Does gluten trigger psoriasis flare-ups, and how to reduce the harm?
Gluten is a fairly recent topic of significant interest and research. You must have heard about gluten being a trigger not only for psoriasis but other autoimmune disorders and gut-related conditions. Unfortunately, it affects the majority. Many people with Psoriasis experience skin flare-ups, joint inflammation and nail psoriasis worsening after eating gluten-containing foods made of; wheat, barley, rye, and triticale.
What is gluten?
“Gluten” means “glue” in Latin, and gluten is a sticky main storage protein that belongs to the class of prolamins found in wheat, barley, rye, and triticale. It is a complex mixture of hundreds of related but distinct proteins, mainly gliadin and glutenin which provides no essential nutrients for our body and is hard to digest, especially for those with digestive disorders.
Why gluten triggers psoriasis flare-ups?
A number of studies suggest that people with psoriasis suffer from Intestinal Permeability also known as Leaky Gut and have increased markers for Gluten Sensitivity and share common genetic and inflammatory pathways with celiac disease, which is also an autoimmune disorder caused by a reaction to gluten. Sensitivity to gluten causes inflammation in the gut that stops the absorption of necessary nutrients. So, If gluten-containing foods are triggering flare-ups, joint inflammation or fatigue, it could be due to gluten sensitivity.
What foods contain gluten?
Varieties, derivatives and byproducts of wheat:
- Durum: In Latin means “hard”, it is the hardest wheat. Durum flour is mainly used in pasta making.
- Einkorn: Ancient wheat with much lower gluten content thus easier to digest than traditional wheat flour.
- Emmer / Farro: Ancient strains of modern wheat, is low in gluten and high in protein and fibre.
- Farina: Coarsely ground endosperm of hard wheat varieties, but not durum, often used for hot cereal (porridge).
- Freekeh: Roasted young, green grains of durum wheat. Has a unique smoky and nutty flavour.
- Graham: Named after Sylvester Graham. Coarse whole-wheat flour and is not sifted during milling.
- Kamut grain: Kamut is the commercial name of Khorasan/oriental wheat, which is a tetraploid wheat species.
- Semolina: is a coarse, high-gluten flour made from durum wheat.
- Spelt: Also known as Dinkel wheat or Hulled wheat, is an ancient wheat, cultivated since approximately 5000 BC.
- Wheat berries: A wheatberry, is a whole wheat kernel, with bran, germ, and endosperm, but without the husk.
- Couscous: Semolina is moistened and tossed with fine wheat flour until it forms tiny, round balls.
- Bulgur: Made from the cracked parboiled groats of several different wheat species, most often from durum.
Common gluten containing processed foods:
- Pastas: raviolis, dumplings, couscous, and gnocchi
- Noodles: ramen, udon, soba (those made with only a percentage of buckwheat flour) chow mein, and egg noodles. (Note: rice noodles and mung bean noodles are gluten-free)
- Breads and Pastries: croissants, pita, naan, bagels, flatbreads, cornbread, potato bread, muffins, doughnuts, rolls
- Crackers: pretzels, goldfish, graham crackers
- Baked Goods: cakes, cookies, pie crusts, brownies
- Cereal & Granola: corn flakes and rice puffs often contain malt extract/flavouring, granola often made with regular oats, not gluten-free oats
- Breakfast Foods: pancakes, waffles, french toast, crepes, and biscuits.
- Breading & Coating Mixes: panko breadcrumbs
- Croutons: stuffings, dressings
- Sauces & Gravies: (many use wheat flour as a thickener) traditional soy sauce, cream sauces made with a roux
- Flour tortillas
- Beer (unless explicitly gluten-free) and any malt beverages (see “Distilled Beverages and Vinegars” below for more information on alcoholic beverages)
- Brewer’s Yeast
- Anything else that uses “wheat flour” as an ingredient 
Should you avoid gluten all together if you have psoriasis?
People with psoriasis report massive improvement after eliminating gluten from their diet. If you are experiencing flare-ups, try to avoid foods containing gluten. This may not be forever but for a period of time, so you can heal your digestive system and restore your Gut Microbiota Ecosystem.
Research shows that diet can rapidly and reproducibly alter the human gut microbiome and that is just within 4 days. Start healing your gut by eliminating gluten other harmful processed foods for a couple of months can possibly help you clear up your skin and restore your gut health. After which, moderation is the key.
Everyone’s triggers are different, it is only through awareness you can establish your triggers, heal your skin from the inside out, and take control over your psoriasis. You can do it! Through an active and healthy lifestyle and balanced and clean eating, you are on the path to achieving even better health than ever before.
What to eat on a gluten-free diet?
In a gluten-free diet, the goal is to avoid wheat, barley, rye, and triticale, and replace them with gluten-free grains. The gluten-free section of groceries offer a wide range of gluten-free grains and flour mixes that may consist of grains, seeds, roots and nuts, and some ingredients in the flour miixes might be those known as a trigger so read the labels and be sure to choose the right product:
Gluten-free grains and possible ingredients in gluten free flour mixes:
Contains; Protein, Carbohydrates, Manganese, Magnesium, Phosphorus, Iron, Selenium, Copper and a small amount of fat.
Contains; Protein, Carbohydrates, Fiber, Potassium, Phosphorous, Magnesium, Calcium, Iron, Copper, Thiamin, Riboflavin, Niacin, Folate, Vitamin K, Vitamin B-6, a very small amount of fat.
Contains; Protein, Carbohydrates, Fiber, Iron, Manganese, Calcium, Magnesium, Phosphorus, Potassium, Zinc, Copper.
Contains; Protein, Carbohydrates, Fiber, Manganese, Magnesium, Phosphorus, Folate, Copper, Iron, Zinc, Potassium, Calcium, Vitamin E. Vitamins B1, B2 B3, and B6.
Contains; Thiamine, Niacin, Vitamin B6, Manganese, Magnesium, Phosphorus, Iron, Zinc. (Brown rice provides much more vitamins and minerals than white rice.)
Contains; Protein, Carbohydrates, Fiber, Copper, Iron, Magnesium, Phosphorum, Potassium, Zinc, Vitamin B1, Vitamin B2, Vitamin B5, Vitamin B6, and small amount of fat.
Contains; Protein, Carbs, Fiber, Iron, Calcium, Niacin Vitamin-B6, Thiamin, Riboflavin, Vitamin K, Vitamin A, Vitamin-E.
Contains; Protein, Carbohydrates, Fiber, Folate, Phosphorus, Potassium, Iron.
Contains; Protein, Carbohydrates, Fiber, Calcium, Phosphorus, Thiamin, Riboflavin, Niacin , Vitamin C, Manganese, Iron, Zinc, Calcium, Magnesium
Contains; Protein, Carbs, Sugar, Fiber, Thiamine, Copper, Molybdenum, Magnesium, Phosphorus and Fat (includes the omega-3 fatty acids.)
Avoid the possible triggers in gluten-free flour mixes:
If you are on a gluten-free diet but psoriasis seems to flare more or not change at all, then analyze your diet to see if you are consuming trigger grains or gluten-free flour mixes that contain trigger ingredients such as; corn, soy, chickpeas, lentils, mung beans, peanuts, lupin beans and white potato starch.
These foods have many vitamins and minerals and may be beneficial to healthy individuals, however, experiences show that eliminating these foods can greatly improve psoriasis and psoriatic arthritis and so many other autoimmune disorders.
Psoriasis is a disease characterized by a leaky gut which is an Intestinal permeability. Leaky gut is associated with Gluten-Related Disorders. Gluten can interfere with the absorption and breakdown of much-needed vitamins and further increase intestinal permeability and trigger an immune response in the body which in the case of Psoriasis triggering flare-ups. Therefore, it is best to avoid gluten to heal the gut and consequently psoriasis.
 Sikora, Mariusz et al. “Intestinal barrier integrity in patients with plaque psoriasis.” The Journal of dermatology vol. 45,12 (2018): 1468-1470. doi:10.1111/1346-8138.14647
 Bhatia, Bhavnit K et al. “Diet and psoriasis, part II: celiac disease and role of a gluten-free diet.” Journal of the American Academy of Dermatology vol. 71,2 (2014): 350-8. doi:10.1016/j.jaad.2014.03.017
 “Sources of Gluten” Celiac Disease Foundation, 20350 Ventura Blvd Ste 240, Woodland Hills CA 91364
 David, Lawrence A et al. “Diet rapidly and reproducibly alters the human gut microbiome.” Nature vol. 505,7484 (2014): 559-63. doi:10.1038/nature12820
5] Camilleri, Michael. “Leaky gut: mechanisms, measurement and clinical implications in humans.” Gut vol. 68,8 (2019): 1516-1526. doi:10.1136/gutjnl-2019-318427
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