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Psoriasis

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Psoriasis is a hypoproliferative skin disorder where the rate of cellular division is 1000 times greater than in normal skin.  It is a distressing condition typically characterised by red patches covered with fine silvery scales. These can be found anywhere on the body although most common are on the scalp, back side of wrists, elbows, knees, buttocks, ankles and sites of repeated trauma. Nails can also be affected. 

The rate at which skin cells divide is controlled by a balance between two internal compounds -- cAMP and cGMP.  Increased levels of cAMP are associated with reduced cell proliferation.  Conversely, increased levels are of cGMP are associated with increased cell proliferation.  In the skin of psoriasis sufferers higher levels of cGMP and lower levels of cAMP have been measured.  This results in excessive proliferation¹.  There also often appears to be abnormal immune system stimulation whereby unidentified allergens can trigger an immune response resulting in the proliferation of skin cells.

Causes

A number of factors that may to contribute towards psoriasis:

• Poor gut health - As with many skin problems there is a link between gut health and psoriasis. If the lining of the intestines is not healthy (due to constipation, poor digestion or food allergies) toxins can get into the blood and affect the skin. Bowel bacteria can act on undigested protein molecules and turn them into toxic compounds called polyamines.  Polyamines are shown to be higher in psoriasis  sufferers  and can Inhibit formation of cAMP -- so contribute to excessive cell proliferation². There is also connection with bowel toxicity - candida, yeast compounds and pathogenic bacteria (Streptococcus) can lead to increases in cGMP.  A connection also exists between psoriasis and both coeliac disease and Crohn's disease - again reconfirming the gut/skin health link^{3 4}.


• Poor liver and bile function. The liver is the body's main detoxification organ.  It filters out toxins from the gut before they circulate around the body. Bile normally detoxifies toxins (such as polyamines and microbial byproducts).  If it does not do this properly then the excess toxins are passed to the liver which can overburden it.  If the liver can no longer cope with detoxifying toxins then they can pass into the blood stream causing a worsening of psoriasis^{5 6 7}.


• Food intolerances, along with bowel toxins and low digestive enzymes all lead to poor intestinal function which encourages greater intestinal permeability and inflammation.  This ultimately allows allergenic and toxic compounds to leave the intestine and travel through the blood stream leading to an immune reaction in skin tissues⁸.


• Candida overgrowth
• A pro-inflammatory diet.  Interestingly, low levels of omega-3 acids are common in psoriasis sufferers⁹
• Nutrient deficiency - deficiency in vitamin A and zinc  is common in psoriasis^{10 11}
• Poor blood sugar control  - increased levels of insulin and glucose have been identified in psoriasis sufferers¹²
• Stress¹³
• Alcohol consumption¹⁴

Nutritional factors to consider

Although psoriasis can have a significant genetic component nutritional intervention can help rebalance the cAMP/cGMP ratio and decrease immune activators present in the blood.

• Blood sugar balancing, anti-inflammatory diet
• Support digestive function and gut health
• Support detoxification
• Removal of allergens and pathogens where appropriate
• Correction of nutritional deficiencies

Possible laboratory tests

• Comprehensive digestive stool analysis
• Liver detoxification profile
• Candida antibody
• Food intolerance including gluten
• Intestinal permeability
• Fatty acids profile
• Serum vitamin A and zinc