Managing autoimmune flares

One of the biggest challenges with autoimmune disease is managing autoimmune flares. You can feel fantastic one day and then floored the next. And what makes autoimmune flares even more frustrating is that they can happen anytime. Planning work and social activities become a strain with repeated last-minute cancellations. 


I know when my autoimmune disease was in its active phase, and I was living flare to flare, I didn’t know how I would feel until I woke up in the morning. And this meant if I had booked an exercise class or I had an early meeting at work, I didn’t know whether I would be able to make it. 

And if I made social plans with friends, I wouldn’t know until the day whether I would feel up to it. And cancelling on friends always never feels good, even if they understand. 

Autoimmune flares range in severity. You can go into minor flare-ups which are manageable and won't stop you from doing your usual activities even though you don’t feel your best. And then there are the flares that all autoimmune sufferers dread. The ones that can last weeks, if not months, and can take a long time to recover. 

And that is why catching a flare in its tracks is a great way to lessen its severity and recover more quickly. I know when I was recovering from autoimmune disease, at first, I didn’t spot a flare coming, and afterwards, I would spend weeks trying to get my body back to where it was before. 

I recall a work social event out bowling where I was already beginning to feel run down, and I had been fighting off a cold all week, but as normal, I went anyway. After bowling for 30 minutes, my wrist started to feel very tender, and then the following morning, I woke up with severe pain in my right wrist. I later discovered it was tendonitis, but it took me weeks to feel pain-free.

Reflecting on this, I now see some tale-tale signs that a flare was on its way. I was run down, I was picking up sinus and throat infections, and my joints had already started feeling tender, even before bowling. 

Now I am much more in tune with my body, so I have the ability to identify an autoimmune flare in its early stages, so I can take action before it takes complete hold of my body.

So, what is an autoimmune flare?

I often talk about my autoimmune conditions in the active and inactive phases, and inactive phases are the point of living free of symptoms, even though you still technically have the autoimmune disease. 

In a flare, there is a marked increase in autoimmune symptoms, which might be identified in lab results as an increase in autoantibodies (if relevant) or inflammation in your body. 

Autoantibodies are the part of the immune system that targets self-tissue in an autoimmune attack, so when these are in larger amounts in your body, your tissues and organs are more likely to be damaged, which is when a flare can arise. 

Every autoimmune disease will present differently in a flare. For example, if you have alopecia areata, a flare might represent a new patch of hair loss, or with multiple sclerosis, a flare might be accompanied by loss of movement in a limb. 

However, some autoimmune flares are less specific and may include symptoms that all individuals with autoimmune disease may experience, such as:

  • exhaustion 
  • migraines
  • anxiety 
  • debilitating fatigue 
  • brain fog
  • skin rashes
  • increase in pain
  • changes in mood
  • loss of appetite

There are many triggers for autoimmune flares, but often they arise when a trigger meets with an already vulnerable person. 

For example, suppose you have already been burning the candle at both ends and have a genetic predisposition to autoimmune disease. When you become infected with a virus, your immune system is weakened and more likely to respond inappropriately. In this example, the virus is the trigger, but the terrain of the person infected with the virus makes a difference in the response. 

What are the triggers for autoimmune flares?

Understanding what triggers your autoimmune flares is vital for managing them. When you remove the trigger from your diet, body and environment, it means that you can begin to recover from the flare. If the trigger remains in place, then it will be an uphill battle to get better.

Here are some potential triggers for autoimmune flares:


Food sensitivities and intolerances can be a huge trigger for an autoimmune flare.  When managing psoriasis flares, I often experienced flares after consuming too much dairy in my diet. Food sensitivities and intolerances are often a trigger for an autoimmune flare, so understanding which foods affect you is crucial for maintaining a flare-free lifestyle. 

And it isn’t just about food sensitivities, as eating too much sugar can cause an imbalance in your stress and sex hormones which can trigger a flare. And certain foods such as grains and nightshade vegetables may impact gut health, triggering autoimmune flares. 


Diet isn’t the only culprit, though. Many people experience flares after life-changing events, bereavement, chronic and acute stress, lack of sleep, infections, seasonal changes and exposure to toxicity such as mould. 

During a stressful event, your body is in fight or flight mode, so digestion often becomes impaired, and your immune system and body have a heightened requirement for nutrients. As a result, this can lead to your immune system becoming dysfunctional and trigger an autoimmune flare for those who are susceptible. 

Building a solid foundation so that your body can withstand a stressful event without too much damage is critical for living flare-free long term. 


Infections can be a driver in an autoimmune flare, which may be why you developed an autoimmune disease in the first place. Many infections are thought to cross-react with self-tissue, which means that your immune system creates an inflammatory response to the infection to protect you, but at the same time, stimulates a response to your own tissue or organs. 

You may feel much better after the illness, but you then develop long-term symptoms, which can develop into autoimmune diseases. 

When you do start to feel sick, being proactive with your diet and lifestyle can be the difference between a fast recovery and living with an autoimmune disease for life. 

How to manage a flare

First things first, identify the trigger for the flare. 

If you are unsure what triggered the flare, reflect on the last couple of days and weeks. Considering the triggers above, has anything happened that could have caused you to flare?

And then, whatever you think the trigger might be, do what you can to remove this from your diet, body or environment as best as you can.

If you think it might be food related but are unsure which food in particular, then start to keep a food and symptom journal to assess whether there is a relationship between what you are eating and your autoimmune symptoms. 

You can also take a food sensitivity test to determine whether you have any antibodies to certain foods. If you are interested in exploring your food sensitivities, then you can find out more about my Food Sensitivity Test Package.

I have developed a five-day approach for resetting a flare in The Autoimmune RESET plan, which guides you through the steps to take when you suspect a flare is coming.

  • Remove inflammatory foods and activities.
  • Eat nourishing gut-healing foods.
  • Stabilise your body and systems.
  • Energise and detox your cells.
  • Thrive in life and health.

You will find more information on this five-step approach in my free download, The Autoimmune RESET.

As well as identifying the trigger for your flare, it is a good reason to slow down and prioritise sleep if you sense a flare is coming. Sleep is hugely regenerative and exactly what your body needs to recover, so when you do feel a flare coming on, ensure you are getting an adequate amount of zzzs.

And even though you may feel very tired or lack mobility during a flare, if you can move, it is good to do some gentle stretching and exercise. Walks in nature, restorative yoga and Pilates are wonderful ways to bring inner peace, as well as keep your blood circulating. 

In the long term, rebuilding your health from scratch by identifying the root cause of your autoimmune condition may be the best way to live flare-free. If you would like to explore my functional testing packages or book a free consultation, then please contact me.

The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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London W1G & Harrogate HG1
Written by V. J. Hamilton, Autoimmune Disease Expert | BSc (Immunology), DipION, mBANT
London W1G & Harrogate HG1

Victoria is a qualified Nutritional Therapist and member of BANT, focusing on autoimmune disease including skin disorders, heart disease & neurological issues as well as gut health & fatigue. Victoria has a BSc in Biochemistry & Immunology which she uses in her practice, using only evidence-based nutritional therapies to support chronic conditions.

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