Psoriasis

Description

Psoriasis is an autoimmune and inflammatory skin disease driven by an overactive immune response, disrupted gut barrier function, and metabolic dysfunction. High-carbohydrate diets, insulin resistance, and chronic inflammation activate immune cells—especially Th17 and Th1 pathways—that release cytokines such as IL-17, IL-23, and TNF-α. These cytokines stimulate rapid keratinocyte proliferation, causing the thick, scaly plaques characteristic of psoriasis. Systemic inflammation, oxidative stress, and leaky gut allow bacterial fragments (LPS) to enter the bloodstream, further activating the immune system and intensifying skin inflammation.

Insulin resistance and blood sugar spikes worsen psoriasis by elevating inflammatory cytokines, increasing oxidative stress, and accelerating skin cell turnover. Stress-related HPA-axis dysregulation raises cortisol, which destabilizes immune activity and can cause flares. Nutrient deficiencies common in high-carb diets—especially zinc, omega-3s, vitamin D, and B-vitamins—impair skin barrier function and worsen autoimmune activity.

Fasting, ketogenic diets, and carnivore diets directly reduce the inflammatory pathways that drive psoriasis. Ketosis lowers insulin, decreases IL-6, IL-17, and TNF-α, and restores immune balance. Carnivore and ketogenic diets eliminate dietary triggers that aggravate autoimmunity (grains, seed oils, sugar, gluten, lectins, and high-omega-6 foods). They also increase intake of anti-inflammatory nutrients such as omega-3 fatty acids, zinc, vitamin A, vitamin D, and complete amino acids essential for skin repair. Fasting activates autophagy, clears inflammatory immune cells, repairs the gut barrier, and reduces keratinocyte hyperproliferation. Together, these metabolic interventions often lead to dramatic reduction of plaques, decreased itching, and long-term remission of psoriasis symptoms.

Root Causes

[ 1 ] Mette GyldenlĂžve et al. (2015) DOI PMID [ 2 ] Alfred A Chan et al. (2022) DOI PMCID PMID [ 3 ] Ewa Duchnik et al. (2023) DOI PMCID PMID [ 4 ] Luigi Barrea et al. (2015) DOI PMCID PMID [ 5 ] Maria L. Musumeci et al. (2022) DOI PMCID PMID
[ 1 ] Mette GyldenlĂžve et al. (2015) DOI PMID [ 2 ] Alfred A Chan et al. (2022) DOI PMCID PMID [ 3 ] Ewa Duchnik et al. (2023) DOI PMCID PMID [ 4 ] Luigi Barrea et al. (2015) DOI PMCID PMID
[ 3 ] Ewa Duchnik et al. (2023) DOI PMCID PMID [ 6 ] Manfred Kunz et al. (2019) DOI PMCID PMID [ 5 ] Maria L. Musumeci et al. (2022) DOI PMCID PMID [ 7 ] Yingjun Gao et al. (2025) DOI PMCID PMID
[ 3 ] Ewa Duchnik et al. (2023) DOI PMCID PMID [ 8 ] Mariusz Sikora et al. (2020) DOI PMCID PMID [ 9 ] Mariusz Sikora et al. (2018) DOI PMID [ 10 ] Sara M Wilchowski et al. (2018) PMCID Link PMID [ 11 ] I. N. Ekimov et al. (2021) DOI Link [ 7 ] Yingjun Gao et al. (2025) DOI PMCID PMID
[ 5 ] Maria L. Musumeci et al. (2022) DOI PMCID PMID

Treatment Options

[ 12 ] Giovanni Damiani et al. (2019) DOI PMCID PMID [ 13 ] Lynda Grine et al. (2022) DOI PMCID PMID [ 14 ] Nawaf Almutairi et al. (2022) DOI PMCID PMID [ 15 ] Shekhar Neema et al. (2022) DOI PMCID PMID
[ 16 ] Vaia Lambadiari et al. (2024) DOI PMCID PMID [ 17 ] Giuseppe Castaldo et al. (2020) DOI PMID [ 18 ] Giuseppe Castaldo et al. (2015) DOI PMID

Sources

[1] Patients with psoriasis are insulin resistant
[ 1 ] Mette GyldenlĂžve et al. (2015) DOI PMID
[2] Association between baseline insulin resistance and psoriasis incidence: the Women's Health Initiative
[ 2 ] Alfred A Chan et al. (2022) DOI PMCID PMID
[3] The Impact of Diet and Physical Activity on Psoriasis: A Narrative Review of the Current Evidence
[ 3 ] Ewa Duchnik et al. (2023) DOI PMCID PMID
[4] Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire
[ 4 ] Luigi Barrea et al. (2015) DOI PMCID PMID
[5] The role of lifestyle and nutrition in psoriasis: Current status of knowledge and interventions
[ 5 ] Maria L. Musumeci et al. (2022) DOI PMCID PMID
[6] Psoriasis: Obesity and Fatty Acids
[ 6 ] Manfred Kunz et al. (2019) DOI PMCID PMID
[7] Characterization of the Gut Microbiota in Patients with Psoriasis: A Systematic Review
[ 7 ] Yingjun Gao et al. (2025) DOI PMCID PMID
[8] Clinical Implications of Intestinal Barrier Damage in Psoriasis
[ 8 ] Mariusz Sikora et al. (2020) DOI PMCID PMID
[9] Intestinal barrier integrity in patients with plaque psoriasis
[ 9 ] Mariusz Sikora et al. (2018) DOI PMID
[10] The Role of the Gut Microbiome in Psoriasis: From Pathogens to Pathology
[ 10 ] Sara M Wilchowski et al. (2018) PMCID Link PMID
[11] Role of damage to intestinal barrier in development of psoriasis
[ 11 ] I. N. Ekimov et al. (2021) DOI Link
[12] The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study
[ 12 ] Giovanni Damiani et al. (2019) DOI PMCID PMID
[13] The Effects of Modified Intermittent Fasting in Psoriasis (MANGO): Protocol for a Two-Arm Pilot Randomized Controlled Open Cross-over Study
[ 13 ] Lynda Grine et al. (2022) DOI PMCID PMID
[14] Clinical implications of intermittent Ramadan fasting on stable plaque psoriasis: a prospective observational study
[ 14 ] Nawaf Almutairi et al. (2022) DOI PMCID PMID
[15] Efficacy of Intermittent Fasting in the Management of Chronic Plaque Psoriasis: A Phase IIb Clinical Trial
[ 15 ] Shekhar Neema et al. (2022) DOI PMCID PMID
[16] The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial
[ 16 ] Vaia Lambadiari et al. (2024) DOI PMCID PMID
[17] Aggressive weight-loss program with a ketogenic induction phase for the treatment of chronic plaque psoriasis: A proof-of-concept, single-arm, open-label clinical trial
[ 17 ] Giuseppe Castaldo et al. (2020) DOI PMID
[18] Very low-calorie ketogenic diet may allow restoring response to systemic therapy in relapsing plaque psoriasis
[ 18 ] Giuseppe Castaldo et al. (2015) DOI PMID