Paolo Gisondi, M.D.
Dipartimento di Scienze Biomediche e Chirurgiche
Sezione di Dermatologia
P.zza A. Stefani, n 1
37126 Verona
045 8122546 / 045 8300521 (FAX) [email protected]
�Folic Acid in General Medicine and Dermatology,�
J Dermatolog Treat, 2007;18(3):138-46. 45996 (11/2007)
Kirk Hamilton: Can you please share with us your educational background and current position?
Paolo Gisondi: I earned a degree in Medicine and Surgery at the Catholic University of Sacred Heart-Rome in October 1997. I did specialty training in Dermatology and Venereology at the University of Parma, in November 2002.
I took qualifying examinations to practice as a basic life support executor in 1998. I earned a NLP (neuro-linguistic programming) practitioner certificate in 2006 at the PNL Italy school. I presently work as a dermatologist at the Department of Biomedical and Surgical Science, Section of Dermatology and Venereology in the University of Verona, Italy.
KH: What got you interested in studying the role of folic acid and dermatologic conditions? What is the physiology of folic acid that might be of benefit in skin conditions?
PG: I am interested in studying psoriasis which is a condition characterized by a serum folic acid deficit, possibly because there is increased skin cell turnover which leads to enhanced vitamin utilization.
Moreover, I frequently prescribe methotrexate (which is a folic acid antagonist) for treating psoriasis and psoriatic arthritis which requires folic acid supplementation in order to reduce gastrointestinal and haematological side effects.
KH: Does folic acid insufficiency cause inflammation? If so how?
PG: An increasing body of evidence supports the existence of a strong link between inflammation, endothelial dysfunction and atherosclerosis. Folic acid has recently gained attention because of its potential to provide beneficial effects on surrogate end-points, such as endothelial function, in patients at high cardiovascular risk. However, the role of folic acid deficiency in inducing an inflammatory state is controversial.
KH: Does folic acid�s effect on homocysteine metabolism have anything to do with skin disorders?
PG: Absolutely YES. We found a higher prevalence of hyperhomocysteinemia (>15 mmol serum homocysteine) in psoriatic patients which may favor atherosclerosis and cardiovascular accidents. Moreover, we found that plasma homocysteine directly correlates with psoriasis severity, and is inversely correlated with plasma folic acid levels.
KH: What skin conditions may respond to folic acid therapy?
PG: Psoriasis and other skin conditions characterized by hyper-proliferation of keratinocytes (i.e. pityriasis rubra pilaris and erythroderma).
KH: Are we using folic acid in these conditions to normalize a deficient state; because of a physiologic characteristic of folic acid that effects the metabolism of the skin disorder; or because folic acid is anti-inflammatory?
PG: Dietary supplementation with folic acid, and vitamins B6 and B12, appear to be reasonable and safe therapeutic options in psoriatic patients with hyperhomocysteinemia, and cardiovascular risk factors such as smoking, obesity, hypertension and dyslipidemia.
KH: What kind of doses are used in treating dermatologic disorders with folic acid?
PG: There are no dose finding trials to give you an appropriate answer, however what I do in practice is as follows. In the case of hyperhomocysteinemia I supplement with folic acid (2.5 mg/day), vitamins B6 (50 mg/day) and B12 (1 mg/day).
In case of concurrent methotrexate therapy supplementation with 15 mg of calcium folinate the day after the administration of methotrexate is recommended.
KH: How do you determine who is a candidate for folic acid therapy? Is it by the skin condition or by assessing folic acid status?
PG: By assessing plasma levels of folic acid. Generally patients who are smokers with diffuse psoriasis have hyperhomocysteinemia and low levels of folic acid.
KH: What is the best way to assess folic acid? Plasma or RBC folic acid or some other type of assessment?
PG: In the routine practice, by assessing plasma levels of folic acid.
KH: Are there any side effects with folic acid therapy?
PG: Absolutely not. It is a vitamin.
KH: Do you have any further comments you would like to make on this very interesting subject?
PG: My final comment is that patients with severe psoriasis have a higher incidence of cardiovascular events, and hyperhomocysteinemia is a possible risk factor for progression of atherosclerosis.
Supplementation with folic acid, vitamins B6 and B12, may be useful in these patients as well as a proper control of diabetes, hypertension and body mass index.
I do all that already for psoriasis, the vitamins part, a ton of folic acid plus all the greens I eat. My homocysteine was borderline high but is no longer. I have no traces of cardiovascular disease.
It is responding to iodine. This kinda confirms what Dr Simoncini states. Psoriasis is a fungal infection for which he recommends lugols iodine topically.
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Interesting. I wonder if taking iodine internally (as an anti-fungal) may further improve the situation? Also, following a general anti-fungal, immune-enhancing protocol would seem to be in order.
It would seem to me that the topical manifestations (the psoriatic scales) are just symptoms. If the underlying cause truly is a fungal infection ... systemic treatment may also be warranted.
If I had psoriasis, I would take plenty of antifungals such as olive leaf extract, oil of oregano, and grapefruit seed extract and probiotics. You can also purchase topical antifungal creams with d-Limonene here:
They don't have much info on their website, but they will send you a free catalog with lots of information about fungus and how their products work. I guess they are afraid of the repercussions of making claims!
Harry, I have taken lots of iodine and have been supplementing about 2 years. At times with heavy dosage. Since I don't know what dosage would be required for psoriasis I am not inclined to play with it. It does work topically for me to some extent. But you can over do iodine, so I am careful with it.
Sally, the d-limonine is interesting and I was looking into that before the MMS whirlwind happened. The day that I got all my olive leaf capsules finally filled was the day my MMS arrived so that got lost in the MMS whirlwind also.
These are good suggestions and I will look further into the limonine cream. When I get to cookin too many things nothing gets made right.
Right now I have started auto-urine therapy via homeopathic preparation. I'll give that a few weeks and if a no go I will return to MMS with likely a 3 month commitment. I have reason to believe that topical applications of activated MMS to psoriasis may also be helpful.
There are also some testimonials at the LongLifeUnlimited website, check 'em out. Someone testified they cured their psoriasis using Rafa Remedy cream, which is shea butter, that has the p-73 in it, which is oil of oregano. The Rafa Remedy cream that contains essential oils contains orange oil as well as other essential oils. You can purchase the d-limonene capsules separately. I hope the homeopathic urine treatment works for you. Honestly, I get nauseous just thinking about the smell of MMS before I add distilled water and juice! Although I would not let that deter me from using it!
I couldn't figure out if the products at citrusdepot were diluted or not? If they are not concentrated as the products at longlifelimited are, than they would be alot more expensive. One gallon of Orange TKO will make 64 gallons of all purpose cleaner for about $90.00, or 8 oz. will make 4 gallons for about $20.00! This is alot cheaper than Citrus Depot prices if they are already diluted! I have used orange oil for cleaning and it works great! I scrubbed a big stain on a wall that was painted with the type of flat paint that was not supposed to be washable. The orange oil cleaner worked great without removing any of the paint or leaving water marks. I just learned recently that it is antifungal. Where I live in Lousyanna mold grows on everything! I have some peroxide cleaners that don't work nearly as well as the orange oil! It smells good, too!
I'll call that company today and see if it is concentrated or not. I saw some woman on TV once, one of those infomercials. She was saying how D-limonene could cure lots of stuff. You could tell she was insinuating "cancer"
Makes sense. If it cures fungal stuff I will cure the cancer too, according to Dr. Simoncini, anyway.
Folic Acid and Psoriasis
I have reason to believe that topical applications of activated MMS to psoriasis may also be helpful.
Orange oil cleaners.
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