A Functional Medicine Approach to Addressing Psoriasis

Psoriasis is an autoimmune condition that targets the skin, and plaques that result commonly appear on the elbows, knees or scalp. The plaques can however show up on any part of the body.


Normally your body will produce new skin cells and shed old ones every 28-30 days. With psoriasis, your immune system is in overdrive, leading to skin inflammation, causing skin cell turnover to occur much faster than normal. Instead of taking 28-30 days for skin cells to turnover, new cells are pushed to the surface in just 3-4 days. Because your body can’t shed the old, dead cells as fast, they pile up and begin to form thick, red, itchy, flaky, scaly patches referred to as plaques. Some people report burning and stinging from the plaques. 


Conventional medicine looks at psoriasis as a skin condition, however it’s important to know that it actually starts underneath the skin and is a chronic disease of the immune system (as are other autoimmune conditions).


Because imbalances of the immune system are involved, we must look for underlying causes of why this is occurring. If we do not address the underlying cause, it is left to persist, and it will cause additional problems over time.


While the exact cause of psoriasis is unknown, there are a variety of factors involved that when occur together result autoimmunity, and in some people, the symptoms of psoriasis. 


Autoimmunity is the result of a genetic component, an environmental trigger, and impaired gut function. Environmental triggers can include stress, diet and nutrient deficiency, food allergies and food sensitivities, medications, and toxins for example. Impaired gut function may be due to inadequate digestion and absorption (which can lead to nutrient deficiency), imbalances and infections of the gut microbiome (which is your gut bacteria, and may be referred to as dysbiosis), and increased gut permeability (which is commonly referred to as leaky gut). 


While we can’t change our genetics, we can identify and work to eliminate environmental triggers and address impaired gut health, and thus bring psoriasis (and other autoimmune conditions) into remission in a natural, holistic manner.


From a functional and clinical nutrition standpoint, the search for the cause of immune system dysregulation begins in the gut. Up to 80% of our immune system is located in our gut microbiome. Therefore imbalances in our gut microbiome can have far reaching effects on our overall health.


Psoriasis is associated with differences in the gut microbiome when compared to the microbiomes of healthy individuals without psoriasis. These differences can adversely impact the immune system by triggering specific, inflammatory immune responses. Interactions between the gut microbiome and the immune system therefore suggest the composition of the microbiome represents a therapeutic target for managing psoriasis.


In addition to the composition of the microbiome and the role it plays in psoriasis, increased intestinal permeability is involved, and this connection has been known for decades. In this scenario, inflammation in the gut (which can arise from a variety of factors including food allergies and food sensitivities, and gut dysbiosis for example) causes the normally tight junctions between the cells of the intestinal walls to loosen. When this occurs food particles and toxins from bacteria are allowed to inappropriately enter the blood stream. Once there, the body identifies them as invaders (because they are not supposed to be there) and mounts an immune response. As long as gut inflammation and subsequent leaky gut persist, the immune system will be chronically stimulated, leading to autoimmune conditions, like psoriasis.


There are a variety of nutrient deficiencies common in skin conditions such as psoriasis, including omega 3 fish oils, zinc, vitamin B2, niacin, vitamin A, vitamin C, and vitamin DEating foods that are rich in these nutrients, and other nutrients that are important for skin health is paramount for healthy skin.


While “medicine deficiency does not cause psoriasis, nutritional deficiency might.”


Adequate detoxification is also important because toxin build up that cannot be excreted via normal routes (through the liver and bowels for example) can make its way out through the skin causing flares in skin conditions. 


In addition to addressing the gut microbiome, the skin has its own microbiome that needs to be addressed, and the skin microbiome also plays a role in the pathogenesis of psoriasis.


Addressing psoriasis, other autoimmune conditions, or any chronic condition you may have that has not resolved with conventional means involves some important considerations that include the following: 


  • Taking into account your biochemistry, and uncovering the root cause of imbalances that may be contributing to your health problems. This is the functional medicine approach. All of the systems in your body are connected. When one is not functioning optimally and the root cause is left to persist, it can adversely affect other systems, creating a domino effect of illness and disease. Medications mask symptoms, leaving us unaware of the continued damage that is occurring within. Functional nutrition is the core of functional medicine and can help you reach optimal health with natural means.
  • Keep in mind we aren't just what we eat. We are what our bodies can do with what we eat. Rather than only making sure you are eating right, we need to make sure your body can digest, absorb and use nutrients from the foods you eat. Your diet may be stellar, but if your body can't use those nutrients, your perfect diet doesn't matter much. For example, impaired digestion can cause dysbiosis, leaky gut, and nutrient deficiencies, among other issues.
  • Nutrient supplementation can be a key factor for improving overall metabolic function, and therefore it can positively impact the issues you are experiencing. Often, due to long standing deficiency and imbalances, the addition of supplemental nutrients can help restore metabolic processes to their optimal state.
  • Too often, our conventional lab results are "normal" yet we still don't feel well.  While labs may appear "normal" for conventional medical practice, they can be far from optimal and therefore underlying dysfunction can be causing your symptoms. This underlying dysfunction is where our opportunity lies to improve your health.
  • Exercise, getting enough sleep, and stress management are examples of lifestyle factors that play a major role in your overall health.


As you may have noticed, these factors are not typically considered in conventional medical practice. This is why a functional approach can produce results, where conventional interventions often fall flat. 


For assistance with identifying your root causes and developing a customized protocol for your unique biochemistry to address your psoriasis (or other autoimmune conditions), contact me today!


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"Your nutritional needs are as unique as your fingerprint, and they are dictated by your individual biochemistry. As a functional and clinical nutritionist, I can help you interpret your body's nutrient needs and customize a plan to reach your health and wellness goals. This is personalized nutrition."
-Jennifer Caryn Brand, MPH, MS, CNS, Clinical Nutritionist