Jan had struggled on and off with psoriasis for over 30 years, and when she came to see Krista, it was the worst it had ever been. Her psoriasis, weight gain and a recent blood test showing her HbA1c level was only one number away from pre-diabetes, gave her the motivation to take ownership of her health and wellbeing.
As a Registered Nutritional Therapist, I sit with women like Jan every week in clinic: a skin condition that has dragged on for decades, a blood marker creeping in the wrong direction, and a sense that medication alone is not going to be the answer. Jan’s story shows what changes when you treat the gut, the blood sugar and the inflammation as one connected picture.
If you are reading this because your own HbA1c is creeping up, or your skin is flaring and nothing seems to shift it, the quickest first step is to book a free 20-minute call and talk it through with one of us.
Where Jan began: testing
Jan had already gone to the initiative of completing a stool test before our initial consultation, which gave me an insight into her gut microbiome. Beneficial bacteria and good amounts of short-chain fatty acids matter enormously in autoimmune conditions, because commensal bacteria help suppress the T cell activity that, in Jan’s case, was attacking skin cells by mistake.
Her results showed high secretory IgA (a sign of gut inflammation or food sensitivity), high faecal fats (poor fat absorption), low ruminococcus and akkermansia (often linked to a leakier gut lining), and an overgrowth of pro-inflammatory strains.
This is the kind of pattern we see in clinic again and again when somebody has a long-running skin condition sitting on top of a rising HbA1c.
HbA1c is the average blood sugar marker your GP runs. The reference ranges I work to in clinic:
- Normal: <37 mmol/L
- Insulin resistance: 38-41 mmol/L
- Pre-diabetes: 42-47 mmol/L
- Type 2 diabetes: >48 mmol/L
Jan walked in at 41. That puts her in the insulin resistance band, one number off pre-diabetes, which is exactly the window where nutrition and lifestyle still have the biggest leverage
The protocol and the gluten-free hurdle
Jan’s protocol focused on anti-inflammatory foods high in omega 3, more colour and diversity on the plate, removing gluten, cutting refined carbs and snacking, and adding the protein, healthy fats, fibre and probiotic foods her gut needed to repair.
Factoring in Jan’s medication, I added supplements to reduce inflammation and support fat digestion. She got on with those quickly. The harder part was the bread.
Like most of the British population, Jan had grown up on sandwiches for lunch. I didn’t want her swapping to shop-bought gluten-free versions, where the additives and seed oils undo the gut work we were doing. So we got practical.
This is one of the most common sticking points we coach women through on the personalised nutrition programme: not the science, but the everyday rebuild of breakfast and lunch.
Jan was open to batch cooking, and with the recipes I sent over, leftovers from the night before quickly became her lunch. Within weeks, the cravings around her coffee mornings began to drop too, which is what tends to happen once blood sugars stop swinging.
Transformations follow changes
After three months of working together, Jan was in a good routine with her meals and had signed up to a gym for the weight loss and the longevity benefit. She felt the accountability still mattered, so we ran another three months. Around the six month mark we redid her bloods.
The shift in her HbA1c was striking. Her level dropped from 41 to 34 mmol/L in just over six months. Pre-diabetes was no longer on the horizon, her blood sugars were balanced, her energy had lifted, and her vitamin D, B12 and ferritin had all climbed while her cholesterol dropped.
Two markers moving in the same direction at the same time is what we want to see in clinic, because it tells us the metabolic engine underneath is shifting, not just one number. It is the same pattern we wrote about in cardio-metabolic health: blood sugar, cholesterol and blood pressure are the same problem.
Over the next three months, gluten-free stopped being a project and started being normal life. In Jan’s words: ‘I no longer think about it.’ She had alternatives she liked, and the cakes at the coffee mornings stopped pulling at her.
Where Jan is now, six months on
- Her psoriasis had completely cleared, after 30+ years of flare-ups.
- She had lost 7lbs and was on her way to her weight goal.
- Energy had returned and the gym had become routine.
- Blood pressure was stable, and the worry of type 2 diabetes was gone.
- She had built genuinely durable habits around food, movement and sleep that fit her retirement.
Jan is thriving and stays in touch a few times a year, just to keep on track and make sure her supplements are still doing the right job.
If Jan’s story sounds familiar, here is where to start:
Most of the women we work with come to us with one foot in pre-diabetes and a second issue (skin, weight, energy, perimenopause) that has gone on too long. There are three ways in, depending on where you are.
- Not sure yet, want a feel for what we do. Book a free 20-minute call and we will talk you through your numbers and what is realistic.
- Want to know what is actually going on under the bonnet. A wellness check gives you the same blood work we ran on Jan, with a clinical interpretation, so you stop guessing.
- Ready to do the work and want a real plan. Our blood sugar and insulin resistance programme is built for exactly the situation Jan walked in with: HbA1c climbing, weight not shifting, and an inflammatory issue running alongside it.
If you would like to read another patient’s story before deciding, Sue reversed her blood pressure through a similar metabolic reset.
