Therapy AND Life

UPDATE: The Daily Mail article cited below was not only silly, it appears to have been dishonest. I’ve received the following email:

There is an article on your website about me (17/2/2011). Yes, I’m Judith Fine and that article was in the Daily Mail. Firstly, they completely twisted everything that I said so that it makes it look as if I have severe eating problems. Most of that article was a complete pack of lies, neither is it me in the photograph. Could you please, immediately remove it from you website as I am in the process of picking this up with the Daily Mail.

I’ve edited the post to remove content related to Judith. — PAJ

“Orthorexia” has been in the news recently, for instance in this Valentine’s Day article by Diana Appleyard in the Daily Mail:

We all know the type. They never let wheat, yeast or dairy pass their lips. They’ve cut out alcohol and caffeine. They’re obsessed with healthy eating — yet every day, they look more unwell and unhappier.

These are the symptoms of a condition called ‘orthorexia’ by dieticians….

Orthorexia was coined in 1997 by Californian doctor Steven Bratman in his book Health Food Junkies, and means ‘correct appetite’ (from the Greek orthos for right and orexis for appetite). It is a fixation with eating ‘pure’ food that, far from doing you good, can become so extreme that it leads to malnutrition, chronic ill health and depression.

Well, I don’t eat wheat; I didn’t even know yeast was a food; and though dairy is a big part of my diet, alcohol and caffeine modest parts, I recognize that milk proteins, alcohol, and caffeine can be problematic.

Given that none of these foods are necessary for good health, it’s not obvious to me why excluding them would lead to malnutrition, chronic ill health and depression.

But from the rest of the article, it looks like the real trouble with orthorexia is not the fixation with healthy eating, but faulty ideas of what constitutes a healthy diet. The article’s leading example of an unhealthy “orthorexic” diet is one that excludes fat.

Any fat-less diet is bound to be malnourishing. Perhaps the trouble is not orthorexia, but mistaken ideas about nutrition. Diets people think are therapeutic are, in fact, damaging.

Therapy versus Life … sometimes

Which brings me to a recent essay by Kurt Harris, “Therapy versus Life.”

It’s almost impossible to excerpt, so I’ll just assume you’ve read it. It’s strongly worded, but the ideas are familiar:  I suspect at least 90% of medical doctors would agree.

Doctors are healers, God bless ’em; but every day they have to face patients they cannot heal. This breeds a certain mental toughness.

As I often say, malnutrition, food toxins, and chronic infections are the primary causes of ill health. In some cases, like Judith Fine’s inability to have periods, it’s easy to recognize malnourishment as a likely cause. But the causes of most patients’ impaired health are much less obvious.

Unfortunately, doctors generally cannot diagnose or treat either bad diets or chronic infections. Doctors are great at treating acute disease, and can mitigate many symptoms that chronic diseases generate, but most are helpless to remedy mild, chronic ill health.

Doctors may believe that a patient’s declining health is simply natural aging; or that genuine health impairments may be undiagnosable, untreatable, or incurable. Kurt says it in his forum:

[T]he healthy should not assume they are sick and even the sick may be wasting their time trying to fix what can’t be fixed.

When patients learn that doctors can’t help them, they often turn to experimental self-treatment.

99% of the time, this works out badly. As Kurt’s car metaphor shows, there are many more ways to damage your body than to heal it.

And the 1% of the time it works, the patient doesn’t go tell the doctor. But when it backfires, the patient goes back to the doctor worse than ever. So the doctors see this method fail 100% of the time.

This reinforces the doctors’ consensus: Be prudent. Try to live normally – as healthy people do. Eat like healthy people, live like healthy people, and bear with your incurable maladies as best you can. Thrashing and groping for cures will only do harm.

Therapy – experimental self-therapies – are damaging to life. Choose life, not therapy.

But Diet Is Therapy

But that’s not all there is to it … because the right diet can fix many health problems.

Kurt says this himself:

[T]here is a dietary metabolic milieu that we are adapted to, and the best chance we have of optimizing our health is to try and emulate it …

The human body often can [fix itself] if we just stop ruining it.

We agree. The Perfect Health Diet is, in essentials, identical to Kurt’s PaNu. And when people in ill health eat this way, they commonly get better.

So the right diet is therapy. Choose this diet as therapy, and you’ll have a better life.

What If Your Life is Malady-Inducing?

I chose life over therapy for decades. I rarely went to the doctor. I focused all my energy on life. But I ate a lousy diet.

This isn’t the place to tell my story – that’s coming – but a lousy diet and a focus on life, not therapy, gave me a disabling chronic disease.

And a therapeutic diet gave me my life back. The Four Steps of our book are essentially the steps I took to cure a disabling neurodegenerative condition. With antibiotics, they worked.

So when Kurt asks,

Do you think every problem in your life can be fixed by changing your diet?

I can honestly say: every health problem was fixed!

Therapy for Life

If the Ewald hypothesis and Jaminet corollary are right, then we all stand in need of dietary therapy. As we age, our infectious burden increases and our immune system gets less effective. Sooner or later, infectious diseases threaten us all.

Our rescue is not from medicine, which does not yet know how to treat chronic infections. Our best chance for a long, healthy life lies in diet, nutrition, and immunity-enhancing behaviors like fasting.

Fortunately, the scientific evidence is accumulating to tell us what the right diet is. Specialist professionals still can’t see the forest for the trees, the elephant for its parts; but generalists, aided by respect for ancestral/traditional diets and for evolutionary selection, have blazed the trail. Kurt lists some reliable guides.


Diet is the best therapy. A good diet is life-giving. Good diet and nutrition may cost a few extra minutes a day, but can add decades of happiness.

So I say: choose therapy AND life. We can be healthy centenarians together. Let’s do it!

Leave a comment ?


  1. Me, I refuse to be cannon food…the point at which I realized I was being used was the instant I took control, for better or worse. Oligarchs and high priests be damned.

    If nothing else I do it for my kids.

    Much thanks Paul.

  2. Paul,

    Great post, I had some of the same thoughts after reading Kurt’s post, which I also enjoyed.

    An interesting perspective on orthorexia is provided by an evolutionary analysis of the emotion of disgust. Disgust likely evolved as a way of protecting animals from taking in even the tiniest bit of things that can hurt you even in tiny bits – microbes or pathogens. Thus, humans and animals are disgusted by things that are likely to contain microbes, such as dead animals, spoiled meat, feces, rats, certain insects, and bodily fluids.

    One of the important features of disgust is that it must make you stay far away from things you can’t even see. In other words, disgust can be a powerfully irrational force. It is likely that disgust is at play in orthorexia.

    It is also interesting to note that several theorists such as Jonathan Haidt have identified disgust as one several primal emotions that get together to create religious behavior. Thus we see in many religions that purification or defilement is a major theme, as well as the idea that just a drop of evil can stain everything it touches. Perhaps this is why people get religious about not eating meat, or animals, or wheat, and can actually feel physically sick at the thought of even getting the tiniest amounts of one of these substances in their meals.

  3. Great post, Paul.

    Eat well, live well.

  4. Did you know that 95% of us are not getting enough whole grains in our diet! I saw it on a tv commercial for the first time yesterday, so it MUST be true…sigh!

    Thanks for another great post. Hopefully you will gradually win favor over General Mills and their misguided but obviously self-serving commercials.

    Now, I am off to read Kurt’s post…thanks for the heads up.

  5. Another great post Paul. Thank you so much for all your writings. I have learned a lot from you and really appreciate all you are doing.

  6. “So when Kurt asks,
    Do you think every problem in your life can be fixed by changing your diet?
    I can honestly say: every health problem was fixed!”

    When I tried to make this point in the comment section of KH’s blog (definitely not as gently & elegantly as you) he got prickly & banned me. His blog has excellent info, which I stressed to him, but if you disagree with him or criticize him – watch out.

  7. dear lord, that looks like my girlfriends diet. I’m been trying to feed her more fat and meat but it is a struggle. she came home and cried when I made her proscuitto wrapped asparagus with cheese as a treat.

    KH’s point was excellent.

    But the problem is you only get to places like his if you are already sick and as Paul says, medicine isn’t working for you. Go back to the low hanging fruit: the US diet is really bad for us. Fix the low-hanging fruit.

    (and in reality, looking a bit more at the picture, it doesn’t look so bad). Clearly needs some more fat but that is about it.

  8. Hi Todd,

    Interesting point about disgust. Maybe we’re programmed to go to extremes a bit.

    Hi Rodney,

    The USDA agrees!

    Hi Chris,

    Thanks for what you do, I love your blog. I’ll mention your girlfriend’s paper tomorrow.

    Hi T.O.,

    If you had been a bit more polite, perhaps he wouldn’t have minded the disagreement. You catch more flies with honey etc.

    Hi Robert,

    I (almost) cried once when I was assigned a vegan diet, unbenownst to me, on an international business class flight. While everyone around me had filet mignon, I had seaweed salad.

    So I know how your girlfriend felt!

    My perspective is a patient’s perspective, Kurt’s is a doctor’s perspective. Both are valid and I think substantively there is little difference in our views, but the emphasis is different. We would both agree that healing begins with diet. As you say, that is the low-hanging fruit.

    I think Ms. Fine needs a little more than fat – what is the choline content of that day’s food do you think? the vitamin K2 content? – but if she ate fatty foods she’d be fine.

    Best, Paul

  9. Paul
    Thanks for another interesting essay. The divergence in perspective between Kurt Harris and perhaps many readers of this blog may be the starting point or motivation re personal health status. If one is healthy then fine-tuning seems not that practical or perhaps necessary. My case is somewhere in between as I have been healthy, eating SAD until age 70 and probably blessed with more favourable genes, at which point the full meaning (finally) became clear via sudden and drastic deterioration of my gums and teeth (lifelong weak point). For the last 8 months I have been following the general nutrition principles laid out in your book with surprisingly good results (thanks again). Actually I had stumbled onto the diet more or less before finding your blog but your analysis ties the pieces into a rational process. So I have been fine-tuning to a small extent but I have to say that I am a bit baffled and (unjustifiably) sceptical of the myriad symptoms and cures readers report. That said, I am overwhelmed by the complexity and quirkiness of my own metabolism. An example is the anomaly of the huge increase in energy intake (500-600cal) and still growing without weight gain. All this without any obvious signs of significant infection and a persistent feeling of good health and energy. So on balance I lean to your way of thinking. Dr. Harris’s essay may be a shot at the bloggers who exploit the gullible (eg ask Grok what to do) and advocate unrealizable magic bullets.

  10. @TO

    you posted an argumentative dissertation that was about as long as my original post. My choice was to delete it or argue back point by point. I chose the former. It was nothing like what Paul just posted, which is in any case is totally appropriate as it is on his blog – perhaps you can start a blog of your own?


    Many seem to take my essay the wrong way. I am not arguing one should just give up, or that diet cannot effect enormous changes. I am saying that if you start with sickness as your default self-concept, you run the risk that even once you have made all the dietary changes one can reasonably make, you will view any difficulties you may still have as fixable by diet.

    Paul says diet fixed all his health problems. That is good, but there are a wealth of health problems that diet does zero to address and there are LIFE problems, including social and mental problems that have nothing whatever to do with diet.

    It frustrates me to see an army of suffering people think they suffer because they haven’t found the magic dietary bullet for things like depression, anxiety, chronic pain, happiness..

    See this to understand what I am talking about:

    I don’t view diet as therapy – I don’t view stopping taking poison as therapy. Quitting smoking is not therapy, it is just ceasing to do harm.

    Ceasing injury is far more powerful than therapy. You might have to be an MD who has seen the abject failure of “therapy” in so many diseases to think this way.
    The diseases I’ve seen – DOC – in my years of practice are universally best treated by removing their causes, and the things viewed as “therapy” are inevitably rear-guard actions that are closing the barn door with horses long gone.

    So for me “therapy” has two negative connotations. The first is expensive ineffective medical (alternative and traditional) care, and the second is the baseline assumption that you are broken.

    So for me proper diet is just part of healthy living, and I choose not to think of it as therapy because that is MORE POWERFUL than therapy.

  11. “Which brings me to a recent essay by Kurt Harris, “Therapy versus Life.”

    It’s almost impossible to excerpt, so I’ll just assume you’ve read it. It’s strongly worded, but the ideas are familiar: I suspect at least 90% of medical doctors would agree.”

    I would have to disagree with this. Among doctors who get paid to do any kind of therapy or dispense any treatment- internists, surgeons, etc.- I would say most would disagree. Most doctors remain positivist due to their medical training – defined mechanical problems have solutions – the solutions may be expensive or not yet invented, but there are always solutions. This is a philosophical outlook deeply embedded in western culture. It is appropriate in engineering, but not in biology and medicine. Few doctors have abandoned positivism, even the ones who just become cynical about the efficacy of treatments.

  12. Thanks, Kurt.

    I totally agree that removing the causes of disease is the first and best step toward recovery. (That has been the focus of my weight loss advice, for instance.)

    I think of “therapy” as anything that is healing, and therefore think of many aspects of diet and nutrition as therapeutic. Therapy does imply that something is broken and needs fixing, but the fix need not be medical. It might just be taking special care to fix a nutritional deficiency. For Judith Fine, 3 egg yolks a day would be highly therapeutic.

    As a patient with a collection of symptoms that didn’t neatly match any known condition, I was over a 15-year span prescribed many (ineffective) treatments and also at times refused treatments (which undoubtedly would have been equally ineffective). I was counseled several times by my primary care physician, an intelligent man and good doctor in his mid-fifties, that I should accept my condition as untreatable and perhaps an inevitable consequence of aging. I’m glad I didn’t accept that advice.

    I agree that most doctors are positivists, but the most disturbing part to me is their rigidity. I know this is due to regulatory/insurance/malpractice issues, not the doctors’ personal inclinations, but very few doctors are willing to cooperate with their patients to experimentally address diseases that don’t fit familiar diagnostic categories.

    In my case, fixing my diet clarified symptoms and made it clear that infections were the problem. A bad diet multiplied and complicated the symptoms to the point that my condition was hard to diagnose.

    I guess one difference here is that I think a combination of infections with bad diet is the usual situation. So fixing diet is essential, but not sufficient, perhaps, to recover health. There are still infections to address — in severe cases, by antimicrobial drugs; in milder cases by therapeutic steps like fasting, probiotics, etc.

    Anyway, being a doctor is a tough job. It’s great that you were able to help Richard! I hope his shoulder heals.

    Best, Paul

  13. great post paul!

  14. Paul, I would just like to say that fair enough, those with orthorexia, like the person you have exampled, may not be eating nutritionally well and so this may add to mentally unstable states of mind. However, that’s not necessarily how the obsession arises, or how it may be healed. I speak with my own experiences in mind. I have suffered from the age of 16, to 23 years old with myriad eating disorder’s, and I completely disagree with your assertion. Fear of food, and what it translates to, is one thing, looking to heal physiological problems without a fear of food, and what it translates to, another. I have lost many years of my life, suffering greatly, wrongly thinking that food was the problem and the solution; if only I could figure it out; the optimal diet, I thought. I am only now realizing that life is therapy, and ‘nutrition’ a much much smaller part. This understanding has, in part, arisen with the realization that there is a wide margin between macronutrient needs; I no longer believe/think that there is an ‘optimal’ diet because searching for one has largely destroyed what life I have had. My obsession has destroyed my confidence, it has destroyed my social relationships, it has destroyed the talents I once possessed and it has destroyed aspects of life for those around me who have cared for me; through despair at not knowing how to make it better, or what they had done wrong. I had nutritionists at eating disorder clinics telling me how to eat, and confront my fallacies in thinking, but I simply could not listen, because I was utterly obsessed with food, and did not believe anything they said. So, just some thoughts, based on my experiences: In terms of those with eating disorders I think knowing what to eat helps in part, but I think it is very much dictated by the individual, and food advice is not necessarily the solution, but simply a perspective. It can be a very long, painful road to realizing what you’re missing with all you need right before your very eyes, just as a starting point. All my energies are now on trying to make a life for myself, that does not revolve around food, and this is where healing begins for me. What has helped the most personally, is going with what I feel like eating, and not what I have been told I should avoid; this has given me a sense of control, as apposed to ‘knowing’ about the foods themselves.

    I really like you site, but I think people finding their own health is a journey.

  15. Though I suppose there is no way of distinguishing what has played a larger part in being able to feel OK about food and making decisions based upon how I feel about something. Perhaps it is the understanding of nutrition that has helped me the most and has allowed me to be OK with making decisions about how I feel about eating different foods. I don’t know. Perhaps it is just that once you start wanting to understand what to eat, the search becomes larger and more important because there is so much information and so many perspectives. Anyway, I feel quite comfortable now that I have a knowledge of what works for me, and it happens to sit on a bed of theory I trust in, though perhaps I trust that much more because I have suffered for it. On this basis I do think it starts with the mind and the individual.

  16. I could be wrong! 🙂

  17. Hi Jenna,

    Thanks much for your perspective.

    I wish you well recovering from your eating disorders. We have several others here with eating disorders – Mallory often comments; and Maggy C is a doctor who treats eating disorders.

    May I ask: do you think Judith Fine has an eating disorder? It seems to me she just has a misguided fear of fats.

    I bet if she realized that fatty foods wouldn’t hurt her and would help her, she might try eating them. Then when she found she really did feel better, her “orthorexia” might be cured.

    I blame all the misinformation about food for confusing people and leading them into bad habits. But bad habits are not the same as a disease.

    The good news is that our bodies evolved to make us feel good when we eat healthy foods. So you’re doing just the right thing to “go with what I feel like eating” … as long as you know to stay away from sugar your body’s signals should be reliable!

    Best, Paul

  18. As a doctor I know that we will all die. I’ve seen it, I’ve held the had of the dying. I’ve wished them well. And I hope that avoiding the neolithic agents of disease (fructose, wheat, vegetable oil) will give me a better chance of having a less gruesome death. And for me, that is a fine ending.

  19. Hi Emily,

    I’ll accept a gruesome death if I can have the full use of my mind for another 60 years!

  20. I don’t think orthorexia ought to be confused with an actual disease, it’s a pop culture descriptive term as defined by the guy who came up with it. It’s a useful adjective for people who become obsessed with their eating (like Fine), just as workaholic is a useful adjective for people who obsess about their work, or paleo is a useful adjective.

    I’m not saying you consider this an actual disease, Paul, I’m saying that people like Jenn who make statements such as, “those with orthorexia” ought to realize the difference between pop-sci-journalism and actual disease. When was the last time you heard some talk about “those with workaholism”?

  21. “May I ask: do you think Judith Fine has an eating disorder? It seems to me she just has a misguided fear of fats.

    …I blame all the misinformation about food for confusing people and leading them into bad habits. But bad habits are not the same as a disease.”

    I really need to read all the comments before I post, I mean I did, then left and came back and posted, meh, you said it better than me before I even said it.

  22. ‘May I ask: do you think Judith Fine has an eating disorder? It seems to me she just has a misguided fear of fats.’

    I don’t think I am in a position to comment about this. But, I will say that my fear of food, was more about fearing being fat. I wanted to be very thin, and still do. That’s at the heart of it, not feeling thin enough; not feeling good enough; which drove my desire to understand nutrition and search for answers where there weren’t any to be found. My behavior was a refusal to stop searching for the, answer, the, solution. And a strong desire to find the answer myself.

    As you possibly know what comes with eating disorders, commonly is body dysmorphic disorder, perfectionism, and OCD, but I’m not too sure it is actually a case of seeing yourself as too fat, or too big, but just hating yourself, and your body; being repulsed by something most people are not, or at least do not become so preoccupied with that one wants to die and tries to die, because ones image of perfection does not, or will not stand up to how you see want to yourself. And all this doesn’t say anything about why the body, and what it looks like becomes of such importance at a young age (or any other age), whereby many others do not suffer. The question is why the body, its appearance, and value as a way of defining the self, becomes considered of such importance.

    Like I said I think it is more about the individual and the mind. I don’t really know what ‘orthorexia’ means. Actually I think it is quite a reductive term to apply to an individual and social disorder.

    The other thing I think about is about the Chimera of the web. I think blogs are possibly most helpful for those who blog, but not necessarily the readers. I think blogs have the propensity to take people away from themselves, and self knowledge; being in tune with the sovereignty of ones own body. Though I guess blogs can be a starting point where other means of socialization and knowledge can not be found in close vicinity. Thats one thing also, about the importance of ‘food traditions’; what does that really mean?

  23. ‘But bad habits are not the same as a disease.’

    I wasn’t sure what this meant. As I do not see them as unrelated, in either the case of so called ‘Orthorexia’, or some physiological problem, such as being obese, or having Parkinson’s; they all regard, I think, a societal problem; and yes, misinformation.

    Sorry I don’t mean to be hypercritical, or illogical. Just to clarify, I do think, in part, food is therapy, but I just think the problem is wider that what is defined.


    I am quite aware that Orthorexia is a pop-culture term-for the use of making a distinction-that is what the language of naming is for!

    My point was simply, that I didn’t like how the term was being used to describe something that goes beyond food, and knowing, simply what to eat. But perhaps that is my misunderstanding of what was being inferred.

  24. Sean, like I said,

    ‘Fear of food, and what it translates to, is one thing, looking to heal physiological problems without a fear of food, and what it translates to, another.’

  25. Jenna, that is some of the most pseudo-intellectual bullshit I’ve ever come across. I wouldn’t bother but I feel like a line has to be drawn in the sand between rationalism and the random strewing together of big words.

    “Like I said I think it is more about the individual and the mind.”

    As opposed to what? The collectivist body?

    “I don’t really know what ‘orthorexia’ means. Actually I think it is quite a reductive term to apply to an individual and social disorder. ”

    You don’t know what it means but it is quite a reductive term? And how is it applied to an individual and social disorder, what are you even talking about?

    “The other thing I think about is about the Chimera of the web. I think blogs are possibly most helpful for those who blog, but not necessarily the readers.”

    The other thing I think about is the Chimera of logic and coherence in people who write these sorts of sentences.

    “I think blogs have the propensity to take people away from themselves, and self knowledge; being in tune with the sovereignty of ones own body.”

    Blogs are well known for that sort of thing. The sovereignty of bodies should not be violated by the Chimera of the sacrosanct to be individualized for the breadth of one’s own self-knowledge.

  26. Easy there, Sara – this is Paul’s house. If you disagree, keep the tone respectful. BTW, I think blogs have the propensity to make people say things they’d never say to someone’s face in real life. At least I hope they wouldn’t.

    Eating disorders seem to be a “bone” (pardon the lousy pun) of contention in the paleo/lowcarb world. I don’t pretend to understand the roots of EDs since I’ve never had one, but I feel obligated to listen without judging if someone shares their experience with me. Ms. Fine could have an ED; the emotional attachment to food seems like a red flag, IMO. Or she might need better information.

    In either case, it doesn’t seem like a good idea to get in the middle of something so personal when you don’t even know the person.

  27. Actually Sean, I wasn’t trying to be anything. I was just wanting to communicate my experiences, and express my concerns. My aim is not to sound like anything I am not, or prove anything I do not possess. I just feel quite emotional about this subject, so yes maybe I think less than I should on this basis of emotion when I write. And I am certainly not the greatest thinker, or writer, your right, and I hold my hands up! Also I would like to let you know, that communicating my experiences makes me feel quite vulnerable, and do you know why? Because I know how little I know, and I understand there are a great number of people who understand much more. I do not communicate for any other reason than to share, in the hope that it adds something to someone else’s perspective who might be going through something similarly to what I have experienced.

    I feel very grateful for all the information that is available on the web to people like myself, but at a certain point I think it becomes harmful, for some people, at the point that ones search is not really about a solution but just expresses habitual behavior. I do not mean to criticize blogging entirely, but I think it is important to look at what is going on socially, closer to home, with regards, to ‘nutrition’ because I think it involves a wider perspective.

    I also think it is OK to have an opinion and not be correct, I am not trying to score points, just learn.

    I take your point, that I am not communicating very well. Actually I now wish I could delete the comments. Appears pointless.

  28. Sean – Mind your manners. Disagreement is welcome, but it needs to be polite.

    Jenna, you’re most welcome to be here. I value your thoughts.

    Best, Paul

  29. I liked Kurt’s blog. It rang clear as a warning bell for many of us that frequent the world of health blogs. The bottom line is we are all falling apart, little by little. For some, its happening quicker (those with muscular dystrophy, ALS, etc) and for others at a more gradual pace. But nonetheless, we’ll all reach the same point at some time. In the meantime, its makes sense to put it all in the fire and see what’s left. I’m pretty sure when I’m lying on my death bed, I won’t be wishing that I spent more time reading health blogs or googling for the latest and greatest supplement. Most of us live with some type of health problem or health goal (lose weight, gain weight, etc) that gnaws at us for a solution. If we’re not careful, the temptation for one more google search or one more blog post, will consume us to the point that our search for answers becomes our life. Is this any way to live? In my own battle with crohns, I’ve come to the point where I’m perfectly happy with “stacking the odds in my favor with diet” and letting the chips fall where they may. Spending time with family and friends and getting outside is way more therapeutic for me than any google search. As its been said, “get busy living, or get busy dying”.,

  30. Jenna & Paul, sorry, I do get carried away sometimes.

  31. On the subject of eating disorders, their incidence has increased over the past 50 years (though to some extent anorexia has leveled off while binge eating and bulimia continues to grow). While there are many likely explanations (and the causes are likely multiple) for the increase, I can’t help but think an inflammatory diet and nutrient deficiencies are in part causative – leading to obsessions, moodiness, and issues with hypothalamic regulation of appetite.

  32. I just saw this blog post (linked from Twitter) that describes some of the mental issues with extreme dieting:

  33. Hi Sean,

    Thanks for that, you’re a good man to come back and apologize.

    Hi Emily,

    I agree that bad diets are probably the primary cause eating disorders – as of all diseases!

    I like that post by thecookiemonster a lot, thanks much. I think it’s true for men too — we’re naturally leaner than women, but I trust the body to go to its right degree of leanness on a good diet. Why force it to look other than natural?

    Clearly, if in order to get lean you have to be hungry, tired, and brain-fogged, you’re doing yourself harm.

    But people have all kinds of weird preferences. I don’t get the desire to defigure the body with piercings, tattoos, or plastic surgery either. The human body has always seemed most beautiful to me in its natural state.

  34. I know it’s not on topic but I was wondering if anyone could help interpret what my recent blood work might point too. I’ve been eating in line with the PHD for a little while now (reasonable protein/carbs and lots of good fats), I feel great, but pressure from my mom lead to a recent physical and blood test. Firstly, my HDL was good at 68, but it says my estimated LDL was high at 139. Also my doctor said my AST and ALT are high at 65 and 156 respectively. I don’t know how to interpret these numbers, but my doctor said my liver is working too hard, my cholesterol is high and my thyroid production is low. Is this all pretty much correct? Am I in danger of hurting my body? At first I felt devastated that my diet experiment has failed, but I’d like to see what other people in the know might think of these results? Any help would be appreciated, THANKS!

    Again, I’m sorry it’s not on topic, but the stress is getting to me, haha.

  35. Bill- what are your triglycerides?

  36. Hi Bill,

    First, feeling great is an important data point. Don’t dismiss that because of a few blood tests.

    LDL of 139 is OK. This is within the optimum range of minimum mortality; the reference ranges on lab tests are set too low. Remember also that when triglycerides are low, LDL is overestimated. My LDL was 117 in my last physical a year ago and I have no reason to believe that is not optimal for me. I don’t think you should be concerned about this one.

    Elevated liver enzymes are concerning. They could indicate an infection; gallstones; use of medications or herbal supplements; alcohol consumption; adrenal insufficiency; gut dysbiosis; or other causes. I would look into nutritional support for the liver (including glutathione/C/NAC) and for bile flow, and ask your doctor to do further tests looking at possible causes including infections and adrenal status.

    You didn’t give me your TSH level but hypothyroidism should also be addressed. We give advice for how to do this in the book. Start with iodine and selenium supplementation, starting low with the iodine.

    Bill, neither of these tests is something to panic or become stressed over. You may be malnourished in some way, have an infection that needs to be addressed, or be taking some medication or herb that is harming you. The dietary change may have revealed an issue that was present all along, but that now you can fix. What is needed are refinements and time for your body to heal itself.

    It would help me interpret things to hear what you were doing and what your health and numbers were like before you starting the PHD, and also whether you have been taking the nutritional supplements. What has changed?

    Best, Paul

  37. Bill– have you taken any medications or drugs lately– or have you been ill recently?

  38. Triglycerides were 55 md/dL. I haven’t been ill or taken any drugs recently, but was on Accutane about 8 years ago and just about everyday I see a commercial for class-action lawsuits because the drug causes so many diseases.

    TSH was 5.25

    Unfortunately I have no before to complement this after data. I’ve always been very active, lean, and generally healthy. I wouldn’t say any particular symptom lead me to PHD, but I always felt that there had to be a way to combat random fatigue, gas, headaches, etc. I follow your supplement protocol as laid out in the book, however I haven’t taken any selenium (in the form of Brazil nuts) for a few weeks because I ran out and it just got put on the back burner. I know you say iodine and selenium are linked, so maybe it’s the iodine supplementation without the selenium? Also, from a commenter on PaNu I was linked to a study showing elevated liver function for up to 7 days after exercise. When I asked my doctor if it mattered that I exercise morning and night, he said it wouldn’t affect the test. So I worked out as normal, heavy work the night before and light handstand work the morning before. Maybe this helped raise the levels more than would be normally? I know that may be grasping at straws, but I thought I’d bring it up. Thank you Ellen and Paul for your interest.

  39. Hi Bill,

    Another possible cause of elevated liver enzymes is too much fish oil / DHA. Make sure you aren’t supplementing that.

    If the LDL was calculated from total cholesterol, HDL, and triglycerides, as is commonly done, then the formula overestimated your LDL. The formula gives accurate LDL numbers for triglycerides over 100.

    Selenium supplementation is important. Thyroid function changes and improves very slowly, it commonly takes years to fix a thyroid problem. It’s good you’ve uncovered it and can now address it. But do it carefully, systematically, and patiently.

    I’m sure exercise or any stress will raise liver enzymes, but I doubt it would be this much in the absence of another issue. Unless you are overtraining — which, if you train twice a day, is a possibility; overtraining is a stressor and can induce adrenal fatigue.

    I would get a full adrenal and thyroid panel to see where you stand, and get to work addressing those issues. For the liver I would just monitor it and try a few extra nutritional supplements or foods. Make sure you get enough choline.

    Bill, the good news is you feel great. The better news is you have some fixable imperfections, so you can feel even greater!

    There’s no need to stress over this, these conditions were probably there all along and aren’t new. Now you know and can get to work fixing them.

    Random fatigue, gas, headaches are consistent with gut dysbiosis and adrenal/thyroid issues so I think all of your problems will probably be cured together.

    Best, Paul

  40. Bill- your cholesterol is lovely! 🙂

  41. Thanks Paul! You’ve really helped to ease my initial panic. Unfortunately this proves I am not superhuman as I once suspected, haha! I will get right back onto the supplement train and continue to monitor my diet for maximizing health. I will also make an effort to better track my health through blood tests, a practice I never thought very important until now. Again thank you for your help, I’ll be resting much easier tonight.

  42. Paul -do you think a few Brazil nuts a day are enough for selenium needs?

  43. Hi Bill,

    Another thing I would do is eat/drink the juice of one lemon per day, that should help clear gallstones.

    Hi Ellen,

    Thanks for your help!

    A few Brazil nuts a day with a multivitamin should be enough, yes. But of course with foods it depends on the soil they’re grown in and quantities can be very variable. I think with a thyroid problem it would be prudent to take a supplement so you know precisely how much you’re getting.

    Best, Paul

  44. Perfect Health Diet » Around the Web - pingback on February 19, 2011 at 2:53 pm
  45. Hi Paul,

    What is the rationale concerning the lemon juice clearing gallstones?

  46. Hi CPM,

    Citrate is commonly used in gallstone cleanses and it has research support, e.g.

    It also works on kidney stones.

    Best, Paul

  47. “Do you think every problem in your life can be fixed by changing your diet?
    I can honestly say: every health problem was fixed!”

    I love you optimism Paul, but I’m losing it.

    I’ve changed my diet several years ago to heal adult cystic acne. I’ve tryed almost all diets (including the PHD) but no diet seems to make it better (very low carb made it even worse).

    Acne can be considered an infectious disease but unfortunately from my experience can’t be fixed by antibiotics and good diet.
    Maybe I have an underlying cause that can’t be fixed or my body is too damaged.

    My last hope is in your reccomanded supplements.

  48. Hi Kratos,

    What a lucky coincidence, I just spent most of yesterday reading about acne.

    I have some thoughts about acne but they are still developing. I doubt our recommended supplements will be enough but you should take them, they will improve your health and make it easier to solve the acne riddle.

    Acne arises from a certain kind of immune response. Some pathogens induce this response – it diverts the immune system away from themselves. Also some chemicals do — lithium, bromide/flouride.

    I will write about it when I can either make clear recommendations, or when it fits some other narrative — such as “my story” — I had terrible acne and when I sought medical help for it in my late twenties is when my bigger problems began.

    Don’t give up hope. I think acne may be a lot simpler than is thought – though the cure may be tricky. You seem to be in a very similar situation to what I was in in my twenties. May I ask how old you are?

    Are you taking iodine yet? That is likely to be important for you.

  49. Hi Paul, thanks for the encouragement!

    I have had acne since 14 years old but it was mild, at 20 years old (when acne is supposed to get better) it became cystic with scarring (maybe also due to the chronic stress I had the year before). Now I’m 23 years old.
    I have a family history for acne but not as bad as mine.

    I recently come across this table:

    Surprisly I have 80% the adrenal disfunction symptoms and 20% of the thyroid.
    Acne is reported to be a symptom of thyroid but I have it with no visible increased sebum production (like when I was an adolescent).

    I’m thinking that my acne may be due to adrenals, I also read that acne is a cushing syndrome and CAH (congenital adrenal hyperplasia) symptom.

    Why do you think iodine can be helpful?
    I don’t eat seaweed or table salt because iodine is know to cause acne.

  50. Hi kratos,

    I think iodine is curative in the long run, though it may trigger acne in the short term, for two reasons: it drives other acne-causing halogens like bromine out of the body; and it improves immune function, especially against the pathogens I think are most likely responsible for acne.

    If Dr. Flechas is right that iodine prevents lipid peroxidation (see Bill’s comment,, that would be a 3rd reason, since PUFA oxidation products are likely highly acne promoting.

    The adrenal and thyroid issues affect immune function and I think it’s via immune modulation that the acne is created. Note that it’s HIGH cortisol but LOW thyroid that promote acne. Infections raise cortisol and lower thyroid levels, so it’s possible everything you’ve described has a single cause.

    I would look toward antifungal remedies, as there are a lot of links between the particular immune pathways involved and fungal infections. If antibiotics didn’t work I’d say that’s the most likely cause.

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