The Autoimmune Care Guide

How to use this guide

This guide covers the full territory of autoimmune care: acupuncture, Chinese herbal medicine, supplements, food, gut repair, sleep, movement, nervous system regulation, environment, and the relationships that hold a person steady over years of living with an immune system that has turned inward.

Read it once through. Then choose one section and work it for two weeks before adding the next. Autoimmune conditions took years to arrive. The body responds to consistency, and consistency comes from starting small and staying with it.

Bring this guide to your next appointment. We will build your version of it together, matched to your diagnosis, your medications, your labs, and the season of life you are in.

Part One: What is happening in the body

The Western picture

Autoimmunity describes an immune system that identifies the body's own tissue as a threat and mounts a response against it. Rheumatoid arthritis targets the synovial lining of joints. Hashimoto's thyroiditis targets the thyroid. Lupus moves through connective tissue, skin, kidneys, and joints. Multiple sclerosis targets the myelin sheath. Psoriasis and psoriatic arthritis target skin and joints. Celiac disease targets the small intestine in the presence of gluten. Sjögren's targets moisture-producing glands. Crohn's disease and ulcerative colitis target the digestive tract. Type 1 diabetes targets insulin-producing cells.

More than one hundred autoimmune conditions have been identified. They share a common pattern: inflammation that never fully switches off, an immune system that has lost its aim, damage to tissue over time, and symptoms that rise and fall in flares.

Three things sit underneath most autoimmune conditions. Genes set the possibility. Something in the environment switches it on: an infection, a chemical load, a long stretch of stress, an injury, a pregnancy, or a season of being truly depleted. And the lining of the intestine, which decides how much passes from your gut into your bloodstream, shapes how hard the immune system has to work.

The Chinese medicine picture

Chinese medicine reads autoimmunity through pattern. Several patterns appear consistently.

Spleen Qi deficiency shows as fatigue after eating, loose stool, heaviness in the limbs, difficulty holding muscle, and poor absorption. The Spleen in this system governs transformation of food into usable energy and holds the body's structure.

Kidney deficiency shows as deep exhaustion, low back and knee weakness, cold that lives in the bones, hair and bone changes, and reproductive shifts. The Kidney holds constitutional reserve and governs the immune foundation known as Yuan Qi.

Blood deficiency shows as dryness, brittle nails, dizziness on standing, pale complexion, poor sleep, and thin hair.

Damp Heat shows as swelling, redness, heat in joints, skin eruptions, heavy discharge, and a thick coating on the tongue.

Blood stasis shows as fixed stabbing pain, dark complexion, purple tongue, and pain that worsens at night.

Liver Qi stagnation shows as tension across the ribs and shoulders, irritability, cycle irregularity, digestive upset that tracks with stress, and a sense of pressure in the chest.

Most patients carry a combination. The pattern shifts across a flare and across a season, and treatment shifts with it. This is why two people with the same diagnosis receive different point prescriptions and different herbal formulas.

Part Two: Acupuncture

Acupuncture works directly on the part of the nervous system you do not control on purpose, the part that runs your heartbeat, your digestion, and your stress response. Needling moves the body out of fight or flight and into the rest and repair state, which is the only state in which digestion, healing, and immune regulation happen. The research shows changes in the vagus nerve, in the stress hormone cortisol, in the chemical messengers that carry inflammation, and in how the brain processes pain.

In autoimmune care, acupuncture serves as adjunctive treatment alongside your rheumatologist, endocrinologist, gastroenterologist, or neurologist. It treats the pain, the fatigue, the dryness, the digestive symptoms, the sleep disruption, and the nervous system state that drives flares. It works well as part of a care team, and outcomes improve when your providers communicate.

What treatment addresses

Joint pain and morning stiffness. Neuropathic pain and burning sensation. Fatigue that sleep does not resolve. Digestive symptoms including bloating, urgency, and reflux. Dry eyes and dry mouth. Headache and migraine. Insomnia and disrupted sleep architecture. Anxiety and the physical residue of stress. Menstrual irregularity. Medication side effects including nausea, hot flashes, and neuropathy.

Frequency

Acute flare: two treatments per week for two to three weeks. Active care: one treatment per week for six to eight weeks. Stabilization: one treatment every two weeks for two to three months. Maintenance: one treatment every three to four weeks, adjusted at the change of season.

Autoimmune conditions respond to cumulative treatment. The first several sessions establish the shift. Consistency is what holds it.

Modalities used within a session

Needling according to your pattern, adjusted at every visit.

Ear acupuncture for nervous system regulation, sleep, cravings, and withdrawal from the stress state. This protocol has been part of my practice since 2006.

Moxibustion, the warming of specific points with mugwort, for cold patterns, deep fatigue, and Kidney and Spleen support. Moxa is used with care in heat patterns and inflammatory flares.

Cupping for muscular tension, fascial restriction, and stagnation along the back and shoulders.

Rest. After needling you are left alone to rest and sleep. That rest is part of the treatment. The nervous system does its work in that quiet.

Part Three: Chinese herbal medicine

Herbal medicine keeps the treatment working between visits. A formula is a combination of herbs built for your pattern, and it gets rewritten as the pattern changes. Herbs are chosen around your medications, which is why I need your full and current medication list before I prescribe anything.

Categories used in autoimmune care

Qi tonics, the energy builders, including Huang Qi (Astragalus), Dang Shen (Codonopsis), Bai Zhu (Atractylodes), and Gan Cao (Licorice), for fatigue, weak digestion, and immune foundation. Licorice raises blood pressure and lowers potassium when taken steadily, so it gets monitored.

Blood tonics, which nourish and moisten, including Dang Gui (Angelica), Shu Di Huang (Rehmannia), Bai Shao (White Peony), and He Shou Wu, for dryness, low blood counts, brittleness, and menstrual support.

Kidney tonics, which rebuild reserve, including Shan Zhu Yu (Cornus), Nu Zhen Zi (Ligustrum), and Tu Si Zi (Cuscuta), for deep depletion and long-standing illness.

Damp Heat clearing herbs, which cool and drain, including Huang Qin (Scutellaria), Huang Bai (Phellodendron), Yi Yi Ren (Coix), and Ku Shen (Sophora), for active inflammation, swelling, skin eruptions, and heat.

Blood movers, which improve circulation, including Dan Shen (Salvia), Chuan Xiong (Ligusticum), Tao Ren (Peach kernel), and San Qi (Notoginseng), for pain that stays in one spot, poor circulation, and long-standing stagnation. These herbs thin the blood somewhat, so they take care alongside blood thinners.

Wind Damp herbs, for joints that ache with the weather, including Qin Jiao, Du Huo, and Sang Ji Sheng.

Classical formulas frequently modified for autoimmune presentations

Bu Zhong Yi Qi Tang for Spleen Qi sinking, prolapse, and profound fatigue. Gui Pi Tang for Spleen and Heart deficiency with poor sleep and worry. Liu Wei Di Huang Wan for Kidney Yin deficiency with dryness and heat. Xiao Yao San for Liver Qi stagnation with digestive and cycle involvement. Juan Bi Tang for painful obstruction in the joints. Si Miao San for Damp Heat in the lower body.

Formulas are modified for you. A patent pill from a shelf is a starting point. A formula written for your pattern is medicine.

Herbs to avoid without supervision

Some herbs are sold to boost immune activity, which is the last thing an overactive immune system needs. Echinacea, spirulina and chlorella at high doses, and the immune-boosting mushroom extracts belong in this group, and they are used only for a clear reason and with close watching.

Ashwagandha pushes the thyroid to make more hormone, and there are documented cases of it tipping people into a dangerous overactive thyroid, along with reports of liver injury. It is avoided in Hashimoto's thyroiditis, in Graves' disease, and alongside thyroid medication such as Synthroid.

Tripterygium wilfordii, known as Lei Gong Teng or thunder god vine, has real research behind it in rheumatoid arthritis and real toxicity alongside it, affecting fertility, the liver, and the bone marrow where blood cells are made. It is prescribed only under direct professional supervision and never bought from an unregulated source.

St John's wort speeds up the liver's processing of many medications, which drops their level in the blood. It is dangerous alongside the anti-rejection drugs tacrolimus and cyclosporine, and it is off the table for transplant patients and for most people on medication that suppresses the immune system.

Turmeric and curcumin at supplement strength change how the liver handles other medications, and in some people they have injured the liver. Cooking with turmeric is a different matter and stays. Curcumin as a supplement is used at a set dose with liver enzymes checked, especially alongside methotrexate.

Bring every supplement bottle to your appointment. The interaction risk in autoimmune care sits in the combination, not in any single product.

Part Four: The supplement protocol

This is the foundation protocol. Doses are adjusted for body weight, labs, kidney and liver function, medications, and diagnosis. Start one supplement at a time, spaced three to four days apart, so that any reaction is traceable to a single product.

Morning

L-glutamine, 5 grams

Glutamine is an amino acid, one of the building blocks your body uses to make protein. The cells that line your small intestine burn it as their main fuel, which is why it sits at the front of any plan to repair the gut.

It comes as a powder with almost no taste. Stir 5 grams into water first thing in the morning, on an empty stomach, and wait twenty minutes before you eat. The studies that measured healing in the gut lining used larger amounts split across the day, so 5 grams is where we start, and we can raise it to three doses a day if your gut needs more.

Skip glutamine if you have cirrhosis of the liver, advanced kidney disease, or a seizure disorder.

Vitamin D3, 5,000 IU, with K2

Vitamin D acts less like a vitamin and more like a hormone that tells the immune system how to behave. Low levels turn up again and again in people with autoimmune conditions.

Take it with whichever meal of your day carries the most fat, because vitamin D needs fat to absorb. K2 is its partner: it directs calcium into your bones and keeps it out of your arteries and soft tissue. On the label K2 shows up as MK-7. Look for 90 to 180 mcg of it.

5,000 IU sits above 4,000 IU, the amount considered the general ceiling for daily use, so this dose comes with a blood test attached. Ask your doctor for a vitamin D level, which the lab prints as 25-hydroxyvitamin D, and a calcium level, before you start and again three months later. We adjust the dose to hold your level where your doctor wants it.

If you take warfarin, the blood thinner also sold as Coumadin, leave K2 out entirely. It works against that medication.

NAD support, in the morning

NAD is a molecule every cell in your body uses to turn food into energy. Levels fall with age and with long illness, and low energy is where that shows up first. Swallowing NAD itself does not work, because it breaks down before it reaches your cells, so supplements use a building block your body converts into it.

Two are sold, and either one does the job. Take one of them, not both, in the morning on an empty stomach:

• NR, short for nicotinamide riboside, 300 mg. Sold under the brand name Niagen.
• NMN, short for nicotinamide mononucleotide, 250 to 500 mg.

NR has been studied longer and has the cleaner history with regulators, so it is the one I start people on.

What the research shows clearly is that these raise NAD in the blood. What that turns into in how a person feels is still being worked out. It sits in this protocol as support for energy, and it does not treat the autoimmune process itself.

With meals

Fish oil, 3 grams of EPA and DHA daily

EPA and DHA are the two omega-3 fats in fish oil. Your body uses them to build the compounds that switch inflammation off once it has done its job. They are the reason fish oil belongs in an autoimmune plan.

Here is the part that trips people up. The big number on the front of the bottle is the weight of the fish oil, not the EPA and DHA inside it. A capsule that says 1,000 mg of fish oil often holds only about 300 mg of EPA and DHA. Turn the bottle over, find those two numbers on the supplement facts panel, add them together, and count from there. Reaching 3 grams takes a concentrated product, otherwise you are swallowing ten capsules a day. If the label offers a choice, triglyceride form absorbs better than ethyl ester form.

Split the dose, half with breakfast and half with dinner.

This amount sits inside the range the FDA considers safe, and above the 2 gram figure that manufacturers are told to print on labels, which is why it belongs under supervision rather than picked off a shelf.

Talk to your prescribing doctor first if you take a blood thinner: warfarin, Eliquis, Xarelto, or a daily aspirin paired with Plavix. Stop fish oil before any surgery. At high doses fish oil has been linked to an irregular heartbeat, so anyone with a history of atrial fibrillation takes a lower amount. Keep the bottle in the refrigerator, and throw it out if it starts to smell like old fish.

Evening

Magnesium glycinate, 400 to 600 mg at night

Magnesium runs more than three hundred processes in the body. The ones you will feel are muscle relaxation, steadier blood sugar, and the calming pathway in the brain that carries you into sleep. Of all the forms sold, glycinate is the kindest to the digestive tract and the most useful for sleep and for muscles that will not let go.

Take it thirty to sixty minutes before bed.

One thing to check on the label. The number on the front is usually the weight of the whole compound, and only a fraction of that is magnesium itself. Turn the bottle over and look for the words elemental magnesium. That second number is what your body actually receives, and it is what we are counting.

Loose stool means the dose is too high, so come back down. Kidney disease makes magnesium a decision for your doctor rather than for you. Keep magnesium four hours away from thyroid medication such as Synthroid, from bone medications such as Fosamax, and from antibiotics in the tetracycline and cipro families, because it blocks their absorption.

Multistrain probiotic, 50 billion, refrigerated, at night

Probiotics are live bacteria of the kinds that belong in a healthy gut. The 50 billion on the label counts how many live organisms are in each capsule. Multistrain means several different kinds rather than one.

Take it at night, away from food, and away from any herbs prescribed to clear an overgrowth. Buy it from the refrigerated case and keep it in your refrigerator at home. Look for a label listing both Lactobacillus and Bifidobacterium, the two families that do most of the work. Change brands every three or four months so your gut meets a wider range.

Which strains are in the bottle matters more than how big the number on the front is.

Check with your prescribing doctor before starting a probiotic if you take a biologic, meaning an injected medication such as Humira, Enbrel, or Remicade, or a high daily dose of prednisone, or anti-rejection medication after a transplant, or if you have a central line or a shortened bowel.

At a glance

Additions considered case by case

Curcumin, the active part of turmeric, for joint inflammation. Buy it paired with piperine, a black pepper extract, or in phytosome form, because on its own the body barely absorbs it. Liver enzymes get checked while you take it.

Boswellia, also sold as Indian frankincense, for joint pain.

Zinc at 15 to 30 mg, taken with a little copper so the two stay in balance, for the gut lining and for immune signaling.

Selenium at 200 mcg daily for Hashimoto's thyroiditis, a dose with real evidence behind it for bringing thyroid antibodies down.

B12 in the methylcobalamin form for anyone taking metformin, taking an acid blocker such as omeprazole, or eating a plant-based diet. All three lower B12.

Methylfolate alongside methotrexate, taken on the day your rheumatologist tells you.

Digestive enzymes, and betaine HCl where stomach acid is low, taken with meals.

Collagen peptides at 10 to 20 grams for connective tissue and the gut lining.

Part Five: Food

The organizing principle

Eat food that was recently alive, prepared at home, from ingredients you can name. This single sentence carries most of the nutritional work in autoimmune care.

Cooking oils

Cook with extra virgin olive oil, avocado oil, coconut oil, and ghee. These are the oils in my protocol, and they carry the fat profile the body uses well.

Reduce industrial seed oils, meaning soybean, corn, canola, cottonseed, safflower, sunflower, and grapeseed oil. These oils dominate packaged food, fast food, and restaurant fryers, where they are heated repeatedly and oxidized. Cutting them removes the largest source of ultra-processed food from a diet, and that is the shift that matters most.

The elimination and reintroduction experiment

An elimination trial identifies personal triggers. It is an experiment with a defined endpoint, and foods return to the diet once it has told you what you need to know.

Weeks one through four, remove: gluten, dairy, refined sugar, alcohol, industrial seed oils, and ultra-processed food.

Weeks five through eight, remove additionally if symptoms persist: grains, legumes, eggs, nightshades (tomato, potato, pepper, eggplant), nuts and seeds, coffee, and food additives and emulsifiers.

Weeks nine onward, reintroduce: one food every three days. Eat a full portion, twice on day one, then wait. Track joint pain, energy, digestion, skin, sleep, and mood for seventy-two hours. A food that produces symptoms goes back on the shelf for six months. A food that produces nothing returns to your diet.

Gluten warrants specific attention in autoimmune thyroid disease and in any condition where celiac disease has been ruled in or ruled out. Test for celiac disease before removing gluten, because testing requires gluten in the diet to be accurate.

Elimination work needs supervision when weight loss, nutrient deficiency, pregnancy, or a history of restrictive eating is part of the picture.

What to build the plate around

Vegetables, six to nine cups daily across three groups. Leafy greens including collard, kale, spinach, and callaloo. Sulfur vegetables including broccoli, cabbage, garlic, onion, and Brussels sprouts. Color including beet, carrot, squash, and purple cabbage.

Protein at every meal, roughly a palm to a palm and a half. Wild-caught fish, pasture-raised poultry, grass-fed meat, and bone broth. Vegetarian patients build from lentils, hemp seed, and quality protein powder, with B12 and iron monitored.

Fats including avocado, olives, olive oil, coconut, and small oily fish such as sardines, anchovies, and mackerel.

Fermented food in small daily amounts: sauerkraut, kimchi, coconut kefir, and miso. Start with one tablespoon and build. Histamine-sensitive patients approach fermented food slowly.

Starch matched to your energy and blood sugar: sweet potato, plantain, yam, cassava, taro, winter squash, and white rice.

Bone broth, one cup daily, for glycine, proline, and collagen.

Herbs and spices used generously: turmeric with black pepper, ginger, rosemary, thyme, oregano, and cilantro.

Hydration

Half your body weight in ounces of water daily, spread across the day. Add a pinch of mineral salt to the first glass. Drink most of your water between meals so that digestive fire stays strong at mealtime.

Meal rhythm

Three meals with the plate built as described. Reduce grazing so that the digestive tract completes its cleaning waves between meals. Leave three hours between the last meal and sleep. Chinese medicine holds that the body digests best around midday, and building the largest meal at lunch follows that rhythm.

Long fasts are approached carefully in autoimmune conditions. A stress hormone rhythm that has already fallen out of pattern, deep adrenal depletion, thyroid disease, and any history of restrictive eating are all reasons to leave long fasting alone. A twelve hour break overnight, between dinner and breakfast, serves most people well.

Part Six: The gut

The lining of your intestine sits at the center of all of this. Roughly seventy percent of your immune system lives along the digestive tract, and how intact that lining is shapes how the immune system behaves.

The repair sequence

Remove. Trigger foods identified through elimination. Alcohol. Unnecessary anti-inflammatory painkillers such as ibuprofen and naproxen, which damage the intestinal lining directly. Under medical guidance, address confirmed overgrowth, parasites, or infection.

Replace. Digestive enzymes, and betaine HCl where stomach acid is low, both taken with meals. Bitter herbs before meals: dandelion, gentian, and artichoke. Chew each bite until it is liquid. Eat sitting down, without a screen.

Reinoculate. The multistrain probiotic in the evening protocol, plus fermented food daily, plus prebiotic fiber from asparagus, garlic, onion, green banana, and cooked and cooled potato or rice for resistant starch.

Repair. L-glutamine at 5 grams. Zinc carnosine. DGL, which is licorice with the blood pressure raising compound taken out, chewed before meals. Aloe vera inner leaf. Slippery elm and marshmallow root to coat irritated tissue. Bone broth daily.

Rebalance. The nervous system governs digestion. No repair protocol works in a body eating in a state of stress. Take five slow breaths before your first bite. This step carries more weight than any supplement in the list.

Bowel rhythm

One to three formed bowel movements a day is the target. When things back up, the waste your liver worked to clear gets reabsorbed instead of leaving. Magnesium, water, vegetable fiber, movement, a footstool that raises your knees above your hips, and a steady morning rhythm all help.

Part Seven: Sleep

Sleep is when the immune system resets, when tissue repairs, and when the brain washes out the waste it built up during the day. A few short nights in a row are enough to raise inflammation in the blood. In autoimmune care, sleep matters as much as medication.

Target seven and a half to nine hours. Autoimmune conditions raise the requirement.

Hold a consistent schedule, including weekends. The immune system runs on circadian timing.

Darkness matters. Blackout the room. Cover the small lights on electronics. Sleep masks work.

Cool the room to sixty-five to sixty-eight degrees.

Reduce blue light for two hours before bed. Amber glasses, night mode, and lamps set at eye level and below.

Wind down for thirty minutes. Reading on paper, stretching, a warm bath with Epsom salt, breathwork, prayer.

Magnesium glycinate thirty to sixty minutes before bed, as in the protocol.

Herbal support where needed: Suan Zao Ren Tang, Gui Pi Tang, passionflower, or a formula written for your pattern.

Chinese medicine places the Liver's restorative window between one and three in the morning. Waking consistently in that window points to Liver Qi stagnation or Blood deficiency and gives us useful information for your formula.

Sleep apnea, where breathing stops and starts through the night, is common, often missed, and it feeds inflammation. Snoring, waking with a headache, and being sleepy through the day are reasons to ask for a sleep study.

Part Eight: Movement

Movement in autoimmune care is dosed like medicine. Too little allows stiffness, deconditioning, and low mood. Too much triggers flares.

The principle

Move daily at an intensity that leaves you more energized afterward. Exhaustion after exercise means the dose was too high.

The weekly structure

Walking, thirty to forty-five minutes most days. Outside where possible. Walking after meals lowers blood sugar and aids digestion.

Strength training, two sessions weekly. Muscle is metabolically protective, supports bone under corticosteroid therapy, and preserves function. Bands and body weight count.

Qi Gong or Tai Chi, three to five sessions weekly, fifteen minutes each. These practices combine movement, breath, and attention, and the research on their effect in inflammatory conditions is favorable. Ba Duan Jin is a strong place to begin.

Gentle stretching or restorative yoga, daily, ten minutes.

Rest days, fully protected, at least one weekly.

During a flare

Movement continues at a reduced dose. Gentle range of motion, walking to tolerance, water-based movement, restorative postures, and breathwork. The body still needs circulation while it is inflamed.

Part Nine: The nervous system

A body held in fight or flight for years starts to lose control of its immune system. The stress hormone cortisol falls out of its normal daily rhythm, the chemical messengers that carry inflammation rise, digestion slows, sleep breaks apart, and the immune system loses its aim. Trauma, whether it belongs to you, to your lineage, or to your people, is stored in the nervous system and holds the body in that state.

This part of the work is where my practice lives. Acupuncture works directly on the nervous system, and it does not require you to tell your story for the treatment to work. Anything you do choose to share is protected.

Daily practices

Breathwork, five minutes twice daily. Extend the exhale longer than the inhale. Four counts in, six to eight counts out. The long exhale activates the vagus nerve.

Morning light, ten to fifteen minutes outdoors within an hour of waking, without sunglasses. This sets circadian timing, cortisol rhythm, and sleep pressure for that night.

Somatic practice, ten minutes daily. Body scanning, shaking, humming, gentle rocking, or simply placing a hand on the chest and following the breath. The nervous system releases through the body.

Time in nature, weekly at minimum. Ocean, trees, garden, bare feet on ground.

Boundaries. Chronic illness in a life with no boundaries stays chronic. Look honestly at obligations, relationships, and work demands, and decide what stays.

Creative and spiritual practice. Drumming, dance, prayer, journaling, ceremony, singing. These are regulating practices with long lineages behind them.

Professional support

Trauma therapy pairs well with somatic work. Therapists build skill and work with mindset. My work addresses how emotion lives and is stored in the body. The two roles complement each other, and I refer patients to therapists and receive referrals from them.

Part Ten: Environment and toxic load

Water. Filter drinking and cooking water. Reverse osmosis or a quality carbon filter. Add minerals back after reverse osmosis.

Air. HEPA filtration in the bedroom. Open windows daily. Address any visible mold immediately, and investigate further where symptoms track with a particular building.

Plastics. Store food in glass. Never heat food in plastic. Replace scratched nonstick cookware with stainless steel, cast iron, or enameled cast iron.

Personal care. Skin absorbs. Simplify products and choose fragrance-free formulations. Fragrance on a label represents an undisclosed mixture.

Cleaning products. Vinegar, baking soda, castile soap, and essential oils handle most household cleaning.

Dental. Chronic dental infection and gum disease feed systemic inflammation. Keep dental care current.

Alcohol. Alcohol disrupts the gut barrier, the liver, and sleep architecture. Reduce it, and remove it entirely during active flares.

Tobacco. Smoking worsens rheumatoid arthritis, lupus, Crohn's disease, and multiple sclerosis. Cessation support is available, and acupuncture assists with it.

Part Eleven: Sunlight, seasons, and rhythm

Sunlight supports vitamin D synthesis, circadian regulation, mood, and immune function. Ten to thirty minutes of midday sun on bare skin, adjusted to skin tone and photosensitivity, supports the protocol.

Lupus and dermatomyositis require sun protection, and photosensitivity is a feature of several medications. Sun exposure in those cases follows your physician's direction.

Chinese medicine reads the year in seasons, and autoimmune conditions often shift with them. Spring aggravates Liver patterns. Summer aggravates heat patterns. Late summer aggravates dampness. Autumn aggravates dryness and Lung patterns. Winter demands Kidney reserve. We adjust your formula and your point prescription at the turn of each season.

Part Twelve: Tracking and the flare plan

What to track

Keep a simple daily log. Energy on a scale of one to ten. Pain location and intensity. Sleep hours and quality. Digestion and bowel rhythm. Mood. Skin. Cycle. Anything new you ate, took, or did.

Patterns emerge in writing that memory misses. Bring the log to every appointment.

Labs to follow

Ask your physician for these, and ask for a copy of the results for your own file. A complete blood count, which looks at red and white cells. A comprehensive metabolic panel, which covers kidney and liver function and electrolytes. CRP and ESR, the two blood markers that rise with inflammation. Vitamin D, printed as 25-hydroxyvitamin D. Serum calcium. Ferritin and a full iron panel. B12 and folate. A full thyroid panel, meaning TSH, free T4, free T3, and the two thyroid antibodies, TPO and thyroglobulin. The antibody panel specific to your diagnosis. Hemoglobin A1c, a three month average of your blood sugar. A lipid panel, meaning cholesterol and triglycerides. Run them once as a baseline before you start, then again at three months and six months.

The flare plan

Build this before you need it.

Rest. Cancel what can be canceled. Rest is treatment during a flare.

Simplify food to broth, cooked vegetables, and easily digested protein. Remove alcohol, sugar, and any known trigger.

Increase hydration with mineral support.

Book acupuncture at twice weekly through the acute phase.

Contact your prescribing physician for any flare involving new organ symptoms, high fever, chest pain, shortness of breath, vision changes, severe abdominal pain, or neurological change. Those symptoms are evaluated medically and quickly.

Continue the supplement protocol unless a symptom points to one of them.

Return to breathwork and gentle movement at a reduced dose.

Note the trigger. Most flares have one: a missed stretch of sleep, an infection, a stressful period, a food, a travel week, a stopped medication.

Part Thirteen: Your care team

Autoimmune care works best as a team. I practice as one member of yours.

Bring your rheumatologist, endocrinologist, gastroenterologist, neurologist, primary care physician, therapist, and pharmacist into the conversation. Outcomes improve with communication between providers.

Continue your prescribed medications. Nothing in this guide replaces the medications that suppress an overactive immune system, the injected biologics, thyroid hormone replacement, or anything else your physician has prescribed. Changes to medication happen with your prescriber. I have worked alongside physicians whose patients reduced medication over time, and every one of those decisions belonged to the prescribing doctor.

Disclose everything. Every supplement, herb, and over-the-counter product goes on your list for both of us. The interactions that matter in autoimmune care come from combinations.

Bring your labs. They shape the protocol.

This guide is education and does not constitute a diagnosis or a treatment plan for any individual. Your protocol is built in the treatment room.

Part Fourteen: The daily rhythm

On waking. Water with a pinch of mineral salt. Morning light for ten to fifteen minutes. Five minutes of breathwork. L-glutamine 5 grams on an empty stomach. NAD support.

Breakfast. Protein and vegetables. Vitamin D3 with K2 taken with fat. Fish oil, first half.

Midday. The largest meal. A ten minute walk afterward. Fifteen minutes of Qi Gong or stretching.

Afternoon. Water. A break away from screens. Herbal formula as prescribed.

Dinner. Three hours before sleep. Vegetables, protein, and starch matched to your energy. Fish oil, second half. Fermented food.

Evening. Screens down two hours before bed. Wind-down ritual. Magnesium glycinate. Probiotic. Journal and log.

Weekly. One to two acupuncture sessions during active care. Two strength sessions. One protected rest day. Time outdoors. Food preparation for the week ahead.

Part Fifteen: The first ninety days

Days one through thirty. Establish sleep, hydration, morning light, and breathwork. Begin acupuncture weekly. Start supplements one at a time, spaced three to four days apart. Begin the daily log. Run baseline labs.

Days thirty-one through sixty. Begin the elimination phase. Add the gut repair sequence. Begin strength training and Qi Gong. Start your herbal formula. Address environment: water, air, plastics, personal care.

Days sixty-one through ninety. Reintroduce foods one at a time. Repeat labs. Review the log with me and adjust the protocol. Set the maintenance rhythm you can hold for the year.

Healing in autoimmune conditions is measured in seasons. Ninety days establishes the foundation. The year builds on it.

Working together

Treatment is available in person in Fort Lauderdale and by telehealth. Telehealth consults include a personalized plan delivered after the session, and preparing that plan takes one to two days.

Valencie Exceus, AP, Acupuncture Physician License number AP2292, board certified by NCBAHM Practicing Chinese medicine since 2006

In person: All Natural Wellness Center, 1306 E Broward Blvd, Fort Lauderdale, FL 33301 Office line: (754) 243-5763 Text: (954) 451-0617 Web: valencieexceus.com