Flares related to eating and only in afternoons?

Hi, I’m new here so I apologise if this is covered somewhere and I didn’t see it. I did a search on “eating” and didn’t see anything. I’ve been diagnosed with erythromelalgia that affects my feet, hands, and nose. My symptoms follow some pretty typical patterns in that heat and exercise exacerbate them. But a few things I’ve noticed that I’m wondering if other people experience are:

  1. I often have an episode after eating.

  2. I almost never have an episode in the morning. The one exception to this is that I also have Raynaud’s so sometimes in the winter after experience a flare related to cold, the rebound hotness will then come as I warm up. But this seems separate from the typical flareup that I attribute to erythromelalgia. Those flares never seem to happen in the morning for some reason.

  3. I think stress and talking for long periods is sometimes a factor but certainly not always. I have noticed that I will often flare after I’ve been talking for a long time and/or I’m in front of people talking (like teaching a class.) But that being said, I can also have a flare when I’m completely relaxed doing nothing.

Does anyone else experience any of these things and if so, do you know why there is a connection? Since eating and talking seem to be culprits for me, and my nose is my most troublesome spot, I have wondered if there is some connection to my throat area? Since I only have flares in the afternoon, I have wondered if general fatigue could be a factor?

I get my flares in afternoon to . Sometimes later in evening but most are afternoon. I only get small flares in knees . My feet and hands flare on and off all day but there are small flares and usually caused by walking or using my hands. I don’t atttribute the afternoon ones to eating bc I have skipped lunch and breakfast too before and noticed no difference. I eat a late lunch and sometimes I will get a flare before that. Right know I’m trying hot pepper cream and will be seeing a nuerologist about mexiletine a sodium channel blocker . I also take 300 of Gabapentin but just started
My flares seem to be sporadic and if I take a hot shower the redness will be present but does not cause to flare if I give myself time to cool before getting dressed. The worst flares seem to just appear for no reason with me or heat and excersie combined

The autonomic nervous system regulates functions of internal organs and mainly has two components, sympathetic and parasympathetic. The sympathetic nervous system main function is to stimulate the body’s “fight or flight response.” The parasympathetic nervous system main function is to “digest and rest.”

The sympathetic nervous system predominates during the day. At night the sympathetic nervous system relaxes; blood pressure falls, muscles relax and skin vessels dilate. The parasympathetic nervous system takes over at night.

After a meal, the parasympathetic is activated due to the distension of the gastrointestinal tract and sympathetic activity is suppressed. Much like nighttime, this causes blood vessels to dilate and your body to warm.

While it would be unusual to have flares only in the afternoon and not evening or night, what you are describing is a fairly basic pattern related to the autonomic nervous system.

I’ve noticed in myself (and a few others on here, if you search the forum) that 600-800 mg ibuprofen / NSAID can prevent my nose from flaring bright red/getting swollen (note my nose does not burn at all). NSAID’s do nothing for other body parts (which burn / are painful), so I only rarely take them though.

Honestly I’m not sure if my nose issue is even part of the EM, technically, or more like Raynaud’s (it doesn’t get white at all though), or what.

I’ve been to an ENT just to make sure I didn’t have any issues (my ears can burn like crazy). He said everything looked totally fine. Maybe seeing one yourself would help put you more at ease?

Best wishes


someone mentioning celebrex helping with their nose

Hi there, the majority of my flares are from 3 PM till 3 AM in mild weather. And I would also experience of flare the majority of the time after I eat something warm, even without spices. So I do feel for you. I find that keeping my feet above the heart to be helpful and being in a cool environment. They do not take away the flares just make me feel as comfortable as possible. Wishing you all the best.

Very interesting, I knew that em is worse in late afternoon through the night but didn’t quite understand why. 4pm is the time of day where it feels like I am on fire. I end up staying up most of the night and sleeping during the day because I flare up so bad at night. I was hoping my body would start tricking itself into flaring worse during the day instead of at night. I am always flaring somewhere but night time I am in full flare. Thank you for explaining this:-)

Keep a journal of what you had to eat when you flare up so you can pinpoint what it is that is causing the flare up. Artificial popcorn butter makes me flare up bad. I bought one of the nice popcorn poppers and it tastes so good and it took me a week to realize what was causing it. If I have to much dark chocolate too. Orange juice and figs too. It weird how different things make us flare and different meds work on some but not all. So keeping note of flares and what you were doing or eating will help. I took magnesium supplements for a week hoping it would help my pain but it made things a lot worse unfortunately.

Thank you all for all of the replies. It’s really interesting to hear everyone’s experiences.

Thanks for the suggestion, I do need to do that to see if I can identify any patterns.

This is so interesting. Now I am wondering if my recent very bad reflux and possibly other digestive disorders are related to EM? Is there any research linking the two? Any help would be appreciated. I’m going to have an endoscopy tomorrow and would love to give docs information since they have never heard of EM or the other disorder I have which is cervical Dystonia. Thanks so much.