Does a Gluten-Free Diet Help Psoriasis? We Asked a Dietitian
People with psoriasis often ask if going gluten-free can improve their psoriasis. There’s no clear-cut answer due to the conflicting information out there, so we asked our nutrition expert, Elizabeth DeRobertis, a New-York based registered dietitian, for the facts about psoriasis and gluten.
Why is a gluten-free diet so common for people with psoriasis to want to try?
There’s no one specific, guaranteed treatment for psoriasis that works for everyone across the board, so people with the condition are often looking for alternative options and answers. Some people are hesitant to take medications, and they feel that if they can improve a condition on their own with food, they would prefer to try this route first.
What is a gluten-free diet, exactly?
A gluten-free diet is one that does not contain wheat, barley, rye, and oats that aren’t gluten-free. Oats don’t contain gluten on their own, but there’s a high level of cross-contamination with gluten-containing foods and oats.
A gluten-free diet can include fresh fruits and veggies, beans/seeds/legumes, eggs, lean proteins, low-fat dairy products, corn, flax, quinoa, rice, and soy.
Many foods that are gluten-free will say so right on the package. There is often an allergen statement on the back of many food packages, near the ingredients, that will specify if a product contains nuts, wheat, or dairy. Become familiar with gluten-containing ingredients, and check the labels.
So, what’s the real deal? Will going gluten-free help people with psoriasis?
The evidence supporting the link between gluten and psoriasis is definitely varied. Several studies suggest a connection between psoriasis and celiac disease. Celiac is an autoimmune condition, meaning the body is attacking itself. Psoriasis is an inflammatory condition and there is some evidence that it may be also be an autoimmune condition. A study published in the journal Autoimmune Diseases suggests that as many as 34-percent of people with one autoimmune disease will have another.
Celiac disease is a medical diagnosis that can be made by a physician via lab work, and often confirmed via endoscopy. Genetic testing is also sometimes helpful to help confirm celiac. A general practitioner or dermatologist can do the initial labs for celiac, but the diagnosis is usually made by a gastroenterologist.
Celiac disease is a small bowel disease that is due to an immune reaction to eating gluten. Over time, the inflammation damages the intestinal villi, which is essential for absorbing nutrients from the food that we eat. People with celiac disease must avoid all gluten to decrease the risk of developing a type of cancer called mucosa-associated lymphoid tissue (MALT).
But there are people who don’t have celiac disease that seem to positively respond to a gluten-free diet, too. These are people who have gluten antibodies, which means their immune systems consider gluten harmful.
A study in the Journal of the American Academy of Dermatology reported that among 33 people with psoriasis who had gluten antibodies, nearly three out of four experienced an improvement in their skin condition after going gluten-free. If someone is not positive for gluten antibodies, they are not as likely to benefit from a gluten-free diet.
If you would like your blood to be tested for gluten antibodies, speak with your physician. And be sure to have some gluten in your diet leading up to the blood work, to get a more accurate reading on whether or not you produce antibodies.
If someone with psoriasis has celiac or has gluten antibodies, and they go gluten-free, what kind of results can they expect to see?
It may take up to three months to see a benefit from a gluten-free diet. But if cutting out gluten helps, it should mean that they have a reduction in skin symptoms and absence of flare-ups. They may also experience less pain and inflammation in joints. Other results may include finding that they may have more energy, and possibly even losing weight by omitting the foods that contain gluten.
If someone is curious about whether a gluten-free diet could help their psoriatic symptoms, and want to try it out, what should they do?
First, familiarize yourself with the foods that contain gluten, like bread, pasta, cereal, and crackers. Find a comprehensive list and save it to your phone. Then, take an inventory of your typical day, and make a list of the foods you eat most that contain gluten, so you can shop for some alternatives. Focus on the most obvious areas first, so you don’t feel overwhelmed. For example, it’s more straightforward to replace bread, pasta, and cereal than it is to worry about the ingredients in your shampoo.
Buy gluten-free alternatives to the things you feel you may need to swap out, or just decide to ditch the gluten food without replacing it. For example, some people choose to eat gluten-free bread, gluten-free pasta, and other gluten-free snacks. Other people just focus on having lean proteins and vegetables and simply omit the foods that typically have gluten. You can also make substitutions like zucchini noodles and hearts of palm pasta, which naturally do not contain gluten.
Give it a few weeks, and even up to three months, as it may take a little time to get used to the diet and for the benefits to show up. Find some gluten-free recipes to keep it interesting. There are thousands of recipes out there, plus cookbooks and gluten-free products that make it easier to make this change.
What else should someone with psoriasis know before trying a gluten-free diet?
A gluten-free diet shouldn’t take the place of a conventional treatment if it’s recommended by your doctor. Rather, it can be supportive of other treatments. Often, things work best in combination with each other. So, if you are already taking medication, and want to add a gluten-free diet, the combination may be even more effective than one therapy alone. Also, if your symptoms improve, then your doctor may slowly taper your prescription treatments over time.
It’s also important to know that gluten-free products sometimes contain more calories and more carbohydrates than the original versions of that food. So if you are watching your calories to manage your weight, take a look at the calories in the gluten-free alternatives you’re eating. If you’re working to control your blood sugar, check out the total carbohydrates to make sure they’re not too high. It may be better to avoid the gluten-containing products altogether than to bring in too many gluten-free alternatives.
The good thing is that it is absolutely possible to meet your nutrient needs without having gluten in your day, so this is worth a try. And you know your own body best, so you will be in the best position to evaluate if this approach works for you.
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