Utilization and Impact of Complementary and Alternative Medicines in Symptomatic Autoimmune Hepatitis Patients

• Published in: Digestive diseases and sciences Vol. 67; no. 7; pp. 2891 - 2898
• Main Authors: Gelow, Kayla, Chalasani, Sai, Green, Kelsey, Lammert, Craig
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2022; Springer; Springer Nature B.V
• Subjects: Alternative medicine; Anesthesia; Anxiety; Biochemistry; Biopsy; Cannabidiol; Chronic active hepatitis; Demographics; Drug interactions; Drugs; Gastroenterology; Hepatitis; Hepatology; Herbal medicine; Liver; Liver diseases; Medical colleges; Medicine; Medicine & Public Health; Mental depression; Mental health; Oncology; Original; Original Article; Patients; Physicians; Questionnaires; Surveys; Transplant Surgery; Variables; AIH; Supplement; Complementary and alternative medicine; Autoimmune hepatitis; CAM
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-021-07112-0

Background Complementary and alternative medicine (CAM) use has become increasingly common. It is also prevalent in patients with chronic liver disease, but the scope, depth, and safety of use is not well known. Aims This study aimed to evaluate the prevalence and patterns of CAM use in autoimmune hepatitis (AIH) patients. Methods Electronic invitation to complete a 22 item CAM-specific questionnaire was posted weekly to well-established AIH Facebook communities (combined membership of 4700 individuals) during a 6-week study period. Age ≥ 18 years and AIH diagnosis made by a treating physician were the eligibility criteria. Results The prevalence of ever CAM use among participants was 56.4%, and nearly 42% used CAM after AIH diagnosis. Among those reporting CAM use after diagnosis, 53.7% (51/95) indicated CAM was used to mitigate AIH-related phenomenon, most often targeting liver inflammation/fibrosis (67.7%), fatigue (51%), joint pain (47.1%), and sleep issues (45.1%). Most frequent physical CAM strategies were exercise (49.5%) and yoga (34%), whereas most frequent consumable CAM included healthier eating (45.3%), cannabidiol preparations (45.3%), and probiotics (44.3%). Seventy-five percent reported that CAM improved AIH symptoms and no severe adverse events were reported. Conclusions CAM use in AIH patients is prevalent, yet providers have historically failed to document their patient’s CAM strategies. Beyond inherent drug-induced liver injury risk, drug-drug interactions remain a concern and could alter baseline immunosuppression levels in AIH. Despite a majority found CAM approaches that improved targeted symptoms, all were unable to alter the course of chronically prescribed medications by physicians.