Autoimmune Hepatitis

What is Autoimmune Hepatitis?

Autoimmune hepatitis is a disease in which the body's immune system attacks liver cells. This causes the liver to become inflamed (hepatitis). Researchers think a genetic factor may predispose some people to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are women, most between the ages of 15 and 40. Autoimmune hepatitis
is classified as either type I or II. Type I is the most common form in North America. It occurs at any age and is more common among women than men. About half of those with type I have other autoimmune disorders, such as type 1 diabetes, proliferative glomerulonephritis, thyroiditis, Graves' disease, Sjogren's syndrome, autoimmune anemia, and ulcerative colitis. Type II autoimmune hepatitis is less common, typically affecting girls ages 2 to 14, although adults can have it too.

What are the symptoms and diagnosis?

Fatigue is probably the most common symptom of autoimmune hepatitis. Other symptoms include:

• enlarged liver
• jaundice
• itching, skin rashes
• joint pain
• abdominal discomfort
• fatigue
• spider angiomas (abnormal blood vessels) on the skin
• nausea
• vomiting
• loss of appetite
• dark urine
• pale or gray colored stools

People in advanced stages of the disease are more likely to have symptoms such as fluid in the abdomen (ascites) or mental confusion. Women may stop having menstrual periods. Symptoms of autoimmune hepatitis range from mild to severe. Because severe viral hepatitis or hepatitis caused by a drug-for example, certain antibiotics-has the same symptoms, tests may be needed for an exact diagnosis. Your doctor should also review and rule out all your medicines before diagnosing autoimmune hepatitis. Your doctor will make a diagnosis based on your symptoms, blood tests, and liver biopsy. 

·         Blood tests-A routine blood test for liver enzymes can help reveal a pattern typical of hepatitis, but further tests, especially for autoantibodies, are needed to diagnose AIH. Antibodies are proteins made by the immune system to fight off bacteria and viruses. In AIH, the immune system makes antinuclear antibodies (ANA), antibodies against smooth muscle cells (SMA), or liver and kidney microsomes (anti-LKM). The pattern and level of these antibodies help define the type of AIH (type I or type II).

Blood tests also help distinguish AIH from viral hepatitis (such as hepatitis B or C) or a metabolic disease (such as Wilson's disease).

• Liver biopsy -A tiny sample of your liver tissue, examined under a microscope, can help your doctor accurately diagnose AIH and tell how serious it is. You will go to a hospital or outpatient surgical facility for this procedure.

What causes it?

One job of the immune system is to protect the body from viruses, bacteria, and other living organisms. Usually, the immune system does not react against the body's own cells. However,sometimes it mistakenly attacks the cells it is supposed to protect. This response is called autoimmunity. Researchers speculate that certain bacteria, viruses, toxins, and drugs trigger an autoimmune response in people who are genetically susceptible to developing an autoimmune disorder.

How do I know I have it?

You may have flu-like symptoms, or other symptoms similar to those described above. However, the only way to know if have AIH is to see your doctor and get a blood test especially for autoantibodies.

What are the treatments for this disease?

• Conventional Treatments

Treatment works best when AIH is diagnosed early. With proper treatment, it can usually be controlled. In fact, recent studies show that sustained response to treatment not only stops the disease from getting worse, but also may actually reverse some of the damage.

The primary treatment is medicine to suppress (slow down) an overactive immune system.

Both types of AIH are treated with daily doses of a corticosteroid called prednisone. Your doctor may start you on a high dose (20 to 60 mg per day) and lower the dose to 5 to 15 mg/day as the disease is controlled. The goal is to find the lowest possible dose that will control your disease.

Another medicine, azathioprine (Imuran) is also used to treat AIH. Like prednisone, azathioprine suppresses the immune system, but in a different way. It helps lower the dose of prednisone needed, thereby reducing its side effects. Your doctor may prescribe azathioprine, in addition to prednisone, once your disease is under control.

Most people will need to take prednisone, with or without azathioprine, for years. Some people take it for life. Corticosteroids may slow down the disease, but everyone is different. In about one out of every three people, treatment can eventually be stopped. After stopping, it is important to carefully monitor your condition and promptly report any new symptoms to your doctor because the disease may return and be even more severe, especially during the first few months after stopping treatment.

In about 7 out of 10 people, the disease goes into remission, with a lessening of severity of symptoms,within 2 years of starting treatment. A portion of persons with a remission will see the disease return within 3 years, so treatment may be necessary on and off for years, if not for life.

Side Effects

Both prednisone and azathioprine have side effects. Because high doses of prednisone are needed to control AIH, managing side effects is very important. However, most side effects appear only after a long period of time.

Some possible side effects of prednisone are

• weight gain
• anxiety and confusion
• thinning of the bones (osteoporosis)
• thinning of the hair and skin
• diabetes
• high blood pressure
• cataracts
• glaucoma

Azathioprine can lower your white blood cell count and sometimes causes nausea and poor appetite. Rare side effects are allergic reaction, liver damage, and pancreatitis (inflammation of the pancreas gland with severe stomach pain).

People who do not respond to standard immune therapy or who have severe side effects may benefit from other immunosuppressive agents like mycophenylate mofetil, cyclosporine or tacrolimus.

• Alternative/Complementary Treatments

Fighting disease is a battle. Some turn to strictly alternative approaches in anguish when conventional treatments are exhausted. However, “alternative” treatments when used in addition to conventional medicine are often referred to as “complementary”. Complementary medicine is a more balanced approach in the effort to treat disease and is recommended because it allows one to take advantage of all options that are available.

It should be noted that because alternative or natural remedies are not regulated, many medical professionals advise against them because of the lack of pier studies and uncertainty of the level of quality control. In addition, they advise that any substance that can affect the body'sc hemistry can, like any drug, produce side effects that may be harmful. In other words, herbal remedies should be viewed as symptom treating aids, just as pharmaceutical drugs are.

However, there is hope. A relatively new science, called Glycobiology, now offers revolutionary and exciting options. Rather than taking the approach of treating a disease or even a symptom, Glycobiology addresses the nutritional requirement at the cellular level. It is believed that:

"Glycobiology is the last scientific frontier to be conquered. It is now understood that there is a 'sugar code' in biological structures that relates to both health and disease. Our ability to define the factors that regulate normal glycosylation of proteins and lipids, resulting in normal structures and functions, and those that cause disruption of normal sugar attachments will be important in understanding disease processes and their management.

Many investigative approaches are being used to study these structure-function relationships and their biological consequences. These include novel analytical techniques to investigate chemical and 3-dimensional structures, proteomics to understand the relationship between glycosylation change and disease, model living systems in which to study the impact of glycosylation, and new enzyme and glycotherapeutic techniques to alter abnormal structures.

Most major diseases that afflict mankind (e.g., cancer, rheumatoid arthritis, heart disease,diabetes, infectious diseases and neurodegenerative diseases) directly involve glycoconjugates.The ultimate goal is to develop the science of glycobiology so that it can have a significant impacton our ability to define and support health, and to diagnose and manage disease."
John S. Axford, BS, MD, FRCP

In 1994, legislation was passed that enabled millions of Americans to enjoy access to safe,effective and affordable dietary supplements. The Dietary Supplement Health and Education Act of 1994 (Enrolled as Agreed to or Passed by Both House and Senate) revealed the following:

Congress finds that:

• The importance of nutrition and the benefits of dietary supplements to health promotion and disease prevention have been documented increasingly in scientific studies;
• There is a link between the ingestion of certain nutrients or dietary supplements and the prevention of chronic diseases such as cancer, heart disease, and osteoporosis; and
• Clinical research has shown that several chronic diseases can be prevented simply witha healthful diet, such as a diet that is low in fat, saturated fat, cholesterol, and sodium,with a high proportion of plant-based foods;

I have seen first hand the power and benefits of Glycobiology as it relates to my wife LaDonna and her battle and victory against liver disease. Her turn around validates the findings that Congress and many scientists in the field of Glycobiology have determined; we must not underestimate the importance of nutrition. A category of specific nutrients led us to find a specific nutritional therapy, which proved very positive. These particular nutrients are called glyconutrients. More specific information on these and other nutritional building blocks associated with this science may be found here.

What would happen if left untreated?

The disease is usually quite serious and, if not treated, gets worse over time. It's usually chronic, meaning it can last for years, and can lead to cirrhosis (scarring and hardening) of the liver and eventually liver failure.

People who progress to end stage liver disease (liver failure) and/or cirrhosis may need a liver transplant. Transplantation has a 1-year survival rate of 90 percent and a 5-year survival rate of 70 to 80 percent.

What would happen if I have this disease and become pregnant?

Women with AIH can become pregnant and can still carry a successful pregnancy. The course of the disease is unpredictable. Although spontaneous remission may occur, maternal death and exacerbation during pregnancy and after delivery have been reported. Therefore, the disease needs to be monitored very closely.

For disease to start and then worsen, it must outmaneuver the many mechanisms of one of the most highly advanced systems ever designed....

the human immune system.

The immune system remains as both your first and last defense against disease.

On a more personal note...

In June of 2004, my wife LaDonna was diagnosed with autoimmune hepatitis after blood tests, a liver scan, and a liver biopsy revealed 85% damage. Her doctor recommended that she should consider a liver transplant as soon as possible.

In March of 2005, we were introduced to some new information that changed our lives forever. This information led to a safe, and effective treatment plan for LaDonna. This treatment plan led to a complete reversal of her autoimmune hepatitis as indicated by a more recent biopsy.

Her liver is now 90% normal and she is no longer in need of a transplant.

The success of her treatment came as a result depending less and less on drugs and more and more on nutrition. The specific category of nutrition that brought about this success is glyconutrients.

We invite you to stay and browse through the other information found on our site. Or perhaps you'd like to speak with us right away, to learn more about glyconutrients and the specifics of LaDonna's nutritritional therapy. Maybe you would like to explore if this therapy might be useful for other disease concerns. If so, please provide an e-mail address in the form below and we would be happy to get back to you with contact information so that we could make arrangements to speak privately with you at your convenience. Important: Please be sure that there are no typos in your e-mail address so that we will be successful in contacting you.

This site is Not Intended for and Does Not Give Medical Advice.

This web site is here for general purposes only. Nothing on it should be considered as medical advice, which can only be given to you by your own medical doctor. Some information you read on this site may be inappropriate for your own situation, or you may interpret or misinterpret something in a way that could be distressing or harmful to you. For advice about your own situation, ask your doctor!

Return from Autoimmune Hepatitis to Home Page

References and Resources:
1. "Autoimmune Hepatitis". The National Digestive Diseases Information Clearinghouse (NDDIC). 26 Jun. 2006. http://digestive.niddk.nih.gov/ddiseases/pubs/autoimmunehep/index.htm.
2. "The liver in pregnancy: Disease vs benign changes". Cleveland Clinic Journal Of Medicine, Volume 72, Number 8, Aug. 2005. http://www.ccjm.org/PDFFILES/Wakim-Fleming8_05.pdf#search='autoimmune%20hepatitis%20pregnancy'.
3. J. Axford. GLYCOBIOLOGY & MEDICINE: A MILLENIAL REVIEW. GlycoScience.org: The Nutrition Science Site. Copyright 2000-2005 Mannatech, Incorporated, Coppell, Texas, U.S.A., all rights reserved.
4. S.784, Dietary Supplement Health and Education Act of 1994, Sec. 2. Findings2,3a,3b.