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A growing body of evidence is beginning to show that there is a connection between psoriasis and gluten intolerance (celiac disease). For a small percentage of psoriasis sufferers there exists an important connection between what they eat and what happens to the skin.
When wheat flour is mixed with water, a complex protein called gluten develops. Gluten is what gives the dough of wheat an elastic structure that allows it to be crafted in a variety of ways. If wheat is high in gluten content it is called "brown" or "white" If it is called "weak" or "soft" the gluten content is low. If you are sensitive to gluten, avoiding wheat products containing gluten is the only way to prevent reaction.
An estimated 2 million Americans suffer from an allergy that many don't even know exists. Celiac or gluten allergy could be the most common allergy afflicting Americans today. Recent research has revealed that an undiagnosed gluten allergy can be especially problematic for those suffering from psoriasis and other skin conditions. Though occasionally patients are asymptomatic, usually symptoms mimic other conditions, and often physicians misdiagnose it as Irritable Bowl Syndrome (IBS). The wide array of symptoms include:
Dermatitis Herpeformis, a persistent, itchy rash with red skin and watery blisters often appears on the knees, elbows, backs and buttocks of individuals with wheat allergies.
Celiac disease is a genetic condition where the body reacts to giladin, a gluten protein found in wheat, barley, and rye, by producing an enzyme called tissue transglutamise. The enzyme triggers an inflammatory reaction in the bowels which eventually leads to flattening of the villi lining the intestinal wall.
Villi, are finger like protrusions which line the sides of the intestines and filter out nutrients as waste passes through. When villi become flattened and unable to function, malnourishment can occur from vitamin deficiencies. If intestinal distress, and malnutrition aren't motivation enough, the Mayo Clinic website states that gluten intolerant people who continue to consume gluten are "at higher risk of developing cancer, especially bowel cancer or intestinal lymphoma."
Often celiac patients seek help from their doctors because they are suffering from mal-absorption problems and don't yet know the root cause. The most commonly seen problem is anemia due to lack of iron in the blood. Symptoms of anemia include: dizziness, insomnia, pale skin, and difficulty concentrating. Other often seen problems stem from lack of folic acid, B-12, Calcium and Vitamin D, all of which have troubling symptoms and some, like calcium deficiency, can lead to irreversible conditions such as osteoporosis. Those severely deficient in Vitamin K may experience abdominal bleeding. Because the villi are virtually stripped away, or severely incapacitated, often harmful bacteria build up in the small intestine causing a host of other problems such as Candida and/or Leaky Gut.
Since both celiac disease and psoriasis are conditions which affect the auto-immune system, research seeking connections between the two has recently increased. A 2004 article in Psoriasis Advance, a magazine published by the National Psoriasis Foundation, conducted an interview with Gerd Michaelsson, M.D., Ph.D, who in 1993 preformed a study which found that some patients with psoriasis also had one of the markers of celiac disease; increased antibodies to gliadin. Dr Michaelsson stressed that "most patients with psoriasis are not gluten intolerant. However, there is a subgroup with silent celiac disease/gluten intolerance and it is important to identify these patients, as there is a chance to considerably improve the skin lesions on the gluten-free diet (GFD). In some patients there may be a total or nearly total clearance on the diet. When gluten is reintroduced there is a flare up of the psoriasis." Dr. Michaelsson thinks that it is possible that some celiac sufferers may be predisposed to psoriasis, but have not had any problems since they adhere to a strict gluten-free diet.
An article in the April 2007 issue of World Journal of Gastroenterology, by L Abenavoli, L Leggio, G Gasbarrini, G Addolorato, seems to corroborate Dr. Michalessons research. Psoriasis patients who tested positive for the markers that indicate celiac and were put on a GFD. Researchers noticed "thirty of 33 patients strictly complied with GFD, have showed a significant decrease of psoriatic lesions." Celiac is a systemic disease, and not one that is isolated simply to the digestive system. The link between psoriasis is some people is clearly tied to a gluten-sensitive enteropathy (pathology [disease] of the intestine). While the cause for psoriasis still remains unknown, and may in fact be the result of numerous factors, celiac is a genetic condition.
The Psoriasis foundation quotes yet another researcher, Dr. Kruger who thinks that the link might just be odds "simple math dictates that it would be surprising if there weren't some people with both diseases." Indeed," Dr. Krueger says, "there is a certain small percentage of people in the general population with celiac disease, and a certain small percentage of people in the general population with psoriasis, so one should not be surprised to find a significant number of people who have both. Notwithstanding, many psoriatics go into remission when adhering to a GFD.
For many, the link between celiac and psoriasis is common sense. Digestive specialist Elizabeth Lispki, Ph.D., CCN asserts in her book Digestive Wellness, that diet is the cause of most auto-immune afflictions ranging from psoriasis to colitis. Dr. John O.A. Pagano and Deirdre Earls, RD, psoriasis specialists, believe that changing what we eat can help to alleviate psoriasis outbreaks.
At DermaHarmony we offer "Your Healing Diet, a Quick Guide to Reversing Psoriasis and Chronic Diseases with Healing Foods" by Deidre Earls RD, LD, an informative book which clearly outlines rules for an effective healing diet, to our clients. Though these diets don't rule out wheat completely, they suggest it be consumed occasionally in whole grain rather than processed form. All stress the importance of wheat avoidance for celiac sufferers. The consensus among these authors seems to be "healthy gut, healthy skin."
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If you suspect that you may suffer from a gluten allergy, it may be tempting to simply start yourself on the GFD and wait for results. It is important that the symptoms be discussed thoroughly with your physician and that you be tested for gluten intolerance.
Most often, a simple blood test can determine if a patient is gluten intolerant. In some cases, physicians may request a biopsy from the intestine for a diagnosis or to determine damage to the villi.
It is important to have confirmation and support of your doctor when dealing with this condition, you may be suffering from extensive mal-nutrition especially with the fat soluble vitamins listed above (D,E,and K). A GFD may seem like an easy fix compared to the treatments for other conditions, but it is a life long commitment, and can be difficult especially in our wheat centered culture. It is also important to find good quality vitamin supplements which are gluten free, to replenish diminished stores.
As research continues, it is probable that additional links will be found between diet and skin conditions. Please visit our library which contains a number of articles on diet, intestinal wellness and their effect on skin health.