woman with hand over her stomach

How Your Gut Health Could Be Affecting Your Psoriasis

By Kerry Weiss
July 19, 2021

Have you ever felt that what you eat has a direct impact on your psoriasis? Or, when you have digestive woes, do you feel they might be connected to your condition? As it turns out, there might be something to both of those theories. Researchers are taking a new interest in studying the relationship between the gut microbiome and psoriasis—and findings are promising. Here’s what we know so far.

The Link Between Gut Health and Psoriasis

“Our gut can be considered our second brain,” says Danielle Currey, N.D., a naturopathic physician based in Troutdale, Oregon, who herself has both psoriasis and psoriatic arthritis. “It’s the main component of our immune system. And with psoriasis, there’s a big boost of inflammation and reactivity in our immune system.”

So, how does this inflammation relate to your gut—and back to your psoriasis? “We’re still trying to figure that out,” says Kory Patrick Schrom, M.D., a dermatology resident at University Hospitals Cleveland Medical Center in Ohio, who has studied the microbiome’s effect on psoriatic disease. “Current research is looking at whether there’s a relative abundance of certain bacteria and potentially even fungi that live in the gut, and how they might implicate the whole pathogenesis of psoriasis.” In other words, organisms in your gut could be causing psoriatic symptoms, but scientists don’t know exactly how yet.

What That Means for People with Psoriasis

Many people with psoriasis also experience gastrointestinal (GI) symptoms, such as IBS (irritable bowel syndrome), frequent heartburn, constipation, diarrhea, gas, or bloating. “You’ll often see a correlation between how severe your psoriasis symptoms are, and any kind of symptoms in your gastrointestinal tract,” says Currey.

If that’s the case, you may want to take a closer look at your diet and how making healthy changes may improve your symptoms.

“We need to think of psoriasis as a full-body disease,” adds Schrom. “People with psoriasis also have higher incidences of diabetes, heart disease, and cancer. We know that weight is one of the contributing factors for those other diseases, and it impacts psoriasis, as well. So, we know that a healthy diet is so important.”

Dietary Changes to Try

Schrom doesn’t recommend any one specific diet; instead, he suggests aiming for a well-balanced diet by following the MyPlate dietary guidelines created by the USDA, avoiding refined sugars and grains, and eating high-fiber foods for their gut-health benefits.

You may have heard of other diet plans you could try to improve your gut health, but it might take a little trial and error to find improvement. “You have to find which diet works best for you—there’s no one-size-fits-all diet,” says Currey. We all vary because of our genetics, nutritional needs, and ability to digest different types of foods, she says.

“I do pretty well on a Paleo-Mediterranean diet,” adds Currey. “I’ve seen patients do well on a vegan diet. I’ve seen patients go gluten-free, and that makes a big difference [for them].”

Diet Trial and Error

No matter what you choose to eat, it’s important to pay attention to how you feel. “You could be eating what you think is a really healthy diet, but if there are a few foods in there that your body can’t digest well, that’s going to increase your inflammation, and that’s going to reduce your ability to actually absorb nutrients from your diet,” says Currey. “It’s a matter of doing a little exploration with yourself and figuring out which foods feel good in your body.”

One of the best ways to do that is to keep a food journal and write down everything you eat and drink. “Also check in about two hours after you eat, to figure out how you feel after you’ve eaten,” says Currey. “Do you feel good? Does it feel like the foods gave you energy? Did they digest well? Or are you sluggish? Do you have gut pain? A headache? Itchy skin? Keep track of stuff like that,” says Currey.

And while what you eat is important—how you eat is equally important. “If you’re constantly eating on the run, that doesn’t give your system a chance to warm up and get ready for digestion,” adds Currey. “Are you sitting back and relaxed? Are you chewing your food thoroughly? Are you thinking about and smelling food and looking at it before you eat? That gives your digestive system a chance to turn on and get ready for food, which is going to make your digestion much better.”

Probiotics for Psoriasis

You may be wondering if probiotics can help with psoriasis management, since they’re said to help promote healthy gut bacteria. At least one study suggests that they could.

“If you’re not having any other issues, and you want to add a probiotic to your regimen, it won’t hurt,” says Schrom. “But there’s not enough data to understand how it actually impacts psoriasis.”

One thing to be aware of, says Schrom, is that the FDA doesn’t regulate probiotic supplements, so the specific quantities each product contains may vary, making it hard to recommend one specific kind.

Plus, different products have different probiotic strains in their formulas, and it’s not clear yet which strains are best for psoriasis, since the preliminary studies have mostly been done on mice. You may want to look for one that contains a higher amount of colony-forming units (CFUs), since those are usually considered the most beneficial. And, always get the go-ahead from your doctor before taking it.

One strategy to consider: changing things up from time to time. “Sticking with the same probiotic over and over doesn’t seem to be best, because then you’re just getting your gut out of balance in another direction—and we have thousands of species in our guts,” says Currey.

“Also, try adding some fermented foods to your diet—things like kimchi, sauerkraut, yogurt, kefir, kombucha,” adds Currey. Those foods contain helpful probiotics for gut health.

That said, probiotics alone aren’t a magic bullet. You’ll need to eat healthfully, too. “You can take all the probiotics you want, but they’re living creatures—so, if your diet doesn’t contain what they need to survive, they’re not going to be helpful,” says Schrom.

Take Charge of Your Health

If you have psoriasis and want to maintain a healthy gut, start by looking at the types of foods you’re currently eating. “Is your diet full of soda, energy drinks, cream, and sugar?” asks Schrom. “Is your plate full of brown and yellow foods—or is it like a rainbow?” Start eliminating that first group, and strive for the rainbow he describes.

The next step: Talk to your doctor. “When anybody wants to improve their health, that is something to be encouraged,” says Schrom. Together, you can discuss what types of dietary changes might be most beneficial for you.

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