After PFS/PSSD/PAS begins, some medications, supplements, creams, herbs, and personal care products that were previously “safe” can trigger crashes/flares or slow recovery. Because they didn’t cause issues before, they’re often overlooked.

Step 1: Identify triggers and simplify to stabilize.

See the Substance Crash Risk Overview and Substance Crash Risk Directory below for commonly reported triggers.

How to do it (when safe):

• Pause potential trigger supplements and products for a short period

• Keep your routine minimal and consistent

• Only add something back if you truly need it

• Before reintroducing, research the item (and consult a clinician when appropriate)

• Reintroduce one item at a time so any triggering substance is obvious

Once triggers are removed, many people find that time, a simpler routine, and an individualized diet can reduce symptoms—sometimes leading to major improvement or remission.

Key points:

• Focus on consistency + time after removing triggers

• Use a simple, personalized diet that you tolerate well

• Many people benefit from reducing or removing: sugar, dairy, gluten, and processed foods

• If you reach stable recovery, continue avoiding:

  • the substance(s) that caused your condition, and

  • any triggers listed in Substance Crash Risk Overview below

If removing triggers, improving diet, and giving your body time still doesn’t bring enough improvement, the next step is protocol planning. This means researching potential interventions and approaching them cautiously—starting with lower-risk options first, then only considering higher-risk protocols if needed, one change at a time. Whenever possible, do this with a clinician who understands (or is willing to learn about) PFS/PSSD/PAS and can help you weigh risks and monitor safety.