Managing my psoriasis with diet and supplements - evidence-based

I have had psoriasis for 16 years. I was first diagnosed when I was 34 years old and I believe it was first triggered by a stressful event. It is also partly hereditary – my mother has it and my grandfather was thought to have it. In the first few years I was treated with a series of medications, including dovonex (useless), light therapy (good but had a flare straight after the treatment was completed, so not long lasting) and dovobet (my lifeline for the last 14 years). My psoriasis covers more than 10% of my body and is mostly on my legs, feet, elbows, scalp and ears. About 2 years ago it began to spread to my torso and flare fairly frequently. I have also developed mild psoriatic arthritis in my hips, knees, feet and hands, including dactylitis in my left thumb. I have had to use dovobet fairly continuously since then. I wasn’t keen to move on to more aggressive systemic treatments (methotrexate and biologics) because of the side effects. At this point I should mention I am a medical writer by trade, and have written extensively on the use of these treatments across a wide range of immune-related disorders, including psoriasis and psoriatic arthritis. I did some research on PubMed to see what studies had been carried out on the natural control of symptoms associated with psoriasis. As everyone has probably read, diet is a big factor. So I decided to try diet as a way of controlling my symptoms. I stopped eating gluten, lactose, sugar and limited alcohol to a couple of glasses of wine a week. I managed to follow this for about 6 months and did notice a gradual improvement. I maintained the diet until about 6 months ago, when I was worried I could make myself gluten/lactose intolerant. So I gradually began to reintroduce these to my diet. I also wanted to enjoy life! So I would have sweet stuff and a few more drinks on occasion. One thing I have noticed through this elimination diet was that I definitely had some dietary triggers that resulted in almost immediate flares (same day). These were wheat (bread/pasta/cake) but not necessarily gluten, more than 3 glasses of wine in one sitting and a high dose of sugar (e.g., large slice of cake). All 3 would be a disaster. The flares start in my joints and the skin itching begins after that. I can minimise the impact of the flares by taking ibuprofen and antihistamines (one loratadine and one cetirizine – generic brand) – and obviously not repeating the dietary mistake! I did some more research to see what evidenced-based natural supplements are out there that could have benefits in an immune-related disorder such as psoriasis. Psoriasis is inflammation – your body attacking itself (in our case our skin). It is also associated with vitamin D deficiency. For many immune-related disorders there has also been the suggestion that gut imbalance is a factor. Basically, our gut bacteria (microbiome) are out of whack. So I focussed my research around anti-inflammatory supplements, supplements good for the skin and probiotics for the gut aspect. I have honed my list of supplements down to the following: 1. Vitamin D (10,000 IU per day) 2. Bio-selenium and zinc (Pharma Nord make which has added vitamin C, E and B6) 3. Turmeric (curcumin 600 mg with 5 mg organic black pepper) 4. Astaxanthin (12 mg) 5. Biotin (10,000 μg) 6. Omega 3, 6 and 9 (1200 mg) - fish oils 7. Optibac probiotics extra strength (they have shown the good bacteria in their capsules make it through the stomach acid – many others don’t) I get 1-6 from Amazon and 7 direct from the manufacturer (in the UK). I take one table of each every day after dinner and have been doing so for 6 weeks now. I have noticed a major improvement in my psoriasis and joint pain. It took about 3 weeks to notice the benefit. I have managed to come off dovobet completely for the first time in over 2 years – I was using it every evening. My plaques have gone from red, scaly, itchy/sore to flat stains in the majority of places. I still have minor raised plaques on my elbow and one on my feet. I am not having any side effects from taking the supplements. I do try and stick to the wheat free, low sugar, sensible alcohol intake diet. I also keep my skin well moisturised by applying an emollient in the morning and at bedtime. It has made a big difference to the quality of my life, which has been fairly dominated by my condition. I would be interested to see if this has any benefit in anyone else willing to try, as I recognise this is only a case study of one person.