Vitamin d and psoriasis

What vitamins are best for psoriasis?

Share on PinterestPsoriasis can be an uncomfortable, persistent condition. However, certain vitamins may help reduce its effects.

The major fat-soluble vitamins include vitamins A, D, E, and K. Water-soluble vitamins include the B vitamins and vitamin C.

The method through which the body absorbs a vitamin helps define its intended effect.

The relationship between heart disease, diabetes, and metabolic disease has led some scientists to suggest that nutrient intake plays a role in preventing or treating psoriasis.

Aside from vitamin D, people can obtain most vitamins only from the diet. The body synthesizes vitamin D after exposure to ultraviolet light from the sun.

Vitamin A

Chemical compounds containing vitamin A, also known as retinoids, are essential for the production of healthy skin cells, Yellow and orange vegetables are often excellent sources of vitamin A.

People sometimes apply vitamin A directly to the skin to treat sun damage. In psoriasis, the body produces too many skin cells. Vitamin A can help improve psoriasis symptoms by reducing this overproduction.

Using retinoids on the skin can reduce inflammation in plaque psoriasis. The body absorbs topical vitamin A creams more slowly than oral vitamin A-based supplements, resulting in fewer side effects.

Vitamin A supplements can help psoriasis. However, it is always better to consume nutrients from food. Speak with a doctor before taking supplements to managwe a particular condition.

Practitioners sometimes treat psoriasis using light therapy.

The therapeutic effect of sunlight lies in its ability to help the body produce vitamin D. This is a powerful hormone that plays a role in hundreds of metabolic reactions.

A study from 2013 showed that using both oral and topical vitamin D preparations improved psoriasis symptoms.

Another more recent study has shown that taking or applying supplemental vitamin D with a steroid cream produces more favorable results than taking only vitamin D.

Vitamin C

Antioxidants can help support the treatment of psoriasis by preventing damage linked to oxidative stress.

Oxidative stress occurs when levels of disease-triggering free radical molecules and protective antioxidant substances are imbalanced. Vitamin C, a water-soluble vitamin that also serves as a powerful antioxidant, may be helpful for psoriasis in reducing the action of free radicals.

Get vitamin C from the diet, from supplements, or both. Vitamin C-rich foods include citrus fruits, green leafy vegetables, and berries.

Vitamin E

People with psoriasis often have low serum levels of selenium, a potent antioxidant.

In one study, vitamin supplements helped to improve selenium concentrations in people with psoriasis. However, there is no significant evidence that this reduces the severity of psoriasis symptoms.

However, as vitamin E and selenium are both antioxidants, they can help to protect against some of the oxidative stress that occurs with psoriasis.

People can take oral vitamin E supplements with the advice of a qualified physician. Pumpkin seeds and spinach are two good sources of vitamin E.

Other nutrients for psoriasis

Vitamins are not the only types of nutrient that might help reduce psoriasis symptoms.

Omega-3 fatty acids, commonly found in fish and flax seeds, glucosamine and chondroitin, and methylsulfonylmethane (MSM) may help to reduce inflammation and assist skin health.

While people often recommend the above vitamins to treat psoriasis, the most reliable solution is to eat a nutritious, balanced diet, free from processed food, alongside conventional treatments.

Psoriasis and vitamin D deficiency

Published: August, 2012

A topical supplement may help your treatment.

Fighting psoriasis, a condition characterized by patches of irritated, flaky skin that usually appear on the elbows and knees and across the trunk, is difficult throughout the year, especially in winter. New research may help explain why. Scientists in Italy found that people with psoriasis also suffer from vitamin D deficiency.

“We speculated that vitamin D might be low in psoriasis patients, but this is the first good study that substantiates it,” says Dr. Suzanne Olbricht, an associate professor of dermatology at Harvard Medical School.

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Vitamin D could provide psoriasis relief

A new study indicates some people with psoriasis might see an improvement in their symptoms from taking a vitamin D supplement, particularly in the colder months. Credit: Massey University

New research suggests increasing vitamin D intake could reduce the symptoms of chronic inflammatory skin condition psoriasis.

Psoriasis is a relatively common condition, affecting an estimated two to four per cent of the population. It is characterised by reddened, raised, scaly patches of skin, which commonly occur on the elbows, knees and scalp but can affect any part of the body. Psoriasis can develop at any age and tends to be a lifelong condition. For many people, it fluctuates in extent and severity, and can be challenging to manage despite the array of treatments on offer.

The Massey University study aimed to determine whether vitamin D supplementation improves psoriasis when compared with those taking placebo capsules. Dr Michelle Ingram, who conducted the research as part of her PhD in Nutritional Science says, “This study was partly motivated by observations that some people with psoriasis report a reduction in symptoms during the summer months, when vitamin D production in the skin is usually at its highest. Vitamin D incorporated into a cream or ointment is also a relatively effective treatment for psoriasis, yet no one had looked into whether vitamin D supplementation might be of similar benefit.”

The main findings of the study were inconclusive due to an unexpected increase in vitamin D levels in the placebo group, probably from sunlight. However, Dr Ingram says further analysis across data from the 101 participants in the study showed strong evidence of a link between higher levels of vitamin D and less severe psoriasis.

“Interestingly, this relationship was only found in about two-thirds of our participants, suggesting that vitamin D may be beneficial for some people with psoriasis, yet make no difference for others. It was not clear from our data why there might have been a difference in response – understanding the variability of response to psoriasis treatments in general is a long-term challenge and one that future research will hopefully be able to address,” she says.

Associate Professor Pamela von Hurst, who supervised the research, says the cause of psoriasis remains relatively mysterious, and treating this disease has long been a source of great frustration for patients and the medical profession.

“The range of treatment options are varied, impact different people in various ways and many of the complexities of the disease are yet to be uncovered,” she says. “Research involving vitamin D supplementation also poses some challenges, as vitamin D levels are primarily influenced by sun exposure. However, the collective impact of psoriasis, which is undoubtedly significant, meant it was important to go ahead with this research. While we could not confirm whether vitamin D supplementation is beneficial for psoriasis per se, we have shown that increased vitamin D levels, which can be achieved through supplementation or sun exposure, are related to less severe psoriasis. This indicates that some people with psoriasis might see an improvement in their symptoms from taking a vitamin D supplement, particularly in the colder months,” Dr von Hurst says.

The study, funded by a Lottery Health Research grant, involved participants with varying degrees of psoriasis, (mild, moderate or severe) and showed statistically significant improvements in the group taking vitamin D supplements, as well as in the group taking placebos, over a one year period. There was also a statistically significant relationship between higher vitamin D levels and PASI (Psoriasis Area and Severity Index) score across the whole group of participants.

Oral vitamin D3 supplementation for chronic plaque psoriasis: A randomized, double-blind, placebo-controlled trial was published in the Journal of Dermatological Treatment last month.

Explore further

Patient’s psoriasis improves with initiation of hepatitis C therapy More information: Michelle A. Ingram et al. Oral vitamin D3 supplementation for chronic plaque psoriasis: A randomized, double-blind, placebo-controlled trial, Journal of Dermatological Treatment (2018). DOI: 10.1080/09546634.2018.1444728 Provided by Massey University Citation: Vitamin D could provide psoriasis relief (2018, March 19) retrieved 2 February 2020 from https://medicalxpress.com/news/2018-03-vitamin-d-psoriasis-relief.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Systemic Role for Vitamin D in the Treatment of Psoriasis and Metabolic Syndrome

Abstract

The novel discovery of the systemic role of vitamin D in the modulation of the immune system especially the Type 1 helper T cell (Th1) pathway reveals its potential for treating Th1 inflammatory diseases. Psoriasis has been recently established to be a systemic disease centered on inflammation and involvement of cytokines of the Th1 pathway. There is an increased prevalence of metabolic syndrome in patients with psoriasis. Metabolic syndrome also involves a proinflammatory state. This paper proposes the idea of the potential use of oral vitamin D to treat psoriasis and metabolic syndrome concurrently. We propose there is merit in more clinical trials investigating the use of vitamin D to treat both psoriasis and metabolic syndrome through its anti-inflammatory effects. On application to psoriasis management and prognosis, the goal is to decrease the risk for cardiovascular disease and decrease disease morbidity and mortality.

1. Introduction

The recent discovery that vitamin D receptors are found in most tissues and cells in the body opened a whole new arena of research. Vitamin D can play a role in decreasing the risk of many chronic illnesses, including autoimmune diseases, infectious diseases, cardiovascular disease, and common cancers such as colorectal, breast, and prostate cancers. It specifically has a role in cellular proliferation, differentiation, apoptosis, and angiogenesis . Vitamin D has been found to be an immune regulatory hormone with beneficial effects on inflammatory diseases, mediated by helper T-lymphocytes type 1 (Th1) cells , such as diabetes, psoriasis, Crohn’s disease, and multiple sclerosis .

Psoriasis is a common Th1-mediated inflammatory disease characterized by scaly plaques on the skin, which can be painful and pruritic. It is also associated with psoriatic arthritis, Crohn’s disease, diabetes mellitus (type 2), metabolic syndrome, depression, and cancer . It affects 1–3% of the general population .

Controversy exists over the precise criteria for diagnosis and classification of metabolic syndrome; however, it is accepted that it consists of a constellation of metabolic abnormalities including glucose intolerance, insulin resistance, central obesity, dyslipidemia, and hypertension . The prevalence of metabolic syndrome varies greatly between populations and age groups ranging from 4% to 46% . Metabolic syndrome is significantly increased in patients with psoriasis .

This paper strives to highlight the association between psoriasis, metabolic syndrome, and vitamin D. In addition, it proposes the hypothesis of potentially using oral systemic vitamin D as a modality to treat psoriasis and metabolic syndrome concurrently.

2. Psoriasis Pathophysiology

Psoriasis was first described as a disease that primarily affects epidermal keratinocyte proliferation and secondary cutaneous inflammatory infiltration . In the last decade it has become evident that psoriasis is a systemic immune-mediated inflammatory disease primarily involving Th1 cells. Cytokines of the Th1 pathway (interferon- , interleukin 2, interleukin 12, and TNF- ) predominate in psoriatic plaques. It is widely accepted that an unknown stimulus activates cutaneous dendritic antigen-presenting cells. These activated antigen-presenting cells then activate helper T cells which lead to the subsequent release of a cascade of inflammatory cytokines. This cascade results in recruitment and activation of other cells types such as endothelial cells and neutrophils, and production of chemokines and growth factors. Eventually this leads to the proliferation of keratinocytes. A chronic inflammatory state then ensures and leads to the formation of psoriatic skin lesions . Recently, Interleukin-17-secreting helper T (Th17) cells have been identified to play an important role in psoriasis pathogenesis. Interleukin-17 promotes inflammation by inducing the expression of chemoattractants that are found in psoriatic lesions. Th17 cells also secrete interleukin 22, which is involved in keratinocyte differentiation retardation leading to keratinocyte proliferation .

3. Metabolic Syndrome Pathophysiology

Metabolic syndrome is accepted to be centered on insulin resistance and obesity. Free fatty acids (FFA) are released from abundant adipose tissue mass. FFA’s effects on the liver include production of glucose and triglycerides, and secretion of very low density lipoproteins (VLDL) . FFA inhibit insulin-mediated glucose uptake and therefore lead to insulin resistance. Increased circulating glucose and FFA increase pancreatic secretion of insulin resulting in hyperinsulinemia which can then increase sympathetic nervous system activity and contribute to hypertension . Adipose tissue also contains cells such as adipocytes and monocyte-derived macrophages. These cells contribute to the proinflammatory state through the secretion of interleukin-6 (IL-6) and TNF- among others . These inflammatory factors lead to further insulin resistance and lipolysis of adipose tissue triglyceride stores and an additional increase in circulating FFA. There are also reductions in the production of adiponectin which is an anti-inflammatory and insulin sensitizing cytokine . The most widely accepted criteria for metabolic syndrome is by the National Cholesterol Education Program Adult Treatment Panel III. The definition defines metabolic syndrome as presence of at least three of the following: abdominal obesity (waist circumference equal to or greater than 102 cm in men; 88 cm in women), elevated serum triglycerides (equal to or greater than 150 mg/dL or drug treatment for elevated levels), low HDL cholesterol (men <40 mg/dL; women <50 mg/dL), and elevated blood pressure (equal to or greater than 130/85 mmHg or drug treatment for hypertension), elevated fasting glucose (equal to or greater than 110 mg/dL). The World Health Organization and the International Diabetes Foundation define metabolic syndrome under similar parameters .

4. Psoriasis and Metabolic Syndrome

The pathogenesis of psoriasis and metabolic syndrome both involve inflammation. There is also evidence suggesting that there is a genetic link. A number of genes such as PSORS2, PSORS3, and PSORS4 are associated with psoriasis susceptibility and are also associated with metabolic disease . Many studies have shown a link between psoriasis and metabolic syndrome . To highlight, Gisondi and colleagues established that there is a 30.1% prevalence of metabolic syndrome in psoriatic patients compared to 20.6% in the control population ( , OR: 1.65, 95%, confidence interval: 1.16–2.35). Sommer and colleagues reported that German patients hospitalized for psoriasis were 6-fold more likely to have metabolic syndrome compared with control patients admitted for melanoma surgery. Few studies have explored the possibility of treating psoriasis by treating components of metabolic syndrome. Naldi and colleagues showed that in a large-scale cohort study of 2000 patients, obese patients had more severe psoriasis that were more resistant to treatment compared to non obese psoriatic patients. Hossler and colleagues observed two patients with body mass indices greater than 50 kg/m2 who had marked improvement in their psoriasis after gastric bypass surgery and weight loss.

5. Cardiovascular Disease Risk

Cardiovascular disease, like psoriasis and metabolic syndrome, also result from a proinflammatory state. Endothelial cells in atherosclerotic blood vessels facilitate the attachment of T-lymphocytes, the attraction of mast cells, and, as a result, the release of a cascade of proinflammatory cytokines such as TNF- is initiated. The proinflammatory state plays a key role in fatty streak formation, plaque formation, and eventually thrombosis . Studies have shown an increased risk of myocardial infarction (MI) and stroke in patients with psoriasis. Gelfand and colleagues showed that 2.9% of patients in the severe psoriasis group developed MIs while only 2.0% of the control population developed MIs. Gelfand and colleagues also found that there is a 50% increase in mortality in patients with severe psoriasis compared to the control group. They found that patients with severe psoriasis died 3.5 (male) and 4.3 (female) years younger than patients without psoriasis. Mehta and colleagues found that patients with severe psoriasis have a clinically significant 57% increased risk of cardiovascular death while adjusting for conventional cardiovascular risk factors (history of MI, stroke, transient ischemic attack, or atherosclerotic disease). This suggests that psoriasis is an independent risk factor for cardiovascular disease.

Similarly, patients with metabolic syndrome are also at an increased risk for cardiovascular disease. Adipose tissue overproduces plasminogen activator inhibitor-1 (PAI-1). In addition, cytokines and FFA in metabolic syndrome also increase the liver production of fibrinogen and PAI-1. The increase in PAI-1 and fibrinogen results in a prothrombotic state. Studies have shown increased risk for cardiovascular disease and mortality in patients with metabolic syndrome . Isomaa and colleagues found that subjects with metabolic syndrome were at a three-fold increased risk for developing coronary heart disease and stroke ( ). Cardiovascular mortality was also markedly increased in patients with metabolic syndrome (12.0%) compared to controls (2.2%; ). Lakka and colleagues reported that men with metabolic syndrome were 2.9–4.2-times more likely to die from cardiovascular disease compared to controls after adjustment for conventional cardiovascular risk factors.

Therefore patients with both psoriasis and metabolic syndrome are at a greatly increased risk for developing cardiovascular disease.

6. Vitamin D and Psoriasis

Vitamin D has been used to treat psoriasis in the topical form with great success . 1- , 25-dihydroxyvitamin D3 (calcitriol) is the hormonally active form of Vitamin D. It affects cellular function by acting through the vitamin D receptor (VDR) on keratinocytes . VDR binds to and activates transcription of genes that influence growth, differentiation, and inflammation in keratinocytes. Calcitriol has also been shown to have immunomodulatory effects on monocytes, macrophages, T cells, and dendritic cells . It is believed that through these mechanisms topical Vitamin D actively treats psoriatic skin lesions. However, the evidence that psoriasis is a systemic disease, which affects many organ systems, and involves many comorbidities, namely, the cardiovascular system suggests merit in revisiting systemic oral vitamin D for treatment of the inflammatory pathogenesis of psoriasis. At this point in time, there are very few studies that have investigated the use of oral vitamin D in patients with psoriasis. Perez and colleagues established that 88% of 85 psoriasis patients treated with oral vitamin D had improvement in their psoriasis, 26.5% had complete clearance, 36.2% had moderate improvement, and 25.3% had slight improvement. An evaluation of serum calcium concentrations and urinary calcium excretion and creatinine clearance suggested that oral Vitamin D altered creatinine metabolism or secretion but did not affect renal function . Werner de Castro and colleagues published the only report to date of the resolution of anti-TNF -induced psoriasiform lesions (biopsy confirmed) by doses of Vitamin D3 in a patient with vitamin D deficiency and rheumatoid arthritis. The recent discovery of the systemic role of vitamin D suggests that there is great merit in revisiting the use of system vitamin D to treat psoriasis with large scale clinical trials to assess the safety and efficacy. It would also be very interesting and relevant to conduct studies looking at the baseline serum vitamin D level in patients with psoriasis.

7. Vitamin D and Metabolic Syndrome

Recent research suggests that vitamin D can improve metabolic syndrome. Vitamin D has been proposed to be sequestered in the abundance of adipose tissue in metabolic syndrome, with decreased circulating levels . Vitamin D deficiency in obese patients is further increased due to decreased sun exposure because of reduced mobility and wearing clothing that covers most areas of skin because of cosmetic preference. Vitamin D reduces inflammation by modulating the expression of several cytokine genes . Tzotzas and colleagues reported rising serum vitamin D levels after weight loss in obese women. Chui and colleagues found that subjects with hypovitaminosis have a higher risk of insulin resistance and metabolic syndrome. Alvarez and Ashraf found in their meta-analysis of both cross-sectional and prospective studies that vitamin D insufficiency (20–29 ng/ml) and deficiency (less than 20 ng/ml) have direct and indirect effects on insulin secretion and insulin action. Maki and colleagues found that serum triglycerides, waist circumference, and body mass index is inversely related to vitamin D levels. They showed that the prevalence of metabolic syndrome is inversely proportional to serum vitamin D levels, suggesting that there is a link between metabolic syndrome and lower vitamin D levels. Future studies need to be performed to assess controlled supplementation of vitamin D and its effects on components of metabolic syndrome .

In addition, low vitamin D levels have recently been associated with an increased incidence of cardiovascular events .

8. Conclusion

In conclusion, metabolic syndrome and psoriasis are closely related and share common genetic and inflammatory components. As discussed above there has been recent research suggesting vitamin D plays a role in metabolic syndrome and improves psoriatic skin lesions. We propose that there is merit in performing large-scale clinical trials aimed at revisiting the use of oral vitamin D to directly target manifestations of psoriasis and metabolic syndrome at the same time. On application to psoriasis management and prognosis, the use of oral vitamin D has great potential in clearing psoriatic skin lesions and at the same time also decreasing the risk for cardiovascular disease and decreasing disease morbidity and mortality. Randomized, blinded, large-scale, and long-term clinical studies are needed to address this important issue.

8 Ways to Get More Vitamin D and Improve Your Psoriasis

Most people know that vitamin D plays an important role maintaining healthy bones and teeth, and not having enough of it is associated with osteoporosis. Vitamin D also assists in immunity to certain diseases, and it helps in brain, heart, and lung function. But did you know there’s a connection between vitamin D and the disease psoriasis?

Research, such as a study published in August 2010 in the journal JAMA Dermatology, suggests that vitamin D deficiency is common among people with psoriasis. According to Suzanne Olbricht, MD, the chief of dermatology at Beth Israel Deaconess Medical Center in Boston, not having enough vitamin D doesn’t necessarily cause psoriasis; but vitamin D deficiency may be a contributing factor because it impairs the body’s ability to keep skin healthy.

Vitamin D may help psoriasis symptoms by changing the way skin cells grow. “Since the symptoms of psoriasis on skin include an increase of the skin’s cells, if you put something on the skin that slows growth, it may cause the plaques to become thinner and less scaly,” says Richard Gallo, MD, the founding chairman of the dermatology department at the University of California in San Diego.

Another way that vitamin D may help psoriasis, which is an autoimmune disease, is by changing the way our immune system operates. A study published in August 2011 in the Journal of Investigative Medicine found that “immune cells in autoimmune diseases are responsive to the ameliorative effects of vitamin D.”

Vitamin D is often referred to as the “sunshine vitamin” because the body produces it naturally in response to exposure to ultraviolet (UV) light. But Maryellen Maguire-Eisen, RN, of the Children’s Melanoma Prevention Foundation in Hingham, Massachusetts, cautions that people should not try to get vitamin D through aggressive exposure to the sun.

“Psoriasis patients have an increased risk of melanoma because they tend to overexpose themselves to UV rays,” she explains.

The good news is that there are other options available for getting your daily dose of vitamin D.

According to the American Academy of Dermatology (AAD) and the Institute of Medicine (IOM), the recommended dietary allowance for vitamin D is 600 international units (IU) for people ages 1 to 70 and 800 IU for adults 71 and older.

The AAD recommends that you get your daily dose from foods that are naturally rich in or fortified with vitamin D, and from supplements.

Dermatologists often treat psoriasis and psoriatic arthritis with light therapy. Also known as phototherapy, this treatment involves focusing specific types of light directly and safely onto the skin.

Here are some safe ways to get the vitamin D that your body needs to manage psoriasis and reap other health benefits.

VitaminDWiki

A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis

Dermato-Endorcrinology January/February/March 2013 Volume 5, Issue 1
Danilo C. Finamor,1; Rita Sinigaglia-Coimbra,1; Luiz C.M. Neves,2; Marcia Gutierrez,3; Jeferson J. Silva,1; Lucas D. torres,1; Fernanda Surano, 1; Domingos J. Neto,5; Neil F. Novo, 6; Yara Juliano,6; Antonio C. Lopes 4; and Cicero Galli Coimbra 1 coimbracg.nexp at epm.br
1 Laboratório de Fisiopatologia Clínica e Experimental; Universidade Federal de São paulo; São paulo, Brazil;
2 Instituto de Ciências da Saúde; Universidade paulista; São paulo, Brazil;
3 Farmácia Sensitiva; São paulo, Brazil;
4 Disciplina de Clínica Médica; Universidade Federal de São paulo; São paulo, Brazil;
5 Hospital Heliópolis; São paulo, Brazil;
6 Disciplina de Cirurgia plástica; Universidade Federal de São paulo; São paulo, Brazil

Autoimmunity has been associated with vitamin D deficiency and resistance, with gene polymorphisms related to vitamin D metabolism frequently described in affected patients. High doses of vitamin D3 may conceivably compensate for inherited resistance to its biological effects. This study aimed to assess the efficacy and safety of prolonged high-dose vitamin D3 treatment of patients with psoriasis and vitiligo. Nine patients with psoriasis and 16 patients with vitiligo received vitamin D3 35,000 IU once daily for six months in association with a low-calcium diet (avoiding dairy products and calcium-enriched foods like oat, rice or soya “milk”) and hydration (minimum 2.5 L daily).

All psoriasis patients were scored according to “Psoriasis Area and Severity Index” (PASI) at baseline and after treatment.
Evaluation of clinical response of vitiligo patients required a quartile grading scale.
All patients presented low vitamin D status (serum 25(OH)D3 ≤ 30 ng/mL) at baseline.

After treatment 25(OH)D3 levels significantly increased (from 14.9 ± 7.4 to 106.3 ± 31.9 ng/mL and from 18.4 ± 8.9 to 132.5 ± 37.0 ng/mL) and PTH levels significantly decreased (from 57.8 ± 16.7 to 28.9 ± 8.2 pg/mL and from 55.3 ± 25.0 to 25.4 ± 10.7 pg/mL) in patients with psoriasis and vitiligo respectively. PTH and 25(OH)D3 serum concentrations correlated inversely. The PASI score significantly improved in all nine patients with psoriasis. Fourteen of 16 patients with vitiligo had 25–75% repigmentation. Serum urea, creatinine and calcium (total and ionized) did not change and urinary calcium excretion increased within the normal range. High-dose vitamin D3 therapy may be effective and safe for vitiligo and psoriasis patients.



Vitiligo results clipped from PDF

Two out of 16 vitiligo patients showed no repigmentation of the affected areas;
four patients showed 1–25% repigmentation,
five patients showed 26–50% repigmentation,
five patients showed 51–75% repigmentation and
none showed more than 75% repigmentation of the affected areas

PDF is attached at the bottom of this page

See also VitaminDWiki

  • All items in category Psorasis and Vitamin D
    54 items

  • Update on Treating Multiple Sclerosis with high dose vitamin D – Sept 2013
    Dr. Coimbra also cured (not just treated) many of MS with 150 ng of vitamin D
  • Search VitaminDWiki for Vitiligo 105 items as of May 2017
    Vitiligo is a condition that causes depigmentation of parts of the skin, incidence < 1%
  • Video by Dr. Coimbra – 95 percent of auto-immune cured with vitamin D in high doses – April 2014
  • Vitiligo (loss of skin pigment) treated by narrowband UVB
  • Vitamin D from low-cost UVB lamps: both Psoraisis and Vitiligo
  • 1000 IU per kg Vitamin D for autoimmune diseases – Coimbra Aug 2013
  • Spotty skin coloring (vitiligo) treated by augmenting topical tacrolimus with oral Vitamin D – Oct 2016
  • Psoriasis – less frequent and shorter duration with higher vitamin D (45 ng is nice) – Dec 2016
  • See also web

    • High-Dose Vitamin D Dramatically Improves Psoriasis and Vitiligo GreenMed Info review of this pilot study, Sept 2017
    • Vitamin D deficiency prevalent in autoimmune skin disorder Vitamin D Council Jan 2013
      Reporting on a study – 97.5% of vitiligo participants were vitamin D deficient, It is behind a $5/month paywall
    • Search web for “Vitamin D” and vitiligo resulted in 580,000 hits on Feb 2014
    • Sept 2013 Dr. Coimbra video with English translation in the background

Can supplements help psoriasis and psoriatic arthritis?

“I encourage patients to work with me when they want to try something, to keep a journal to log what and how much they’re taking and what effects they experience,” he said. “Then we can review it together and see how well something’s working.”

Supplements and vitamins, while natural, can have potent effects and cause serious problems, Liao said.

“St. John’s wort, for example, can interfere with several medications, including cyclosporine, which is used to treat psoriasis, he said. “Supplements aren’t regulated by the FDA, which means you don’t really know what dosage or quality you’re getting, or what problems could occur. Always check with your doctor before taking anything.”

That lack of government regulation allows manufacturers to tout health claims that aren’t backed up by science, said Dr. Nancy Anderson, professor of dermatology at Loma Linda University in California. She said it is critical to get a doctor’s input before taking any supplement, including vitamins, minerals and herbs.

“Some may have the potential to worsen your condition or cause other issues,” she said. “Vitamin E, for example, can increase bleeding, which can be a problem if you’re undergoing surgery, or even an in-office cosmetic procedure.”

Here, we review the evidence for some better-studied vitamins and supplements.

Fish oil/omega-3s

Oils from cold-water fish show the most promise for improving symptoms in psoriasis among the four possibilities studied by Liao and his dermatology group, which published an evidence-based review in September in the Journal of the American Academy of Dermatology.

“The findings make intuitive sense, as we know the omega-3s in fish oil reduce inflammation by opposing an inflammation-causing molecule called leukotriene B4,” Liao said.

He and his colleagues reviewed 15 trials of fish oil use in psoriasis; 12 found some benefit, typically a moderate improvement in skinredness, plaque thickness and scale amount. Several studies found omega-3s seemed to boost benefits of traditional psoriasis therapies, including UVB therapy and oral retinoids.

Patients in the studies took different amounts of fish oil — with some taking very high amounts — for periods varying from six weeks to six months. Fish oil was found to be most effective in people taking it for three months or more.

Anderson, who often recommends fish oil to her psoriasis patients for its potential to benefit both skin and heart health, usually suggests starting at 1,000 milligrams a day, as higher doses may cause stomachupset. Fish oil quality varies, so ask your doctor to recommend a brand.

Vitamin D

People with psoriatic disease often have low-levels of vitamin D, which helps regulate immune system function. A 2012 study in the British Journal of Dermatology found that 57 percent of people with psoriasis had vitamin D deficiency, a figure that rose to 80 percent in winter months. Anderson checks vitamin D levels in most of her psoriasis patients and said the practice is becoming more common.

In people who aren’t vitamin D-deficient, the evidence for supplementation is mixed, said Liao.

“Six of the seven studies we looked at found an improvement in skin symptoms with vitamin D supplementation — but the one trial that didn’t show benefit was also the only randomized, controlled trial,” the most reliable kind of clinical research, she said. “We need more study to know if there’s really a benefit.”

While the benefit is unknown, the downside is not. Too much vitamin D can cause excess blood calcium and kidney stones, and Anderson cautions against doubling or tripling up on recommended doses of vitamins and supplements “because they’re natural.”

Vitamin B12 and selenium

There are very few studies testing vitamin B12 and selenium supplementation in people with psoriasis, and the ones that have been conducted have produced contradictory results, said Liao. Anderson said she advises her patients with psoriasis to take a good multivitamin, one that contains selenium and zinc, which have been shown to be good for the skin and other organs.

Other options

Possibilities being tested in the lab, used by naturopathic doctors or tried by psoriasis patients, include the spice turmeric, which is being studied at MD Anderson Cancer Center at the University of Texas for its anti-inflammatory and antioxidant properties; bitter melon, a plant used in traditional Asian and African medicine; resveratrol, an antioxidant plant compound; and probiotics, gut-friendly bacteria that may benefit immune system function and reduce inflammation.

However, approach any potential vitamins and supplements with a dose of skepticism, and always check with your doctor before beginning a new regimen.

Vitamins and Supplements

There is no direct link between vitamins and dietary supplements and psoriatic disease. However, many with psoriatic disease find that including vitamins and supplements in their diet helps their skin clear and may ease joint pain.

Dietary supplements can be extracts or concentrates, and they can occur in many forms, such as tablets, capsules, softgels, gelcaps, liquids or powders.

The U.S. Food and Drug Administration (FDA) does not regulate dietary supplements for safety or effectiveness. This can also lead to an inconsistency when it comes to active ingredients. It’s important you talk to your doctor before adding any vitamins or supplements to your treatment plan, as some may interfere with your medications.

Here are some of the more popular vitamins and supplements used to combat psoriatic disease.

Omega-3 fatty acids

Omega-3 fatty acids have been shown to decrease inflammation, and psoriasis is a disease of inflammation. Omega-3 fatty acids also seem to have a positive impact on the body’s immune system.

Types of omega-3 fatty acids:

  • Alpha-linolenic acid
  • Eicosapentaenoic acid (EPA)
  • Docosahexaenoic acid (DHA)

Alpha-linolenic acid is found in some vegetable oils, nuts, seeds and soy foods. EPA and DHA are found in fatty fish and algae. Fish oil is readily available in capsule form as a supplement. Some individuals with psoriasis show a deficiency of omega-3 fatty acids and elevations of omega-6 fatty acids, which tend to increase inflammation.

The research on whether omega-3 fatty acid supplements can help reduce the severity of psoriasis is mixed. More long-term clinical controlled studies are needed.

Fish oil can thin your blood, so check with your doctor before you start taking it, especially if you are taking warfarin (Coumadin) or other blood thinners.

Vitamin D topical ointments have been around and used to treat psoriasis for some time. Vitamin D is the main active ingredient in two prescription medications – Vectical and Dovonex – which are applied to the skin. Vitamin D can change the way cells grow. Psoriasis increases the growth of the skin’s cells. Vitamin D may slow the skin cell growth.

Research on whether vitamin D can help alleviate psoriasis symptoms is small and limited. A report in the May 2011 Science Translational Medicine journal, found that vitamin D helps counteract the body’s response to inflammation associated psoriasis.

Too much vitamin D can be dangerous. Before you add vitamin D to your psoriasis regime, talk with your doctor. The safest source of vitamin D is food.

Food sources of vitamin D include:

  • Cod liver oil
  • Salmon (sockeye)
  • Mackerel
  • Tuna fish canned in water
  • Milk, non-fat, reduced-fat, and whole, vitamin D-fortified
  • Orange juice fortified with vitamin D
  • Yogurt fortified with 20 percent of the daily value of vitamin D
  • Eggs, vitamin D is found in the yolk
  • Swiss cheese
  • Fortified cereals

You also can get vitamin D from 10 minutes of mid-day exposure to the sun. However, prolonged sun exposure has been linked skin cancer and is not recommended.

A simple blood test can tell you whether you’re deficient in vitamin D. If you’re concerned, talk with your doctor.

Glucosamine and Chondroitin

Glucosamine and chondroitin are dietary supplements that can be bought over the counter and can be taken individually or together. Glucosamine and chondroitin occur naturally in and around the cells of the body’s cartilage. Glucosamine is thought to help in cartilage formation and repair and may inhibit inflammation. Chondroitin is thought to promote cartilage elasticity and inhibit the breakdown of cartilage.

A growing body of research shows that these supplements may slow the progression and reduce the pain of osteoarthritis, a degenerative disease characterized by cartilage deterioration of the joints. However, psoriatic arthritis and osteoarthritis are different forms of arthritis and have different symptoms. No studies have found that glucosamine and/or chondroitin supplements effectively reduce symptoms of psoriatic arthritis.

Glucosamine contains substances extracted from animal tissue including shrimp, lobster shells and shark cartilage. People who are allergic to shellfish should avoid glucosamine. Also, children and women who are pregnant or plan to become pregnant should not take these supplements.

Glucosamine can increase blood sugar levels in diabetic patients. If you have diabetes, talk with your doctor before taking glucosamine supplements.

Methylsulfonylmethane (MSM)

Methylsulfonylmethane (MSM) is an organic sulfur-containing compound found in plants, fruits and vegetables that is destroyed when food is processed. The body needs sulfur to maintain healthy connective tissue.

You can buy MSM as a dietary supplement. However, there is little scientific evidence that it relieves joint pain or has anti-inflammatory benefits. One 2006 study by researchers at the Southwest College Research Institute found it improved symptoms of pain and physical function in patients with knee osteoarthritis without major adverse event. More research is needed.

Things to Keep in Mind About Supplements

  • Tell your doctor before taking any OTC supplements. Every substance has a potential to interact with your other medications and treatments.
  • Supplements should never replace medications your doctor has prescribed.
  • The FDA does not regulate the manufacturing of dietary supplements. Purity, quality, strength and composition can vary widely among different brands.
  • Should you take supplements and experience side effects, stop taking them! And tell your doctor.

Help is just a click away

To learn more about how vitamins and supplements can help your psoriatic disease, contact NPF’s Patient Navigation Center. Patient navigators can help you find a licensed naturopathic physician in your area who understands conditions related to the immune system, like psoriasis.

Last updated 6/24/19 by the National Psoriasis Foundation.

Best Multivitamin For Psoriasis

In today’s hectic lifestyle, we are rushing our meal times, failing to prepare healthy, wholesome and nutritious breakfasts, lunches and dinners.

The overreliance on pre-packaged and processed foods in today’s diet results in a huge deficiency in essential nutrients, which leads to serious health conditions, such as heart disease, stroke and cancers.

The Center For Disease Control (CDC) states that adults should eat approximately 2 cups of fruit and 3 cups of vegetables per day. However, a further CDC report stated that over 3/4 of US adults do not eat enough fruit and nearly 90% of US adults do not consume enough vegetables.

So what is the best way to get the right amount of nutrients? The answer is a daily multivitamin! Now, because people with psoriasis have an immune system that is out of control, we need to ensure we are using the best multivitamin for psoriasis, and not a cheap knock-off version.

Not only will a good multivitamin help you stock up on all the essential nutrients and minerals that you are missing from your diet, but it will ensure your auto-immune system is at least in a healthy shape so it can fight off all the common ails and stresses that could trigger a bad flare up.

What is Psoriasis?

Psoriasis is a chronic condition of the skin that occurs in about 1 in every 50 people. This disease is characterized by red, scaly and itchy skin that often occurs in the groin, elbow, knee, lower back, and scalp. Treatment for psoriasis involves the use of topical creams for your skin, oral medication, and sometimes light therapy to help relieve itching, inflammation and the rapid growth of skin cells. One of the most common and efficient treatment includes the best multivitamins for psoriasis.

Some of the major and essential vitamins for treating psoriasis include Vitamins A, E, D, and K. You can get all these from your diets except Vitamin D which is also created by your body when it is exposed to the ultraviolet rays of the sun.

Historically, Psoriasis have been treated with light therapy through the sun. Researchers believe that the healing effect lies in the sun’s ability to aid the body produce Vitamin D, a potent hormone that has a significant role in various metabolic reactions in the body. This vitamin helps to build a strong immunity against certain diseases and aids in heart, lung and brain function. Vitamin D can also be found in fatty fish (salmon, tuna, mackerel), beef liver, cheese & egg yolks.

According to a research study published in the Journal JAMA Dermatology in 2010, vitamin D deficiency is a common trait among
people with psoriasis. Adding vitamin D to your diet helps to make your skin grow slower resulting in the plaques becoming thinner and less scaly. Recent research has shown a direct advantage of using both topically as well as oral vitamin D preparations for easing the symptoms of psoriasis safely and efficiently.

Vitamin C is water-soluble and serves as an antioxidant. Antioxidants can be a potent aid in the treatment of psoriasis by averting damage that is as a result of oxidative stress.

Vitamin E can be taken in oral form with the advice of a qualified physician. You can get this vitamin from Spinach and Pumpkin
seeds which are both rich in the nutrient. You can also obtain it from
supplements and foods such as citrus fruits, berries, and green leafy
vegetables.

This vitamin is commonly found in orange and yellow
colored vegetables and is vital for the healthy production of skin cells. Vitamin A has been used topically for many years to treat photo-damage and psoriasis by decreasing the excessive production of skin cells that occurs with psoriasis. It also helps reduce skin inflammation in plaque psoriasis.

A vitamin A supplement can be used to ease your psoriatic symptoms. However, it should only be administered after getting a
go-ahead from your doctor.

Will Supplements Help Clear Psoriasis Plaques?

Although supplements are not obligatory, you will find multiple benefits by adopting certain specialized dietary supplements into
your diet. Adding vitamins and supplements into your daily routine can help keep your skin clear and allow it to heal much faster. Although nutritional supplements can help treat your psoriasis, it is not a miracle cure for psoriasis.

However, unlike the conventional drugs, you will not have to worry about side effects. It is necessary that you get good advice from a health professional with experience and knowledge working with dietary supplements and psoriasis before you start using them.

Clinical Research

There is no clinical research or study that shows a direct link between vitamins, dietary supplements, and psoriatic disease. Still, many people with psoriasis find that adding vitamins and supplements in their diet helps their skin clear and ease joint pain.

Additionally, the United States’ FAD (Food and Drug Administration) does not regulate the use of dietary supplements. Therefore, it is crucial that you speak with your doctor first before adding any supplement to your treatment plan. There are supplements that may interfere with the medication that you are taking to manage your psoriasis.

Here are our top 5 supplements for psoriasis:

by Dakota Hamilton

Finally wearing shorts after 47 years of psoriasis. Photo by Daniela Ciucci

• In the summer of 2014, my psoriasis flared dramatically. By the time I saw my dermatologist, 90% of my body was affected by a combination of plaque and guttate psoriasis. The diagnosis: severe.

Psoriasis is a chronic skin condition that affects three to five out of every 100 people in North America and Europe. It’s a four-billion-dollar-a-year business for pharmaceutical companies in the US alone. It devastates its sufferers and it’s incurable.

Those who suffer with this disease spend thousands of dollars on creams and medications. They fall for pyramid scheme snake oil promises of a cure because they are desperate. They risk their health on pharmaceuticals that can thin their skin, suppress their immune system or damage their liver or kidneys. There are always side effects.

My dermatologist suggested methotrexate, a chemo drug that can possibly affect the liver. To be eligible for MSP (Medical Services Plan of BC) coverage of the newer “biologics,” it would have to be proven that the methotrexate was either not working or was damaging my body. If I wanted to bypass the methotrexate – and MSP coverage – and go directly to biologics, it would cost in the neighbourhood of $20,000 to $25,000 a year. And there is no guarantee the biologics will work.

Here’s where a handful of luck is better than a boatload of knowledge. I searched the Internet and found the National Psoriasis Foundation (NPF) and joined the NPF-sponsored Team Inspire discussion group. There, I found a thread – patient hosted discussion – about a little known combination of the vitamins D3 and K2. And there were impressive photos. With nothing to lose, I ordered the vitamins. I had already eliminated dairy from my diet.

Six weeks after starting this vitamin protocol, I did not have one spot of psoriasis on my body, for the first time in 47 years.

I started my own thread on the NPF Team Inspire site called “…and his jaw dropped.” I chose this title because when my dermatologist saw me after I’d been on this protocol for only five weeks – his jaw dropped. Within a few months, the thread had grown significantly. Other people were also getting results.

But then things got strange. Trolls began visiting the thread with warnings about the dangers of high vitamin D3 consumption. Warning letters came from Team Inspire. Deletions of posts occurred – some of them mine and some from those who posted on the thread. More warnings from the “Team” arrived threatening my suspension from my own discussion group. I wrote to them asking “Why?” but received no response.

I found another like-minded psoriasis sufferer, Charlie, in Kansas. He was writing about magnesium chloride used topically. Charlie had found out about magnesium chloride by accident when he was working on his pond, tormented by mosquitoes. He noticed his friend wasn’t getting bitten.

It turned out his friend was taking magnesium chloride, orally. Charlie found a bag of road de-icer, which is mostly magnesium chloride and, interestingly, the highest mineral content in the Dead Sea, a destination for thousands of people suffering from psoriasis. He mixed it with water and sprayed it on his arms. It worked and the mosquitoes retreated.

A few weeks later, he noticed the psoriasis on his arms was going away. He sprayed the solution all over his body and although it burned, he kept it up – several times a day. Four months later, he was psoriasis free for the first time in over 30 years.

I was also using magnesium chloride along with the K2 and D3 so I suggested we join forces and start a new thread. Charlie was concerned he might have trouble running two discussion groups at the same time. His worries were promptly made irrelevant when Team Inspire shut down his thread. No explanation was given.

It had taken five months to get to 1,000 posts on my original thread. Our combined thread hit 1,000 in one month, the fastest growing thread in NPF history. People who had been using the K2-D3 combination saw their clearing jump dramatically with the addition of magnesium chloride. And the reverse was also true. When those who were using only magnesium chloride added the K2 and D3 supplements, their skin cleared more rapidly. We knew we were on to something.

But, as we were beginning to suspect, not everyone was happy about our success.

Here’s the reality. Pharmaceutical companies do not fund research of alternative remedies. There’s no money in it for them. They cannot patent supplements or vitamins. They fund research for allopathic – treatment by conventional means – medicines. Period.

Here is the list of the National Psoriasis Foundation corporate members in 2014:
Platinum: Abbvie, Celgene
Silver: Amgen, Janssen
Bronze: Novartis, Pfizer
Corporate: Lilly, Stiefel

Was this foundation being funded by large pharmaceutical companies? Were they in a conflict of interest? We had to wonder, especially after Charlie was again suspended, this time permanently. The more that people sent testimonials about the effectiveness of the protocol, the more we were being targeted.

We gave up, deciding the only way to get this information out to people was to start our own website, in which all the information about this protocol would be free. We used the testimonials that had been sent to us on the Inspire site – 40 testimonials plus 10 sets of photographs from people who had gotten results.

Within two days, we were threatened by the NPF Team Inspire with legal action if we did not remove all the testimonials from our website. A second letter threatened permanent suspension for me, with the additional threat that all my posts on the Inspire site – nine months of work – would be removed.

We removed the testimonials. And Team Inspire removed all evidence that I had ever written on their site. Nothing remains. And I have been permanently banned from the National Psoriasis Foundation site.

My crime? I had shared a natural remedy that was non-patentable and that worked, not just for me, but also for many others. A remedy that costs very little to maintain. A remedy with virtually no side effects.

There is logic to this new protocol. If three to five people in North America and Europe suffer from psoriasis and only one to two per 1,000 suffer from it in Asian countries, some questions need to be asked, including, “Could diet effect psoriasis?”

Excess calcium has been found in psoriasis plaques. Another study stated that people with psoriasis had an inability to metabolize calcium. Until recently, most Asian countries consumed little dairy. As their consumption rises, so does their incidence of psoriasis.

The highest amount of the vitamin K2 (MK-7) can be found in only one food source: natto, a popular food in Japan.

Magnesium chloride is used in the production of tofu, eaten in most Asian countries. And it is used in other Asian foods.

Vitamin D3 is the sunshine vitamin. The use of sunscreen, along with spending most of the workday indoors, has created a D3 deprived population.

How does this protocol work? In a simplified version, vitamin D3 pulls excess calcium from soft tissue (skin) and arteries where it shouldn’t be. Magnesium chloride keeps the calcium fluid. And vitamin K2 (MK-7) directs the calcium to bones and teeth where it should be. Dairy is too concentrated a form of calcium for most psoriasis sufferers to tolerate.

It’s encouraging to see more documentaries showing the questionable workings of large pharmaceutical companies. They have deep pockets and use them to silence or discount the findings of smaller companies that promote less invasive, alternative treatments for numerous diseases.

But we need to beware. Recently, a so-called documentary about psoriasis shows a man whose life has been shattered by the disease, although you never actually see his psoriasis. His doctor puts him on an unnamed medication. It’s a feel-good story. His skin is cleared. Happy ending. However, scroll down through the credits and you see the final credit – in small print – is Janssen, a large pharmaceutical company and a Silver Corporate Member of the NPF.

While there is no cure – hence the expression, “the heartbreak of psoriasis” – there are natural remedies that can reduce it to a minor irritation. Haven’t heard of them? Now you know why.

After decades of suffering from psoriasis, my skin has remained clear for over a year and a half.

For more information about this protocol – all information is free – visit freedomfrompsoriasis.com

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