The American Autoimmune Related Diseases Association estimates that in the United States alone, more than 50 million individuals have autoimmune diseases, with women representing more than 80% of autoimmune patients. These diseases affect a wide range of organs and tissues in the body, including the body’s largest organ, the skin. Because the skin is so visible and important to overall function, autoimmune skin disorders can significantly impact individuals’ physical and mental well-being. With an increasing understanding of the gut-skin axis, the connection between hormones, gut health, and autoimmune skin disorders is gaining interest as a potential avenue for managing these conditions.
[signup]
What Are Autoimmune Skin Disorders?
The immune system consists of cells, tissues, and organs that defend the body against pathogens and foreign invaders to prevent infection and disease. A properly functioning immune system is able to discern the difference between the body’s own cells and foreign cells, a concept called immune tolerance. In autoimmune diseases, the immune system loses self-tolerance and begins to attack the body’s own tissues. While the exact causes of autoimmunity are not completely understood, it is believed to involve a combination of genetics and environmental factors. Genetic predisposition can make certain individuals more susceptible to autoimmune diseases, while various triggers, including infections, chemical exposures, and hormone imbalances, may initiate or exacerbate the autoimmune response. (35)
Autoimmune diseases vary in terms of which organs or tissues are affected, extending to skin involvement. Some autoimmune diseases exclusively target the skin and mucous membranes, while others can affect multiple organs or systems, including the skin. Some common autoimmune disorders affecting the skin include:
Certain digestive disorders increase the risk of developing skin disorders. For instance, psoriasis, atopic dermatitis, and rosacea have been observed to be more prevalent in inflammatory bowel disease, highlighting the bidirectional relationship that exists between these two systems, known as the “gut-skin axis.” Emerging research suggests that the health of the gut has a significant impact on the health of the skin and vice versa. The gut and skin even share commonalities in terms of structure and function. Both are physical barriers, serving as first-line defenders of the immune system. Furthermore, they each are home to immune cells, neuroendocrine connections, and a unique composition of microorganisms collectively known as the microbiome. These similarities underscore the interconnectedness between these two bodily systems. (19)
The gut’s microbiome performs many functions, including preventing infection from pathogens and synthesizing important nutrients and short-chain fatty acids (SCFA’s). Each person’s microbiome is unique and is influenced by factors like diet, stress, and environmental exposures. 70-80% of the immune system resides in the gut, where it interacts with the microbiome. This interaction influences the development and activity of immune cells.
Certain commensal bacteria strains stimulate immune cells, called regulatory T cells, that help to maintain balance in the immune system and self-tolerance. Others can stimulate immune cells that increase the production of inflammatory mediators. Molecules associated with the microbiome, such as bile acid metabolites, SCFA’s, and endotoxins (lipopolysaccharide or LPS), also influence the activity of the immune system.
The gastrointestinal tract ideally functions as a physical barrier preventing the absorption of pathogens and other unwanted molecules. When this barrier becomes compromised, as observed in a condition called intestinal permeability or leaky gut, this barrier deteriorates. Consequently, it permits the unwanted absorption of these molecules, allowing them to interact with the immune system. This interaction triggers immune system activity and systemic inflammatory responses.
Systemic inflammation, often identified by elevations in biomarkers like c-reactive protein (CRP) and interleukin-6 (IL-6), is an underlying imbalance often seen in autoimmune conditions. (63, 65) Many factors, including stress and disruptions to the composition of the microbiome, referred to as dysbiosis, contribute to the development of intestinal permeability. (48) Both dysbiosis and intestinal permeability have been associated with the development of autoimmune disorders in general, as well as skin conditions specifically. (9, 18, 57)
This is not solely a one-directional relationship. UV exposure to the skin can increase the diversity of the gastrointestinal microbiome. An impaired skin barrier, as seen in conditions like atopic dermatitis, also increases the risk of food allergy. (19)
Contribution of a dysbiotic gut to the onset of cutaneous inflammation. Adapted from: Targeting the gut-skin axis—Probiotics as new tools for skin disorder management?, M. Szántó, 2019, Experimental Dermatology, 28(11).https://doi.org/10.1111/exd.14016
Hormones and Skin Health
Hormones are chemical messengers in the body, regulating important physiological processes. Hormones impact numerous aspects of skin health, including the regulation of sebum production, the maintenance of the skin's protective barrier function, the promotion of collagen synthesis for skin elasticity, the control of sweat production, and the regulation of hair growth. Given the extensive array of functions they govern, hormonal imbalances can have a substantial impact on the overall health and appearance of the skin.
Excess sebum production is one underlying cause of acne. Androgens, like testosterone and DHEA, increase sebum production. This connection is exemplified in the case of polycystic ovarian syndrome (PCOS), a condition in which women have elevated androgen levels and often experience acne as a result. (25)
Hormonal factors appear to play a role in other skin conditions like rosacea, an inflammatory skin disorder primarily affecting the face. Studies suggest that women undergoing hormone therapy and those using oral contraceptives are at a higher risk of developing rosacea, while postmenopausal women, who typically have lower estrogen levels, seem to have a lower risk, implying a potential contribution of estrogen to this condition. (77)
Hormones can modulate immune activity, including in the skin, which can impact the disease course of autoimmune skin conditions. This dynamic is seen in psoriasis, where periods of reproductive hormone fluctuation like puberty, pregnancy, and menstruation influence symptoms. (10, 30)
A higher prevalence of hypothyroidism is also seen in autoimmune conditions like vitiligo, alopecia areata, and lichen sclerosus. Although the mechanism behind this association is not fully understood, thyroid hormone can act directly on various skin cells, like keratinocytes, sebaceous glands, and vascular endothelial cells, as well as various immune cell types, which might help to explain the connection. (29, 52)
Triggers and Aggravators: Diet, Stress, and More
Having already discussed that genetics, microbiome composition, intestinal permeability, and hormonal fluctuations influence the development of autoimmune skin diseases, we will now delve deeper into additional triggers and exacerbating factors in these conditions.
Stress
Stress has been identified as a possible precipitating factor in the development of certain autoimmune skin conditions like psoriasis, vitiligo, and alopecia areata. (5, 26) When individuals are under higher amounts of stress, it stimulates a neuroendocrine response. The hypothalamic-pituitary-adrenal (HPA) axis releases hormones like corticotropin-releasing hormone (CRH) and cortisol, and the nervous system releases neuropeptides like substance P.
The skin also has its own peripheral HPA axis that is stimulated by central HPA axis activity. There are receptors for CRH on the skin, allowing it to trigger mast cell (a type of immune cell) activation and increasing inflammation, interrupting barrier function in the skin. (43)
Brain–skin axis: association between psoriasis and depression. Adapted from: “The Brain–Skin Axis in Psoriasis—Psychological, Psychiatric, Hormonal, and Dermatological Aspects”, L. Marek-Jozefowicz, 2022, International Journal of Molecular Sciences, 23(2). https://doi.org/10.3390/ijms23020669
Dietary Triggers
A Western diet is thought to be one contributing factor to the increasing prevalence of autoimmune diseases. This style of diet is one with an overabundance of processed sugars and foods, salt, refined grains, and saturated fats, and is limited in fiber, vitamins, minerals, and antioxidants. A Western diet directly stimulates inflammatory responses and can negatively impact the gut microbiome composition. Food sensitivities might also play a role in the development of autoimmune diseases in certain individuals. (11, 55)
Gluten, a protein found in grains like wheat, can directly cause autoimmune diseases like celiac disease and dermatitis herpetiformis. Individuals with autoimmune diseases have also been found to have a higher prevalence of food-sensitivity reactions on serum antibody testing.
Environmental Toxins
Exposure to environmental toxins contributes to microbiome disruption, intestinal permeability, immune system dysregulation, and inflammation, increasing the risk of autoimmunity. Furthermore, certain environmental toxins, called endocrine-disrupting chemicals (EDCs), can cause hormone imbalances, further disrupting the gut-hormone-skin relationship. Autoimmune conditions affecting the skin, such as psoriasis, alopecia, SLE, and vitiligo, have been found to be associated with a variety of toxic compounds like pesticides, air pollution, heavy metals, cigarette smoke, and household chemicals. (6, 38, 51, 81)
Lab Testing to Investigate the Gut-Hormone-Skin Connection
The human body operates as an interconnected system in which the health of one system significantly influences the functionality of another. When managing autoimmune skin conditions, an understanding of the relationship between the gut, hormones, and skin must be fully understood to provide comprehensive, holistic treatment. Functional medicine tests offer practitioners a means to evaluate the function of both the endocrine and gastrointestinal systems to understand their reciprocal impact on one another as well as their collective influence on skin health.
Diagnosing Autoimmune Skin Conditions
Although the characteristic appearance of skin lesions may be suggestive of a particular skin disorder, a biopsy is generally needed for a definitive diagnosis of an autoimmune skin disease. Doctors may also use swabs and skin cultures to assess for infections of the skin.
Blood tests for autoimmunity can be ordered, like antinuclear antibodies (ANA). Nonspecific tests for inflammation, such as c-reactive protein (CRP) might also be considered. (3)
Intestinal Permeability Screen
Cyrex’sArray 2, also known as Intestinal Antigenic Permeability Screen, measures antibodies against specific proteins associated with the gastrointestinal lining. Elevations in these antibodies indicate gut barrier damage, indicative of intestinal permeability.
Food Sensitivity Tests
Cyrex’sArray 10, known as the Multiple Food Immune Reactivity Screen, assesses IgG and IgA antibody reactions to foods in various forms (raw, cooked, and modified), along with food enzymes, lectins, and artificial additives. In contrast to many other food sensitivity tests that exclusively target raw foods, this panel ensures that reactions are not overlooked due to cooking, modification, or ingredient combinations.
HPA Axis function is assessed thoroughly by including a 4-point cortisol measurement throughout the day to identify any deviations from the normal circadian rhythm.
The Thyroid Panel by BostonHeart Diagnostics measures TSH, T4, T3, free T4, free T3, reverse T3, and thyroid antibodies. This provides a thorough picture of thyroid function to identify any conditions like hypothyroidism or autoimmune thyroid disorders that are associated with skin conditions.
[signup]
Healing from the Inside Out
Embracing a holistic skincare approach is about recognizing that true skin health is more than skin deep. It involves delving beneath the surface to address the underlying causes of skin issues rather than merely treating superficial symptoms. Holistic skincare strategies take into account the importance of achieving optimal hormone balance and supporting the gut-skin axis when selecting appropriate therapies and lifestyle changes.
Nutrition
A whole-food, nutrient-dense, and high-fiber diet can support optimal hormone balance, immune system function, microbiome diversity, and overall gut health. Vitamins, minerals, and phytonutrients found in fruits and vegetables help support hormone production and metabolism as well as immune system function. (46, 66) Oxidative stress is a contributing factor in at least some autoimmune skin conditions (53, 54). Incorporating plenty of fruits and vegetables ensures an adequate intake of antioxidants to combat free radicals and oxidative stress.
The Mediterranean Diet is an eating pattern that emphasizes the intake of vegetables, fruit, legumes, nuts, and healthy fats from foods such as olive oil and fish. This style of eating can help to reduce inflammation and support a healthy microbiome. Studies have shown its benefit in some autoimmune diseases, including psoriasis. (50)
Individuals who either have diagnosed or suspected food sensitivities might need to work closely with their healthcare provider to customize a personalized elimination diet. In an elimination diet, all potentially problematic foods are removed for at least several weeks. If desired, individual foods can then be reintroduced one at a time over the course of a few days to see if any problematic symptoms arise. Any foods that provoke unwanted symptoms are then removed for a longer period of time before any attempts for reintroduction are made again. The goal of an elimination diet is to remove foods that promote inflammation, thereby improving gut and immune health in the patient. Including a reintroduction phase allows patients to transition to a more diverse diet over time if no adverse reactions are experienced.
Stress Management
Stressful life events can serve as precipitating and exacerbating factors in autoimmune diseases. Additionally, autoimmune skin conditions increase feelings of stress, anxiety, and depression. (27) Mind-body therapies support the body’s relaxation response to counteract the negative effects of stress and restore equilibrium to the nervous system and hormones. Some of these techniques include mindfulness, meditation, yoga, deep breathing, progressive muscle relaxation, and biofeedback.
Prebiotics & Probiotics
Prebiotics are non-digestible dietary compounds, typically carbohydrates or fiber, that serve as a nutritional source for beneficial gut bacteria, promoting their growth and activity. Prebiotics can be found naturally in some foods like certain fruits, vegetables, whole grains, and legumes or can also be taken in supplemental form. Common prebiotic supplements available include fructooligosaccharides (FOS), inulin, resistant starch, and galactooligosaccharides (GOS).
Probiotics are supplements containing live microorganisms, usually beneficial bacteria or yeast, that help restore balance to the microbiome. They inhibit the growth of potentially problematic organisms in the gut while simultaneously supporting the growth of beneficial commensal organisms. The probiotics themselves can also act directly on immune cells to help modulate inflammatory responses. (37)
Serum-Derived Bovine Immunoglobulins (SBI)
Immunoglobulins are proteins produced by immune cells to recognize and remove foreign substances from the body. Serum-derived bovine immunoglobulins (SBI) are immunoglobulin preparations derived from the serum of bovine animals. These supplements contain a mixture of antibodies, particularly immunoglobulin G (IgG), to help support various aspects of immune function. In the gut, immunoglobulins bind to pathogens and endotoxins and improve microbial diversity, which helps to reduce gastrointestinal inflammation and permeability. (13, 49, 70)
Curcumin
Curcumin is a compound found in turmeric. In the gastrointestinal tract, it can modulate the microbiome inflammatory cytokines and provide antioxidant protection. Outside of the gastrointestinal tract, it also decreases systemic inflammation and skin inflammation. (45, 69)
[signup]
Summary
The gut-skin axis exerts a profound influence over autoimmune skin conditions. Hormones interact with both of these systems, thereby affecting this axis. An integrative approach to autoimmune skin disorders addresses skin health holistically from the inside out. Utilizing functional medicine tests provides a comprehensive assessment of gut and hormone health simultaneously to create personalized protocols, strengthening the synergy between these systems.
The American Autoimmune Related Diseases Association estimates that in the United States alone, more than 50 million individuals have autoimmune diseases, with women representing more than 80% of autoimmune patients. These diseases affect a wide range of organs and tissues in the body, including the body’s largest organ, the skin. Because the skin is so visible and important to overall function, autoimmune skin disorders can significantly impact individuals’ physical and mental well-being. With an increasing understanding of the gut-skin axis, the connection between hormones, gut health, and autoimmune skin disorders is gaining interest as a potential avenue for managing these conditions.
[signup]
What Are Autoimmune Skin Disorders?
The immune system consists of cells, tissues, and organs that defend the body against pathogens and foreign invaders to help maintain health. A properly functioning immune system is able to discern the difference between the body’s own cells and foreign cells, a concept called immune tolerance. In autoimmune diseases, the immune system loses self-tolerance and begins to attack the body’s own tissues. While the exact causes of autoimmunity are not completely understood, it is believed to involve a combination of genetics and environmental factors. Genetic predisposition can make certain individuals more susceptible to autoimmune diseases, while various triggers, including infections, chemical exposures, and hormone imbalances, may initiate or exacerbate the autoimmune response. (35)
Autoimmune diseases vary in terms of which organs or tissues are affected, extending to skin involvement. Some autoimmune diseases exclusively target the skin and mucous membranes, while others can affect multiple organs or systems, including the skin. Some common autoimmune disorders affecting the skin include:
Certain digestive disorders may increase the risk of developing skin disorders. For instance, psoriasis, atopic dermatitis, and rosacea have been observed to be more prevalent in inflammatory bowel disease, highlighting the bidirectional relationship that exists between these two systems, known as the “gut-skin axis.” Emerging research suggests that the health of the gut may have a significant impact on the health of the skin and vice versa. The gut and skin even share commonalities in terms of structure and function. Both are physical barriers, serving as first-line defenders of the immune system. Furthermore, they each are home to immune cells, neuroendocrine connections, and a unique composition of microorganisms collectively known as the microbiome. These similarities underscore the interconnectedness between these two bodily systems. (19)
The gut’s microbiome performs many functions, including helping to prevent infection from pathogens and synthesizing important nutrients and short-chain fatty acids (SCFA’s). Each person’s microbiome is unique and is influenced by factors like diet, stress, and environmental exposures. 70-80% of the immune system resides in the gut, where it interacts with the microbiome. This interaction influences the development and activity of immune cells.
Certain commensal bacteria strains stimulate immune cells, called regulatory T cells, that help to maintain balance in the immune system and self-tolerance. Others can stimulate immune cells that increase the production of inflammatory mediators. Molecules associated with the microbiome, such as bile acid metabolites, SCFA’s, and endotoxins (lipopolysaccharide or LPS), also influence the activity of the immune system.
The gastrointestinal tract ideally functions as a physical barrier helping to prevent the absorption of pathogens and other unwanted molecules. When this barrier becomes compromised, as observed in a condition called intestinal permeability or leaky gut, this barrier deteriorates. Consequently, it permits the unwanted absorption of these molecules, allowing them to interact with the immune system. This interaction may trigger immune system activity and systemic inflammatory responses.
Systemic inflammation, often identified by elevations in biomarkers like c-reactive protein (CRP) and interleukin-6 (IL-6), is an underlying imbalance often seen in autoimmune conditions. (63, 65) Many factors, including stress and disruptions to the composition of the microbiome, referred to as dysbiosis, may contribute to the development of intestinal permeability. (48) Both dysbiosis and intestinal permeability have been associated with the development of autoimmune disorders in general, as well as skin conditions specifically. (9, 18, 57)
This is not solely a one-directional relationship. UV exposure to the skin can increase the diversity of the gastrointestinal microbiome. An impaired skin barrier, as seen in conditions like atopic dermatitis, also increases the risk of food allergy. (19)
Contribution of a dysbiotic gut to the onset of cutaneous inflammation. Adapted from: Targeting the gut-skin axis—Probiotics as new tools for skin disorder management?, M. Szántó, 2019, Experimental Dermatology, 28(11).https://doi.org/10.1111/exd.14016
Hormones and Skin Health
Hormones are chemical messengers in the body, regulating important physiological processes. Hormones impact numerous aspects of skin health, including the regulation of sebum production, the maintenance of the skin's protective barrier function, the promotion of collagen synthesis for skin elasticity, the control of sweat production, and the regulation of hair growth. Given the extensive array of functions they govern, hormonal imbalances can have a substantial impact on the overall health and appearance of the skin.
Excess sebum production is one underlying cause of acne. Androgens, like testosterone and DHEA, increase sebum production. This connection is exemplified in the case of polycystic ovarian syndrome (PCOS), a condition in which women have elevated androgen levels and often experience acne as a result. (25)
Hormonal factors appear to play a role in other skin conditions like rosacea, an inflammatory skin disorder primarily affecting the face. Studies suggest that women undergoing hormone therapy and those using oral contraceptives may be at a higher risk of developing rosacea, while postmenopausal women, who typically have lower estrogen levels, seem to have a lower risk, implying a potential contribution of estrogen to this condition. (77)
Hormones can modulate immune activity, including in the skin, which can impact the disease course of autoimmune skin conditions. This dynamic is seen in psoriasis, where periods of reproductive hormone fluctuation like puberty, pregnancy, and menstruation may influence symptoms. (10, 30)
A higher prevalence of hypothyroidism is also seen in autoimmune conditions like vitiligo, alopecia areata, and lichen sclerosus. Although the mechanism behind this association is not fully understood, thyroid hormone can act directly on various skin cells, like keratinocytes, sebaceous glands, and vascular endothelial cells, as well as various immune cell types, which might help to explain the connection. (29, 52)
Triggers and Aggravators: Diet, Stress, and More
Having already discussed that genetics, microbiome composition, intestinal permeability, and hormonal fluctuations may influence the development of autoimmune skin diseases, we will now delve deeper into additional triggers and exacerbating factors in these conditions.
Stress
Stress has been identified as a possible precipitating factor in the development of certain autoimmune skin conditions like psoriasis, vitiligo, and alopecia areata. (5, 26) When individuals are under higher amounts of stress, it stimulates a neuroendocrine response. The hypothalamic-pituitary-adrenal (HPA) axis releases hormones like corticotropin-releasing hormone (CRH) and cortisol, and the nervous system releases neuropeptides like substance P.
The skin also has its own peripheral HPA axis that is stimulated by central HPA axis activity. There are receptors for CRH on the skin, allowing it to trigger mast cell (a type of immune cell) activation and increasing inflammation, interrupting barrier function in the skin. (43)
Brain–skin axis: association between psoriasis and depression. Adapted from: “The Brain–Skin Axis in Psoriasis—Psychological, Psychiatric, Hormonal, and Dermatological Aspects”, L. Marek-Jozefowicz, 2022, International Journal of Molecular Sciences, 23(2). https://doi.org/10.3390/ijms23020669
Dietary Triggers
A Western diet is thought to be one contributing factor to the increasing prevalence of autoimmune diseases. This style of diet is one with an overabundance of processed sugars and foods, salt, refined grains, and saturated fats, and is limited in fiber, vitamins, minerals, and antioxidants. A Western diet may directly stimulate inflammatory responses and can negatively impact the gut microbiome composition. Food sensitivities might also play a role in the development of autoimmune diseases in certain individuals. (11, 55)
Gluten, a protein found in grains like wheat, can directly cause autoimmune diseases like celiac disease and dermatitis herpetiformis. Individuals with autoimmune diseases have also been found to have a higher prevalence of food-sensitivity reactions on serum antibody testing.
Environmental Toxins
Exposure to environmental toxins contributes to microbiome disruption, intestinal permeability, immune system dysregulation, and inflammation, increasing the risk of autoimmunity. Furthermore, certain environmental toxins, called endocrine-disrupting chemicals (EDCs), can cause hormone imbalances, further disrupting the gut-hormone-skin relationship. Autoimmune conditions affecting the skin, such as psoriasis, alopecia, SLE, and vitiligo, have been found to be associated with a variety of toxic compounds like pesticides, air pollution, heavy metals, cigarette smoke, and household chemicals. (6, 38, 51, 81)
Lab Testing to Investigate the Gut-Hormone-Skin Connection
The human body operates as an interconnected system in which the health of one system significantly influences the functionality of another. When managing autoimmune skin conditions, an understanding of the relationship between the gut, hormones, and skin must be fully understood to provide comprehensive, holistic management. Functional medicine tests offer practitioners a means to evaluate the function of both the endocrine and gastrointestinal systems to understand their reciprocal impact on one another as well as their collective influence on skin health.
Diagnosing Autoimmune Skin Conditions
Although the characteristic appearance of skin lesions may be suggestive of a particular skin disorder, a biopsy is generally needed for a definitive diagnosis of an autoimmune skin disease. Doctors may also use swabs and skin cultures to assess for infections of the skin.
Blood tests for autoimmunity can be ordered, like antinuclear antibodies (ANA). Nonspecific tests for inflammation, such as c-reactive protein (CRP) might also be considered. (3)
Intestinal Permeability Screen
Cyrex’sArray 2, also known as Intestinal Antigenic Permeability Screen, measures antibodies against specific proteins associated with the gastrointestinal lining. Elevations in these antibodies indicate gut barrier damage, indicative of intestinal permeability.
Food Sensitivity Tests
Cyrex’sArray 10, known as the Multiple Food Immune Reactivity Screen, assesses IgG and IgA antibody reactions to foods in various forms (raw, cooked, and modified), along with food enzymes, lectins, and artificial additives. In contrast to many other food sensitivity tests that exclusively target raw foods, this panel ensures that reactions are not overlooked due to cooking, modification, or ingredient combinations.
HPA Axis function is assessed thoroughly by including a 4-point cortisol measurement throughout the day to identify any deviations from the normal circadian rhythm.
The Thyroid Panel by BostonHeart Diagnostics measures TSH, T4, T3, free T4, free T3, reverse T3, and thyroid antibodies. This provides a thorough picture of thyroid function to identify any conditions like hypothyroidism or autoimmune thyroid disorders that are associated with skin conditions.
[signup]
Healing from the Inside Out
Embracing a holistic skincare approach is about recognizing that true skin health is more than skin deep. It involves delving beneath the surface to address the underlying causes of skin issues rather than merely addressing superficial symptoms. Holistic skincare strategies take into account the importance of achieving optimal hormone balance and supporting the gut-skin axis when selecting appropriate therapies and lifestyle changes.
Nutrition
A whole-food, nutrient-dense, and high-fiber diet can support optimal hormone balance, immune system function, microbiome diversity, and overall gut health. Vitamins, minerals, and phytonutrients found in fruits and vegetables help support hormone production and metabolism as well as immune system function. (46, 66) Oxidative stress is a contributing factor in at least some autoimmune skin conditions (53, 54). Incorporating plenty of fruits and vegetables ensures an adequate intake of antioxidants to combat free radicals and oxidative stress.
The Mediterranean Diet is an eating pattern that emphasizes the intake of vegetables, fruit, legumes, nuts, and healthy fats from foods such as olive oil and fish. This style of eating may help to reduce inflammation and support a healthy microbiome. Studies have shown its potential benefit in some autoimmune diseases, including psoriasis. (50)
Individuals who either have diagnosed or suspected food sensitivities might need to work closely with their healthcare provider to customize a personalized elimination diet. In an elimination diet, all potentially problematic foods are removed for at least several weeks. If desired, individual foods can then be reintroduced one at a time over the course of a few days to see if any problematic symptoms arise. Any foods that provoke unwanted symptoms are then removed for a longer period of time before any attempts for reintroduction are made again. The goal of an elimination diet is to remove foods that may promote inflammation, thereby supporting gut and immune health in the patient. Including a reintroduction phase allows patients to transition to a more diverse diet over time if no adverse reactions are experienced.
Stress Management
Stressful life events can serve as precipitating and exacerbating factors in autoimmune diseases. Additionally, autoimmune skin conditions may increase feelings of stress, anxiety, and depression. (27) Mind-body therapies support the body’s relaxation response to counteract the negative effects of stress and help restore equilibrium to the nervous system and hormones. Some of these techniques include mindfulness, meditation, yoga, deep breathing, progressive muscle relaxation, and biofeedback.
Prebiotics & Probiotics
Prebiotics are non-digestible dietary compounds, typically carbohydrates or fiber, that serve as a nutritional source for beneficial gut bacteria, promoting their growth and activity. Prebiotics can be found naturally in some foods like certain fruits, vegetables, whole grains, and legumes or can also be taken in supplemental form. Common prebiotic supplements available include fructooligosaccharides (FOS), inulin, resistant starch, and galactooligosaccharides (GOS).
Probiotics are supplements containing live microorganisms, usually beneficial bacteria or yeast, that may help restore balance to the microbiome. They may inhibit the growth of potentially problematic organisms in the gut while simultaneously supporting the growth of beneficial commensal organisms. The probiotics themselves can also act directly on immune cells to help modulate inflammatory responses. (37)
Serum-Derived Bovine Immunoglobulins (SBI)
Immunoglobulins are proteins produced by immune cells to recognize and remove foreign substances from the body. Serum-derived bovine immunoglobulins (SBI) are immunoglobulin preparations derived from the serum of bovine animals. These supplements contain a mixture of antibodies, particularly immunoglobulin G (IgG), to help support various aspects of immune function. In the gut, immunoglobulins may bind to pathogens and endotoxins and improve microbial diversity, which may help to reduce gastrointestinal inflammation and permeability. (13, 49, 70)
Curcumin
Curcumin is a compound found in turmeric. In the gastrointestinal tract, it may modulate the microbiome inflammatory cytokines and provide antioxidant protection. Outside of the gastrointestinal tract, it may also help decrease systemic inflammation and skin inflammation. (45, 69)
[signup]
Summary
The gut-skin axis may exert a profound influence over autoimmune skin conditions. Hormones interact with both of these systems, thereby affecting this axis. An integrative approach to autoimmune skin disorders addresses skin health holistically from the inside out. Utilizing functional medicine tests provides a comprehensive assessment of gut and hormone health simultaneously to create personalized protocols, strengthening the synergy between these systems.
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
Learn more
No items found.
Lab Tests in This Article
ANA Screen by Access Med Labs
Serum
The ANA Screen detects the presence of clinically relevant circulating autoantibodies in serum.
C-Reactive Protein, Inflammation (CRP) by Access Med Labs
Serum
This is a single-marker test measuring C-reactive protein (CRP). It is used to test for inflammation, infections, and neoplastic diseases.
Array 2 by Cyrex Laboratories
Serum
The Array 2 Intestinal Antigenic Permeability Screen™ is an important initial screening test for patients with multiple chronic GI and neurologic symptoms, suspected food sensitivities, chemical intolerances, or a history of pathogen-induced autoimmune conditions. Array 2 differentiates transcellular versus paracellular intestinal permeability, epithelial barrier dysfunction in the form of actomyosin antibodies, and immune reactivity to lipopolysaccharides (LPS). These types of immune reactivity can lead to imbalances of the gut-brain axis and disruption of the blood-brain barrier.
Array 10 by Cyrex Laboratories
Serum
The Multiple Food Immune Reactivity Screen (Array 10) evaluates immune reactions to 180 raw and/or modified foods, food enzymes, lectins, and artificial food additives, including meat glue, colorings, and gums. It can detect dietary-related triggers of autoimmune reactivity and monitor the efficacy of customized dietary protocols.
Urine Toxic Metals - Random/FMV by Doctor's Data
Urine
The Urine Toxic Metals test can be used to evaluate exposure to toxic elements and the efficacy of detoxification therapy. This test uses a random urine collection. It is also available as a timed or 24-hour collection.
Thyroid Panel by Boston Heart Diagnostics
Serum
BostonHeart's Thyroid Panel measures eight biomarkers to assess overall thyroid health and function. Please be advised that Boston Heart Diagnostics policy states that practitioners cannot order labs on themselves or their immediate family members.
Saliva Profile III - female/male by ZRT Laboratory
Saliva
The Saliva Profile III provides a baseline assessment of four sex and adrenal hormones. It includes a diurnal cortisol profile.
Environmental Pollutants Profile (EPP) by US BioTek
Urine
The Environmental Pollutants Profile provides quantitative measurement of 14 select metabolites that can help define an individual’s toxic burden and provide valuable information for a targeted nutritional and detoxification intervention.
Alexander, C., & Rietschel, E. (2001). Bacterial lipopolysaccharides and innate immunity. Journal of Endotoxin Research, 7(3), 167–202. https://doi.org/10.1179/096805101101532675
Artantaş, Ş., Gül, Ü., Kılıç, A., & Güler, S. (2009). Skin findings in thyroid diseases. European Journal of Internal Medicine, 20(2), 158–161. https://doi.org/10.1016/j.ejim.2007.09.021
Autoimmune diseases in dermatology. DermNet. (n.d.). https://dermnetnz.org/topics/autoimmune-diseases-in-dermatology
Bagatin, E., Freitas, T. H., Rivitti-Machado, M. C., Ribeiro, B. M., Nunes, S., & Rocha, M. A. (2019). Adult female acne: A guide to clinical practice. Anais Brasileiros de Dermatologia, 94(1), 62–75. https://doi.org/10.1590/abd1806-4841.20198203
Balieva, F., Schut, C., Kupfer, J., Lien, L., Misery, L., Sampogna, F., von Euler, L., & Dalgard, F. J. (2022). Perceived stress in patients with inflammatory and non‐inflammatory skin conditions. an observational controlled study among 255 Norwegian dermatological outpatients. Skin Health and Disease, 2(4). https://doi.org/10.1002/ski2.162
Barbhaiya, M., & Costenbader, K. H. (2016). Environmental exposures and the development of systemic lupus erythematosus. Current Opinion in Rheumatology, 28(5), 497–505. https://doi.org/10.1097/bor.0000000000000318
Birenbaum, D., & Young, R. C. (2007). High prevalence of thyroid disease in patients with lichen sclerosus. PubMed, 52(1), 28–30. https://pubmed.ncbi.nlm.nih.gov/17286064
Burge, K., Gunasekaran, A., Eckert, J., & Chaaban, H. (2019). Curcumin and intestinal inflammatory diseases: Molecular mechanisms of protection. International Journal of Molecular Sciences, 20(8), 1912. https://doi.org/10.3390/ijms20081912
Catinean, A., Neag, M. A., Mitre, A. O., Bocsan, C. I., & Buzoianu, A. D. (2019). Microbiota and immune-mediated skin diseases—an overview. Microorganisms, 7(9), 279. https://doi.org/10.3390/microorganisms7090279
Ceovic, R., Mance, M., Bukvic Mokos, Z., Svetec, M., Kostovic, K., & Stulhofer Buzina, D. (2013). Psoriasis: Female skin changes in various hormonal stages throughout life—puberty, pregnancy, and menopause. BioMed Research International, 2013, 1–6. https://doi.org/10.1155/2013/571912
Christ, A., Lauterbach, M., & Latz, E. (2019). Western diet and the immune system: An inflammatory connection. Immunity, 51(5), 794–811. https://doi.org/10.1016/j.immuni.2019.09.020
Cloyd, J. (2023, February 28). A functional medicine protocol for leaky gut syndrome. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-protocol-for-leaky-gut-syndrome
Cloyd, J. (2023, July 7). A functional medicine microscopic colitis protocol: Testing, therapeutic diets, and supplements. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-microscopic-colitis-protocol-testing-therapeutic-diets-and-supplements
Cloyd, J. (2023, July 20). A functional medicine PCOS protocol: Comprehensive testing, therapeutic diet, and supplements. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-pcos-protocol-comprehensive-testing-therapeutic-diet-and-supplements
Cloyd, J. (2023, August 21). A root cause medicine protocol for patients with psoriasis: Comprehensive lab testing, therapeutic diet, and supplements. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-protocol-for-patients-with-psoriasis-comprehensive-lab-testing-therapeutic-diet-and-supplements
Cloyd, K. (2023, October 9). Endocrine disruptors: Unveiling the impact of environmental factors on Hormonal Health. Rupa Health. https://www.rupahealth.com/post/endocrine-disruptors-unveiling-the-impact-of-environmental-factors-on-hormonal-health
Coucke, F. (2018). Food intolerance in patients with manifest autoimmunity. observational study. Autoimmunity Reviews, 17(11), 1078–1080. https://doi.org/10.1016/j.autrev.2018.05.011
De Luca, F., & Shoenfeld, Y. (2018). The microbiome in autoimmune diseases. Clinical and Experimental Immunology, 195(1), 74–85. https://doi.org/10.1111/cei.13158
De Pessemier, B., Grine, L., Debaere, M., Maes, A., Paetzold, B., & Callewaert, C. (2021). Gut–skin axis: Current knowledge of the Interrelationship between microbial dysbiosis and skin conditions. Microorganisms, 9(2), 353. https://doi.org/10.3390/microorganisms9020353
DeCesaris, L. (2022, June 6). What is gut dysbiosis? 7 signs to watch for. Rupa Health. https://www.rupahealth.com/post/how-your-gut-bacteria-affects-your-overall-health#:~:text=There%20are%20many%20different%20signs,and%20mucus%20in%20the%20stool.
DeCesaris, L. (2022, August 30). How to do an elimination diet. Rupa Health. https://www.rupahealth.com/post/how-to-do-an-elimination-diet
Easthope, A. (2022, April 1). Possible root causes of rosacea and how to treat them naturally. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-rosacea
Ebrahimzadeh, A., Abbasi, F., Ebrahimzadeh, A., Jibril, A. T., & Milajerdi, A. (2021). Effects of curcumin supplementation on inflammatory biomarkers in patients with rheumatoid arthritis and ulcerative colitis: A systematic review and meta-analysis. Complementary Therapies in Medicine, 61, 102773. https://doi.org/10.1016/j.ctim.2021.102773
Gainder, S., & Sharma, B. (2019). Update on management of polycystic ovarian syndrome for dermatologists. Indian Dermatology Online Journal, 10(2), 97. https://doi.org/10.4103/idoj.idoj_249_17
Güleç, A. T., Tanrıverdi, N., Dürü, Ç., Saray, Y., & Akçalı, C. (2004). The role of psychological factors in alopecia areata and the impact of the disease on the quality of life. International Journal of Dermatology, 43(5), 352–356. https://doi.org/10.1111/j.1365-4632.2004.02028.x
Henderson, A. D., Adesanya, E., Mulick, A., Matthewman, J., Vu, N., Davies, F., Smith, C. H., Hayes, J., Mansfield, K. E., & Langan, S. M. (2023). Common mental health disorders in adults with inflammatory skin conditions: Nationwide population-based matched cohort studies in the UK. BMC Medicine, 21(1). https://doi.org/10.1186/s12916-023-02948-x
Immune tolerance. National Institute of Allergy and Infectious Diseases. (n.d.). https://www.niaid.nih.gov/research/immune-tolerance
Jara, E. L., Muñoz-Durango, N., Llanos, C., Fardella, C., González, P. A., Bueno, S. M., Kalergis, A. M., & Riedel, C. A. (2017). Modulating the function of the immune system by thyroid hormones and thyrotropin. Immunology Letters, 184, 76–83. https://doi.org/10.1016/j.imlet.2017.02.010
Kanda, N., & Watanabe, S. (2005). Regulatory roles of sex hormones in cutaneous biology and Immunology. Journal of Dermatological Science, 38(1), 1–7. https://doi.org/10.1016/j.jdermsci.2004.10.011
Khakham, C. (2023, June 8). Exploring the complexities of autoimmune diseases: Unraveling mechanisms, risk factors, and integrative approaches to testing, diagnosis, and treatment. Rupa Health. https://www.rupahealth.com/post/understanding-autoimmune-diseases-mechanisms-and-risk-factors
Kim, M., Choi, K. H., Hwang, S. W., Lee, Y. B., Park, H. J., & Bae, J. M. (2017). Inflammatory bowel disease is associated with an increased risk of inflammatory skin diseases: A population-based cross-sectional study. Journal of the American Academy of Dermatology, 76(1), 40–48. https://doi.org/10.1016/j.jaad.2016.08.022
Kurup, S. & Pozun, A. (2022).Biochemistry, Autoimmunity. In StatPearls. essay, StatPearls Publishing.
Liaw, F.-Y., Chen, W.-L., Kao, T.-W., Chang, Y.-W., & Huang, C.-F. (2017). Exploring the link between cadmium and psoriasis in a nationally representative sample. Scientific Reports, 7(1). https://doi.org/10.1038/s41598-017-01827-9
Liu, Y., Wang, J., & Wu, C. (2022). Modulation of gut microbiota and immune system by probiotics, pre-biotics, and post-biotics. Frontiers in Nutrition, 8. https://doi.org/10.3389/fnut.2021.634897
Lowe, M. E., Akhtari, F. S., Potter, T. A., Fargo, D. C., Schmitt, C. P., Schurman, S. H., Eccles, K. M., Motsinger-Reif, A., Hall, J. E., & Messier, K. P. (2022). The skin is no barrier to mixtures: Air pollutant mixtures and reported psoriasis or eczema in the personalized environment and genes study (pegs). Journal of Exposure Science & Environmental Epidemiology, 33(3), 474–481. https://doi.org/10.1038/s41370-022-00502-0
Maholy, N. (2023, April 14). How to reduce stress through mind-body therapies. Rupa Health. https://www.rupahealth.com/post/how-to-reduce-stress-through-mind-body-therapies
Maholy, N. (2023, April 19). Functional medicine protocol for treatment of Acne. Rupa Health. https://www.rupahealth.com/post/functional-medicine-protocol-for-treatment-of-acne
Maholy, N. (2023, June 29). The role of probiotics and prebiotics in Gut Health: An integrative perspective. Rupa Health. https://www.rupahealth.com/post/the-role-of-probiotics-and-prebiotics-in-gut-health-an-integrative-perspective
Malani, S. (2023, February 22). Inflammatory markers 101: How to interpret. Rupa Health. https://www.rupahealth.com/post/inflammatory-markers-101-what-do-they-mean
Manolache, L. (2013). Stress involvement as trigger factor in different skin conditions. World Journal of Dermatology, 2(3), 16. https://doi.org/10.5314/wjd.v2.i3.16
Marek-Jozefowicz, L., Czajkowski, R., Borkowska, A., Nedoszytko, B., Żmijewski, M. A., Cubała, W. J., & Slominski, A. T. (2022). The brain–skin axis in psoriasis—psychological, psychiatric, hormonal, and dermatological aspects. International Journal of Molecular Sciences, 23(2), 669. https://doi.org/10.3390/ijms23020669
Mata, I. R., Mata, S. R., Menezes, R. C., Faccioli, L. S., Bandeira, K. K., & Bosco, S. M. (2020). Benefits of turmeric supplementation for skin health in chronic diseases: A systematic review. Critical Reviews in Food Science and Nutrition, 61(20), 3421–3435. https://doi.org/10.1080/10408398.2020.1798353
Nagpal, R., Shively, C. A., Register, T. C., Craft, S., & Yadav, H. (2019). Gut microbiome-mediterranean diet interactions in improving host health. F1000Research, 8, 699. https://doi.org/10.12688/f1000research.18992.1
Naik, P. P., & Farrukh, S. N. (2021). Association between alopecia areata and thyroid dysfunction. Postgraduate Medicine, 133(8), 895–898. https://doi.org/10.1080/00325481.2021.1974689
Paray, B. A., Albeshr, M. F., Jan, A. T., & Rather, I. A. (2020). Leaky gut and autoimmunity: An intricate balance in individuals health and the diseased State. International Journal of Molecular Sciences, 21(24), 9770. https://doi.org/10.3390/ijms21249770
Petschow, B., Burnett, B., Shaw, A., Weaver, E., & Klein, G. (2014). Serum-derived bovine immunoglobulin/ protein isolate: Postulated mechanism of action for management of enteropathy. Clinical and Experimental Gastroenterology, 181. https://doi.org/10.2147/ceg.s62823
Phan, C., Touvier, M., Kesse-Guyot, E., Adjibade, M., Hercberg, S., Wolkenstein, P., Chosidow, O., Ezzedine, K., & Sbidian, E. (2018). Association between Mediterranean anti-inflammatory dietary profile and severity of psoriasis. JAMA Dermatology, 154(9), 1017. https://doi.org/10.1001/jamadermatol.2018.2127
Rmadi, N., Kotti, N., Bahloul, E., Dhouib, F., Sellami, I., Sellami, K., Jmal Hammami, K., Masmoudi, M. L., Turki, H., & Hajjaji, M. (2022). Role of chemical exposure in the incidence of vitiligo: A case–control study in Tunisia. Libyan Journal of Medicine, 18(1). https://doi.org/10.1080/19932820.2022.2132628
Sander, C. S., Ali, I., Dean, D., Thiele, J. J., & Wojnarowska, F. (2004). Oxidative stress is implicated in the pathogenesis of Lichen sclerosus. British Journal of Dermatology, 151(3), 627–635. https://doi.org/10.1111/j.1365-2133.2004.06142.x
Shah, A. A., & Sinha, A. A. (2013). Oxidative stress and autoimmune skin disease. European Journal of Dermatology, 23(1), 5–13. https://doi.org/10.1684/ejd.2012.1884
Shi, Z., Wu, X., Santos Rocha, C., Rolston, M., Garcia-Melchor, E., Huynh, M., Nguyen, M., Law, T., Haas, K. N., Yamada, D., Millar, N. L., Wan, Y.-J. Y., Dandekar, S., & Hwang, S. T. (2021). Short-term western diet intake promotes il-23‒mediated skin and joint inflammation accompanied by changes to the gut microbiota in mice. Journal of Investigative Dermatology, 141(7), 1780–1791. https://doi.org/10.1016/j.jid.2020.11.032
Shim, J. A., Ryu, J. H., Jo, Y., & Hong, C. (2023). The role of gut microbiota in T cell immunity and immune mediated disorders. International Journal of Biological Sciences, 19(4), 1178–1191. https://doi.org/10.7150/ijbs.79430
Smyth, M. C. (2017). Intestinal permeability and autoimmune diseases. Bioscience Horizons: The International Journal of Student Research, 10. https://doi.org/10.1093/biohorizons/hzx015
Stojanovich, L., & Marisavljevich, D. (2008). Stress as a trigger of autoimmune disease. Autoimmunity Reviews, 7(3), 209–213. https://doi.org/10.1016/j.autrev.2007.11.007
Su, X., Gao, Y., & Yang, R. (2023). Gut microbiota derived bile acid metabolites maintain the homeostasis of gut and systemic immunity. Frontiers in Immunology, 14. https://doi.org/10.3389/fimmu.2023.1127743
Sweetnich, J. (2023, February 22). How stress affects our gut health. Rupa Health. https://www.rupahealth.com/post/how-stress-affects-our-gut-health
Sweetnich, J. (2023, February 24). The importance of testing DHEA levels. Rupa Health. https://www.rupahealth.com/post/evidence-based-health-benefits-of-dhea#:~:text=DHEA%20is%20a%20hormone%20made,into%20other%20hormones%20when%20needed.
Sweetnich, J. (2023, February 28). Testosterone testing 101. Rupa Health. https://www.rupahealth.com/post/testosterone-testing-101
Szalai, A. J. (2004). C-reactive protein (CRP) and autoimmune disease: Facts and Conjectures. Clinical and Developmental Immunology, 11(2), 221–226. https://doi.org/10.1080/17402520400001751
Szántó, M., Dózsa, A., Antal, D., Szabó, K., Kemény, L., & Bai, P. (2019). Targeting the gut‐skin axis—probiotics as new tools for Skin disorder management? Experimental Dermatology, 28(11), 1210–1218. https://doi.org/10.1111/exd.14016
Tanaka, T., Narazaki, M., & Kishimoto, T. (2014). IL-6 in inflammation, immunity, and disease. Cold Spring Harbor Perspectives in Biology, 6(10). https://doi.org/10.1101/cshperspect.a016295
Teeter, L. A. (2023, April 13). Using functional nutrition to address hormone imbalances. Rupa Health. https://www.rupahealth.com/post/using-functional-nutrition-to-address-hormone-imbalances
Thangapazham, R. L., Sharma, A., & Maheshwari, R. K. (2007). Beneficial role of curcumin in skin diseases. Advances in Experimental Medicine and Biology, 343–357. https://doi.org/10.1007/978-0-387-46401-5_15
Van den Abbeele, P., Detzel, C., Rose, A., Deyaert, S., Baudot, A., & Warner, C. (2023). Serum-derived bovine immunoglobulin stimulates SCFA production by specific microbes in the EX VIVO SIFR® technology. Microorganisms, 11(3), 659. https://doi.org/10.3390/microorganisms11030659
Vaughn, A. R., Branum, A., & Sivamani, R. K. (2016). Effects of turmeric (curcuma longa) on skin health: A systematic review of the clinical evidence. Phytotherapy Research, 30(8), 1243–1264. https://doi.org/10.1002/ptr.5640
Weinberg, J. L. (2022, February 28). An integrative medicine approach to celiac disease. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-celiac-disease
Weinberg, J. L. (2022, November 16). What is the Mediterranean diet. Rupa Health. https://www.rupahealth.com/post/4-science-backed-health-benefits-of-the-mediterranean-diet#:~:text=A%20Mediterranean%20diet%2C%20emphasizing%20vegetables,fatty%20liver%20disease%20(NAFLD).
Weinberg, J. L. (2022, December 19). How short chain fatty acids affects our mood, digestion, and metabolism. Rupa Health. https://www.rupahealth.com/post/how-short-chain-fatty-acids-affects-our-mood-digestion-and-metabolism
Weinberg, J. L. (2023, April 12). An integrative medicine approach to lichen sclerosus. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-lichen-sclerosus
Weinberg, J. L. (2023, July 26). An integrative and complementary approach to vitiligo: Testing, nutritional considerations, and complementary therapies. Rupa Health. https://www.rupahealth.com/post/an-integrative-and-complementary-approach-to-vitiligo-testing-nutritional-considerations-and-complementary-therapies
Weinberg, J. L. (2023, August 2). Integrative and complementary approach to alopecia areata: Testing, nutrition, supplements, and more. Rupa Health. https://www.rupahealth.com/post/integrative-and-complementary-approach-to-alopecia-areata
Wiertsema, S. P., van Bergenhenegouwen, J., Garssen, J., & Knippels, L. M. (2021). The interplay between the gut microbiome and the immune system in the context of infectious diseases throughout life and the role of Nutrition in Optimizing Treatment Strategies. Nutrients, 13(3), 886. https://doi.org/10.3390/nu13030886
Wu, W.-H., Geng, H., Cho, E., Eliassen, A. H., Drucker, A. M., Li, T. Y., Qureshi, A. A., & Li, W.-Q. (2022). Reproductive and hormonal factors and risk of incident rosacea among us white women. Journal of the American Academy of Dermatology, 87(1), 138–140. https://doi.org/10.1016/j.jaad.2021.06.865
Yoshimura, H. (2023, May 8). A functional medicine systemic lupus erythematosus (SLE) protocol: Testing, diagnosing, and treatment. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-systemic-lupus-erythematosus-sle-protocol-testing-diagnosing-and-treatment
Yoshimura, H. (2023, June 7). The gut microbiomes role in skin health. Rupa Health. https://www.rupahealth.com/post/the-gut-microbiomes-role-in-skin-health
Your immune system: What you need to know. Cleveland Clinic. (n.d.). https://my.clevelandclinic.org/health/body/21196-immune-system
Yu, V., Juhász, M., Chiang, A., & Atanaskova Mesinkovska, N. (2018). Alopecia and associated toxic agents: A systematic review. Skin Appendage Disorders, 4(4), 245–260. https://doi.org/10.1159/000485749
Zouboulis, C. (2004). The human skin as a hormone target and an endocrine gland. Hormones, 3(1), 9–26. https://doi.org/10.14310/horm.2002.11109
Hey Practitioners! Ready to become a world class gut health expert? Join Jeannie Gorman, MS, CCN, for a Free Live Class that dives into how popular diets impact the gut microbiome, the clinical dietary needs of your gut, biomarkers to test to analyze gut health, and gain a clear understanding of the Doctor’s Data GI360™ profile. Register here.
%201.svg){kind=logo}
Ready to become a world class gut health expert? Join Jeannie Gorman, MS, CCN, for a 
