Psoriasis – Natural Support, Tests and Treatment options

Psoriasis is an immune-mediated inflammatory disease of the skin characterised by red scaly patches (psoriasis plaques).  These plaques are areas of excessive skin cell production and inflammation and frequently occur on the skin of the elbows and knees, but can affect any area, including the scalp and genitals.  The disorder is a chronic or recurring condition which can vary in severity, from minor localised patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy), as are the joints (psoriatic arthritis).

Contributing factors for psoriasis include:

• Periods of stress/trauma or major infection.
• Familial/genetic predisposition
• Immune system diseases (including autoimmune disorders like Rheumatoid arthritis)
• Obesity
• Infections
• Skin injuries/sunburn and damage
• Certain drugs (chloroquine, gold, lithium, beta-blockers), recreational drugs, smoking and alcohol.
• Acidic foods
• Nutritional imbalances (e.g. low zinc/high copper levels, low B12, folate, magnesium and iron)
• Changes in season and climate can trigger psoriasis outbreaks.

Signs and Symptoms

Common signs and symptoms of psoriasis include:

• Raised skin lesions, deep pink with red borders and silvery surface scales; may be cracked and painful.
• Blisters oozing aseptic pus.
• Pitted, discoloured, and possibly thickened fingernails and/or toenails; may be separated from underlying skin.
• Itching of skin around plaques
• Joint pain (psoriatic arthritis) and swelling of the affected areas
• Sensitivity to friction and sweating.

Testing Considerations

Omega-3 Index Test*

A validated test that measures red-blood cell EPA and DHA status to personalise supplemental and diet prescriptions, as well as identifying those at risk of health conditions associated with omega-3 deficiency. An Omega-3 Index in the desirable range of 8%-12% is an indicator of better overall health. This can be done at home and costs approx.. $95

Blood tests:

Tests to consider include assessing zinc: copper ratio; and requesting iron studies, B12/folate;  magnesium; and fasting homocysteine to assess methylation requirements. Coeliac disease should also be screened.

Mood and Stress Questionnaire: To assess levels of anxiety depression and stress.*

Food sensitivity Testing or Elimination/Challenge diet*

*Doreen can organise the Food Inflammation test (see https://hub.rnlabs.com.au/tests/fit-132-food-inflammation-test-gut-barrier-panel   and Omega Test on request or email through a Mood and stress questionnaire

Diet:

Foods that may worsen psoriasis include red and processed meats, dairy products, gluten-containing foods, sugary foods and drinks, alcohol & nightshade vegetables (e.g. Tomatoes, potatoes, eggplants, and peppers).

Foods That May Help Manage Psoriasis

1. Fatty Fish rich in anti-inflammatory omega 3 fats Salmon, mackerel, sardines, and trout.
2. Fruits and Vegetables, gluten free whole Grains
3. Nuts and Seeds Like walnuts, almonds, flaxseeds, and chia seeds.
4. Healthy Fats like olive oil, avocados, and avocados.
5. Legumes
6. Herbs and Spices like Turmeric, ginger, and garlic as they have natural anti-inflammatory and antioxidant properties that can help reduce psoriasis symptoms.

General Dietary Tips for Psoriasis

• Maintain a Balanced Diet: Focus on a diet rich in fruits, vegetables, lean proteins, and whole grains.
• Stay Hydrated: Drink plenty of water to keep your skin hydrated and support overall health.
• Monitor Food Triggers: Keep a food diary to track which foods may trigger or worsen your psoriasis symptoms or organise a test to see what foods you’re reactive to (see: https://hub.rnlabs.com.au/tests/fit-132-food-inflammation-test-gut-barrier-panel)
• Maintain a Healthy Weight: Obesity is a known risk factor for psoriasis severity.
• Ensure regular bowels (as the bowels are a major eliminative channel)

Pharmaceutical Treatments & Potential side effects

• Corticosteroids: used topically or internally to reduce inflammation/irritation. Prolonged use causes skin thinning, pigment changes, and suppresses the immune system, causing vengeful flare-ups upon cessation.
• Coal tar ointments/shampoos: used topically these ease discomfort, improve effectiveness of UV light therapy but may cause folliculitis; increased squamous cell carcinoma risk.
• Anticancer drugs: drugs like Anthralin and methotrexate are used internally to reduce proliferation of skin cells.  Long-term use causes hepatic, renal, hematologic toxicity; nausea, vomiting and diarrhoea, with a significant risk of squamous cell and other cancers.
• Immune modifiers: may be used for severe psoriasis. These include immunosuppressive agents such as cyclosporin, and biological response modifiers such as etanercept and efalizumab. Use may be associated with increased incidence of infections and tumours; low platelet counts and other adverse effects.
• Retinoids: Acetretin is a retinoid which decreases epidermal proliferation and keratinisation with psoriasis. It may cause liver toxicity. Retinoids may also be administered topically.

Natural supplements:

1. Targeted probiotics that balance the overactive immune system (like some Practitioner only options specific for autoimmunity and allergies)
2. Omega 3 fish oils (if Omega 3 test indicates low omega 3)
3. Nutrients as needed after testing.
4. A course of a gut restorative immune balancing powder containing herbs and medicinal mushrooms
5. Specialised pro resolving mediators to reduce inflammation.
6. Stress support if indicated
7. Stem cell nutrition – see https://www.holistichealth.com.au/revolutionise-your-approach-to-wellness/
8. Research on using sulforaphane for psoriasis is emerging and shows potential due to its anti-inflammatory and antioxidant properties. Sulforaphane is a compound found in cruciferous vegetables, particularly in broccoli sprouts. There are concentrated forms that are usually well tolerated and effective that can be prescribed by your practitioner.

Note: Pictures courtesy of https://www.webmd.com/skin-problems-and-treatments/psoriasis/ss/slideshow-psor-overview