass of water before each meal. Eat more fibrous carbs, less starchy and simple carbs, less animal produce (dairy, eggs, flesh).

Good luck. This will be a process of self discovery.
Thanks Winston. It was amazing how many of those questions were a yes!!!

I really appreciate the hints regarding the meals and will try and ease work on the liver.

Much appreciated

Hi Chris, I wish you all the best with your health and dealing with it! I had a specialist suggest I had an autoimmune disease about 18 months ago. It devistated me and became one of the most stressful times in life. Waiting for test results felt like forever. I really wasn't ready to deal with it. The blood tests came back negative and specialist ended up deciding I didn't have it. Through some other recent blood tests with another specialist for a seperate issue I've had some abnormal test results for autoimmune (Lupus). I get tested again in another couple of weeks to see if they're still abnormal. I'm a lot more prepared for it this time though if it is positive. There's no point thinking the worst, keep your chin up!!