EP 135 WTH?!? The Doctor's Chat: Reverse Your Psoriasis with Dayna Hrovath

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Hey, welcome back, everybody, to what the health. I am Dr. Greg Eckel, and we are bringing you another fine episode of the Doctor's Chat. And I have Dana Rovath on board today, and she is a dermatology physician's assistant since 2005 with a specialty in psoriasis, which is a very difficult condition to help. So I'm. I'm looking forward to sharing this episode with you all. She's been help helping frustrated people with psoriasis improve the itch, the pain, and the rash using a unique approach that few in healthcare have even access to. And she's going to share that. She's also going to help talk. She's going to talk about her program that she's launching later this month that, you know, if you know anybody with psoriasis, it would be a great one to get them involved with. And Dana, welcome aboard.

Thank you. Thanks for having me.

Yeah, you're welcome. I wanted to start out with, you know, that's pretty. That's pretty niched out. And you shared you've been in dermatology since 2005. How did you arrive at dermatology and in particular psoriasis?

Sure. Well, with dermatology, ever since high school, I had an interest in that. I started as an acne patient and in high school and through the years and really liked. I knew I wanted to do medicine, but dermatology drew me in. I liked being able to see what we're helping people clear up and improve. And people, you know, they care to a degree about their blood pressure or things that are invisible, but they care a lot about things that are visible to themselves and to everyone else. And I joke with people when they ask me that question. You know, I just like to pick at things, but geez, yeah, got it. But I wanted to really focus on psoriasis and in particular, because there are over the years a lot more options out there for people as far as conventional medicine treatment. But typically, if you would go to your dermatologist and want to have a conversation about my diet or anything outside of here, take this pill, use this cream, use this shot, they'll be like, I don't know. Or that doesn't have anything to do with it or just kind of poo, poo you and finding how much inflammation can be impacted by our lifestyle just throughout any disease state. Finding that and learning that outside of conventional medicine really made me think of my psoriasis patients in a different light. And what can we do to support them rather than just covering up their Symptoms with the medications.

Yeah. So traditional root for people with psoriasis now maybe kind of describe what psoriasis is because not maybe everyone's not familiar with it.

Sure. So psoriasis is an autoimmune type of skin condition that causes typically red flaking plaques on the skin. They look like they're stuck on, often with a silvery white scale. In people with a darker skin tone, it may look less red and more look. Look more purple or brown. And they can be anywhere from your head to your feet. Some people get large patches on their skin, other people get tiny little circles. Sometimes it's just elbows and knees. That's what people often think about when they think of psoriasis. But you can have someone who has it only on their scalp or only have it in their nails and not have much skin involvement. But this inflammation that's in our body that is affecting the skin and what happens with the immune system is it's causing our skin cells to shed fast, too fast, and instead of turning over the way they're supposed to, they end up just piling on top of themselves. And that's what gives us these plaques on our skin. But that inflammation isn't only affecting your skin. It can also cause a specific type of arthritis called psoriatic arthrit. It can make people more prone to metabolic syndrome with high blood pressure, high cholesterol, diabetes. People with psoriasis are more prone to certain types of cancer like lymphoma. That's still rare, but it is an increased, it is an increased risk. Things even that you wouldn't necessarily associate but really come hand in hand. Is depression can be a side effect from psoriasis. Not only that inflammation affecting your skin, but it also affects your brain. And then you have the self conscious aspect of it. You know, you have to think about what color clothes am I going to wear so I don't look like I have snow on me or what do I need to hide so people don't see it and think I'm contagious or what's wrong with you, boy?

Yeah, it is such. It's. I actually just had a consult this morning with a patient that saw an integrative provider and the doctor told her, oh, I can't help you with that. That's too hard. I was like, are you kidding me?

Yeah. How heartbreaking.

I know. And I actually said I was having this interview with a, you know, dermatologist expert in psoriasis today. So thank you for reaching out, coming on the show because this is a Big one. I mean it is, there is a lot of stigma. I mean you have, you know, the red plaques, sometimes the white flaky plaques. And, and there was a great article in the Atlantic, one of the writers wrote about it. Firsthand experience of what it felt like to have psoriasis. Almost like a pariah in society. And so what is at like, what's the prevalence of this out there?

Yeah, worldwide it's about 2 to 3% of the world's population. Think around the, in the United States, that equals around 8 million people. Between 7 and 8 million.

Considerable number of folks with this. And you write about it and really looking at, so you're conventionally trained, you're still bridging the worlds, which I think is a great way to practice. It provides the, you know, most comprehensive care for people on the planet. But you also write about some alternatives that you've come to. So how did you kind of unplug from the matrix, so to speak?

Sure. So wanting to find alternatives for people and really just looking at the different ways that we can really address the inflammation in the body and bringing it together in a step by step program. Because you can say, oh, you know, I'm gonna eliminate this food, but just that alone isn't going to really die down that inflammation and reset your immune system. Or you could say, I'm only going to address my gut health. Now, gut is so important. That's probably the backbone of this. But there's so much more that needs to be addressed. And rather than picking and choosing off a tree, you know, oh, let me try this or let me try this. It's doing all of these things in a step by step approach in a certain way that you want to. I want to address my gut and then I want to address my stress and then I want to address my toxic load. And by doing different steps in each of those three main categories, which I call calm your gut, clear effects of stress and clean out toxins. That's when people really can see some long lasting improvement. Now it's not going to be poof tomorrow. I mean, autoimmune diseases take some time to help kind of clean out the gunk that's in the body. But you should start seeing some symptom relief pretty quickly and then the lasting clearance. As long as you're focusing on, you know, those three main pillars.

I love it. You know, that is really the foundational component of like treating heart centered, dynamic beings moving through time and space. Because, you know, conventionally, what were you taught or what Were the. What was the. Basically, the protocol was typically around suppressive agents. Correct.

Yeah. So I, I have the discussion with my conventional patients about, you know, think of your treatment options like a ladder. Our first rung, we do creams, we do steroids topically to just calm the inflammation in the skin, but that's not. That's just chasing it. You'll clear up a patch and then another one pops up, and they don't even always clear up. There are other types of topicals that we use as well. And kind of next on the ladder, we have UV treatments, getting your vitamin D. But to the amount that you have to get to see improvement with psoriasis, you're increasing your risk for skin cancer. And we have oral medications like methotrexate and scriptane, which can cause liver issues. Methotrexate suppresses your immune system, requires blood work, monitoring. It's got its issues. And then we have the biologics or what you see the commercials for on tv, the shots, and those do a great job at calming inflammation. And. But they're a lifelong treatment that you have to stay on. And no medicine is without its negatives. So there are issues. They're also expensive for the insurance companies, and depending on your particular health care insurance plan, you know, that can be a very expensive cost, too. And so, yes, we've, in conventional medicine, we've really, over the past 15 years, seen a massive improvement in people's symptoms with medications. But that's not a. A choice everyone should have to make that I, I have to choose this medicine, and if it helps, I have to take it for the rest of my life. Otherwise my psoriasis is just going to come back. It's good to have a way of just helping your body kind of take care of itself. Yeah.

And then, so what, when in your career did you think, I got to start looking for other alternatives for folks?

Yeah, I'd say it started probably five or six years ago, is where kind of my eyes were opened. And that was through just my own health journey and not getting the answers that I thought there should be out there in my typical conventional medicine knowledge and looking at alternatives. And because we're not taught these type of things, were barely taught lifestyle factors in medical training. So taking extra courses and looking into things and just like, wow, you know, not only can I help people's skin with this, but this is going to be good for their whole health, their longevity, everything. And people would often ask me, why do I have psoriasis? Well, the medical answer Is if it doesn't run in their family is good question, you know.

Right, right. Yeah. And so what. How do you answer that now?

Yeah. So now we know. Yes, genetics that can. That can play a role. There are people where it is a genetic issue, but other times it can be from past stressors in your life that kind of triggered your immune system, which a stressor could be a medical issue, it could be a stressful event in your life. It can be negative relationships, it could be having a sedentary lifestyle or the other side where you're exercising too hard, too much and just really driving that cortisol and pounding your body. And you can only do that so long without repercussions. Your gut health matters and the amount of toxins that you've been exposed to, think of your body like a vase. You can only pour so much stuff into it before it bubbles out. And what, that bubbling over could look different for different people. For some people, that might be psoriasis. For other people it could be another type of autoimmune disease.

Yeah. And do you find other autoimmune diseases run with psoriasis?

Often. One in particular that's. Well, there's two in particular that are common. Celiac disease is one. And thyroid, like hypothyroidism is another that I commonly see that people don't think one has anything to do with the other.

Got it. And what in your framework, I mean, tell us about your program that you've put together.

Yeah, so I like to do things in a group rather than just strictly say, here's your plan, good luck, have at it. So for 10 weeks, I work with a group of people, and so you not only have access to me, but you have other program participants with you who are going through those changes you're trying to make together. And you have the accountability and the support because unfortunately not everybody has a good support system at home. So it's great to have your buddies that get it and feel the same way and have the same problem as you to begin with. So we work together. Each week a new module session is released with your lessons on what you need to learn and then your action steps on what to do for each of those weeks to go through those three main pillars with calming the gut, clearing effects of stress and cleaning out toxins. And we're addressing diet, we're addressing gut health, we're addressing how movement matters, how you sleep, we're addressing your stress. And we can't eliminate stress, but we can do things to help our body Kind of deal with the effects of stress better. And we're looking at how to minimize your toxins that you're exposed to on a daily basis and how to gently detox those out regularly to help support your body in the best way possible.

Lovely. And that component. So in the group, how. How many people can you have in a group or as many as sign up?

Yeah, as many as sign up. Ideally you like to keep it not too crazy because then people are more shy about wanting to interact with each other. It gets a little too overwhelming.

Yeah. Is there an ideal number that you're shooting for there?

Yeah, ideally I would think a perfect range would be no more than 20. Yeah.

Cool. Yeah, that makes sense for discord and conversation and actually connection. I love that aspect of what you're putting together is that group component. I mean, now more than ever, community is really important. And in having it in a healing environment, led and facilitated by somebody in the know is really important. Those components. Do you. So what, what kind of outcomes or what are you seeing in your practice with psoriasis? Because like I mentioned earlier, so one physician, even in the alternative world just said, oh, that's just too tough for me. I gotta. I can't help you.

Yeah. So typically what people first notice is less itch. They'll still see the plaques, but they won't feel as itchy or having as much burning and discomfort. And then typically, even before I see an improvement on how it looks, they're noticing other whole body improvements. They may having some weight loss that they're noticing. A lot of times psoriasis and extra weight go together. And so by reducing that inflammation can help the body release some of that extra weight that it's holding onto. People will say, I have more energy, my brain fog is kind of lifting. And then the skin starts clearing up little by little and can hopefully reduce all of it, but at least make a major difference on the amount that's on the skin.

Got it. That's cool. So what, what have you seen? What are your. What are your patients, group participants seeing as far as, you know, numbers wise or. No, it's different for everybody, but yeah, yeah.

People. Does it work for every single person in the world? No, nothing in the world does. Like, there's going to be the occasional stubborn person that maybe needs a deeper look at a deeper type of detox, or maybe someone needs some more hormonal support outside of what we do, but majority of people see a massive difference and are as long as they're willing to make those Changes and stick with them. It's. That's for all of us. That's the hardest thing is sometimes once we see the improvement, we're like, start being like, oh, I could cheat a little here or maybe I could get by if I do this. And then we slowly start falling off the wagon and things start kind of creeping back on us.

Yeah. You know, I had a patient early on in my career, probably 20 years ago now, Meredith, I still remember to this day, she was 80 pounds overweight, had a really significant case of psoriasis where, you know, you knew, she just looked uncomfortable in her skin because it was so, so inflamed. And through what we did in the clinic, she was like my best referral source for the first two years of my practice because, you know, she lost 80 pounds, her skin cleared up, she didn't even have to open up mouth because, you know, people were like, meredith, what are you doing? And she said, I'll just go see Dr. Greg. But that component is that that comprehensive aspect of what you're putting together for folks in community is so phenomenal because it is very isolating and folks can feel ostracized and kind of cast out and not included or, you know, really separated because it, like they lead with it on their skin. I'm wondering, do you see any kind of, any emotional patterns or any, anything like that as far as past histories or anything that could be contributing into that inflammatory state on their skin?

Oh, absolutely. People who have had even back to childhood traumas affect how your skin can be as an adult. Just because you didn't have psoriasis as a kid doesn't mean that what happened then didn't affect you. Even people with stressful careers, they don't think anything about that affecting their skin, but that builds up and that contributes. And any type of, you know, someone who's more prone to anxiety or having unsupportive people around them, that this all matters to our gut and our brain and our skin. They're all so intertwined. And if one of those things isn't happy, it's going to affect the others.

Yeah. And what do you think? You're see, you're helping people with their skin, but underlying this whole condition is inflammation. So what other, what other areas of their health and life are improving as a result of the program?

Yeah. So if you're someone who has both psoriasis and psoriatic arthritis, or even just the typical aches and pains, the participants notice less of that as the time's going on. As they're going through the program, their joints aren't going to be so stiff, they're not going to be so achy. When they first wake up and get out of bed. They can recover from activity easier, but they also can see tangible results. When they're going to their primary care doctor to get their yearly blood work, typically they often see their glucose, their blood sugar has been improving, their blood pressure is improving. There are times where people are on medications for those and their numbers have done so well that they're able to start either decreasing their doses or getting off medications. How people look and feel about themselves, that is massive. You know, you can just see it on their faces or they're coming in and a tank top instead of being all bundled up and hiding and they're just, you can see them glowing because they're not so self conscious about being out there or having relationships with others, being intimate, all of those things. It's like a new person coming out.

Yeah, that, that's gotta, that is so rewarding when you usher facilitate that space for folks. What else around the. Either the program or the condition. What would you like to share with us?

Yeah, really like to. Bottom line for people is that inflammation and trying to control it as much as we possibly can. We want to expose ourselves as much as we can to clean air and clean water, optimal nutrition, getting enough vitamins and minerals and the right ones for you, eliminating toxins as much as you possibly can. You know, we live in a toxic environment. You're not going to be able to get rid of everything. But there are definitely things even just in our personal care products in our home that we can easily control and reduce that burden on our immune system, controlling our stress levels and how we react to it and removing as much negativity as we can, putting a big focus on our sleep, our rest movement and really, truly having a positive mindset makes a massive difference as well. Just one actionable step for the listeners. If you're like, what's one thing I can do to get started? Would be trying to remove gluten from your diet. Because even if you're not that person who has both celiac disease and psoriasis, gluten very much can be an inflammatory trigger for people and can really start swinging that pendulum in the right direction by taking that burden off of your gut and then therefore your brain and your skin and everything else.

What. How do you, how do you help people with that? Because it is, it's a, it's a massive, it's a Massive issue. Right. We know every individual that eats gluten, whether you have celiac or wheat sensitivity or not, it creates about four hours of inflammatory process in the bowel for everybody that eats gluten. I mean, we love gluten. It's on every corner. And, and you know, you look around and what your options are is like, gluten, gluten, gluten. So you know, the top five items that have gluten, it's not just wheat, but it's barley, rye, oats, wheat and spelt. And so I know you're helping patients every day with that. So what, what are the, what are suggestions to get into that action?

Yeah, so first of all, I recognize that's super overwhelming. And whenever someone gets told that, they're just like, well, there you go, I can't eat anything, you know, and so I. In a perfect world and there are some people who are good about all or nothing, where they just full steam ahead, they clean out their house and make all those changes at once. But majority of people aren't that way. That I've come across that they do better making one change at a time. So, okay, say maybe every day I eat a peanut butter and jelly sandwich for lunch or a turkey and cheese sandwich. You know, let's make a new plan on what is a good alternative to that, where you still feel like you're enjoying it. And maybe at first it's just getting some gluten free bread, but then finding that there's even better choices than that down the road, but picking one thing at a time, making one manageable change, even though it may take longer, I think that it's more sustainable and less overwhelming than just handing the full list, which I do give everyone a full list of things to watch for and how to make the changes into a gluten free lifestyle. But it is easier just taking it in bite sized chunks and rather than all at once. Sure.

The, the component. Do you ever do food sensitivity or allergy testing, anything like that?

Yeah, food sensitivity is an option that people can do while they're in the program because they're. It's not always gluten and dairy and your typical things. You know, there are other foods that you don't think of because you don't get the symptoms necessarily as soon as you eat them. And it could be something that people are eating every day, thinking they're eating something healthy, but it's not healthy for them.

Yeah. Yeah. Awesome. Anything else that you'd like to share with our listeners and viewers.

No, I think I just really want to let you know if you're suffering with psoriasis that you are not alone, that there are people out here who we love to help you. And even if you're on medications, you still can make these changes. It's still great for you to do to help support your body, not only for your skin, but for your longevity, for your health. We want to move towards optimal health, not just keeping ourselves stuck in this, just kind of disease free. We're not dying, but we're not also healthy either. So it's good to help move that pendulum. Or if you're someone who just wants another alternative other than the medications, this is a great place to go and just want you to know you're not alone, that I'm here for you.

I love it. Thank you Dana for coming on the show and sharing such wise words around a really tough condition and creating that community for folks and offering support is truly awesome. So thank you and you all listening out there in what the health land. If you enjoyed the show, please give us a five star rating. Also, if you know anybody, it could be a little awkward of like, hey, I noticed you have some skin stuff. I want to share this podcast with you. However, I think you can do it in such a manner as, wow, I found this super fascinating and I'm wondering if you've heard anything like this woman provided a lot of options for folks with psoriasis. So you know, it's a really, it's a kind of giving the gift of health that I recommend. So please share the show with your friends and family members and until next week, we will see you on what the health the Doctors chat. Thank you.