Curing Psoriasis

With old fashioned doctoring

Photo by Melissa Askew on Unsplash

Most people would be surprised to hear that the NHS has a hospital-based Dermatology clinic run by a medical herbalist. Patients with severe and chronic skin diseases are referred, by their consultant dermatologist, to see the herbalist.

Most of the NHS patients referred to the clinic don’t really have much understanding of what medical herbalism is. They don’t know what to expect. They are very unlike the usual people who seek out herbal medicine, who tend to be well educated middle class people dissatisfied with conventional treatment.

At the NHS clinic we saw a patient of Somali origin with severe psoriasis. He had been prescribed the standard treatment protocol: steroid creams, steroid tablets, then a couple of different biologics. None of it had helped, and he had suffered severe side effects from the biologics.

Biologics are strong drugs that suppress the immune system. Methotrexate, commonly prescribed for psoriasis, was originally a chemotherapy agent and side effects include nausea, tiredness, fever, increased risk of infection, low white blood cell counts, and breakdown of the skin inside the mouth. Other side effects may include liver disease, lung disease, lymphoma, and severe skin rashes. It works by blocking the body from using folic acid.

Then he took another biologic that he didn’t get along with, either. This was Humira, and common side effects are listed as infections, cancer, reactivation of previous viral infections, and new onset or exacerbation of demyelinating diseases.

Having exhausted all the NHS protocols, his consultant sent him to us.

Herbal consultations are very different from conventional consultations. We aim to figure out what might be causing or exacerbating the condition, and this necessitates taking a full case history, reviewing all current (and past) medications and test results, and sometimes, if warranted, a physical examination. If you pay to see a herbalist, the first consultation will last 90 minutes, and subsequent ones about half an hour.

The NHS will not pay for appointments of that length, of course, so in the dermatology clinic all appointments last 20-30 minutes. But still, it was enough time.

We asked a typical herbalist question, “Does your skin ever spontaneously improve?” We like to understand the warp and the weft of the condition.

The patient responded that it did indeed improve. It cleared up when he visited family in Somalia. He thought that the sunshine or the lack of stress might be healing for his psoriasis.

We pressed on with the case history. We like to get a full picture of diet and lifestyle. Our patient shared that he was on a low income and when he was in the UK, he was subsisting on two meals of Weetabix per day, with the occasional sandwich included.

Of course, when he returned to Somalia he ate a traditional diet. The traditional diet did not comprise Weetabix, or indeed gluten, as the traditional grain in Somalia is teff, which is gluten free.

In herbal practice, gluten intolerance is very often observed to be the root cause of skin diseases such as eczema or psoriasis, even if patients are not coeliac. Gluten is very hard to digest, particularly for people whose ancestors never ate it as a staple food and managed to adapt to it. There is growing evidence that the gluten, particularly in modern varieties of wheat, can cause the gut cells to release zonulin, a protein that can break apart the tight junctions holding the intestines together.

Once these tight junctions get broken apart, the gut can allow toxins, microbes, undigested food particles, and antibodies to escape from the intestines and travel throughout the body via the bloodstream. This can result in inflammation and autoimmune diseases such as psoriasis.

We advised him to cut out the Weetabix and the bread, and instead buy traditional Somali food from a local Somali grocer. We also advised him to take vitamin D to compensate for the lack of sun in England.

And his skin completely cleared up. We didn’t even have to break out the herbs.

Instead of standardised protocols prescribing increasingly strong and toxic drugs, all he needed was someone to ask the right questions, listen to the answers, and do some actual thinking about the root cause of the problem.

That’s what doctoring used to be.