Cold weather and poor gut health may seem unrelated, but both are known to negatively impact psoriasis. Psoriasis is a chronic, autoimmune skin condition estimated to affect over 120 million people worldwide. Its prevalence in developed countries is almost four times greater than in other parts of the world. While it appears as red, scaly, itchy patches, it is more than merely an unpleasant irritation. In many cases it leads to physical, psychological, and financial burdens.
Treatments typically include prescribed anti-inflammatory and steroidal creams, and light therapy. Although these topical therapies can provide symptom relief, research studies showing the complex physiology of the disease and its causes suggest a multifaceted approach to treatment.
As well as being an autoimmune disorder with a strong genetic component, psoriasis is reflective of systemic inflammation. Studies have established an association between it and other inflammatory conditions, i.e. cardiovascular disease and metabolic syndrome as well. Although details of the relationship remain allusive, having one condition increases the risk of having the other, and vice versa. The fact that they all stem from inflammation highlights the importance of addressing inflammation in treatment protocols, beginning with where it originates, in the gut. With new studies focusing on the significant role gut health has on health and disease, we know that cultivating a healthy gut microbiome is a key component towards resolving diseases such as psoriasis. These research findings bring new perspectives, which shine light on risk factors and treatment protocols encompassing nutrition, environment and lifestyle.
Conditions Associated with Psoriasis:
- Cardiovascular Disease
- Metabolic Syndrome
- Insulin Resistance
- Altered gut bacteria
- Leaky Gut
- Celiac Disease
- Night shift work
- Poor diet
What is Psoriasis?
Psoriasis is a common recurring autoimmune disease that affects the skin. Autoimmune means the immune system is misdirected, such that the body attacks itself. Stemming from an overactive immune-mediated inflammatory response, skin cell formation occurs faster than it “sheds”. Normally skin turnover is approximately 28 days, yet in this case new cell formation occurs in less than a week. The consequence of this process is redness, thickness, and scaling known as “plaques” which are most commonly found on the elbows, torso, knees and scalp. In severe cases the accelerated skin turnover can also lead to nutrient deficiencies.
The role of hormones, stress, and glucose (blood sugar) regulation in the health of the skin is also significant. It’s all connected. For instance, stress affects hormones, and hormones impact the skin. Polycystic ovarian syndrome (PCOS) is a similar example of this interplay. Hormones and stress also impair proper glucose regulation, often resulting in excess fat, which is inflammatory. Inflammation impacts hormones, and again, the skin. This is just a snippet of the complex cycle, which will perpetuate itself unless one makes changes in these areas.
- Cold weather – cool dry air
- Traumatic skin injury
- Stress- physical or psychological
- Alcohol – in excess
- Drugs, i.e. lithium and beta blockers
- Bacterial overgrowth – gut
Role of Inflammation and the Gut:
Current research on the gut and its estimated ten trillion microbes, is redirecting the way health and disease is treated. It is worth pausing to note celiac disease and gluten sensitivity have a greater prevalence in psoriasis patients. Therefore, it is prudent to include gluten intolerance testing as part of any treatment protocol via celiac test and/or elimination diet.
The majority of the immune system is in the gut, and thus, a healthy gut translates to a well functioning immune system. Bacteria and yeast are part of the microbial environment governing the gut. When levels of colonies diminish, others multiply. For example, overgrowth of the yeast Candida albicans is common in psoriasis patients. Implementing a low sugar anti-Candida diet, and starving the sugar-hungry microbes, can restore the balance. Another example comes from NYU where researchers identified three bacterium necessary for proper immune function, all of which are reduced in psoriatic arthritis patients: Akkermansia, Ruminococcus, and Pseudobutyrivibrio. Though impossible to identify them all, some microbes can be tested via stool analysis. Alternatively, the following blood test markers are indicators of systemic inflammation in general:
- CRP (C-reactive protein)
- LPS (lipopolysaccharides)
Nutrition and Lifestyle:
It’s clear that diet and lifestyle can either contribute to the problem, or to the solution. For instance losing weight, reducing stress and avoiding gluten are means of reducing inflammation and hormone disruptions. Conversely, rotating shift work showed an associated risk of psoriasis in a study of female nurses. Altered circadian rhythms and melatonin production, as well as diet, overweight, smoking, stress and low vitamin D are suspected contributing risk factors in this case too.
Ways in which nutrition can be used as a vehicle for minimizing psoriasis outbreaks and systemic inflammation are listed below. Key factors include restriction of sugars, high carbohydrates, dairy, and red meats; while incorporating healthy fats and lean protein.
- Weight loss
- Elimination diet (identify food sensitivities)
- Gluten free diet
- Mediterranean diet
- Vegan diet/Vegetarian diet/Low Candida diet
- Anti-inflammatory diet
- Medium-chain unsaturated fatty acids (MUFAs), i.e. Coconut oil
- Evening Primrose Oil (Gamma-linolenic Acid)
- Vitamin D –maintain therapeutic levels (45-65ng/dL)
- Fish Oil (studies are conflicting)
Although psoriasis appears as a skin condition, evidence is clear it goes deeper. With no known cure it is important to keep in mind that one is not powerless over it. By implementing whole life changes, one can minimize risks of outbreaks, along with risk of more serious associated conditions.
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