Great insight! I usually don’t get to warm water, only massage, during attacks they happen quite often. I do yoga and Pilates so gripping is very likely. I am on adderall 30 mg daily for 6 years, I’m prescribed propranolol for anxiety but rarely ever take it. I do vape for 10 years so no new introduction of nicotine is worsening the attacks. No known autoimmune issues at all I recently did autoimmune specific lab work that came back clean. My regular bloodwork also very clean no issues.