Naturopathic Newsletter January 2009: PSORIASIS

January 2009

JANUARY 28th at 12pm, I will be giving a lecture at the Ville St-Laurent Library entitled Demystifying Stress, discussing how stress impacts our physical, mental and emotional health. For more info, pls contact Elaine Sauve of the VSL library at #514-855-6130 ext 4726. 

Wednesday nights starting FEBRUARY 18th until March 25th, from 7:30-9pm, I will be giving a 6 part lecture series on the Foundations of Naturopathic Nutrition as part of the Continuing Education Department at John Abbott College. For more info, pls contact Jocelyne Duchesneau at #514 457 6610 ext 5277.

MARCH 9th at 10:30am, I have been invited to discuss Naturopathic Medicine by the Senior Group of Dollard-des-Ormeaux.

MAY 4th at 7:30pm, I have been invited to discuss Cancer Fighting Foods by the West-Island branch of the Cummings Center.

Since opening my practice nearly 4 years ago, there has been little to no increase in the price of supplements. In light of inflation and increased shipping costs, I have had to review this matter and bring the price of the supplements to par with the times. I thank you for your understanding.

I would like to take this opportunity to share an exciting development in my professional life. I have been invited to be part of the health team at Millennium Health Center in Cornwall, Ontario. I am visiting with patients on Fridays, and I look forward to all the new and exciting experiences that this projects continues to bring. 

Weighing 6 pounds in the average adult and covering an area of two square yards, the skin is the largest organ of the human body. The functions of the skin include: the synthesis of vitamin D, the regulation of body temperature, a player in immune function, and an organ of elimination. When looking at skin conditions, the latter two functions of the skin, both immune and eliminatory, are of central importance. These two functions provide a window into the holistic approach of skin conditions, where underlying causes are assessed and addressed. This article will discuss underlying factors involved in the development and propagation of skin conditions, in particular psoriasis, as well as highlighting naturopathic therapeutic approaches.

 

Psoriasis is estimated to affect 2-4% of the Western population, most commonly Caucasians, with an equal prevalence in both sexes. Although psoriasis can occur at any age, the average age of onset of chronic plaque psoriasis is 33 years old. Interestingly, 30% of sufferers have a family history of the condition. Although several subtypes of psoriasis exist, 90% of cases are characterized by chronic plaques. This subtype includes sharply demarcated red, scaly, silvery patches occurring most commonly on the extensor surfaces of the elbows, knees, scalp, sacral region, and groin area. Acute flare ups can demonstrate the Koebner phenomenon, in which new lesions form at the site of trauma or pressure. Also, pinpoint bleeding when the plaques are scraped is a positive diagnostic criterion called Auspitz's sign  

Although the cause of psoriasis is unknown, we are gaining greater understanding into the underlying biochemical processes of this condition. As mentioned above, the skin is a member of our immune system that helps to protect us from unwanted microbes, such as bacteria and viruses. When immune function goes awry, as implicated in psoriasis, inflammation is triggered, causing a hyperproliferation of keratinocytes (cells found in outermost layer of the skin), and the subsequent formation of psoriatic skin lesions. 

The ultimate question is: what triggers this inflammatory response in the first place? 

 

In approaching disease from a holistic perspective, let's look at potential triggers that have been proven to contribute to psoriasis, as well as those postulated based on clinical observation. Although the exact mechanism is unknown, it has been clearly demonstrated that both alcohol and cigarette smoking foster the development of psoriatic skin lesions. These unhealthy habits contribute the body's overall toxic load, which can hamper both the eliminatory and the immune function of the skin. 

 

As with most conditions, it is important to look at the possible involvement of prescription medications. It has been shown that medications such as beta-blockers (used for cardiovascular conditions) and lithium (used for mood stabilization) can be involved in the development of psoriasis. 

 

As with most conditions when viewed with the naturopathic lens, an examination of dietary influences is critical. Numerous studies have shown that psoriatic patients benefit from a whole foods diet high in cold water fish, legumes, whole grains, fruits and vegetables, while avoiding animal based protein, preservatives, additives, and refined sugars. Such a diet is high in anti-inflammatory unsaturated fats, low in pro-inflammatory saturated fats, high in fiber promoting elimination, high in antioxidants supporting skin healing, and low in processed foods that insult the body on numerous levels. 

 

An important dietary factor seen in clinical practice time and time again is the importance of identifying food intolerances. The presence of food intolerances can aggravate skin conditions, including psoriasis, by promoting inflammation, as well as by burdening the body's toxic load. The dietary culprits that I see most often in practice are gluten, dairy, and eggs. Testing for food intolerances can be discussed with your local ND. 

 

Similar to food intolerances, it is important to rule out the possibility of environmental and chemical sensitivities. The presence of such sensitivities is often overlooked by conventional allergy tests, including: household mold, laundry detergent, and accumulated heavy metals.

 

Of all the proven and possible contributing factors to psoriasis, we mustn't forget the role of stress. As with the majority of health issues, stress is a likely contributing factor. Many patients report the onset of disease correlating to a significant stressful event, as well as symptoms waxing and waning with the degree of stress in their daily lives. It has been tried, tested, and trued that stress contributes to a pro-inflammatory environment within the body, often causing the glass to overflow and spill over as dis-ease. 

Aside from the lifestyle and dietary options explored above, let's look at some well documented nutraceutical approaches to addressing psoriasis. 

 

Most inflammatory conditions benefit from supplementation with fish oils. In the case of psoriasis, these essential fatty acids have a threefold impact: first, they impact cellular communication supporting normal skin cell function; second, they improve blood flow within the different layers of the skin; and third, they have a balancing effect on the immune system, quelling inflammatory and hypersensitivity reactions. As a generalization, I recommend supplementing daily with 2-4 grams of high quality (screened for heavy metals) fish oils.

 

Antioxidants are molecules that quench free radicals, and thereby protect cells from oxidative damage. There are several antioxidants that have been shown to be effective in varied skin conditions, including psoriasis. This list includes: vitamin A (dosage should be monitored by your ND), vitamin E (400 - 800 IU daily), zinc picolinate (30 mg daily or twice daily), and selenium (200 mcg daily).

 

Currently, vitamin D is one of the most researched nutraceutical supplements, revealing, on the one hand, it's vast range of therapeutic effects, and on the other hand, it's wide spread deficiency in the North American population. Added to its list of benefits is psoriasis, in which vitamin D acts at the level of keratinocytes to support healthy skin. It is also postulated that vitamin D may benefit psoriasis via supporting immune balance. Discuss with your local ND the importance of having your vitamin D levels assessed, at which point the appropriate dosage recommendations for supplementation can be made. 

 

An important naturopathic avenue when discussing most skin conditions, including psoriasis, is assessing the individual's capacity for liver detoxification and toxin elimination. As discussed above, the skin is a major outlet for the elimination of toxins, along with the bowel, lungs and kidneys. If the other organs of elimination are not working properly, then they will put an extra burden on the skin. This can lead to a spill over of toxic material in the skin, aggravating conditions such as psoriasis. An assessment and individualized protocol for dealing with such matters is best done with your local ND, where dietary recommendations, along with a combination of lifestyle modifications, infra red saunas, herbs, nutraceuticals and homeopathic remedies will be discussed. 

 

As with most skin conditions, psoriasis is a multi factorial condition that warrants a holistic approach for an effective therapeutic outcome. I hope that this information provides some insight into that holistic approach, bringing you one step closer to achieving greater health and well being.