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Psoriasis and Celiac Disease 10/12/2009 - I recently read an article in The Economist, of all places, that intrigued me.  Titled, “Breathe Easy”, (The Economist, May 23, 2009, page 85) it explained a link between eczema and asthma.  What intrigued me was the mechanism:  researchers showed that a signaling molecule called thymic stromal lymphopoietin (TSLP) secreted by damaged skin cells can enter the blood stream  and eventually sensitize the lungs to react to what should be harmless allergens.

So, why my intrigue?  Well, I am severely gluten intolerant and have had psoriasis my entire life.  Natural doctors bemoan the fact that my ultra sensitivity to anything and everything (from vitamins and whole-food supplements to Chinese herbs) prevents them from being able to help me.  I wondered if TSLP from damaged psoriatic skin cells had sensitized my gut to react to what would otherwise be harmless food substances. 

A quick search proved quite helpful.  First and foremost, Scott Adams had already reviewed an article that established a link between celiac disease and psoriasis back in November of 2004 (Br.J. Dermatol. 2004 Oct;151(4):891-4) 2004).  Also, a peer-reviewed journal search yielded hundreds of results that showed this was not one isolated study.  So, what about celiac disease and asthma?  Well, once again, a quick search of the site showed many bloggers and authors personally discussing this very link. 

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Next, I went to the medical literature in the hopes of finding whether or not TSLP could be considered the culprit for hyper sensitizing me to an ever increasing list of food substances—gluten is only the start.  Researchers have proven that elevated T cells (Bulletin of Experimental Biology & Medicine. 2004 Mar; 137(3):302-7) and eosinophils ( Allergy & Asthma Proceedings. 2004 Jul-Aug; 25(4): 253-9) are found in the intestinal mucosa of patients with asthma thus proving a link of lung mucosa to gut mucosa.  If elevated TSLP from damaged skin cells could lead to asthma, and the mucosa of the lungs is linked to the mucosa of the gut, then hypothetically elevated TSLP could lead to a hypersensitive gut. 

In other words, damaged skin cells from psoriasis elevate levels of TSLP and patients with psoriasis often have celiac disease.  There is also a link between TSLP and asthma and a link between asthma and celiac disease.  Thus, it could be argued that the TSLP from damaged skin cells plays a role in sensitizing the gut to previously harmless food substances.  Now if only a researcher out there would design a study to prove me right!

What does this to for me?  Not much at the moment, although, I do find it incredibly interesting.  What can this exercise in possible commutability do for all of us?  Maybe train us to view our bodies as an entire, interrelated system and to take our skin lesions seriously.  What do I do to keep my psoriasis at bay?  I hold fast to the gluten free diet and consume vast quantities of fish oil which, incidentally, also aids in restoring a damaged intestinal lining… welcomes your comments below (registration is NOT required).

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9 Responses:

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said this on
02 Nov 2009 1:57:35 PM PDT
Jennifer, thank you for your thoughtful article. I had asthma as a child and was finally properly diagnosed with celiac disease five years ago, after a lifetime of problems. You mention fish oil, but with psoriasis I hope you are also mega-dosing with the B vitamins. Under stress I take 5000% of the daily requirement of B5 and B6 especially. The part of the intestine that absorbs the B's is the part most likely damaged by celiac. Also, beware of xanthum gum. As another super sensitive I can tell you it can be highly allergenic. thanks again for the great inquiry.

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said this on
05 Nov 2009 5:41:33 AM PDT
Rita, I appreciate your comment. I have recently found a B-complex that I tolerate well (Solgar B50) - around 2500%. I will watch xanthan gum. I know I don't tolerate tapioca, which is in a ton of gluten free products.

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said this on
01 Jan 2010 6:44:20 PM PDT
I was diagnosed Celiac 10 years ago but have just recently developed psoriasis. What does"vast quantities of Fish Oil" mean exactly?

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said this on
02 Jan 2010 5:05:13 AM PDT
Someone asked me what "vast quantities of fish oil" really meant. Since writing this article, I have recently changed my regime and now add about 1tsp of Nordic Arctic brand of fish oil to half a tablespoon of Hemp oil. Since it's a food, though, I will increase the fish oil according to need or how I feel I'm responding to it, so I can't give you an exact amount. I also have noticed with psoriasis that I have to really limit refined gluten-free carbs. I hope this answers your question.

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said this on
24 Jan 2010 8:36:44 AM PDT
Psoriasis is a disease whose main symptom is gray or silvery flaky patches on the skin which are red and inflamed underneath. In the United States, it affects 2 to 2.6 percent of the population, or between 5.8 and 7.5 million people. Commonly affected areas include the scalp, elbows, knees, arms, stomach and back. Psoriasis is autoimmune in origin, and is not contagious. Around a quarter of people with psoriasis also suffer from psoriatic arthritis, which is similar to rheumatoid arthritis in its effects. Psoriasis was first given that name in complete differentiation from other skin conditions by the Austrian dermatologist Ferdinand von Habra in 1841, although there are what are believed to be descriptions of the disease in sources going back to ancient Roman and possibly even biblical times.

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said this on
31 Aug 2010 8:38:21 PM PDT
Great read I had been thinking there was a link between celiac disease and Psoriasis. After my last flare up (caused by Phototherapy) I did some diet research and found a Psoriasis diet that was gluten free wheat free and night shade free. I started late March this year and had my skin totally clear by late June.
It seems chloramine might also play a part in causing flare ups and since most water systems use chloramine.I've also only been drinking spring water.To me dr.s really should be looking into hypersensitivity of the gut/liver in a main role in causing Psoriasis.My main guidelines to keeping things under control are 1/Keep the alkaline foods to a minimum (NIGHTSHADE foods)
2/Eat gluten-free wheat-free foods
3/drink spring water
4/cut refined sugars to a minimum
5/exercise daily and get good amount of sleep
Sorry for going on and on but If I can add anything to this situation which will help someone out there I'll be happy.

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said this on
04 Feb 2011 1:32:55 AM PDT
Thank you for comment; 11 year old daughter suffering with psoriasis of scalp for more than 1 year. What I was told at the pediatrician's office was less than what I found on-line and what I read there did not include anything on nightshades and chloramine. I will look into that. Thanks. Unfortunately, psoriasis hit after she'd been gluten free for nearly 3 years.

...and to Jennifer--Thank you for this article. Helps me understand the mechanism for 5yr old/eczema-laden son's elevated risk for asthma (I pray it doesn't hit him!)

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said this on
22 Oct 2010 12:22:17 AM PDT
I suffered from moderately severe asthma as a young child, as the doctors said I grew out of it. I acquired (for lack of better terms) psoriasis at the age of 8 and have dealt with creams, injections, biologics, you name it. About two years ago I cleared my skin without any drugs, but i don't know how I did it. I was exercising, taking evening primrose oil & fish oils, eating healthier, but mainly I was gluten free. I went off of my gluten free diet when I got onto a new medication. I am now back to being gluten free but am tempted to get off of the cyclosporin and attempt my GF diet again. Point in case, I also believe there to be some connection between digestion & allergies to psoriasis; this article just opened by eyes to the third piece of the puzzle, my adolescent asthma.

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said this on
26 Jul 2012 6:39:59 AM PDT
This is very informative for a doctor, also. Thanks!

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If you're going to continue to push for a diagnosis stay on gluten! A break could lead to a false negative. It's a lot harder to go off it and then go back on...

I still prefer steaming, but I wash my white rice throughly. I purchase California rice which has a lower level of arsenic. Moderation is key to most everything! ?

I eat pretty much grain free just fine, I eat fats instead. But on a side note I posted some specialty and grain free options as of late in the food alternative page where I list companies and food product alternatives. I honestly just welcomed bread back into my life, I found a company that makes grain free bread out of nut flours. Given you have to toast the dang bread to use it well but seems to work decently. Pasta there are carb free versions out there, and there are ones made with quinoa, buckwheat, or other grains, I even know one company that makes nut flour based ones. You can get these gluten-free options and avoid the rice. As to levels of arsenic they do test foods for these, and all should be safe, the trace amounts and the sheer amount you would have to eat to get effected is staggering, a bit of rice will not hurt you regardless if your concerned I know gluten-free watchdog does arsenic testing on products you could check and find the "safest ones" for your concerns.

I've forgotten them, just remember the good stuff. Weekends in Baja or Vegas or up Pacific highway to see the Redwoods and Frisco. Watching the sunrise at Mount Soledad and watching it drop into the Pacific in the evening. Carne Asada Burritos on Garnet* Solana beach ale* Gorgeous women entranced by my exotic accent, humboldt county weed, raves at the romper room, *1.99 are you out of your mind Denny Breakfasts, Christmas on the beach, *Beers in the gaslamp quarter. I need one of these * which by the power of my imagination have magically become gluten free AANNNYWAAY... Arsenic in rice. Yeah.

Oh, it definitely struck me as very odd! It also says "no significant increase in intraepithelial lymphocytes". That's their favorite word I guess! My blood work pre-biopsy also showed increase lymphocytes and my primary doctor said it usually means increased inflammation. Doing all the things I can now---filing a complaint, I've emailed my doctors to tell them I'm upset and don't think I received proper care, I'm in the process of trying to see a naturopath that diagnosed a friend of a friend w celiac. I'm going to see if i can get the other blood work done with them---and I've been gluten free for a week and a half!