The connection between Psoriasis and Gut Health

Category: IBS

Published: November 19, 2024

Author: Victoria Tyler

Medical technician swabbing a test dish parasite test

Is Psoriasis linked to Gut Health?

Post Author: Victoria Tyler

Have you been struggling with Psoriasis, trying countless restrictive diets creams and steroid treatments, but still dealing with flare-ups?

Are you confused about what might be causing it and wondering if diet or gut health could make a difference? You’re not alone—psoriasis is a complex condition that goes beyond the skin, and understanding the root causes can be confusing.

Functional medicine offers a fresh approach by focusing on the gut-skin connection and uncovering hidden triggers that may be fuelling inflammation. In this blog we’ll explore:

How gut health impacts psoriasis and why addressing it can be a game-changer
The best functional medicine tests to help identify what’s triggering flare-ups
Key supplements including probiotics to restore gut balance and reduce inflammation naturally

What is Psoriasis?

Psoriasis is a chronic autoimmune condition that affects the skin, causing red, scaly patches that can be itchy, painful, and prone to cracking. The most common areas affected include the elbows, knees, scalp, and lower back, but psoriasis can appear anywhere on the body. Psoriasis occurs when the immune system mistakenly attacks healthy skin cells, speeding up skin cell turnover and leading to a build-up of cells on the skin’s surface.

Psoriasis has several forms, with symptoms and appearances that vary. It’s not just a skin condition; it’s a systemic inflammatory disease that can also increase the risk of other health issues, like arthritis (known as psoriatic arthritis), heart disease, and metabolic disorders. The exact causes of psoriasis are not fully understood, but it’s thought to involve a combination of genetics, immune system overactivity, and environmental triggers.

Inflammation is strongly linked to psoriasis. Psoriasis is an autoimmune condition where the immune system mistakenly triggers inflammation in the skin, leading to the rapid buildup of skin cells and the characteristic red, scaly patches. This inflammation stems from an overactive immune response, driven by specific immune cells (like T-cells) and inflammatory cytokines such as TNF-α, IL-17, and IL-23. Chronic inflammation in psoriasis can also affect other parts of the body, increasing the risk of conditions like psoriatic arthritis, cardiovascular disease, and metabolic syndrome.

What is the Link Between Gut Health and Psoriasis?

Our gut and skin are more connected than we might think. Known as the gut-skin axis, this connection means that imbalances in gut bacteria can directly affect the immune system and, in turn, the skin.

Research indicates a strong connection between gut microbiome imbalances and psoriasis.

Gut Dysbiosis- an imbalance in Gut bacteria

A healthy gut microbiome—comprising trillions of beneficial bacteria—helps regulate immune responses and maintain a balance between pro-inflammatory and anti-inflammatory signals. Dysbiosis (an imbalance in gut bacteria) can disrupt this balance, triggering systemic inflammation.

Dysbiosis refers to an imbalance in the gut microbiome, where harmful bacteria, fungi, or other microorganisms overpopulate and outnumber beneficial ones.

Reduced beneficial bacteria (like Lactobacillus and Bifidobacterium) and an overgrowth of harmful bacteria (like Proteobacteria or Firmicutes) have often been found in psoriasis patients. This imbalance affects the production of short-chain fatty acids (SCFAs), such as butyrate, which are anti-inflammatory and essential for gut and immune health. This means that you may be more likely to experience inflammation.
How it affects psoriasis: This imbalance can lead to systemic inflammation, which worsens autoimmune conditions like psoriasis. An imbalanced microbiome can disrupt the immune response, triggering skin flare-ups.
Causes: gut dysbiosis is often caused by a poor diet high in sugar, processed foods, and low in fibre, which promotes harmful bacteria while starving beneficial microbes. Other factors include antibiotic overuse, chronic stress, infections, and exposure to toxins, all of which disrupt the gut’s microbial balance.

The Link Between SIBO and Psoriasis

A study using breath tests found that 21% of psoriasis patients had SIBO, suggesting a possible link between excessive bacterial growth in the small intestine and systemic inflammatory conditions like psoriasis.

What is SIBO?

SIBO (Small Intestinal Bacterial Overgrowth) happens when an excessive amount of bacteria colonizes the small intestine, where they are not typically found in large numbers. These bacteria ferment undigested food, producing gases and toxins that can damage the gut lining and worsen systemic inflammation.

Connection to Psoriasis: SIBO has been linked to increased levels of bacterial endotoxins, like lipopolysaccharides (LPS), in the bloodstream.

These toxins contribute to chronic inflammation, a hallmark of psoriasis, and can exacerbate skin lesions and other symptoms. SIBO often causes a condition called leaky gut, where the gut lining becomes too permeable. This allows harmful substances to escape into the bloodstream, triggering inflammation that can make psoriasis worse.
SIBO disrupts the gut barrier, leading to leaky gut (increased intestinal permeability). This allows harmful substances to enter the bloodstream, triggering immune responses and systemic inflammation that can worsen psoriasis symptoms and even psoriatic arthritis.

Causes of SIBO: Several factors can contribute to the development of SIBO, including:

Food Poisoning: Can damage gut motility and promote bacterial overgrowth.

Low Stomach Acid: Reduces the stomach’s ability to kill bacteria, allowing overgrowth in the small intestine.

Surgery: Particularly abdominal surgeries or those affecting the gut, which can disrupt normal motility.

Medications: Proton pump inhibitors (PPIs), which lower stomach acid, and antibiotics, which disrupt gut flora balance.

Diet: Diets high in sugar, processed foods, or low in fiber can feed harmful bacteria.

Leaky Gut and Psoriasis

Research shows that leaky gut syndrome (intestinal permeability) may worsen psoriasis by contributing to inflammation. A damaged gut lining allows harmful substances like bacterial toxins to enter the bloodstream, which can trigger an immune response and exacerbate psoriasis symptoms. This process is part of what scientists call the gut-skin axis, where gut health directly impacts skin health.

So how does leaky Gut Develop?

When your gut bacteria are out of balance, known as gut dysbiosis, it can weaken the protective lining of your gut. Normally, good bacteria in your gut produce helpful substances like short-chain fatty acids (SCFAs), which keep the cells of your gut lining strong and tightly connected. When there aren’t enough good bacteria, these helpful substances decrease, and the gut lining becomes weaker and more likely to “leak.”

At the same time, harmful bacteria can take over. These bad bacteria release toxins and trigger inflammation, which can damage the gut lining even more. The protective mucus layer in your gut, which acts like a shield, may also get thinner or weaker, leaving your gut lining exposed.

All of this makes it easier for harmful substances, like toxins and bacteria, to escape from the gut into your bloodstream. This is what’s called leaky gut syndrome. It can lead to inflammation and other health problems.

The heightened immune response can worsen skin inflammation, leading to the flare-ups and lesions characteristic of psoriasis.

Taking care of your gut bacteria by eating healthy foods, avoiding too many processed foods, and possibly using probiotics can help strengthen your gut lining and prevent these issues.

Food Sensitivities and Psoriasis

Food sensitivities, such as to gluten, dairy, yeast can trigger inflammation in the body, especially when the gut is compromised.

ertain foods may act as triggers for psoriasis flare-ups by increasing gut permeability (leaky gut) or by stimulating an inflammatory immune response, leading to more severe skin symptoms.

Toxin Build-Up and Detoxification Issues

What it is: When the gut is imbalanced, toxins from the environment, food, alcohol or gut bacteria can accumulate in the body. The liver and detoxification systems may become overwhelmed.
How it affects psoriasis: These toxins can circulate in the bloodstream and contribute to inflammation and immune system dysfunction, which aggravates conditions like psoriasis.

Stress and Cortisol and Psoriasis

What it is: Stress affects the gut and can cause digestive disturbances, including IBS and SIBO. It also elevates cortisol levels, which can further imbalance gut health.
How it affects psoriasis: Stress can trigger or worsen psoriasis flare-ups, as elevated cortisol levels can weaken the immune system, making it more reactive and inflamed.

What are the Best Gut Tests to consider if you have Psoriasis?

Comprehensive Stool Analysis

A comprehensive stool test provides a detailed look at the health of your gut microbiome, which is closely linked to immune function and inflammation in psoriasis. This test can reveal:

Levels of beneficial and harmful bacteria (to assess for dysbiosis)
Presence of inflammatory markers, like calprotectin and lactoferrin
Fungal or yeast overgrowth, such as Candida
Parasitic infections

Since gut health plays a crucial role in managing psoriasis, this test is often recommended to identify any microbial imbalances or infections.

SIBO (Small Intestinal Bacterial Overgrowth)

SIBO is a common condition where bacteria overgrow in the small intestine, often leading to inflammation, bloating, and nutrient malabsorption. A hydrogen and methane breath test can diagnose SIBO by measuring gas production after consuming a sugar solution. This test is helpful for psoriasis sufferers, as SIBO can disrupt gut health and worsen skin inflammation.

Food Sensitivity Testing

Food sensitivities can trigger immune responses and inflammation that may worsen psoriasis. A food sensitivity test, often measuring IgG antibodies, helps identify which specific foods may be contributing to flare-ups. Common triggers include gluten, dairy, nightshades, and processed foods, but individual sensitivities can vary widely. Unfortunately these tests are not 100% reliabe so following an elimination diet many be more beneficial. These tests are not 100% accurate but can give you clues.

Vitamin and Mineral Testing

Nutrient deficiencies are common in people with psoriasis, partly due to inflammation and poor absorption. Testing for key vitamins and minerals helps identify deficiencies that may worsen skin health, including:

Vitamin D: Known for its anti-inflammatory properties and crucial for immune health.
Vitamin B12 and Folate: Important for cell renewal and immune support.
Zinc: Essential for skin repair and immune function.
Omega-3 fatty acids: These help reduce inflammation, and low levels can increase inflammation and exacerbate symptoms.

Hormone Panel

Hormone imbalances can play a role in immune regulation and inflammation. A hormone panel can reveal levels of cortisol (stress hormone), thyroid hormones (which influence metabolism and immune health), and sex hormones like estrogen and testosterone. Stress and hormonal shifts can be major triggers for psoriasis, so assessing these levels can help create a more targeted approach.

Heavy Metal and Toxin Testing

Environmental toxins and heavy metals like mercury, lead, and arsenic can build up in the body and contribute to systemic inflammation. Testing for these substances can help determine if detoxification support might be beneficial, as reducing toxic load can often relieve psoriasis symptoms.

Foods to Avoid if You Have Psoriasis

Adjusting your diet can help manage psoriasis symptoms by reducing inflammation and avoiding common dietary triggers. Here are some foods to consider avoiding if you have psoriasis:

Processed and Sugary Foods
Examples include sweets, fizzy drinks, pastries, packaged snacks, and sugary cereals.
Gluten-Containing Grains
Examples include bread, pasta, baked goods, and anything made with wheat, barley, or rye.
Dairy Products
Examples include milk, cheese, yoghurt, ice cream, and butter.
Nightshade Vegetables
Examples include tomatoes, potatoes, aubergines, bell peppers, and chilli peppers.
Red and Processed Meats
Examples include beef, pork, bacon, sausages, hot dogs, and deli meats.
Alcohol
Examples include beer, wine, spirits, and cocktails.
Refined Carbohydrates
Examples include white bread, white rice, pastries, and many processed snacks.
Fried and Fatty Foods
Examples include chips, fried chicken, crisps, and other fried snacks.
Certain Condiments and Spices
Examples include ketchup, hot sauce, barbecue sauce, salad dressings, and spices like chilli powder and paprika.

What are the best probiotics for Psoriasis?

When it comes to choosing the best probiotics for managing psoriasis, it’s essential to understand that the effectiveness of probiotics largely depends on the individual’s underlying health conditions. Probiotics can be beneficial for supporting gut health, reducing inflammation, and balancing the immune system, all of which are helpful for managing psoriasis.

However, not everyone responds to probiotics in the same way, and specific strains may benefit some people more than others based on their unique health needs.

For example, traditional probiotics containing Lactobacillus and Bifidobacterium strains are generally effective at supporting gut health, but they may not be suitable for everyone, especially if there are other factors at play, such as gut imbalances or bacterial overgrowth.

If you have Small Intestinal Bacterial Overgrowth (SIBO), for instance, typical probiotics may not be beneficial and could even worsen symptoms. SIBO is characterized by an overgrowth of bacteria in the small intestine, so adding more bacteria (even beneficial strains) can sometimes aggravate bloating, gas, and discomfort.

In cases of SIBO, soil-based probiotics (like Bacillus strains) or beneficial yeasts (such as Saccharomyces boulardii) may be safer options, as they do not contribute to bacterial overgrowth in the small intestine. Ultimately, selecting the right probiotic depends on an individual’s specific gut health status, and it’s often beneficial to work with a healthcare provider to identify the best probiotic strains for your unique needs, especially if you have coexisting conditions like SIBO.

Best Supplements for Psoriasis

Here are some of the best supplements commonly recommended for psoriasis to support skin health, reduce inflammation, and address underlying factors that may trigger flare-ups:

Vitamin D

Why: Vitamin D plays a crucial role in immune regulation, and many people with psoriasis are deficient in it. It has anti-inflammatory properties and supports skin cell renewal, helping reduce psoriasis symptoms.
How to Use: Look for Vitamin D3 (the most bioavailable form) and consider getting your levels checked before supplementing to determine the right dosage.

Omega-3 Fatty Acids (Fish Oil)

Why: Omega-3 fatty acids have powerful anti-inflammatory properties and can help reduce redness, scaling, and itching associated with psoriasis. They are especially helpful in reducing inflammation throughout the body and improving skin hydration.
How to Use: Choose a high-quality fish oil or algae-based omega-3 supplement, aiming for 1,000–3,000 mg of combined EPA and DHA daily.

Probiotics

Why: A healthy gut microbiome supports immune health and can reduce inflammation that may trigger psoriasis. Probiotics can help restore balance in the gut microbiome, though the best probiotic strains may vary depending on individual factors like gut health.
How to Use: Look for a high-quality multi-strain probiotic, especially those with Lactobacillus and Bifidobacterium strains, or soil-based probiotics if you have conditions like SIBO.

Curcumin (Turmeric Extract)

Why: Curcumin, the active compound in turmeric, has potent anti-inflammatory and antioxidant properties. It can help reduce the overactivity of immune cells involved in psoriasis and has been shown to improve skin health in some individuals.
How to Use: Opt for a high-quality curcumin supplement with black pepper extract (piperine) for better absorption, taking 500–1,000 mg daily.

Zinc

Why: Zinc is essential for skin healing and immune support, and it can help reduce psoriasis-related inflammation and improve skin cell turnover. Many people with psoriasis benefit from zinc supplementation.
How to Use: Look for a bioavailable form of zinc, such as zinc picolinate or zinc gluconate, and take 15–30 mg per day.

Vitamin B12 and Folate

Why: Vitamin B12 and folate support skin cell repair and immune function. Deficiencies in these vitamins are common in people with psoriasis and can contribute to fatigue and worsened skin symptoms.
How to Use: A B-complex supplement is often beneficial for getting B12 and folate together, but check for active forms like methylcobalamin (B12) and methylfolate for better absorption.

Milk Thistle

Why: Milk thistle supports liver health, which is important for detoxification and reducing toxin load. As liver health is often linked to skin health, milk thistle may help improve psoriasis symptoms by supporting the body’s natural detox pathways.
How to Use: Standard doses are 150–300 mg of milk thistle extract taken 1–2 times daily.

Quercetin

Why: Quercetin is a bioflavonoid with anti-inflammatory and antihistamine properties. It helps reduce skin inflammation and protect cells from oxidative stress, which can be beneficial for managing psoriasis flare-ups.
How to Use: Look for a quercetin supplement and take 500–1,000 mg daily, ideally with a meal for better absorption.

Takeaways for Managing Psoriasis Through Gut Health

Consider Testing for Underlying Gut Issues

SIBO Breath Test: Determines if there’s bacterial overgrowth in the small intestine, which can worsen inflammation and disrupt nutrient absorption. Small Intestinal Bacterial Overgrowth (SIBO) is often linked with conditions like leaky gut and can impact overall immune health.
Comprehensive Stool Analysis: A stool test can provide insights into gut bacteria balance, identifying beneficial and harmful bacteria and checking for dysbiosis (microbial imbalance). It also screens for inflammatory markers and potential pathogens that could be exacerbating psoriasis.
Leaky Gut Assessment: Certain tests, such as zonulin testing, can help assess intestinal permeability. When the gut barrier is compromised, toxins and bacteria can enter the bloodstream, triggering immune responses and inflammation, which can worsen psoriasis.

Identify and Address Food Intolerances: Food intolerances can trigger inflammation and exacerbate psoriasis. Common triggers include gluten, dairy, processed foods, and refined sugar. Work with a practitioner to identify intolerances through elimination diets or testing, and tailor your diet to reduce these triggers.
Adopt an Anti-Inflammatory Diet: Focus on whole, nutrient-dense foods (leafy greens, berries, fatty fish), and avoid processed foods, sugar, gluten, dairy, and alcohol to reduce inflammation.
Support Gut Health: Restore balance with probiotics, gut-healing supplements like L-glutamine, and targeted dietary changes to improve microbial health and repair the gut barrier.
Manage Stress: Practice techniques like meditation or yoga to reduce stress, which impacts both gut and immune health.
Consider Key Supplements: Vitamin D, omega-3s, probiotics, curcumin, zinc, and L-glutamine can reduce inflammation, support the immune system, and promote skin healing.

Working with a healthcare provider can help tailor a tests, dietary advice and a tailored supplement regimen to your specific needs for optimal results.

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References

The Role of the Gut Microbiome in Psoriasis: Source: Journal of Clinical and Aesthetic Dermatology.
Gut Dysbiosis and Psoriasis: The Role of Short-Chain Fatty Acids: Source: International Journal of Molecular Sciences (MDPI).
Small Intestinal Bacterial Overgrowth in Psoriasis Patients: Source: Gastroenterology Review. Read here
MDPI
Diet and Microbiome Alterations in Psoriasis: Source: Clinical and Experimental Dermatology. Read here
JCAD
The Gut-Skin Axis and Psoriasis: Microbiome and Inflammatory Pathways: source: Journal of Translational Medicine.

Author – Victoria Tyler BSc Hons MBANT

Victoria Tyler owns and runs two busy clinics : Nutrition and Vitality and the IBS and Gut Disorder Clinic.
Nutrition and Vitality, along with the IBS and Gut Disorder Clinic, were founded with the goal of helping patients alleviate IBS symptoms by uncovering and addressing the root causes of their digestive issues.
As a Registered Nutritional Therapist, Victoria holds a BSc (Hons) in Nutritional Therapy and has trained with the Institute of Functional Medicine. She is also accredited by BANT and CNHC.
Before transitioning into health, Victoria earned a degree in Economics and an MBA, working with corporations including Canon and Vodafone. However, her own health challenges led her to pursue a career in Nutritional Therapy.
With a passion for learning, Victoria is committed to staying at the forefront of Functional Medicine. She helps patients manage IBS and other digestive disorders, including SIBO, Candida, and IBD, by identifying and addressing their root causes.
Victoria strongly believes that every symptom has an underlying cause, and there is always a solution to every health condition. To learn more, or to see patient reviews, visit Victoria’s profile on Google.

DISCLAIMER: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. The products and methods mentioned are not a substitute for professional medical advice from a trained healthcare specialist. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Use of the information and products discussed is at your own risk.