Digestive Health Celiac Disease Related Conditions The Link Between Gluten and Psoriasis Could a gluten-free diet reduce psoriasis flares? By Jane Anderson Updated on April 19, 2024 Medically reviewed by Suzanne Fisher, RD Print Table of Contents View All Table of Contents Autoimmune Disorders Evidence Gluten-Free Diet Several studies suggest a connection between psoriasis and celiac disease. Both are autoimmune diseases in which the body turns its immune defenses on itself. With psoriasis, the primary target is the skin; with celiac disease, the lining of the small intestine is attacked. Although the evidence is far from conclusive, some scientists believe that gluten—the dietary protein found in certain cereal grains—not only triggers celiac disease but may also instigate psoriasis in some people. This article discusses the potential link between gluten and psoriasis. Howard George / Getty Images Autoimmune Disorders and Inflammation Celiac disease and psoriasis are both autoimmune disorders, meaning that the immune system mistakenly attacks normal cells and tissues. With celiac disease, the immune system will attack the lining of the intestine, known as the villi. With psoriasis, the immune system attacks cells known as keratinocytes in the outer layer of skin (epidermis). One of the common denominators in all autoimmune disorders is inflammation. With celiac disease, inflammation flattens and damages the finger-like villi, interfering with their ability to absorb nutrients. With psoriasis, inflammation triggers the hyperproduction of keratinocytes, leading to the formation of dry, scaly plaques. Inflammation also contributes to joint damage with rheumatoid arthritis and nerve cell damage in people with multiple sclerosis. Up to 25% of people with an autoimmune disease will have more than one. This is called polyautoimmunity. Whether psoriasis and celiac disease are inherently linked or occur independently of one another has yet to be established. Role of Genetics Genetics also plays a central role. According to a 2016 review in the Journal of Immunology Research, genetic mutations are commonly shared between different autoimmune disorders, increasing the risk of polyautoimmunity. One such example is a signaling protein called human leukocyte antigen (HLA). Among its functions, HLA presents disease-causing microorganisms to the immune system for destruction. If the protein is flawed, it may direct the immune system to attack normal cells instead of abnormal ones. The role of certain HLA-DRB1 alleles, including the HLA-DRB13 allele, have been associated with certain autoimmune diseases, including psoriasis, rheumatoid arthritis, psoriatic arthritis, multiple sclerosis, and myasthenia gravis. Psoriasis and celiac disease also share HLA mutations, specifically HLA-DR3, HLA-DQ2, and HLA-DQ8. With that being said, it remains unclear how these mutations influence either disease and what, if any, role they play in gluten sensitivity. How Psoriasis Is Diagnosed Current Evidence for Gluten and Psoriasis Link The evidence supporting the link between gluten and psoriasis flare is both compelling and conflicted. The proof is based largely on the presence of gluten antibodies in many (but not all) people with psoriasis. Antibodies are immune proteins that the body produces in response to any microorganism it considers harmful. Their role is to alert the immune system whenever the microorganism is present so that a defensive attack can be launched. The body produces a unique antibody in response to every new microorganism it detects. Afterward, the antibody remains so it can be called on during subsequent infections. These antibodies are the "fingerprint" that pathologists use to identify celiac disease. The fact that a person has gluten antibodies means that the immune system considers gluten harmful. If it didn't, there wouldn't be any antibodies. The presence of gluten antibodies in people with psoriasis can mean one of several things: It could mean that a person has two independent autoimmune disorders with no genetic link. Even if there are no overt signs of celiac disease, the disease could be latent and only manifest with symptoms in later years.It could mean that there are shared genetic links between the autoimmune disorders, but they are only activated in response to specific environmental triggers. It is important to note that the presence of gluten antibodies in people with psoriasis does not mean that gluten is a trigger for psoriasis. To date, the evidence supporting this link is uncertain. A few studies have found that people with psoriasis are more likely to have gluten antibodies than people without psoriasis. They're also more likely to have higher concentrations of these antibodies. This raises the possibility that the affected people may, in fact, have latent celiac disease. Other studies have tried to find a genetic cause of the association. One study found that people with celiac disease were at greater risk for developing psoriasis, but that psoriasis did not increase the risk of developing celiac disease. Research into the link between psoriasis and celiac disease is ongoing, but the fact that not everyone with psoriasis has gluten antibodies leaves plenty of room for doubt. Currently, no medical association in the United States or abroad has issued recommendations for celiac disease antibody testing in people with psoriasis. How Celiac Disease Is Diagnosed Benefits of a Gluten-Free Diet If you have been diagnosed with celiac disease, you will need to follow a gluten-free diet. If you also have psoriasis, the diet may also help your skin condition as a bonus. One study found that people with psoriasis who had high or very high gluten antibodies benefited from a gluten-free diet. After one year of following a gluten-free diet, participants reported significant improvements in the severity of their psoriasis symptoms. This does not necessarily mean that improvements would also occur in people with low levels of gluten antibodies. It is also unlikely that a gluten-free diet would benefit people with no gluten antibodies. The National Psoriasis Foundation (NPF) believes the evidence for a gluten-free diet as a viable treatment for psoriasis is still inconclusive. With that said, obesity is also a major trigger for psoriasis. If you are overweight, embarking on a healthy, weight-loss diet could help control your psoriasis. In the end, the positive results may be attributed to weight loss rather than the alleviation of gluten sensitivity. Further research is needed before any conclusions can be made. An Overview of the Gluten-Free Diet Summary There may be a link between psoriasis and celiac disease. Research has found that people with psoriasis tend to have gluten antibodies more often than people who don't. However, the research is still ongoing as to whether a gluten-free diet might help improve symptoms of psoriasis. If you think you might have celiac disease, talk to your healthcare provider. A diagnosis is the first step towards understanding and managing your condition. 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Barygina V, Becatti M, Prignano F, Lotti T, Taddei N, Fiorillo C. Fibroblasts to keratinocytes redox signaling: The possible role of ROS in psoriatic plaque formation. Antioxidants (Basel). 2019;8(11):566. doi:10.3390/antiox8110566 Autoimmune Association. What is autoimmunity? Ceccarelli F, Agmon-levin N, Perricone C. Genetic Factors of Autoimmune Diseases. J Immunol Res. 2016;2016:3476023. doi:10.1155/2016/3476023 Crux NB, Elahi S. Human leukocyte antigen (HLA) and immune regulation: How do dlassical and non-classical HLA alleles modulate immune response to human immunodeficiency virus and hepatitis C virus infections?. Front Immunol. 2017;8:832. doi:10.3389/fimmu.2017.00832 Cintoni M, Palombaro M, Maramao FS, et al. Metabolic disorders and psoriasis: Exploring the role of nutritional interventions. Nutrients. 2023;15(18):3876. doi:10.3390/nu15183876 D'erme AM, Kovacikova Curkova A, Agnoletti AF, Milanesi N, Simonacci F, Gola M. Gluten-free diet as a therapeutic approach in psoriatic patients: if yes, when. G Ital Dermatol Venereol. 2015;150(3):317-20. Cebolla Á, Moreno ML, Coto L, Sousa C. Gluten immunogenic peptides as standard for the evaluation of potential harmful prolamin content in food and human specimen. Nutrients. 2018;10(12):1927. doi:10.3390/nu10121927 Vekić-Mužević M, Tomić L, Pondeljak N, Lazić Mosler E. Positivity of celiac disease-specific antibodies and non-celiac hypersensitivity in psoriasis. Acta Dermatovenerol Alp Pannonica Adriat. 2023;32(3):87-92. Li L, Fu L, Zhang L, Feng Y. Mendelian randomization study of the genetic interaction between psoriasis and celiac disease. Sci Rep. 2022;13;12(1):21508. doi:10.1038/s41598-022-25217-y Kolchak NA, Tetarnikova MK, Theodoropoulou MS, Michalopoulou AP, Theodoropoulos DS. Prevalence of antigliadin IgA antibodies in psoriasis vulgaris and response of seropositive patients to a gluten-free diet. J Multidiscip Healthc. 2017;11:13-19. doi:10.2147/JMDH.S122256 Kunz M, Simon JC, Saalbach A. Psoriasis: Obesity and fatty acids. Front Immunol. 2019;10:1807. doi:10.3389/fimmu.2019.01807 Additional Reading Ceccarelli F, Agmon-Levin N, Perricone C. Genetic factors of autoimmune diseases. J Immunol Res. 2016;2016:3476023. doi:10.1155/2016/3476023 National Psoriasis Foundation. Gluten-free diet. Ungprasert P, Wijarnpreecha K, Kittanamongkolchai W. Psoriasis and risk of celiac disease: A systematic review and meta-analysis. Indian J Dermatol. 2017;62(1):41-6. doi:10.4103/0019-5154.198031 By Jane Anderson Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit