• Cat Calhoun

Autoimmune Hepatitis

Hepatitis is an inflammation of the liver. Generally it's a virus that causes hepatitis, but autoimmune hepatitis (AIH) is an exception. Autoimmune hepatitis causes a liver inflammation resulting when the immune system mistakenly attacks the liver cells. This chronic, inflammatory condition can cause scarring and hardening of the liver and can eventually lead to liver failure.


As with any autoimmune disease, no one really knows the specific cause. The known risk factors, however, are considered to be a familial history of autoimmune disease (specifically AIH), history of bacterial or viral infections, and use of certain medications such as minocycline. Women are more susceptible than men.


Other autoimmune disease are also linked to AIH. These include Graves, thyroiditis, ulcerative colitis, type 1 diabetes, rheumatoid arthritis, scleroderma, IBD (inflammatory bowel disease), SLE, and Sjögren's syndrome.


Signs and symptoms

Signs and symptoms can express from mild to severe. Early stage patients may have none at all, s/sx may appear suddenly, or develop slowly over time. Common s/sx include: enlarged liver, abnormal blood vessels on the skin (like multiple spider angiomas), swelling in the abdomen and abdominal distention, darker urine, pale colored stools, yellowing of the eyes and skin (jaundice), itching of the skin caused by bile build-up, fatigue, loss of appetite, nausea and vomiting, and joint pain.


Tests

Be sure to ask for lab work and see what you see there. Don't take another practitioner's word for it! Common tests given to determine AIH will rule out viral hepatitis. Look at liver function tests, anti-smooth muscle antibodies, anti-liver and kidney antibody tests, ANA (anti-nuclear antibody) tests, IgG antibody tests, and possibly a liver biopsy.


Treatment

Western medical therapy offers immunosuppressant drugs, corticosteroids, and possibly a liver transplant. Chinese medicine uses lifestyle changes, diet changes, acupuncture, and herbal therapies. See the autoimmune page to learn more about lifestyle and diet changes to incorporate.


Acupuncture basic Rx

The basic Master Tung acupuncture prescription below is about channel relationships and standard TCM points to both guide and treat AIH. Don't get too caught up about the sides given for the points. This is an internal disease. You can treat bilaterally or switch the sides up if you need to. No problem. Just go with as few points as possible to address the dysfunctions and imbalances you see. Treat 2-3 times per week if at all possible.

  • Bilateral or single side Gan men, Chang men

  • Right side: Huo Ying, Huo Zhu, Lv 6,* Gb 36, Gb 41, Gb 43 *Master Tung's Lv 6 is needled next to the tibia on the Spleen channel rather than on the bone itself. Use your fingernail to palpate and slide the needle right next to the bone. Palpate Dan Nang Xue (TCM extra point 1-2 cun distal to Gb 34) for tenderness to see if there is gallbladder inflammation. If so, you can needle this point as well.

  • Left side: Xia San Huang, St 34, St 36, St 44

Point Discussion

  • Gan men and chang men points can be used on the left side, right side, or needled bilaterally. These points have a strong effect on liver and intestinal disease and are located on the Small intestine meridian. They remove damp heat, therefore addressing jaundice (which is considered damp heat in the case of AIH). This point is needled with the patient lying face up (or sitting with their arms on an armrest) and the arm placed with the palm down. These points are just below the ulna and should be palpated with your fingernail. Slide the needle in right next to the bone.

  • The Huo Ying, Huo Zhu, Liver and Gallbladder points on the right treat both the enlarged liver and jaundice. They also treat liver channel and organ dysfunction as well as gallbladder inflammation and other problems. Be aware that Dan Nang Xue is only located on the right side!

  • Xia San Huang and the Stomach points on the left treat fatigue and circulate blood due to the Yangming connection. (Hepatitis in general often mimics a Spleen Yang xu.) They also move a lot of Qi and Blood and assist with stomach pain and upset.

Herbal treatment basics begin with the classic formulas Yin Chen Hao Tang (bile and jaundice), Chai Hu Shu Gan Tang (all kinds of Liver issues), and Long Dan Xie Gan Tang (Liver fire, etc.). You can use Chai Hu Shu Gan Tang and Yin Chen Hao Tang in a 50/50 mixture or even all 3 in a 33/33/33 mixture. Evergreen Herbs has a great Liver DTX formula. Combine it with their Herbal DTX formula.

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