Psoriasis
The skin is our bodies biggest organ. It protects us from the outside world and all that we come in contact with. Our skin is something that we often take for granted. Ask anyone that struggles with a skin condition. Psoriasis is a skin condition that I have seen first hand the frustrations that comes with it. Extreme itching, pain, infection and for some the visible implication it can have on self esteem. Unfortunately like so many conditions there is no one size fits all way to manage it. There is no cure. There are a few key contributing factors that are underlying and supporting them can help to manage the symptoms!
What is psoriasis?
Psoriasis is an immune-mediated, multisystem inflammatory, genetic disease that appears on the skin, in the joints or both. It is characterized by red, itchy patches, with silvery scales over the skin. Most often found on the scalp, arms, legs and torso. The exact cause of the disease is unknown and will go through periods of inflammation and remission.
There are four main forms:
plaque type (which is the most common)
guttate (usually occurs 2-4 weeks after a bacterial infection)
generalized pustular (rare and can be life-threatening)
erythroderma (the rarest form that can cause illness or be life threatening).
Interestingly a chronic disorder call Psoriatic Arthritis will occur in approximately 20-30% of people with psoriasis.
What are the signs and symptoms?
Psoriasis typically diagnosed in clinic. Plaque psoriasis which is the most common, has classic psoriasis patches called plaques that are well defined, symmetrical, red, raised, itchy and can be painful with overlying silver scales. The scaling of the skin occur as the rate of skin cell replication occurs so fast that the top layer of skin is unable to shed at its normal rate. Plaques are typically found on the scalp, trunk, buttocks, extremities but really can be found anywhere on the body including the nails.
Other less common forms of psoriasis present differently. Guttate typically will have an acute eruption of “dew-drop”, pink fine-scales on the trunk. Pustular is most commonly on the palms of the hands and soles of the feet and is sheet like pustule. Erythroderma and annular both extremely rare are often present with more complicating health conditions such as hypothermia, electrolyte imbalances and can be life threatening
Beyond the physical symptoms, psoriasis has emotional and psychosocial effects; it can result in poor self-esteem, increased stress and affect social and interpersonal relationships.
Are there other contributing factors?
While psoriasis is a partially inherited inflammatory skin disease, it is influenced by environment; infection, stress and diet.
Flare-ups are initiated by stress, dysbiosis, poor liver function, alcohol, excess saturated fat consumption and deficiencies in essential fatty acids, vitamin D and selenium. Incomplete protein digestion is also a contributing factor that results in the microbial putrefaction (decay) of amino acids and formation of ptomaines. This inhibits a process called cAMP and creates an imbalance of cell turnover.
As mentioned the diet is a factor that can contribute to the psoriasis. Since psoriasis is an immune-mediated, multisystem inflammatory disease, when supporting the body with food we want to be mindful of foods that pro-inflammatory and create spike in blood sugar; as well as foods that negatively impact immune function.
Are there foods that I should avoid?
Gluten is found in barley, rye and wheat. Sensitivities to gluten maybe one of the largest contributing leaky gut, by breaching the intestinal barrier. Once gluten has leaked out it then affects the immune system and is likely to cause the production of antibodies and inflammation.
Dairy proteins found in milk, yogurt and cheese are highly insulinogenic. Which means they promote the release of insulin. High amounts of insulin can stimulate inflammation as well as, hunger and sugar cravings.
Refined sugar makes food palatable and leaves us craving for more. Simple carbohydrates and/or refined sugars are everywhere; chips, crackers, pasta, candy, baked goods, etc. The sugars from these foods are rapidly absorbed into the bloodstream causing a spike in blood sugar levels. Chronically high blood sugar results in inflammation
Vegetable oils are a combination of oils derived from canola, corn, soybean, safflower and cotton seeds. These are examples of Omega-6 fatty acids that are found in abundance in processed foods. When we overconsume Omega-6’s in relation to Omega-3’s they become pro-inflammatory. It is very important to read the labels of all foods; many ingredients are hidden even in “healthy” foods!
Red meat from both beef and pork contain an abundance of saturated fatty acids and dietary heme. A diet too high in these can lead to systemic inflammation. A diet too rich in red meats may aggravate the inflammation in psoriasis . Looking at red meat more as a side versus the main event would be a good practice.
Alcohol is something that many consume in a social setting, some as often as daily. Alcohol may initiate or aggravate inflammation in psoriatic skin lesions along with inducing dysbiosis of the gut microbiota.
What foods should I be eating?
Proteins are essential in the healing process. Meat sourced from quality sources are an easily digestible complete protein and good source of healthy saturated fat. Not to mention when animals have been raised in pastures eating grasses they are loaded with vitamins and minerals that will support immune health. The connective tissues of the animal are important to consume, bone broth is a great example as it contains glycine which is essential for healing- skin lesions, microscopic gapping in the gut barrier, damage due to inflammation and a dysfunctional immune system. Bone broth is easily made at home from boiling down the bones from quality animal source in a soup pot with a variety of vegetables. It can then be used for homemade soup, cooking rice and quinoa or just sipping on it!
Flax Seed Oil is one of the richest source Omega-3 fatty acids. Deficiencies in omega-3’s can lead to dry scaly skin, along with helping to improve psoriasis, immune function and has anti-inflammatory affects. Flax oil should be consumed raw using it in homemade salad dressing or adding it to smoothies.
Leafy Greens are a vitamin and fiber rich food! Spinach, kale, swiss, chard, collards, mustard greens etc. They are loaded with antioxidant carotenoids, including beta-carotene, lutein and zeaxanthin along with vitamins C, E, K, folate and omega-3 fatty acids . These are all strong anti-inflammatory nutrients. Eat lots of greens!
Blueberries are one of the most antioxidant rich foods. They have a very high content of vitamin C which makes them excellent support for the immune system. Berries arealso one of the lowest sugar content fruits, therefore minimizing their effect on blood sugar.
Turmeric is a beautifully coloured spice that adds wonderful flavour to any recipe. It is also a component of curry powder. Curcumin which is the orange-yellow component of turmeric has been traditionally used for its effects as an anti-inflammatory; but more recently has be found to be an immunomodulatory agent. Turmeric is great to add to scrambled eggs, makes a delicious latte, or a wonderful addition to homemade salad dressings.
Mushrooms are a great addition to many meals; sauté them and add them as a topping to salad, alongside your meat or into a quiche or omelette. Mushrooms have been used to help treat skin diseases and are anti-allergic and act as a prebiotic by stimulating growth of gut microbiota. Not to mention the Eastern countries have been using mushrooms for their immunostimulating properties for thousands of years
Legumes are an excellent source of dietary fibre. Dietary fiber is found complex carbohydrates that are resistant to digestion in the small intestine. These starch resistant fibers ferment in the colon. They then promote activity in both the colon and skin by increasing circulation leading to regulation of psoriasis.
Eggs are an excellent source of selenium. Selenium is an essential trace element that has anti-oxidative and immunoregulatory properties. Individuals with psoriasis are often deficient in selenium.
To sum things up psoriasis is an immune-mediated disease where the effects of the disease varies individual to individual. Although there is no known cure we can control the symptoms through diet, lifestyle and medical interventions. It will be important to support one’s immune system, maintain a balance in blood-sugar in order to reduce inflammation. A diet rich in whole foods is one of the best ways to achieve this. Along with managing sleep and stress levels.
Have more questions? Please feel free to contact me directly.
References
Boehncke, Wolf-Henning, and Michael P Schön. “Psoriasis.” Lancet (London, England)vol. 386,9997 (2015): 983-94. doi:10.1016/S0140-6736(14)61909-7
Nair PA, Badri T. Psoriasis. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448194/
Di Meglio, Paola et al. “Psoriasis.” Cold Spring Harbor perspectives in medicinevol. 4,8 a015354. 1 Aug. 2014, doi:10.1101/cshperspect.a015354
Lessard-Rhead, Brenda. Nutritional Pathology. Third, Richmond Hill, Ontario, Canada, CSNN Publishing, 2015.
Kim, Whan B et al. “Diagnosis and management of psoriasis.” Canadian family physician Medecin de famille canadien vol. 63,4 (2017): 278-285.
Lessard-Rhead, Brenda. Nutritional Pathology. Third, Richmond Hill, Ontario, Canada, CSNN Publishing, 2015.
Kanda, Naoko et al. “Nutrition and Psoriasis.” International journal of molecular sciences vol. 21,15 5405. 29 Jul. 2020, doi:10.3390/ijms21155405
Gisondi, Paolo et al. “Concept of Remission in Chronic Plaque Psoriasis.” The Journal of rheumatology. Supplement vol. 93 (2015): 57-60. doi:10.3899
Ballantyne, Sarah, and Robb Wolf. The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body. 1st ed., Victory Belt Publishing, 2014.
DiNicolantonio, James J, and James O'Keefe. “The Importance of Maintaining a Low Omega-6/Omega-3 Ratio for Reducing the Risk of Autoimmune Diseases, Asthma, and Allergies.” Missouri medicine vol. 118,5 (2021): 453-459.
Kanda, Naoko et al. “Nutrition and Psoriasis.” International journal of molecular sciences vol. 21,15 5405. 29 Jul. 2020, doi:10.3390/ijms21155405
Haas, Elson, and Buck Levin. Staying Healthy with Nutrition, Rev: The Complete Guide to Diet and Nutritional Medicine. 21st ed., Celestial Arts, 2006.
Cnc, Balch Phyllis. Prescription for Dietary Wellness: Using Foods to Heal 2nd Edition. 2nd Revised and Updated ed., Averey, 2003.
Disclaimer
The entire contents of this website are based upon the opinions of Green Thumb Health & Nutrition. Please note that Green Thumb Health & Nutrition is not a dietitian, physician, pharmacist or other licensed healthcare professional. The information on this website is NOT intended as medical advice, nor is it intended to replace the care of a qualified health care professional. This content is not intended to diagnose or treat any diseases. Always consult with your primary care physician or licensed healthcare provider for all diagnosis and treatment of any diseases or conditions, for medications or medical advice as well as before changing your health care regimen.
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