AIH Autoimmune Hepatitis Trigger of Exercise/Anxiety Prednisone

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New Member

Date Joined Mar 2010
Total Posts : 1
   Posted 3/7/2010 10:52 AM (GMT -7)   
I've been diagnosed recently with Autoimmune Hepatitis. I'm 46 now, my autoimmune problems started with I was 12, with Psoriasis.  In my 20's w/Hashomoto Thyroiditis (lost my thyroid), in my 30's with Sarcoid, 3rd stage effecting my lungs, spine, spleen, etc. (now in complete remission...I hope), Now in my 40's with AIH.  In Sept. '09 my Liver Enzymes soared to 1300's.....
The reason I'm seeming to be different it seems than everyone writing in this forum, is because my trigger seems to be my running/exercise, any physical or mental anxiety?    I had a tough run in Aug. with a 10K, I felt discomfort in my upper abdomin.  A pressure.  Dark Urine after the run.   I did have a positive with Herpes Simplex, and so my hepatologist was concerned, because HSP can be fatal relating to Hepatitis.....that was excluded however, with the biopsy, and overall with my general health being good.   He said I would be very very ill.
After my enzymes came back down without medication (to the 200's).  I went for another run in Jan '10 (stupid), My enzymes shot back up to 800's then 1100's.  I was put on prenisone 40mg  (Feb. 11th).  after 3 weeks, back down to 200's.  now I'm on 30mg. for 2 weeks.  The plan is 2 weeks, then down another 10mg and a presumed ramp-up of imuran. (not sure what to really expect with that).
I've read about prednisone and food/water consumption for no weight gain.  This is a major concern of mine.  What I've done is limit my sodium to 400 mg / daily (3) 28 oz waters/day, and I'm not gaining weight.  I'm eating grain bread (no sodium bread) with low sodium turkey/ blood tests are coming back ok for minerals.  My dr. was concerned with my not consuming enough calories, and flushing my system of nutrients.  The Egg Beaters are GREAT, low in sodium high / lots of vitamins, and tasty!  I use cut-up fresh onions/mushrooms with the eggs. 
I really enjoy my exercise.  I feel that exercise helps me with anxiety, feeling fit and ironically, now I'm told by my Dr.  No, I shouldn't even walk the next 1/2 marathon this coming weekend!  I can't imagine not even walking!!   I believe now that I can feel an 'episode', as long as the weather is good, I will be fine to walk.  I'm still in great physical shape.  Everyone is worried though.  My dr. said that with AIH, you never really know how many 'hits' your liver can take.   The prednisone does seem to be working, and my original Nov '09 biopsy came back fine.   So they've caught this early.  
I wonder if there is anyone else who feels their trigger may be exercise or anxiety?  I really am a very calm person,  yet I feel I'm walking on eggshells.  I wonder if anyone else has a trigger like mine, and how they've done over a period of time with this condition and medication? 

Elite Member

Date Joined Jul 2005
Total Posts : 12014
   Posted 3/7/2010 1:18 PM (GMT -7)   

friendtoanimals, I want to welcome you to the forum.  You certainly have been through a lot!  It is common, however, for a person with one autoimmune disease to have others.  I have to say that I've not heard of anyone having a trigger of exercise.  However, we do have quite a few people here with AIH so maybe one of them can respond.

Considering what you have experienced thus far, I think it would be wise to listen to your doctor for the time being.   No marathons or half-marathons!  Then, after several weeks, try walking again--no running.  I also want to suggest to you something else for anxiety:  Yoga.  You will be stretching your body gently and calming your body and mind without stressing your liver.  I do know that stress is not good for liver disease, be it emotional or physical.  You might also consider Tai Chi and bicycling (no racing!).  The idea here is to find an alternative to running/brisk walking that will not cause problems for your liver.

Good luck!

Forum moderator - Hepatitis
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland

Forum Moderator

Date Joined Apr 2007
Total Posts : 844
   Posted 3/8/2010 5:23 PM (GMT -7)   


I, too, have AIH.  I haven't heard of it being triggered by exercise.  Stress (therefore anxiety) can be a trigger and that's why we are supposed to avoid heavy periods of stress (as much as possible).  As per exercise, we are encouraged to remain as active as we can since there is an increased risk for fatty liver disease.  Perhaps the type of exercise you have been doing (marathons are no easy walk in the park smilewinkgrin ) are too stressful for your body.  Everyone is different.  Other forms of exercise should be fine as Connie suggested yoga and walking - not power walking since you appear to be more sensitive.  I do spin and go to the gym when I can.  I also do the breast cancer 3-day which is a 60mile walk over 3 days but we have all day to do it so it really isn't very taxing provided we've trained enough.  I haven't had any restrictions put on me.  I did gain weight and still have to lose some but I haven't put a huge amount of pressure on myself to do it.  I only have 12 lbs to go to pre sickness weight.  It should be gone by summer!

You said "ramp up of Imuran".  So you are currently on it?  How much?  I have HSV but was diagnosed after the AIH and it hasn't affected anything...knock on wood!  I am currently on 100mg of Imuran and no more pred.  Got off that in Dec 2008.  I was on it a total of 22 months.  I was on 5mg of pred for 11 months and then before my final wean (which is the slowest of all the pred weans) I boosted up to 100mg Imuran.  The 5mg to 0 wean took 2 months.  It has to be the slowest to allow your adrenals time to kick back in to work.  I haven't had any problems with the Imuran...except for possible cholestasis but I opted to treat that separately with Urso and not lower my Imuran dose as I didn't want to risk a flare.  There is a test they can do to find out how much or if any Imuran your body can tolerate.  It measures TPMT (wikipedia that and you'll find out more).

Are you seeing a hepatologist?  You should be!  They have a specialty in liver disorders which is better than seeing a GI unless you don't have access to a hepatologist.  You should also have a baseline bone density test and be taking calcium with Vit D as pred causes bone loss.

Keep up posted,

Diagnosed with AIH January 2007,
CMV (cytomegalovirus) June 2008
Raynaud's February 2010
meds: Azathioprine 100mg, Ursodiol 250mg BID

Veteran Member

Date Joined Sep 2009
Total Posts : 1176
   Posted 3/14/2010 12:38 AM (GMT -7)   
Hi friendtoanimals,

Welcome to the forum!

Just like the other posters, I've never heard of AIH flares being exacerbated or triggered by exercise, but most people with AIH don't have the energy to do much exercise. The same is true of most autoimmune diseases (AI diseases).

However, I have read on the lupus forum posts from people who said that they triggered a lupus flare by exercising, and since lupus is also an AI disease, this is most likely related to your problem.

I think that the others are right in that stress, in any form, be it physical, mental, emotional, can be bad for us and act as a trigger. So please listen to your doctor!

Take care,
Lyme Disease, Babesiosis, Ehrlichiosis, AIH, Hashimoto's, lupus, fibro, RA, celiac disease, asthma, psoriasis, Raynaud's, hypertension, osteopenia, sleep apnea, RLS, GERD, DDD, L3-4 and L4-5 radiculopathy -> severe lower back pain, cubital tunnel, tarsal tunnel, Doxycycline, Zithromax, Prednisone, Imuran, Plaquenil, Lyrica, Cymbalta, Levothyroxine, Atenolol, Cozaar, Zyrtec, Fosamax, Albuterol, Prilosec, CPAP

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