Flare Repair
For those of us who have chronic conditions that act up from time to time, you know what it is like. When you are feeling good, you try to get as much done as possible knowing the rug can get pulled out at any time. You are nervous to make plans, wondering if the event will fall on a good day or a bad day. The possibility of a “flare” hangs around like a specter or an unpleasant odor, never completely freeing you from its nearness. And when a flare happens, the frustration closes in, as you always hope tomorrow is finally the day you will wake up feeling like yourself again.
Welcome to the club.
Since becoming a functional medicine patient in 2015 until now, 10 years later, I have worked incessantly to learn how to prevent flares from taking over my life. After a few good years, I thought I had finally cracked the code. But no. What I have learned is how to deal with them when they come.
What is a flare?
Flares occur when a chronic condition intensifies due to being triggered. A doctor I worked with used to say, “everyone falls down differently” when experiencing inflammation. For some people, it is neurological, such as migraines, anxiety or insomnia. Others might have a sensitive GI tract that gets extra reactive. Where you fall down depends on a number of factors, including genes, history (such as injury or surgery) and/or environment. A common thread amongst most flares is fatigue, while most other symptoms are unique to the individual who is experiencing them.
What triggers a flare?
Like symptoms, there are many possible combinations of triggers. These may include viruses (new or reactivated) or bacterial infections; antibiotics or medications; surgeries or injuries; stress; hormonal fluctuations; gut issues; allergies; toxin exposure…really, anything that sets off the inflammatory cascade.
While the effects of the inflammatory response may not be pleasant, it means that your body is working correctly. The release of inflammatory mediators occurs as the body fights off invaders, responds to an injury or tries to correct an insult. For most people, the reaction begins and ends in a short time as the body heals and moves on. Flares are unique in that the response may linger, and/or be an overreaction. (There is actually a condition known as the Cell Danger Response where all of these mechanisms kick on as the body perceives an invader, regardless of whether there actually is one.) Conditions related to flares include Chronic Inflammatory Response Syndrome, an overreaction to an exposure; or Mast Cell Activation Syndrome and Chronic Inflammatory Response Syndrome, where the immune system goes into overdrive at the slightest provocation.
Unfortunately, those of us with chronic conditions know how easy it is to fall into the “hole” of a flare and the difficulty of climbing out of it. Calming down a wildly overreacting immune system is a tall order, and typically does not happen quickly. The body must feel that the danger is resolved to begin the process of calming down. One of the reasons I began to study functional medicine was to learn how to manage my issues and heal myself when flares had me circling the drain . (Visiting a functional medicine doctor every time was seriously cost prohibitive.) Unfortunately, I have learned that shutting off a flare is not as simple as cutting out a specific food, eating perfectly, taking a specific supplement or meditating. This is contrary to what many health influencers claim…I have fallen prey to more than one of these scams, hoping for the magic bullet to recover my health. (These are so counterproductive…it only makes us more frustrated, wondering why it isn’t working for us? Not to mention the cost. But I digress.)
Based on my education and experience in functional medicine, and my personal health struggles, here is what I recommend for flares:
Look at what factors might be involved. Is there something that can be addressed? Did your microbiome get wiped out from antibiotics? A gut-rebuilding regime might help. Are your hormones out of whack? Is it a stressful time of year? Looking at what took you down might provide clues on how to build back up.
Accept what is happening and don’t freak out. (This is way easier said than done.) Acknowledge that you have experienced the same symptoms in the past and survived. Panic does not help AT ALL, in fact the vagus nerve activation that results can massively increase the inflammatory response.
Accept that you are not going to be able to operate at the usual pace. During a flare, I feel like I am in slow motion…as my coworker used to say, it is like carrying a piano uphill in the mud. Everything is hard and tiring, so I try to keep my expectations lower knowing that I will catch up when I feel better.
Do you have notes, bookmarks, screenshots or labwork/testing from previous flares? (If you are OCD like me, you do.) Review what was going on in the past. What helped? What made it worse?
Try to distract yourself a little. Doing even one small thing you enjoy can help reset the nervous system, which decreases inflammation.
Get as much sleep/rest as possible.
Don’t load up on processed or convenience foods. It is definitely easier to avoid cooking when you don’t feel well, but junk food during a flare is like pouring gasoline on a fire.
Things like massages or acupuncture can be helpful IF they calm you down. I have personally gone overboard seeking a quick fix (i.e. IVs) which led to worsened symptoms, so be careful and take things low and slow.
Wait it out. Flares heal in time…never as fast as we would like, but rest and time will usually do the trick.
Supplements for flares:
Supplements can be helpful, but need to be researched and used thoughtfully. People in flares can be very reactive to things they are normally okay with. It is always important to consider other medications you are taking and symptoms you are experiencing before starting supplements.
Since antibiotics are typically involved in my own flares, I always address gut health. For this, tests like Viome, Thorne Microbiome or GI Map can help identify what is out of balance and what interventions might be needed.
For leaky gut/gut repair, I like GI Repair (Thorne), Gastro D (D’Adamo), ZInc Carnosine, Ultra GI Replenish (Metagenics).
Testing can indicate which specific probiotic strains are lacking. Without testing, I rotate probiotics to get as many strains boosted as possible.
I try to eat prebiotic foods, such as bananas or onions, or take a prebiotic supplement.
If a specific bacteria is overgrowing, I might take an herb to help knock it out.
For more information, see my Gut Rebuilding Guide.
2. I address inflammation.
Herbal anti-inflammatories include bromelain, ginger, curcumin and boswellia.
For mast-cell inflammation, I like quercetin, luteolin, citrus pectin and vitamin C.
I make sure to take my vitamins such as B Complex, Vitamin D and fish oil.
Yep, no sexy magic solutions here. Like many health challenges, flares often occur as the result of a “perfect storm”...several of YOUR issues coming together at once. The phrase “every storm runs out of rain” is one I keep close, as I have found it to be true. There is a moment when you realize you are back to your old self, and it is glorious.
