So, I’ve been trying to help the body heal itself, where taking systemic meds for Pso works on a number of different approaches at this point… simplistically put: either turning the immune system off, turning parts of it off, or disabling the parts sent out by it that cause an inflammatory response. So (most current) systemic meds appear to be aiming at the symptoms instead of the problem.

Newer meds now in the R&D pipeline include some aimed at healing the gut, which will be interesting indeed!

That’s where the answer to your questions becomes difficult.. since I don’t understand what effect Otezla is supposed to have ( or has as a side effect) on the gut.. it’s not something I can answer. I’ve only ever tried to treat the gut directly, I’ve not had to treat it around the side effects of a medication.

The way the Slippery Elm Tea appears to work is several fold.. a biproduct of the fiber in it being digested is the formation of SCFAs or short chain fatty acids, and also butyrate, which is apparently in shorter supply in those with Pso. Some people talk about taking butyrate as a supplement, but I think there’s something beneficial in the process fiber goes through that helps us, as do many specific foods, making them better than throwing supplements at it.

Slippery Elm’s said to help fill the gaps in the permeable intestines ( dunno what I think about that as much as other things it does) it’s also a valuable prebiotic, which feeds “ good” bacteria.. and I’ve recognized its ability to help fight constipation and aid motility.. (which, without the side effects you’re experiencing from Otezla would probably help you.) When I was looking for others using Vtama, a woman I spoke with told me she’d found Vtama and stopped using Tremfya after having been on it for seven years, which she stopped because she didn’t like the side effects. We are all SO different. But again, I’m not just using this new (non steroidal topical) I’m eating to support my gut and immune system.

The other tea I drink is the American Saffron tea, which is said to be an antiseptic of sorts, so my guess is that by drinking that regularly at night it’s setting up an antiseptic environment that’s less hospital “ bad “ bacteria. Besides these two teas ai only drink water.

The problems with your side effect us that it has the potential to cause you to dehydrate, lose important electrolytes and miss out on nutrition that you should be getting as food is being digested.. instead of things going straight through. I can’t guess how it affects your gut, but tell an MD about this, please? Dermatologists aren’t GPS, Gastroenterologists or Immunologists.. do they care about side effects? Or look at the whole body?
( continued below )

Good questions.. I’ve wondered this myself, but from a slightly different standpoint as Ive never taken any systemic medicine for Pso. From the very beginning I could tell something had happened in my digestive tract.

After reading hundreds if not thousands of forum posts, articles and scientific papers, I can report that I’m seeing an ever-increasing parallel observed to be shared between Pso and other autoimmune conditions.. which is the link to the Microbiome. Two symptoms shared in many autoimmune conditions are Intestinal Dysbiosis (imbalance of good and bad bacteria) and Intestinal Permeability ( thinning of intestinal walls.) The thinning walls are a likely reason psoriatics have a hard time getting enough nutrients from food, for example D, and think about how many foods are vitamin D fortified.. that should be easy to get. But what if you fed your puppy through a tube full of holes.. they’d probably be malnourished.. eh? So figuring out how to heal that is a big AIM.

That these symptoms are shared between millions of people with different autoimmune conditions adds support for the claim that the bacteria we transport around in our gut are really running the show. There are more of them than there are of “us” and since we need them to be able to be healthy ourselves, it’s our gig to foster a climate that will support them and feed them what makes them thrive, so that they make our immune systems strong.

Think about the fact that everything we swallow goes through the intestines AND that over 3/4 of the immune system lives in there. So eating and drinking things that irritate the gut being likely to result in an immune response makes sense. The first thing to uncover is what’s going on in there? Then a plan can be formed to try to resolve that.

After doctors didn’t offer me answers ( one gastroenterologist told me “ I’m basically a plumber”- meaning he was just concerned with the “pipes” and apparently not what is in them ) .. I started looking and found a mail-in stool test ( lovely) offered by Verisana, their Comprehensive Gut Health Microbiome Test, which looks at gut bacteria, but also at SIgA, or secretory immunoglobulin A, which tests the health of the mucous lining of your gut. It was well worth it because it showed mine was at rock bottom, almost all gone. I also had some bad bacteria, but mainly all bacteria were wiped out ( thanks to antibiotics ). Next my GP suggested S. Boulardii, which firmed things up. Following that I started mail in testing my D levels.. and then I looked at pretty much full bloodwork.. and slowly built myself back up.

That’s what I’ve been doing. Avoiding systemic meds and trying to get to the root of the problem. Trying to heal the intestines and their contents and keep them healthy through what I feed them. It involves some abnegation, but the results are worth it to me. I can only tell you my experience, not by any means what to do.. ( continued below , expand comments )

I started taking slippery elm bark pills several weeks ago. I take 2 -1000mg pills with 10-12 oz glass of water every afternoon between meals. They seem to have solved my intestinal problems. Wanted to let everyone know.

@A MyPsoriasisTeam Member

I don’t use anything caffeinated, which black tea is. something about caffeine being bad for autoimmune? Maybe someone better informed can weigh in? I’m a huge Earl Grey fan but haven’t had it in years now although I know they make Earl Green..

I don’t really see those teas, the Slippery Elm and American Saffron as tea in the way people see tea, ie, something you might add cream and sugar to, to relax, or to raise energy or to enjoy. I see them more as herbal meds that serve a purpose, so I drink them straight and with a thankful smile. If you use those, they’re specifically described in the book I found them in..

You might consider reading the book those are suggested by, Pagano’s Healing Psoriasis Naturally. I believe he was the first to popularize Pso’s gut connection and he also put out another little book on Leaky Gut towards the end of his career, both of those are on Amazon, as are the Baar Teas, but you can still get those direct links from Baar.com.

There are specific bacteria being looked at in context to psoriasis, and lots of people supporting getting those from yogurt or fermented foods or other things.. as well as companies working in this as a dietary supplement. One is AxisBiotix, which has created ( perhaps the first?) probiotic specifically designed to combat Pso, that was based on a study from the University of Manchester, UK.. they have a lot of customer testimonials and also TrustPilot reviews.

We’re each carrying around a galaxy or more’s worth of bacteria in our gut.. there’s definitely more of them than there are of us.. but we’re a bit away from understanding how to steer the ship by tweaking those, other than that broad spectrum antibiotics are a bad idea for many, including us. The idea of “ phages” being developed to target specific bad bacteria may seem like science fiction at this point, but it’s happening, so we have that to look forward to.

I know that many studies have shown gut bacterial imbalance in Pso, but I’m not sure which bacteria will help.. though having a MORE diverse microbiome is definitely a goal to optimize health. But first.. is the intestine permeable? In other words, will the probiotics ( or for that matter, the nutrients from food actually make it through? )
I’ll say reading about which are fostered by which foods has been of greater interest to me than just downing strains, because I can’t tell which should be chosen. I will mention, there’s one being talked about as a way to combat the Strep that’s associated with triggering Guttate Pso.. and that’s called Streptococcus Salivarius and is said to be provided in a probiotic called “UltraBlis” with another called Bifidobacterium Lactis as well as Lactobacillus Acidophillus.. looks like it can be taken prophylactically, to set up an environment unfriendly to Strep Throat?

I don’t take any of the probiotics mentioned, but I’m very interested.

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A MyPsori...

I am ordering some Slippery Elm pills and will try them. I do appreciate your information you sent. I had every test and inspection known to man, and the gut specialist told me he could find nothing wrong. Thanks