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Updated: May 5, 2026

Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
Psoriatic arthritis
Kara Fitzgerald1, Mark Hyman, Kathie Swift
1Kara Fitzgerald, ND, is coauthor of Case Studies in Integrative and Functional Medicine and is on faculty for the Institute for Functional Medicine, Gig Harbor, Washington.
Abstract:
Autoimmune diseases (ADs) are chronic, often debilitating and potentially life-threatening conditions that collectively affect up to 23.5 million Americans, and their incidence is rising.(1) They are heterogeneous in pathology but share common etiopathogenic factors such as intestinal hyperpermeability.(2) Although up to 100 ADs have been identified, there are likely more.(1) Genetics plays a clear role in the predisposition for the development and phenotype of AD, but various combinations of factors, such as toxins, endogenous hormone imbalances, microbes (including of GI origin), infections, stress and food antigens, are involved in disease expression.(2-5) Standard treatments include NSAIDs, steroids, antineoplastic agents and tumor necrosis factor-alpha antagonists. These tools have potentially devastating side effects and are often applied regardless of the diagnosis. Frequently, they are only modestly effective in relieving symptoms and limiting the advancing disease process. Direct health-care costs of AD are estimated at around 100 billion dollars per year in the United States. By comparison, cancer care costs about 57 billion dollars per year.(1) The rising incidence of this debilitating and costly group of conditions dictates that safe, alternative approaches to treatment be considered now.
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