If you live with an autoimmune condition, alcohol isn’t “just a drink.” The effects of drinking when you have an autoimmune disease can mean more than a hangover: worse flares, stronger fatigue, scary lab results, and higher risk for serious complications. People often ask, “Is it really that bad if I keep drinking?” or “Everyone else has wine with dinner—why can’t I?” But when you mix alcohol, immune dysfunction, and (often) addictive patterns, the danger is real. In the U.S., autoimmune diseases affect an estimated 8% of the population—over 50 million people—and cases are rising every year. At the same time, alcohol is now recognized as a toxin that fuels inflammation, damages organs, and increases the risk of many chronic illnesses. When you put those two together, the stakes get high fast.
Effects of Drinking When You Have an Autoimmune Disease
Autoimmune diseases—like lupus, rheumatoid arthritis, psoriasis, Crohn’s disease, and many others—happen when your immune system attacks your own tissues by mistake. That attack already causes chronic inflammation, pain, and fatigue. Now add alcohol.
Alcohol affects both parts of the immune system (innate and adaptive). Heavy or frequent drinking can weaken your body’s defenses, change how immune cells behave, and make it harder to fight infections. For someone with an autoimmune condition, that can mean more frequent illnesses, slower recovery, and flares that seem to “come out of nowhere.”
Here’s the twist: some people with autoimmune disease also struggle with addiction or self-medication. Maybe you’re in Phoenix, Arizona, exhausted from pain, frustrated by doctors, and that nightly drink (or three) feels like the only way to calm down. Over time, that coping pattern can turn into alcohol use disorder—right on top of an already serious health condition.
You’re not weak if this is happening to you. But it is dangerous, and it’s worth taking seriously.
Alcohol and Autoimmune Disease Flare Ups: What’s Going On Inside Your Body
Alcohol doesn’t just “relax” you. It’s a chemical that:
- Triggers inflammation in the gut and liver
- Disrupts the gut microbiome (the “good bacteria” that help regulate immunity)
- Alters immune signaling pathways that already misfire in autoimmune disease
For many people with autoimmune disorders, that can translate into:
- More frequent or intense flare ups (joint pain, rashes, GI symptoms, brain fog)
- Worse fatigue the day or two after drinking
- Higher inflammatory markers on blood tests (sometimes leading to medication changes)
Some research even suggests that alcohol abuse may increase the risk of developing autoimmune connective tissue diseases in the first place. When your immune system is already confused and attacking healthy cells, anything that further stirs up inflammation is playing with fire.
And if mental health is in the mix—depression, anxiety, trauma—alcohol might feel like a quick escape, but it often leaves your immune system and mood worse in the long run.
Medications, Alcohol, and Dangerous Interactions
Most people with autoimmune disease are also on medications—sometimes several at once. That’s where things get even riskier.
Common issues include:
- Liver strain. Drugs like methotrexate are known to stress the liver. Many rheumatology and arthritis guidelines warn that drinking alcohol with methotrexate can increase the risk of liver damage, especially at higher doses.
- GI bleeding. If you use NSAIDs (like ibuprofen or naproxen) for pain and inflammation, adding alcohol raises your risk of stomach irritation and gastrointestinal bleeding.
- Immune suppression. Alcohol can interact with immunosuppressant drugs (steroids, biologics, other DMARDs), worsening side effects and further compromising immune function.
On paper, a glass of wine might look “moderate.” In a real person with an overactive immune system, a toxic liver burden, and multiple medications, that same glass can carry a very different weight.
If you find yourself hiding how much you drink from your rheumatologist, or ignoring their recommendation to cut down, it may be a sign that alcohol has more control over you than you’d like to admit.
True Stories of Addiction: When Autoimmune Disease and Alcohol Collide
On our True Stories of Addiction series, we’ve heard people describe life with autoimmune disease and alcohol like this:
“I hurt all the time. The meds made me tired. Drinking was the only thing that made me feel ‘normal’—until I couldn’t stop.”
Someone might start with a few beers to take the edge off joint pain. Then they add stronger drinks to sleep. Soon, appointments in the infusion center are followed by “just one” that turns into four. Lab tests get worse, flares become more frequent, and family members worry, but the cycle keeps spinning.
This is why we share these stories: not to shame, but to show that you’re not alone—and that help is possible.
Use that story section to connect the science to a real human life: the fear, denial, wake-up call, treatment, and hope.
How to Protect Yourself or a Loved One
If you live with an autoimmune disease and drink regularly, ask yourself:
- Do flares seem worse after weekends or nights of heavier drinking?
- Have doctors mentioned liver enzymes, inflammation, or medication changes linked to alcohol?
- Have you tried to cut back and found it harder than you expected?
If the answer is “yes” to any of these, it’s time for a conversation—with your doctor, a therapist, or an addiction specialist.
Practical steps:
- Be honest with your medical team. They can’t help you if they don’t know the truth.
- Ask about safer limits—or whether you should stop completely. For some medications and conditions, no alcohol is the safest choice.
- Consider support for addiction. If you can’t cut down on your own, that’s not a moral failure—that’s a medical condition. Treatment, counseling, and peer support (like 12-step programs) can help.
- Bring family into the conversation. Loved ones often see patterns we miss and can help you stay accountable.
Your immune system is already fighting a battle every day. Adding alcohol—especially when addiction is involved—can tip the balance in a scary direction. The good news is that every sober day is one less hit to your body and one step closer to more stable health.
You deserve more than just surviving flares. You deserve a full, clear life where your choices support your healing, not sabotage it.
