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Am Ending The Autoimmune Drinking Game

Ending the Autoimmune Drinking Game: Alcohol, Inflammation and Avoiding Flares

How much alcohol can you drink and avoid an autoimmune flare?  That’s a drinking game you don’t want to play with your body, and it’s one of the million dollar questions asked by anyone experiencing autoimmunity.  This is a critical question to have answered before the next girls’ night out, so let’s drill down and work toward helping you to answer this question for yourself, because the reality is, blanket recommendations just won’t do.

Personalized medicine is where it’s at.

Even if you are following the guidelines of moderate drinking, which is 1 drink per day for women and 2 drinks per day for men, and being meticulous about serving size, you are still likely to be wreaking havoc on your immune system and tissues.  Why?  Because having an autoimmune disease means:

a) You have genetic susceptibility to autoimmune reactions resulting from a variety of toxin exposures and triggers, including alcohol and its additives and constituents (which are not readily apparent, by the way)

b) A serious comprehensive campaign for healing the gut lining and restoring intestinal microbial balance and diversity is in order, maintenance of which will be a lifelong practice

Given that consuming alcohol directly causes an increase in intestinal permeability (aka: Leaky Gut) and that even moderate drinking can lead to overgrowth of pathogenic bacteria and absorption of their toxic waste products such as lipopolysaccharide, this means that alcohol can be dangerous territory  and must be approached with caution and intelligence, and in some cases not at all.

Before you imbibe, I would recommend working through a gut-healing protocol with a Functional Medicine physician or nutritionist, and once you’ve had considerable healing and abatement of symptoms, it may be ok to have 1 drink twice per week, although some may find that more or less is appropriate. Be sure to avoid gluten-containing drinks such as beer and grain-based alcohols, since gluten is highly associated with autoimmunity. Avoid drinks with additives or constituents that you may be sensitive to, such as sulfites or yeast in wine.

All of that said, there may be some benefit to moderate drinking for people with autoimmune diseases, or at least those with Rheumatoid Arthritis.  A 2010 study in the journal Arthritis & Rheumatism concluded that moderate drinking slowed disease progression in people with RA.  Heavy drinking worsened symptoms and accelerated disease progression.

For those with Inflammatory Bowel Disease (IBD), study results have not been as rosy.  A 2011 study published in Digestion, evaluated the effect of moderate daily red wine consumption (defined as 1-3 glasses per day) for 1 week on intestinal permeability and stool calprotectin levels — two factors associated with recurrent IBD disease activity.  Although there were no flares during the study, it was only one week in duration; stool calprotectin decreased, which is not desirable, and intestinal permeability increased, again not desirable.  Researchers concluded that “moderate” drinking increases the risk of long-term disease relapse for those with IBD.

How do you find your own good threshold?

In any case, no clear mechanism or individual threshold has been identified. Since individual threshold is what we’re really after here, I will be frank.  The truth is that there is no way to generalize something so, well, individual.  Each person is unique, and must figure out his or her own threshold, given their own personal circumstances and resiliency.  This is what the healing journey is all about.

In a recent ground-breaking Detox Summit interview, when discussing toxicity and the brain, Dr. Deanna Minich pointedly asked Dr. Martha Herbert, MD, PhD, pediatric neurologist and author of The Autism Revolution, if there is a threshold at which even our coveted red wine might become a toxin rather than a benefactor.  Dr. Herbert eloquently stated that there is simply no way to generalize a threshold for everyone in the same way.  She noted that some people are much closer to the edge of vulnerability than others and pointed to the allostatic or total load model, which she defines as, “ all of the physical, emotional, psychological, electromagnetic and radiation stressors you’ve been exposed to that you haven’t been able to recover or clear out.”

She went on to say this:  “your vulnerability to being toxic is your resourcefulness minus the total burden.  So if your resources are depleted, if you’ve burned yourself at both ends and you haven’t built yourself back up, it won’t take much for you to take a hit from a toxic exposure, whether that be alcohol or heavy metals or pesticides or toxic household products.  So the big issue is, are you maintaining your ability to have your cells carry out repair processes?”

Now, although this interview was focused on toxicity and the brain, it would seem that this paradigm could apply to any body system or disease state, since all cells have relatively the same basic needs.  If so, this begs a series of questions:

  • How are you doing at giving your cells what they need to function and repair properly?
  • Are you eating a nutrient rich diet and taking appropriate quality supplements?
  • Are you avoiding the avoidable toxin exposures in your day-to-day life?
  • Are you protecting your microbiome and digestion with probiotics, lacto fermented foods, culinary herbs and fiber-rich foods, and avoiding flora annihilators as much as possible,  such as antibiotics, pesticides, chlorine, hand sanitizer, anti-bacterial soap, etc.?
  • Are you avoiding preventable infections, such as oral infections, with good oral hygiene?
  • Are you sleeping well and enough?
  • Are you making time to exercise regularly?
  • Are you beating stress by staying organized and practicing mind-body techniques to modulate your stress response?

These are some very important questions to ask yourself, and some very important areas to address where your answer is no.  Improving in these areas will help you to bolster your resources and decrease your total load, so that once you’ve had some time to heal and repair, you can have a glass of red wine or a clean margarita from time to time, without worrying about having an autoimmune flare.  However you decide to handle your alcohol intake, always remember that healing is a highly actionable process, and there are no shortcuts or easy answers.  We all want an escape sometimes, and it is best to create routes that not only make us feel carefree, but leave us able to easily recover in the aftermath.


About the Author
Angie King-Nosseir MS, RD is an Integrative and Functional Registered Dietitian, with a passion for walking with people along their path toward health transformation. Angie has a Master’s degree in Nutrition, is a Certified LEAP Therapist, corporate wellness health coach, freelance nutrition and wellness writer, and certified yoga instructor. She is trained in Functional Nutrition and Medicine through the Institute for Functional Medicine and in Food as Medicine through the Center for Mind-Body Medicine.

This blog post was originally published by, written by Angie King-Nosseir, and first published on Sep 12, 2014.

This post contains the opinions of the author. Autoimmune Association is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. Autoimmune Association does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.

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