4 Things to Do Before Taking Vitamins for Psoriasis
Have you ever wondered if adding a vitamin or supplement to your psoriasis treatment regimen could help you have fewer or less severe flare-ups? The truthful answer is that it might not—the data to support the use of vitamins and supplements in psoriasis isn’t quite there yet. But some people with the condition have found success with them, so you might find they’re worth a shot. Before you stock your medicine cabinet with dietary supplements, there are a few things to do and to consider.
1. Talk to Your Doctor or Pharmacist
Before you hop on the supplement train, it’s important to discuss what could be beneficial to take with your doctor or pharmacist first. “If you’re on other medications, certain vitamins and supplements can interact with those meds,” explains Morgan Herring, Pharm.D., Board-Certified Pharmacotherapy Specialist and clinical associate professor at the University of Iowa College of Pharmacy in Iowa City. “Don’t be afraid that your doctor or pharmacist will judge you, or force you to stop taking any supplements—we really just want to make sure we’re thorough and check for potential interactions that can be ineffective or even cause you harm.”
Your care team can also recommend specific supplements that you should be taking. “There may be cases where, if you are taking a certain medication, it’s depleting your levels of certain vitamins and minerals, so getting supplementation can actually help,” adds Danielle Currey, N.D., a naturopathic physician based in Troutdale, Oregon, who herself has both psoriasis and psoriatic arthritis.
And if your doctor isn’t on board with you trying dietary changes or incorporating vitamins and supplements into your psoriasis management plan, know that there are doctors out there who may be more open to these approaches. For example, you could work with a naturopathic physician or an M.D. who specializes in functional medicine or integrative medicine.
2. Check Your GI Health
Newer research suggests that there could be a link between your gastrointestinal (GI) tract health and psoriatic disease. “Before starting on supplements for psoriasis, we have to make sure your gut health is optimal first,” explains Currey. “A lot of people with psoriasis also have irritable bowel syndrome and other gastrointestinal complaints.”
While you may often hear the phrase, “You are what you eat,” Currey explains that’s not necessarily true. “You are what you absorb,” she emphasizes. “And if your gut lining is compromised, and you have a lot of symptoms in the GI tract, there’s a good chance that any pills or supplements you’re taking aren’t going to get absorbed properly.” So, adds Currey, there’s no use spending money on supplements until you know they’ll get absorbed as intended.
3. Know Which Vitamins and Minerals May Help Psoriasis
Before you hop on the supplement bandwagon, it may be worth your while to address your diet. In a survey published in Dermatologic Therapy, some people with psoriasis reported improvement in their skin after reducing alcohol, gluten, or nightshades, or by eating more vegetables. Some also said they had improvement after adhering to a Pagano, vegan, or Paleo diet. And another study, published in JAMA Dermatology found that people who say they followed the Mediterranean Diet were also less likely to say they experience severe psoriasis.
Plus, many vitamins and minerals are easier for the body to absorb and use when they’re in the form of food rather than a supplement.
“I’m always a fan of getting any of these nutrients naturally in food—by eating healthy, balanced meals,” says Herring.
“Food sources are going to be your best sources [of these vitamins and minerals]—and supplements are meant to fill in the gaps,” adds Currey. “You can have tests done—there are blood tests that can be done, there are hair analysis tests which are more hit and miss—but you can get some testing to see if there are specific vitamins and minerals that you are deficient in.”
Though, if you’ve already made changes to your diet and you’re ready to try adding supplements to your psoriasis treatment regimen, there are some options to consider, including:
“The first thing to consider is a really good-quality multivitamin and multi-mineral,” says Currey. “People with psoriasis tend to be deficient in a few different vitamins and minerals, but it’s kind of across the spectrum, so getting a really good quality multivitamin and multi-mineral is going to be a really good way to plug in some of those gaps.”
Zinc, Selenium, and Magnesium
Currey says that many people with psoriasis may need extra doses of zinc, selenium, and magnesium, in addition to a multivitamin. “Though you can’t really tell until you’ve already started on the general multivitamin and multi-mineral—unless you’ve gone through some testing to figure out what your individual needs are, which vary from person to person and change throughout the course of your life.”
Food sources high in zinc include oysters and red meat; food sources high in selenium include Brazil nuts, seafood, and organ meats; and food sources high in magnesium include spinach, legumes, nuts, seeds, and whole grains.
Vitamin D is known to be good for psoriasis—it can actually be found in certain topical treatments. Plus, it’s common to be deficient in it. “Vitamin D seems to be a really good one to include, not just for people who have psoriasis, but for anybody with any kind of immune-system deficiency or irregularity,” says Currey.
Though you don’t want to go overboard. “Every vitamin and mineral does have a level where they get to be toxic—so, we don’t want you deficient, but we also don’t want you to be toxic, because you’re going to have symptoms on either end of that spectrum,” says Currey. “All substances do have an upper limit—even water can be toxic in the right circumstances, so we want to be very careful. But again, there’s good testing for that—so, you want to get tested before you start taking it willy-nilly.”
The National Psoriasis Foundation advises that the safest way to increase your vitamin D intake is through foods. Good sources include fish; like salmon and mackerel; milk; cheese; and, vitamin-D fortified items such as orange juice, yogurt, or cereal.
Vitamins A and E
“These vitamins can be really good for skin health,” explains Currey. “Same with a vitamin B complex. Though, if you’re taking a good-quality multi-vitamin, you’re probably covering those bases,” she adds.
You can find high concentrations of vitamin A in liver and fish oils; vitamin E can be found in nuts, seeds, and vegetable oils.
Curcumin and Turmeric
Curcumin, which is found in the popular spice turmeric, is known to have anti-inflammatory properties, but take caution before you start adding more to your diet. “These minerals can be beneficial if they’re part of a more comprehensive approach to supplements,” explains Currey. “On their own, they do have anti-inflammatory effects, but they’re also really hot and drying—so, if you have irritation in your gut, you’re going to get irritation from taking turmeric.”
And if you have psoriatic arthritis, this might not be the best option for you. “If you have psoriatic arthritis, and those joints are really hot and dry feeling, turmeric might actually aggravate that, so we’d want to be working with something else that’s more cooling and moistening, as well as anti-inflammatory—something along the lines of marshmallow root,” explains Currey. “So, it has to be a part of a whole comprehensive plan that takes you as an individual into full consideration. When we just one-off grab herbs and try to take them, we might notice a difference for a short period of time, but then we might start to have aggravations if we take them for too long. You have to be careful with that.”
Omega-3 fatty acids are known to help decrease inflammation, but before you start supplementing with omega-3s, try getting them through your diet instead, advise both Currey and Herring. Good food sources of omega-3s include fatty fish like salmon, as well as vegetable oils, nuts, and seeds.
“Eating some fish two to three times per week is a great way to increase your omega-3 fatty acid intake,” says Currey. “Also, grass-fed meats have a higher ratio of omega-3s, and olive oils and flaxseeds can be helpful for getting more omega-3s in.”
If you’re leaning toward supplements, be very careful with omega-3s if you’re on blood thinners, says Currey, as fish oil can thin your blood.
Other Vitamins and Minerals
Depending on your specific circumstances and any other health conditions you may have, says Currey, you may also consider adding choline, which is found in raw spinach, eggs, and collard greens; and/or lecithin, which is found in organic sunflower seed oil; and chromium, which is found in meat and whole grains.
4. Know How to Shop for Good-Quality Supplements
If you’re eating a healthy diet and have gotten the green light from your doctor to start supplementing further with vitamins, there are a few things you should know before you hit the drug store.
“Psoriasis drugs have to go through a pretty stringent FDA approval process,” says Herring. “But vitamins and supplements are only under the FDA from a food perspective,” which means that these supplements aren’t regulated for safety or effectiveness.
“You can’t always guarantee that what you’re getting in your bottle is what it says on the outside label,” explains Herring. “From that perspective, I always tell people to be skeptical about your supplements, and if you feel it’s not effective, then there may not be a consistent concentration in every dose.”
And the kind you buy can make a difference. “Some brands do more purity and safety checks to prove consistency and concentration, but not all brands,” adds Herring. Look for USP-verified supplements, since they tend to have a slightly higher standard of quality. “Also, make sure you are aware of the dosage,” says Herring. “Sometimes, in order to get the recommended dose, you need to take two or three pills or capsules.”
What’s more, knowing how much you should take in order to gain improvements in your psoriasis can vary from person to person. This is why it’s best to work with an integrative physician or a naturopathic doctor to help guide you through this process and discover which supplements will work best for you, rather than go it alone. These types of physicians are trained to consider a patient’s all-around health and lifestyle, rather than just specializing in one area.
Currey adds, “When done intelligently, I find nutritional supplementation makes a big difference in my patients with psoriasis and psoriatic arthritis.”
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