When Painkillers are GOOD for You

This post may contain affiliate links. Click here to see what that means.

a variety of NSAID pills scattered on a white background

“When there is pain, there are no words.”
~ Toni Morrison

Speaking Out

When I see versions of the paleo autoimmune protocol forbid NSAIDs, my blood pressure spikes. When I read yet another article on how NSAIDs will kill you, I get angry. Why? Because I have experienced excruciating pain, when NSAIDs didn’t feel like a choice, so much as a means to survive.

Then, I take a deep breath, calm myself down and remember that I also love these bloggers. Like me, they offer their blogs to the public for free, with a heartfelt desire to help people. Mainstream Americans often take medication without thinking, believing that if something is sold over-the-counter, it’s harmless. Healthy living websites simply want to educate people about the risks.

My concern stems from the fact that people with autoimmune disease aren’t mainstream America. Their lives are much more challenging, and the medical decisions they make aren’t lighthearted at all. Telling them to give up their pain medication increases the burden on someone who is already overwhelmed.

This article is a call for compassion: If you want to help people in pain, you need to understand their experience. The pain needs to go away before the pain killers do.

A Few Facts:

  1. Although some people with autoimmune disease don’t have pain, many live with a level of pain impossible to imagine, unless you’ve experienced it yourself. Doctors even prescribe anti-depressants, because the pain can lead to suicidal thoughts.
  2. NSAID stands for nonsteroidal anti-inflammatory drug. They were created as an alternative to steroids, which have a dizzying array of side effects. NSAIDs are also an alternative to narcotics, which in addition to serious side effects, carry the risk of addiction and overdose. This isn’t to say NSAIDs don’t carry risks as well, but it’s important to remember that people take them as an alternative to more debilitating medication.
  3. Although there are anti-inflammatory supplements available that can be very helpful (and I will detail them later in this article), they aren’t as strong as NSAID medication and for people with chronic pain, they often aren’t enough.
  4. Usually, people who tell others to go off NSAIDs cold-turkey either haven’t experienced excruciating pain, or their pain went away immediately after making dietary changes, or trying one of the herbal alternatives. If you are one of those people, that is awesome and cause for celebration. However, most people aren’t that lucky. Autoimmune disease involves immune and inflammatory processes that are chronic and complex. Toning them down is a long-term endeavor. It can be done! But if your disease involves inflammatory pain, it’s natural to need NSAIDs during that transition.
  5. The autoimmune protocol was originally designed to be a food elimination diet, done for 30 days, after which foods would be reintroduced while the body is monitored for symptoms. It’s an old and very effective technique for identifying food intolerances. Medication isn’t food and should never be added to an elimination protocol. Rather, as food intolerances are identified and removed from the diet, pain decreases, and people are able to reduce their dosage naturally.
  6. While NSAIDs have been linked to leaky gut, which is a contributor to autoimmune disease, STRESS is also linked to leaky gut. And there is literally nothing more stressful than pain. (I’ll go into the science of this below.)
  7. If people are in pain, they can’t sleep, and poor sleep is linked to increased inflammation and the development of autoimmunity. Since the autoimmune protocol stresses the importance of reducing stress and getting enough sleep, the advice to stop NSAIDs cold-turkey is contradictory.

The Pain Effect

When we experience pain, the brain releases a number of neurotransmitters and hormones in response. One of those is cortisol – the fight or flight hormone. When it’s released, our heart beats faster, our blood pressure goes up, the immune system is suppressed, organs slow down, and blood is redirected to skeletal muscles. This response is designed to protect us, by giving us the energy we need to react in a dangerous situation. However, it’s also meant to be temporary, with full function of our organs and immune systems restored once the danger has passed. With chronic pain, cortisol keeps getting released over and over, and these effects which are meant to be brief, become chronic as well. Needless to say, this damages our bodies over time. We aren’t meant to live in pain. Studies even show that people with chronic pain have shorter life spans.

In addition, the stress of living with pain creates a vicious cycle that causes more pain.
Drawing provided by Krames Patient Education:

drawing which shows how pain affects sleep, mood, activity and energy
A Balanced Approach

When I was researching a holistic approach to rheumatoid arthritis treatment, I fell in love with this sentence from an alternative medicine doctor:

“Pain relief is obviously very important, and if this is not achieved, you can go into a depressive cycle that can clearly worsen your immune system and cause the RA to flare. So the goal is to be as comfortable and pain free as possible with the least amount of drugs.”

Having treated many people with RA and seen the pain experience up close, he expressed an empathy which I desperately needed to hear. Note the last sentence in his quote – he doesn’t tell people to go off their medication. Instead, his treatment protocol offers advice on alternatives, helping people lower their dose. For those who need to continue some level of NSAID use, he offers advice for doing this safely. This is the balanced approach I would love to see more of in the paleo and real food community.

How to Reduce Your Pain Medication Safely

  1. Go on a healing diet such as GAPS, Wahls or Paleo, and as your symptoms improve, your dose can reduce naturally. Don’t put the cart before the horse and spike your inflammation by removing medication first. If you would like to try the autoimmune protocol, stick to the food eliminations; identifying food intolerance and removing those foods often leads to dramatic pain relief
  2. Here is a list of natural supplements with pain-relieving and anti-inflammatory properties. They are absolutely worth trying, and I take some myself. For some people, they eliminate the need for NSAIDs completely. For others, they allow you to lower your dose. Work with your healthcare team to discern which is best for you: Curcumin, Cat’s Claw, Fish Oil, Krill Oil, Black Currant Oil, Boswellia, Willow Bark, and Tart Cherry. There are also essential oil roll-on sticks that have a reputation for relieving headaches, even migraines.
  3. Don’t “bear the pain” thinking that is a healthier choice. (See the pain cycle information above.) If you need to take NSAIDs, simply do it mindfully, and make every effort to live healthfully and reduce your need for them. Don’t take them on an empty stomach. Take them with a full meal, and once per year to have your liver and kidneys tested for full function (good advice for anyone on any medication long-term.)

Guilt-Free Zone

Healing from rheumatoid arthritis, I struggled with feelings of guilt and shame about relieving my pain, due to the anti-medication message of the alternative health and paleo communities. Now that I write this blog, I receive emails from people having similar struggles. Some people say they feel like a failure if they still need pain relief. Others fear the diet won’t help them at all if they aren’t willing to go off their medication first. Guess what? Taking painkillers hasn’t stopped my healing process. In fact, I would say it’s been integral to my healing process, because it has kept my stress at a manageable level and allowed me to sleep at night. Prior to starting a healing diet, I was taking very high doses of ibuprofen and naproxen, to survive the daily flares. Once I started GAPS, the flares started to diminish, and so did the dose of my medication. I then added anti-inflammatory supplements, which allowed me to reduce my dose even more. Currently I’m doing the core autoimmune protocol (food only), and my inflammation is continuing to drop. I hope someday I won’t need any painkillers at all, but right now I still take 1 Aleve tablet twice daily. Why? Because when I stop taking it altogether, the inflammation in my body ramps up, bringing pain back to my daily life and making sleep almost impossible. With this small dose, I’m comfortable both day and night. That is a feeling that promotes healing. Pain is not.

I’m not an anomaly when it comes to healing through diet while still taking painkillers. Dr. Terry Wahls still takes some on a daily basis, although like me, her dose has reduced dramatically. As a woman who understands excruciating pain, Terry has never advocated going off pain medication if you are still experiencing pain. Ann Wendel is another person who shared her story on Robb Wolf’s website; she reversed Hashimoto’s through the Paleo diet, but it took 9 months before she could start to reduce her anti-inflammatory medication. It didn’t stop her healing. And I guarantee you there are others, but you won’t find a lot of evidence on the internet, because people tend to keep that information secret, out of fear of judgment. All I ask is that we stop judging and start understanding. I’m not pro-NSAID; the goal is definitely to reduce and ideally eliminate the need for this medication.  I’m just saying that can take time, and while we heal, NSAIDs can help.


This website has a disclaimer on its legal page that is always in effect, but since I’m talking about medication here, it seems prudent to end the article with this reminder: I’m neither a doctor nor a dietitian. This blog is designed to chronicle my own health journey, share what I learn in the process, and connect with others on a similar path. Everything I write here is simply my opinion and not a replacement for medical advice. May we all be well!

Update 2/2/14

After writing this article, a new book was published dedicated to the autoimmune protocol: The Paleo Approach by Sarah Ballantyne, Ph.D. The book includes a section on medications that can exacerbate leaky gut. These include NSAIDs, Steroids, DMARDs, Oral Contraceptives, Hormone Replacement Therapy, Antibiotics, Acid Reflux Medication, Laxatives and Anti-Diarrheals. However, the author is very clear that people shouldn’t go off their medication cold-turkey. The information is given, so we can be aware of their effects on our bodies and set the goal to find alternatives and/or taper off these medications as we heal. Here’s a quote from the book:

“Changing, tapering, or discontinuing your medication – especially if you are taking prescription drugs, but also any daily over-the-counter medication that your doctor may have recommended – should, without exception, be done under the supervision of a health care professional. I must also emphasize that changing your medication is not, in most cases, something to tackle when you initially adopt the Paleo Approach. By improving your diet and addressing lifestyle factors first, you will be able to heal your body as much as you can while you are still taking these drugs, which will significantly help you adjust to discontinuing them.”

That’s the balanced advice I’ve been looking for in the paleo community.

You May Also Be Interested In

Do You Have My Books?

159 comments on “When Painkillers are GOOD for You”

  1. Do you have any advice on how to do reintroduction while taking NSAIDs? I wanted add foods back in but am concerned I wouldnt feel symptoms if they arise. Thank you!

    1. Hi Paloma. I did my reintroductions while taking NSAIDs and was still able to get clear feedback from my body. It’s rare for NSAIDs to mask all symptoms. If you think your dose is high enough that no inflammation would be felt, you might experiment with reducing your dose to see how your body feels naturally before beginning reintroductions. Caveat: I’m not a doctor, so this isn’t medical advice. This is just what I would do in your situation. Best wishes with your reintros!

  2. Joannabanana1989 .

    I was unfortunate in the fact that diet change never helped my severe inflammatory bowel disease. I still follow paleo for general health but it hasnt helped my pain or disease spreading. I still have to take all of my my medications and sometimes need opiods in a severe flare or extra strength Tylenol for joint pain. I have had this disease for 14 years and have tried all of the natural painkillers without luck. I am happy you wrote this post. It is about living your best life and taking medications allows me to have a job, go on vacation, go for walks (still not pain free), and be a better daughter, sister and friend.

  3. Quercetin is another amazing help for inflammation. It also helps cartilage. Bromelain and vit c help absorption. I take it with coconut oil as well for activation. (I use it as medicine.). All together very gut healing!

  4. Oh my Gosh Eileen. This info is so incredibly timely for me. I only this week gave in to taking NSAIDS twice a day so I could make it thru my day without tears. I came to the conclusion that I have let myself endure too much pain. I tried to give AIP only a chance but the inflammation from RA slowly increased and the pain has been unbearable. With the simple addition of NSAIDS on a regular basis, life can resume. I do return to a new Rheumatologist next month. As you said, a lot of pain and guilt. Thanks for the fabulous encouragement and for sharing your journey.

    1. Teri, I’m so glad you made that choice. This is exactly why I wrote this article. The AIP shouldn’t be about medication decisions. Those should be done in consult with our doctors. Excruciating pain isn’t healing. I hope you’ve let go of all those feelings of guilt as well.

  5. When I had a root canal re-treat and 2 other dental procedures within a month, I had to take Advil for the pain – every day for 2 months. It knocked my gut and body so far out of balance that it took me months to recover. Whew! Now, whenever I feel pain, I just move through it. And that usually happens if I’ve been on vacation and cheated with alcohol and caffeine. eBut it can be quite different for someone with RA, so each of us has to decide what’s best for us. And in addition to all the things you mentioned in your great article, there are also all kinds of new technologies that are coming out (or that have already been out). Some are more expensive than others, but things to be on the lookout for are the BioCharger, Iyashi Wand, BioAmethyst Mat, and LET SCENAR technology. And the 4th State of Water (plasma), A2M and PRP and Stem Cell Therapy, Prolotherapy, etc. And, of course, I’ve done acupuncture and chiropractic for years. Rolfing (Structural Integration) and Myofascial Release also work really well. Rolfing can be very painful, so I’m not sure if it can help with RA because I don’t know enough about RA. But it’s certainly worth looking into. Thanks for a great article, Eileen! :O)

    1. You are so right that we are all individual, and what works for one doesn’t always work for another. That’s why it’s so important that medication decisions aren’t a mandatory part of any dietary protocol. Thanks for sharing the list of what works for you! As for RA, yes it’s a very intense level of pain. I’ve actually been through the rolfing series prior to developing RA and found it helpful then. Now, my body prefers gentler therapies. For anyone undergoing dental procedures, I have one more recommendation: lymph drainage therapy. That was one of my specialties when I was a massage therapist, and it was amazing for eliminating inflammation that sometimes lingers after dental procedures. It doesn’t replace the need for the procedure, but it opens up pathways that sometimes get blocked as a result of the procedure. Just be sure to seek someone who is skilled in the neck sequence, and even better – someone trained in the lymph drainage pathways of the face and mouth. That latter specialty is rare, though, but most skilled lympatic practitioners can do the neck, and that alone can make a big difference.

  6. Bless you! I’m new to strict AIP, and have a dental infection. Treating the root cause, but in the meantime, I was trying to meditate through the pain. Maybe one day, but I’m about two weeks into real meditation practice, so I’m not that talented! But the guilt over a Tylenol or Advil was fierce. So, of course, the stress caused other symptoms to creep back.
    I took the meds. I took four cloves of garlic each day to stop the infection. I made a dental appointment. And I slept – finally – after two sleepless nights.
    Thank you for acknowledging the truth that sometimes modern medicine saves lives, or makes them worth living. I love healing my body with stuff from the yard and garden, but sometimes we just need to use what will work for our lives, “approved” or not.
    Thank you.

  7. Kimmy Fläschner

    Thank you so much. I am crying right now as I feel so relieved. I have done aip since January 2nd for endometriosis which is controlled pain wise by CBD oil and started to really feel good. Then I had a nasty fall which injured my shoulder ligament and the pain is excruciating, especially at night. The doctor prescribed ibuprofen and novaminsulfon and I felt terrible for taking it and still do but thanks to this article it might be even worse to not take them as I simply didn’t sleep when I tried and also wanted to seriously chop my arm off one night.

    1. Kimmy, this is exactly why I object that NSAIDs being listed anywhere related to the AIP. Pain is serious business; it’s unreasonable to tell people to simply suffer. Wishing you deep sleep and quick healing from your injury. Leave all guilt behind.

  8. Hello from Australia! This post really resonates with me as I have been suffering chronic gut and nerve pain for nearly two years now. I have had to take time off work, and feel like I am letting my family and friends down constantly. I have no “label” for my condition but after 3 endoscopies, 1 colonoscopy, 4 visits to the emergency room and a myriad of different specialist visits, it has just been put down to severe dyspepsia, with all other tests coming back normal. My endocrinologist believes that it is autoimmune related as I have suffered from premature unexplained menopause at age 37 (now 45), early childhood psoriasis, endometriosis, iritis and now ongoing gut issues. I have severe bloating most afternoons, severe heartburn which leads to chronic nerve pain down both arms and legs, and muscle spasms everywhere. Over the course of two years I became addicted to over the counter mersyndol (codeine and paracetamol) and have only recently been able to stop taking them completely. Nothing works on the pain, however I do get some relief at night with Endep (amitriptyline) at allows me to sleep and heal. I have now put my faith into the hands of some well thought of naturopaths and nutritionists to see if I can heal with food, supplements, meditation etc I have come to the realisation that stress and anxiety are playing a huge part in continuing to feel unwell and I am trying to overcome this with counselling, oils and exercise. I think it will be a long process but feeling hopeful (most days!).

    1. Lainie, thank you so much for sharing your story. I’m so glad you’ve found some new and inspiring partners to join your healthcare team. You are so right that both food and stress can have such an impact. Wishing you relief and wellness at every level. One step at a time.

  9. I came across the article to do research because I am brand new to AIP. Though I’ve been tested for everything imaginable, my labs consistently come back normal. I am textbook Hashimotos, so this is why I am taking the AIP approach to hopefully resolve my issues. My question is, I have dental work that needs to be done and antibiotics and pain killers are prescribed. What do I do? Take them sparingly? Or are there any ways to get around taking the antibiotic?

  10. Thank you for this post! I needed this since I had a flare from reintroducing a food. I was torn between taking something, but being able to move and feel kind of normal is such a relief!

    1. Absolutely! May your flare pass quickly, Amy. And while it’s always sad when a food reintroduction fails, I hope you also feel empowered by that knowledge and the ability to hear your body so clearly. Gentle hugs coming your way.

  11. Have you (and other readers) tried cannabis oil or prescriptions? Personally, my pain went away after six months of parasite meds, removal of two root canaled teeth, bone cleaning surgery on four wisdom tooth sockets, plus a veggie, meat, raw milk and butter, little fruit, no processed food regime. After the oral surgery, I felt immediate relief of pain I had gotten used to living with. Along the way, I became sensitized to mold and mold toxins – I do wonder if that was a trigger for me as I moved into a house that had a minor mold problem. Sleeping on the patio in a tent brought immediate partial relief. I highly recommend trying removing yourself from your current environment to see if it’s environmental or if environment is a component. Dental was huge, I didn’t realize stuff was draining down my throat till it wasn’t. A big step was debugyourhealth and Susan Luschas, a fellow MIT alumna, she’s not selling anything, just sharing a step by step approach to what she did.

    Women have carried enough guilt. This was a beautiful post.

  12. I am so happy to see this article, I have been AIP for nearly a year and still have flares for Hashimoto’s.. I have taken a total of 8 naproxen sodium in that year, only after turmeric and white willow bark didn’t help. I almost never took pain meds before my diagnosis in July 2016. I always felt tremendous guilt at taking these. I will not feel that way any longer, I will take it when I really need it and not when I don’t. There is no one size fits all……..I’m glad to hear somebody say it that also struggles.

  13. You are always such a weight-lifter – I cannot tell you what this article meant to me tonight. I suffer from Hashimoto’s and have extremely painful periods and am needing to get to a gyno but struggling financially. ..but in fact this last weekend was rushed to the emergency room.. I have been experiencing a lot of emotional, financial stress & life turmoil so I do know that that had it’s effects too. But wow did I need an Advil the other night….If I had the energy to cry right now I would be because I just can’t thank you enough. But jus know you are in my prayers and I would like to send you so much love and light tonight for helping me worry less about taking the NSAID – as I have feared so many times that I will be “making myself worse” but that mentality alone can make yourself worse. SO thank you for being such a positive light and helping us all feel more balanced.

    1. Angela, I’m so happy you found this article when you needed it. Here’s to approaching our health journey with balance. How scary to have been rushed to the emergency room! I’m sending healing wishes and gentle hugs your way.

      1. Thank you so much, Eileen. You are a little health angel. <3 Yes, it was scary as I have not been in that much pain in a long time if ever, but once the Advil had kicked in the pain subsided a lot so I didn&#039t have to do heavier painkillers at the ER which I was really thankful for. So really I am seeing this as and hoping it&#039s because of my stubbornness to not take an NSAID. I am definitely going to be more prepared this time around especially seeing your article now I will have the Advil ready. Cannot thank you enough again for being so brave and caring. Amen to balance! Sending healing wishes and hugs right back your way! Be blessed!<3

  14. April Richardson

    I have recently been diagnosed with leaky gut and subsequently “leaky brain.” The changes and healing modalities are daunting, to say the least. Having suffered from Migraines since I was 7 years old, I am familiar with pain and hundreds of relief methods from medications to massage. As I sat suffering with an extremely debilitating migraine and trying to just “bare” it in order to stick to my paleo dietary changes, I came across your posts. It gave me the “ok” I needed to go take my pain medication and anti-inflammatory and 40 minutes later I am pain free. This might not sound very legitimate to some people, but when you experience severe pain and cannot relieve it, even thinking can hurt. I was/am so determined to treat and heal my gut and brain, I was willing to suffer in order to heal over-all. I am new to all of this and just wanted to say “thank you” as sincerely as I possibly can for your post and position on pain relieving medications.
    Thank You,
    April Richardson
    Lexington, SC

    1. April, I’m so glad you found this post. I don’t believe suffering is a healing state. You can heal and still relieve your pain when necessary. Gentle hugs to you!

  15. I think this is a necessary article , there is far to much fear surrounding NSAIDs, considering how useful they are. But I am coming from a slightly different perspective, where while acknowledge the value of NSAIDs/the post. I have experienced a damaging amount of their prescribing and subsequently, use of. NSAIDS are not really a pain killer, despite being referred to as so commonly. While a majority of the average persons aches and pains, are rooted in inflammation, not all pain is. NSAIDS are along the lines of a muscle relaxer in function, where the source of pain is targeted, not the sensation itself. Unfortunately the spource of pain is not always that easily targetable, especially in cases of nervous system damage or nerve degenration. It is very common for patients with pain having nothing to due with (ie) inflamation , to be relying on anti inflammatory medications almost solely, due to the aforementioned majority, ease of access, reluctance to prescribe appropriately for one reason of another, etc. I honestly expected the article to be focused on opioid analgesics, as it is a perfect title and much needed message, given the polarization of ideology that has recently surrounded their use. Despite the current hysteria , they are the most effective painkillers we have available to us and provide equally safe relief when dosage is adhered to. . The opioid epidemic has blinded many to the necessity of opioid medications in pain management, when many times it is the only relief a patient can find when pain persists. Patients can go for years needlessly straining their bodies system with NSAIDS when benefits may be limited for their condition. The patients symptoms could be managed with a lesser amount of an alternative medication. I personally could not do without NSAIDS in my regiment, but it is something to keep in mind given the extremely biased prescribing ideologies existing in today’s medicine.

    1. Hi Booter. Thanks for your thoughtful comment. I agree that pain relievers should be targeted to needs. Where NSAIDs are highly effective for rheumatoid arthritis pain (my diagnosis), my friends with multiple sclerosis take medication that targets nerve pain instead. As for opiates, that’s its own topic and getting more exposure in the press all the time, like this article on Prince’s recent overdose: http://www.rawstory.com/2016/05/prince-did-not-die-from-pain-pills-he-died-from-chronic-pain/

      Personally, I’ve had negative experience with opiates, so I’m not the person to write an article promoting their use. I took them following surgery and when I tried to stop taking them after just one week (my surgery pain was gone), I went through withdrawal symptoms. My body had already become dependent on the drug. Thankfully, since my dose was low and my use short-term, the withdrawal was manageable, but I will be mindful of accepting opiate prescriptions in the future. I also have a close family member who became so addicted to opiates, she regrets ever being given a prescription. So while they may have a place in healthcare, they also come with a high price.

  16. Hello Eileen! So glad I’ve found your site. I’ve been using the advice on paleomom.com and have done very well – never went on meds and only had RA symptoms for a year or so, so I have been extremely fortunate and I don’t take any nugget of advice from you or others for granted, and am sorry to hear of what you all had to go through to figure it out! Anyway, one of the results of my RA is a bit tricky, I ended up with a hernia due to my spine being hit first, and am now headed in for surgery but as a recent convert to AIP I do not want to take NSAIDs for it, especially this short of a period after dealing with it all (peak pain was in August-Sept 2016, I’m feeling almost normal again!). However, the doc insists I do. Are there any meds that are better than others re: how they affect the gut? I would even consider narcotics first, which I’ve never needed to use before, if they don’t affect my healing gut. I know your not the doctor, but as a healer, would you have any friendly advice for which to use? Thank you!

    1. Andy, surgery is serious business and pain management is an important part of the healing process. I recommend following your doctor’s advice. You can support gut health at the same time by taking your prescribed medication with food and drinking plenty of broth and eating fermented foods daily. Sending wishes for a smooth surgery and quick recovery!

  17. Just wanted to say thank you as well. I have chronic pain and while most of it has diminished by avoiding certain foods, I get flares from other reasons. Tart cherry juice is liquid gold for me but pretty darn expensive! As much as I hate to, I sometimes have to turn to otc nsaids just to breathe. Since I’m all about the healing power of food, I hate to admit that! I also hate that I sometimes can’t figure out the reason for the pain (I have Celiac so sometimes I think my body just rebels because it can) in order to make the adjustments I need. Anyway, thank you for pointing out the elephant in the room of ‘healing diets’.

    1. Thanks so much for writing, Nicole. I had a huge RA flare this Fall – the biggest one I’ve had in years. It took me totally by surprise, and while stress played a part, it couldn’t explain the severity. It has since passed, but one of the lessons I learned from that experience was to accept that while I can control my diet and lifestyle to minimize my autoimmune experience, sometimes flares happen anyway. The more I forgive myself and my body, the less emotionally painful those times are, and the more I appreciate the times in between. I’m very grateful flares are extremely rare for me now, where they used to be a daily experience. May your pain pass quickly! Gentle hugs coming your way.

  18. Thank you Eileen!
    For 2 years and some I have suffered from CRPS. I am on the the AIP again. I initially got better, then had failed ortho surgery plates and screws removed, and things got worse. I have longed for some ibuprofin. Right now I am in a pain flare. After reading your piece on pain, I took an aleve. We need more compassionate guidance with the AIP. Thank you, Kate Sparks

    1. Kate, I’m so glad you found this article at the right time. It breaks my heart when I hear of people suffering like this. Wishing you a pain-free and gentle night’s sleep!

  19. I appreciate your words so much! I came to this conclusion myself a short while back; the affirmation is comforting. Suffered severely for months, interrupted or no sleep, crying frequently, depressed with thoughts that not living would be better. Finally gave in and put myself on a low dose of NSAID and accepted the risks, (two 200mg of ibuprofen twice daily or less.) Got my life back and if it’s cut short as a result so be it. I feel like I have been on my own to figure out ways to cope with the pain. No one seems to care or understand. When diagnosed, my sister, a 30+ year veteran nurse commented that at least I didn’t have cancer and that I shouldn’t bother my rheumy for advice on pain management as, “She is busy and there are people dying in hospitals.” My rheumy said don’t use NSAIDS to just, “Learn to live with it.” (I am healthy otherwise.) I tried…really hard to do just that and failed. Until my labs show I can’t tolerate NSAIDS I will use as sparingly as possible. It’s my life, I can not live it in agony. Thanks again.

    1. Wow, Pusheen. You received no support at a time when you really needed it. I’m so sorry you had that negative experience. While your sister might have been trying to give you a “positive perspective”, that kind of dismissal simply hurts and doesn’t help. A good rheumatologist knows that pain management is an essential part of every patient’s treatment plan, and they want to help. Are you still with that rheumatologist? If yes, I would try another doctor. There are good ones out there, but sometimes you have to go through a few before you find one. In the meantime, you are doing great! That’s a very small dose of NSAIDs for a very severe disease. Wishing you pain-free days and nights.

    2. As a RN, I am shocked at your sister’s response to your pain management. RN’s are taught to look at pain management as a very serious part of helping treat their patients. If you cannot ask your Dr. for pain management, why would you even go? Find another doctor and sister. I hope that I am never treated by your sister, which I won’t be, because I do not trust traditional RN’s.

  20. Thank you so much for this, I needed it. I have RA and am 3 weeks into AIP. Trying to do everything “just right” and it helps to hear that I’m not totally blowing it if I need to take some ibuprofen.

    1. Not at all, Missy. RA pain is serious business. Suffering is not a requirement of healing. Gentle hugs coming your way!

  21. I just want to say thank you for this post. I am in the elimination phase of aip. I was on the verge of quitting twice because of the pain. I am not on prescription strength NSAIDs yet so thought maybe I could do without. I just cannot…. thankfully, very low dose. Maybe I can get off of them eventually.

    1. Jessica, you’re very welcome. Pain is not a healing state, and the AIP can be combined effectively with medication. It doesn’t need to be either/or. Sending gentle hugs your way.

  22. I absolutely love your site. I was dx Hashimoto’s last week and I’m already on board with AIP. You’ve got some fabulous information here so thank you from the bottom of my heart

    1. Aimee, thanks for saying hello. That is awesome that you went AIP so quickly after diagnosis. Wishing you healing in every way.

  23. Hi Eileen,
    I now had to quit the Naproxen that I took for many years, because I had back surgery mid January and NSAIDs interfere with fusions. I was actually glad to finally get off them, but my pain gets overwhelming when I overdo now that I’m healed enough for physical therapy. I retried Tramadol 2 days ago but it triggered my burning mouth syndrome again. The surgeon gave me hydrocodone, but I developed severe (tear-my-skin-off) itching. I have fibromyalgia too but deal most days without help. Do you know of anything herbal or tinctures that can help? Not white willow bark though I react to that too.
    On a good note: when I began the AIP in December my DAILY migraines went away within 2 weeks. I have now discovered that eggs were the main trigger, even just the yolks. I’m sad cause I had free home grown eggs available. I still get occasional ones which may be due to my high neck (occipital area) going out. That was the case yesterday, my chiropractor adjusted it, NO headache today! The other bonus is I have shed 42 pounds since Dec. 1st. (AIP start) 65 total since last May (Whole30 start), woo hoo!
    I’m on disability and it is so hard to afford organic, grass-fed everything. I run out of money every month. Now I have to spare some food money to get new pants 🙂 Do you know where I could get some AIP friendly braunschweiger?

    1. Hi Lori. That’s exciting that you discovered your migraine food trigger. That’s so empowering to know! I’m sending you wishes for full healing from your back surgery, and a pain-free future. To answer your questions: The article itself lists some options for alternatives to NSAIDs. It’s in the section above called “How to Reduce Your Pain Medication Safely.” As for AIP Braunschweiger, I don’t know of any. However, US Wellness sells a nightshade-free one. So if you have reintroduced fruitbased and seedbased spices, that’s a good option.

  24. Eileen, this has to be one of my favorite of your blog posts. I’ve come back to read it a few times over the years and always experience a sense of relief from reading it. We all need more compassion for others on their healing journeys. As always, thank you.

  25. Thanks for that. In general, I don’t take NSAIDS very often because I know they have only limited benefit for my fibromyalgia symptoms, but there are times when an anti-inflammatory is useful, even necessary. I guess I need a little solidarity and balance where it comes to the use of these modern helpers. Was it this post or another of yours that said ‘it took 2 years to heal from RA, but it certainly took longer than that for it to develop’ – or at least that’s my paraphrase of what you wrote. It’s helpful for me to keep that in mind.

    So thanks. I found your blog a while back and am only starting to go through archives now. I am appreciating what you have shared.

    1. Hi Ray. I don’t think I ever give a timeline for healing, because that’s so unpredictable, but yes – Terry Wahls says that autoimmune disease develops in the body for years before we start to experience serious symptoms, so it makes sense that it takes years to reverse that process. I’m glad you found my blog. Wishing you a pain-free life!

  26. I just shared this page on FB with the following comment:

    I never thought I would say this, but: Eileen, you have changed my mind.
    I now, do believe that pain killers can be beneficial.
    Before I also thought it was “wrong” to take pain killers when you want to live as healthy as possible. But we (I) can become too much of a purist.
    Let’s throw the shame out, and be loving to ourselves and our bodies.
    Next time when I am in such pain again, I will look for relief.

  27. What are your thoughts on allergy medicine? After a bad sinus infection in the fall, I ended up in an ENT office two months later since the ringing & whooshing in my ears was not subsiding along with edema swelling under my eyes that seemed to form in pockets. I was told by the ENT that my sinuses were perfectly clear & that my jaw joints appeared to be very inflamed which was pushing on my ear canals making any fluid hard to drain, also causing pressure & ringing. That is when I told him I have RA & it all came full circle. That was December. I began AIP in January, I have noticed a lot of changes but the pressure, ringing, whooshing & eye swelling have not subsided at all. I wonder if allergies are getting trapped in there & if it is okay to take a daily allergy pill. I feel so heavy & tired in my sinus area &, of course, my eyes. While my healing processes I started thinking a daily allergy pill might help the current issues along.

    1. Hi Melissa. I’m not qualified to give medical advice. I always tell people to make their own decisions based on consulting with their healthcare team and their own inner wisdom. Wishing you wellness in every way!

      1. Hi Eileen,

        I understand. I guess I should have asked would taking allergy medicine at all mess with being AIP. I don’t want to mess up what I have worked so hard on.

        Thanks, Melissa

        1. I’m sorry, Melissa. That’s the same question I’m unqualified to answer. The AIP is a diet, not a medication protocol, and each individual has to decide for themselves what, if any, medication they take alongside it for optimal health. Every medication has side effects and consequences on the body. Sometimes, the benefits far outweigh those side effects; sometimes not. You can always treat it as an n=1 self-experiment and see if you feel better or worse with allergy medication, both short and long-term. But I can’t advise you on that decision.

  28. Hi Eileen,

    I have Alopecia Areata for the last 2 years, and I have started AIP like 6 months ago all my patches have healed . (Which I am extremely happy about this) unfortunately I have developed swimmer’s ear and my doctor wanted to prescribe some antibiotics and ibuprofen.. I convinced her to prescribe only antibiotic drops but as you said pain is crucial and I really need that ibuprofen pain killer. And if my ear will not get better in next 5 days I will start oral antibiotics because i have no choice … Or do I? And what can I do to not lose my good gut microbime over antibiotics if that will be the case to start oral antibiotics? I would like to hear back from you and your opinion around this. Very much appriciated and the article was really useful. Thank you very much.

    1. Selem, congratulations on your success. That’s wonderful! As for your other question, I’m not a medical professional so I can’t advise you on your specific situation, but I will tell you that there is a time and place for antibiotics. Even Sarah Ballantyne, who is considered the current leader of the AIP, has taken antibiotics herself when necessary. The standard recommendation is to focus on gut healing and replenishment afterward, through lots of bone broth, fermented foods and perhaps some probiotics.

  29. I’m almost two weeks in on my AIP for my RA. I’ve never cared much for NSAIDs, does nothing for my RA, but there are two days a month when NSAIDs save me… My special lady time. I’m committed to my strict healing journey on AIP, but this is a matter of being able to stand up straight and function. Do you have recommendations for alternatives or is this one of those times I just be mindful of the NSAIDS?

    1. Hi Stacey. There are alternatives listed in the article in the section “How To Reduce Your Pain Medication Safely”. Depending on the severity of your pain, one of those may work for you. Also, when it comes to menstrual pain, working with a functional medicine practitioner on hormone balance can be very helpful. Dr. Fiona McCulloch is one that I know.

  30. I am on week two of a very strict AIP journey. I have Rheumatoid Arthritis & today at work I am experiencing a terrible headache & neck pain. I stopped myself before I decided I was giving in & going to take NSAIDS. I decided to google Can you take NSAIDS on an AIP diet? I am not at all surprised that Eileen’s site came up first in the search. Eileen, I have learned so much from you, thank you for giving all of your wonderful FREE advice. I greatly appreciate it!

  31. Thank you for this article. I have been on AIP for a year and a half. I gave up NSAIDs cold turkey and felt great at first. For whatever reason my pain and inflammation is back and full force. I’ve taken Tylenol with some relief but not like an NSAID does. I cried through this whole article because someone understands my pain. Thanks, again!

    1. Shawna, I’m glad you found this article too. Pain isn’t a healing state. Tylenol has never done anything for me, and it comes with its own risks anyway. May you find the source of that inflammation soon. Gentle hugs coming your way!

  32. Hi Eileen,
    Thanks for your blog.
    I’m often in intolerable pain and will be having back surgery mid January. I’ve tried to reduce my Naproxen to twice a week and got into a severe pain syndrome with NO sleep some days even with a sleeping pill. My doc said to go back to twice a day, but once a day helps most of the time. I will try cutting them in half twice a day to see if that is workable for more a consistent lower dose. My meds are covered and I don’t want to pay for Aleve.
    I just started AIP a 2 weeks ago with some bumps in the road. I’ve been on Paleo since April. I have Grave’s Disease (with my thyroid completely destroyed by radioactive iodine 35 years ago), celiac and possible MS. My neuro doc says since MRI lesions show stable he doesn’t thinks its MS but from chronic migraines. My back doc and primary care both say it sounds like MS. In any case I have muscle weakness and foot drop not caused by my back but from the brain, plus my eyes keep crossing, etc.
    I need something to work because I refuse to go on steroids. I already have chronic candida, sinus infections, and frequent bladder infections which would worsen.
    I’m not sure what symptoms to watch for signs of remission. Migraines and back pain are the only frequent and regular symptoms. My eyes crossing are too sporadic, foot drop and heartburn went away before without diet changes.
    I would love any suggestions you might have from your experiences.

    1. Don’t cut your pills in half Lori. That removes their protective coating and exposes your stomach lining directly to the NSAID. I made that mistake once myself, and a pharmacist set me straight. We need to take whole pills when it comes to Naproxen. You can buy generic Naproxen next to the Aleve at stores like Wal-Mart, and it’s very inexpensive. It’s worth it if it’s a lower dose than your prescription. Once you start healing on the AIP, your body will give you lots of indications – more energy, better sleep, better moods, in addition to reduced pain and inflammation. Some people’s back pain even goes away. Wishing you wellness!

  33. I just recently started the AIP protocol, and thought I had to stop taking painkillers. After a few very high pain days, including headaches preventing me from sleeping well, I decided to revisit this idea and found this website. It was just the reminder I needed about pain=stress=bigger problem than allowing myself to take painkillers until I start to see more of the healing benefits of the AIP protocol. Thank you!

  34. I have read this article before but I had to read it again this morning. My eczema flares have been worse lately (due to the change in weather, ongoing healing crisis, stress) and I had a panic attack while making a cup of golden milk this morning. I was trying to avoid taking an OTC but I had to in order to get up and get to work. Although I know I should not feel shame or guilt for taking medication I deem necessary to manage my pain, I still feel it to some extent. Thank you again Eileen for this article because it really motivated me this morning and helped me to feel okay making the decision to take an allergy pill. Since starting AIP, my meds intake has dropped dramatically (I no longer take OTC or prescribed meds everyday, but more like 1-2 times a week) but I feel bad for even doing that due to all the information I’ve read in the Paleo/AIP community. Thank you for giving me and many others hope and empowerment to heal our bodies as well as peace of mind that we are not derailing our own healing by wanting to manage our pain in the process.

    1. You’re welcome, Melissa. My hope is that Paleo/AIP community will become more balanced in their medication message over time.

  35. Dear Eileen, thank you so much for this post! It comes on a day when I’ve had to take NSAIDs for my RA in order to be able to work, and you’ve taken a huge layer of guilt and stress off my shoulders.
    This post made me realize that I’ve been “holding my breath” since I’ve been diagnosed with RA last summer, in a way not wanting to acknowledge that I now have a serious chronic condition, and that changing my diet alone will not make it disappear.
    Thank you for your blog, it is immensely comforting.

  36. Thank you for the article. I have been on the AIP diet for 10 months, prior to that 6 months on Paleo. I have hashimotos and fibromyalgia. Also have a high rheumatoid factor level but not RA. The diet has helped inflammation, also take fish oil. For the most part my pain is under control but I do continue to have flares of intense pain at times, in the knees and thighs. I have tried to not take anything for pain because of the unnatural feel to it. I have worked hard on eating natural and reducing stress in my life. It’s feels like a failure to take something. Your site is the only spot I have read any opinion on this. I read your article a few months back and it has helped me to feel better about taking something when needed. In the past I know I have taken way too much. But over the years I have received varied advice from health professionals on what to do. I have not seen anyone else write about taking pain meds while on AIP and just wanted to thank you for it. Take care, Eva

    1. You’re welcome, Eva. You’re a perfect example of a self-aware person with autoimmune disease. Like you, I’ve done everything I can with diet, supplements and lifestyle to keep my inflammation as low as possible. But autoimmune disease is tough, and when we need pain relief, we can be trusted to make thoughtful choices. May you continue to feel better and better all the time.

  37. Oh thank you! Those look great! Unfortunately, I still have a migraine. I think it might be from my neck alignment when I sleep so I got a new pillow and am praying that helps.

  38. Thank gd I stumbled across this post! I’ve just started AIP yesterday. I suffer from headaches. They used to be chronic but over the years I’ve changed my eating and have had way less. I did a Whole 90 this past summer and fall and felt great. I started AIP, gave up my meager cup of coffee a day, and have had a terrible migraine for three days. I was at my wits end and came across this. It really helped put it all into perspective. I need my migraine gone so I can sleep and not have so many stressors and increased cortisol. I popped Advil and am hoping it finally goes away.

    1. I hope you slept well last night, Alex and your headache is gone for good! I wanted to let you know about two essential oil roll-on sticks that are especially helpful for headaches. Definitely worth a try if it comes back. You can read the Amazon customer reviews for details. One is called Mygra-Stick, and the other is DoTerra’s PastTense. Welcome to the AIP community. Wishing you full health and happiness.

  39. Thank you so much for writing on this because some autoimmune sufferers HAVE TO use aspirin daily! As one of them, I feel so ostracised when I read some autoimmune blogs. I always wanna shout “What about antiphospholipid syndrome sufferers? Without aspirin we could have a stroke!”
    I have no idea what to use instead of aspirin to make my blood less sticky in a safe way. I don’t think I can find a doctor who would be willing to take me off aspirin saying “Take this plant root instead, now that you’re on paleo diet!” If anyone has info on this, I’d be very interested to hear.

  40. I really needed to read this!! I’ve woke up with stiff, painful muscles in my back for over a year. It’s only recently that my doctor connected it with my Hashimotos. She suggested AIP and 4 months later I was still having pain, just not as severe. I finally took some prescription Aleve and felt like I was cheating. But I found it to be the biggest relief. Not only did I sleep better, but I don’t have to take it every night as I now have many mornings I do not wake up in pain and didn’t take Aleve the night before. I still have healing to do but I finally feel like I’m making progress.

    1. Thanks for sharing your experience, LaTanya. It shows there is a balanced choice here. I’m so glad you’re sleeping better and therefore feeling better.

  41. I also suffer from HS…. And ibuprofen has been my go to medication. I’ve struggled immensely with going cold turkey off it and am thankful for this article that helps ease my guilt. I know that nightshades are indeed a trigger, but trying to find out what also may be.

  42. This article was a godsend. As someone who has been doing AIP for 16 months, I have often wondered how people get pain relief when they have medical issues. By the sound of everyone’s blogs you would think nobody ever had an infection/procedure that required medical attention. I have just had major dental work and also have to take antibiotics for the infections and I feel horribly guilty…like I’m doing something bad. And my Dr. Just prescribed me Aleve and Tylenol to get me through the next couple of days….and I was wondering how that works. I’m pretty sure once this novocaine wears off I won’t give a darn, I’ll be begging for medication…but now I won’t have to feel bad about it. Keep up the food work!

    1. I’m so glad you found this article at the right time, Gina. Even Sarah Ballantyne herself has taken everything from antibiotics to steroids when the situation warrants it. We all need to make thoughtful decisions about when medication helps vs. harms, but there is indeed a time and place for it. I have an extra tip for you! Here’s a video of a lymphatic technique you can do on yourself, and it’s often profoundly helpful in reducing the inflammation from dental work: https://youtu.be/QA-wi0d7-Ro

  43. Hi,

    Thank you so much for your perspective and gracious article. I found it an encouragement as I along with many of your readers experience excruciating period pain every month and have had no choice but to take 3-4 aleve a day every period. I have tried just about everything short of surgery. My last straw is trying either an IUD or finding a non-addictive anti-flammatory drug that doesn’t cause intestinal permeability. Do you know of any alternative medications? I’ve tried chaste tree, turmeric, white willow, acupuncture, etc but it hardly touches the pain. I feel stuck…

  44. Hello again Ellen, I took 2 ibuprofens the other morning when the pain was unbearable and it really did dial it down… unfortunately, I took it on an empty stomach so I felt really tired, etc. When I take it with food I don’t feel the drug. How many days do you have to be “off” ibuprofen before taking Naprexone? Or did I see that you take these together? Thank you.

    1. Yes, NSAIDs always need to be taken with food. Laurie, I recommend talking with your doctor about dosing and which drug is most appropriate for you. The one thing I can say is that they aren’t meant to be taken together. They are comparable drugs, and taking them both would double the side effect risk.

  45. Thank you SO much for this article. Reading through other blogs, I was beginning to feel shameful for starting the AIP AND taking NSAIDs, but the swelling and pain in my fingers was becoming overwhelming and I just couldn’t see myself waiting for months for a possible reduction in my symptoms.

  46. Thank you so much for this great article. I’ve had chronic pain, migraines, allergies, disordered eating, anxiety and depression since I was a small child. I’m sure a sugary diet and excessive use of antibiotics are contributing factors. My parents took me to many doctors, but no one could help me. So when I became a teenager I was given free access to the medicine cabinet and so I pounded NSAID after NSAID to control the pain. I’ve been working with natural doctors for about five years now and you are so right that pain killers are really frowned upon almost to the point of making the patient feel shame. The good news is that through working with these health care providers I am 75-85% better on most days. My anxiety and depression are under control (except when I have pain flare ups) and I have been off anti-depressants for 2 1/2 years after 17 years of use. While I haven’t officially been diagnosed with an auto-immune disease I have removed dairy, gluten, refined sugars and cook almost everything from scratch. My husband’s Celiac diagnosis 3 years ago has helped our family make these changes and never look back. I was diagnosed with hypothyroidism and adrenal fatigue. Starting dessicated thyroid medication has eliminated my migraines and it is my hope that they will never come back! I tried the GAPS diet at one point and developed gastritis while on it. This is when I realized that I needed to eliminate FODMAPS. I have been reluctant to give up eggs and nuts. I have oral allergy syndrome so I react to many foods and the idea of taking away more foods is scary. However, my muscle pain has become chronic even though I have been in physical therapy for over 6 months. I have to grind down my food because on bad days I get spasms in my jaw when I chew. I have been using aspirin sparingly on the really awful days just to sleep. After reading your article and feeling miserable with pain last night I just went ahead and took some Motrin. It was the best night of sleep I have had in months. I’m not pain free today, but it is back to a level that I can manage with oils and stretches. Thank you for your website! It is such a blessing. I’m hoping that over time this diet will help me see further healing.

    1. Thank you so much for sharing your story. Your improvements are really impressive! Healing is a journey, isn’t it? I think you’re wise to be wary about removing more foods. Nourishment is an important part of healing, too, and when we remove too many foods at once, nutrient deficiencies often result. I’m so glad you slept well. Wishing you many sweet nights of sleep.

  47. Dear Eileen,
    Thank you so much for your wonderful research on this. I have hashimoto’s and started AIP two years ago. My antibodies went down from 2000 to 400. That is the good thing. The bad thing is that I developed more inflammations. I don’t understand how that is possible. I now have joint inflammations, the doctor prescribes NSAID. Also too high in purines and I have to take allopurinol. Is that because of the high content of animal protein that I was eating with AIP? It is supposed to be that pain disappears when doing AIP or GAPS, mine only started after AIP. Please help with some insight.

  48. Another thank you from someone who also bought the Aleve, but I have hesitated taking it! I have yet to get a diagnosis, but I know I have autoimmune disease(s),and the pain in the mornings is pretty bad. Non-restful nights from pain happen too. I have been paleo and GF for years, and this is my sixth month of AIP. I have started introductions, and so far, so good on stage 1. But I still have some pains, and now I feel like I have “permission” to take the aleve!

    1. Congratulations on your reintroduction success! That’s wonderful. As for the pain, have you tried any supplements? They can make a big difference. I have a bunch of them listed in the article above.

  49. God Bless you and thank you! I found your website at 1am when I couldn’t sleep for the 3rd night in a row due to a horrible rash/rosacea that had me in extreme pain. I also have fibromyalgia and possible lupus. I’d just started AIP 4 days prior, after not eating for 2-3 days sick with a kidney stone, and was following it 100%, including no meds. I was doing cold compresses and lotion on my face every 1-2 hours just to keep from tears, and like I said, no sleep more than 2 hrs at a time for 3 days. After reading your “when pain killers are good for you” page, I rejoiced, almost cried, and got a cup of tea, 2 of my premade homemade sausages, and took some Motrin, which in 6 months is the only true relief I get for this rash yet. My pain from fibro had also flared yesterday, I’m sure because of the lack of sleep. Thank you for your kind and practical words from someone who’s obviously been there!

  50. Thank you so much for this. I could just hug you. I have Hashimotos, and FMS. I started the AIP three weeks ago, and saw improvement, but seem to have had a relapse. Yesterday the pain hit so hard, and I tried every natural pain relief I could to no avail at all. All day I struggled. At my kids’ bedtime I was in tears the pain was so bad. I found your article and took to Advil. It is the only thing that has ever worked to release the grip of my pain when it hits. 20 minutes later, I felt the first relief of the day. I only ever take Advil when I can no longer bare the pain. And I can bare a lot. Thank you for giving me permission and reasons why it is better to take something that will help than to spend who knows how long stressing and not resting.

    1. You clearly don’t over-medicate, Susan. I think a lot of people have simply never experienced high levels of pain, so they don’t understand, hence the flippant advice to “bear it.” I’m glad you’re feeling better. Rest well.

  51. Thank you for your informative, inspiring, and compassionate blog! Do you know what a safe level of NSAIDs is? My doctors have prescribed two Aleves twice a day and Tylenol every 4 hours, in addition to Prendisone. Even with dietary changes and supplements I can not function without NSAIDs. I would love to be kind to know how to balance healing my gut with pain management. Thank you!

    1. Hi Lynn. Safe levels really vary from person to person. Some people tolerate higher doses, while others have risk at smaller amounts. You might want to consider consulting with Anne Angelone at The Paleo Mom Consulting. She has Ankylosing Spondylitis herself, so is very familiar with pain, and has helped many people eliminate or reduce their need for steroids and NSAIDs.

  52. I wanted to see if you have any insight for me. I recently weaned off methotrexate; I think I took the last dose of 2 pills 3 weeks ago. I had healed my gut enough with GAPS that I was able to do this, and then I wanted to start AIP to see if I could heal even more. I started AIP yesterday. While I don’t have the debilitating pain that I had before going on methotrexate, I do have a lot of aches and muscle weakness that make it difficult to do things during the day and to get restful sleep. I’m a little weary of taking ibuprofen now when I had not needed it before, though, because I’m worried I won’t be able to tell if I am having improvement with the AIP diet. Will NSAIDs mask the symptoms too much for me to tell? I would hate to go through this diet and have it be inconclusive. Thank you for any thoughts you could share with me.

    1. Hi Alison. Keep in mind that I’m not a doctor, so you’ll want to consult with yours on your symptoms. I’ll just share my general knowledge with you. My understanding is that methotrexate takes 2-8 weeks to take effect when you first start your prescription, and it takes the same amount of time for it to leave your body, if you go off the medication. It sounds to me that you’re starting to feel increased inflammation/immune response from going off the methotrexate. I recommend waiting until the full 8 weeks have passed, so you can have a clear baseline for how your body feels off this medication. Then you and your doctor can decide how to proceed – whether you need some form of medication to be comfortable. Wait until your symptoms are stable, and then start the AIP, because you’re right that your body is too “in flux” right now to accurately be able to tell when/if the AIP starts to work for you.

      1. I just wanted to update and thank you so much for this post. After going off methotrexate and starting the AIP diet, my pain got so much worse as my body adjusted to no immunosuppressants. It was pretty debilitating for awhile even while taking a LOT of ibuprofen. I stayed strict AIP more than two months to make sure I was improving before adding anything back in. Three months in, I am down to one ibuprofen in the morning and one at night and I am functional during the day! It might not have been the best plan to go off my medication before starting AIP, but I am happy to say that I am through it and now only have the small dose of ibuprofen every day. So thank you so much for this post. I think people don’t realize how much pain RA can cause and that “just take some turmeric” does not make a dent in it.

        1. Thanks for the update, Alison! That’s so wonderful that you’ve improved so much on the AIP! And I agree with you that people who have never experienced RA pain really don’t get it. I know for me, I had no idea how extreme pain could be. Empathy comes through experience.

  53. You’re absolutely right. I was in a near fatal car wreck and burst fractured my spine, crushed my pelvis, etc. Multiple surgeries and permanent nerve damage have changed my quality of life drastically. I recently started to eat AIP right before a c-section (must have them since I crushed my pelvis in the car wreck). I was so scared of pain medication I would refuse it everytime they offered in the hospital. I only took Ibuprofen and when I took/take it (I’m only 2 weeks post cesarean), I get very bad anxiety because of what I read about NSAIDS through AIP. I feel like I can’t win. My mind and body are constantly stressed from pain I can’t control (nerve damage is the worst!) but I’m too scared to take pain medication.

    1. I wrote this article for just this reason. It’s okay to relieve your pain; in fact, it’s beneficial when your pain is that severe.

  54. So grateful to have landed here. My RA was manageable up until about two months ago. I have dealt with it naturally but have been on pain meds every day, in a lot of pain, still not sleeping much and feeling guilty about everything. This gives me hope for healing and sticking with natural methods. I have a great doctor who continually encourages me but I don’t know anyone personally who deals with this. Thank you so much.

    1. Hi Kathy. Never feel guilty for relieving your pain. However, if you’re taking a lot of pain meds and are still in a lot of pain, I recommend trying something new. There are two paths to take: one is to go on immunosuppressants temporarily, to get the RA under control so the natural methods have a chance to work. Healing is complex and takes time, and sometimes meds + diet/lifestyle are the answer. Here’s a good article by someone who recently made that choice. If you don’t want to do that, I highly recommend working with a functional medicine practitioner who has experience with quickly getting autoimmune symptoms under control through a combination of the autoimmune protocol, anti-inflammatory supplements (some of which are mentioned above), and functional tests to find other inflammation triggers. I recommend Anne Angelone from The Paleo Mom Consulting. She has Ankylosing Spondylitis herself, which is similar to RA, and she understands pain. Wishing you full healing, Kathy, and help in the meantime. Gentle hugs.

  55. Thanks so much for this post, I too have avoided NSAIDS while implementing the AIP for Hashimotos, but the chronic joint and muscle pain I feel keeps me impaired, and somewhat depressed. Thanks for the balanced perspective, and the encouragement to find what works.

  56. Eileen, I am on my way right now to get a bottle of Aleve. I have been one of the those people “white knuckling” our way through RA pain and I’ve been in that vicious cycle you mention above: pain, no sleep, cortisol, more pain, no sleep. I’ve been loathe to take painkillers these years on paleo, especially an NSAID, but reading that it hasn’t slowed your gut healing or that of others, I’m going for it. A small dose, but one that hopefully will promote more internal ease which will surely promote less stress and more healing. One other question, have you written about some of the studies about RA and personality traits? I know there have always been studies about that, but some of the work that Dr. Gabor Mate has done more recently has resurrected some of those ideas about an RA “personality type” and I’m wondering what you think? Thanks as always for everything you do.

    1. Yes, pain isn’t healthy either, and I’m glad you are seeking relief. As for Dr. Gabor Mate, I read some of his essays. I believe in the mindbody connection, and I think looking into repressed emotions, and unmet personal needs is wise for anyone to do, RA or not, but I don’t believe in a “personality type” for autoimmune disease. I think we human beings are more complex than that, and I hesitate to step into the boxes people sometimes draw for us. That said, he seems to be a gentle and caring man, and undoubtedly, there is some wisdom to find in his books. There are lots of avenues to healing, and I wouldn’t close the door on any of them.

  57. Hi Eileen,

    Thank you for writing this. I am a 26 year old dancer who has had excruciating joint pain and just recently got diagnosed with rheumatoid issues. I changed my diet to the Autoimmune protocol, and have immensely decreased my pain (it is wonderful), but am still in pain and need to dance until the end of my season at the end of may. I felt guilty for taking NSAIDs occasionally because I was scared they were interrupting my ability to heal from my gut. This post made me feel so much better. Your blog is so inspirational to me, I have not found anyone writing about RA and doing the autoimmune protocol and so I just wanted to thank you.

  58. Just finished reading this and I literally want to cry (tears of joy!!). Just recently, I self-diagnosed myself with HS. I’m assuming at least one culprit is my heavy use of ibuprofen to alleviate horrendous monthly menstrual cramps. I have been taking, for as long as I can remember (15 ish years) 600 iu ibu every 4 hours for the usual 2 days/month that I experience the otherwise unbearable pain. I’ve been at the AI Protocol diet as best I can for the last 2 months or so, with no ability to even decrease NSAID use just yet. Frustrating, & I feel like I’m wasting my time by not doing the 100% by the book protocol. Your article gives me such a huge sigh of relief, knowing that there are others out there still needing to rely on the old NSAID standby…for now at least. Just want to say thank you.

    1. Oh Emily, I’m so glad you found this article. You aren’t wasting your time at all. The food & lifestyle portion of the AIP are the primary healing components. Two tips that might help you with the pain in the meantime: (1) Have you ever heard of Chasteberry? It’s an inexpensive herb that is known for regulating hormone imbalances and the associated pain. The dosage is 400mg twice daily, not just during your period. It’s an ongoing daily supplement that takes about a month before you notice the effects. I’ve taken it myself and noticed a huge difference Here’s a link to more information: http://www.wholehealthchicago.com/464/chasteberry/ . (2) For immediate pain relief during your period, Mickey Trescott from the blog Autoimmune Paleo found willow bark to be really effective. So, those are some things you can try while your body heals. Disclaimer: since I’m not a medical professional, simply consider this advice from a friend, and check with your healthcare team, to be sure there are no contraindications for you. Gentle hugs coming your way!

  59. Thank you for providing so much helpful information. My doctor has finally ordered some additional tests because I haven’t been healing as quickly as I used to, and there is a strong history of autoimmune disorders in my family. I have been taking diclofenac for my chronic low back pain, and it also manages the pain in my hands and joints. I had the stomach bug 3 weeks ago, and there was a concern I had a perforation in my stomach from long-term NSAID use, so I discontinued for nearly a week. My pain came screaming back. I’m grateful I have a doctor that understands how active I am, and how health-conscious I am. She completely supports my adoption of the W30 for management of chronic inflammation. I was cleared to go back on diclofenac and my pain dropped back down almost immediately. I have felt a bit like a traitor since my inflammation isn’t responding completely to the dietary changes. I’m now trying the AIP, but that is much harder for me, because I love peppers! La, la, love peppers. The spicier, the better. However they might be very troublesome for me. I haven’t been able to stay compliant for more than 24 hours at this point, but I keep trying. I am very grateful that you have posted your journey so people like me can benefit from your experience.

    1. Hi Lori. Thanks for sharing your story. Nightshades might very well be the problem. They are my biggest inflammation trigger. I know, they seem impossible to give up at first, but when you feel so much better, they’re not even tempting. I also recommend you check out some of the supplements mentioned in the article. They really helped me reduce my NSAID use, and some people find they’re so effective that they can go off NSAIDs altogether.

  60. Eileen,
    Thanks so much for bringing this post to my attention. I started taking MTX and 15mg meloxicam (NSAID) in Jan 2012. My MTX increased to the max dose over the next several months, with my RA symptoms only worsening. I started Humira in Aug 2012, and it felt like things were finally starting to get better. I was able to start reducing my MTX in Dec 2012. I started a GF diet in Jan 2013, that quickly evolved to a paleo/primal/perfect health diet. I was able to completely remove my NSAIDs in Feb 2013. I continued to reduce my MTX until I was down to 5 mg (2 tabs) in Sept 2013. Stress, lack of sleep, disrupted exercise routine and a retired rheumy all contirbuted to a re-activation of my RA symptoms. I increased my MTX back to 4 tabs in Nov 2013, got a new prescription for my NSAID in Jan 2014, and my new rheumy doubled up my MTX to 8 tabs in early Feb. I am now trying to get things back under control with the AIP. My symptoms have not improved, 3 weeks in, so I ditched my NSAID on Tuesday. My symptoms worsened tremendously over the past few days, but I thought I should tough it out. Your article has helped me to realize that it’s better to get my pain under control first. I will continue to follow the AIP, but with stick with my NSAIDs until I feel better! Hugs, Karen

    1. Thanks for sharing your story, Karen. It’s empowering to remember how you healed once, so you know that you can do it again, and tapering meds as you heal is the safest way to go. You also gained some hard-earned wisdom about the role stress and sleep play in our autoimmune disease. Sarah Ballantyne says that’s tougher to manage than diet sometimes, and I totally agree. But it’s so worth it. I believe in you! Gentle hugs to you, as well.

  61. Eileen,
    This post is such a breath of fresh air! I am a physical therapist who had to stop working (among other things such as strenuous exercise) due to rheumatoid arthritis. Even though I have counseled my own patients over the years on how to surrender and take things day by day, it is still hard not to feel guilty for taking the necessary medications or not always sticking to the restrictive diets that may or may not help my condition. At times, it is hard to have hope at times and it is hard not beat myself up.
    Your blog and it’s contributors have given me some hope and softness that I needed today.
    Thank you.

  62. I am struggling with CFS and have been taking ibuprophen for pain. I also have IBS so have been feeling conflicted about medicating pain if it is detrimental to long-term healing. But the protocol for optimal health is so overwhelming between diet restrictions, herbs, suppliments etc. living “clean” seems nearly impossible! I’ve been taking my diet one step at a time, trying to appreciate the progress without beating myself up for not getting it all right immediately. I found the advice here very helpful in applying the same perspective to meds. Thank you!

    1. You’re welcome. One step at a time still gets you there. Getting off medication is a worthwhile goal, but that doesn’t mean it’s achievable overnight, and guilt is not a healing state!

  63. Ty so much for this post!! I googled paleo and inflammation and found you! I’ve been paleo for 2 years and it significantly reduces my arthritic inflammation. However, almost 2 weeks I got immunized (a whole other topic!) for an upcoming Cuba trip and am in the middle of a massive flare up. Feeling horrible that I’m about to ruin any progress I’ve made, I need to take a stronger anti inflammatory. I’ve been religiously taking turmeric and ginger and it is has not made a difference AT ALL in the amount of inflammation! And I’m getting more worried as this flare up is highly unusual since going paleo. I’m taking ibuprofen today to just settle this crazy inflammation. Ty for easing my guilt and concern over doing so.

    1. Marni, you are so clearly someone who would never abuse painkillers. I’m so glad you found this article; they definitely have their time and place. May your flare pass quickly!

      1. I’m just so thankful for your post as it eased all guilt. And ibuprofen has made a huge difference in cutting down the flare up, for which I’m also thankful. 🙂

  64. Thanks very much for your blog, and for this post in particular, as well as your experience with the Autoimmune Protocol! I’m 35 and beginning to suspect that I have Ankylosing Spondylitis, which runs on both sides of my family. I’m not in anywhere near the excruciating and debilitating pain that you and others have dealt with, but I’m always uncomfortable and wakeful while sleeping and stiff/sore in the mornings. I have periods of very limited motion and tingly/numb sensations that come and go. I have not been diagnosed, but at this point I’m not even sure what good a diagnosis would do me, since I would first want to try a natural and nutritional avenue to feeling better and controlling the disease, with the help of over-the-counter NSAIDs too (thank you for affirming something I was strongly questioning in the AIP!) This is such a drastically different way of eating than I or my family is used to that it really scares the crap out of me. I don’t like to cook, but I LOVE food. I feel like I have an emotional attachment to food. I actually cried when I was reading the AIP guidelines. I guess I’m not yet quite at the point where the pain is enough motivation. But I’m glad to know that this works for people! Your story (and Paleo Mom’s, whose blog I came upon yesterday in researching this online) is so amazingly inspiring! Thanks for sharing it!

    1. Hi Ann Marie. Have you seen my interview with Charles, who has successfully treated his AS through diet? For him, starch was the key, which I hear is true for many with AS. Don’t feel like you have to jump right into the AIP. Try full paleo first, then maybe remove starch as a test. If that doesn’t work, try the AIP. It’s absolutely OK to approach all of this in stages. I love food, too! The good news is that you can find really delicious replacements for the foods you’ve come to love. A healing diet can still reward the tastebuds (and the heart). It’s really a change of mindset, more than anything else. Thanks for reaching out.

  65. Thanks for your post — YOU motivated me to get some Napoxone compounded without additives. It’s sitting in front of me waiting for me to take the plunge — I’m nervous because of drug reactions, but I think I’ll take a little at a time STARTING TOMORROW, since seeing this post reappear after I thought it lost seemed like a little sign — a little nudge. I’m in horrible pain 24/7 in my lower body (burning, bone chilling, aching, stiffness, etc.) — various neuros say it is ms — one nuero said it absolutely isn’t ms — and now from research I suspect protracted w/d to pain killers as the culprit as I took pain killers before this pain started, so I have been tapering. I have been on GAPS for about 1.5 years, though since I can’t tolerate ferments, or anything beyond chicken, duck, pheasant, and a lot a veggies (soups and stews and broths and a little chicken liver) and a lot of duck fat, I’d say I’m really on a paleo/ketogenic diet, though I’d love to be ON GAPS! Even be on paleo and eat all that yummy food. I started going into shock from food intolerances and my doctor recommended GAPS. My paelo/ketogenic diet prevents shock when I eat – it has stabilized the food intolerances — I believe that is a form of healing? When I eat too many peas or too much squash (sugars I guess) the pain dials up and and I back off these a while. I do feel I crave the move starchy/sugary veggies.. When I get a good amount of fat, the pain dials down. I don’t know exactly what’s happening with my body but it’s totally knows what it needs and doesn’t. Now to reduce the pain… thanks!!!

    1. Hi Laurie. You absolutely deserve pain relief, and I’m glad you’re working with your doctor to find a medication that works with your sensitive system. If your food intolerances are stabilizing, you are definitely healing. Sometimes medication and a healing diet work better together, than either one does alone. At least for a while. Gentle hugs to you.

      1. Thank you Eileen! I get discouraged because I’m not “progressing” on GAPS, and get anxious because I feel stuck — like “can’t get out of it” even if I wanted to without going into shock and dying. Do paleo people ever get “stuck” like this? Not going into shock by eating this limited (but I might add delicious soups and stews) diet IS life saving, so I need to keep remembering it’s keeping me alive. I’m glad you think that I am healing too. Oddly, I’m never fatigued and am very productive in spite of the pain. Another pay off to a paleo/ketogenic diet I’m guessing! The pain has worsened over time, and it seems pain begets pain, so I’m looking forward to Napoxine dialing it down! Thanks again!

        1. When you plateau and feel “stuck”, it’s a good time to work with your healthcare team to add something new to your protocol. It can be addressing sleep patterns, or adding daily meditation, doing emotional freedom technique, looking into supplements, or trying an elimination diet like the paleo autoimmune protocol. We are all unique and complex, and there are many ways to tweak our healing process in the right direction. Each time I plateau, this is what I do.

          1. Feeling so stuck right now, and stress of losing my job or needing to quit (massage therapist with RA) is causing more stress and pain. What a vicious cycle! I agree wholly with not beating yourself up about relieving pain. Thank you. It is so helpful not to feel so alone.

          2. It’s especially hard when it affects your career, and I can relate, because I’m a massage therapist as well. When RA first hit, I took extra painkillers to continue working, but I got to the point where (1) the flares got so bad I couldn’t work through them any more and (2) I accepted that I couldn’t keep that up long-term. I needed to make a change. Even though I’ve healed a ton and no longer flare at all, I still have low level inflammation in my joints, which limits my strength and flexibility. I don’t notice it in daily life, but I would notice it if I tried to return to deep massage as a career. Thankfully, our career has other options. I’m still working as a bodyworker, but I now specialize in lymph drainage and craniosacral therapies. They’re light touch modalities that are easy on my hands, yet very effective for my clients. I know it’s hard to be forced to make a change, but sometimes it sends us in a positive direction long-term. Most massage therapists I know WITHOUT RA eventually shift to modalities that are easier on their bodies, if they stay in the career long enough. I just want you to know I’ve been where you are and come out the other side, and I’m doing great, both personally and professionally. I have the same hope for you. Gentle hugs, Emily.

  66. Thank you. I found this at exactly the right time. I am new to the autoimmune paleo community (I have Ankylosing Spondylitis) and have been panicking and crying and beating myself up about NSAIDs. I felt like a failure and felt like I was sabotaging all my hard work. I also felt so weak when I had to “give in” to the pain and take some Naproxen.

    1. I’m so glad you found this article, Amy. You are NOT a failure. Just do the food portion of the AIP, and as your symptoms decrease, you can slowly decrease your NSAIDs. There’s no such thing as “giving in” to excruciating pain. It’s a matter of survival and self-love. You have every right to relief. Hugs!

  67. Well said! I couldn’t explain it better myself and my doc would agree! I hate pain killers and I take some strong ones. My husband hates the thought of any drugs and has always been anti drugs. Mannn when I am in pain he is begging me to let him help me with some pain relief. Massage, heat packs, TENS unit, patches, distraction and yes pain killers. As he puts it, I have to sleep some time. There has been times I have not slept for over 24 hours due to pain. Am I going to be ashamed for taking a pain killer? HELL NO! Am I going to be stoic and deal with the pain? OK maybe yeah… but when the cranks get real bad … HELL NO!

    Thanks for writing this. Pain killers can help with healing if they allow you to sleep. If they allow you to swim and get joints moving.

    They can also break the cycle of pain. I notice my muscles start tensing when I am in bad pain which makes the pain worse. With pain relief, my muscles relax which lessens the pain beyond the pill. Add in some distracting relaxation and who knows? Maybe Sandman will come knocking…..

  68. I agree with you. I’ve had two terrible car accidents that have caused me horrible migraines and back pain. I wasn’t pleased with the free manner in which my doctor wanted to prescribe painkillers and anti-inflammatories, but I did take them to get me through some of the worst of it, and to help me sleep at night. I took them only as a temporary measure, and once the negative side effects (grogginess, upset stomach, etc) got more annoying than the other pain, I stopped, but I don’t feel guilty about it. Excruciating pain that prevents me from living my life is not an alternative. Over the years I’ve worked with physios, personal trainers, acupuncturists and massage therapists. Now I do yoga and exercises regularly to strengthen my back to avoid taking meds again, but I would never judge someone who did take them when things are bad.

    Thanks for sharing this well-written defence on Waste Not Want Not Wednesday 🙂

    1. Thanks for sharing your story, Danielle. It shows exactly the kind of balanced approach that makes sense. I think when you’ve experienced that level of pain, you get it in a way that others may not. I’m so glad that both the pain (and the need for pain meds) are behind you. Hugs.

  69. Thank you! I do not have an auto-immune disorder but have suffered from frequent migraines for years. I may never be rid of them, but 3 years ago I decided to do everything I could to have fewer migraines, and I’ve reduced them about 80%. One of the things I had to do was get myself to take medicine at the first sign of trouble! For me, NSAID taken with caffeine is more effective than the prescription migraine drugs, but for either option, it is important to take it at the first sign of migraine rather than waiting until the pain becomes unbearable. The idea that “healthy, natural” people shouldn’t swallow pills was one of several bad ideas blocking me from doing that.

    1. Reducing your migraines by 80% is awesome, Becca, and I’m so glad you have a pain relief system that works for the few that remain. Thanks for sharing your story!

    2. I have lived with migraines since I was about 13. I’m now 62. The AIP helped reduce mine about 50%, I found out my daily eggs were the trigger. Now I still get some from my unstable neck-many injuries.
      I had back surgery a year ago for my low back injuries and I’m still in pain. I had to quit NSAIDs for the fusion to take. I switched to Tylenol #3 as needed. It helps the back pain and the migraines when added with coffee, but without the problems of additional leaky gut issues from NSAIDs. I’m grateful to find an acceptable combination for pain relief without adding to my leaky gut syndrome. I also have Graves Disease (thyroid gone) and Fibromyalgia.
      The major bonus, in 9 months I dropped 90 pounds and have now been stable at my goal of 155 # for 3 months. The diet really works!
      I found that I can now eat most seeds, almonds, macadamias and pecans; but no dairy, beans or grains other than 8 hour chilled white rice (resistant starch). I still can’t have nightshades other than Annie’s ketchup for some reason. Probably how its cooked and maybe no skin or seeds included, which reduces the lectins.
      Anyway I’m grateful for the things I can have.

  70. Something interesting is happening in response to this article. Usually people comment publicly when they like one of my posts. Instead, I’m getting lots of private emails from people thanking me for writing it. I think that demonstrates again how taboo this subject is. I’m respecting people’s privacy by not posting the emails here, but know that this article has touched a lot of hearts, souls and hurting bodies.

    1. Hi Eileen-

      Thank you for all of your great advice! I sincerely appreciate reading it. You mentioned all of the alternative medications to try, like tart cherry and cat’s crill, etc. do you recommend taking ALL of those? or just some? I would like to take a list to my co-op to get started on them. I currently am on the AIP without any supplements. Thank you!

      1. Hi Kate. First, I have to say that I’m not a medical professional, so consider this recommendation “advice from a friend” and definitely run it by your own healthcare team before you make your decision. (1) Only try one supplement at a time. You want to take as few pills as possible, and there’s no sense taking one where you don’t notice a difference. Also, what works for one person may not work for another; we’re all unique. (2) Whatever you choose, be sure to read the label and make sure it’s allergen-free (no wheat, corn, soy or dairy). (3) I don’t necessarily recommend one supplement over another, but I can give you some advice for choosing quality within each category. Curcumin is a great anti-inflammatory, but it’s very difficult for the body to absorb. There’s one brand that is formulated to be more bio-available: Life Extension Super Bio-Curcumin. Cat’s Claw is similar, in that there’s a substance within it that’s beneficial called POA, and formulas which focus on that ingredient seem to be more effective: one such brand is Saventaro. As for fish and krill oil, there’s a wide range of quality. Chris Kresser wrote a detailed article with recommendations. Dr. Mercola recommends krill oil over fish oil. Boswellia & willow bark are recommended by Dr. Cowan, and since they need no special formulation to be effective, they’re easy on the budget. Tart cherry, in contrast, can be quite expensive. Ginger is something that’s easy to try as a food. You can buy the root at the grocery store and make ginger honey tea. So, that’s some of my research shared. Health food stores often have experts on staff as well, so see what they have to say. But again, choose just one to start with. Over time, you can add others, but it’s best to start slow and see how your body responds.

  71. Buckley Freeman

    Thanks for all of your great information, Eileen! I know how much time is spent in trying to heal, and also in maintaining this (very helpful) blog. It is inspiring and encouraging!

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top