Psoriasis:
The Problem is Not Just Skin Deep By Vicki Kobliner MS RD, CD-N
few of us may remember when adver- tisements for the medicated shampoo Tegrin promoted the product as an opportunity for relief from “the Heartbreak of Psoriasis”, but for many suffering with this uncomfortable and at times unsightly skin condition, the effects on quality of life can truly be emotionally damaging. Psoriasis is a chronic skin disorder in
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which the immune system sends out mis- guided signals that hasten the growth cycle of skin cells, causing them to form scaly, red or silvery patches on the skin. These patches can be small and localized, or diffuse, affect- ing the whole body, and may be accompa- nied by itching, swelling or pain. In some cases, the immune disorder affects the joints in what is called psoriatic arthritis, or pro- duces blister-like formations under the skin. Severe cases of psoriasis can result not only in physical pain, but in depression, social isolation, and problems with intimacy which affect sufferers on a daily basis. Studies of people with psoriasis indicate that they often experience a diminished quality of life. The lack of effective medications further com- pounds the problem. Beyond the discomfort and physical
changes that make living with psoriasis a challenge, evidence is mounting that the skin disorder not only affects quality of life, but life itself. In 2008, the Journal of the American Academy of Dermatology printed a review article which highlighted a correla- tion between psoriasis and heart disease. Another, more recent study from Denmark found that people with severe psoriasis were over 50% more likely to suffer a stroke, 21% more likely to have a heart attack and 53% more likely to die over a 10 year period than those without it.
Heart disease is not the only concern- people with psoriasis have an increased risk for some cancers, including lymphoma, skin cancer and prostate cancer. In addition, Crohn’s disease, diabetes, depression, and arthritis are just a few of the other disorders associated with psoriasis.
The question that remains unanswered
is whether psoriasis increases the risk of these other diseases, or they in fact cause the skin condition. Also not known is whether medication used to treat psoriasis is the culprit. What is known is that like psoriasis itself, a number of the disorders, including heart disease, arthritis, and Crohn’s, are in- flammatory conditions. Therefore, a logical course for anyone living with psoriasis is to adopt lifestyle changes designed to reduce chronic inflammation.
Medication selection, diet changes, and nutritional supplements can offer relief from the discomfort of psoriasis, either individual- ly or in combination. Foods or medications that cause inflammation can be removed, while nutrients, herbs and supplements which reduce inflammation can be incorpo- rated on a daily basis.
A number of prescription medications
such as lithium for bipolar disorder, beta blockers for heart failure and high blood pressure, non-steroidal anti-inflammatory drugs, and tetracycline can induce, trigger or exacerbate psoriatic lesions. In some cases, the medication can be switched: for example, using a different antibiotic than tetracycline. In other cases, the psoriasis can be ameliorated, as in the case of lithium for treatment of bipolar disorder. When psoria- sis increases as a result of lithium, a B vita- min called inositol can be added, which is effective at reducing the psoriasis, but does not work in those who don’t use lithium. Diet changes are often effective at reducing psoriatic plaques. A gluten-free diet should be considered by anyone suffering from pso- riasis. The diet has been shown to reduce the severity of skin patches in individuals with increased antibodies to gluten, even those without true celiac disease. Others re- spond well to the elimination of nightshade vegetables (e.g tomato, eggplant, pepper) or other food allergens.
Nutrients that normalize the immune system are also important tools to employ. Both Vitamin D and the essential omega-3
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fatty acids found in fish oil can reduce psori- atic symptoms. Vitamin D is easily obtained from 15-20 minutes of unprotected sun in the summer, but requires supplementation in the winter months in cold climates. The amount of essential fatty acids needed to calm the immune system is far more than one could get from simply eating a few ounces of fish daily. It is best obtained from a high quality, mercury and PBB free fish oil supplement that is higher in EPA (eicosap- entanoic acid) than DHA, since EPA is the compound that is effective in this case. In fact, topical application of high EPA fish oil can be added to oral supplementation for greater benefit. Fish oil is also beneficial for heart health, so provides a double benefit to psoriasis sufferers at increased risk of heart disease.
Psoriasis is clearly more than an un-
pleasant annoyance- it is a serious disease which can have negative consequences both internally and externally. There are no medications available that can eradicate the problem and many of the ones that do exist have undesirable side effects. Conversely, incorporating natural interventions such as diet changes and nutritional support can have multiple benefits, reducing inflamma- tion, decreasing plaques, and protecting against heart disease and other chronic ill- nesses which go hand in hand with psoriasis.
Vicki Kobliner MS RD, CD-N is a Registered Dietitian and owner of Holcare Nutrition (
www.holcarenutrition.com). Vicki works with infants, children and adults with diges- tive disorders, food allergies, ADHD, autism and other chronic illness, and provides fertil- ity and prenatal nutrition counseling. Vicki has extensive experience in using dietary modification, appropriate supplementa- tion and functional lab testing to achieve
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