Risk Factors of Acute Intermittent Porphyria #3 - Dietary Style and Psychological Factor

Diet style also have effect on the attack of AIP. Fasting, which one’ who used to lose weight rapidly, or only have little food intake for a prolonged period, may results in exacerbate acute attack (Raigal, Lledo, Raigal, Muriel, Perez, & Monero, 2008). These consequences are the outcome of calorie restriction, especially insufficient carbohydrates intake, as carbohydrate and glucose works in suppress the secretion of ALAS, which possibly in triggering AIP (Handschin et al., 2005). According to Garcia-Diz et al. (2012) study, patients with AlP have relatively lower level of macronutrients and micronutrients intake than the control group. Thus, dieting and lack of carbohydrates intake may provoke AIP. 

Figure 16. Losing weight while staying healthy

Besides of the biological and behavioural factors, psychological factors also play a vital role in affecting occurrence of AIP acute attack. This includes biopsychosocial model aspects, involving physical and emotional stress, exhaustion, intercurrent disease, surgery, infections (Balwani & Desnick, 2013; Ventura, Cappellini, Biolcati, Guida, & Rocchi, 2014).

According to Divecha, Tullu, Gandhi and Deshmukh (2016), one of the main concern and factors of acute attack of AIP is stress.  If an individual often suffer from stress, this stress can cause and increase the rate from acute attack (Divecha, Tullu, Gandhi, & Deshmukh, 2016; Simon & Herkes, 2011).  Prior findings also emphasize that acute attack from AIP typically started from minor changes in psychological ways such as anxiety, impatience, aggresiveness and impulsivity (Demily & Sedel, 2014). Therefore, it would often lead to chronic fatigue and relationship difficulties (Demily & Sedel, 2014).

Figure 17. Picture of stress