Gluten-Free Diet Benefits Psoriasis

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It seems like everyone is trying out a new diet these days—some cut out dairy, others push aside sugar, and many extoll the virtues of a plant-based regimen.

And while it may be easy to dismiss these as “fad” diets, medical research has proven that some of them can truly benefit people suffering from various diseases.

This seems to be the case with psoriasis, the most common autoimmune disease in the United States, especially in regards to following a gluten-free diet.

Psoriasis is an inflammatory condition in which the body produces too many new skin cells too quickly; this results in red, scaly patches on the skin called plaques that can be itchy and painful. Treating psoriasis can be tricky—patients begin by trying topical creams and ointments, and then if those don’t work, they may move on to more systemic medications: prescription drugs that affect the whole body. Most psoriasis treatments, both topical and systemic, attempt to stop the skin cells from growing so rapidly, thus decreasing inflammation and the development of plaques. Inflammation plays a big role in psoriasis, and many patients try different diets with the goal of reducing this inflammation. Studies have shown, for psoriasis patients with a sensitivity to gluten, a gluten-free diet can greatly lower levels of inflammation and vastly improve symptoms.

Gluten and Psoriasis: What the Research Tells Us

Recent studies have found up to 25% of people with psoriasis may benefit from cutting gluten from their diet. Gluten is a protein found in grains like wheat, barley, rye, spelt and sometimes oats. Some people have an autoimmune disease called celiac disease, where ingesting gluten results in inflammation of the small intestines; this inflammation damages the intestines and causes discomfort, pain, gastrointestinal problems and cognitive challenges. Other people may have a sensitivity to gluten without celiac disease, called non-celiac gluten sensitivity, which causes similar, but less severe, problems. Following a gluten-free diet is the one and only treatment for celiac disease and non-celiac gluten sensitivity, and after cutting out gluten, patients can resume their normal lives and feel much better.

For people with celiac or sensitivity, their immune systems perceive gluten as an intruder, and synthesize special molecules called antibodies to fight gluten particles; this battle ignites inflammation and causes damage to occur. And research suggests that psoriasis and celiac disease share several common genetic and inflammatory characteristics. A 2015 analysis of peer-reviewed studies looking at this connection found psoriasis patients are significantly more likely to be sensitive to gluten than people without psoriasis, and they’re twice as likely to have celiac disease.

To be clear, not all psoriasis patients will benefit from a gluten-free diet. But those who have a sensitivity to the protein may greatly benefit from avoiding it. One study out of Sweden tracked 33 psoriasis patients with a known gluten sensitivity as they followed a gluten-free diet. After three months, 73% of patients saw a nearly 50% improvement in their psoriasis symptoms. However, once the patients began eating gluten again, their psoriasis returned to previous levels. Three case studies have been presented in peer-reviewed journals examining the experiences of patients who saw a rapid clearing of their psoriasis plaques after following a gluten-free diet, and another clinical trial studying 28 patients found a significant decrease in their plaques as a result of avoiding gluten, as well.

These studies provide a foundation, but since they look at small sample sizes, more research is needed to discover the true relationship between gluten and psoriasis. Until further information is published, patients can see for themselves whether this diet will benefit them.

Will a gluten-free diet help your psoriasis?

If you think you may benefit from a gluten-free diet, it’s important that you don’t stop eating gluten before getting tested for celiac disease. The blood test for celiac looks for high levels of the antibodies that fight gluten, so you must have gluten in your system to get an accurate assessment of these antibody levels. If your test results show no signs of celiac disease, it’s possible you still have a gluten sensitivity. We don’t yet have reliable tests to confirm this sensitivity, so the best way to find out is by adopting a gluten-free diet for 30 days, under doctor supervision. Pay close attention to your symptoms and keep detailed notes of your daily observations. After a month, you can try adding gluten into your diet again—if your psoriasis symptoms worsen, or if you experience returning cognitive or digestive issues, it’s likely that you have some gluten sensitivity.

If your test results show no indication of celiac disease, and if your symptoms don’t improve after following a gluten-free diet, then there’s no need to cut out gluten. Following a gluten-free diet can be challenging, expensive, and restrictive, so there’s no reason to continue it if you’re not experiencing an improvement in your health. But for those who have celiac or sensitivity, avoiding gluten can be an effective way of reducing your psoriasis plaques and keeping your body healthy. Keep in mind that gluten-free foods are not automatically healthy, though: often, manufacturers will add more sugars, fats, and gums to replace gluten, so try sticking to naturally gluten-free foods, like lean proteins and vegetables. It may be difficult at first, but over time, committing to this diet will get easier—and the rewards will be worth it.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 15

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