Psoriasis is a chronic inflammatory condition that affects various bodily systems. A person with psoriasis may experience skin changes as well as pain and inflammation in the joints.

Some studies have suggested that eating a gluten-free diet can help reduce the symptoms.

Psoriasis develops when the immune system does not function properly, causing the inflammation that affects the skin and joints.

People with psoriasis seem to have a higher chance of developing other autoimmune diseases, including celiac disease.

According to the National Psoriasis Foundation, up to 25% of people with psoriasis have a sensitivity to gluten. So, a gluten-free diet might help these people manage their symptoms.

Gluten refers to a group of proteins that occur in wheat and other similar grains, including rye, barley, oats.

Celiac disease

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Some people with psoriasis find that a gluten-free diet improves symptoms.

People with celiac disease tend to avoid foods that contain gluten, as it can lead to worsening symptoms and sometimes complications.

Celiac disease is an autoimmune condition wherein the immune system treats gluten-derived peptides as foreign invaders and attacks the gluten and lining of the intestines. It affects around 1% of people globally.

Gluten occurs in a wide range of foods, from baked goods and soups to some alcoholic beverages. It can also be present in some cosmetics and medications.

The following foods typically contain gluten:

  • breads
  • pastas
  • pizzas
  • cookies
  • cakes
  • some processed meats
  • salad dressings

A person who wishes to avoid gluten should read all food labels carefully, as it can be hard to predict which foods contain gluten.

Gluten sensitivity

Some people may have a sensitivity to gluten as opposed to celiac disease. These people may also benefit from avoiding gluten.

If someone has a sensitivity to gluten but does not have celiac disease, they may have a condition called non-celiac gluten sensitivity.

According to some research, up to 13% of people have a gluten sensitivity. However, it is difficult to know the exact figures.

Symptoms can occur when a person consumes something that contains gluten. They include:

There is no specific way to diagnose gluten sensitivity. If a person experiences problems after eating gluten, a doctor will first need to rule out celiac disease and other conditions before diagnosing gluten sensitivity.

What other diet tips can help with psoriasis? Learn more here.

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In studies, gluten-free foods have helped some people manage their symptoms.

Many people with psoriasis wonder whether or not a gluten-free diet can help improve their symptoms.

A 2001 study demonstrated the impact of a gluten-free diet in 33 people with psoriasis who had high levels of a certain type of antibody called anti-gliadin antibodies (AGA).

Antibodies form when the body tries to fight foreign invaders. Gliadin is one of the main proteins in gluten, and it is mainly responsible for gluten sensitivity. A person with high AGA levels is likely to have celiac disease or a gluten sensitivity.

After 3 months on a gluten-free diet, 73% of people with psoriasis and AGA in their bodies saw an improvement in their condition, compared with none of the people without AGA.

One review from 2014 revealed that celiac-related AGAs were present in 14% of people with psoriasis compared with 5% of people without psoriasis.

In another study, this time from 2010, blood samples showed that about 1 in 3 people with psoriasis have high levels of AGA.

These results suggest that a gluten-free diet might benefit some people with psoriasis.

Adopting a gluten-free diet can have pros and cons.

A gluten-free diet may help relieve some of the symptoms of psoriasis.

For some people, making careful decisions about food can also lead to a more healthful diet and lifestyle overall, especially if a person increases their intake of fresh fruits and vegetables.

In fact, some people with celiac disease say they have more energy when they follow a gluten-free diet.

It is easier now to find gluten-free foods than in the past either in stores or for purchase online.

People who follow a gluten-free diet can only eat foods that are gluten-free. Therefore, it is vital to read the packaging carefully and to avoid anything that contains gluten. Many stores now have a range of gluten-free products, but these can be expensive.

Other considerations include:

  • possible nutritional deficiencies as a result of this diet
  • impact on social activities
  • the effects of following a restrictive diet

It can be challenging to find the right foods and to follow the diet, especially when cooking for a family who may not be following a gluten-free diet. Many restaurants now offer gluten-free items, but these can make eating out somewhat restrictive.

Possible deficiencies

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A doctor may recommend taking supplements.

Following a gluten-free diet may also result in low levels of certain vitamins and nutrients, including:

A person should speak to their doctor before starting the diet and ask for advice on how to get these vital nutrients. A doctor may recommend taking vitamins and other supplements.

In 2018, researchers expressed concern that some people were following a gluten-free diet when they did not need to, and that this could have a negative impact in some cases.

Doctors may advise some individuals not to follow a gluten-free diet.

People with psoriasis who follow a gluten-free diet may need to follow it for at least 3 months, as it may take this long for them to see any improvements in their condition.

However, it is difficult to predict an exact timeline or expected improvements.

After 3 months, a person can consider adding gluten back into their diet while monitoring for any psoriasis symptoms, such as skin changes and joint pain.

If symptoms do not return when adding gluten, the person can probably return to their usual diet.

Anyone considering a gluten-free diet should talk to their doctor and a dietitian about the best way to go about it. The Celiac Disease Foundation offer information about gluten-free diets.

Their website contains lists of foods to avoid and include as part of a gluten-free diet.

Q:

When my psoriasis is not flaring, it does not bother me very much, and I don’t think about it. But when a flare starts, it bothers me a lot. If I decide to follow a gluten-free diet, should I do it all the time or only during flares?


A:

Although the evidence suggests that a gluten-free diet may be useful for certain people with psoriasis, many studies are not totally conclusive. For this reason, it is not exactly clear if or when following the diet would be helpful.

If a person finds that a gluten-free diet helps their psoriasis and prevents flares, they may wish to pursue the diet even when they are not flaring. Remember that a gluten-free diet is not meant as a replacement to conventional therapies for psoriasis. A person should discuss the risks and benefits of this diet beforehand with their doctor and a dermatologist.

Owen Kramer, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.