Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (148 page)

Psoriasis can also occur with joint inflammation as psoriatic arthritis (see
Chapter 26
), and joint inflammation is found in 3 to 7 percent of people with psoriasis. It isn’t clear whether psoriasis and psoriatic arthritis are the same disease or two almost identical diseases.

Thirty-six percent of people with psoriasis have one or more family members with psoriasis, which suggests a genetic component. Psoriasis is also influenced by insulin resistance, impaired glucose tolerance, obesity, liver disease, and high cholesterol and/or triglycerides. It’s thought to be an indicator of risk for atherosclerosis and may be an early warning sign.

Digestive issues in psoriasis have been found in many cases. There is a clear relationship between celiac, gluten sensitivity, Crohn’s disease, and psoriasis. In psoriasis and these other conditions, researchers found increased intestinal permeability and microscopic bowel lesions. Some people with psoriasis also have gastritis, duodenitis, celiac disease, or inflammatory bowel disease. Disturbances in pancreatic function and even acute pancreatitis have been found to be prevalent in people with psoriasis.

Drs. Michael Murray and Joseph Pizzorno note a number of factors that influence the progression of psoriasis, including incomplete digestion of protein, bowel toxemia, food sensitivities, poor liver function, reaction to alcoholic beverages, and eating high amounts of animal fats.

When protein digestion is incomplete or proteins are poorly absorbed, bacteria can break them down and produce toxic substances. One group of these toxins is called polyamines, which have been found to be higher in people with psoriasis than in the average population. Polyamines contribute to psoriasis by blocking production of cyclic AMP. Vitamin A and goldenseal inhibit the formation of polyamines. Because protein digestion begins in the stomach, low levels of hydrochloric acid there can also cause incomplete protein digestion. Digestive enzymes and/or hydrochloric acid supplementation aid protein digestion. (See
Chapter 3
.)

Poor liver function may contribute to psoriasis as well. Liver function profile tests and the metabolic screening questionnaire can help you determine liver function, and the metabolic screening questionnaire can also be used to follow your progress. Incorporate a detoxification program with an elimination-provocation diet to determine which foods may trigger your psoriasis. (See
Chapters 15
and
18
.)

Alcohol consumption contributes to psoriasis because alcohol contains many toxic substances, which stress an overburdened liver. Alcohol also increases intestinal permeability.

Many studies hypothesize that there is a microbe or pathogen that triggers psoriasis. H. pylori has been found in some people with psoriasis. When treated, some people have had large improvements, while there has been no benefit in others. Studies on dysbiosis in psoriasis are lacking. Dr. Zhan Gao and colleagues extracted DNA from skin lesions of six people with psoriasis. He found increased levels of Firmicutes and low levels of Actinobacteria and Propionibacterium species in people with psoriasis compared to controls. Dr. Luciana C. Paulino and colleagues found no significant differences in yeast levels in healthy skin and psoriasis skin.

In a recent study, 21 out of 34 people with psoriasis were found to have Candida albicans in the spaces between their fingers or toes, and the majority were also affected by fungi from the tinea family. Other research found a 56 percent increase in nail fungus in people with psoriasis. Another study looked at stool samples of people with psoriasis and other skin disorders. Researchers found a high number of disease-producing microbes, predominantly yeasts, in the colon. This may not be the cause of psoriasis but rather an indication of poor gut ecology. Treatment for yeast infection corresponded with a decrease in skin inflammation.

Studies on fasting, vegetarian diets, and diets rich in fish oils have all been shown to produce benefit in people with psoriasis. All of these diets reduce inflammation.

Although I have not seen studies on elimination diet, people with psoriasis have high levels of IgE antibodies, which indicates an allergic component. An elimination diet makes sense to try. Allergy and food sensitivity testing could be helpful in figuring out how someone may benefit the most.

Sixteen percent of people with psoriasis have antibodies to gliadin, the protein found in wheat, rye, and barley. However, when tested for gliadin intolerance, their endomysium antibodies were normal. Nonetheless, a gluten-free diet for three months greatly improved the psoriasis. A follow-up study discovered high levels of tissue transglutaminase antibodies in the skin of people with psoriasis. This decreased by half after a three- to six-month gluten-free trial.

The causes and treatments of psoriasis are complex. Successful treatment must encompass several approaches reflecting its complexity. Look for underlying causes and develop a personal program based on your needs.

Food and environmental sensitivity testing—IgE and IgG4

Celiac testing

Candida testing (either blood or stool)

Organic acid testing

Liver function profile

Intestinal permeability testing

Blood testing for vitamin and mineral status

Fatty acid testing

Try an elimination-provocation diet.
Explore the relationship between your psoriasis and food and environmental sensitivities through laboratory testing and the elimination-provocation diet. For best results work with a nutritionist or physician who is familiar with food sensitivity protocols.