Steroids for AIH: What You Need to Know About Use, Risks, and Alternatives

When your immune system attacks your own liver, that’s autoimmune hepatitis, a chronic condition where the body’s defenses mistakenly target liver cells, causing inflammation and potential scarring. corticosteroids, a class of powerful anti-inflammatory drugs that suppress immune activity are often the first-line treatment. They’re not a cure, but they can calm the attack, lower liver enzymes, and buy time for your liver to heal. For many people, this means avoiding cirrhosis or liver failure—something that could otherwise lead to a transplant. But steroids for AIH aren’t simple. They come with side effects that can change your life: weight gain, bone thinning, mood swings, high blood sugar, and even a risk of adrenal crisis if stopped too fast.

What most patients don’t realize is that steroid tapering, the slow, careful reduction of dosage over months or years is just as important as starting the drug. Jumping off too soon can trigger a flare-up, sometimes worse than the original. And even when you’re stable, your doctor needs to monitor your liver function, bone density, and blood pressure closely. There’s also a growing group of patients who don’t respond well to steroids at all—or can’t tolerate them. That’s where alternative treatments, like azathioprine, mycophenolate, or budesonide come in. These aren’t magic bullets, but they offer a way to reduce steroid doses or replace them entirely. Some newer options are still being studied, but they give hope for long-term control without the heavy side effects.

The posts below dig into the real-world side of using steroids for AIH. You’ll find clear explanations of how steroids affect your liver, what happens when you stop them too quickly, and why some people feel worse even when lab numbers look good. You’ll also see how other drugs compare, what symptoms to watch for, and how to talk to your doctor about safer, longer-term plans. This isn’t just about pills—it’s about protecting your body over years, not just weeks. Whether you’re just starting treatment or have been on steroids for a while, these articles give you the facts you need to make smarter choices.