Modifying Paleo to Treat Psoriasis

April 19, 2012 in Categories: , by

Print Friendly

In the paleo community, we are accustomed to assuming that a standard paleo diet will cure (or at least significantly improve) virtually every health problem.  But, if you have psoriasis (or dermatitis or eczema), be prepared:  paleo not only may fail to resolve these skin conditions, it might even make it worse.  Now, don’t go running for the hills.  The principles behind the paleo diet are still sound.  It is still the best way to eat for your long-term health.  And there are certainly some people who find complete resolution of their psoriasis symptoms with the switch to a paleo diet (for those people, the root cause of the psoriasis is typically a gluten sensitivity).  For me (and for many others), switching to paleo made my psoriasis worse.  This isn’t because paleo has us on the wrong track; it’s simply because out-of-the-box paleo is not actually enough.

I am a long term sufferer of lichen planus, a form of psoriasis where the inflammation occurs in the mucosal layer of the skin (and very unnerving, you can actually get lesions in the gut mucosa as well!).  In fact, it was my search for a cause (and hopefully cure) for this condition that brought me to paleo in the first place!  All my other health issues either completely resolved or improved substantially within weeks of switching to a paleo diet, but my lichen planus did not improve.  If anything, it got worse.  But since paleo was working so well for me in every other respect, my search for a solution stayed within a paleo framework.

What you might not know (and certainly I didn’t) was that psoriasis (and dermatitis and eczema) is an autoimmune disease.  It’s not always listed in those lists of autoimmune diseases that can be put into full remission by a paleo diet (it is listed in The Paleo Answer, but not The Paleo Diet nor The Paleo Solution).  Why is it so often left out?  I guess it’s because when compared to Lupus, Multiple Sclerosis or Non-Hodgkin’s lymphoma, psoriasis is small potatoes.  And let’s just take a moment to appreciate how lucky we are that, when our bodies formed antibodies against our own cells, we only ended up with psoriasis!

Psoriasis is also an indicator of a severely leaky gut (that’s how we develop the autoimmunity in the first place), with a very high likelihood of Small Intestinal Bacterial Overgrowth.  It is also very commonly linked to a gut-brain connection problem with inflammation and autoimmunity targeting skin cells.  I went into some details about the gut-brain connection in this post, but I also recommend listening to the explanation of the gut-brain-skin axis that Chris Kresser gives in his Revolution Health Radio podcast episode titled “Naturally Get Rid Of Acne By Fixing Your Gut”.  There is a complex interplay between a leaky gut, a stressed body, loss of insulin and leptin sensitivity, mood issues, food sensitivities, and the inflammation that manifests as psoriasis.  Basically, if you suffer psoriasis, chances are your gut, your immune system and your hormones are all really messed up.

So, what do you do about psoriasis?  The first and most important step is to follow the paleo diet “autoimmunity protocol”.  This means that in addition to all of the foods we already avoid while eating paleo, we must also avoid:

  • Eggs (especially the whites)
  • Nuts and Seeds (or at least severely restrict quantities)
  • Nightshades (tomatoes, eggplant, peppers of all kinds)

We are also people who Can Not CheatEver.  We can not tolerate any dairy, not even grass-fed butter or ghee.  Food quality becomes extremely important, so the more we can eat grass-fed meat, wild-caught fish, pastured eggs and chicken, and organic vegetables, the better (I know it’s expensive and I certainly can’t afford this 100%, but I just do the best I can).  And we are people who can’t tolerate very much sugar (even the sugars in fruits) or starches (even from superfoods like sweet potatoes) as they tend to feed the organisms in Small Intestinal Bacterial Overgrowth.  It would be worthwhile to have a look at the GAPS diet food list as an indicator of which fruits and vegetables should be avoided (although I wouldn’t suggest starting with the GAPS diet protocol unless you really have tried everything else).  And that’s not all.  Because stress hormones can play a key role in the perpetuation of psoriasis, it is especially important for us to get lots and lots of high quality sleep, avoid excessive caffeine intake (or cut it out completely), severely limit alcohol consumption (or avoid it completely), get lots of low-strain exercise, manage the stress in our lives, get sun exposure and take a Vitamin D3 supplement (on the higher dose side; I take 12,000IU per day in addition to trying to get outside every day).  I also suggest reading my recommendations on Repairing The Gut.  In particular, I suggest incorporating organ meat into your diet at least twice per week, consuming bone broth or other collagen-rich foods (like gelatin, stew hens and heart meat) at least twice per week (every day would be even better), consuming fermented foods (like raw Sauerkraut or coconut milk kefir) every day, and consuming coconut oil every day (I like it in my coffee).

So how long until you see some results?  You should start to see improvement very quickly, within a couple of days for some people up to 3-4 weeks for others.  If you do not see improvement within a month, you may also have developed additional food sensitivities (your gut is leaky, after all).  If doing all of the above still isn’t enough to see improvement in your symptoms, it would be worth finding a physician, naturopathic doctor, or chiropractor who will order an IgG and IgA food sensitivity blood test (you might also investigate Small Intestinal Bacterial Overgrowth, internal yeast infections and parasite infections as possible confounding factors as well).  These food sensitivities are transient and once your gut has healed (and at least 6 months have passed without exposure), you should be able to reintroduce the foods.  Actually, you should be able to reintroduce eggs, nuts and seeds, higher sugar fruits and vegetables and maybe even nightshades at some point in the future as well.  Are you wondering how long this is going to take?  I’m afraid the answer is anywhere between 2 months and 2 years, depending on exactly what the root causes are for you.  But, if you could see how much my lichen planus has improved in 3½ months, you would be amazed.  I know that the extra dietary restrictions are tough, but it is worth it to be able to cure such an aggravating condition without the use of steroids.  And the thing to keep in mind is that once the psoriasis is gone, out-of-the-box paleo really will be enough for us.



Hello, I just read your article and it has some very interesting information. It seems psoriasis is a lot harder to treat than I thought. I’ve had scalp psoriasis since I was 14 (I’m 20 now). After years of drug abuse, smoking and a junky vegetarian diet (pizza, box cereal, pb n j’s….ohhh I shutter just thinking about it haha >.<) I quit smoking, doing any drugs legal or illegal and started following a candida diet. I stumbled upon a site called, I felt like I discovered a prophet of healing. She is very knowledgeable about natural medicine and I learned a tremendous amount from reading her articles. When I read her article on the symptoms of candida overgrowth I felt that my psoriasis was caused directly from candida, so I started her diet for treating candida. The diet was very strict, very low carb (pretty much just eggs, meat and above ground vegetables…no caffeine) and she recommended natural anti-fungals, bone broth, coconut oil, butter/ghee and organ meats. Plus no nightshades since I know that psoriatics don't do well with them.

After the first couple weeks of carb withdrawl and detoxing I felt great, full of energy and joy and hope for the first time since childhood. My psoriasis was better than it had ever been, my acne cleared up completely, my brain fog dissipating. I did have a couple slip ups whenever I would go to my mom's house and binge on some nuts, I would break out the next couple days and my psoriasis would come back. After about 5 months of this diet my psoriasis had cleared but I felt that I wasn't getting enough carbs. I was becoming fatigued, I developed dark circles under my eyes, I was always dehydrated no matter how much water I drank, I couldn't think very well and I was skin and bone skinny. So I felt that I needed a new dietary approach as my health was rapidly deteriorating.

I came across the PHD (Perfect Health Diet) by Paul and Shou Ching Jaminet while reading some posts on They believe that low carb diets can be dangerous especially over long periods of time as ketosis can put a real strain on your body (as I can attest to) and that good health can be achieved through moderate carb intake and correct macronutrient portioning. So I decided to add in sweet potatoes to my diet at every meal. I immediately felt relieved and had energy again. I could think normally and my dark circles began to disappear but alas my psoriasis came back :(, although my acne did not.I became very frustrated as to how to go about my predicament.When I was at my local health food store I began talking to a store clerk about my psoriasis and she told me to go down 2 doors to see a psychologist and auryvedic medicine practioner who does food allergy testing. He told me to look into the GAPS diet, he said that some people who did the GAPS diet were able to clear their psoriasis. I've since cut out sweet potatoes (sweet potatoes aren't allowed in the GAPS diet) and I'm going to replace them with winter squashes to see how I do. I'm also going to take your advice and cut out eggs/butter/ghee.

This whole journey has been eye-opening about sooooo much. I feel like I am getting close to healing myself completely and now with all this knowledge I've acquired about health and nutrition I feel like I'm doing myself a good service for the rest of my life. If there is anything you would suggest that I do, please let me know. I'm all ears (or eyes I should say hehe). Thank you so much :)


i feel for people searching for a cure or relief to an illness as there are too many so called treatments for serious auto immune disease like psoriasis candida eczema etc

One thing we all should be concerned with is the intake of protein . excess animal protein causes ammonia production in the body . In 2009 study showed that participants on a high-meat diet excreted twice as much ammonia as those on a low-meat diet. This ammonia increases the pH level of your colon, making it more alkaline.

An alkaline colon is the perfect environment for your Candida overgrowth to

And most of us with any gut problems have low stomach acid which i think is the key to this so breaking down animal protein would put extra strain on the liver and kidneys.

I have had eczema develop early last year and was prescribed several antibiotics before seeing a skin dermatologist and now have really bad yeast infection causing eczema or psoriasis to develop in new spots .

I tried gaps but i found the high intake of protein and fat causing my flare ups :(

I still cannot get my head around increasing protein to heal the gut . I do think we need to eat less of it as i have cut down my consumption and my condition has calmed down for the moment .

I truly believe a plant based diet will be the key to reversing some auto immune diseases with the supplementation of zinc to heal intestinal permeability or leaky gut.

Psoriasis/candida fungus is generally toxins not being processed by your liver coming out on your skin and I believe a plant based diet might be the key to reversing this auto immune disease with the supplementation of zinc to heal intestinal permeability or leaky gut.

Hi Sarah, Thank you so much for sharing your research and understanding on this site – what would we do without people like you? Your posts regarding your struggles with autoimmune issues make me feel hope and despair at the same time! I, too, am suffering a ‘less severe’ autoimmune response in the form of hives and eczema and have just recently found this is because I have developed a high sensitivity to salicylates in my diet. I’ve been doing ‘strict paleo’ for 3 weeks now, and noticed an immediate improvement in my general health and digestion. I’m holding your AIP in reserve at the moment, as I am very limited in what veges (and no fruit except pears) that I can eat already, so I’m a bit concerned about removing eggs and sweet potatoes, in particular. Interestingly, I’ve noticed I can tolerate medium salicylate foods if I’m eating paleo, but had to restrict myself to low salicylate foods on an elimination diet – all I can think is that removing grains has helped my body tolerate more salicylates. I was thinking of sticking with basic paleo for a while (overlayed with my restricted fruits/veg), hoping that I would see further improvement over time without needing to resort to a very strict version of AIP – what do you think would be a reasonable period of time for this trial, or am I just kidding myself and should leap into AIP? Thanks for all the wonderful advice and great recipes you so willingly share!

I think you’re plan is a good one. It makes sense to me to see how far paleo can get you first. I’d give it a month or two before deciding whether or not you need to try the AIP.

Hi your blog is very important to me. Thank you !
I follow the Paleo over 1 year but i can not lose weght and worse i still have my Hashimoto and rosacea.
Last week i found here AIP and i started without any diary, nightshades, eggs and nuts mainly.
I have some questions about sun exposure and my rosacea. Prescriptians are to avoid Sun and use a very high sun factor. I followed everything the last 10 years but no change. Every year or every 2 i do a corse of antibiotics.
I would appriciate if you could advise me about that. I think rosacea is similar to psoriasis and other skin deceases.
Thank you.

Most skin conditions actually improve with sun exposure, although there are some that can be made worse. I’m not sure about rosacea, but I have heard from many people who had rosacea disappear with the autoimmune protocol so I definitely recommend that as a place to start (there’s definitely a link between nutrient status, meaning whether you are deficient or have a surplus of any micronutrients in your body, and how your body reacts to the sun too).

Happy to have found you. Thanks for the science. I eagerly await the publication of your book.

I have HLA-B27+ associated auto-immune issues. First showed @ 10 years ago as psoriasis during 2nd trimester of first pregnancy, with more psoriasis/arthritis/uveitis/hashimotos when my first child weaned (common). Had another bout of uveitis during 2nd trimester of my second pregnancy.

Started eliminating foods during that first pregnancy….

Over the course of the past 10 years removing:
dairy – cleared up my acne, improved GI issues
gluten/other grains/legumes – improved psoriasis, improved GI issues
grapes/grape products (including wine) – *huge* improvement in my psoriasis (no clue why, as it’s not a common allergen)
corn – helped stabilize moods (less rage)
nightshades – majority of my arthritis pain slowly went away
most sugar (only berries and a small amount of 85% chocolate daily) – the last of my psoriasis

I (hooray!) managed to not have a uveitis flare with the birth or weaning of my second child even though it is VERY common, and I credit the diet.

The ‘low sugar’ has been a very recent thing, and I’ve been thrilled that the last of my psoriasis is gone. It’s so ‘odd’ and so lovely to not be constantly itchy.

I do eat lots of nuts and an absurd amount of eggs. So my questions:

1) I’m planning on implementing the full AIP with hope of improving my hashimotos symptoms: low moods, brain fog, difficulty with sound sleep, and thyroid function – I currently take 62.5 mcg of snythroid daily. Are some people finding improvement of thyroid function with the AIP? It would be lovely to have my thyroid bump up it’s functioning.

2) Is it o.k. to roast beef marrow bones prior to making bone broth with them? I love the smell/taste of poultry broth, but beef marrow broth reminds me of the smell of 3 hour post-mortem rat (huzzah for science). Roasted meat smells yummy, and I’m hoping that roasting the bones first will improve the smell/taste of the broth, but will only do so if it won’t mess with the ‘healthful’ benefits of the broth.

3) What is a ‘normal’ quantity of meat/fish for a meal?


Lol! There are probably not that many bloggers out there familiar with *that* smell. Ugh.

Yes, people do find that they can decrease their thyroid meds and some even go off completely (usually when they make changes relatively soon after diagnosis). Check out the forum Hashimoto’s 411.

Yes, it’s find to roast marrow bones before making broth.

You should be getting anywhere between 0.5 and 1g protein per pound bodyweight. For most people that’s somewhere between 4 and 8oz per meal.

Interesting Blog! Surely Paleo helps to treat Psoriasis. You Express very well manner about paleo or paleo diet those more helps to recover psoriasis. Hi, really impressed with your blog, Great information. Keep up the great work and thanks again.

Thanks for sharing your blog. I know this is helpful. One treatment for psoriasis that works for me is dead sea salt. Dead sea salts from San Francisco Salt Company are effective in treating psoriasis and many skin conditions. Soaking in dead sea salts helps your skin feel hydrated and less itchy. See how it works at and save 5% off your first order of Dead Sea Salt with coupon code: skincare5 at checkout. Hope it helps.

Amazing all the stories covered here…I thought psoriasis hadn’t a real cure, or so I’ve been always told by medics :(. I’ve psoriasis for 20 years now and I’ve eating paleowise for 5 months now with occasional weekend cheats (sugar,cereals, dairy) and my psoriasis is worse than ever… I’m interested in doing the AIP but I’ve not very accessible grass fed meet and wild caught fish, what should I do?

You can still do AIP even if you can’t get the highest quality foods. Just do the best you can. Farmed fish or canned fish is a great option. With conventional meats, stick to leaner cuts and try and keep chicken to a minimum since it’s pretty high omega-6.

Amazed whith all the stories on this blog!!I’ve always thought that psoriasis hadn’t a cure,or so I’ve been told… :( I’v had psoriasis for 20 years now and I’ve been eating paleowise for 5 months , lots od eggs nuts, and my psoriasis is worse than ever. I’m interested in doing the AIP but I don’t have very accesible grassfed meet and wildcaught fish, what should i do?

I would try eating no nuts at all. My psoriasis hates them, as well as any grain. Looks I’m fine with some dairy, but eat small amount only. I eat mostly eggs, coconut oil, green vegs, grass fed beef. I’m not fussy about variety :)

thank you very much!!!what a quick response!!so what if I eat mostly fish and very little meat? Another question, should I take also vitamin D supplements? as normally I eat lots of tuna and salmon…

Hi- I’m a long time reader and I love what you do. Thank you for sharing your experience and offering your help!

If someone with SIBO / leaky gut / skin rashes adopts a lifestyle that mostly eliminates these conditions, is it viable to add back tubers, other starchy vegetables and rice, especially if one eats with fermented foods? If the gut is healed, there seems to be reason to believe these foods would be well tolerated, unless the gut flora irreversibly changed in a way that leaves the person prone to overgrowth of some cultures in the gut. Also, have you ever eaten resistant starch as a significant part of your diet? Thanks again and looking forward to hearing your thoughts!

It is definitely possible that these foods will be well tolerated in the future (although there are no guarantees). I like green bananas, and eat a fair amount of green plantains and other starches, like kuzu. But, usually I eat green plantains and kuzu cooked, which would reduce the resistant starch, so I don’t know how significant a part of my diet that is. I haven’t noticed any particular benefit or detriment.

One question….I’m starting on Monday the AIP and I’m confused about fruit, how much should i eat, how much is 10-20 gr fructose?

Hi! Thank you very much for all this information! looking foward to buy your book!
My story is long but I have a few questions…
I learned I had psoriasis when I was 13 years old. I had asthma until I was 14 and came back a few years ago (I’m 39). I was diagnose with gastroparesis ( lazy stomach) aroun 7 years ago. Lately I developed severe allergies to food ( visit to the ER for natural carrot juice), and allergies to local trees also fibromalgya for almost 10 years.
I have been doing paleo since August ( with many mistakes while learning) but someone suggested your site and I found AIP. I have been doing that for 2 week. Some success on the psoriasis. I have been eating liver (witch I really like) got the bones that I’m making today. and been eating much fish like you said :). Still have a lot of tissue pain and some headaches…
My questions… I have allegies to cocunut and all its products, with what oil I can cook? (I’m allergic to almonds too) Why not to cook with olive oil? I can’t avocados either…:/
Can I eat bacon? Cook with the fat?
Can I eat meat or organs that say “vegeterian diet” or the meat has to say ” no corn feed”?
I’m still very constipated…
I know its a lot and I’m really sorry! But it has been a long road of doctors and specialists and no help. Hope you could help me out a little
Thank you very much!

I think the best cooking fats are quality animal fats, like grass-fed tallow, pasture-raised lard, bacon fat from pasture-raised bacon, etc. Palm oil and shortening are okay. Olive oil has a very low smoke point, so it’s only okay for very low temperature cooking. Yes, you can eat bacon-pasture raised is best. Vegetarian diet usually means grains… it’s not the best, but if you’re eating lots of fish, you’ll be able to balance your omega-3 to 6 intake. For the constipation, try digestive enzymes, magnesium supplement, and using a stool when you go potty (like a squatty potty). Skin is the lowest priority organ for your body to heal, so if you’re seeing differences in as little as two weeks, that’s great!

you are wonderful! thank you so much for your answer!! I will follow all your advices and I’ll keep reading your site! thank you very much!
The best for you :)

Hello Sarah,

I’m starting with AIp since I have psoriasis and it’s become worse lately, I can’t get too much sun exposure for the vitamin D (or D·??) but I eat lots of salmon, tuna and so…should I take supplements? how much?

I suffer from extreme dandruff, and the last dermatologist I saw about it said that he couldn’t tell me whether it was scalp psoriasis or seborrheic dermatitis, but that it didn’t matter because the treatment for both would be the same (antifungals and steroids). If it’s seborrheic dermatitis, would the autoimmune protocol also help? I’m confused about the difference between these two conditions and whether they would require varied approaches. I’ve also had two babies in the last two years, and after each pregnancy I have experienced a flareup of some kind of rash on my arms and hands that looks like round, scaly coins of various sizes. I’m not sure if this is psoriasis or something else, and I don’t plan to see a dermatologist to get an official diagnosis, but given the post-pregnancy flareup can I assume that this too is autoimmune in nature?

Skin conditions are all either autoimmune or immune in nature (well, I guess there are some viral, bacterial and parasite rashes, but that doesn’t sound like what you’re dealing with at all). So, whether immune or autoimmune, either way the autoimmune protocol should help. Also, skin conditions appear to be especially sensitive to sleep deprivation and stress. Glycine-rich foods, vitamin A and D rich foods (bone broth for glycine, organ meat and seafood for both) are especially helpful for healing the skin.

I’ve been two weeks on the AIP an my psoriasis is better, less itchy, less plaque…I’m sure it’s improving! I’m intending to get some fish-oil and vitamin D, but I don’t know how much should I take of both…I eat lots of salmon, sardines, tuna and grass-fed meet ocassionally. Any suggestions?

First off, I’m a HUGE fan of your website and this post is incredible, thank you!!!
I recently developed guttate psoriasis while studying abroad in the UK. I had a bad sore throat a few weeks prior to developing the rash which is what I’m assuming triggered it. But I’m also thinking the lack of sunlight (and maybe decrease in Vitamin D levels?) could have contributed as well. My mom also has a history of psoriasis (although not guttate) so guess I’m also genetically predisposed to it.
The rash started as a few red bumps on my stomach and then progressed into bright red dots all over my body (even one on my nose!) I went to the doctor who diagnosed it and gave me a moisturizing cream as well as a topical steroid gel to put on the rash once a day. I don’t like the idea of using a steroid cream but started using it on a section on my arm at first and after a few days of noticeable reduction in that rash I began using it on my entire body. It’s helped significantly but hasn’t gotten the rash to go away completely, just lightened it up a great deal.
I’d like to stop using the steroid gel however and target this through diet. Can the same diet be applied to healing guttate psoriasis? I eat a strict paleo diet that consists of primarily meats, veggies, & fats. I seldom eat fruit or nuts however have been eating nuts more out of convenience when traveling abroad. I don’t eat many starchy veggies except for half a sweet potato post workout. I do however eat tomatoes and peppers nearly everyday – they’re two of my favorite veggies! Eggs I eat probably 4-5 times a week, and I never used to eat butter but have begun cooking with Kerry Gold grass-fed butter since abroad.
I’m going back to Denver, Colorado in about three weeks so I’m hoping once I get some more sunlight back into my life my Vitamin D levels will go back up and the psoriasis will start to heal more quickly but I’ve started taking a Vitamin D3 supplement since I got the diagnosis (about 8,000 – 12,000 IU / day). I have also just begun taking a fermented cod liver oil supplement and drinking about 1-2 tablespoons of gelatin (green can from Great Lakes) dissolved in water everyday. These three changes have all been made in the last 2-3 weeks, post development of the rash.
Should my next steps be removing nightshades and eggs? Is guttate something that is now in my system forever similar to the other types of psoriasis? Also, is it ok to just stop using the steroid gel altogether?

Sorry for the excessive post but I’d really appreciate any feedback you can give me!

Yes, but I would urge you to check out the most up-to-date version of this protocol here: This is much more about elimination (and yes, I think eliminating the butter, nightshades, nuts and eggs is a good idea), but also about increasing nutrient-density. Sleep, managing stress, moderate-intensity activity are all also important. I only recommend supplementing with vitamin D if you’ve had your levels checked and they are low (too much vitamin D can cause problems too). Gelatin and FCLO are great ideas.

I recommend talking with your doctor about the best way to stop the steroid gel. Generally, topical steroids are safe to stop cold turkey, but this is still important to ask a healthcare professional first. Also, make sure you’ve got the diet and lifestyle stuff dialed in first. You also might find some relief from natural fat based moisturizers like tallow balm or Green Pasture beauty balm.

Hi Sarah,

First of all, you blog has been one of the greatest discovery for me and my personal health. It’s been more than one month in AIP and I’m doing great. My Psoriasis has improved it’s aspect a lot, the patches have not started to disappear but look way better! As Christmas days are coming,and I dont want to look like a social introvert, I’m planning to make some conscius reintroductions to see how my body responds. As I am doing so good, I would like to avoid every food that can cause me harm. If I do an intolerance test, will it show EVERY food I should avoid? Or should I eat those types of food and se how they affect my body?plus I will accelerate the process of knowing which foods I should avodi.I’m planning also to start with some vitamin D supplementatios, as I’ve read many people with psoriasis have experienced hughe benefits. Also, when I make an introduction…how much time does it take to start again the healing process?Thanks for everything!!

There are many ways you can be sensitive to foods that won’t show up on tests. You can still do testing to know which foods you for sure shouldn’t reintroduce yet, but I would still recommend cautiously reintroducing one new food every 4-7 days. I would only recommend supplementing with vitamin D if you have been tested and have low levels (although a food based supplement like fermented cod liver oil is very safe because of the other synergistic vitamins in it). If you reintroduce a food that isn’t working for you, you can expect anywhere from a few days to several months to start seeing healing again (since you’re seeing improvement so quickly though, probably not months for you).

But I’ve read that blood type tests for food sensitivities and allergies are very accurate. Is there any possibility that I can be affected by foods that aren’t shown in the tests? I’m planning to do a test that combines food allergies and food sensitivities.

Allergies are very accurate, there’s a lot of controversy about how accurate food sensitivity tests are… I think this really stems from how dynamic food sensitivities are compared to allergies. They can come and go and when you do a test, you get a measure of just one point in time.

Thank you so much for your research. My husband has psoriatic arthritis and for 2 1/2 months has gone gluten, casein and nightshade vegetable-free and is doing fabulous! I know not everyone may do as well but I want to encourage those to try, he’s not even as strict as the AIP and sees HUGE improvements. As physicians ourselves we were skeptical but not anymore! Thanks from the bottoms of our hearts.

I was just diagnosed with psoriasis after suspecting it for a couple of years. I notice that you said you were taking 12,000IU of Vit D a day when you wrote this post. Do you think this is still a reasonable target? I live in Connecticut and get hardly any sun, though I will be vacationing in Arizona for a couple of months this winter. My dermatologist recommended 2,000IU a day plus daily sunning, but maybe I should shoot for at least a slightly higher dose. I eat a very restricted paleo diet and am currently transitioning to strict autoimmune.

I don’t take any at all now. I recommend getting your levels tested and working with a healthcare professional to figure out a starting dose, then retest to see how you’re doing.

Oh I just read your comment about only supplementing with Vit D if your levels are low…I was tested last summer and was in the 40s I believe. What do you think–should I still supplement with Vit D? I have taken the FCLO/BO blend in the past, but I don’t want take that one because I’m worried about the butter oil…and I didn’t really notice any difference from it.

What worked for me? About 90% of my dermatitis/psoriasis/dandruff/lesions was gone after just 3 days of not eating any RED MEAT. My small plantar wart even disappeared from childhood. Sometimes I eat some quality fish once a week. I love unpasteurized dairy cream, but avoid all store bought dairy such as cheese, yogurt, milk, etc. I don’t eat bread, grains, wheat, pasta, gluten. Generally dairy and grains have a lesser effect on psoriasis compared to RED MEAT. I mostly avoid nightshades except fresh potatoes occassionally. I try and limit my intake of fruit, oils/fats, and legumes. I try and eat mostly raw/grated or lightly cooked vegetables and salads.

This may have solved all my problems for a while. But actually I have just taken out some of the most nutritious and body-building foods known to man. Soon the end result will be a weak, shrivelled human being with little energy and vitality.

Why do poor kids in India have so much energy, vitality and enjoy beautiful healthy skin after eating only a handful of bread and beans for the day? Why do some people eat red meat, nightshades, dairy, bread without any skin issues?
The problem isn’t as much as the food, as it is our LIFESTYLE. We need PLENTY of exercise and sunlight. We need to become so physically tired at the end of the day that we gladly accept peaceful slumber. This is how we stop eating at night because we are so tired, and then our bodies go to work and repair and heal while we sleep. We fast during the night and during springtime we detox with light fresh foods. We eat small meals with lots of variety. During the day we sweat, detoxify, and eliminate wastes from our bodies thanks to exercise.

I think moderation in all things healthy like the Japanese eat, tiny portions of everything. I think we are made to eat almost anything. My theory is that we no longer do anything that is natural to our bodies so they just get diseased. Our lifestyles have to change. No more sitting on a chair in the office for 6 hours, imagine what this does to our digestive system, hormones, skin, lungs, etc.
We can’t eat bread, meat, and dairy expecting the body to somehow filter out and process these highly rich and nutritious foods, if we do not physically move our bodies and get sunlight everyday. We are designed from nature.
If we return to nature and a natural way of living then we won’t even have to think about most of these problems, it just becomes natural to us. We become happy, healthy and complete.

The End….


I have been Paleo for 2 years now as a 65 YO woman of normal weight and feel great. I had no major health issues when I started and don’t have any now. A year ago, I got patches of what I believe is eczema. I have never had rashes ever in my life so I am puzzled by this. I stopped Kombucha (2 months ago) brewing and drinking because I read that histimine levels could cause this, along with sauerkraut, which I gave up also. Some areas with rash healed, but I still have an angry patch on my hand and now my husband has the same thing on his chest. He eats “kind of” Paleo. What do you think of the nightshade elimination now? This really ticks me off as I eat as clean as I can. I have eaten basically the same salads with peppers and tomatoes for YEARS before this. Eating more eggs, of course now, but little dairy (except Kerrygold). Insight here would be appreciated.

Hi! I ordered your book and can’t wait for it to arrive.
I suspect my husband has low stomach acid. He developed psoriasis when our oldest son had first asthma attack. Approx. five years later he was effected by psoriatic arthritis in upper back, shoulder, toes and hands. So he’s been on meds for this approx four years. I switched to paleo diet in last six months and he’s slowly being dragged along. He dropped grains so far and felt immediate relief in hands and shoulder. But minimal change from psoriasis on legs and head. So my question. Could low stomach acid (runs in family) cause leaky gut, which caused proriasis (triggered by stress) which caused psoriatic arthritis? I also believe that his stomach issues now may involve SIBO or IBS. Should he give up dairy and sugar before night shades? I think too much fruit and potatoes and of course double double coffees effects his stomach. Baby steps.
Thanks so much for all your information and hard work.
Laurie, Canada

Thank you so much, Sarah, for sharing your knowledge and experiences on Paleo Mom. I struggle with psoriasis as well, and knowing how to modify out-of-the-box paleo for this issue is really helpful. My husband and I have been on the auto-immune protocol for almost a month, and though we’ve both seen progress, my psoriasis has not improved as I’d hoped, and in fact has flared a bit, as you’ve described it might. Reading your posts on the subject are very informative and encouraging, and this helps me to have the patience to let my body, and specifically, my gut, heal. God bless you, and your family, for your faithfulness to consistently share what you know!

Hi Sarah,

I have one question about coffee and green tea for psoriasis sufferers. I’m looking for a stimulant beverage allowed in the AIP, which I’m following. I’m aware that coffee should be limited because of the cross gluten reactivity and because caffeine can rise cortisol levels, which can be harmful also. But for green tea, caffeine is much lower and I’ve read also that it can indeed help to balance autoinmune response in TH1 autoinmune diseases, as psoriasis. Am i right? How much green tea would be too much?

Of the record, I’m from Spain and I’ve bought your book. I’m really looking forward to receive it!!YOu’ve made such a great job! congrats!!

When you receive your copy of The Paleo Approach you will see that caffeine is discussed. The book states that there may be some benefit to drinking green tea in moderation, but definitive studies have not been performed. You may want to join our new The Paleo Approach Community group on Facebook and ask for support there. The group has over 4,000 members, you can request to join here: — Tamar, Sarah’s assistant

I am just starting out on Paleo, but I’ve drastically cut my wheat intake over the last 4 years. My psoriasis disappears until I slip up. I’m one of the lucky ones, I assume.

Thank you for all your hard work. I have a teenage daugther with type 2 diabetes. Your website is beneficial and so easy to follow! I’ll purchase your books when the budget allows!

I have had Lichen Sclerosis for over 12 months, and actually it’s been ‘waiting in the wing’s’ for about 10 years I suspect. I have read a lot on your blog about eczema, psoriasis and lichen planus, and wondered if you think Lichen Sclerosis is similarly an auto-immune problem? I am trying Paleo, but not being strict enough, and keep failing. I’ve had intolerance testing which shows up low-range intolerance to Eggs (white and yolk), cashews and coconut. If I heal my gut do you think the intolerances will go? At least then on a Paleo regime I could use eggs and coconut.

Yes, it is mentioned as a suspected auto immune disease here: Sarah recommends following a strict version of the Auto Immune Protocol for thirty days before reintroducing any foods. You can read about food reintroduction here: And you may also be interested in this post: The AIP is discussed in detail in The Paleo Approach. — Tamar, Sarah’s assistant

Hi Sarah,

Love your work,

I have psoriasis and am also underweight. I have a lot of digestive problems. If I limit fruit and starchy veggies as well as all those other things, I’m not sure how I get enough calories. I also suffer from terrible insomnia and eating a lot of meat seems to aggravate that further. I’m don’t quite know what to eat. Any thoughts?

Sarah discusses weight gain on the AIP (auto immune protocol) here: Do you take probiotics and/or any type of digestive support supplement? You can read about sleep issues in these posts: and and These topics are also discussed in The Paleo Approach. You may want to join The Paleo Approach Community group on Facebook: — Tamar, Sarah’s assistant

Hi Tamar
I don’t take any digestive aids or probiotics. Probiotics sometimes make feel me worse. I know eating fat is the best way to gain weight but it always seems to trigger more psoriasis. I am still eating white rice but no other grains. Do you think if I dropped the rice the fats would have less effect on my psoriasis? Thanks for your time. Keith

I am really hoping for some advice, please bear with me. My father has terrible psoriasis on his hands and feet that is barely kept in check by methyltrexate. Without the chemo drugs, it spreads everywhere fast. It is painful and really interferes with his life. He also has arthritis and carpel tunnel, and now is having teeth and eye issues as a result of 7 years of meds. I really believe that his quality of life would go up significantly if he could heal his gut and eat better (he’s only 50!). They also recently discovered a growth on his thyroid. We don’t yet know what it is.

The curve ball is, he and my mom recently divorced. They were married for almost 30 years, and he has never before lived alone until my youngest sister moved out to go to college last fall. He is not an experienced or interested cook. He works a lot of crazy hours at an oil refinery, which I know helps nothing. He has been brainwashed into believing that he needs a low-fat, low-carb diet. I have been slowly chipping away at that. I have given him books that don’t get read. I have even gone and made a bunch of food for the freezer and bought him a slow cooker for Christmas…he still eats Special K with skim milk for breakfast.

I would really love some advice on how to approach it with him so that he can easily start to adapt some of the changes into his life style and convince him that this is the way to go. I live almost an hour away, so I can’t take him food every day. But I hate to see him suffering, knowing that I have the knowledge that will likely heal him.

Any advice you have would be appreciated. Thanks!

I’m sorry to hear about your dad. I’m not sure what more you can do than set a good example and offer him the resources he needs to learn about his conditions and how diet and lifestyle may help them (Sarah’s book is the most comprehensive resource for autoimmune patients to date) and emphasize how much it would mean to you and your family if he took better care of his health. The bottom line is that no one is going to change their lifestyle if they aren’t ready to do it, especially if they have to go out of their way to eat the right foods. – Christina, Sarah’s assistant

Thank you for all your research and study into auto immune disease. I was diagnosed with psoriasis when I was 8 years old…I turn 49 this year. Puberty and my teen years were awful in dealing with it but as I got older it got a little better. While I have used the gamut of steroid creams and had PUVA light treatments and later just went to tanning salons, I fortunately have not had to use any chemo drugs. Now I just use the old over the counter tar based ointment. During pregnancy I had NO patches or lesions at all.

In 2010 I had my gall bladder removed and since then my scalp has been in quite a state. I keep things in check with T-Gel shampoo and the tar ointment. I only recently discovered what Paleo is all about and what it can do to help with diseases like psoriasis. My case is definitely genetic in origin but most certainly exacerbated by eating a SAD diet most of my life.

I just ordered your book and can hardly wait to get started and see how eating in this way can help. I have also recently been diagnosed with low thyroid function and am trying to manage that with prescription with prescription meds. Looking forward to feeling better soon! Thank you for your passion and hard work!

I recently started the AIP diet (4 days now) and am consuming grass-fed beef, bone broths and am trying to find grass fed offal, but that has been hard in Seattle. I started eating chicken liver, but I react to that so I think those chickens were fed some types of grains. A local butcher verified that as well. I am going to the farmers market today but was wondering why my skin has gotten redder and almost created a dry layer on top of the red spots since starting the diet? Is this the skin healing or is it making it worse.

Additionally, I eat a lot of food as I used to be a college athlete who consumed 6,000 calories a day. Am I feeding my body too much protein in my meals. It’s usually like 1/4 lb to 1/2 lb of meat/offal in a meal in addition to bone broth and some veggies.

I saw noticeable differences when I was consuming just chicken and lettuce for a few days, but was worried that eating too much chicken would cause an overload of omega-6. I was vegan for 1.5 years prior to starting this diet. I have had severe psoriasis for 8 months.

I would appreciate any help I can get.

Psoriasis has been anything but small potatoes for me. After years of dealing with skin problems from psoriasis, I started having joint pain in my early 20’s. Being so young, Dr’s blew it off. I always had strange symptoms and fatigue – but raising 4 children and working, I kept going. I had viral meningitis at, chronic yeast infections, epstien barr, asthma, pneumonia, toxoplasmosis in my R eye, shingles, uveitis finally alerted Dr’s I had psoriatic arthritis – what I would have given to know this information years ago!! I’ve done well by controlling diet, and hoping this added knowledge will be the final key to complete healing. Very grateful.

Just wanted to say that as a person born with psoriasis, I have tried everything out there (expensive creams, ointments, home remedies, etc) in my 35 years on this earth and the only thing that has really helped to completely rid parts of my body affected with psoriasis has been pork fat.

It may seem gross and primitive but by rubbing the fat in areas affected by psoriasis, you can manage the condition and actually cure it if you do it on a daily basis. Just give it a try and stop using harmful creams and ointments that contain betamethasone and various corticosteroids.

Thanks for all your blogging about paleo and health issues. Recently diagnosed with psoriatic arthritis (on top of the psoriasis; the psoriasis itself is not pretty but the PA is painful.) Have been doing strict AIP for 4 weeks now — don’t see any change in the psoriasis or the PA pain. How much longer should I be on it before trying something else and/or reintroducing foods? On the one hand, I’d like to give my body a fair shake in healing. On the other hand, it’s demotivating to me to just keep trying the same thing if I’m not seeing results, so wondering how long I should keep in there.

Hi, hoping you can clear up some confusion for me. I thought red meat was meant to be a big no-no if you have psoriasis (I think I got this from Pagano?). Are you able to shed any light on this? Many thanks.

Can you provide evidence for the leaky gut. My rheumatologist refuses to believe it exists and I need to show them.

Can this diet also help with the arthritis associated with psoriasis?

Hi. Thank you for your site. I was wondering if you would have any ideas for my hubby and I. We really need to try the autoimmune protocol. My husband has non curable thyroid cancer, anxiety and a serious addiction to sugar. His immune system is going haywire. He gets full body eczema with stress and usually turns to a staph infection. I have granular annuloma, celiac, panic attacks and lots of food intolerances. Candida and/or leaky gut may be in the mix for both of us. I know I’m being overly open with our issues but would love to know if you have any thoughts on the situation. How did you find out exactly what you could and could not eat? Thank you again. Oh. Also we are low income and trying to do this on a tight budget. Make’s things interesting. 😉

I forgot. I had my galbadder removed not too long ago. I was inflamme and the bile infected. Can’t do a lot of fat now either.

This has been a great read! I went to my new naturopath and she recommended the autoimmune paleo diet for me to clear up my psoriasis/leaky gut and also my horrendous keratosis pilaris. Im very saddened by the eggs, and am hoping I can do the yolks, as this past spring we actually got chickens!!

This diet is going to be very hard with a 20 month old who is a terrible sleeper (I havent had a full night of sleep in 20 months…), but Im wanting to feel better and lose the bloat that makes me look like Im constantly 5 months pregnant.

Thanks again for all the info!

Oh this article is just what I’ve been looking for! I’ve been a paleo follower for about two years now, me probably 80/20 and my partner more like 60/40. He has eczema which is just getting worse and I have scalp psoriasis that is worsening too, and in an effort to remove chemicals from my life I’m no longer using traditional shampoos or prescription medication for it.

We’re both half way through our third Whole 30, thinking it would help, and it appears to be getting worse. This article explains some of why that might be. My acne is improving though.

I’m curious about how long of an elimination period is necessary. Alcohol would be the hardest thing for us to give up as an occasional treat. We both love to eat out and really enjoy nice wine. This diet feels like a bit of a prison sentence, I can’t imagine being able to eat out on this. With his birthday and Christmas approaching it would be almost impossible to control everything with being at other people’s houses and parties. How long of an elimination period do you recommend? And what are the implications of exposure to something that might irritate? Not just on the skin but also on the gut…

I’m also interested in supplements. I’ve never taken them for years as I felt I should be getting what I need from my food. Naive possibly! We live in Scotland and our winter daylight is very limited. I’m assuming a Vit D supplement would be wise? My only concern is how to know we’re getting a good quality one. What other supplements would you recommend and are there any good brands?

Thanks for your help. Feel a bit despondent about it all!

Hi Sarah, sorry for the long comment but I’m at the end of my wits, I hope you can find the time to reply. You have been the one thing I’ve consistently clung to since starting the AIP for psoriasis. I was fed up with my refractory skin (got better in the Summer, always worse afterwards even with UV therapy/ isotretinoin) so I got your book, took a deep breath and started the AIP diet 7 days. I’m not a horrible cook and now bereft of food I love for but at least I have your recipes and knowledge as a foundation, thank you for that. I hope you can help me find out what I’m doing wrong, though I’m not hopeful that these comments are still being read after all this time. At any rate, I’ve followed your recommendations religiously but two days into it I flared up horribly and it hasn’t gotten better yet. In fact, and for the first time in my life, I had a lesion right outside my eye that popped out of nowhere (as they do). Lesions still look horribly pink and skin is painful, especially on my hands and knees, and my hands and lower leg lesions are coalescing at a frightening rate. Scalp very itchy and scaly too, far more than usual.

I can’t fathom what is triggering this. I’d already given up gluten and started using coconut oil months ago. I don’t eat any of the forbidden foods, restrict fruit (eat mostly banana and berries as ice-cream) and have also cut out starches + fermented food, like you suggest, and my beloved ghee too. As per Dr. Kresser’s recommendation I just started taking Lauricidin, Prescript-Assist and enzymes for the biofilm (all post-flare and the other supplements I take I have been taking for a long time too), started the no-shampoo, drink rooibos tea instead of coffee, put broth/stock in everything and eat organ meat every day. I might wonder about the red meat (I ate only organic chicken and fish for over a decade) but I’ve actually been eating it since the beginning of September (with barely any poultry since then) with no ill effects. The beef organ meat is a new thing, though, but I’m not eating anything I’ve never eaten before, I’ve always been a big fan of organ meat and regularly ate chicken gizzards and liver (my absolute favourite). I became nauseated when I drank the bone stock for the first time but I’d forgotten to remove the fat and I’ve been adding it to food daily with no problems. I can’t find a natural practitioner here – or even a regular one that believes in leaky gut et al. – so I’m not sure how to further troubleshoot this. What am I missing, what am I reacting to or what am I doing wrong, can you pinpoint anything? My only available choices when I went on the AIP diet was that or immuno-supressants and I very much wish to stay away from the latter, they are very scary things. I want to address the cause and I know my gut’ll take a long time to heal but I was expecting at least an improvement of the lesions in colour and thickness, something that would give me some hope of success. I certainly didn’t count on it becoming worse. I will still give AIP a fair shot but I must admit I’m feeling a bit despondent right now. Again, apologies for length and thank you for your assistance.

Sarah has consultants available at ThePaleoMomConsulting who can help troubleshoot medical/dietary problems. She also recommends and – Christina, Sarah’s assistant

Hello Sarah & Christina
I have a long list of curses. Scalp psoriasis (since puberty) not severe, but troublesome. Endometriosis (had a hysterectomy 3 years ago), PCOS (still have the ovaries), and seven years ago I was diagnosed with fairly mild crohn’s disease. I recently had a colonoscopy which was just routine and it appears the crohn’s has significantly advanced which was quite a shock to me because I don’t really have many symptoms. That is the same with all my curses, they are just there in the background. What I do feel I suffer is greater fatigue than a person with my level of activity and at times low moods, anxiety and low motivation. I started Paleo 2 weeks ago, working towards doing the AIP after the Xmas holidays as we will be travelling 5 weeks. I feel I can stick to Paleo, but the AIP is best done in the comfort of my own home, I would think. I feel better already but I am confused as I don’t suffer severe symptoms as to how I will know if I need to go onto the AIP. My question is the hormonal component. I keep telling my doctors my problems are so cyclical (changes in bowel movements, energy, headaches and moods can be predicted on a calendar). For a few days at a time I am on top of the world, no matter what I eat and then for a week at a time I am as good as useless. I am kind of looking forward to my ovaries giving up, but according to tests, that is not anytime soon. I am 45. I have bought and read both your books cover to cover. What’s the deal with the hormones? I have been like this for years.

The AIP can certainly help balance hormones and clear up stubborn symptoms if Paleo alone isn’t enough. For personalized medical/dietary advice, Sarah has consultants available at – Christina, Sarah’s assistant

Hi, I was looking at your website on my sister’s behalf. You mentioned lichen planas (sp.?)
My husband had it for years, until he got off ALL gluten. Then it 100% cleared up.

Hi, do you have any suggestions for treating sebhorrheic dermatitis? Mine seems to have worsened on the keto diet and I believe has been made worse by using coconut oil.

I’ve kind Of gone the other way, I’ve been primal for around 4 years, with more cheating than I’d care to admit, but the amount of non primal foods I was consuming was steady and not extreme, ie I’d have a cookie or piece of cake, but for 4 years that was fine. I recently had a sore throat and runny nose, which lasted longer than normal, after not having one for over a year. Straight after it cleared up I developed psoriasis. I went to my doctor to confirm it was this, who said psoriasis can be caused by a sore throat (obviously she didn’t mention it was an autoimmune disorders) then didn’t use the cortisone based cream she prescribed, as I had read bad things about this. My question is should I immediately try AIP to heal, or stick to a more conventional paleo diet first, as this has been ok in the past. I never had a problem with dairy, that I could recognise physically, and even when I did eat sugar or drink alcohol it never really affected me too negatively, in the grand scheme (I know I would have been causing damage somewhere, I’m not naive). It just seems strange that I’ve developed it after being on a similar routine for 4 years. The lesions are starting to itch now, after 3 weeks of no itching. Can anyone advise?

Many thanks,


I’m not Paleo Mom Sarah, nor am I a doctor, but I have had psoriasis since birth (41 years). A sore throat is not correlated to psoriasis. Strep throat, on the other hand, is. It can cause severe flares, particularly of guttate psoriasis. If you didn’t have active psoriasis before, you’ve suffered an immune system response that has kicked it into gear. I’m sorry about that. There’s no cure, so really, whatever you can do to minimize stress, get good sleep, and eat in a way that doesn’t inflame your psoriasis may help. Your body will tell you if your diet is the correct course or if it’s actually causing you more stress. Anything you can do to avoid inflammation, get healthy fats, Vit D, etc. is *likely* to help but not guaranteed. It is a complicated condition, and it won’t be cured by diet alone. But yeah, refraining from sugar, liquor, etc. is a good idea right now.

If you don’t want to use corticosteroids or other creams, do some googling and look for ways to support your skin during the winter months. My friend makes a thick cream for me using coconut oil, shea, and other natural ingredients. Univ of Michigan used to make its own cream for its psoriatic patients — other medical centers may do the same. UV therapy is expensive and hard to find in certain regions but can help clear you up in the winter from a strep flare (I had 85% of my body covered post-strep, so I speak from experience).

Hang in there. You didn’t develop this from your diet, and you didn’t do anything wrong. You have the genes, and it would appear that you had strep throat. This is a common pathway for a flare, regardless of any dietary intervention. You got unlucky.

For what it’s worth, I was pretty strict VLC Paleo (with some dairy) for 2 years and doing awesome, but then developed what I believe is eczema. I am 66 years old and never had a rash or dematitis or eczema before. So I was puzzled. My hand had a terrible flare up last late winter and my leg. Right around then, I began to add potato starch and other of the prebiotics, ferments, I was reading about, upping my carbs with safe starches and taking daily probiotics–1 soil based probiotic supplement too. This was all for my gut microbiota which I believe I had degraded because of the too low carb diet (for me) and not much for the gut bugs to munch on. I learned a lot about our immune system connection with the gut. I then read from Mr. Heisenbug blog that the probiotic strain L. Plantarum had helped his hand eczema. I added that and my hand flare up went away. This is the time of the year all this flares up again and since I have been using the prebiotic foods and probiotics regularly this past year I have only had a couple of little itchy spots and none on my hand. This is the way to go for me. I tried eliminating histamine foods and that didn’t help much.

Leave a Reply

Your email address will not be published. Required fields are marked *