Dietary Cure for Hidradenitis Suppurativa

What is the role of dairy- and yeast-exclusion diets on arresting and reversing an inflammatory autoimmune disease?

A landmark study suggested that exposure to dietary yeast, like baker’s yeast, brewer’s yeast, and nutritional yeast, may worsen the course of Crohn’s disease, an autoimmune inflammatory bowel disease. The reason the researchers even thought to do the study was because Crohn’s patients tend to have elevated levels of antibodies to yeast, but Crohn’s is not the only autoimmune disease with increased yeast antibodies. The same has been found in lupus patients, found in rheumatoid arthritis, found in another joint disease called ankylosing spondylitis, found in autoimmune liver disease, and also found in autoimmune thyroid disease. So, might avoiding yeast help those conditions, too? They haven’t been put to the test, but hidradenitis suppurativa has. What is that? I discuss this in my video Dietary Cure for Hidradenitis Suppurativa.

Hidradenitis suppurativa can be a gruesome disease. It starts out with just pimples, typically along parts of the body where there are folds, such as the armpits, groins, buttocks, and under the breast. Then, painful nodules form that turn into abscesses and drain a thick, foul-smelling pus. And then? It gets even worse, forming active tunnels of pus inside your body.

And, it is not that rare. It has an estimated prevalence of about 1 to 4 percent, which is like 1 in 50. Clothes typically cover it up so it remains hidden, but you can often smell the pus oozing out of people. There are all sorts of surgical options and chemotherapy, but why did researchers even think to try diet for the condition? I mean, since Crohn’s is a disease of intestinal inflammation, you can see how a food you react to could make matters worse, but why a disease of armpit inflammation? Because there seems to be a link between hidradenitis suppurativa and Crohn’s disease. Having one may make you five times more likely to have the other, so there may be an “immunopathogenic link” between the two—they may share similar abnormal immune responses. Given that, if cutting yeast out of Crohn’s patients’ diets helps them, then maybe cutting it out of the diets of people with hidradenitis suppurativa might help them. A dozen patients with hidradenitis suppurativa were put on a diet that eliminated foods with yeast, like bread and beer, and they all got better, 12 out of 12. There was an “immediate stabilization of their clinical symptoms, and the skin lesions regressed,” that is, reversed, and went away within a year on the diet. Okay, but how do we know it was the yeast? By cutting out a food like pizza, you also may be cutting out a lot of dairy, and that also appears to help. Indeed, a dairy-free diet led to improvement in about five out of six patients.

See, those tunnels of pus are caused by the rupturing of the same kind of sebaceous glands that can cause regular acne. In hidradenitis suppurativa, however, they explode, and “[d]airy products contain 3 components that drive the process that blocks the duct [clogging your pores] and contributes to its leakage, rupture, and ultimate explosion.” First, there’s casein, which elevates IGF-1. (I have about a dozen videos on IGF-1.) Second, the whey and lactose, and third, the hormones in the milk itself—six hormones produced by the cow, her placenta, and mammary glands that end up in the milk. So, why not try cutting out dairy to see if things improve?

There is a whole series of nasty drugs you can use to try to beat back the inflammation, but as soon as you stop taking them, the disease can come roaring back. Even after extensive surgery, the disease comes back in 25 to 50 percent of cases, so we are desperate to research new treatment options. But, patients aren’t waiting. They’re getting together in online communities, sharing their trial and error though social media, and people have reported successes cutting out dairy and refined carbohydrates, like white flour and sugar. So, a dermatologist in New Hampshire decided to give dairy-free a try, and 83 percent of the hidradenitis suppurativa patients he tried it on started to get better. What’s more, he didn’t even try cutting the sugar and flour out of their diets. Now, he didn’t conduct a clinical trial or anything. He just figured why not give dairy-free a go? It’s not easy to conduct randomized, clinical, dietary interventions, but that doesn’t stop individual patients from giving things a try. I mean, you can understand why there have to be institutional review boards and the like when trying out new, risky drugs and surgeries, but if it’s just a matter of trying a switch from cow’s milk to soy milk, for example, why do they have to wait? “As patients search for an effective path to clearance [of this horrible disease], they need support and guidance to follow the most healthful diet available, free of dairy and highly processed sugar and flour. Nothing could be more natural.”

But what about the yeast? How do we know it was the yeast? In the study we discussed earlier, 8 of the 12 patients had just gone through surgery, so maybe that’s why they got so much better. It’s similar to when I hear that someone with cancer had gone through the conventional route of chemotherapy, surgery, and radiation before going to some questionable clinic and then attributes their cure to the wheatgrass colonics or whatever else they got. How do they know it wasn’t the chemo/surgery/radiation that saved them? Well, in this study, why do we suspect it was the yeast? Because not only did every single one of the patients get better, “all the patients demonstrated an immediate recurrence of skin lesions following accidental or voluntary consumption of beer or other foods” like bread. So, not only did the elimination of yeast result in “rapid stabilization” and “a slow, but complete, regression of the skin lesions within a year,” but, in every single case, within 24 to 48 hours of taking a little brewer’s yeast or other “yeast-containing foods,” BAM!—the symptoms were back. So, that’s why the researchers concluded a “simple exclusion diet could promote the resolution of the skin lesions involved in this disabling and [perhaps not so] rare disease.”

What was the response in the medical community to this remarkable, landmark study? “Why was there no mention of informed consent and ethics committee approval…?” Letter after letter to the editor of the journal complained that the researchers had violated the Declaration of Helsinki, which is like the Nuremburg Code or Geneva Convention to protect against involuntary human experimentation, and asked where was the institutional review board approval for this yeast-exclusion study? In response, the researchers simply replied that they had just told them to avoid a few foods. They had given them the choice: We can put you on drugs that can have side effects, such as liver problems, or you can try out this diet. “The patients preferred the diet.” Let’s not forget, I would add, that they were all cured!

Anyway, bottom line, by avoiding foods, like pizza, which contains both dairy and yeast, sufferers may be able to prevent the ravages of the disease.

This is the fourth and final installment of a video series on the role baker’s, brewer’s, and nutritional yeast may play in certain autoimmune diseases. If you missed any of the others, see:

For more on dairy hormones, see:

Check out our IGF-1 topic page if you’re unfamiliar with this cancer-promoting growth hormone, which I highlight in my video Animal Protein Compared to Cigarette Smoking.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Armpit Shaving and Breast Cancer

Shaving before applying underarm antiperspirants can increase aluminum absorption. Could this explain the greater number of tumors and the disproportionate incidence of breast cancer in the upper outer quadrant of the breast near the armpit?

A famous case report called “The Mortician’s Mystery,” published in the New England Journal of Medicine back in the 1980s, described a man whose testicles started shrinking and breasts started growing. It turns out the mortician failed to wear gloves as he massaged embalming cream onto corpses. It was concluded there must have been an estrogenic compound in the cream that was absorbed through his skin into his body, one of the first such cases described.

This case was cited as inspiration by a group of researchers who came up with a new theory to explain a breast cancer mystery: Why do most breast cancers occur in the upper outer corner of the breast? The standard explanation was simply because that’s where most of the breast tissue is located, as the so-called tail of the breast extends up to the armpit, but that doesn’t explain the fact that it wasn’t always this way. Indeed, there has been a shift toward the appearance of breast cancer in the upper corner of the breast. And, it also doesn’t explain why “greater genomic instability”––chromosome abnormalities––has been “observed…in outer quadrants of the breast,” which may signal precancerous changes. There definitely seems to be something happening to that outer side of the breast, and it’s something relatively new, occurring in the last 50 years or so.

Is it possible that the increasing use of [underarm] antiperspirant which parallels breast cancer incidence could also be an explanation for the greater number of ductal tumours…and disproportionate incidence of breast cancer in the upper outer quadrant” of the breast near the site where stick, spray, or roll-on is applied? I discuss this possibility in my video Antiperspirants and Breast Cancer, where you can see a graph of U.S. breast cancer incidence and antiperspirant/deodorant sales at 1:38.

There is a free flow of lymph fluid back and forth between the breast and the armpit. If you measure aluminum levels in breasts removed during mastectomies, the “aluminum content of breast tissue in the outer regions [near the armpits]…was significantly higher,” presumably due to the “closer proximity to the underarm” area.

This is a concern because, in a petri dish at least, it has been demonstrated that aluminum is a so-called metalloestrogen, having pro-estrogenic effects on breast cancer cells. Long-term exposure of normal breast tissue cells in a test tube to aluminum concentrations in the range of those found in breasts results in precancerous-type changes. Then, as you can see at 2:41 in my video, once the cells have turned, those same concentrations “can increase the migratory and invasive activity of…human breast cancer cells” in a petri dish. This is important because women don’t die from the tumor in the breast itself, “but from the ability of the cancer cells to spread and grow at distant sites,” like the bones, lungs, liver, or brain. But, we don’t care about petri dishes. We care about people.

In 2002, a paper was published in the Journal of the National Cancer Institute in which the underarm antiperspirant habits of 800 breast cancer survivors were compared with those of women who had never gotten breast cancer, the first study of its kind. The finding? No indication of a link between the two.

Based on this study, Harvard Women’s Health Watch assured women that antiperspirants do not cause breast cancer and “women who are worried that antiperspirants might cause breast cancer can finally rest easy.” But two months later, another study was published that found that “frequency and earlier onset of antiperspirant/deodorant usage with underarm shaving was associated with an earlier age of breast cancer diagnosis.” As you can see at 3:56 in my video, it’s as much as 20 years earlier in women using antiperspirant and shaving their armpits more than three times a week. And, the earlier they started before versus after age 16 appeared to move up their breast cancer diagnosis by 10 or 20 years. The researchers concluded that “underarm shaving with antiperspirant/deodorant use may play a role in breast cancer” after all.

But what does shaving have to do with it? Shaving removes more than just armpit hair. It also removes armpit skin; you end up shaving off the top skin layer. And, while there is very little aluminum absorption through intact skin, when you strip off the outer layer with a razor and then rub on an antiperspirant, you get a six-fold increase in aluminum absorption through the skin. Though this is good news for women who don’t shave, the high transdermal, or through-the-skin, aluminum uptake on shaved skin “should compel antiperspirant manufacturers to proceed with the utmost caution.”

Both European safety authorities and the U.S. Food and Drug Administration (FDA) specifically advise against using aluminum antiperspirants on damaged or broken skin. However, shaving before antiperspirant application “can create abrasions in the skin…thereby negating the specific warning by the FDA and EU.” (I’m sure everyone knows about the FDA’s cautionary advice, having read Title 21 Part 350 Subpart C50-5c1 of the Code of Federal Regulations.)

We get so much aluminum in our diet from processed foods—such as anticaking agents in pancake mix, melting agents in American cheese, meat binders, gravy thickeners, baking powder, and candy—that the contribution from underarm antiperspirants would presumably be minimal in comparison. “But everything was turned topsy-turvy in 2004,” when a case was reported of a woman with bone pain and fatigue suffering from aluminum toxicity. Within months of stopping the antiperspirant, which she had been applying daily to her regularly shaved armpits, her aluminum levels came down and her symptoms resolved. Although not everyone absorbs that much aluminum, the case “suggests that caution should be exercised when using aluminum-containing antiperspirants frequently.”

Recently, as you can see at 6:29 in my video, it was shown that women with breast cancer have twice the level of aluminum in their breasts compared with women without breast cancer, though this doesn’t prove cause and effect. Maybe the aluminum contributed to the cancer, or maybe the cancer contributed to the aluminum. Maybe tumors just absorb more aluminum. Subsequent research has suggested this alternative explanation is unlikely. So, where do we stand now?

The latest review on the subject concluded that as a consequence of the new data, given that aluminum can be toxic and we have no need for it, “reducing the concentration of this metal in antiperspirants is a matter of urgency.” Or, at the very least, the label should warn: “Do not use after shaving.” Of course, we could cease usage of aluminum-containing antiperspirants altogether, but then wouldn’t we smell? Ironically, antiperspirants can make us stink worse. They increase the types of bacteria that cause body odor. It’s like the story with antidepressant drugs, which can actually make one more depressed in the long run (as I discuss in my video Do Antidepressant Drugs Really Work?). The more we use antiperspirants, the more we may need them, which is awfully convenient for a billion-dollar industry.

Is there any way to decrease body odor through changes in diet? An early video of mine discusses Body Odor and Diet, and I have some new updated ones coming down the pike!

What else can we do to decrease breast cancer risk? See, for example:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: