Thursday, September 22, 2022

How Do You Get Autoimmune Hepatitis

Autoimmune Liver Diseases Occur When The Bodys Immune System Attacks The Liver Causing Inflammation If Left Untreated The Liver Inflammation May Eventually Cause Cirrhosis Of The Liver Which May Lead To Liver Cancer And Liver Failure

Autoimmune Hepatitis | Gina Choi, MD | UCLA Digestive Diseases
Overview and Symptoms

Although a number of autoimmune conditions may involve the liver, the three most common autoimmune liver diseases are autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis. These conditions may occur individually or as part of overlap syndromes.

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Types Of Autoimmune Hepatitis

There are two types of AIH based on serum tests:

  • Type I is more common, tends to affect young women, and is associated with other autoimmune diseases. This is the most common form of AIH in the United States.
  • Type II primarily affects girls between the ages of 2 and 14.

While AIH generally occurs in adolescence or early adulthood, it can develop at any age.

Symptoms of AIH range from mild to severe. In the early stages, you may have no symptoms, but in later stages, symptoms can appear suddenly. They may also slowly develop over time.

AIH symptoms include:

Blood tests can also measure the amount of immunoglobulin G antibodies in your blood. IgG antibodies help the body fight infection and inflammation.

A liver biopsy may sometimes be necessary to diagnose AIH. It can reveal the type and severity of your liver damage and inflammation. The procedure involves removing a small piece of your liver tissue with a long needle and sending it to a laboratory for testing.

Treatment can slow down, stop, and sometimes reverse liver damage. Approximately 65 to 80 percent of people with AIH will go into remission. However, remission can take up to three years.

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S To Reduce Inflammation

Here are the best action steps to get started with on your journey to prevent and/or heal chronic inflammation and autoimmune disease. You should always consult with your physician before stopping or changing medications or taking on new health strategies.

Additionally, you should be working with a functional health practitioner to help guide you through these strategies. This is not an exhaustive list and there are other natural therapeutic strategies that I and functional health practitioners will utilize to help individuals with chronic inflammation and autoimmune disorders.

What Is The Treatment For Autoimmune Hepatitis

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Treatment is almost always needed. Early treatment can improve symptoms, reduce the risk of complications, and also greatly improve your outlook . Treatment aims to reduce inflammation and suppress the immune system with immunosuppressant medicines:

  • Steroid medication is the usual first treatment. Steroids are good at reducing inflammation. A high dose is usually needed at first. The dose is then gradually reduced over a few weeks. The aim is to find the lowest dose needed to control the inflammation. The dose needed varies from person to person. See the separate leaflet called Oral Steroids for more detail.
  • Azathioprine is an immunosuppressant medicine that works in a different way to steroids. It is usually used in addition to the steroid. A steroid plus azathioprine tends to work better than either alone. Also, the dose of steroid needed is usually less if you also take azathioprine. This means that any side-effects from steroids may be less severe.

Treatment works well in most cases. Usually, the inflammation settles and symptoms improve within a few months of starting treatment. However, it may take a year or more to get the disease totally under control. Azathioprine is usually taken for at least two years.

For some people a liver transplant may be an option – for example:

  • In the few people who do not respond to treatment with the medicines mentioned above or
  • In people diagnosed in the late stage of the disease with severe ‘scarring’ of the liver or liver failure.

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Optimize Your Vitamin D Levels

Vitamin D is considered to be more of a hormone than a vitamin based around its role in the body. Hormones are chemical messengers that communicate with cell receptors to produce specific biological responses in the body. In this way, calcitriol, which is the active form of vitamin D, has the ability to activate over 1,000 genes in the body .

All the major immune cells have vitamin D receptors and these immune cells are all capable of synthesizing the active vitamin D metabolite. Vitamin D modulates the balance between the innate and adaptive immune responses. Studies have shown that vitamin D deficiencies are associated with increased autoimmune development and increased susceptibility to infection .

This article goes into more of the benefits of vitamin D and the best strategies to optimize your levels. You must optimize vitamin D levels to heal autoimmune disease!

If testing reveals they are highly deficient, we will do higher dosages. I also encourage all of my clients to get out in the sun everyday for at least 15 minutes. I rarely see vitamin D levels too high, but on occasion with someone who has been doing high dosage supplementation for an extended time it will happen. This is why you should stay around 5-10,000 IU in supplemental form unless given specific instructions from your health care practitioner.

Things You Can Do To Help Reverse Your Autoimmune Disease That Your Doctor Isn’t Telling You

Functional Medicine Doctor & NYT Best Selling Author

March is Autoimmune Disease Awareness Month. If you’re one of the 50 million Americans who suffers from an autoimmune disease, I want to tell you, as a functional medicine physician who specializes in treating autoimmune patients and as someone who has battled an autoimmune disease myself, that the most important thing to know about autoimmune diseases is that they can be reversed.

Contrary to what most conventional doctors say, an autoimmune diagnosis does not mean resigning yourself to debilitating symptoms that get worse and worse over time, or settling for a lifetime of harsh medications.

Your autoimmune disease didn’t happen overnight. Sure, you may have a genetic predisposition towards autoimmunity. However, we now know about epigenetics and that our genes are not static and they can be both turned on and turned off by environmental and lifestyle factors. As a functional medicine physician, I work with my patients to find the root cause of their autoimmunity by uncovering these environmental and lifestyle factors that turned on these genes. After treating thousands of patients with autoimmunity and other chronic health conditions, I have found that by addressing five common environmental and lifestyle factors we can help restore the balance of your immune system and often reverse your autoimmune disease.

  • Restore the Good — Replenish enzymes and acids necessary for proper digestion
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    Incomplete Or Failed Response To Treatment

    Some people with autoimmune hepatitis have an incomplete response to treatment, meaning that treatment helps but does not lead to remission. If you have an incomplete response to treatment, you may need to take different medicines to help prevent liver damage.

    Some people may fail to respond to treatment, meaning that the inflammation and liver damage of autoimmune hepatitis keep getting worse. Your doctor may recommend additional blood tests and higher doses of medicines. If liver damage leads to complications, you may need treatment for complications.

    Clinical Presentation And Diagnosis

    How does someone get cirrhosis?

    Most patients are currently diagnosed when asymptomatic, having been referred to the hepatologist for abnormal liver function tests performed for annual screening blood tests. Other frequent scenarios include screening of patients with nonliver autoimmune diseases, e.g. rheumatoid arthritis, or investigation of elevated cholesterol, evaluation of itch or unresolved cholestasis post partum. Diagnosing PBC is generally straightforward. The basis for a definite diagnosis are:

    • Abnormalities in are usually present and elevated and are found in early disease. Elevations in occur in advanced disease.
    • are the characteristic serological marker for PBC, being found in 90-95% of patients and only 1% of controls. PBC patients have AMA against , an enzyme complex that is found in the . Those people who are AMA negative but with disease similar to PBC have been found to have AMAs when more sensitive detection methods are employed.
    • Other may be present:
    measurements are not diagnostic for PBC because they are not specific, but may have a role in prognosis.
    , and to a lesser degree , correlate with the disease’s progression toward end-stage liver failure. Anti-gp210 antibodies are found in 47% of PBC patients.
    often correlate with developing portal hypertension.
    Anti-np62 and anti-sp100 are also found in association with PBC.

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    What Is Autoimmune Hepatitis

    The liver is a large organ that sits up under your ribs on the right side of your belly . It helps filter waste from your body, makes bile to help digest food, and stores sugar that your body uses for energy. Autoimmune hepatitis occurs when your bodys infection-fighting system attacks your liver cells. This causes swelling, inflammation and liver damage.

    It is a long-term or chronic inflammatory liver disease.

    Autoimmune hepatitis:

    • May occur at any age
    • Affects women more than men
    • Is often linked to other diseases where the body attacks itself

    S To Heal Autoimmune Disease

    With the growth of chronic inflammatory conditions, we need more information on strategies to heal autoimmune disease. We live in a world that puts high demands on our bodies to perform and produce all day long. Many of us sacrifice rest in order to strive towards our goals. We stay up late to work, watch movies, surf the web or spend time with family and friends. When our body gives us signs of fatigue, we hit it with caffeine and energy drinks to keep on going strong.

    What is the result? We now have an epidemic of people with adrenal fatigue, hormone imbalances, autoimmunity and chronic inflammatory issues. Autoimmune diseases plague over 250 million people all around the world and many more suffer from a wide-variety of chronic inflammatory conditions . In this article, you will learn strategies you can take to reduce inflammation and heal autoimmune disease.

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    The Impact Of Immunosuppressant Therapy On Prognosis

    Prior to the 1970s, most individuals diagnosed with autoimmune hepatitis died from their disease. Multiple studies in the early 1970s demonstrated the positive impact of corticosteroid therapy on disease outcomes. Sherlock and colleagues looked at the long-term impact of prednisolone therapy on survival and found that 63% of treated patients were alive at 10 years compared with only 27% of untreated patients in the control group . The median survival in the treatment group was 12.2 years versus 3.3 years in the control group.

    More recent literature described markedly improved outcomes with immunosuppressive treatment. Czaja and colleagues reported a 90% transplant-free survival at 10 years for patients without cirrhosis at presentation and 89% for patients with cirrhosis at presentation. These survival rates were similar to those of the general population.

    Studies utilizing serial liver biopsies have demonstrated how successful immunosuppressive therapy can improve both liver inflammation and fibrosis, potentially preventing the development of cirrhosis.

    Common Autoimmune Disease Symptoms

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    Despite the varying types of autoimmune disease, many of them share similar symptoms. Common symptoms of autoimmune disease include:

    • Fatigue
    • Abdominal pain or digestive issues
    • Recurring fever
    • Swollen glands

    Many women say its hard to get diagnosed, something that Orbai agrees with. Its not black or white, she says. Theres usually no single test to diagnose autoimmune disease. You have to have certain symptoms combined with specific blood markers and in some cases, even a tissue biopsy. Its not just one factor.

    Diagnosis can also be difficult because these symptoms can come from other common conditions. Orbai says women should seek treatment when they notice new symptoms.

    If youve been healthy and suddenly you feel fatigue or joint stiffness, dont downplay that, she says. Telling your doctor helps him or her to look closer at your symptoms and run tests to either identify or rule out autoimmune disease.

    Autoimmune Disease: Why Is My Immune System Attacking Itself?

    Autoimmune disease affects 23.5 million Americans, and nearly 80 percent of those are women. If you’re one of the millions of women affected by this group of diseases, which includes lupus, rheumatoid arthritis and thyroid disease, you may be wondering why your immune system is attacking itself.

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    Potential Outcomes Of Immunosuppressant Therapy

    The goal of treatment is disease remission. In remission, patients experience the improvement of symptoms, the normalization of abnormal liver chemistries and gamma globulin levels, and the reduction or elimination of inflammatory activity on liver biopsy.

    Most patients who embark on a course of immunosuppressant therapy respond well initially. More than 90% of adults started on corticosteroid treatment experience improvements in liver chemistries and gamma globulin levels within 2 weeks.

    Remission, if it is to be achieved, typically requires 18-24 months of immunosuppressant therapy. Remission can be achieved in about 65% of patients within 18 months and 80% of patients within 3 years. Once a drug-induced remission is achieved, an attempt should be made to withdraw immunosuppression. However, a sustained remission after total drug withdrawal is seen in 13% of patients at 5 years. Patients who relapse need to restart long-term immunosuppressant therapy in an effort to normalize their biochemical abnormalities and to delay the progression of liver disease. Many such patients are maintained on chronic maintenance therapy with azathioprine.

    About 13% of patients experience an incomplete response to treatment, without worsening of their condition. Most incomplete responders need long-term immunosuppression in an attempt to stabilize levels of aspartate transaminase and alanine aminotransferase andby extensionprevent disease progression.

    References

    Boost Up Your Glutathione

    Glutathione is considered the master anti-oxidant within the body and is produced by every cell in the body where it functions to protect our DNA. Glutathione is our cells security guard that protects the cellular components from outside free radical attack. Longevity scientists now believe that the level of glutathione in our cells has a direct relationship with how long we will live .

    Glutathione plays a very important role in establishing immune tolerance . Studies have demonstrated that glutathione enhances the function of T cells and modulates immune activity . In this way, optimizing glutathione levels are extremely important for reducing collateral damage associated with inflammation and autoimmune reactions .

    This article goes into more detail on glutathione and its role in reducing inflammation. Hopefully, this article has given you hope and several major action steps to reduce inflammation and heal autoimmune disease.

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    How Is Autoimmune Hepatitis In Children Diagnosed

    Your childs health care provider will do several tests to look for autoimmune hepatitis and other related diseases. These tests may include:

    • Blood tests
    • Liver biopsy
    • Special scans of the liver, such as ultrasound and magnetic resonance cholangiopancreatography
    • Exam of the inside of the intestines , under anesthesia

    Autoimmune Disease And Your Health

    Autoimmune Hepatitis (Lupoid hepatitis)

    Having lupus, rheumatoid arthritis or psoriatic arthritis raises your risk for heart disease. While taking steps to reduce heart disease is always a good idea, it is even more essential if you have one of these conditions. Talk to your doctor about what you can do to keep your heart healthy and strong. For example, keeping your blood pressure and cholesterol levels within healthy ranges, eating a nutritious diet and exercising regularly can be lifesaving.

    These steps can also help reduce the symptoms of autoimmune disease. Orbai admits that making time for healthy living can be hard, given womens fast-paced lives, but she insists that finding the balance is key to living with autoimmune disease.

    Its something thats going to involve commitment, and sometimes its going to be tough, she says. But learning to listen to your body and being smart about what triggers your disease is important. Its something you do for yourself.

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    Balance Your Blood Sugar

    Blood sugar stability plays a huge role in the inflammatory process. One of the most powerful anti-inflammatory compounds within the body is the stress hormone cortisol. Cortisol is called a glucocorticoid because its primary role is to mobilize glucose.

    The antagonist to cortisol is insulin, which takes glucose and puts it into cells. Insulin also has a pro-inflammatory nature, so that the higher the blood glucose, the increased need for insulin and the more inflammatory activity will be produced .

    Elevated blood sugar also reduces the strength and tone of the immune system. When the immune system loses its tone, it favors chronic inflammation as a way of prioritizing survival.

    When we have blood sugar imbalances, we cycle through periods of both high and low blood sugar. Low blood sugar, signals cortisol levels. Overtime the body becomes resistant to both insulin and cortisol and we end up with increased inflammatory activity . It is critical to get your blood sugar and insulin levels under control in order to reduce inflammation and heal.

    What Are The Symptoms Of Autoimmune Hepatitis In A Child

    Both Type I and Type II autoimmune hepatitis have similar symptoms. Autoimmune hepatitis symptoms can come on suddenly or may develop over time. Some children with autoimmune hepatitis do not show any obvious symptoms such children may only be diagnosed because of abnormal blood test results. When symptoms do appear, they may include:

    • Fatigue
    • Pale or gray stool
    • Aches in joints

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