Psoriasis: Is Anxiety Like OCD Related?

Psoriasis as well as OCD which is a form of anxiety are both caused by excessive chronic inflammation.

Sure! Those health problems are related!

Even though OCD is considered to be a only a low serotonin issue and psoriasis the dysfunction of immune system both of those theories are wrong as they can be.

Psoriasis vs. OCD

OCD just like psoriasis can be dramatically improved by many different ways like treating the adrenergic, cholinergic, dopaminergic and serotonergic pathways.

I would like to mention here one of my previous blog posts where I suspected that acetylcholinesterase levels might be the main reason why that diet works for some people.

But today I will present here another possible way how low tryptophan diet might positively affect the psoriasis and (neuro)inflammation – by lowering the levels of toxic metabolites produced by kynurenine pathway.

By the way turkey meat has high tryptophan content and that’s why I chose header image with this bird.

Indoleamine 2,3-dioxygenase enzyme overexpression causes low serotonin production

…and guess what induces the Indoleamine 2,3-dioxygenase (IDO enzyme) expression?

Yes, it is the inflammation! [1]

So, we are still going around the one and same thing when it comes to most chronic diseases – inflammation. In psoriasis and many other chronic inflammatory conditions something is inducing it and we are in a vicious circle of inflammation induced health problems (symptoms) which we so desperately are trying to resolve.

 

What exactly happens to serotonergic pathways when excessive inflammation is present in the body?

One of the big players in this is the above mentioned enzyme – Indoleamine 2,3-dioxygenase (IDO).

 

Tryptophan metabolites present in inflammation

Metabolism of amino acid tryptophan. The catabolites in red were proved to be directly toxic to immune system specifically to T lymphocytes.
Image Source: Soliman H, Mediavilla-Varela M, Antonia S. Indoleamine 2,3-dioxygenase: is it an immune suppressor? Cancer J. 2010 Jul-Aug;16(4):354-9.

 


The mechanisms by which administration of interferon-α induces neuropsychiatric side effects, such as depressive symptoms and changes in cognitive function, are not clear as yet. Direct influence on serotonergic neurotransmission may contribute to these side effects. In addition, the enzyme indoleamine 2,3-dioxygenase (IDO), which converts tryptophan into kynurenine, may play an important role, first, because IDO activation leads to reduced levels of tryptophan, the precursor of serotonin (5-HT), and thus to reduced central 5-HT synthesis. Second, kynurenine metabolites such as 3-hydroxy-kynurenine (3-OH-KYN) and quinolinic acid (QUIN) have toxic effects on brain function. 3-OH-KYN is able to produce oxidative stress by increasing the production of reactive oxygen species (ROS), and QUIN may produce overstimulation of hippocampal N-methyl-D-aspartate (NMDA) receptors, which leads to apoptosis and hippocampal atrophy. Both ROS overproduction and hippocampal atrophy caused by NMDA overstimulation have been associated with depression.
” [1]

The Indoleamine 2,3-dioxygenase enzyme converts tryptophan into kynurenine thus causing the reduction of available tryptophan which is a precursor to serotonin (5-HT).

Additional problems arise from metabolites of kynurenine such as 3-hydroxy-kynurenine (3-OH-KYN) and quinolinic acid (QUIN) which both have the neurotoxic effects.

3-OH-KYN contributes to oxidative stress and quinolinic acid may overstimulate the NMDA receptors in hippocampus (part of the brain) leading to hippocampal atrophy.

Maybe you don’t know but magnesium is a natural NMDA receptor antagonist.[4]

Are there any Indoleamine 2,3-dioxygenase enzyme inhibitors?

Yes, it is possible to inhibit this enzyme with many different chemicals – drugs which are COX-2 inhibitors (Ibuprofen) – and Rosmarinic acid which is found in many herbs.[5, 6]

Popular herbs containing high concentrations of rosmarinic acid are Melissa officinalis, Mentha spicata, Salvia officinalis, Thymus vulgaris, Origanum vulgare.

The highest concentration of rosmarinic acid was found in

Psoriasis and depression?

… and anhedonia, low motivation, low libido?

Is there any other enzyme which could be responsible for low activity of dopaminergic system?

Yes!

It is very similar as in the case of serotonin but this blog post is not about depression so just in a few words…

Body is a huge factory running the billions of biochemical reactions every second so how to identify the exact problem in every individual person and how to find out what is causing it is hard if not impossible.

 

There is NO WAY to do that without genetic testing, extensive (blood) tests and testing for infections.

And even if you pinpoint the exact cause or culprit you still may not know all needed information to reverse it.

 

That’s why medical system especially when treating the chronic diseases is so ineffective, expensive and a big fraud!

 

The only surefire way and fact we know is that inflammation and/or infection and toxicity are causing the symptoms (and thereby all problems) of chronic diseases!

Actually those 3 factors are causing the chronic diseases.

 

How?

  • INFLAMMATION: LPS (endotoxin from the gut or infected teeth) induce inflammatory pathways which lead to formation of scar tissue, hypercoagulation, hypoxia,…
  • INFECTION in the tissues: nail fungus, sinusitis, tooth decay, H. pylori,… induce the inflammation and toxicity – local but often also systemic.
  • TOXICITY: Heavy metals, man-made chemicals and bacterial/fungal toxins poison the “healthy” biochemistry. Those toxins may directly interfere with various enzymes in the body which are essential for the ATP (energy) production in cells. Without the proper energy production diseases appear and once your body is unable to form enough energy to fuel the brain or heart cells then we call it a death.

How to cure anxiety and OCD?

Inflammation and toxins may affect the nutritional status of the body a lot as we already explained that above.

 

Pyridoxine is an extremely important vitamin for nervous system and its deficiency leads to all forms of anxiety disorders including OCD and psoriasis.

Let’s say that you supplement with pyridoxine (vitamin B6) because you heard it is critical for neurotransmitter production and overall well-being.

You take high enough dosage (50 mg) compared to Recommended Daily Intake (about 1.5 mg) but somehow you still struggle from symptoms of B6 deficiency.

 

How is that possible?

There is a lot of possible causes.

One is that you have a high levels of kryptopyrrole (condition known as pyroluria) in your blood which bind to zinc and vitamin B6 and pass them out through the urine.

The other possible explanation is that the enzyme responsible for conversion of inactive form of vitamin B6 is blocked by some bacterial or fungal toxin and therefore unable to make active form of vitamin B6.

 

Even though pyroluria is not generally considered to be caused by some infection I think it is either directly caused by infection or (infection induced) inflammation. It surely is not genetic even though genes play a BIG role in everything and predispose us to be strong or weak in one way or another.

 

And by the way vitamin B6 is also heavily involved in kynurenine pathway! [7]


Vitamins B2 and B6 are cofactors in the kynurenine pathway. Many of the kynurenines are neuroactive compounds with immunomodulatory effects. In the present study, we aimed to investigate plasma concentrations of vitamins B2 and B6 as determinants of kynurenines and two markers of interferon-γ-mediated immune activation (kynurenine:tryptophan ratio (KTR) and neopterin). We measured the concentrations of vitamins B2 and B6 vitamers, neopterin, tryptophan and six kynurenines (i.e. kynurenine, anthranilic acid, kynurenic acid, 3-hydroxykynurenine, 3-hydroxyanthranilic acid and xanthurenic acid) in plasma from 7051 individuals.

These results demonstrate the significant and complex determination of kynurenine metabolism by vitamin status.
” [7]

 

The neurotoxic metabolites of Tryptophan

Metabolism of amino acid tryptophan. The catabolites in red were proved to be directly toxic to immune system specifically to T lymphocytes.
Image Source: Soliman H, Mediavilla-Varela M, Antonia S. Indoleamine 2,3-dioxygenase: is it an immune suppressor? Cancer J. 2010 Jul-Aug;16(4):354-9.

 

The best way how to resolve possible pyroluria-like condition (when you feel better on higher dosages of B6 daily) is to take B6 supplement and zinc along with the antimicrobials – naturals are better in my opinion – because they are generally less toxic and effective against the viruses, bacteria and fungi instead of just one type of pathogen.

Like if you take oregano oil which is effective against the bacteria, viruses and fungi you may avoid taking the man-made bacterial antibiotics, antivirals and antifungals like Diflucan (fluconazole) or Sporanox (itraconazole).

Nystatin as a non-absorbable antifungal acting locally in the digestive tract is an antifungal drug which I would considered when treating the yeast infections. Yeast is often a significant contributing factor to psoriasis pathogenesis.

But keep in mind that heavy metals toxicity can do a lot of problems so support the detoxification with NAC and maybe R-Lipoic Acid.

 

Hopefully, now you understand that killing the infections is essential in chronic diseases not only physical like psoriasis but also mental including anxiety and depression.

You may attenuate the inflammation by drinking the herbal teas and taking various supplements but following the endotoxin-lowering diet (low starch and sucrose) and taking the antimicrobials is essential!

 

References:

1) Marieke C. Wichers and Michael Maes. The role of indoleamine 2,3-dioxygenase (IDO) in the pathophysiology of interferon-α-induced depression. J Psychiatry Neurosci. 2004 Jan; 29(1): 11–17.

2) Matthew A Ciorba. Indoleamine 2,3 dioxygenase (IDO) in Intestinal Disease. Curr Opin Gastroenterol. 2013 Mar; 29(2): 146–152.

3) Soliman H, Mediavilla-Varela M, Antonia S. Indoleamine 2,3-dioxygenase: is it an immune suppressor? Cancer J. 2010 Jul-Aug;16(4):354-9.

4) Sun X, Chan LN, Sucher NJ. Magnesium as NMDA receptor blocker in the traditional Chinese medicine Danshen. Phytomedicine. 2005 Mar;12(3):173-7.

5) da Silva Dias IC, Carabelli B, Ishii DK, de Morais H, de Carvalho MC, Rizzo de Souza LE, Zanata SM, Brandão ML, Cunha TM, Ferraz AC, Cunha JM, Zanoveli JM. Indoleamine-2,3-Dioxygenase/Kynurenine Pathway as a Potential Pharmacological Target to Treat Depression Associated with Diabetes. Mol Neurobiol. 2016 Dec;53(10):6997-7009.

6) Lee HJ, Jeong YI, Lee TH, Jung ID, Lee JS, Lee CM, Kim JI, Joo H, Lee JD, Park YM. Rosmarinic acid inhibits indoleamine 2,3-dioxygenase expression in murine dendritic cells. Biochem Pharmacol. 2007 May 1;73(9):1412-21.

7) Theofylaktopoulou D, Ulvik A, Midttun Ø, Ueland PM, Vollset SE, Nygård O, Hustad S, Tell GS, Eussen SJ. Vitamins B2 and B6 as determinants of kynurenines and related markers of interferon-γ-mediated immune activation in the community-based Hordaland Health Study. Br J Nutr. 2014 Oct 14;112(7):1065-72.

8) Maryam Shekarchi, Homa Hajimehdipoor, Soodabeh Saeidnia, Ahmad Reza Gohari, and Morteza Pirali Hamedani. Comparative study of rosmarinic acid content in some plants of Labiatae family. Pharmacogn Mag. 2012 Jan-Mar; 8(29): 37–41.

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