Lifestyle medicine for psoriasis
Do you suffer from psoriasis?
Did you know there are scientifically backed ways to improve it with nutrition and lifestyle?
Psoriasis is an autoimmune skin disorder where inflamed thickened patches form on the skin - plaque psoriasis is the most common, but there are other types such as guttate, pustular, and flexural. It can also damage nails, and less commonly, cause arthritis and joint damage
Psoriasis is usually treated with topical medications or occasionally oral immunosuppressants or UVB light, these can all be helpful, but can also have side effects
Triggers for psoriasis include:
genetics (nearly half of psoriasis patients have an affected 1st-degree relative)
certain medications (in particular lithium, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, antibiotics, psychotropics, and nonsteroidal anti-inflammatory drugs (NSAIDs))
infection (people with human immunodeficiency virus (HIV) and children with recurring infections, especially strep throat, are at increased risk of psoriasis)
stress (this can cause a psoriasis flare up to a month later!)
obesity
excess sun exposure (moderate amounts of sunlight can improve psoriasis, but UV damage from excessive sun exposure can trigger or worsen psoriasis).
vitamin D deficiency
tobacco and alcohol
Nutritional interventions can significantly help psoriasis yet are often not widely known about - however as they are simple and tend to improve all aspects of health they can be worth exploring if you are interested!
ANTI-INFLAMMATORY DIET
✓ There is a strong link between psoriasis and poor heart risk markers (high 'bad' cholesterol levels (triglycerides and LDL), low 'good' cholesterol (HDL) and high CRP/homocysteine levels). Diets that improve these markers also significantly improve psoriasis symptoms - suggesting a common trigger of chronic inflammation (see other posts on this)
✓These diets are high in whole plant foods, high in omega 3, low in refined carbs, and high in fibre - plant based diets and Mediterranean style diets both help psoriasis in clinical trials
✓These diets are also known as 'anti-inflammatory diets', and have wide ranging health benefits in addition to improving psoriasis - they can also help other auto-immune issues, as well as mental health, gut health, brain health, heart health, and metabolic health (ie diabetes and high cholesterol). See posts on diet and inflammation for more info.
ARACHIDONIC ACID AND AGEs
✓Arachidonic acid and AGEs (advanced glycolic end products) can also aggravate psoriasis, these are found in red meat, some dairy products, margarine, seed oils, and processed /fried foods and are generally avoided with an anti-inflammatory diet
GLUTEN
✓There is a link between coeliac disease and psoriasis (over 2x higher risk of coeliac disease in people with psoriasis), and some people find gluten free diets help psoriasis symptoms, although trials are mixed. The biggest benefits are in people with postive coeliac (antigliadin) antibodies, which is checked on a blood test through your doctor. If you have negative antibodies and negative coeliac tests, then a trial off gluten for 4-6 weeks can be useful - if no improvement is noted then you don’t need to stay gluten-free
OMEGA 3 AND OILS
✓Omega 3, oily fish, and olive oil all have good evidence for improving psoriasis, and are part of a Mediterranean heart and brain healthy diet, omega 3 helps to reduce inflammation and immune function
✓Although the evidence is limited, it is also advised to avoid refined seed oils and high levels of omega 6, as these may be ‘inflammatory’. Try to get your oil from whole food plant sources (ie nuts, seeds, avocados), and extra virgin olive oil if possible. As saturated fat increases bad cholesterol levels (see above), then swapping this out for unsaturated fat is a good idea (see seperate post on cholesterol for more details)
SUPPLEMENTS
✓Some small trials have shown curcumin (Tumeric extract) can help psoriasis, this is also used as an anti-inflammatory
✓Several studies have linked low selenium and vitamin E levels with psoriasis, one trial found that supplementing selenium, vit E (50mg/d) and Coq10 improved psoriasis symptoms - this can be worth trialling if dietary changes don’t help
GENERAL LIFESTYLE
✓Reducing weight (if obese) and avoiding alcohol can also significantly help psoriasis, these both increase inflammation. Weight loss is a complex topic, and can be challenging, however intentional weight loss in people who are overweight is shown to improve psoriasis symptoms, so it’s important to keep in mind - sustainable holistic weight loss is key here though rather than restrictive diets.
✓As stress can trigger psoriasis, stress reduction techniques such as exercise, mindfulness, yoga, breathwork etc can all be beneficial as well 😊
While we certainly still recommend taking medical advice when it comes to treating psoriasis (especially psoriatic arthritis), like with all things in lifestyle medicine, trialling lifestyle and nutritional measures alongside traditional medical care is always helpful - and tends to improve overall health too!
As usual, please talk to your doctor before making any changes, especially if you are taking immunosuppressive medication.
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