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 ,

(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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