Porphyrias are a rare group of hereditary conditions which involve defects in heme metabolism, resulting in excessive secretion of porphyrins. Heme is the iron part of hemoglobin in blood. Acute Intermittent Porphyria (AIP) is a medical condition which forms a part of these porphyrias and causes intermittent episodes of acute abdominal pain, neuropathies, and constipation. Skin and central nervous system involvement are seen in other types of porphyrias. Elevated levels of urine porphobilinogen confirm the diagnosis of AIP, and conservative treatment is with intravenous glucose infusion, which inhibits heme synthesis and helps reduce mild abdominal pain. A medicine called Hematin is reserved for patients having attacks of severe pain and those with neurological involvement.
Though this genetic defect causes increased levels of porphyrins secretion, all affected individuals do not experience symptoms. Systemic inflammation blood indicators are high in symptomatic patients and it is postulated that this brings about a reduction in kidney function along with neurological damage, which in turn causes peripheral and autonomic neuropathies and psychiatric symptoms. AIP usually occurs in the age from 18 to 40, with women being more affected than men. Attacks of abdominal pain usually last from 3 to 7 days. While the cause for acute attacks is unknown in many patients, there are some known precipitating factors like fasting, alcohol consumption, prolonged exposure to sun, stress, heavy exercises, and the intake of drugs like Phenobarbital, estrogens, and sulphonamides.
Patients with AIP who have recurring attacks, severe incapacitating neuropathies and severe neuropsychiatric manifestations have a very poor quality of life, and can benefit tremendously from Ayurvedic herbal treatment. Ayurvedic treatment provides good symptomatic relief, significantly reduces inflammation, and also effectively treats skin and central nervous system involvement.
Ayurvedic treatment can provide relief from severe pain within 1 to 5 days and regular treatment for about 3 to 5 months can help to get lasting relief and freedom from recurrence of the symptoms. After reviewing the progress of the patient, medicines can then be tapered off and stopped completely. Day to day medical issues not related to AIP can also be treated with short courses of simple Ayurvedic medicines. Ayurvedic medicines are tolerated quite well and have not been known to aggravate or precipitate AIP; however, patients should avoid self-medication, and take treatment from a qualified Ayurvedic practitioner. For preventing recurrence of symptoms, it is equally important to avoid all known precipitating causes.
The commonest symptom of skin involvement is severe itching; this can be controlled very well with Ayurvedic herbs within a few weeks. Patients having neuropsychiatric symptoms or motor neuropathy need specialized treatment for longer periods – nearly 6 to 9 months. Along with oral medication, Ayurvedic Panchkarma procedures like full body massage, fomentations, medicated enemas, periodical mild purgation and Shiro-basti may be required. Shiro-basti procedures involve treating the cranium for fixed durations using medicated oils. A few patients with severe involvement of the nervous system may even require Ayurvedic medications for up to 2 years for a full remission of symptoms.
Ayurvedic herbal medicines can thus be judiciously utilized in the successful management and treatment of AIP as well as all porphyrias.