Gut health, diet, supplements may effectively treat inflammation in psoriasis patients

Photo Cred: Anthony Shkraba/Pexels

By Kat Black

Todd Adam Born, ND, CNS, has seen more than 500 patients with psoriasis and psoriatic arthritis. Most of them, he said, have achieved complete remission from their symptoms – often through a combination of dietary interventions and treating bacterial imbalances in the gut.     

“It’s well-known that gut dysbiosis can trigger autoimmune disease,” said Born, a naturopathic practitioner based in Gig Harbor, Wash. “I’ve never seen a skin condition that did not have a gut component to it.”   

Psoriasis is an autoimmune disease that affects more than 7.5 million people in the United States, according to the American Academy of Dermatology. Though often misclassified solely as a skin condition, psoriasis is caused by systemic inflammation that can result in several comorbidities. Thirty percent of psoriasis patients will also go on to develop psoriatic arthritis (PsA), according to a webinar presented by Jason Oberdick, PA-C, for the National Psoriasis Foundation (NPF).

NPF reports that complementary therapies may benefit some psoriasis and PsA patients by treating the root cause of inflammation, which can also lower the risk of developing associated conditions like cardiovascular disease, type 2 diabetes, and depression.

According to a 2018 review published by JAMA Dermatology, dietary modification and supplements are among the most effective complementary treatments for psoriasis. A growing body of research also provides promising evidence for a link between psoriasis treatment and intestinal microbiome restoration.

The role of the gut microbiome in psoriasis

One 2015 study reported that patients with PsA had lower levels of intestinal bacterial diversity and that the gut microbiota profile for PsA was comparable to that in patients with inflammatory bowel disease.

Born frequently prescribes a gut dysbiosis treatment and rebuilding regimen to his patients, a process that may take six to eight months. He said that by the end of the first year of treatment, which may also include constitutional homeopathic remedies and a food allergy elimination diet, patients usually report complete remission or a reduction in the size of their skin plaques.

He recommends the use of probiotics to promote the growth of beneficial gut bacteria, which can be naturally found in fermented foods such as yogurt, kefir, kombucha, sauerkraut, pickles, and kimchi. He may also prescribe topical castor oil and herbs such as neem, which has well-documented anti-inflammatory and antimicrobial properties and has been used to treat a number of skin conditions, according to a 2016 study published in Evidence-Based Complementary and Alternative Medicine.

Julie Greenberg, ND, a naturopathic dermatologist at the Center for Integrative Dermatology in Los Angeles, said that fiber is essential to maintaining gut health in her psoriasis patients.  

“Once we balance the gut, [patients] need to consume 35 grams of fiber per day,” she said, recommending that patients aim to eat 30 vegetables a week. Sometimes she will prescribe supplements like L-glutamine and butyrate, both of which may help to sustain the balance of the gut microbiome, according to studies published in International Journal of Molecular Sciences and World Journal of Gastroenterology.

Supplements and diet

Anti-Inflammatory Diet

In some cases, an anti-inflammatory diet may benefit psoriasis and PsA patients. The NPF recommends eating tomatoes, olive oil, green leafy vegetables like spinach and kale, nuts such as almonds and walnuts, fatty fish, and fruit (specifically strawberries, blueberries, cherries, and oranges).

Curcumin   

There are several studies supporting the potential efficacy of curcumin, a compound with anti-inflammatory and antioxidant properties derived from turmeric, in treating psoriasis. According to research cited by a 2018 article published in Open Access Macedonian Journal of Medical Sciences, curcumin inhibits the proliferation of psoriatic cells and may also reduce the oxidative stress of psoriatic lesions.

Vitamin D

Vitamin D, which has steroidal properties, is an active ingredient in some psoriasis medications and is often used to treat psoriasis via topical ointments. A 2017 study published in Reviews in Endocrine and Metabolic Disorders reports a connection between psoriasis and low levels of vitamin D.

One of the safest ways to access vitamin D is through nutrition. The NPF recommends consuming cod liver oil, sockeye salmon, mackerel, tuna fish canned in water, milk, vitamin D-fortified orange juice, yogurt fortified with 20 percent of the daily value of vitamin D, eggs, Swiss cheese, and fortified cereals.

Born frequently prescribes cod liver oil to his patients since it also contains omega-3s and vitamin A, both of which may benefit psoriasis patients. He also advises against overdosing patients with vitamin D, recommending that patients maintain a level between 34-45 ng/mL.

Omega-3 Fatty Acids

NPF recommends eating fish twice a week or more, specifically cold-water fish rich in omega-3 fatty acids, to lower the risk of cardiovascular disease in psoriasis patients. A 2011 study published in Clinical, Cosmetic and Investigational Dermatology found that patients with plaque psoriasis who received a nutritional supplement of omega-3 fatty acids in conjunction with topical treatments reported significant improvement in quality of life and reduced severity of psoriasis symptoms, including skin redness, scalp lesions, itchiness, and scaling.