There are many different things that can trigger rheumatoid arthritis (RA), as I know from experience. More common triggers include stress and not getting enough sleep. Those are big triggers for me as well.

However, there are also some possible RA triggers that may surprise you. This list covers triggers that have affected me personally — and that surprised me the most.

I’m going to be honest, I’m a coffee drinker. I need to have a cup to start my day, and it’s usually best to avoid me until I’ve had my coffee. However, I can’t drink decaf coffee. Decaf coffee increases my pain levels significantly.

For a long time, I gave up drinking pop altogether. I felt better. The habit has crept back in a bit, but I’m reminded why I stopped. Drinking pop, like decaf coffee, contributes to my pain levels significantly. It literally makes my bones hurt when I drink it.

Along with the other health benefits of cutting out carbonated beverages, cutting out pop has helped me manage RA.

I’m not a big alcohol drinker, but over time, my tolerance has lessened dramatically. Nearly every time I drink now, even if it’s just one drink, I get that feeling like I’ve been hit by a truck. It doesn’t seem to matter how much I drink, and drinking wine seems to be worse for me than drinking beer.

I’ve been a vegetarian for 15 years, and I’ve been seriously considering going vegan. But the bottom line is, the more unprocessed whole foods I eat, the better I feel. And the more processed junk I eat, the worse I feel.

For me, extreme temperatures are a trigger. When it’s really cold or really hot, my body doesn’t respond well at all. This is one of those triggers that I don’t have much control over.

Maybe this one is obvious to some people — but for me, it came as a surprise.

I have a habit of getting myself into situations that I know have a high likelihood of making me flare. When I travel, I need to have at least one buffer day on either end of the trip.

Once, I took a trip and I was gone and back in 36 hours. I flew, but didn’t change time zones. But when I got back, I was wrecked for days. I could barely get out of bed. My body made me pay dearly for my thrills.

It might seem like there’s an easy answer to reduce my risk of RA flares. If I know what triggers my RA, I should simply eliminate the trigger and take it out of the equation.

Unfortunately, in most cases, it’s not as simple as completely cutting something out of your diet or your life. Yes, I can cut out soda pop and alcohol, if I really put my mind to it. But I certainly don’t have the power to change or control the weather.

And even when I know when something is a trigger, it’s hard to really be prepared for getting hit with a flare. I know that I likely won’t feel good after a whirlwind trip, but I’m never quite prepared for what happens afterward.

Have you taken the time to think about what triggers your RA flare-ups, and what you can do to avoid those triggers? For me, keeping track and staying aware of triggers has made a difference. Keep in mind, it’s always important to talk to your doctor before making any major lifestyle changes.

Leslie Rott was diagnosed with lupus and rheumatoid arthritis in 2008 at the age of 22, during her first year of graduate school. After being diagnosed, Leslie went on to earn a PhD in Sociology from the University of Michigan and a master’s degree in health advocacy from Sarah Lawrence College. She authors the blog Getting Closer to Myself, where she shares her experiences coping with and living with multiple chronic illnesses, candidly and with humor. She is a professional patient advocate living in Michigan.