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When a Flare Happens: Stress and Autoimmune Disease

Maureen had been working with me for about 6 months for her Crohns disease and we had gotten her to a pretty stable place and she was able to incorporate the diet changes into her life and was happy with the results. However, she had recently taken on some new stressful work projects, plus was having some trouble with her teenaged son and not surprisingly she had a flare of her autoimmune disease.

Flare-ups happen with autoimmune diseases. They do. And they are worse when there is stress involved. OR stress actually causes the flares. Not surprising that Maureen would have a flare with the added stress in her life. Though most of my patients who have a flare will find that if they are still on the protocol, their flares will be less frequent, less intense and shorter in duration. And then it becomes a bit easier to pinpoint what contributed to the flareup. Those cookies you ate while you were having an emotional eating session, the extra hours of work you have taken on, the loss of needed sleep due to crazy work and travel schedules? The relationship or financial stress all can contribute to having a flareup. All of those things that can happen in your real life.

Increased emotional stresses, such as anxiety, depression or even the adrenaline rush of a time crunched deadline increase your adrenal gland’s secretion of adrenalines and cortisol. Cortisol is the main hormone that is increased when the body goes through a fight or flight response. While humans evolved with this fight or flight response in order to be able to outrun a predator or deal with an attack, these days most people living in the modern world have to deal with chronic day to day stresses of deadlines, relationship stress, working sedentary jobs that do not allow for proper movement of the body to discharge the stress and to create endorphins.

Increased cortisol levels in your body will increase overall inflammation in the body which in turn can aggravate an autoimmune situation such as Hashimoto’s Thyroiditis, Rheumatoid Arthritis, Colitis, Crohn’s Disease, Lupus, and other autoimmune diseases. Because at this point, inflammation makes the body feel like it is under attack so it creates more opportunity for antigen antibody complexes to form. And in turn antigen-antibody complexes also trigger even more inflammation. So a high level of stress in your life will increase inflammation and it will flare your autoimmune disease.

Recently I was caught in an airline glitch while picking my son up from camp.

It took us over 2 days to get back home from my son’s camp which was an 18 ½ hour drive away. Since I had driven him all the way out there and back,

I reasoned that flying would be somewhat easier and shorter, and on the way out there it was! It was like a dream compared to the long drive and I was congratulating myself on making such a smart decision! But as they say “Pride goeth before a fall” and the airline glitch was certainly a fall because it was exhausting, stressful and full of unknowns because since we missed our connection, we kept getting bumped from Standby. We finally did get home in the middle of the night /early morning after the 2nd day, but we were exhausted!

Where am I going with this? I consider myself pretty aware of stress and its effect on my body so I do a lot of practices to manage my stress and cortisol levels. I eat an optimal diet , avoid my allergens, get plenty of sleep, practice yoga and meditation which are ways that I have learned to self-sooth my anxiety and tendencies to worry. I packed plenty of snacks and supplements for the 4 days I was expecting to be away from home.

But I got caught.

I ran out of said snacks and supplements, had no time to do yoga or meditate in a busy airport full of fellow cranky stranded passengers. I did my best to avoid allergens while we ate airport food, but I know I got glutened because I could feel it ! I am usually a very calm person who radiates equanimity (or so I’ve been told!) but after we got bumped from yet another flight, after 2 cancellations, a 2-3 hour taxi ride to the next closest airport, a missed connection and a flight I didn’t even know if we could get that was in itself delayed 3 hours, I was a little bit cranky! I think that gate attendant knew that she had to get us on the next flight or we might throw a fit… so finally we got on. God bless that gate attendant because I know that she had been working really long shifts for the 2nd day in a row! Dealing with cranky customers with complicated stories just like us hour after hour couldn’t have been fun. Stress brings out the worst in people’s moods and their bodies, and we cannot always avoid stress because… life happens!

Someone with an autoimmune disease who has chronic stress due to lifestyle, diet, a challenging job or relationships   is more likely to suffer flares with increased frequency, intensity and duration. A flare can happen during a major stress, immediately after or even several months and years after a stressful period.   Most of my patients can report the start of their autoimmune disorder following a major life transition or loss.

Grief also plays a large part in the development of a chronic illness. One of the paths to healing is to unwind the sympathetic nervous system trauma through some sort of stress management practice or therapy.   Some people burn off steam through exercise which is great at creating endorphins. Yoga, tai chi and a mindfulness practice where you learn to self regulate your emotions is an invaluable transformative way to help reduce autoimmune flares. Diet is also key to reducing inflammation in the body and during a flare I often make very specific recommendations to my patients. When they can control their inflammatory responses, they can begin to heal their body and mind from the inside out. My practice tends to focus on ways that one can heal biochemically. Through diet and getting to the root cause of autoimmune disease by healing the digestive system and leaky gut syndrome as well as dealing with imbalanced gut flora one begins to calm the flare. But I also need to strongly emphasize that having a regular practice to manage stress and to activate your parasympathetic nervous system is also instrumental. Even something as simple as sitting, closing your eyes in a quiet room and taking 10 -20 long deep breaths can settle your nervous system down enough to help your body heal through the mind/body connection.

If you are in the middle of a flare, the best things you can do for yourself are:

  1. Tighten up your diet. Some of my patients have to go pretty hard core and get really strict. Most of my patients have some sort of a maintenance diet that they are doing once they are well and sometimes they can add in more foods and still do fairly well, but if you have a flare, it is time to tighten things up and take a step back to the original therapeutic diet.
  2. Make sure you are getting adequate sleep. Sleep is instrumental in the recovery from an autoimmune flare, so if sleeplessness is part of your flare picture, that needs to be handled so that you can rest and recover.
  3. Manage your stress through practices that sooth your sympathetic nervous system (fight or flight) and increase the activity of your parasympathetic nervous system ( massage therapy, yoga, meditation, prayer)
  4. Try to pull back from your activities if you can. Many of us are doing way too much stuff all of the time, and during a flare things like housecleaning, errands, etc. can perhaps be outsourced even temporarily so that you can get back your health. Can you reduce your work hours temporarily without losing your job? Can you pull away from stressful relationships if they do not support your healing? Can you cut out some of your obligations and delegate them to others? How can you simplify?

Getting through a flare as quickly and easily as possible is often assisted by working with a Naturopathic Doctor along with your Medical Doctor who may need to adjust your prescription medications (if you take them) .   This, in my many years of experience is the best way to shift a flare back to healthy functioning of your body. But many of my patients have opted away from prescription medications and are managing their flares which are more and more seldom, with naturopathic medicine alone!

Maureen was able to take control of her flare relatively quickly (compared to past flares) by delegating responsibilities to others on her work project , cleaning up her diet again as well as dealing with some of her relationship difficulties that were contributing to her increased stress loads. She and her partner learned more skillful ways to communicate with each other regarding her health care as well as how to navigate keeping the home and finances going while she needed to pull back on her obligations. She recovered and with new awareness is able to live a satisfying happy life.

If you are interested in working one on one with me for your gut health, inflammation and/or autoimmune disease issues, I work in-person if you live local to the Boulder/Denver area, or I also can consult long-distance for those living far away via secure HIPAA compliant video or phone. I offer a FREE 15 minute phone consult if you want to have the opportunity to ask me questions to see if we are a good fit for each other. You can schedule that either by calling (303)443-2206 M-F 8:30-5 Mountain Time or anytime online by using this link:

I hope to connect with you soon!


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