Dietary supplements
The category of "dietary supplements" covers a lot of ground. It includes the basic essential nutrients—vitamins, minerals and proteins—as well as herbal supplements and a wide range of miscellaneous substances, such as garlic, ginseng and enzymes. Fish oil, evening primrose oil and shark cartilage all are considered "dietary supplements."
Many Americans believe that herbs and other supplements are safer than pharmaceuticals because they are "natural." However, "natural" doesn't necessarily mean safe. Complications and serious side effects can occur from taking dietary supplements. The quality, safety and effectiveness of these products are not regulated by the federal government.
To be on the safe side, the Psoriasis Foundation recommends that people with psoriasis who are considering taking a dietary supplement consult with a health-care provider.
Evening primrose oil
Anecdotal reports suggest that a diet supplemented with evening primrose oil might prove helpful in psoriasis. Studies using evening primrose oil as a dietary supplement have not revealed any significant effect.
Evening primrose oil can also be used on the skin as a topical product. For more information about using evening primrose oil topically, please see alternative topical treatments.
Fish oil
Dietary supplementation with fish oil is said to have a variety of favorable effects on both the cardiovascular and immune systems in laboratory animals. Psoriasis is an immune-mediated disease, so it follows that fish oil—if it alters immune reactivity—could improve psoriasis. Multiple studies have been conducted in humans, with mixed results.
Max-EPA fish oil supplement has been used in studies and has shown mild to moderate improvement in people's psoriasis. It is sold over the counter in health food stores in capsules.
A study published in The Lancet in 1988 showed psoriasis patients who took 10 fish oil capsules daily for eight weeks had "significant lessening" of itching, redness and scaling. Patients in the placebo group who took 10 olive oil capsules saw no improvement. The patients were advised not to change their regular diet.
Another study published in the New England Journal of Medicine in 1993 showed that dietary supplementation with fish oil was no better than dietary supplementation with corn oil.
Studies reported in the Journal of the American Academy of Dermatology in September 1993 suggest that fish oil supplementation may help patients with psoriasis who are receiving long-term retinoid treatment by reducing their risk of atherosclerosis, a disease that “clogs” the arteries with fatty plaques. Another study suggested fish oil may prevent kidney damage in patients taking cyclosporine, an immune-suppressing medication used to prevent organ transplant rejection and treat moderate to severe psoriasis.
Studies reported in the Journal of the American Academy of Dermatology in September 1993 suggest that fish oil supplementation may help patients with psoriasis who are receiving long-term retinoid treatment by reducing their risk of atherosclerosis, a disease that "clogs" the arteries with fatty plaques. Another study suggested fish oil may prevent kidney damage in patients taking cyclosporine, an immune-suppressing medication used to prevent organ transplant rejection and treat moderate to severe psoriasis.
However, increased ingestion of fish oil, particularly of cod liver oil, may lead to excess levels of vitamins A and D. Fish oils also can inhibit the blood from clotting, although this potential side effect is not dangerous in most circumstances.
Because of the high doses of fish oil used in these experiments, it must be considered a medication and not a mere dietary supplement. If you want to try fish oil, consult with your health-care provider.
Herbal remedies
Herbal remedies are increasingly popular and mainstream. Many people dealing with chronic diseases such as psoriasis turn to these alternatives when Western medicine stops working.
Caution is advised in taking herbal remedies. Many of them can have potentially dangerous interactions with medications. For example, St. John's wort, a popular natural "mood lifter," has been found to lower the blood level of cyclosporine.
St. John's wort and other dietary supplements can also cause increased sensitivity to light, which could be dangerous for people who sunbathe or undergo ultraviolet light treatment for their psoriasis.
It is important to carefully examine the herbal remedy you choose to use, as some cannot be used during pregnancy or when you have a pre-existing medical condition. If you are unsure of the potential side effects or possible interactions with medications, consult a health-care professional before starting to take an herbal remedy.
Milk thistle
Milk thistle has been shown to inhibit human T-cell activation, which occurs in psoriasis; however, no specific studies have been done with psoriasis patients. Milk thistle products can be purchased at health food stores in tablet or fluid extract form. The herb should not be taken when a person is also taking antipsychotics or male hormones. Few adverse effects have been seen when patients take milk thistle supplements, except for brief gastrointestinal disturbances and mild allergic reactions.
Oregano oil
Oregano is a commonly used spice for baking and cooking. It possesses antibacterial and antifungal properties, which may be helpful with some infections associated with psoriasis. Oregano oil can be purchased at most health food stores.
Many people have contacted the Psoriasis Foundation to let us know that use of oregano oil, either orally or topically, has helped their psoriasis. Oregano oil has been known to cause allergic contact dermatitis when applied to the skin.
Shark cartilage
Studies have shown that shark cartilage extract prevents the formation of new blood vessels. The growth of new blood vessels is believed to play a role in the development and progression of psoriasis lesions. Shark cartilage is also known to have anti-inflammatory properties.
AE-941 is a shark cartilage extract that has demonstrated some promising results in treating psoriasis. It is currently in clinical studies for treating psoriasis. It is taken by mouth once a day. Short-term side effects of AE-941 include nausea and skin rashes. Long-term side effects are not known at this time.
Shark cartilage is normally taken in pill form as a food supplement and can be found at most health food stores.
Turmeric
Turmeric is a primary component of curry powders used in cooking. The spice has a long history of being used in traditional Chinese medicine. Turmeric can be found in capsules to be used as a dietary supplement; however, many people who call the Foundation use the powdered form of the spice and mix it in with their food.
Turmeric has also been reported to help relieve the swelling, pain and inflammation associated with arthritis.
People suffering from gallstones or bile duct problems should avoid turmeric. A small study in 1999 showed that curcumin (a compound in turmeric) can cause contractions of the gallbladder. These contractions could potentially harm a person with gallbladder problems.
Vitamins
According to the scientific community, vitamin supplements do not improve psoriasis when taken in daily recommended doses.
The active ingredient in the prescription drug Dovonex is calcipotriene, a derivative of vitamin D3, but this is not the same as the vitamin D found in supplements sold over the counter. Taking large doses of vitamin D has not proven effective for psoriasis, and it can be dangerous.
In trying a vitamin approach to psoriasis treatments, seek the advice of a doctor, a certified nutritionist or a registered dietician. Several vitamins and natural supplements can be dangerous when taken in large, continuous doses.
Updated October 2005
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