Living with psoriasis is rough. Treating it can be even rougher. Since psoriasis can't truly be cured, the best option is to manage symptoms. But in addition to the topicals, light therapy or other treatments your doctor prescribes, it's a good idea to evaluate your eating habits. More clinical research is still needed to understand the link between nutrition and psoriasis, but certain foods have been shown to make symptoms better or worse.
The reason is that psoriasis isn't necessarily a skin problem; it's an autoimmune disease. And autoimmune diseases are caused by an overactive immune system, which may have a lot to do with chronic inflammation and a leaky gut — or, at least, that's how Dr. Nikki Arguinzoni-Gil explains it. She's a licensed doctor of naturopathic medicine at Aloha Naturopathic Healthcare. "Over a period of time, the intestinal lining can sustain damage, creating holes that allow unwanted things to get through into the bloodstream like toxins, bacteria and undigested food particles," she says.
This triggers an autoimmune response that can surface as gastrointestinal issues, migraines, arthritis, eczema and even — you guessed it — psoriasis. "Identifying food triggers, cleaning out the gut and healing the gut are very important to reducing inflammation throughout the body and a plays a huge role in healing the skin and strengthening the immune system," says Arguinzoni-Gil.
With that in mind, here are a few food guidelines that can make life with psoriasis easier. Just be warned that it's going to be a process of trial and error, so keep your own doctor in the loop.
1. Avoid nightshades
If you love potatoes and tomatoes, this is a hard pill to swallow. Nightshade vegetables, such as white potatoes, tomatoes, peppers and eggplant, can increase inflammation and make psoriasis symptoms worse.
It is worth noting again that research is somewhat lacking in this area, but one survey of roughly 1,200 psoriasis sufferers published in a 2017 issue of Dermatology and Therapy found that 51 percent were able to improve symptoms by reducing the number of nightshades in their diet.
Conclusion: it's worth trying — a no harm, no foul situation.
2. Consider supplements
Certain supplements have also been linked to improved symptoms. A clinical review published in Indian Journal of Clinical Dermatology evaluated several studies on how dietary guidelines play a role in psoriasis. In one case, vitamin B12 completely cleared plaques in 32 percent of patients.
Psoriasis patients tend to have low levels of vitamin D as well as vitamin B12. In the same review, various studies found that supplementing with vitamin D also improved psoriasis symptoms either completely or moderately in many cases. Talk to your doctor about fish oils, pine bark extract, grapeseed extract, milk thistle and turmeric supplements... which brings us to the next point.
3. Turmeric is your friend
More clinical studies need to be done to prove the extent of its benefits, but curcumin (the active ingredient in turmeric) is considered to have anti-inflammatory properties. This is why so many people with psoriasis add turmeric to their diet, take capsules and even try topical treatments. Arguinzoni-Gil would tell you to opt for capsules because of the concentration. "One would need to get six to eight teaspoons a day [in powder form] to get the equivalent of what is given in capsules and have the desired anti-inflammatory effect," she explains.
4. Cut down on gluten
The jury is still out, but some studies suggest that people with psoriasis also have an increased sensitivity to gluten. According to the National Psoriasis Foundation, if you have an existing gluten sensitivity, that could also make your psoriasis symptoms worse. Further, in the survey of psoriasis patients published in Dermatology and Therapy, 53 percent saw skin improvement by eliminating gluten.
"When the body recognizes something like gluten as a foreign invader, it forms antibodies," Arguinzoni-Gil says. So, people with gluten sensitivity may have elevated levels of anti-gliadin antibodies (gliadin being one of the major proteins found in gluten). If you can reduce the anti-gliadin antibodies, you may be able to decrease inflammation and other psoriasis symptoms. Again, more research needs to be done, but it's worth a shot. Best-case scenario: You might improve two conditions with one lifestyle change.
5. Switch your proteins and reduce dairy
Red meat and dairy were also on Arguinzoni-Gil's no-no list. One study published in Alternative Medicine Review showed that reducing red meat intake, along with other dietary guidelines like eating minimal protein in general (aim for cold-water fish only) and increasing fruits and vegetables (except for nightshades), can supplement other treatments for psoriasis.
The Indian Journal of Clinical Dermatology's review of the link between psoriasis and nutrition found that both red meat and dairy contain high amounts of arachidonic acid, which is thought to trigger psoriasis outbreaks. However, the authors also concluded that more clinical studies are needed to determine to extent of the effects.
6. Pick a diet, one of these three diets
The anti-inflammatory diet is somewhat straightforward: Cut out inflammatory foods that can make symptoms worse. Additionally, the Mediterranean diet and the Pagano diet are both thought to improve symptoms associated with psoriasis.
"The Pagano diet involves the removal of foods that are difficult to digest, highly acidic foods and food allergens," Arguinzoni-Gil says. "A Mediterranean-style approach is high in organic whole foods, vegetables, cold-water fish and olive oil, and it's low in sugar."
Of course, make sure to discuss these approaches with your doctor to determine what may or may not be right for you. It's probably best to try one thing at a time to see which strategy you find most effective. It's not a simple road, but it's not uncommon for psoriasis patients to find significant relief through dietary changes.
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