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Psoriatic Arthritis
Psoriatic arthritis links skin, joints, and the immune system. Alongside rheumatology care, we address gut, metabolic, inflammatory, and stress drivers of the immune response.
What you may be noticing
Joints that are stiff and swollen, especially in the morning. A finger or toe that swells along its whole length. Pain where tendons attach to bone, such as the heel or the back of the ankle. Pitting or lifting of the nails. Psoriasis patches on the scalp, elbows, or knees, though joint symptoms sometimes come first. Fatigue that feels out of proportion.
Why it is rarely one thing
Psoriatic arthritis is an immune-mediated inflammatory condition affecting a portion of people with psoriasis. The IL-23 and IL-17 inflammatory pathways are central, which is why modern biologic medications target them. Early diagnosis matters, because uncontrolled inflammation can cause lasting joint damage, so rheumatology care is essential.
Many factors raise the immune volume. Research links psoriatic disease with obesity and insulin resistance, gut microbiome changes, and inflammatory bowel disease. Abdominal fat produces inflammatory signals that feed the same pathways, and weight reduction can improve treatment response. Smoking, alcohol, infections, and chronic stress are recognized contributors.
My stance is that immune activity can often be turned down when we find what keeps provoking it. Skin and joints both sit downstream of the gut: the gut-skin axis is one of the clearest examples of a barrier problem showing up far from where it began. I also picture a toxic burden bucket, where infections, chemicals, and dietary triggers accumulate until the immune system overflows into inflammation. So the sequence is upstream first: open drainage, seal the gut barrier, lower the load, and rebalance metabolism. That sequence is a working clinical framework that runs alongside rheumatology care.
Patterns we look for
- Inflammatory markers: CRP and sedimentation rate.
- Fasting insulin, glucose, triglycerides, and waist measurements.
- Gut microbiome balance and intestinal permeability.
- Inflammatory bowel symptoms.
- Food reactivity and infection triggers.
- Vitamin D and omega-3 status.
- Uric acid, since gout can mimic or overlap.
- Sleep, stress physiology, alcohol, and smoking.
- Cardiovascular risk markers, since psoriatic disease raises them.
How I evaluate it
The comprehensive functional neurological exam assesses joint and tendon findings, movement patterns, balance, and autonomic balance, and it evaluates how chronic pain is shaping central processing.
Functional labs may include CRP, sedimentation rate, a complete blood count, a comprehensive metabolic panel, fasting insulin, HbA1c, a lipid panel, uric acid, vitamin D, omega-3 index, intestinal permeability markers, and a comprehensive stool analysis. I coordinate with your rheumatologist and dermatologist on imaging and medication. Tracking morning stiffness, swollen joints, skin activity, and energy shows which changes move the pattern.
How we address it
- Keep your rheumatology care central. I never ask anyone to stop or change a prescribed medication.
- Open drainage pathways: bowels, hydration, and lymphatic flow.
- Identify personal triggers, including food reactivity and infections.
- Repair the gut barrier and rebalance the microbiome.
- Reduce inflammatory load with an anti-inflammatory, whole-food eating pattern, and replete vitamin D and omega-3 fats.
- Rebalance blood sugar and insulin, support healthy body composition, and protect sleep and stress physiology.
- Restore movement with joint-friendly strength and mobility work and brain-based rehabilitation for pain processing.
Skin and joints are speaking for a deeper system. When that system calms, both often follow.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.