AIP triggers

Attacks are usually due to the additive effects of several exacerbating factors, including:1,2

  • Use of alcohol or illicit drugs
  • Use of certain prescription drugs
  • Smoking
  • After ovulation and during the last part of the menstrual cycle when progesterone levels are high
  • Reduced food intake, often in an effort to lose weight
  • Infections
  • Surgery
  • Stressful situations

All patients should be counseled about avoiding potential triggers for acute attacks and monitored regularly for the development of long‑term complications.3

References:

  1. Anderson KE, Bloomer JR, Bonkovsky HL, et al. Recommendations for the Diagnosis and Treatment of the Acute Porphyrias. Ann Intern Med 2005;142:439‑450.
  2. Rare Diseases Clinical Research Network. The Porphyrias Consortium. Disorder Definitions. Accessed May 6, 2026, at https://www.rarediseasesnetwork.org​/cms/porphyrias/Healthcare-Professionals/Disorder-Definitions
  3. Wang B, Rudnick S, Cengia B, et al. Acute Hepatic Porphyrias: Review and Recent Progress. Hepatol Commun 2019;3(2):193‑206.