AIP triggers

Attacks are usually due to the additive effects of several exacerbating factors, including:

  • Use of alcohol or illicit drugs1
  • Smoking1
  • After ovulation and during the last part of the menstrual cycle when progesterone levels are high2
  • Reduced food intake, often in an effort to lose weight2
  • Infections2
  • Surgery2
  • Stressful situations2

All patients should be counseled about avoiding potential triggers for acute attacks and monitored regularly for the development of long‑term complications.3


  1. Anderson KE, Bloomer JR, Bonkovsky HL, et al. Recommendations for the Diagnosis and Treatment of the Acute Porphyrias. Ann Intern Med 2005;142:439‑450.
  2. Rare Diseases Clinical Research Network. The Porphyrias Consortium. Disorder Definitions. Accessed January 14, 2020 at​/cms/porphyrias/Healthcare-Professionals/Disorder-Definitions
  3. Wang B, Rudnick S, Cengia B, et al. Acute Hepatic Porphyrias: Review and Recent Progress. Hepatol Commun 2019;3(2):193‑206.