The problem with espousing diet for psoriasis and psoriatic arthritis symptom relief

Posted Thu 11 Apr 2019 05.01 by wendyloish

I have been assigned a new young doctor at my local medical centre. Straight out of medical school, I can see his eyes glaze over the minute I mention diet and symptom control of psoriatic arthritis. I see almost contempt when I refuse referral to a rheumatologist. Why is that? He has a belief that he knows better than me. I don't wear my B.Sc. (Hons) on my tracksuit, nor do I have time to persuade him of my background in scientific research. To him I am just another old chook. He assumes, probably, that I have spent time on the internet and come up with a conclusion from the multiple postings about natural remedies. And he knows that the internet is awash with pseudo-science, people with irrelevant degrees from less than prestigious institutions who make their money out of perpetrating so called natural remedies to the gullible. I am sure that there are many people who are on this forum who have come to the same conclusion as young doctor "I know better". The mere mention of diet, and they conclude that here is another gullible person drinking celery juice a whole celery at a time, or swallowing rocks as a treatment for cadmium poisoning (who the hell ever gets that today in the modern world?). Why would the rational forum reader be prepared to follow my advice, when their rheumatologist or dermatologist has a temporary fix by suppressing the immune system, and is making a living prescribing and monitoring what these specialists call a chronic disease? And I don't even pretend that I have the answers! So let me tell you about helicobacter pylori. H. pylori was first discovered in the stomachs of patients with gastritis and ulcers in 1982 by Drs. Barry Marshall and Robin Warren of Perth, Western Australia. At the time, the conventional thinking was that no bacterium could live in the acid environment of the human stomach. In 2005, the Karolinska Institute in Stockholm awarded the Nobel Prize in Physiology or Medicine to Marshall and Warren, "for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease". Their discovery challenging decades of medical doctrine holding that ulcers were caused primarily by stress, spicy foods, and too much acid. It allowed for a breakthrough in understanding a causative link between Helicobacter pylori infection and stomach cancer. But the research did not go unchallenged. It was not readily accepted. After their research discovered the H. pylori , in 1983 the two doctors submitted their findings so far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received in 1983. In 1984, Marshall, after having a baseline endoscopy done, drank a broth containing cultured H. pylori, Within two weeks he had evidence of the bacteria inflaming and colonising his stomach, and he began antibiotics to cure himself. Even after this it took time for the profession to accept the bacterial basis for stomach ulcers, and eventually, stomach cancer. The point of this story is that often medical advances mean overturning the conventional expert backed wisdom. I am challenging that conventional wisdom. And I am not even a medical researcher from Perth, Western Australia. I cannot even get young doctor "I know better" to listen to me. I have been targeted on the forum here. So why do I persist? Because it makes me sad to see that something may help, for even some people. I will tell you, though, that fasting and autophagy are medically recognised (2016 Nobel prize), and the FODMAP diet has been developed by proper scientific research in a first rate university (Monash in Melbourne). The only stretch I am asking a reader to make is that a diet developed for one autoimmune disease has an impact on another. And this aught to make sense as both of them have the same underlying cause, inflammation. So, I am not a supporter of pseudo-science. I know how to google on google scholar where the charlatans cannot hang out. I have no overall magical cure for psoriasis or psoriatic arthritis. I just know that for me an anti-inflammatory diet has lead to my own symptom control. Without immuno-suppressing drugs! I have just come out of hospital after a bout of pneumonia. Where would I have been if I had been taking methotrexate? wendyloish

Posted Tue 30 Apr 2019 22.01 by Kate Dunbar

Hi Wendy, I am in the UK and a patient advocate for the Plant-Based Health Professionals UK who use evidence based research to promote the way of eating that I also follow. I am off my methotrexate and completely pain and symptom free for over a year from psoriatic arthritis and psoriasis of 17 years (18 1/2 years ago diagnosed). I am Wholefoods Plant-Based Vegan. I don't drink either. If you have not heard of the diet check out Forks Over Knives website, and Nutritionfacts.org and Dr Gregor...both not for profit sites. When I was really sick, I was bed-bound for 3 months, nearly lost the sight in my eye from several bouts of iritis, and could not get off my meds as a vegan....just lowered them. I am running now (aged nearly 56!) and signed up for my first half marathon later this year! My story is on this page: https://www.plantbasedhealthprofessionals.com/patient-stories I believe I have healed my gut and have a healthy microbiome, and can now eat fruits such as apricots and plums, dried fruit that I was intollerant of before. Animal products, fats and sugars bring back joint symptoms. I have heard of FODMAP.....but there is the one diet where you eat animal products, and then a vegan version as well. I have friends and aquaintances who are also following this diet and have reversed their own diseases too. Good luck with your diet and health. If you are interested I will tell you more :-)

Posted Tue 30 Apr 2019 23.24 by wendyloish

Hi Kate, Thank you for your response. I have a son currently staying in a monastery in Burma who is doing the vegan thing and I have been talking to him about this. But I have a problem. I have irritable bowel syndrome along with my psoriatic arthritis (and a list of other health issues). My gut already reacts to wheat and dairy and now I find I have developed a problem with peanuts. Pulses are out, as are soy products because they inflame my gut as well. So if I were to cut out all animal products from my diet, where would my protein come from? With this new adverse response to peanuts I have begun researching food allergies as a possible source of my health problems and I have already identified a possible allergy source, non IgE allergic reaction. This looks like a promising lead as it fits in with my family history, but I need more work to confirm this. In the mean time I have decided to do some elimination testing. One thing about irritable bowel, you know pretty quickly what has an impact! So back to the point. If I eliminate the most common allergens (eggs, tree nuts, peanuts, shellfish, wheat soy and fish) from my diet, as well as the things that have already gone (like the high fructose fruits), what source of protein will be left besides meat? I will be looking at this over the next couple of weeks, but suggestions would be welcome. I had a quick look at the Forks Over Knives website, scrolled through some recipes, but they seemed to feature such things as wheat, oats and soy. I will look into what you have said further. wendyloish

Posted Thu 2 May 2019 00.11 by Kate Dunbar

Hi Wendy, Poor you! It sounds awful. You are in conundrum! Take a look at https://www.paddisonprogram.com/about/ This program has helped many people and starts off with gentle healing foods. I know someone who has followed it and cured their RA. Are you getting support from a nutritionist? https://nutritionfacts.org/2012/09/20/why-meat-causes-inflammation/ https://www.monashfodmap.com/blog/low-fodmap-vegan-guide-how-to-get/ Normally, protein is the least thing to worry about as a vegan because apparently in the West we eat far too much protein anyway, and contrary to what we have all been told, protein is actually in lots of plant foodstuffs (if you can tollerate them)..it's where the animals get it from.. It is fibre, which feeds our healthy microbiome, that we get too little of. I am so sorry that you are in a tricky place right now but hopefully not forever! I did an elimination diet initially and it was very helpful. I am really conscious of feeding (and breeding) my good gut bacteria with the stuff they love, and find I can eat all veggies, grains, fruits etc now no problem. But I am lucky as my gut was not as sore as yours. I know it is all incredibly complicated, and we are all trying to find our way through the complexity. It is good that you are taking charge of your own health and body….you know best where that is concerned :-)

Posted Thu 2 May 2019 06.25 by wendyloish

Hi Kate, Thanks for all that. I will have a look at the sites you have recommended. Give me a week and I will get back to you. I think my current problem has been exacerbated by having pneumonia at the end of March. It took 4 days of intravenous antibiotics and two weeks of post hospital oral antibiotics to get it under control. My gut was in a precarious place before that, now I think it is just plain trashed. At 72 I am not quick to heal any more. I am back on the eggs already as a protein source, and they seem to be OK. I plan to try fish at the end of next week. The vegan FODMAP intrigues me. Thanks again. wendyloish

Posted Mon 6 May 2019 22.35 by wendyloish

Hi Kate, I had a look at the sites you suggested, and they were rather long on the testimonial side and short on the science side. Still I do not totally discount them. However CSIRO (the Australian Government research body) has come out with a book on diet that emphasises the importance of protein. I did a bit of digging on this subject and found that with age a person develops ANABOLIC RESISTANCE, which means that they become less able to take up protein from diet. This is what causes people to become weak in old age. To counter this a person needs to increase their protein intake as they age. 3 times a day is suggested I am 72. I should therefore have a relatively high daily protein intake. 1g to 1.3g per kg per day seems to be the amount (see harvard.edu). For me that would be 100g odd per day. I have looked at the protein content of various foods. If I exclude meat, fish and eggs, and taking out the pulses which I cannot eat because of my irritable bowel, I am only left with tofu (made from a pulse). I could eat tofu 3 times a day, or I could eat 20 medium potatoes, 40 something stick of broccoli, 20 large ears of corn, etc per day. You see the problem? My conclusion is that vegan is not a viable alternative for me. Luckily, I live in rural Victoria where the cows and sheep still wander around paddocks eating grass, so the meat is reasonable quality. Dairy is out for me as recently I have even had problems with the cheeses that FODMAP allows. Thank you for your advice, but I cannot follow down the vegan path. I am glad it has worked for you. I guess FODMAP is probably the best I can do for me. It has certainly allowed the psoriatic arthritis to go into remission (to borrow a term from elsewhere). FODMAP was not designed as a permanent diet, but whenever I stray from it there are consequences. wendyloish

Posted Wed 8 May 2019 21.10 by Kate Dunbar

Hi Wendy, The meat is probably what is causing your gut issues, even though you may find that hard to believe. My husband is fully whole food vegan and has no protein issues. He is 77 and used to have irritable bowel amongst other conditions. He is super well now. All the links I have sent you are science and evidence based, and not influenced by profit. Here are some other links that might help you; especially interesting is the podcast to do with the microbiome, and the talk by Gastroenterologist Dr Alan Desmond. Good luck with your health, whatever path you choose. Very best, Kate. Colon Cancer fact sheet: https://docs.wixstatic.com/ugd/0bb022_c9e0f02c741946598608fb6fca7df7c4.pdf Dr Will Bulsiewicz podcast on microbiome: https://plantproof.com/building-a-healthy-gut-with-dr-will-bulsiewicz/ Dr Alan Desmond: https://www.youtube.com/watch?v=-X3rQbOynXA Reversing Arthritis on Plant-Based Diet: https://www.facebook.com/wholefoodplantbasednutrition/videos/401626553767343/ How a plant-based diet can change your world; Dr Alan Desmond: https://www.facebook.com/wholefoodplantbasednutrition/videos/378959552959603/ Statement from Nutrition Facts .Org https://nutritionfacts.org/about/

Posted Wed 8 May 2019 23.10 by wendyloish

Hi Kate, Thanks for the response. I will look at the references you have suggested. But have you considered the problem of anabolic resistance? Your husband may be superwell, but also slowly losing his muscle tissue. My brother is 76 and it is noticeable how much muscle bulk he has lost in the last 20 years. One of my sisters, aged 70 next month, has been vegetarian for much of her adult life. (I think she might occasionally eat fish) I am not sure she is any healthier than I am. We all suffer from psoriatic arthritis. My brother I have persuaded to go on FODMAP, and this has helped him a lot. My sister swears by tumeric and, like me, she does back stretching exercises. I am worse than either of them, but I am obese, so that would be to be expected. I look to them and my son as people with shared genetic history. I suspect other people with different genetic makeup might have more of a problem with meat than I do. My ancestors were Northern European, and they went from hunter gathering to farming at a relatively recent time. And a lot of their diet was seafood. Fish. Cod in particular was important, and they got their vitamin D from cod liver. So from a genetic standpoint, I would expect that I would be genetically adapted to a diet with a significant seafood intake. Incidentally, while I am on FODMAP I do not have gut issues. Except for my recent problems with FODMAP allowed cheese and peanuts. Now I have eschewed them my guts have returned to normal. I do have meatless days, though. I suspect that might be the way to go. wendyloish

Posted Wed 8 May 2019 23.51 by Kate Dunbar

Hi Wendy, You seem to have done a lot of research into your diet and that of your family, which is really interesting. There is bowel cancer in my family, so I have to be careful of that. My mum also had psoriasis and really bad psoriatic arthritis, Her hands were terribly deformed and she was on a lot of medication, for that, irritable bowel and serious depression......now all thought to be linked possibly, to the microbiome. My son has inherited psoriasis and the arthritis too, but follows my diet now. I have just looked at this paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424190/ It seems to suggest that obesity and insulin resistance can play a part? Diabetes is also a dietary disease and contrary to what many believe, linked to high fat intake, particularly from animals: https://docs.wixstatic.com/ugd/0bb022_cfa420e01c4b43f8a3a408a83e13377c.pdf My hubby is pretty fit and runs a bit and shows no sign of muscle loss. He does quite a lot of physical work outside also. He looks much fitter and more well than may people over 10 years younger. In fact, he was more ill 10 years ago before adopting my diet. He was diagnosed by a lung x-ray of having emphysema ( no known cure) and arrhythmia. He still has arrhythmia, but so do a huge percentage of the population apparently. But no sign of emphysema now. He has been signed off from the clinic. They couldn’t believe it! I am signed off from my consultant rheumatologist's clinic also. He was incredibly surprised also, especially when I showed him my running medals! I probably sound completely potty to you, and twenty years ago, I would have agreed! I feel so so lucky to have found a way to heel both myself and my husband….and some friends also actually. Anyway, I hope you work out what is best for you and your lovely family. Very best wishes Kate

Posted Thu 9 May 2019 04.03 by wendyloish

Hi Kate, Thanks for you prompt response. I am very aware of diabetes. The weight problem seems to be a by-product of my thyroid problems. I had a thyroid tumour over 3o years ago and had half of my thyroid removed. As a result I developed Hashimoto's thyroiditis (hypothyroidism). This is another aspect of autoimmune attack. The weight gain followed this, and as anyone on thyroid medication will tell you, it is extremely difficult to lose weight once you have thyroid issues. Every GP I have ever had has been obsessed with my diabetes risk factors, but so far I have avoided the problem. I think it is because of my obsession with diet. So I don't think you are potty. In fact I think you are very well informed and maybe a little obsessive about diet, but them so am I, and I attribute my being able to control my symptoms, more or less, to the effort I have gone to in that regard. Best wishes to you, as well. wendyloish

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