Would a gluten-free diet help with such inflammatory diseases as psoriasis? — James Spall, FNP, Knoxville, Tenn.

In the absence of symptoms of celiac disease, I generally do not recommend that patients go gluten-free as a treatment for inflammatory disease. No research has yet shown that psoriasis can be improved with a gluten-free diet.

Anyone who decides to eliminate gluten from his or her diet should first consult a dietitian for guidance. Gluten can be hidden in unexpected foods, such as lunch meat and salad dressing. A gluten-free diet must be maintained for at least 90 days before improvement can be assessed. — Abby A. Jacobson, PA-C (188-2)

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These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical question, submit it here.