Psoriasis and Chronic diseases

[Kat]

I started seeing a new dermatologist. As we were going over medical history stuff, I mentioned that I had been diagnosed with NAFLD (nonalcoholic fatty liver disease) and she replied that was common for people with psoriasis. Which surprised me a bit as I hadn't heard that before, nor had it been mentioned to me so I did a little looking up on the internet to see what I could find. I found the following information which seemed to explain it best:

Although many people think of psoriasis primarily as a skin disease, it is a systemic condition that affects other organs as well. People with psoriasis have increased inflammation throughout the body, which increases the risk of developing comorbid conditions (more than one chronic disease at the same time). For example, people with psoriasis have a higher prevalence of fatty liver disease compared to the general population.

Psoriasis is associated with a higher risk for developing obesity (high body mass index), insulin resistance, and metabolic syndrome — factors that can also increase the risk of NAFLD. A person may be diagnosed with metabolic syndrome if they have three of the following:

Abdominal obesity
High triglyceride levels
Low HDL cholesterol levels
High glucose levels
Hypertension (high blood pressure)
People with metabolic syndrome and severe psoriasis are at a higher risk of developing NAFLD.

I tick quite a few of those. Also with inflammation being mentioned it has made me wonder about other things going on with me and how it all ties in together. Of course having arthritis is a factor for the inflammation as well.

So now I'm really hopeful to see how Skyrizi will work out for me (calling them next week to have them ship to me). Maybe if my psoriasis is calmed down so might some other stuff? It would be nice if it works that way!

[Caroline]

Good and very relevant post, Kat.

I did already know about the fact that people with psoriasis do have the risk of getting all kinds of comorbidities, of which obesity is one of them and very often seen.
Now there is also the chicken-egg problem with obese markers. Is it so that psoriasis has the comorbidity of obesity or is it so that obesity has the comorbidity psoriasis?

We do know, from several of our members, that food/life style is an important factor in psoriasis.. so there is a lot that is pointing at the Metabolism as the underlying cause. Personally I suspect that a fault in the metabolism causes the immune system to react finally leading to psoriasis.
If you depart from this point, then a lot of comorbidities, like you describe them Kat, are explainable, comorbidities like NAFLD, Crohns, metabolic syndrome, etc all have a relation to the metabolism as a whole.
It also explains why some of our members have such good results changing their food pattern.

I recently heard that in the Netherlands the association of dermatologists are now working on a guideline on food and lifestyle for psoriasis (again they forget PsA), so also the medical profession sees that there is ‘something’ over there.

For myself, because of I all suspect this, I keep a good eye on my weight. Now I do have kind of a slim figure, I also realise that around my waist there is more than I personally like, but it is very hard to get rid of it.
What I have remarked the past year is that my quitting with alcohol, not that I was a extensive drinker and nowadays I only drink in the Psoriasisclub bar, did have as a result that my PsA is now at the lowest level ever.
I must admit that I changed more in the food area, as I am living much more meatless than before.

[Fred]

Good luck with Skyrizi Kat. 

Yes as Caroline said there are a lot of comorbidities in people with psoriasis. I just put liver in a search and here are a couple of threads that may interest you.

Psoriasis and liver problems

Psoriasis Study says higher risk of non alcoholic fatty liver disease.

[Forest Walker]

A very interesting topic.  I'm hoping we hear good results for Kat's use of Skyrizi.  

[D Foster]

That's very interesting Kat, I am overweight a little even though the B12 problems have lost me weight it's muscle loss that has happened. When I first started with P at around 30 I did a lot of weight lifting and I didn't start being overweight until I was in my early 40s when the results of the job started catching up because of the amount of entertaining I had to do. I have an appointment with the dermatologist consultant next month and I will have to get the full blood test including liver and kidney tests so it will be interesting to see what the outcome is. It's been a year since I had my last one which was okay.

[Kat]

I've lost some weight, still have quite a bit more I'd like to lose and my liver levels are "close" to normal. Still a bit enlarged but good enough last visit to go from 3 month check ups to 6 month check ups. It's frustrating as my daughter and husband (neither with psoriasis) also changed their diet and have had far more success with the weight loss. It's been slow going for me, but it seems I have more hurdles to cross than they have to get to where I want to be with my weight and my health. My A1C level is now in the normal range... it's about as high as it can get and still be in the normal range but at least I've gotten that far.

[Fred]

We're all different Kat. I have two brothers one is about the same as me but the other is as slim as a rake, the one the same as me lost weight the last time I saw him and I have to say he didn't look well.

I started off very slim but now I'm round, but I'm still me.