Approximately 1 out of 3 Americans meet the criteria for metabolic syndrome. Some studies show that people with psoriasis are twice as likely as the general population to have metabolic syndrome. In fact, researchers estimate that up to 50 percent of people with psoriasis may have the condition, which is associated with an increased risk of cardiovascular disease (heart disease), heart failure, stroke, type 2 diabetes, and other serious conditions.

Metabolic syndrome is defined as when someone has at least three of the following risk factors:

• High blood pressure (130/85 millimeters of mercury or greater)
• High blood sugar (100 milligrams per deciliter or higher when fasting)
• High triglycerides (150 milligrams per deciliter or more)
• Large waist circumference (over 35 inches for women and over 40 inches for men)
• Low levels of high-density lipoprotein (HDL) cholesterol, or “good cholesterol” (less than 40 milligrams per deciliter for men and less than 50 milligrams per deciliter for women)

Metabolic syndrome is more common in cases of severe psoriasis than in milder forms, but all people with psoriasis should be mindful of their potential risk. Taking a step back and viewing health conditions as part of a bigger picture can help people with psoriasis make positive changes that contribute to better total health.

Causes and Risk Factors of Metabolic Syndrome in Psoriasis

Chronic inflammation from psoriasis or psoriatic arthritis can increase insulin resistance and contribute to atherosclerosis (hardening of the arteries). Specifically, the cytokines (proinflammatory substances in the body) called TNF-alpha and interleukin-6 are associated with higher blood pressure, larger waist circumference, and insulin resistance.

When the body becomes resistant to insulin, it can’t convert sugar into energy. So, instead of getting absorbed by the cells for use, the sugar from food stays in the blood. Insulin resistance leads to the high blood sugar readings associated with metabolic syndrome and is a marker of diabetes.

The indicators of metabolic syndrome are often interrelated. Insulin resistance is typically accompanied by high triglycerides (a type of lipid, or fat) and low HDL cholesterol levels. The more severe one condition gets, the more likely other issues are to appear. In many cases, psoriasis and psoriatic arthritis can be viewed as signs of an overall health imbalance rather than standalone conditions.

Living With Psoriasis and Metabolic Syndrome

Many people find that treating their metabolic syndrome improves psoriasis symptoms. Treating psoriasis may also help improve symptoms of metabolic syndrome. For example, biologics that suppress inflammation in psoriasis can also help reduce cardiovascular risks, according to some research.

Getting blood sugar and other signs of metabolic syndrome under control can change your outlook and improve your skin. Research shows that hypoglycemic agents used to treat diabetes can lead to weight loss and reduce psoriasis symptoms. Work with your dermatologist to learn about the side effects of your medication. You may discover that some side effects are beneficial to aspects of your health that are more than skin deep.

Managing Metabolic Syndrome

Metabolic syndrome is managed on a case-by-case basis depending on your lab results, family history, and diagnosed conditions. Your options may include lifestyle changes, medication, and in some cases, surgery.

Lifestyle Changes

To treat metabolic syndrome, your doctor may recommend the following lifestyle changes:

• Consistently exercising for 30 to 60 minutes per day
• Maintaining a healthy body mass index and waist circumference
• Quitting smoking and limiting alcohol
• Switching to a Mediterranean or heart-healthy diet

As one member of MyPsoriasisTeam said, “My doctor said I should lose about 20 pounds to help with my joints and blood pressure.”

Another shared, “I try to eat less bread and more vegetables, meat, and healthy fats. I walk for 40 minutes a day, but it’s slow now because of my psoriatic arthritis. I have lost 35 pounds over a number of years. Eating less salt should help lower your BP some. It’s a lifestyle change and doesn’t happen fast.”

Other members have had similar experiences making lifestyle changes to improve their metabolic syndrome, with benefits to their psoriasis. “I’ve dropped 20 pounds in seven weeks on a low-carb diet. The one other big bonus is that my psoriasis is 90 percent clear,” said one member with diabetes. “My new doctor informed me that many type 2 diabetics have some kind of psoriasis or dermatitis. If the patient can bring their blood sugars down and shed some weight, it can often clear most of their skin issues. I’m feeling so good. Even my arthritis pain is much less, and I’m able to exercise again. Things are looking up.”

Medication

Your health care provider will likely continue to monitor your labs for changes. Your doctor may recommend medication if lifestyle interventions don’t produce a strong enough effect on key markers like lipids, blood pressure, or blood sugar levels. Some medications used to treat metabolic syndrome include:

• Low-dose aspirin
• Statins
• Metformin
• Diuretics

One member shared their success with medication: “I discovered a few weeks ago that my blood sugar was out of control. With some help and a new medication called Ozempic, my sugars are now averaging around 129, and my A1c [a blood test for type 2 diabetes and prediabetes] is under 6.”

Surgery

If your doctor believes obesity is the underlying cause of your other health conditions, they may suggest bariatric surgery (gastric bypass or Lap-Band surgery) as treatment options.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 106,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you living with psoriasis and metabolic syndrome? Share your experience in the comments below, or start a conversation by posting on your Activities page.