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:

Cancer Risk from Arsenic in Rice and Seaweed

A daily half-cup of cooked rice may carry a hundred times the acceptable cancer risk of arsenic. What about seaweed from the coast of Maine?

“At one point during the reign of King Cotton, farmers in the south central United States controlled boll weevils with arsenic-based pesticides, and residual arsenic still contaminates the soil.” Different plants have different reactions to arsenic exposure. Tomatoes, for example, don’t seem to accumulate much arsenic, but rice plants are really good at sucking it out of the ground—so much so that rice can be used for “arsenic phytoremediation,” meaning you can plant rice on contaminated land as a way to clear arsenic from the soil. Of course, you’re then supposed to throw the rice—and the arsenic—away. But in the South, where 80 percent of U.S. rice is grown, we instead feed it to people.

As you can see at 0:52 in my video Cancer Risk from Arsenic in Rice and Seaweed, national surveys have shown that most arsenic exposure has been measured coming from the meat in our diet, rather than from grains, with most from fish and other seafood. Well, given that seafood is contributing 90 percent of our arsenic exposure from food, why are we even talking about the 4 percent from rice?

The arsenic compounds in seafood are mainly organic—used here as a chemistry term having nothing to do with pesticides. Because of the way our body can deal with organic arsenic compounds, “they have historically been viewed as harmless.” Recently, there have been some questions about that assumption, but there’s no question about the toxicity of inorganic arsenic, which you get more of from rice.

As you can see at 1:43 in my video, rice contains more of the toxic inorganic arsenic than does seafood, with one exception: Hijiki, an edible seaweed, is a hundred times more contaminated than rice, leading some researchers to refer to it as the “so-called edible hijiki seaweed.” Governments have started to agree. In 2001, the Canadian government advised the public not to eat hijiki, followed by the United Kingdom, the European Commission, Australia, and New Zealand. The Hong Kong Centre for Food Safety advised the public not to eat hijiki and banned imports and sales of it. Japan, where there is actually a hijiki industry, just advised moderation.

What about seaweed from the coast of Maine—domestic, commercially harvested seaweed from New England? Thankfully, only one type, a type of kelp, had significant levels of arsenic. But, it would take more than a teaspoon to exceed the provisional daily limit for arsenic, and, at that point, you’d be exceeding the upper daily limit for iodine by about 3,000 percent, which is ten times more than reported in a life-threatening case report attributed to a kelp supplement.

I recommend avoiding hijiki due to its excess arsenic content and avoiding kelp due to its excess iodine content, but all other seaweeds should be fine, as long as you don’t eat them with too much rice.

In the report mentioned earlier where we learned that rice has more of the toxic inorganic arsenic than fish, we can see that there are 88.7 micrograms of inorganic arsenic per kilogram of raw white rice. What does that mean? That’s only 88.7 parts per billion, which is like 88.7 drops of arsenic in an Olympic-size swimming pool of rice. How much cancer risk are we talking about? To put it into context, the “usual level of acceptable risk for carcinogens” is one extra cancer case per million. That’s how we typically regulate cancer-causing substances. If a chemical company wants to release a new chemical, we want them to show that it doesn’t cause more than one in a million excess cancer cases.

The problem with arsenic in rice is that the excess cancer risk associated with eating just about a half cup of cooked rice a day could be closer to one in ten thousand, not one in a million, as you can see at 4:07 in my video. That’s a hundred times the acceptable cancer risk. The FDA has calculated that one serving a day of the most common rice, long grain white, would cause not 1 in a million extra cancer cases, but 136 in a million.

And that’s just the cancer effects of arsenic. What about all the non-cancer effects? The FDA acknowledges that, in addition to cancer, the toxic arsenic found in rice “has been associated with many non-cancer effects, including ischemic heart disease, diabetes, skin lesions, renal [kidney] disease, hypertension, and stroke.” Why, then, did the FDA only calculate the cancer risks of arsenic? “Assessing all the risks associated with inorganic arsenic would take considerable time and resources and would delay taking any needed action to protect public health” from the risks of rice.

“Although physicians can help patients reduce their dietary arsenic exposure, regulatory agencies, food producers, and legislative bodies have the most important roles” in terms of public health-scale changes. “Arsenic content in U.S.-grown rice has been relatively constant throughout the last 30 years,” which is a bad thing.

“Where grain arsenic concentration is elevated due to ongoing contamination, the ideal scenario is to stop the contamination at the source.” Some toxic arsenic in foods is from natural contamination of the land, but soil contamination has also come from the dumping of arsenic-containing pesticides, as well as the use of arsenic-based drugs in poultry production and then the spreading of arsenic-laced chicken manure on the land. Regardless of why south central U.S. rice paddies are so contaminated, we shouldn’t be growing rice in arsenic-contaminated soil.

What does the rice industry have to say for itself? Well, it started a website called ArsenicFacts. Its main argument appears to be that arsenic is everywhere, we’re all exposed to it every day, and it’s in most foods. But shouldn’t we try to cut down on the most concentrated sources? Isn’t that like saying look, diesel exhaust is everywhere, so why not suck on a tailpipe? The industry website quotes a nutrition professor saying, “All foods contain arsenic. So, if you eliminate arsenic from your diet, you will decrease your risk…and you’ll die of starvation.” That’s like Philip Morris saying that the only way to completely avoid secondhand smoke is to never breathe—but then you’ll asphyxiate, so you might as well just start smoking yourself. If you can’t avoid it, you might as well consume the most toxic source you can find?!

That’s the same tack the poultry industry took. Arsenic and chicken? “No need to worry” because there’s a little arsenic everywhere. That’s why it’s okay the industry fed chickens arsenic-based drugs for 70 years. If you can’t beat ’em, join ’em.

How can the rice industry get away with selling a product containing a hundred times the acceptable cancer risk? I cover that and so much more in my other videos on arsenic and rice, which also include concrete recommendations on how to mediate your risk.


Check out:

Pesticides were not the only source of arsenic. Poultry poop, too, if you can believe it! I cover that story in Where Does the Arsenic in Chicken Come From? and Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?.

Chronic low-dose arsenic exposure is associated with more than just cancer. See The Effects of Too Much Arsenic in the Diet.

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:

Topical Green Tea for Acne and Fungal Infections

Which plant should we use for which skin disease? That’s the topic of my video Natural Treatment for Acne and Fungal Infections. Thousands of studies have been published to date about the health effects of green tea, but it wasn’t until fairly recently that researchers began to look at the possibility of using green tea for the prevention and treatment of infections. Patents have been taken out on the antibacterial, antifungal, and antiviral properties of tea. Let’s review some of the evidence.

In terms of fungal infections, green tea compounds have demonstrated “potent antifungal activity” against the primary cause of athlete’s foot, fungal nail infections, jock itch, and ringworm—comparable, in some cases, to powerful antifungal drugs like fluconazole. This was shown in a petri dish, though. How about a green tea footbath for athlete’s foot fungus between the toes? Evidently, tea leaves were once used as a folk remedy for the fungus, so why not put it to the test? Indeed, a once-a-day, 15-minute dilute green tea footbath led to a significant improvement in symptoms compared to controls.

Green tea baths also appeared to help with fungus-associated atopic dermatitis, though there was no control group in that study, and a full-strength green tea may help clear candida yeast from poorly cleaned dentures. What about the bacteria that cause plaque and gingivitis? Even a 2% green tea mouthwash was found to be effective. Yes, you should be able to control plaque just with proper brushing and flossing—with an emphasis on “proper.” Most people don’t brush for the recommended four minutes a day, so a dilute green tea mouthwash may help.

In terms of plaque bacteria-killing ability, green tea was beaten out by a “garlic with lime mouth rinse,” but I think I’ll just stick to green tea, especially when green tea appears to not only kill plaque bugs directly but also boost the antibacterial capacity of saliva after you drink it.

What about green tea for acne? Six weeks of a 2% green tea lotion cut the number of pimples by more than half and significantly reduced the severity, as you can see at 2:48 in my video, making it a cheap, effective treatment for acne.

Impetigo is another bacterial skin infection that can affect the face, but a tea ointment can affect an 80 percent cure rate, on par with antibiotics given topically or orally.

What about bladder infections? We know a certain concentration of green tea compounds can kill the type of E. coli that causes urinary tract infections. The question then becomes how much tea do you have to drink to achieve those concentrations in your bladder? Not much, it turns out. Just one cup of tea might have an effect, but you may need to space out multiple cups over the day because it gets cleared out of your system within about eight hours, as you can see at 3:45 in my video.

So, where do we stand now? The test tube data look promising, but there has yet to be a single study to put it to the test. At this point, green tea should just be used as an adjunct therapy for bladder infections. But, with emerging multidrug-resistant organisms, green tea certainly holds potential.

Wait a moment. If green tea is so good at killing bacteria, might we be killing the good bacteria in our gut when we drink it? No. That’s what’s so amazing. “It has also been shown that green tea has no effect over intestinal flora, which is a great advantage against other bactericidal [bacteria-killing] agents.” But that may not actually be true. Drinking green tea may actually boost the levels of our good bacteria by acting as a prebiotic, thereby improving the colon environment, so it may actually have some effect on our gut flora after all, but it appears to be all good.


Drinking tea with meals may impair iron absorption, so it’s better to drink it between meals. For more on green tea, one of my favorite beverages, along with water and hibiscus tea, see:

For more on acne, check out:

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:

The Crowding Out Strategy to Eating Healthier

It may be more expedient politically to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.

The World Health Organization has estimated that more than a million deaths “worldwide are linked to low fruit and vegetable consumption.” What can be done about it? I explore this in my video Is it Better to Advise More Plants or Less Junk?

There’s always appealing to vanity. A daily smoothie can give you a golden glow as well as a rosy glow, both of which have been shown to “enhance healthy appearance” in Caucasian, Asian, and African skin tones, as you can see at 0:24 in my video.

What about giving it away for free?

A free school fruit scheme was introduced in Norway for grades 1 through 10. Fruit consumption is so powerfully beneficial that if kids ate only an additional 2.5 grams of fruit a day, the program would pay for itself in terms of saving the country money. How much is 2.5 grams? The weight of half of a single grape. However, that cost-benefit analysis assumed this minuscule increased fruit consumption would be retained through life. It certainly seemed to work while the program was going on, with a large increase in pupils eating fruit, but what about a year after the free fruit program ended? The students were still eating more fruit. They were hooked! Three years later? Same thing. Three years after they had stopped getting free fruit, they were still eating about a third of a serving more, which, if sustained, is considerably more than necessary for the program to pay for itself.

There were also some happy side effects, including a positive spillover effect where not only the kids were eating more fruit, but their parents started eating more, too. And, although the “intention of these programs was not to reduce unhealthy snack intakes,” that’s exactly what appeared to happen: The fruit replaced some of the junk. Increasing healthy choices to crowd out the unhealthy ones may be more effective than just telling kids not to eat junk, which could actually backfire. Indeed, when you tell kids not to eat something, they may start to want it even more, as you can see at 2:20 in my video.

Which do you think worked better? Telling families to increase plants or decrease junk? Families were randomly assigned to one of two groups, either receiving encouragement to get at least two servings of fruits and veggies a day, with no mention of decreasing junk, or being encouraged to get their junk food intake to less than ten servings a week, with no mention of eating more fruits and veggies. What do you think happened? The Increase Fruit and Vegetable intervention just naturally “reduced high-fat/high-sugar intake,” whereas those in the Decrease Fat and Sugar group cut back on junk but didn’t magically start eating more fruits and vegetables.

This crowding out effect may not work on adults, though. As you can see at 3:12 in my video, in a cross-section of over a thousand adults in Los Angeles and Louisiana, those who ate five or more servings of fruits and veggies a day did not consume significantly less alcohol, soda, candy, cookies, or chips. “This finding suggests that unless the excessive consumption of salty snacks, cookies, candy, and sugar-sweetened beverages”—that is, junk—“is curtailed, other interventions…[may] have a limited impact….It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.” In most public health campaigns, “messages have been direct and explicit: don’t smoke, don’t drink, and don’t take drugs.” In contrast, food campaigns have focused on eat healthy foods rather than cut out the crap. “Explicit messages against soda and low-nutrient [junk] foods are rare.”

In the United States, “if one-half of the U.S. population were to increase fruit and vegetable consumption by one serving each per day, an estimated 20,000 cancer cases might be avoided each year.” That’s 20,000 people who would not have gotten cancer had they been eating their fruits and veggies. The U.S. Department of Agriculture recommends we “fill half [our] plate with colorful fruits and vegetables,” but less than 10 percent of Americans hit the recommended daily target. Given this sorry state of affairs, should we even bother telling people to strive for “5 a day,” or might just saying “get one more serving than you usually do” end up working better? Researchers thought that “the more realistic ‘just 1 more’ goal would be more effective than the very ambitious ‘5 a day’ goal,” but they were wrong.

As you can see at 4:56 in my video, those told to eat one more a day for a week, ate about one more a day for a week, and those told to eat five a day for a week did just that, eating five a day for a week. But here’s the critical piece: One week after the experiment was over, the group who had been told to eat “5 a day” was still eating about a serving more, whereas the “just 1 more” group went back to their miserable baseline. So, more ambitious eating goals may be more motivating. Perhaps this is why “in the US ‘5 a day’ was replaced by the ‘Fruits and Veggies—More Matters’ campaign…in which a daily consumption of 7–13 servings of fruits and vegetables – FVs –  is recommended.” However, if the recommendation is too challenging, people may just give up. So, instead of just sticking with the science, policy makers evidently need to ask themselves questions like “How many servings are regarded as threatening?”


For more on appealing to vanity to improve fruit and vegetable consumption, see my videos Eating Better to Look Better and Beauty Is More Than Skin Deep.

What does the science say about smoothies? See:

The flipside of free fruit programs is to tax instead of subsidize. Learn more by checking out my video Would Taxing Unhealthy Foods Improve Public Health?

For more on the paternalistic attitude that you don’t care enough about your health to be told the truth, see my videos Everything in Moderation? Even Heart Disease? and Optimal Diet: Just Give It to Me Straight, Doc.

I explore this same patronizing attitude when it comes to physical activity in How Much Should You Exercise?

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: