Nutrition Diet: What are you deficient in if you have psoriasis?

Studies have shown that up to 60% of people with psoriasis may have a Vitamin D deficiency, with low levels often correlating with more severe disease. Understanding what are you deficient in if you have psoriasis is a key step toward managing the inflammatory nature of this chronic autoimmune condition and its symptoms.

Quick Summary

Psoriasis patients frequently show deficiencies in key nutrients such as Vitamin D, Vitamin B12, and Omega-3 fatty acids, which can impact inflammation and immune function. Adopting an anti-inflammatory diet and addressing potential gut health issues are supportive strategies for managing symptoms.

Key Points

• Low Vitamin D is Common: Many individuals with psoriasis are found to have a Vitamin D deficiency, which is linked to disease severity and immune regulation.

• Omega-3s Combat Inflammation: These fatty acids possess anti-inflammatory properties that can help reduce common psoriasis symptoms, such as redness and scaling.

• Consider B12 and Folate Levels: Deficiencies in Vitamin B12 and folate can be associated with high homocysteine levels and may contribute to inflammation in some patients.

• Gut Health is Tied to Skin Health: Gut microbiome imbalances and intestinal permeability are increasingly linked to systemic inflammation in psoriasis.

• Diet Is a Complementary Strategy: While diet cannot cure psoriasis, a nutrient-rich, anti-inflammatory diet (like the Mediterranean diet) can support overall health and potentially minimize flare-ups.

• Gluten Sensitivity Matters for Some: Only a subset of psoriasis patients with diagnosed celiac disease or gluten sensitivity may see improvements on a gluten-free diet.

The Role of Diet in Psoriasis

Psoriasis is a chronic, immune-mediated inflammatory disease that primarily affects the skin, but it is now recognized as a systemic condition with various comorbidities. While diet does not cause psoriasis, certain nutritional factors can influence the body's inflammatory response and may exacerbate or improve symptoms. Research points to specific nutritional deficiencies, gut health, and inflammatory foods as contributing factors that, when addressed, can support overall management of the condition.

Key Nutritional Deficiencies Associated with Psoriasis

For those with psoriasis, maintaining optimal nutrient levels is important due to the accelerated loss of nutrients from rapid skin cell turnover and heightened inflammatory processes.

Vitamin D: The Immunomodulator

Known as the 'sunshine vitamin', Vitamin D is crucial for immune system regulation and maintaining skin homeostasis. Numerous studies have identified a significant association between low Vitamin D levels and psoriasis severity. The active form of Vitamin D (calcitriol) has an anti-proliferative effect on skin cells, helping to control the overproduction of keratinocytes seen in psoriatic plaques.

• Dietary Sources: Fatty fish (salmon, mackerel), fortified dairy products and cereals, cod liver oil, and egg yolks.
• Sunlight: Moderate, careful sun exposure can trigger the skin's Vitamin D production, but sun safety is paramount for psoriasis patients.
• Supplementation: Oral supplements are an option, but should be discussed with a doctor, as excessive intake can be harmful.

Vitamin B12 and Folate

An insufficiency in Vitamin B12 and folate is also linked to psoriasis. These vitamins are essential for managing homocysteine, an amino acid often found at high levels in individuals with psoriasis. The rapid cell proliferation during flares can deplete folate stores. By regulating homocysteine, Vitamin B12 helps control inflammation and protect cells from damage.

• Dietary Sources: B12 is found in animal products like meat, fish, and eggs, while folate is rich in leafy greens, legumes, and whole grains.
• Supplementation: Topical Vitamin B12 ointment has shown promise in reducing symptoms, though oral supplementation needs more evidence.

Omega-3 Fatty Acids: The Anti-Inflammatory Fats

Omega-3s, particularly EPA and DHA found in fish oil, have demonstrated anti-inflammatory and immune-modulating effects. They work by limiting the synthesis of pro-inflammatory substances in the body. While some studies show benefit from fish oil supplementation, others have found the evidence inconclusive. However, the overall anti-inflammatory effect of a diet rich in omega-3s is well-regarded.

• Dietary Sources: Fatty fish (salmon, sardines, mackerel), walnuts, flaxseeds, and chia seeds.

Essential Minerals: Zinc and Selenium

Zinc and selenium are minerals with antioxidant and immune-modulating properties that are vital for skin health. Research on their levels in psoriasis patients is mixed, with some studies showing lower-than-average levels in some individuals. While supplementation may be considered, current clinical studies are limited and have produced conflicting results.

• Dietary Sources: Zinc can be found in pumpkin seeds, legumes, and meat. Selenium is abundant in Brazil nuts, shellfish, and whole grains.

The Gut-Skin Axis: Addressing Systemic Inflammation

Emerging evidence highlights the importance of the gut microbiome in psoriasis pathogenesis. A state of 'leaky gut' or increased intestinal permeability has been observed in some psoriasis patients, which can allow bacterial antigens to enter the bloodstream and trigger systemic inflammation. This gut dysbiosis can disrupt immune regulation, potentially contributing to psoriasis flares. Supporting gut health with probiotics and fiber is an important dietary strategy.

Dietary Approaches to Support Psoriasis Management

Beyond individual nutrients, adopting a specific dietary pattern can help reduce overall inflammation. A heart-healthy diet is recommended, as psoriasis is linked to an increased risk of cardiovascular disease.

• The Mediterranean Diet: Rich in anti-inflammatory foods like fruits, vegetables, fish, and olive oil, this diet is a popular and well-regarded choice for managing psoriasis symptoms and related comorbidities.
• Weight Management: Obesity can worsen psoriasis severity due to chronic, low-grade inflammation in adipose (fat) tissue. Losing weight through a balanced diet can significantly improve outcomes.
• Gluten-Free Diet: While not necessary for all psoriasis patients, a subgroup with confirmed celiac disease or gluten sensitivity may see symptom improvement after adopting a gluten-free diet. A healthcare provider can test for related antibodies.

Comparison of Key Nutrients for Psoriasis Management

Nutrient	Primary Role in Psoriasis	Dietary Sources	Role in Psoriasis Management
Vitamin D	Immune system regulation; slows skin cell growth	Fatty fish, fortified dairy, eggs, sunlight	Potentially reduces disease severity and inflammation
Omega-3 Fatty Acids	Anti-inflammatory action	Fatty fish, flaxseeds, walnuts	May reduce symptoms like erythema, scaling, and pruritus
Vitamin B12 & Folate	Regulates homocysteine; supports cell function	Meat, fish, eggs (B12); leafy greens, legumes (Folate)	Addressing deficiency may help manage inflammation
Zinc	Immune function; skin healing	Pumpkin seeds, meat, legumes	May support skin health, but evidence is mixed
Selenium	Antioxidant properties	Brazil nuts, shellfish, whole grains	Lower levels sometimes observed, but supplementation evidence is limited
Probiotics	Improves gut microbiome; reduces inflammation	Yogurt, kefir, kimchi	Supports overall gut-skin health

Conclusion: A Multi-Faceted Approach to Nutrition

In summary, there is no single food or supplement that acts as a cure for psoriasis. However, the evidence suggests that individuals with psoriasis are often deficient in several key nutrients, including Vitamin D, B12, and Omega-3 fatty acids, which play a significant role in modulating inflammation and immune response. While supplementation can help, it is most effective as part of a broader, anti-inflammatory dietary strategy, such as the Mediterranean diet, especially for those with comorbidities like obesity. Addressing potential gut sensitivities, such as to gluten for some individuals, is also a relevant factor. Always consult a healthcare provider or registered dietitian before making significant dietary changes, as nutritional interventions should complement, not replace, standard medical treatments for psoriasis.

For more information on dietary management and living with psoriasis, visit the National Psoriasis Foundation.(https://www.psoriasis.org/dietary-modifications/)

Frequently Asked Questions

Can a diet cure psoriasis?

No, a diet cannot cure psoriasis. It is a chronic, autoimmune disease, and while dietary changes can help manage symptoms and reduce inflammation, they are a supportive measure and not a cure.

Is Vitamin D supplementation necessary for psoriasis?

Many people with psoriasis have low Vitamin D levels. Supplementation may be beneficial, but it should be done under a doctor's supervision, as excessive intake can be harmful.

Should all people with psoriasis go gluten-free?

A gluten-free diet is not recommended for everyone. It is primarily beneficial for the subset of psoriasis patients who also have celiac disease or a non-celiac gluten sensitivity.

What foods should be avoided with psoriasis?

Foods that can trigger inflammation, such as processed meats, high-sugar foods, high glycemic index carbohydrates, and excessive saturated/trans fats, may exacerbate psoriasis symptoms.

Are Omega-3 supplements effective for psoriasis?

Evidence on the efficacy of omega-3 supplements for psoriasis is mixed. While some studies show benefit, others are inconclusive. Food sources are a more reliable way to boost intake.

What role does gut health play in psoriasis?

The gut microbiome is linked to the immune system. Dysbiosis ('leaky gut') can trigger systemic inflammation that may contribute to psoriasis. Improving gut health with fiber and probiotics is a relevant strategy.

How can weight loss impact psoriasis?

Obesity is associated with increased systemic inflammation, which can worsen psoriasis. Weight loss through a healthy diet can improve disease severity and overall outcomes.