Autoimmune Flare Self-Care

You did it! After months of failures with autoimmune protocol (AIP) eliminations and the frustrations that come with it, you finally made it through to the reintroduction phase and have discovered your food triggers. You have gained a new appreciation for nourishing foods and your body because it can function better than it has in years.

You feel like a new person and ready to take on the world. Because you feel better than you have in years and better than you thought you would be able to ever feel after your autoimmune diagnosis, it’s GO TIME!

You set out to accomplish all of the goals you had before your diagnosis but couldn’t make them happen because your symptoms prevented you from taking action. With your newfound energy, you feel like a superwoman and can now be everything to everybody. In the words of the popular 80’s tune by Matthew Wilder, “Nothin’ is gonna break [your] stride, nobody gonna slow [you] down, oh no – [you] got to keep on moving.”

Can you relate? I am sure that most of us who have completed AIP successfully can. I finally felt like I was the person I desired to be, full of goals and aspirations and overflowing with the energy I needed to accomplish them. One of my goals at the time was to improve at running, and I wanted to go LONGER distances, go FASTER, and do MORE. Once I completed AIP, I was like the woman described in the song’s next verse – “the road behind was rocky, but now I was feeling cocky.” Little did I know that although I thought I was finished with my AIP journey, it was just beginning.

Not long after completing the Autoimmune Protocol, I realized that living with an autoimmune disease meant that self-care would have to be at the forefront of my life for the rest of my life. To thrive with my autoimmune disease, I could not just focus on food. I would also have to focus on autoimmune-specific self-care tools. I had to learn to “break my stride” and slow down in order to manage my autoimmune flares.

What is Happening to the Body During a Flare?

One of the most frustrating parts about living with autoimmune disease is the uncertainty of autoimmune flares – the ebbs and flows. After completing the AIP Protocol, my symptoms were in remission, and I was in my “autoimmune flow zone.” My immune system was regulated. However, as I began getting back into my old habits, my immune system became dysregulated. As a result, I saw an increase in the symptoms I experienced before completing my AIP eliminations and reintroductions. I was in my “autoimmune ebb zone .” Although I knew and avoided the foods that triggered autoimmune symptoms, I was aware of the non-dietary factors that impacted my symptoms, but I chose not to prioritize them as a part of my wellness plan.

Your Symptoms Return

Each autoimmune disease may have different symptoms during a flare. These symptoms can also vary from person-to-person for the same autoimmune disease. During my Hashimoto’s flares, when I put too many activities on my plate or have a lot of external stressors, I began to experience extreme fatigue and swelling in my neck to the point where it felt as though my throat was closing. I would even become hoarse. I liken it to how one would feel when they have a virus and the symptoms first appear.

Though each autoimmune disease has its own set of symptoms, there are also some more general symptoms you may experience:

Common Flare Symptoms

  • Anxiety
  • Depression states
  • Brain fog
  • Digestive issues
  • Dizziness
  • Fatigue that doesn’t get better with rest
  • Headaches
  • Increased heart rate
  • Sleep issues
  • Muscle and body aches
  • Puffiness, usually located around the eyes
  • Sensitivity to sun, heat or cold
  • Unexplained weight gain or weight loss

What is Triggering Your Autoimmune Flares?

When your immune system is dysregulated, you are more vulnerable to an immune response to an environmental OR internal trigger. Often, the triggers that drove the autoimmune disease in the first place will be the triggers that cause a flare.

Some common triggers are:

Environmental Triggers

  • Diet
  • Emotional Charge
  • Exhaustion
  • Exposure to toxins
  • Medications
  • Nutritional Weakness
  • Recent Illness
  • Stress (even good stress)
  • Trauma

Internal Triggers

  • Adrenal glands are exhausted
  • Estrogen imbalance, menstruation and synthetic hormones
  • Leaky gut
  • Microbiome disturbed from antibiotics
  • Perimenopause or menopause
  • Pregnancy or postpartum
  • The body became too acidic
  • The blood sugar is too high or low

When beginning AIP, the focus is to put the disease into remission. Once you have successfully completed the elimination and reintroductions of AIP, if a flare occurs, the goal once again is to put it in remission.

Just like the type and severity of symptoms can vary for each person, the length of time symptoms will linger can vary as well. Flares can last from weeks to months unless there is a change in your self-care to address them.

Self-care for Autoimmune Flares

When self-care is not at the forefront of your autoimmune journey, the potential to flare increases exponentially. However, it is essential to note that you could be doing everything in your power to proactively prevent a flare and still experience them. As a part of the mindset shift that you need to be successful on AIP, you must understand that flares are not failures.

Because we are not always in control and life is sure to throw us curve balls, sometimes those external and internal triggers are not always in our control. Life is unexpected, and as a result, so are our flares.

What Not to Do During a Flare

When you’re in a flare, it’s easy to say, “Oh well! I feel like crap anyway. I might as well eat what I want.” But indulging in unhealthy food and falling back on bad habits will only exaggerate and prolong the flare. This is a time when we want to slow down and pay attention to our actions so that we can determine if our actions could be a contributor to our flares. The most common things that I have seen when clients are going through a flare are self-medicating with caffeine, sugar, energy drinks, inflammatory comfort foods and OTC pain meds and/or self-sabotaging by judging themselves, indulging in negative self-talk, or ignoring the signs that their body needs more rest.

It is imperative that you realize that those anti-self-care practices will only prolong your symptoms and your frustrations and keep you from moving forward on your journey to better health.

What To Do to Mitigate Flares

Autoimmune self-care is what we do to reach the most balanced state possible. It sets your body up for success with your medical treatment plan and helps us to mitigate the impact of flares. Below is a list of some tools for your autoimmune self-care tool box. If you are currently in a flare, use these tips to learn about your options and talk with your health care provider to ensure that you make choices that are safe and appropriate for you. However, even if you are not currently in a flare, these techniques will help support your body and maintain balance.

Practice self-compassion and a positive mindset: Living with autoimmune disease is hard. You must be patient with yourself and practice self-compassion. To practice self-compassion is to let go of all blame, guilt, and judgement. When you are in a flare, it is common to feel like your body has betrayed you. This can leave you with a heavy heart and a negative mindset. Stressing and having a negative attitude towards your body can aggravate your flares and make them worse.

It is important that your self-care during this time include reframing your “I can’t” thoughts into opportunities to grow. Difficult situations like flares can feel overwhelming, but looking at them through the lens of growth and being able to learn your body better to minimize future flares can help to alleviate a lot of weight surrounding this stressful time.

The self-care tools I suggest to clients to help navigate life with more self-compassion and a positive mindset are affirmations and gratitude. Saying affirmations and practicing gratitude can have a powerful impact on our lives. What we think about expands, and we have the ability to produce positive outcomes if we choose.

Journaling. Because autoimmune disease can be frustrating and isolating, journaling is a tool that can offer a release for emotions, fears and feelings. By pouring out your thoughts and things onto paper you can get everything out.

Journaling is also a wonderful tool to keep track of symptoms and see how different self-care strategies are serving you. Take a baseline before beginning anything new. How are you feeling, sleeping, pooping, eating, etc. Once you’ve been employing a new technique for a few weeks, reevaluate and ask the same questions. This will help you better pinpoint the causality of the flares.

Diet. When experiencing a flare, t is a good time to reevaluate your diet to assure there are no nutritional deficiencies. However, even the best diets can be deficient in some factors needed to support health. Supplements can be a good short-term solution for a boost.

Blood tests can help you determine if you need to supplement basics like Vitamin D, omega-3, zinc, selenium and magnesium. Immune balance hinges on those being available to the body in sufficient quantity. People with autoimmune issues are usually deficient in magnesium because magnesium is depleted as a result of stress.

These are the 5 most common deficiencies that affect women with autoimmunity. Be sure to include plenty of these foods into your diet plan.

Vitamin D – Oily fish, oysters, liver, eggs, and mushrooms.
Selenium – Shrimp, scallops, fish, and brazil nuts.
Iodine – Ocean vegetables and seafood (not iodized salt!)
Iron – Red meat, eggs, dark chocolate, spinach and pumpkin seeds.
B Vitamins – Eggs, dark leafy greens, seeds, nuts and most meat.

Hydrate. One of the things that is often overlooked during a flare is hydration. Dehydration leads to inflammation and can impact everything from pain perception, sleep, and focus. Chronic dehydration is linked to an increase in cortisol, which can trigger a flare due to prolonged stress. Focus on drinking approximately half of your body weight in ounces per day. Consider adding a pinch of quality Celtic Sea Salt to your water to improve electrolyte balance.

Sleep. Lack of sleep creates stress and can have a profound impact on autoimmune imbalance and overall health. When you are not getting enough sleep, your brain starts to suffer and go haywire. When this happens, the vagus nerve that serves as the information highway from your brain to your gut, can’t properly communicate and as a result, your body doesn’t function as well, which can lead to a flare. Focusing on improving your sleep hygiene will help you get better rest, reduce stress and allows for your body to rest, recover and regulate itself more efficiently and effectively. We should always practice good sleep hygiene, but it is especially important during a flare. Some things you can do to optimize your sleep are:

  • Exercise earlier in the day
  • Avoid eating dinner 2 to 3 hours before bedtime
  • Use blue-blockers while using your devices in the evening
  • Avoid bright screens 1 to 2 hours before bedtime
  • Make your bedroom dark and shut off the light from digital clocks
  • Try a magnesium supplement about an hour before bed
  • Take a warm/hot bath an hour before bed
  • Create a slightly cooler environment where you sleep
  • Wake up and go to bed at the same time each day
  • Avoid later bedtimes and sleeping in on the weekends
  • Expose yourself to morning sunshine within 1.5 hours after sunrise.

Reduce your stress. One of the most important things you can do during a flare is manage your stress. . During a flare, your body is under an immense amount of stress, therefore it is imperative that you focus on relaxation which will help support the immune system and reduce the length of time the flare continues.

As a part of your autoimmune self-care routine, it is important that you take the time to identify what type of stress you are under: emotional, mental, physical, environmental, etc. Once the stressors are identified, create a plan of action to begin reducing them or learning self-care techniques to better manage them. Some of these self-care techniques are continued below.

Deep breathing. Breathing exercises are well-known for their ability to reduce stress and calm the mind. Breathing can have amazing benefits for both your physical and mental well-being if you are in a flare. When you experience feelings of anxiety, depression, and stress, the inflammatory molecules in your body increase and your symptoms worsen. When you practice controlled, intentional breathing, your body makes the switch from a sympathetic state to a parasympathetic state. Studies have shown that individuals who practice deep breathing regularly have significantly lower levels of circulating inflammatory molecules.

Meditation. One way to practice deep breathing is through meditation. The American Autoimmune Related Disease Association (AARDA) recommends meditation as a tool for people with autoimmune disease. Nothing can quite compare to the impact meditation can have on your mood and overall outlook on life. An autoimmune flare can be difficult and frustrating to deal with, and it can be hard to take your mind off the discomfort or pain that you feel.
Begin meditating by simply focusing on breathing in through your nose and out through your mouth while seated quietly and comfortably. Aim to take 5-10 breaths this way. Slowly inhale, slowly exhale. You can progress by trying a one-minute meditation and work your way up to 20-30 minutes a day.

Grounding. Grounding is a holistic technique that has become more and more popular over the past few years. The practice of grounding is literally allowing the body to come in contact with the Earth. It is simply done by placing your bare feet on the grass, dirt, ground, sand or a natural body of water. A 2015 study provides insight into the practice of grounding and how the electromagnetic field of the earth can realign that of the body. According to the study, “grounding produces measurable differences in the concentrations of white blood cells, cytokines, and other molecules involved in the inflammatory response… Grounding reduces pain and alters the numbers of circulating neutrophils and lymphocytes, and also affects various circulating chemical factors related to inflammation.” You have the option of taking barefoot walks on the beach to sitting outside in your grass with your shoes off. Both are awesome options as you will also get some fresh are and vitamin D from the sun.

Relaxing bath. Soaking in a hot bath with mineral-rich Epsom salt or a cool bath with calming chamomile leaves and baking soda can help ease aching muscles and joints as well as release stress. Hot baths can induce hyperthermia or sweating. When you soak in a hot bath for 15-20 minutes and then get out, your body has to work to cool down. This cooling process is relaxing and can help you get to sleep faster and deeper if done 60-90 minutes prior to bed. If you prefer, cool baths can tap into the cryotherapy techniques and also ease inflammation. They are great for sensitive skin and still maintain the relaxation benefit.

If sitting in a bathtub isn’t relaxing for you during a flare, contrast showering may be an option. In the shower, alternate between hot and cold water to support lymphatic drainage. The hot water brings blood flow to the skin’s surface while the cold water directs blood flow inward to the organs. You can alternate between one minute of hot water and one minute of cold water and work your way up to 3 minutes as you continue with this practice over time. Repeat this process for 15 minutes, making sure you always finish with cold water.

Massage. A 2017 review in Complementary Therapies in Clinical Practice found benefits to massage when used to treat a range of conditions that included autoimmune diseases. Pain relief was the primary benefit. In addition to this preliminary research about the therapeutic effects of massage for specific autoimmune conditions, massage is relaxing, helps people reconnect to their body and promotes lymph movement. If resources allow, having a good massage therapist as a part of your autoimmune self-care team is recommended. If not, there are several self-massage tools and self-massage how-to videos on the internet that will work wonders for both pain and stress relief.

Practice intuitive movement. Intuitive movement is about learning to tune in, listen to your body’s needs, and provide that with gentleness and mindfulness. We often force workouts that don’t serve us well and lead us into an autoimmune flare.
Intuitive movement is focused on overall well-being. It’s about movement that feels good, creating space to learn your body’s needs and eliminating the rigidity that comes with the standard “burn calories and lose weight” workouts.
One of my go-to movement practices I suggest for clients is yoga. It has been proven that yoga is an excellent method to reduce inflammation and boost immunity and is an excellent practice for restoring the function and performance of the body and mind. During a flare, I suggest Yin Yoga, restorative yoga or gentle yoga. Power or hot yoga may not be appropriate during times of healing.

Connect. Social connection is important to health and immune function. UCLA researcher Steven Cole has done groundbreaking work that links social behavior and social connection with immune response. Feeling connected helps strengthen the immune system, increase longevity and may help you recover from flares faster.
However, it is common for friends and family members, who do not understand autoimmune disease, to lack compassion and understanding. This can be especially true when you seem to be in remission, are doing well, then have a flare. It can be difficult to bear the burden of living with autoimmune disease alone. Social connections can be the lifeline you need to cope with your illness during your most difficult times.

Connection doesn’t mean having lots of friends or even being in public. What it involves is feeling as though you have people you can turn to for support. Feeling heard and understood are part of the equation. If you don’t have relationships like this in your life, think about ways that you can reach out and make new connections. Online communities or local meet-ups with people who are going through the same thing as you can be helpful. The caution is to be mindful that you choose a group who practices positivity rather than dwelling in negativity. That vibe will drag you down and the purpose of connection n this way is to lift you up.

Contact your practitioner and connect with an AIP coach. As previously mentioned, you can be doing everything right for self-care and still have flares. As a general measure, if you have been doing AIP for over a year and continue to have severe flares, it is highly suggested that you talk to your practitioner about adjusting your plan.

When you are on the proper protocol for your body, there should be incremental improvements as you progress. If you are in a state of continual flares and are not making progress, that is a sign that the protocol isn’t the right fit, you may need to change your medications, or you need to look past AIP eliminations and dig deeper into what is causing your flares.

An Ounce of Prevention is Worth a Pound of Cure

This by far is not an all-inclusive list of autoimmune self-care practices. However, by choosing a few from this list or others that you already have in your self-care toolbox, and implementing them consistently, you will be taking great strides to regain control back over your body, lessen the length of time for your flare, and begin to put the symptoms in remission.

But can we be real here? By the time we have gone through the symptom ebbs and flows over several years of being undiagnosed, taking several years and several doctors to get a diagnosis, finding the support and education we needed to go on our AIP journey and then having the heart, determination and motivation to make it through the often times challenging and frustrating process of finding our food triggers through AIP, anything we can have control over, we should cherish.
Taking care of ourselves and putting our health of our body, mind and soul is not an option with autoimmune disease.

Anything we can do, we should do to lessen the likelihood of a flare. Autoimmune self-care is a lifestyle and all of the self-care tools outlined should be a part of your daily self-care. Simply choose a few to do daily, weekly, monthly and quarterly and schedule time for you. It’s necessary to “break your stride” and you should “slow down” so that you are able to move when you want to and not just when your body allows you to. Self-care is the ounce of prevention that will keep your autoimmune flares at bay and allow you to live life optimally in spite of your autoimmune disease.



About Jamie Nicole

Jamie Nicole is a Certified Health Coach through the Institute for Integrative Nutrition and a fitness instructor whose passion and purpose are not only to educate women with autoimmune disease to live an AIP lifestyle, but to help remove the inequities that exist in the AIP BIPOC community that are barriers to the successful implementation of AIP. In her practice, Jamie helps women identify their triggers, and empowers them to take control of their bodies and gain freedom and balance thru Healthy Eating and Active Living. You can learn more about Jamie Nicole at You can also find her on Instagram.


  • Tosha Dearbone says

    I’m literally in tears as I read this. Over this past year of trying to understand my autoimmune illness I have encountered many of these triggers and felt like giving up. I can’t thank you enough for sharing your journey and helping myself and others face some hard truths and recognize how to conquer them. God bless you.

  • Jackie says

    I absolutely love and needed this right now. Thank you!

  • Deana says

    This is an incredible help to me! Bless you!

  • Kathy Fong says

    This was an excellent article, Jamie!! Thank you so much for your comprehensive information!!! Good to

  • Ali says

    Thank you so much for this article. It’s compassionate and realistic and I feel really seen.
    Bookmarking for those times when I have a flare and feel like it’s never going to end 🙂

  • Becky says

    I’m in the middle of a flare now and feeling really down about it—this arrived in my email inbox at the perfect time. Thank you for reminding me that I’m not alone and to have compassion for myself.

  • I love your guide on “Autoimmune self care” , its an extremely helpful resource. I had a question. Do all the Environmental & Internal Triggers need to be present or could you just have some of them and be in a flare? Thank you!

    Joan Thompson

  • Jenny says

    I was diagnosed with RA last fall. I felt so much better within days on the AIP diet and over weeks my bloodwork was even completely back to normal. I’ve tried to add foods back in, but haven’t had much luck. Only about 6 months out, I’m in my first flare since diagnosis. Very discouraging. This article really helped me understand what to expect and how to try to prevent more. Thank you!

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