Understanding AHP and Eating Well With a Simple Chicken Salad

Living with a rare condition like acute hepatic porphyria (AHP) can feel overwhelming, especially when symptoms are unpredictable and often misunderstood. In this interview, Cynthia Levy, M.D., shares practical insights to help patients better understand AHP: from recognizing symptoms and triggers to navigating treatment and daily life. Her guidance highlights the importance of education, early diagnosis and building a strong care team to manage this complex condition.

Alongside these insights, Levy also offers a simple, nourishing recipe for Chipper Chicken Salad, originally published on the American Liver Foundation, designed with patient needs in mind. Because skipping meals or restrictive dieting can trigger AHP attacks, maintaining regular, balanced nutrition is key. This easy recipe combines lean protein, fresh vegetables and bright flavors, with the option to add grapes for a boost of carbohydrates (an important consideration for some patients with AHP). Together, the interview and recipe reinforce how small, everyday choices, from diet to disease awareness, can make a meaningful difference in managing health.

Chipper Chicken Salad

Ingredients:

• 1 cup diced chicken breast
• 1/2 cup diced celery
• 2 tablespoons chopped green onion
• 1 tablespoon light mayonnaise
• 1 teaspoon Dijon mustard
• 1 1/2 tablespoons lemon juice
• Salt-free seasoning to taste

Directions:

1. Preheat oven to 350 degrees. Place diced chicken breast on baking sheet and put in oven. Cook for about 20 minutes, or until chicken has reached 165 degrees internally.
2. Combine celery, green onion, mayonnaise, Dijon mustard and lemon juice in a bowl. Once chicken cools slightly, place chicken in the bowl with combined ingredients and mix until chicken is coated.
3. Serve on whole-wheat bread as a sandwich, or with sliced vegetables such as cucumbers and bell peppers.

Levy also suggests adding a handful of diced red grapes to up the carbs a bit because it’s good for patients with AHP.

What is AHP, and how is it different from other types of porphyria?

Cynthia Levy, M.D.: Acute hepatic porphyria (AHP) is a group of rare liver disorders that affect how the body makes heme, a substance needed for red blood cells. In AHP, harmful chemicals build up and can affect the nervous system. This makes it different from other types of porphyria, called the cutaneous porphyrias, which mainly affect the skin rather than causing internal symptoms.

What symptoms should patients be aware of, and why can AHP be so difficult to diagnose?

CL: Common symptoms include severe abdominal pain, nausea, vomiting, weakness and sometimes confusion or mood changes. Many people also have automatic body symptoms, like a fast heartbeat, high blood pressure, sweating or trouble with bowel or bladder control, which reflects involvement of the nervous system and can be an important clue to AHP. Even with these signs, the condition can be hard to diagnose because symptoms overlap with many common illnesses and often come and go.

What typically triggers an acute attack, and are there ways patients can reduce their risk?

CL: Triggers can include certain medications, alcohol, infections, stress and hormonal changes. Skipping meals or dieting can also increase the risk of an attack. Patients can reduce risk by avoiding known triggers, eating regular meals and using trusted resources — such as the United Porphyrias Association (UPA) and the American Porphyria Foundation (APF) — which offer safe drug lists to help guide medication choices.

What treatment options are available today to manage acute attacks and prevent future episodes?

CL: Acute attacks are often treated in the hospital with intravenous hemin, which helps stop the attack, along with pain control and supportive care. For patients who have frequent attacks, a medication called givosiran (Givlaari) is available and can significantly reduce the number of attacks and the need for hemin treatments. Treatment plans are individualized, and your doctor will help decide the best approach based on how often attacks occur and how severe they are.

How can living with AHP affect mental health, daily functioning and quality of life?

CL: Living with AHP can be stressful because attacks are painful and unpredictable. Many patients may feel anxious or depressed, especially if symptoms interfere with work or daily life. Support from health care providers, family, patient support groups and mental health professionals can make a big difference.

What is the most important advice you would give to someone newly diagnosed with AHP?

CL: Learn about your condition and understand your personal triggers. Stay connected with a health care team that has experience managing AHP. Most importantly, know that with proper care and support, many people can manage their symptoms and live full lives.