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. Find out how…
Before we start with Jan’s story, let’s clarify what HbA1c is and means.
The term HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells, joins with glucose (aka sugar) in the blood, becoming ‘glycated’. By measuring HbA1c, we are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months.
Normal range | HbA1c – <37 mmol/L |
Signs of insulin resistance | HbA1c – 38-41 mmol/L |
Pre-diabetes | HbA1c – 42-47 mmol/L |
Type 2 diabetes | HbA1c – >48 mmol/L |
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 having good amounts of small chain fatty acids (SCFA’s) is imperative when helping someone with an autoimmune condition, because commensal bacteria can help suppress T cell (a type of white blood cell) function which is what becomes highly active and in Jan’s case, attacks skin cells by mistake. This then leads to other parts of the immune system to spring into action where Inflammation happens, and skin cells grow too fast.
Jan’s stool test revealed:
- High secretory IgA suggests inflammation or potential food sensitivities.
- High faecal fats suggest she was struggling to absorb the fats from her diet.
- Low ruminococcus and akkermansia bacteria, can often mean increased intestinal permeability. This can allow greater exposure to antigens and toxins which can be deposited along the basement membrane, into the skin, potentially contributing to the severity of Jan’s psoriasis.
- Higher strains of certain bacteria are representative of being pro-inflammatory.
The information from Jan’s stool test and initial consultation allowed me to build a bespoke protocol that was focused on:
- Adding in anti-inflammatory foods, high in omega 3 fatty acids and rich in colour and diversity to feed her beneficial gut bacteria and help heal her gut lining.
- Removing gluten. This isn’t something I do often, but with her autoimmune condition and high sIgA, the evidence suggested it was a good idea.
- Cutting down on snacking and refined carbohydrates.
- High protein and healthy fats to support with gut and skin integrity. Adding in protein and fats can also help with keeping Jan full, making snacking less of an issue.
- Probiotic foods to feed the beneficial bacteria as well as focussing on fibre to help with the production of SCFA’s.
Gluten-free challenges
Factoring in Jan’s medication, I also added some supplements to help with reducing inflammation and supporting fat digestion. Whilst compliant with her supplements and adding in more colourful vegetables and omega 3, understandably, Jan initially struggled with the gluten-free aspect of the protocol and needed some inspiration, particularly around lunches.
We’re creatures of habit, and Jan admitted that like most of the British population, she had grown up on sandwiches for lunch and continued with this tradition as an adult. I didn’t want Jan replacing bread with the gluten free version as the additives and seed oils wouldn’t be helping her inflammation or gut healing, so we needed to experiment.
Jan was open to batch cooking and with some new recipe ideas I sent over, she was inspired to trying different lunches. Jan admitted that the batch cooking made her life easier and she would often have leftovers from the night before.
Transformations follow changes
After working together for 3 months, Jan was starting to get into a good routine with her meals and even signed up to a gym to help with her weight loss and support longevity. Jan felt she still needed the accountability, so signed up for another 3 months. At this point, I thought it would be a good time to get her bloods redone as it was around 6 months since she last had her blood sugars tested.
The improvement in Jan’s Hba1c was incredible. Her levels had gone down from 41mmol -34mmol in just over 6 months! This was literally life changing for Jan, she was no longer one number away from being prediabetic, her blood sugars were balanced, her energy levels had improved, and we also saw an increase in her vitamin D, B12 and ferritin and a reduction in cholesterol.
We continued to work on Jan’s eating habits over the next 3 months and eventually being gluten free became a normal part of Jan’s everyday life and she even said herself “I no longer think about it” she had good alternatives and no longer craved the cakes when she was out with her friends on her coffee mornings.
After 6 months:
- Jan’s psoriasis had completely disappeared which gave her a huge amount of confidence.
- Jan was well on her way to reaching her weight loss goals, losing a total of 7lbs and feeling so much better in her clothes.
- The improvement in energy levels meant Jan was regularly going to the gym and feeling happier and more confident in her skin.
- Jan’s blood pressure became stable and she had waved goodbye to the worry of type 2 diabetes.
- Jan had built new habits that was focused on movement, sleep and adding in nutrients that are supportive for her psoriasis, weight loss and help provide her with the energy to really make the most of her retirement!
Jan is thriving and continues to keep in contact a few times a year to ensure she remains on track and with the right supplements to hand.
