-IBIS-1.7.6-
tx
cutaneous system
psoriasis
Nutrition
dietary guidelines
eating principles:
Rule out food sensitivities: consider gluten avoidance
(Lithill, H. Acta Derm. Vener. Stockholm 63:397-403, 1983; Douglass, J. (Letter) California Med. 133(5):450, 1980)
Vegan diet
Avoid sources of arachidonic acid: decrease the ingestion of animal fats
Limit simple carbohydrates: Increased levels of both insulin and glucose have been noted in psoriatic patients. (Marz, p. 416. 1997)
Increase fiber in diet: Low fiber is associated with increased numbers of gram negative rods and diverticular disease, both of which contribute to endotoxemia which can activate the ACP and guanylate cyclase directly.
Weight reduction, if applicable
Chew food thoroughly
Vegetable juice fasting
Enhance digestion, correct hypochlorhydria (if applicable)
Elimination/rotation diet, rotation diet, rotation diet expanded
therapeutic foods:
Foods that tonify the Lung and clear Heat
Foods rich in Silicon and lecithin (Jensen)
Foods rich in Vitamins A, B-complex and E
Liver-cleansing foods: beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root
Increase omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil, black currant oil
Unripened dry prunes, guava skins, pearl barley, vinegar, garlic, walnuts, cucumber, beet tops, dandelions, squash, mung beans (Ni, p. 154)
Black bass, rye, avocados, sea vegetables, whey, apple, cucumbers, millet, rice polishings, rice bran, sprouts (Jensen, p. 63)
fresh juices:
Carrot, celery, lemon (Jensen, p. 63)
Cucumber, endive, pineapple (Jensen, p. 63)
Carrot (Walker, p. 151)
Carrot and spinach (Walker, p. 151)
Carrot, beet, and cucumber (Walker, p. 151)
Spinach (Walker, p. 151)
Carrot, beet, cucumber (Airola, p. 146)
Black currant (Airola, p. 146)
Grape (Airola, p. 146)
specific remedies:
Decoct dried, unripe pitted prunes into tea, then reduce into syrup. Take in 2 tbsp. warm water three times daily (Ni, p. 154)
Cut up and crush 250 g fresh ginger and soak in 500 ml white wine for 2 days. Apply externally to affected area three times daily-four times per day
Crush peeled garlic cloves, mix with sesame oil or lard to make ointment, then apply externally (Lu, p. 156)
Mix 20 g whole cloves with 70% alcohol to make l00 ml. Apply externally to affected area (Lu, p. 156)
Oil of avocado applied externally (Bricklin, p. 387)
avoid:
Food intolerances: consider gluten avoidance
(Lithill, H. Acta Derm. Vener. Stockholm 63:397-403, 1983; Douglass, J. (Letter) California Med. 133(5):450, 1980)
Avoid activation of the Alternate Complement Pathway (ACP). This pathway exacerbates psoriasis because of the promotion of PMN release and lipoxygenase products. Herbs such as arctium lappa, echinacea, and inula are contraindicated because they promote the ACP.
Avoid cyclo-oxygenase inhibitors such as aspirin, non-steroidal anti-inflammatory drugs
Tryptophan
Avoid cyclic GMP stimulators: biotin, ginseng, Vitamin C, and cyclic AMP antagonists like beta-blockers (Marz)
Spicy foods, Heat producing foods, alcohol, coffee, caffeine, stimulating foods, fatty foods, fried and rich foods
Citrus fruits, animal products, pork, milk, butter, eggs, processed foods, refined foods, foods with hydrogenated fats, white sugar (Airola, p. 145)
supplements
Evening Primrose Oil (EPO): 4 capsules three times daily In psoriasis it is especially important to avoid sources of arachidonic acid because it gets converted into inflammatory leukotrienes. GLA, because it is largely converted into the anti-inflammatory PGE1 series and little is converted into arachidonic acid, is very useful.
EPA or flax seed oil: 1 tablespoon per day, promotes anti-inflammatory PGE3 and not inflammatory PGE2.
Omega-3 fatty acids (Zihoh, 1986.)
Vitamin E: 400-800 IU per day, an antioxidant, inhibits lipoxygenase, and promotes PGE1.
Vitamin A: 50,000 IU per day (Proctor, 1979, 945.)
Vitamin B6: 50 mg per day
Vitamin B12: 1000 mcg IM (Cohen, 1963, 125.)
Vitamin D: activated forms Calcitriol®/Calcipotriol® Donitol topical ointment. Topically applied 50 ug/g twice daily; inhibits epidermal proliferation and promotes epidermal differentiation by binding to skin receptors.
(Kragballe, Knud. J Cell Biochem; Stewart DG, et al. J Clin Pharm Ther 1996 Jun;21(3):143-148.)
Folate: 25 mg three times daily (Fry, 1971, 539.)
Magnesium: 500 mg per day
Selenium: 200 mcg per day, is involved with the breakdown of HPETE through glutathione peroxidase. (White, 1983, p. 541ff)
Silica (Jensen)
Zinc picolinate: 30 mg per day, promotes PGE1, inhibits calmodulin receptors, which, when stimulated, increases cGMP levels. (Donadini, 1980, 9.)
Garlic: 2 capsules three times daily, inhibits lipoxygenase
Bioflavonoids: 2 g three times daily
Quercetin: 1/4 teaspoon three times daily
Lecithin: 3-6 g per day (Gross, 1950, 683.)
Shark cartilage: Immune-modulating and anti-inflammatory functions may help alleviate symptoms.
(Fontenele JB, et al. Braz J Med Biol Res. 1996 May;29(5):643-646; Dupont E, et al. J Cutan Med Surg. 1998 Jan;2(3):146-152.)
» treatment of drug side-effects:
anthralin: Vitamins A and E, acting as topical antioxidants, may eliminate skin inflammation, a common side-effect (Finnen, et al., 1984; ii: 1129)
» drug interaction:
Prednisone/prednisolone: causes Sodium retention
- causes reduced activation of Vitamin D (Travato, 1991; 44:1651-1658; Tuttle, 1982; 126: 1161-1162); 1,25(OH)2D3 can be measured to determine if supplementation necessary, with low levels can use calcitriol
- causes increased urinary excretion of Zinc, Vitamin K and Vitamin C (Buist, 1984; 4 (3):114)
Folic acid and methotrexate (Amethopterin): methotrexate interferes with activation of folate, therefore disrupting DNA replication for cells
footnotes
Douglass J. Psoriasis and Diet. Letter to the Editor. California Med. 1980;133(5):450.
Abstract: 6/6 patients improved on elimination diets. One improved on a diet which avoided fruits (especially citrus), nuts, corn, milk; another improved on a diet which avoided acidic foods such as coffee, tomato, soda, and pineapple.
Dupont E, Savard PE, Jourdain C, Juneau C, Thibodeau A, Ross N, Marenus K, Maes DH, Pelletier G, Sauder DN. Antiangiogenic properties of a novel shark cartilage extract: potential role in the treatment of psoriasis. J Cutan Med Surg. 1998 Jan;2(3):146-152.
Abstract: BACKGROUND: A number of inflammatory and immune diseases are associated with vascular changes. Psoriasis, as an example, is a common inflammatory skin disease with dilation of capillaries as an early histological change. In more developed psoriatic lesions there is proliferation of blood vessels and neovascularization. The use of agents that target these vascular changes represents a novel therapeutic strategy in the treatment of inflammatory diseases. Since cartilage is an avascular tissue, it has been hypothesized that there may be factors found in cartilage that inhibit blood vessel formation. OBJECTIVE: The objectives of this study were 1) to determine whether extracts of cartilage could inhibit angiogenesis, and 2) since altered angiogenesis is associated with certain diseases, including psoriasis, to examine whether inhibition of angiogenesis could potentially contribute to the treatment of psoriasis. METHODS: Extracts of shark cartilage were prepared by homogenization and ultrafiltration to derive the active agent termed AE -941. This agent was tested for antiangiogenesis activity using the embryonic vascularization test, which is a modification of the ex vivo chick embryo culture (CAM). Since one of the first steps in angiogenesis is degradation by metalloproteinases of the basement membrane of capillaries, AE -941 was tested for collagenase activity using a fluorogenic peptide substrate. Anti-inflammatory properties were tested using a cutaneous irritation model in humans. RESULTS: A dose dependent inhibition in embryonic neovascularization as well as in collagenase activity by AE -941 was demonstrated. When test compounds were applied on the forearms of test subjects, AE -941 was shown to have anti-inflammatory properties. Anecdotal data suggested that topical AE -941 had a beneficial effect in psoriasis. CONCLUSION: Our results show that AE -941 has anti-angiogenic and anti-inflammatory properties. Antiangiogenesis agents such as AE -941 provide an entirely new class of agents to treat cutaneous and systemic diseases associated with altered vascularity.
Fontenele JB, Viana GS, Xavier-Filho J, de-Alencar JW. Anti-inflammatory and analgesic activity of a water-soluble fraction from shark cartilage. Braz J Med Biol Res. 1996 May;29(5):643-646
Fontenele JB, Araujo GB, de Alencar JW, Viana GS. The analgesic and anti-inflammatory effects of shark cartilage are due to a peptide molecule and are nitric oxide (NO) system dependent. Biol Pharm Bull. 1997 Nov;20(11):1151-1154.
Jensen B. Foods That Heal. New York: Avery Publishing Group, Inc., 1988.
Jensen T, Sorensen S, Solvsten H, Kragballe K. The vitamin D3 receptor and retinoid X receptors in psoriatic skin: the receptor levels correlate with the receptor binding to DNA. Br J Dermatol. 1998 Feb;138(2):225-228.
Kragballe K, Dam TN, Hansen ER, Baadsgaard O, Gronhoj Larsen F, Sondergaard J, Axelsen MB. Efficacy and safety of the 20-epi-vitamin D3 analogue KH 1060 in the topical therapy of psoriasis: results of a dose-ranging study. Acta Derm Venereol. 1994 Sep;74(5):398-402.
Kragballe K. Vitamin D analogues in the treatment of psoriasis. J Cell Biochem. 1992 May;49(1):46-52. (Review)
Abstract: It has been found that 1,25-dihydroxy cholecalciferol inhibits epidermal proliferation and promotes epidermal differentiation by binding to skin receptors. Topically applied at 50 ug/g twice daily, it is more efficacious than betamethasone.
Lithill H. A fasting and vegetarian treatment trial in chronic inflammatory disorders. Acta Derm Venereol. (Stockholm) 1983;63:397-403.
Abstract: Patients improved on a fasting and vegetarian regime.
Prudden JF, Balassa LL. The biological activity of bovine cartilage preparations. Clinical demonstration of their potent anti-inflammatory capacity with supplementary notes on certain relevant fundamental supportive studies. Semin Arthritis Rheum. 1974 Summer;3(4):287-321.
Stewart DG, Lewis HM. Vitamin D analogues and psoriasis. J Clin Pharm Ther 1996 Jun;21(3):143-148.
Abstract: Over recent years there has been increasing interest in the effects of vitamin D3 and its analogues upon the skin, with particular relevance to the treatment of psoriasis. As well as offering an alternative therapeutic option, research into the mode of action of vitamin D3 upon the psoriatic lesion has provided insight into the pathogenesis of psoriasis. This article reviews the effects of vitamin D3 and its analogues upon normal skin and on psoriasis.
Yutani Y, Kono T, Ishii M, Chanoki M, Chanoki Y, Asada K, Shimazu A, Hamada T. Alteration of cartilagenous proteoglycan in psoriasis. Clin Exp Dermatol. 1991 Jan;16(1):22-24.