A number of factors may precipitate a painful neuropathy or other symptoms in a patient with porphyria. Reducing these factors can improve the quality of life of these patients.
Endocrine factors:
(1) menstruation in women
(2) oral contraceptives
(3) occasionally pregnancy
Drugs (listing of unsafe drugs at the American Porphyria Foundation , www.enterprise.net):
(1) drugs that induced the hepatic P450 system
(2) other drugs considered unsafe (sulfonamides, etc.)
(3) smoking
(4) ethanol ingestion
Nutritional factors:
(1) dieting or fasting (high carbohydrate intake may reduce porphyrin excretion, so a low carbohydrate diet may precipitate attacks)
(2) malnutrition
Stress-related factors:
(1) emotional stress
(2) surgical procedures
(3) infections
(4) critical care
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