Gluten-Free Diet

New research estimates that up to 25 percent of people who have psoriasis also may be sensitive to gluten.

Just what is gluten?

Gluten is the name for a complex protein found in common cereal grains. Gluten is found in wheat, barley and rye and all of their derivatives.

Products, such as bread, pasta and crackers, are obvious sources of gluten. But gluten is used in many unexpected places in the processing of foods including lunch meats, soy sauce, licorice, ice cream, monosodium glutamate (MSG) and salad dressings, just to name a few.

Can a gluten-free diet help your psoriasis?

Many people with psoriasis wonder whether gluten-free diets will improve their condition. There are individuals with gluten sensitivity and those with celiac disease, an actual allergy. Both require the elimination of gluten from your diet. You may want to talk with your health care provider about an elimination diet or a blood test to screen for celiac disease.

While more studies are required to better understand the link between gluten and psoriasis, many patients report dramatic improvement in skin condition or joint pain when following a gluten-free diet. A 2010 study in the Journal of Clinical Laboratory Analysis found that psoriasis patients with the HLA CW6 gene, a gene linked to psoriasis, had an increased sensitivity to the gliadin protein (gluten).

Another study in the 2009 Brasilian Annals of Dermatology found that patients who had gluten sensitivity had an improvement in their psoriasis when they followed a gluten-free diet. By contrast, studies conducted in the U.S. and in Kashmir found no elevation in anti-gladin (AGA) and anti-endomysial (AEA) antibodies in people who had mild to moderate psoriasis.

While a gluten-free diet may not be the answer for everyone, if you are one of the individuals who is sensitive to gluten, it may make a noticeable difference for you.

Pros and cons of a gluten-free diet

With a dramatic increase in the diagnosis of celiac disease and gluten intolerance in recent years, mainstream grocery stores, restaurant chains and bakeries are introducing more and more gluten-free products.

Following a gluten-free diet requires you to become educated on all the hidden sources of gluten, as well as educating loved ones. To avoid all gluten, you must read labels carefully. You need to avoid not only wheat but its derivatives: durum, graham, kamut, semolina and spelt. The same goes with barley derivatives: malt flavoring and malt vinegar, as well as rye, MSG and soy sauce. Remember just because a food is labeled wheat-free doesn't mean it is gluten-free.

Following a gluten-free diet requires you to read labels regularly because manufacturers can change ingredients without notice.

Some manufacturers add sugar, saturated fats and preservatives to their gluten-free offerings to make them taste better, but they also add calories. Just because a diet is gluten-free it does not mean its calorie-free. You still need to apply principles of a balanced diet.

On the other hand, says Jerry Bagel, M.D., director of the Psoriasis Treatment Center of Central New Jersey in East Windsor and a member of the National Psoriasis Foundation Medical Board, if someone's skin improves as a result of a gluten-free diet, it's likely the patient's digestive system is improving as well, and absorbing more nutrients.

Gluten-free diets allow you to still eat all fresh fruits and vegetables, which should be part of your healthy diet. Beef, chicken, fish, lamb, pork and dairy products are also naturally gluten-free. Again, just be sure to watch for additives.

How long do you need to give it?

If you try a gluten-free diet, it can take several months for the inflammation to subside. It is recommended that you remain completely gluten-free for at least three months, being sure to remove all sources of gluten from your diet. After three months, if you are unsure if you've seen a benefit from eliminating gluten, add it back into your diet. Over the next three to four days be sure to make note of increased itching, joint pain, headaches etc. If you don't notice any benefit, you may choose to add gluten back into your diet.

Before your try a gluten-free diet on your own you may want to talk to your doctor or a nutritionist.

The Celiac Disease Foundation provides a list of foods to eat and those to avoid on a gluten-free diet, it may be helpful to reference when planning your meals.

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