Terry’s Experiences
A description of Terry’s experiences with psoriasis and its treatment.
I’ve found diet extremely effective in controlling psoriasis. Experience has taught me that there is precious little besides water that I can drink on a regular basis. Beyond that I eat a variety of lean meats in smaller quantities and I minimize my dairy consumption. I try to cope with tendencies to addiction and gluttony by limiting myself in a week to some coffee on weekends, a serving or two of ice cream, a pastry or two and one carbonated or alcoholic beverage per week. Below are more details of my experience, thoughts, and opinions.
In the late 60s a college acquaintance showed me a long list of proscribed foods and beverages distributed by the National Psoriasis Foundation, in Portland, Oregon. (All traces of the list have long since vanished from the institutional memory of the NPF.) She had found it helpful when she could bring herself to follow the advice. I was interested but extremely resistant to the idea of having to eliminate forever — without absolute proof of necessity — all consumption of such things as coffee, tea, alcohol, carbonated beverages and cigarettes from my life. I have long since paid the price for my folly. I spent years in total denial about any dietary relationship, years of physical misery, expensive, risky, ineffective treatments sanctioned by the medical establishment and more years of frustrating experimentation on my own. Now, I think I have a good handle on it.
Diet is not always easy, but it is free, safe and the only thing which has worked consistently for me. I occasionally use Neutrogena T/Gel shampoo, but I haven’t used other tar, cortizone ointments/creams,UVB or PUVA in years. I never did Methotrexate (MTX), but I did try an experimental drug, some heavy-duty metabolic poison to slow rapidly dividing cells, which was probably just as scary, requiring liver function studies. It didn’t do much, and it was withdrawn from trials while I was still taking it. At various times sunbathing has helped, and at others it made my skin worse. I think the difference in response at any given time was dietary. I’ve used a little sunbathing to speed up clearing from my last folly with coffee, and it didn’t taken much to produce good results. I suspect that anything one is already doing which is at all effective will only work better with dietary support.
Given that the Bible’s Book of Leviticus — in the section dealing with skin diseases — contains a prescription for fasting in the desert in order to distinguish between leprosy and other white or silvery, flaking skin conditions, it would seem that a recognition of a common dietary (and maybe UV) relationship may be an ancient one. It was also observed in WWII that the skin of Allied prisoners cleared with prison camp diets. I’m an unabashed hedonist, not into starvation, and I have not found it necessary. I have no doubt thatJohn Pagano’s diet is effective for those who can follow it, but from what I’ve read it has seemed impractical, much more extreme and difficult than it has needed to be for me. I haven’t been inspired to buy his book. I aim for gourmet instead of gourmand. I find it important to distinguish between absolute avoidance and minimizing or avoiding regular consumption, which may be difficult enough when addiction is involved.
Triggers
I do not think that the allergy model applies — except, perhaps in the special case of pruritus (itching), which may be an allergic complication. I have found it more useful to think in terms of what foods have in common than in eliminating particular ones — other than the beverages. I think that the factors to watch are fats and maybe protein, acids, and, I think, what may be a lengthy list of the compounds plants use to defend themselves against being eaten by more vulnerable creatures than we: caffeine, tannin or tannic acid (tea and grape skins), lectins (beans), solanines (peppers, tomatoes, potatoes) and vitamin A. Daily or regular consumption of alcohol, coffee, tea, juices or carbonated beverages does not work for me, but, even knowing that, I sometimes delude myself into re-testing limits. I have also found that it was easy to give up one beverage only to subsitute for it another just as bad, which led me to the mistaken conclusion that I had no problem with the first. I believe that giving up the beverages other than water is a rational place to begin with a simplification of one’s diet, as they are either nutrionally expendible or worthless.
Fats
It was the opinion of health food guru Adelle Davis that psoriasis was the result of faulty fat metabolism. I think fat consumption is definitely a factor. I don’t know if it matters whether the fat is animal or vegetable, but, for whatever reason, Dr. Andrew Weil has also advised avoiding pro-inflammatory oils (all polyunsaturated vegetable oils, margarines and partially hydrogenated oils). I think he is correct in this. Fats seem to show up particularly as psoriasis on my scalp. (Test it yourself with french fries and donuts!) I aim for low fat consumption, keeping my salad dressings light, both in oil and acids. I would use olive oil, but I am allergic to it and to olives. I cook with peanut oil or canola, and I use small amounts of butter. There is some thought that the fats in coldwater fish (such as tuna and salmon) are beneficial. I can’t say I have noticed any effect from taking Omega-3 oils on a regular basis, but some report it is a useful thing to do. I probably eat fish a couple of times a week or more. Dr. Stephen Barrett has some useful suggestions for reducing fat in one’s diet.
Protein
I don’t know to what extent my problem with meats is the protein and to what extent it is the fat. I haven’t found a significant difference between red meats and poultry. I eat a variety of meats, usually in small quantities (think “Oriental” or meat as flavoring). I find support in the nutritional belief that Americans consume way more protein than is necessary or good for them. I have not been able to bring myself to try the so-called Paleolithic Diet, eating meat and fats instead of grains/cereals; I’ll leave that to some other brave soul.
Carbohydrates
I don’t know if carbohydrates are a factor or if it is a matter of the particular proteins or amounts of proteins associated with different sources. I seem to do better with more rice or even corn, than lots of wheat/oats or potatoes. I’ve found some wheat products, such as English muffins, extremely constipating, and that, whatever the effect of wheat, does not help my skin. Clearly fat is a major consideration in the consumption of pastries. I find it easiest not to try to keep cookies around the house. If I buy a bag of Milano cookies they are gone that day. I found improvement when I quit my morning regimen of oatmeal, doing better with a wheatless, honey-puffed cereal from Trader Joe’s. I do not attempt to avoid all consumption of wheat and oats; I’ve merely reduced it. I have potato maybe twice a week.
Sugar
As with caffeine, I have been unable to ascertain the degree to which it may be a factor for me. It is certainly a component in foods and beverages which cause me trouble, but sugar-free versions of the same will also cause me trouble. Cutting out those foods which are high in sugar might well be useful for other reasons. I suppose one might test the sugar factor by drinking plain sugar water or eating lots of plain sugar, but I am not inspired to do put myself through that.
Dairy
I confine regular or daily consumption of dairy to grating parmesan on salads and a little 2% milk on cereal. Obviously dairy is high in fat content; I also find it very constipating. The last time I drank milk on a regular basis the back of my neck broke out badly with psoriasis. If I am a guest or eating out, I don’t worry about cheese or ice cream; I don’t try to keep them in the house, as I don’t trust my will power when it comes to rationing them. As for the constipation, I would rather modify my diet than take laxatives. Pagano prescribes enemas for “purifying” the intestine, but I cannot imagine they are of long-term benefit and might actually be harmful.
Yeast
I have read of evidence of a higher titre of particles of yeast and other intestinal bacteria in the bloodstreams of psoriatics. I suspect that yeast can at the least be a complication. It can infect psoriatic tissue. I think it might be wise to avoid consuming large amounts of combinations of things that cause yeast to flourish, e.g., grains with sugar and/or fruit/juice. I gather there are some yeasts that live on fat. Years ago I tried doing an anti-yeast diet, taking Nystatin, with no apparent result. I don’t think there is much point to trying to eliminate all yeast from one’s system, as yeast is everywhere. I am curious about rumors regarding the benefits of particular antibiotics for psoriasis, but I would hesitate, myself, to take any on a permanent basis.
Caffeine
I have read that caffeine has been found to stimulate cell growth. I don’t know the extent to which it contributes to my psoriasis, as decaffinated varieties of all of the same beverages also cause me trouble. I do think that it contributes to flaking. (Test it yourself by washing down those donuts with coffee and seeing how your scalp does the next day.) Caffeine has been implicated in pruritus (itching), but it has not been a significant factor in my psoriatic itching, which has been, mercifully, rare. I am very suspicious of the role of caffeine in psoriasis, as it is one of the compounds which plants have evolved to defend themselves against being eaten. I am at least as intolerant of tea as coffee. Eating large amounts of chocolate (a pound in two or three days) makes my skin worse; I don’t think small quantities hurt.
Pruritus (itching)
Back in the early 70s I was told by a dermatologist at the U. of Oregon Med. School that psoriasis does not itch unless there is an allergic complication, a reaction to something topical and/or dietary. It is the most useful information I ever received from a dermatologist. It seems to me that one of the reasons I quit topical cortizones, many years ago, was the conviction that the itching was related to whatever cream or ointment I was using at that time. I have also sought out hypo-allergenic moisturizers. Clearly another possibility would be itching as a result of yeast infections of psoriatic skin, especially in those moist, warm places where yeast infections are most common. I associate my worst episodes of chronic itching of plaques with consumption of whole wheat and cheese. I associate dramatic flares of scarlet, itching psoriasis in the pectoral regions with having consumed combinations of large quantities and multiple meals of whole wheat, beef/onion/potato stew, and beer/wine. I can easily imagine such a diet leading to the need for my hospitalization for heat loss. The condition cleared after several very, very unpleasant days.
Stress
I don’t regard stress as a problem in my life. I long ago conluded it is largely relative to one’s perspective. I have never been persuaded that stress plays any role in my psoriasis, but I have noticed that both psoriasis has caused me a lot of stress and that caffeine (coffee, tea, and chocolate) increases my stress level dramatically. I know I tend to eat and drink differently in times of stress; I can easily imagine that other people do, also.
Seasonality
I haven’t noticed any seasonal difference, myself, but I can imagine that differences in beverage consumption and diet might account for it.
Legumes
I have conjectured that the problem I’ve observed with large/regular amounts of lentils and the dried beans (such as pintos and kidneys) is due to their lectins, but they are also high in protein. At any rate, they’ve caused me a dramatic reddening of existing plaques; so I do not eat them daily or in large amounts. I have not found a problem with fairly regular or large consumption of peas, green beans, limas, or garbanzos (chickpeas) — except maybe for gas! Eating some peanuts (dry-roasted or blistered) seems to work for me; eating peanut butter on a regular basis does not. The difference may be in the hydrogenated or partially hydrogenated oils. I do not have an opinion about soy beans; I haven’t seen a problem with soy sauce — which I think is on Pagano’s taboo list.
Nightshades
I have not observed any problem with consumption of the occasional fresh tomato, green pepper, chile, potato, or eggplant. I use paprika. I’m not likely to eat more than a couple of potatoes a week. I don’t happen to eat eggplant often; I’d be more concerned about the amount of oil with which it is usually prepared, and I happen to be allergic to olives/olive oil. I do avoid any daily consumption of concentrated tomato products, such as juice or soup; I minimize tomato sauce on pasta. I do not worry about condiments, such as catsup, which is likely to be the least of my problem with French fries. :)
Tobacco
I was a moderate smoker for about thirteen years. When I quit I did not notice any improvement in my psoriasis, but there was a definite improvement in my circulation, and I think the texture and feeling of myskin improved. Psoriasis quite aside, I think smoking was a really bad idea, and I would encourage anyone to quit anyway.
Nails
Carbonated beverages and alcohol both wreck my nails, and I’m also suspicious of the effects of large amounts of either juice or coffee. Alas, it takes a long time for them to grow out, again. My latest experiment with a small amount of daily coffee seemed to result in brittle toenails. I also have some concerns about the possible role of sugar in nail involvement.
Palms & Soles
I haven’t had trouble with them except when drinking carbonated beverages on a daily basis. They have always cleared pretty quickly. For me they have always been the last place affected. (I think the scalp may be the first.)
Fruits & Veggies
Eating a variety of fresh fruits and vegetables works for me; drinking large, daily amounts of juices does not. I conjecture that the problems with juices are a combination of acid, perhaps additives such as preservatives and vitamin C, and in the concentration of those marvelous compounds plants use to ward off insects. One could probably replicate the effect by eating large amounts of particular vegetables. I avoid large, regular amounts of those high in vitamin A. I’ve found large amounts of summer squash, cauliflower and mushrooms harmless.
Spices
I haven’t isolated any spices as being a significant problem for me, but then I don’t eat chiles or curries on a daily basis. I don’t worry about them. Life is short. MSG gives me headaches, which is, I gather, a common response.
Dietary Supplements
Taking daily multiple vitamins has made my skin worse — a gradual process — and taking vitamin C daily has also given me dramatic rheumatoid symptoms in my knuckles. I haven’t observed that vitamin E helped my skin, but it was sure great for my libido — alas, it also hastened hair loss associated with male pattern baldness, which seems a rational, hormonal relationship, as E stimulates the production of testosterone. I tried lecithin years ago — on the advice of Adelle Davis, I think — but I did not notice any effects. I have found some benefit from 50 mg daily of grape seed extract (an anti-oxident), a daily B-complex and EPO. (I was initially more interested in the relationship between B12/folic acid and reducing the risk of heart disease.) Andrew Weil suggests GLA or gamma-linoleic acid, found in black currant and evening-primrose oil, suggesting a two-month trial. (He says the former, in doses of 500 mg, twice per day, is cheaper.) Others have reported good results with their nails, in particular, and I think my experience bears it out. The effects of EPO and the B-12 are not rapid. I am not optimistic that there exists some magical supplement which would permit loss of all dietary restraint. Weil also suggests taking beta-carotene, but I think he is misguided in this, as I believe it stimulates skin growth, and that would seem the last thing anyone with psoriasis would wish to encourage.
I have found it very useful to consider how my diet (including beverage consumption) changed when my symptoms first appeared or got worse (beginning with the increased dietary autonomy of adolescence), and I find it useful to pay attention to diet and what is going on with any particular place on my skin. Dietary things can sneak up, but if there is affected skin to study, some reactions may be observed within about a day. It’s your skin; pay attention to it; study it; play with it. Go ahead and prove to yourself that too much of something makes your skin worse and is something which should be moderated. It is reversible. Absolute avoidance of most things is probably not necessary; regular, daily consumption may be. Gain some control.
There are those who believe that diet has absolutely nothing to do with their psoriasis. It took me years to discover it for myself. I think there is a lot of resistance and denial related to it, and I think the complexity of variations in personal diet make that very difficult or impossible to know, as does the extreme difficulty in knowing the care and reliability with which observations have been made. I also think it is possible to achieve different balances. I am merely offering my personal experience as a possible starting point for dietary explorations by those with interest in doing so. What I happen to believe about any universal relationship between diet and psoriasis seems irrelevant; it is something that anyone can explore for oneself. It’s something I would want to try before doing PUVA, MTX, trips to the Dead Sea or injections under or removal of finger/toenails, but that’s just my personal opinion now, having first tried the other way.
Finally, at the risk of sounding mystical, I think I would recommend a commitment to personal growth, as a means of getting in touch with one’s relationship with food, in particular. We are all addiction prone. It is a means of avoiding unpleasnt emotions, like pain and fear, a futile and destructive effort to fill the void. Don’t try to fill the void, just jump on in. It might also be useful to examine how the condition affects you emotionally and to consider what it prevents you from doing or having to do.
Love is the right place. Walk in beauty.
— Terry