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Table of Contents
General Nutritional Information
Calculations for Glucose IVs
Acute Hepatic Poprphyria Dietary Notes
     Foods to Avoid
     Must Have
A Hypertension Diet
A Diet for Neuropathy
Potassium Deficency Diet
Sulfa,Sulfur,Sulfites Notes
Nutritional and Dietary Data

Glucose IV Calculations

Formula:
7.5 grams of carbohydrate = 56 Calories
Note: To empty a 1000 ml bag at 150 ml per hour requires 6 hr 40 min.
We use 6hr or 900 ml in the calculations below.

5% DW at 150 ml per hour = 7.5 grams of glucose per hour
5% DW at 150 ml per hour = 56 calories per hour
For a 24 hour period (4 -1,000 ml bags back-to-back) = 180 grams of glucose.
For a 24 hour period (4 - 1,000 ml bags back-to-back = 1344 calories

*To bring AIP into remission a total of 400 grams of carbohydrate is
needed. An additional 220 grams of carbohydrate must be consumed.

If DW 10 is being used one would realize 15 grams per hour. Which
would be 360 grams of carbohydrate by infusion with 40 grams remaining to be consumed.

Acute Hepatic Porphyria Dietary Notes

Glucose and other carbohydrates can repress the pathway for synthesis of heme in the liver. As a result, the overproduction of porphyrin precursors and porphyrins is repressed by carbohydrate administration.

AVOID
Alcoholic beverages
Negative caloric intake -more than 10% below your BMR (basic metabolic rate)
Low carbohydrate intake (less than 300 grams daily)
*During active acute attacks avoid having less than 450-500 grams daily
including IV infusion supplementation.
Fasting more than 3 hours
*Vital to have steady carbohydrate intake around the clock.

Porphyrinogenic foods
     *Porphyrinogenic foods contain chemicals that stimulate heme synthesis.

     Cabbage
     Brussel sprouts
     Red plums
     Red grapes
     Red / purple grape juice
     Prunes


Sulphur containing foods
     Tomatoes
     Cabbage
     Caluiflower
     Broccoli
     Brussel sprouts
     Kale
     Kohlrabi
     Mustard
     Raw onion
     Rutabaga
     Turnips
          Egg Yokes

Sulphite containing foods

          *Be aware of presevatives in foods as most contain sulphites.
     Dried fruit
     Lemon & Lime Juice
     Wine
     Molasses
     Sauerkraut
     Fresh shrimp
     Grape Juice

Iron supplements

Restrict fat and protein during active porphyria, otherwise follow RDA.
Remember that acute porphyria increases CSF protein levels, elevates cholesterol, lipids and blood glucose level.

Avoid High fiber intake due to bezoar formation in acute porphyria patients <40%

Avoid Chamomile containing foods

*Known sensitive reaction for acute porphyria patients, like that of ragweed.

Balsam containing foods
     Citrus fruits
     Cola
     Chocolate
     Spices including Vanilla
     Tomatoes
     Soy containing products.
          *Soy is a natural estrogen. Estrogens are contraindicated in acute porphyria.
Cholesterol must be <300 daily.

POTASSIUM DEFICENCY DIET

*In the acute porphyrias there is often an associated deficit of potassium when blood serum electrolytes are run in the laboratory.
Therapy to correct the Potassium deficit uses a combination therapy.br> Close monitoring of your blood serum potassium is necessary. Be sure to have it check regularly.

Most likely the potassium deficit is twofold.
Potassium deficit is due in large part to (1) the manifestations of acute porphyria and the loss of potassium due to vomiting during attacks
and (2) the daily use of a diuretic.

The normal blood serum potassium range runs (3.6 - 6.5). For acute porphyria patients the desired level runs 4.00 - 6.00.

Potassium therapy calls for the daily prescription intake of Potassium tablets. During times of acute activity added potassium of 20 meq's per 1,000 ml iv solution every 6.5 hours gives an additional 80 meq's daily during the times of peak loss of Potassium.

Daily ingestion of potassium is also important. The following is a guideline of food potassium levels.


High Potassium Levels (201 -350 mg)
Apricots
Asparagus
Avocado
Banana
Cantaloupe
Celery

Dates Honeydew Orange Orange juice Pepper Chilies Prunes

Potato Pumpkin Rutabagas

Spinich Tomato Juice Tomato Sauce

Medium Potassium Levels (101 - 200 mg) Apple
Apple Juice
Apricot Nectar
Apple Juice
Blackberries
Cherries
Figs
Grapefruit
Lemons

Lemon Juice Papaya Peaches (Canned)Plums Raisins Strawberriess Tangerines Watermelon

Broccoli Carrots Cauliflower Corn Mushrooms Onions Radishes Sauerkraut

Low Potassium Levels (0 - 100 mg)

Applesauce Blueberries Cranberries Cranberry Juice Grape Juice Grapes Papaya Nectar Peach Nectar Pears (Canned)

Alfalfa Bean Sprouts Cabbage Cucumber Green Pepper Watercress Waterchestnuts