That time of year again. Shamrocks everywhere. Green-colored everything. The inevitable flood of St. Patrick's Day party invitations and bar specials clogging up my social media feed.

But for those of us who juggle life with autoimmune disease or chronic disease, March 17th is not a matter of whether we're up for partying or not. It's a matter of risk vs. reward, because what we do today can ripple through our bodies for days or weeks to follow.

"Just one drink" is simple to most. To us? Not exactly.

So let's talk about why alcohol requires special attention when you're chronically ill, and how to make your way through the social maze of celebration-ridden holidays without destroying your health.

Our Immune Systems Are Already Confused Enough

For those of us with autoimmune diseases, our immune systems are already behaving like overzealous hall monitors turned loose. They're attacking things they shouldn't attack, ignoring real attacks, and in general making a mess of normal body functions.

Adding alcohol to the mix is like adding water to a grease fire:

• It suppresses immune response when many of us are already taking drugs that have the same effect.
• Activates inflammation flares, frustrating for lupus warriors.
• Worsens neurological symptoms for MS patients.
• Enhances joint pain for individuals with rheumatoid arthritis.

My own rheumatologist spoke plainly: when your immune system is already struggling to perform optimally, alcohol can deplete your body's defenses against everyday infections.

Medication Roulette Is No Game Worth Playing

My medicine cabinet and purse looks like a mini branch office of a pharmacy. I'm not alone - most of the folks I know who have chronic disease take multiple meds every day just to survive.

Alcohol doesn't mix well with many of these meds:

• Methotrexate (a common autoimmune drug) and alcohol? A potentially poisonous liver poison combination.
• Pain medication mixed with alcohol increases stomach bleeding and ulcer risk.
• Antidepressants become ineffective with alcohol, but their side effects are worse.

These are no small nuisances. One of my friends ended up in the ER after mixing alcohol with her regular meds at a holiday party last year. The hospital bill and week-long flare that followed definitely weren't worth those two glasses of wine.

Our Gut Health Is Already Walking a Tightrope

The relationship between gut health and autoimmune function isn't merely a buzzword of wellness. For all of us, it's a day-to-day reality that impacts everything from drug absorption to symptom management as a whole.

Alcohol is infamous for being rough on the digestive system:

• In IBD patients, alcohol is a direct irritant of the lining of the intestines, which may cause flares.
• Most alcoholic beverages contain gluten or gluten-based ingredients, a celiac patient's worst nightmare.
• Those with IBS or gastroparesis tend to find that alcohol delays digestion and makes existing uncomfortable symptoms worse.

Even in the absence of a diagnosed gut disorder, alcohol makes the gut more permeable, possibly allowing more substances to pass into the bloodstream and provoke immune reactions.

Our Poor Overworked Livers

When you're living with chronic illness, your liver never gets a moment off. From detoxing drugs, regulating inflammation markers, and dealing with daily toxins, this vital organ is working overtime shifts without time-and-a-half.

Alcohol is a further strain that's particularly dangerous if:

• You have autoimmune hepatitis with underlying liver inflammation.
• You're on liver-processed medications (which includes most autoimmune medications).
• You've built up fatty liver disease on top of your underlying illness.
• You're a cancer patient with a liver already on chemotherapy.

At some point, it's like asking someone working three jobs to work a fourth - something will have to break.

Finding Alternative Ways to Celebrate

The good news here? St. Patrick's Day doesn't have to be all about drinking to be fun.

I've been able to over the years find plenty of ways to join in the celebration without hurting my health:

• Braving the world of mocktails - there are fantastic recipes to try out there that are just as celebratory as alcoholic drinks.
• Taking a step into Irish food heritage instead - from soda bread to shepherd's pie.
• Attending cultural festivals like parades, concerts, or dance performances.
• Just dressing up in green and decorating my space to put me in a better mood.

These alternatives enable me to remain connected to friends and society without the health consequences that would result from alcohol consumption.

The Social Pressure Is Real

Sometimes the hardest part is not avoiding alcohol itself - it's dealing with the questions, pressure, and even outright judgment from others who do not perceive our invisible boundaries.

I've learned to have answers on hand. A simple thing like, "I'm on medication that can't be combined with alcohol" tends to shut off questions without having to tell strangers my entire medical history.

Healthy friends respect health boundaries without requiring an explanation. Those who don't? Well, they're showing us something important about how much they value your health.

Toasting to Choices That Respect Our Bodies

Living with chronic illness is all about making difficult decisions others don't have to make. Forgoing alcohol may feel lonely at times, but not having days or weeks of added symptoms is a sacrifice most of us have found to be well worth it.

This St. Patrick's Day, I'll be raising a glass of something besides liquor, toasting to making choices that respect what our bodies need. Celebrating in moderation without jeopardizing our health is something very much worth celebrating.

Sláinte to choosing our health! 🍀