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NEXT weekend!

Laboratory, Endocrine, & Neurotransmitter Symposium

August 28-30, 2020

Earn up to 14.5 CMEs


New speakers include:

Paul Anderson NMD

Myles Spar MD

Dan Kalish DC

Thomas Guilliams PhD

Registration is $429. Discounts available for a 2-pack of tickets (one for you, one for a colleague.)


Wellness Wednesday Webinar

Spoonful of Sugar

By: Krista Anderson Ross, ND

September 2, 2020

Review the rise of sugar consumption globally and the associated health burdens. Review the anatomy of brain chemistry vis a vis sugar cravings and dependence. Examine the role that excess sugar plays in glucose metabolism and insulin resistance. Clearly define metabolic syndrome including its impact on sex hormones and the HPA axis. Discuss laboratory testing to identify insulin resistance and hormone imbalance. Consider dietary, nutritional and herbal treatments for blood sugar management.


A Gut Microbiota Approach to Psoriasis


By Julia Malkowski ND, DC | August 18, 2020

Approximately 125 million people worldwide have been diagnosed with psoriasis. Psoriasis is a chronic inflammatory skin disease with genetic and autoimmune components. Gastrointestinal dysbiosis has been described for psoriasis patients, and dysbiosis is a factor in the pathophysiology of the systemic disorder. Identification and remediation of gastrointestinal dysbiosis, and specific probiotics may influence psoriasis prognosis.   

The initial trigger of psoriasis pathogenesis is not known, but an exaggerated immune response ensues. Keratinocytes become active targets of dendritic cells, which release cytokines that activate T cells. The T cells produce additional cytokines, further stimulating keratinocytes to proliferate via an inflammatory cascade. The net result is a thickened epidermis amassed with immune cells. T helper cells, especially Th17 cells, are influential in the development and progression of psoriasis. The inflammatory immune aspect of psoriasis pathogenesis presents potential therapeutic options. A common treatment entails subcutaneous administration of a biologic agent, human IgG1 monoclonal antibody, to neutralize TNF-α and suppress the inflammatory cascade.  

The gut microbiota play a significant role in host homoeostasis and subsequent immune response, particular with respect to Th17 cells. Psoriasis may be associated with a proinflammatory dysbiosis by comparison to healthy cohorts. At the phyla level, the gut microbiota of patients with psoriasis was shown to have a higher ratio of Firmicutes: Bacteroides and less abundant Actinobacteria. Akkermansia muciniphila, that imparts anti-inflammatory effects,has also been shown to be less abundant in patients with psoriasis. Further, greater abundance of Veillonella species have been reported in association with psoriasis, consistent with elevated levels of serum CRP. Patients with psoriasis have also displayed a higher prevalence of H. pylori.   

Gut microbiota appear to be consistent among the four different types of psoriasis that were studied. Microbial diversity and abundance has been reported to be similar for patients with plaque, guttate, inverse and pustular psoriasis. Regardless of type, the microbiota of psoriasis patients in the severe state differs from that of patients with more mild conditions. Dysbiosis in psoriasis patients is not limited solely to bacterial differences. The fungal species Candida albicans and Geotrichum candidum are more prevalent in psoriasis patients than controls.   

Specific probiotic strains have shown therapeutic benefit with regards to psoriasis. Pustular psoriasis has been shown to respond positively, and improve with administration of Lactobacillus. One study found patients who received a daily oral dose of Lactobacillus paracasei NCC2461 exhibited decreased skin sensitivity, improved barrier function, and improved efficiency in preserving skin moisturizing agents. In a murine model, a milder form of psoriasis was observed following administration of Lactobacillus pentosus. Lactobacillus pentosus has been shown to suppress psoriasis associated pro-inflammatory Th17-associated cytokines.  

Psoriasis is an increasingly common autoimmune disorder of idiopathic origin. Current effective approaches include biologics to neutralize TNF-α, a critical point in the inflammatory cascade. Recent evidence regarding a gut dysbiosis for psoriasis patients illuminates a gut-skin axis component that may be an avenue for therapeutic intervention. Evidence-based approaches may include identification and remediation of gut dysbiosis, as well as specific probiotics to improve psoriasis symptomology.  


Alesa DI, Alshamrani HM, Alzahrani YA, Alamssi DN, Alzahrani NS, Almohammadi ME. The role of gut microbiome in the pathogenesis of psoriasis and the therapeutic effects of probiotics. J Family Med Prim Care. 2019;8(11):3496-3503. Published 2019 Nov 15. doi:10.4103/jfmpc.jfmpc_709_19 

Benhadou F, Mintoff D, Schnebert B, Thio HB. Psoriasis and Microbiota: A Systematic Review. Diseases. 2018;6(2):47. Published 2018 Jun 2. doi:10.3390/diseases6020047 

Buslau M, Menzel I, Holzmann H. Fungal flora of human feces in psoriasis and atopic dermatitis. Mycoses. 1990 Feb;33(2):90-4 

Hidalgo-Cantabrana C, Gómez J, Delgado S, et al. Gut microbiota dysbiosis in a cohort of patients with psoriasis. Br J Dermatol. 2019;181(6):1287-1295. doi:10.1111/bjd.17931 

Huang L, Gao R, Yu N, Zhu Y, Ding Y, Qin H. Dysbiosis of gut microbiota was closely associated with psoriasis. Sci China Life Sci. 2019;62(6):807-815. doi:10.1007/s11427-018-9376-6 

Tan L, Zhao S, Zhu W, et al. The Akkermansia muciniphila is a gut microbiota signature in psoriasis. Exp Dermatol. 2018;27(2):144-149. doi:10.1111/exd.13463 

Vena GA, Cassano N. Drug focus: adalimumab in the treatment of moderate to severe psoriasis. Biologics. 2007 Jun;1(2):93-103. PMID: 19707319; PMCID: PMC2721299.

Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.