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. I didn’t know about the acne-PUFA correlation!

    I eat no fish (due to IGG intollerance) so no omega3 and about 5% of PUFA from nuts and olive oil, maybe they are too much.

    I go heavy with coconut oil (55 g/day) for its antifungal properties. Garlic seem to make my acne worse but I’m not sure.

    I’ll try iodine soon.

  2. Hi Kratos,

    Go slowly with the iodine … Start at 500 mcg/day kelp tablets, do that for 4 weeks, double the dose, repeat, spend 6 months working up to 12.5 mg, then stay there. If thyroid symptoms get worse, either hyper or hypo, after an increase then back off a bit until symptoms disappear.

    Drink lots of water and eat plenty of salt while doing this, that will help clear toxins.

    Best, Paul

  3. Kratos – I feel some of your frustration with the acne. I’m 27 and still have some. (argh!)

    It seems to be independent of the quality of my diet at any given time, and trying to figure out causation is very difficult. But I’d like to think that fixing my longstanding zinc deficiency helped with the acne.

    Got some shredded dulse (seaweed) today, and will see if this seems to help.

  4. Hi Mike,

    The immune-related antioxidants should help — zinc, copper, selenium, vitamin C, N-acetylcysteine.

    Iodine is likely to aggravate acne in the short-term … but I believe it will help in the long term (years) … and improve overall health.

  5. Re: iodine and acne. I came across a report of a Q&A with Dr. Flechas ( that, among other subjects, touched on this:

    “I also asked about the acne I get every time I stop Iodoral even for a
    short period. Was that bromide continuing to come out? He doesn’t think
    it’s bromide but rather the skin cells and sweat glands re-orienting to
    higher iodine levels and a die off of bacteria. These cells turn over
    fast so even a few days off iodine can affect the bacterial balance. I
    mentioned that it appeared I needed little deodorant on iodine and he
    said he hears this often.”

  6. Two more intriguing nuggets from the Q&A with Dr. Flechas that may be of interest around here:

    What’s the relation of iodine and high fat diets? Do those of us
    on traditional higher saturated fat diets need more iodine?
    Absolutely yes?.he said he thinks the relationship between fat,
    meats and breast cancer is basically an iodine problem. He went on to
    tell me about one of his patients that was diabetic. His doctor put him
    on a few fish oil tabs a day as he heard that helped with diabetes and
    an iodine related problem returned (I can’t recall what it was it was on
    the tape that went bad?.but once they increased his Iodoral it went
    away. Sorry don’t know what the increase dose was but he did say iodine
    if beneficial to diabetes)

    Could you say more on the relationship between thyroid meds and
    breast cancer? Should we ideally only be taking iodine instead of
    thyroid? Does it apply to all ages and sexes?
    Flechas said that he thinks that this is due to the cyclical nature of
    our endogenously produced hormones so they are pulsing and between
    pulses the breast is allowed to regain iodine. When we take thyroid the
    reloading between pulses isn’t available to the breast cells. A 1979
    study showed a 12% increase in breast cancer with women on thyroid
    medication. After 15 years it increased to 20%.

    This applies to all types of thyroid including compounded bio-identical,
    armour, and synthroid.

  7. Hi Bill,

    Very interesting about the pulsing. Lots of things do operate on ultradian and shorter rhythms. That makes sense.

    Also interesting about the deodorant. Personally I like the idea of an odorless deodorant, iodine, that is also antimicrobial.

    Best, Paul

  8. Hi Paul,

    I would be interested in a future post on acne as I still have trouble finding a cause and healing it. It can be caused by a number of things. From what I see, it could be hormone fluctuations during the cycle (progesterone drop) fluoride probably (acne only became a problem in my 30s after I moved to Ireland where tap water is fluoridated) gut flora (hard to correct) and related to it, immune response (Treg activity according to dr. Ayers) but I’m not sure. I’m taking the recommended supplements.
    I’m 43 this year and although I try not to be vain or too self-conscious I’m sure people observe it and must find it disgusting.

  9. Hi simona,

    I’ve started gathering notes for a series on acne. It’s a bit complex and I don’t have a clear story-narrative in my mind yet, but you can expect posts within a few months. It’s very interesting.

    I myself had severe acne in adulthood and it was medical treatments for the acne that launched many of my troubles.

    Definitely fluoride causes acne, but many other things do too. The immune response involved can be invoked in many different ways.

    I do think there are therapeutic steps that can be taken, and it can probably be cured in nearly all cases, but I need to do more research before I can suggest experimental therapies.

    Best, Paul

  10. Wowza! A lot has happened since logging in last time! I’ve been away on a short family vacation.

    Hi Jenna! I have suggested elsewhere that a proper, healthful diet would probably be helpful in the treatment of eating disorders. I don’t think it’s everything, but it’s important. Many of the patients I’ve treated have cycled repeatedly through treatment center protocols that put them on ADA-style food pyramids that are bound to fail. Alternately, treatment is divided between a psychotherapist on the one hand and a nutritionist on the other, who may mean well, but may undermine what progress is had in the psychological department. I think people with eating disorders have a lot of difficulty trusting themselves, let alone trusting others, when it comes to food, eating, bodies, and numerous other parts of living. My feeling has been that the treatment has to be consistent and unified; that the therapist has to be available to talk about food choices, if that is, indeed, something the patient wants help with. Truth is, it’s better to get good advice than to receive bad advice and then judgment. There are all kinds of philosophical issues here that we don’t need to get into.

    An eating disorder is as much a cultural phenomenon as it is a psychological and physical disorder. Like it or not, we live in a profoundly misogynistic culture that seeks to distract women from what can be personally meaningful, and seeks to makes food, eating, body image the central focus of their lives. It doesn’t suffice to deconstruct it solely from a medical or psychological perspective. The culture that necessitates and supports eating disorders needs to be exposed and deconstructed as well. I encourage all who are interested to read Susan Bordo’s work: “Unbearable Weight”.

    As an aside, of late, I have been grappling with something others have hinted at regarding the “Paleo Blogosphere”, namely that it seems to be a mostly male discourse. The main bloggers are men, many of whom are interested in muscle building, training, etc. The eating of an animal-based diet is certainly a gendered thing in American culture, as something that is done by men more than by women. Perhaps Perfect Health is less so, but I think many people would agree that there is a predominant male voice in this movement. I don’t quite know what this means or why this is, but I do think it is worth noting and thinking about, particularly in terms of what happens when matters more peculiar to women (although not exclusively so) come up for discussion.

  11. Hi Maggy,

    I hope you enjoyed your vacation! Was it warm?

    I agree about the male bias of Paleo, but I think that’s changing. I think “lean meat and vegetables” high-protein Paleo, a food preference I associate with men, is on its way out. The fitness aspect will probably keep a certain male bias though.

  12. Hey Paul. It was a quick 3 days in NYC to reconnect with some old friends who were also in town. It was in the high 60’s on Friday, only to plummet down to below freezing with the wind chill factor on Saturday. But seeing loved ones was incredibly warming to the heart.

    It’s interesting that you see lean meat and veggies as being more male in character. I see male paleo followers as being very fat friendly, with women being more wary of fat. I’ve always thought of “I’ll just have a salad with chicken breast and the dressing on the side”-style eating to be a much more feminine orientation, a vestige of the low calorie faith minus the carbs.

  13. Paul,
    I have had a similar experience with doctors. I have been told too that I shouldn’t keep looking for causes and I should just accept that I am like this because my body is changing as a consequence of aging or wear and tear. Very strange attitude from a GP. It’s true, if your signs and symptoms don’t match a particular disease description then their conclusion is that there is nothing wrong physically. I’ve been told by the endocrinologists that there is no hormonal imbalance or PCOS in my case (although I presented with hair loss, hirsutism, acne). The gynecologist told me that he can’t do much about my menstrual irregularities, maybe put me on the pill or a synthetic hormone. They generally treat symptoms with medication and do not look for causes. The only thing they noticed was the elevated cholesterol, the very low T3 didn’t matter.

  14. Hi Maggy,

    Great point about the salad and chicken breast. I guess I’d say that fat-phobia is female, protein-mania is male. They may work out the same though!

    Hi simona,

    I think our experiences are very common. I long for the scientific tools we’ll have in 30 years, but the culture of medicine of 50 years ago — when doctors didn’t worry about lawsuits or losing their license, and worked cooperatively with patients and were willing to experiment.

  15. WOW, lots of ranges of thought on the eating disorder topic. Interesting, I don’t really think orthorexia is ‘real’ and I also don’t think the chick in the video has an eating disorder at all. Confused about food definitely(poor soul), but not eating disordered. Anorexia is actually a neurological miswiring/misfiring in the brain. What happens is this :

    That is literally how I felt, what my mind went through when I was on the verge of death. I was told so much pointless crap by nutritionists and dieticians not to mention told when I was 88lbs I was ‘healthy as a horse’ at a paps mere, when I had no period, and ovary cysts. I have since absolutely despised the medical industry and doctors. the only choice I had was to deal with my brain and try and understand it(which obviously led me to a paleo/primal ‘diet’) and learn to accept and trust everything(gaining weight, sleeping, eating, nutrition) about whatever is really wrong up in my noggin. Any ED infested individual can find ‘reason’ for every SINGLE thing they do, think or eat. All of them will attempt to back up everything and justify everything about their every move in life. I use to do the whole spiel. when I found helped me was the acceptance, which is why the only ‘advice’ I will ever give out regarding eating disorders is ‘eat real food. I have never been bulimic so I can’t assist you in purging help’.

    I will never really understand it, but understanding the human body allows me to be okay with food and eating. I don’t really have any food fears, and I accept when I am hungry I eat and when I am full I stop. I do still have problems with eating when I am not hungry, this is probably my biggest attached stressor. when I am hungry, I am gung ho on fixin a meal, but if I am not, then I want nothing to do with food

    Wanted to make one more note… I don’t think bulimia is a real eating disorder, but a simple chemical imbalance in the brain that is a learned response(to binging and purging). I think it is fixed with the correct amino/nutritional therapy and the individual to change what they have ‘learned’ to comfort themselves with, but as far as epigenetics and neurobiology, I don’t draw the same conclusions as I do with anorexia.

  16. Paul, there is also something red meat phobic in American women, and it starts very young. My daughter, a second grader, brought a home-made beef stick to school as a snack once and was told by her female classmates that girls aren’t supposed to eat meat as snacks, only boys were supposed to do that.

  17. Hi Maggy,

    That’s terrible! Of course girls need iron much more than boys (once they start menstruating) … so red meat is healthier for them!

    Somehow our diet ideas have gone terribly astray.

  18. Paul, it is really bad. The girls in my daughter’s class are already firmly convinced that nonfat flavored yogurt is “healthy”, that meat is gross, that whole milk is bad, while skim milk is great. Froot Loops are great and granola, even better. Carrots and celery sticks dipped in fat free ranch dressing are awesome, as are apples dipped in fat free caramel sauce. Hard boiled eggs are nasty. Straight hair is better than curly hair.

    It’s all very distressing, and it’s a constant conversation that happens every day at our house to counteract the misinformation and to promote critical thinking.

  19. Maggy, I agree that the nutritional misinformation w/r/t kids is a massive challenge, in my opinion largely due to parental or organizational blind spots. And even when we convince the parents to change their ways those blind spots will remain.

    I have numerous friends who are very close to buy-in on my seemingly crazy diet ideas (almost none actually read the sources I recommend, so they take my word, which is perhaps the problem). But when it comes to the kids, it’s the exact scenario you mention. Nonfat yogurt, skim- or lowfat milk, “healthy” pastas, desserts as rewards, etc. The weekly bagel sales at my son’s elementary school — again, a “healthy” fundraiser — drive me crazy. And don’t get me started on school lunches.

    We fight the same constant battle just with our own boys, which I know will only get harder as they get older. I think there is some credence — SOME — to the notion of kids being kids, let them eat cake (at birthdays), have some candy, etc. But instilling that critical thinking you mention is the only real way to mitigate it, I think.

    I also try and tell parents that that nonfat yogurt, loaded with corn syrup, is equivalent to a chocolate bar or ice cream. So if you’re going to give the kids something bad, at least make it something awesome. That argument works surprisingly well — sometimes it leads to the kids getting the awesome treat instead, which is a win-loss, but at least it’s facing the truth straight-on!

  20. I second the comments about iodine and acne. I use Proactive, which keeps acne in check pretty well, but I once supplemented with iodine and the results on my face were horrific. Really, really bad acne- easily the worst of my life- that seemed to spread by the hour. Fortunately I quickly realized it was the iodine and it wasn’t for too long. But while it lasted little children would look at me and run away crying. The iodine supplementation is the only part of PHD I don’t follow, although like Paul said maybe I can try building up to it very slowly.

    BTW, for those frustrated with acne, you might want to check out Thermaclear. It’s a device that uses a split second of intense heat to zap zits, and is especially effective if you get to them at the first sign of trouble. FDA approved, I believe. It’s not 100% effective, but it works very well in conjunction with a skincare system like AcneFree or ProActive.

    Don’t pay full price for it, check ebay. No, I don’t own Thermaclear stock or sell it on ebay 🙂

  21. Hi Maggy,

    I find it difficult to talk about nutrition with my daughter who is almost 8. The parent needs to be very careful and aware of the child’s tendencies. I think she finds herself in the middle, between two conflicting views, that of their peers, who are happier than her in their ignorant ways, eating without stressing over how harmful something is and that of her parents, or let’s say her mother’s who would like her to eat real nutritious food. I don’t want her to be really neurotic about it. She went to a party and she refused almost everything as it was all crap food (we never eat pizza, drink soda, eat crisps or sweets) but that put her in a difficult situation, she felt bad, the mother of the party girl worried about her, told my husband who gave out to me that I make her obsess about food. So I told her that she can eat what she wants if she wants it but in moderate amounts (another rule coming from me that I had to explain) She is trying to make sense of it and she compares herself to others. ‘They have chocolate bars for snacks I have apples, they’re going to get sick, aren’t they?’ I feel that I’m not doing it the right way. I would like her to be strong and have her own views, not feel that she is inadequate because she is different. Obviously her views at this age are her parents’ which means that they will become questionable in the following years.

  22. Hi Paul,

    as we’re talking more about the relationship between the mind/brain and the body (after Richard’s post and the reference to Sarno or dr. BG talking about Bruce Lipton, or the recent experiments regarding the brain overriding the body’s experience – first link) maybe it will make you challenge your beliefs. I have just found this website and immediately thought of your general interest in the role of infections in chronic disease.

  23. Sorry, too rushed. I meant to say ‘this’ instead of ‘it will make…’ and I should have said that the new German medical paradigm deserves some thought. I’m not criticising your ideas.

  24. Thomas wrote: “I once supplemented with iodine and the results on my face were horrific”

    As you may know, the appearance or worsening of acne with iodine supplementation is a common result of bromine toxicity: the iodine drives the toxic bromine out of the tissues where it doesn’t belong and the body has to eliminate it. Meanwhile, it can cause all kinds of toxic reactions. Acne is classic. Skin is a detox organ (via sweat), as are the kidneys (via urine), etc.

    Although it is true that lower iodine doses may be easier to tolerate (and may be necessary if detox symptoms are too intense), it is also true that getting the bromine out of the body can require a high dose (50 mg/day or even more) for several months. I took 12.5 mg/day for months and still tested very high for bromine on a 24 hour iodine loading urine test. That wasn’t enough iodine for me.

    Many people, including me, have found that bromine detox can be managed with salt; the chloride helps drive the bromine out in urine. I am very bromine toxic and was advised to take a teaspoon of Celtic salt per day (those with high blood pressure who are salt sensitive can use potassium chloride instead). There is also a “salt loading” procedure that can be used temporarily, and effectively to get over the initial bromine detox misery.

    Steambaths are often recommended, too, to assist detox via sweating. I imagine this would be particularly good for acne symptoms. Some have found zinc helps with “bromine acne.”

    There’s a lot of experience out there with these issues, so if you decide to try iodine again there’s a lot you could do to try to make it more tolerable. In fact, if you get an iodine loading test through FFP Laboratories, as I did, you can consult with Dr. Flechas himself, who has worked through these issues with, I believe, several thousand patients.

  25. Hi Thomas,

    As Bill says, the acne in response to iodine is probably due to bromine or fluorine poisoning. Iodine itself doesn’t cause acne directly, though it can increase immune activity in the skin when there are infections.

    So longer term iodine should be beneficial for acne as it drives out bromine and infections.

    As Bill says, it may take 1 to 5 grams of iodine, salt, water, and time before bromine can be driven out of the body. I would still go slowly with the iodine, but interpret the symptoms as signs you really need the iodine.

    Best, Paul

  26. Hi simona,

    The relation between the mind and the body is interesting but notoriously difficult to pin down.

    Unfortunately I think there is also an extremely strong tendency among doctors to attribute physical symptoms they don’t understand to stress, psychosomatic illness, etc., when in fact it is dietary/nutritional/infectious.

    I doubt the puzzles over the mind’s role in health will be resolved any time soon!

    Best, Paul

  27. Hi Paul,

    I can see anorexia sufferers being drawn to a paleo way of eating because it’s harder to get fat.

    It’s the same game but with different tools. Whilst the paleo diet is more nourishing, initially improves well-being, etc. I can see a point coming when the natural weight gain reaches a tipping point and the sufferer re-starts their old bad habits just within the constraints of “paleo”.

    Whilst the anorexic is in “recovery” they’re still fairly lean, feeling better for the weight gain (the brain is literally euphoric it’s no longer starving), abs on show, etc. but there will come a point when a certain amount of weight is gained, the abs start to blur and an alarm goes off signalling the AN disease back into action.

    Then it’s back to denial, restriction, obsession, just with different foods.


  28. Hi Winalot,

    If anorexia were a psychological syndrome, then I could see that happening.

    But I think most diseases are physiological in basis — our bad diets and pathogens mantra — and that a good diet is therapeutic. Until proven otherwise I’ll believe that of anorexia too.

    Without knowledge of the disease it’s hard to say if a Paleo diet would address it, but I wouldn’t exclude the possibility.

  29. Thursday 2/24/11 « Derby City CrossFit – Louisville, KY - pingback on February 23, 2011 at 10:04 pm
  30. Hi Simona, So far the only parents I know who aren’t struggling with the whole false healthy food paradigm are ones who home school. For me, it’s stopped being so much about food and more about critical thinking. I try to do my best to give my kids accurate info in an age appropriate way, but beyond that I don’t have a policy of co-opting control of their bodies. At the end it’s their bodies, after all, and there’s only so much fighting I’m willing to do. My daughter (7) has started to notice that she doesn’t feel good when she eats badly. Also, as junk food goes, pizza isn’t the worst thing a kid can eat. But my kids are so used, at this point, to the pizza I make, with excellent ingredients, they simply won’t eat much of it elsewhere. Lately my daughter’s favorite food is onigiri, plain white rice with a touch of salt, wrapped in nori. She also enjoys steak and salmon. It’s a work in progress.

    My son isn’t quite there yet, but I have to trust he will be.

    My other strong recommendation to moms-to-be is extended nursing if at all possible. I nursed my son for a solid 3.5 years, until he self weaned. I have no doubt in my mind that that makes up for some of the bad choices he makes with food. He is 5, and we’re
    working on it. But something must be working because, knock wood, his immune system is in excellent shape. Even without perfect eating or seamless hygiene, he rarely ever gets colds or tummy problems.

  31. Paul, I just wanted to say, thanks. I’ve thought a lot about what was said here in these comments over the months that have passed. My understanding about what may have happened to me regarding my eating disorder/’s is a bit clearer now. I’ve just had to sort through my judgements and experiment! Actually probably what is helping the most is being able to see my thoughts down somewhere and seeing how I may regret, or see fault hoping to revise my understanding as I learn a bit more. Really, thanks a lot for all the gems of information you gather and share.

  32. Hi Jenna,

    We do have a thoughtful group of commenters. Thanks for contributing to the discussion. It’s been good hearing your point of view.

    Best, Paul

  33. Regarding the iodine/acne issue discussed above, I’ve made a discovery that may be of interest to Paul and his readers: for me, large doses of Vitamin C (5-10 g daily) taken in conjunction with any increase in iodine dosage completely eliminate any acne eruptions. And I do mean completely, 100%, totally gone.

    Previously, even tiny increases in iodine dose (from 500 to 600 mcg, for example) would make me break out all over my face and neck. Over time, with constant iodine dose, the acne would gradually disappear, only to reappear in full force when I increased the dose again.

    While taking Vitamin C, not only have NO new pimples formed, but previous acne lesions are noticeably improved, and my skin looks and feels subjectively healthier. I don’t know enough about either nutrient to propose a mechanism, but for anyone struggling with acne breakouts caused by iodine supplementation, adding Vitamin C into the mix is worth a try. It totally eliminated the problem for me, overnight.

    Perhaps this is why the Brownstein/Abraham protocol for iodine supplementation includes liberal doses of Vitamin C. It is mentioned in several resources that Vitamin C aids in the excretion of bromine, and that 3 g of Vitamin C is often sufficient to alleviate side effects. I was already taking magnesium and selenium, but after seeing such a dramatic and immediate improvement from the Vitamin C, I won’t neglect it from now on.

    Hope this helps!

  34. Thanks Jeremy! Great discovery.

    Interestingly, it’s thought that vitamin C evolved in the first land animals to help them cope with the loss of abundant iodine from the sea. So vitamin C works along similar pathways to iodine, eg acetyl-l-carnitine which is made from vitamin C is inversely regulated with thyroid hormone levels.

    Perhaps we now need a balance of vitamin C and iodine – more iodine, more C. Interesting thought.

  35. Interesting.

    What really puzzles me about Vitamin C requirements in humans is this: if it’s so incredibly important, and beneficial in such massive quantities, then where the heck did ancestral humans obtain substantial quantities of Vitamin C?

    Unless they all had constant access to an inexhaustible citrus grove, I just cannot imagine how paleolithic humans were not constantly in danger of scurvy. And even among those who did have regular access to quantities of C sufficient to prevent scurvy, surely the gram doses that seem to have so many benefits must have been completely unattainable?

    Or perhaps this is an example of something that we evolved to benefit from in minute quantities, and by a lucky accident we can benefit still more profoundly from the much larger quantities available through modern supplementation…


  36. Jeremy, I take 10x the amount of iodine you do along with the rest of Dr. Abraham’s iodine protocol and have also confronted acne as a result. The key for me (as recommended by Dr. Flechas, another MD using who’s had phenomenal success with the iodine protocol), was taking 1 teaspoon of Celic salt a day as a supplement, plus very liberal use on food.

    The iodine docs believe the acne is generally a result of bromide toxicity. Bromine in tissues is displaced by the iodine and enters the bloodstream as bromide. If it can’t be excreted in urine fast enough, it can cause all kinds of toxic symptoms. Acne is classic.

    The salt promotes bromide elimination via the kidneys. It’s a critical part of the iodine protocol, since almost everyone these days is toxic in bromine to one degree or another.

    I’m a little surprised you could have bromide detox symptoms on such a low dose of iodine, though I’m sure it’s possible. As you probably know, if you want you can determine your iodine and bromide status via Dr. Abraham’s 24-hour iodine loading test, available from FFP Laboratory (Dr. Flechas’s lab) or Hakala Labs.

  37. Hey Bill, the apparent symptoms of bromide detox surprise me too. I had these symptoms at less than 200 mcg of iodine per day. So I suppose it’s possible that some immune response or other reaction to the iodine itself is actually the culprit here.

    I also have reason to believe that I may have an unusually high burden of bromide and other halides. Why? Because (a) I developed hypothyroid symptoms at the incredibly young age of 17, and I’ve repeatedly tested negative for Hashimoto’s; (b) my father had thyroid cancer, and grew up drinking the same Colorado tap water that I drink, which is known to be high in fluoride and God knows what else; (c) throughout my childhood I used a hot tub containing huge amounts of a bromide-based disinfectant on a daily basis; and (d) I hated seafood throughout my childhood, so I’ve probably been iodine-deficient my entire life. This situation is exacerbated by at least one chronic infection (H. pylori) that further reduces the pool of available iodine for competition with other halides.

    So my situation may be unique.

    All I know is that megadosing Vitamin C with no other changes to my diet or supplement regimen has completely alleviated all side effects, most notably the acne. When increasing iodine while megadosing Vitamin C, I just feel a nice boost of supra-normal energy for a few days and then return to baseline, with none of the negative symptoms I was having before.

    I do apply unrefined salt liberally to all of my food as well.

    Out of curiosity, what dose do you take? And what dosages of the companion nutrients? And have you monitored thyroid function throughout the process?

  38. I completely forgot that I posted on this thread over a year ago. I didn’t see Bill and Paul’s responses to my comment about iodine causing acne breakouts. A very belated thanks to you both!

    Jeremy, thanks for the Vitamin C tip. I will be sure to try that. I too break out at pretty low doses of iodine (just 229 mg of potassium iodide).

    I started supplementing iodine again about 10 days ago using the salt-loading protocol Bill mentioned. Still have had some minor breakouts, but nothing like the horror in the past, so the salt seems to be helping. Hopefully the Vitamin C solves the problem completely.

  39. Oops, 229 mcg,not mg.

  40. For Thomas: if you do decide to try the Vitamin C, what seems to work best for me is to take 1 or 2 g every couple of hours throughout the day, rather than a big dose all at once.

    I should also note that I would probably still break out, even with the Vitamin C, if I tried to increase the iodine dose by more than about 100 MCG (micrograms) at a time. So remember to go VERY slowly…for people like us that react to minuscule quantities of iodine, full iodine repletion might be a long-term project that takes several years. I’ve already spent over 6 months just getting up to 600 mcg!

    Trying to go faster still gives me pretty intense reactions. But it looks like the Vitamin C might make things a bit easier from now on. And I have heard that getting up above 1 mg is sometimes the biggest challenge, and it gets easier after that.

    Good luck, and let me know how things progress!

  41. Hi Jeremy,

    I, too, developed hypothyroidism at a very early age. Unusual, especially for a male, since this is overwhelmingly a female disorder. I do seem to fit the criteria for Hashimoto’s, however.

    I also suspect bromine toxicity and iodine deficiency, which are probably closely related, could be an explanation. I tested so high in bromide on my first iodine loading test that Dr. Flechas told my doc I was lucky I didn’t have frank schizophrenic symptoms!

    After that test, I increased my Iodoral dose from 12.5 mg/day to 50 mg/day at Dr. Flechas’s suggestion. I did great for a long time. I felt better and over time found that I needed less and less supplemental thyroid hormone. I cut my dose almost in half. My endocrinologist said he had never before seen anyone actually start to get better from hypothyroidism. A follow-up loading test showed much lower bromide and better iodine saturation.

    Eventually, however, my dose requirements started to creep back up. A subsequent loading test showed even higher bromide toxicity than the first one did! I now believe the reason for my setback was that I slacked off on the Celtic salt supplementation. Not smart. Dr. Flechas thought that explained everything, including how lousy I felt. Without the extra salt I couldn’t excrete bromide fast enough and so I became toxic. I had terrible acne at that time. I believe my thyroid medication dose was increasing because I could not absorb the iodine due to competition from the bromide; and the bromide may have been compromising my thyroid function directly as well.

    Since I’ve been back on the daily 1 tsp salt religiously, I feel much better. Soon I’ll know if my thyroid hormone dose requirements are going back down, as expected. I do feel overdosed, but it’s not always possible to tell from symptoms alone. My bloodwork is monitored quarterly by my endo.

    I take the full Abraham iodine protocol: 50 mg Iodoral, 2g vitamin C, 400 mg magnesium, 200 mcg selenium, 1 tsp Celtic salt.

    Like you, I have my suspicions about how I got into this mess. I never drank Mountain Dew or other bromine-containing sodas or took brominated medications. I was, however, a huge bread consumer for many years, so brominated flour is a likely suspect. Listening to the standard medical advice, I also strictly avoided iodine, even iodized salt with its minuscule amounts. As a former long-term vegetarian, I did not eat fish, either. Maybe all those veggies contributed due to brominated pesticides. I’ll never really know.

  42. Thanks again for the tips, Jeremy. I would like to get up to a 12.5 mg dose one day. I was going to double the dose every month, but might have to reconsider and go a lot more slowly like you said if the Vitamin C doesn’t solve the problem.

    @Bill, the mention of “bread” in your last post jumped out at me. I almost mentioned in my last post that I am wondering whether my apparently excessive bromine is due to heavy consumption of wheat bread in the past. I used to eat 6-8 slices a day for years, along with a lot of wheat pasta. Who knows? (I don’t have thyroid problems, or at least not any severe ones).

  43. Bill, do you take the Celtic salt all at once? I tried dissolving 1 tsp in water once and it was almost unbearably salty, like drinking saltwater. Hard to stomach the idea of choking that down every day.

    For both Bill and Thomas:

    It is my opinion that the safest strategy is probably just to strictly avoid all (avoidable) ongoing exposure to bromine and other toxic halides, and then take a relatively conservative dose of iodine. Yes, it might take a very long time to excrete all of the stored bromine, but as long as your ongoing exposure is low, it’ll happen eventually (at least that’s my assumption…?). And if you go too fast, you might do more harm than good, because your body cannot eliminate the toxins fast enough, as all of us have experienced to some extent or another.

    I think that acne is probably an indication that the normal detoxification pathways are overwhelmed to some extent. If you continue to push a very high dose even when you’re breaking out, you will probably harm your body by mobilizing bromine much faster than it can be excreted.

    I plan to be extremely cautious when increasing the dose above 3 mg or so. This is more than sufficient to relieve any acute deficiency, and is high enough to mobilize some portion of the stored bromine (hopefully without overwhelming detoxification pathways).

    Meanwhile, I’ll keep taking my supplemental thyroid hormone, which has kept my levels relatively normal (but not ideal) for years.

  44. Thomas, I’m just guessing that maybe all that bread over many years is how I got so toxic in bromine.

    When I got my first iodine loading test results showing the extreme bromide levels, I did some research on bromine exposures. I recall concluding above all that no one really knows the relative contribution of various modes of exposure. But it did seem to me that dietary exposures were likely the most important.

    It could also be, however, that I am poor at clearing bromide, rather than that I have had unusually high exposures. I’ve discussed this with my holistic doc, and he’s not sure, either. I have tested high on some other toxins as well, including heavy metals and environmental pollutants, so who knows?

    I do suspect that the years of avoiding iodine contributed to the bromine toxicity, whatever its sources. More bad official dietary advice!

    Bread is the only story that makes sense to me right now, but really it’s a mystery. Now I’m focussed on clearing the bromine and seeing how much more progress I can make on reducing my thyroid meds and feeling better. It’s going to take quite a while, even at 50 mg Iodoral/day, apparently.

  45. Jeremy, I do take 1 tsp of Celtic salt in a big glass of water all at once! I’ve gotten used to it, but it’s not pleasant. That’s probably the reason I gradually slacked off on the practice and got myself in even more trouble.

    The people on the Yahoo iodine group all seem to feel it’s equally good to take the salt in divided doses, and I have no reason to doubt that. I just find this way simpler, and it is tolerable to me.

    It’s interesting that as far back as I can remember I’ve always had an enormous taste for salt. I’m always begging for it at restaurants, and I always use more than anyone else. Now I wonder if that desire for salt was an adaptive response to the bromide toxicity. Just a guess, but it makes some sense. I’ll have more data if or when I manage to clear the bromide. Then we’ll see if the salt craving, and associated enormous water consumption, abate.

    As for how much iodine to take, I’ve debated that myself. On the one hand, I hate taking does that are so huge compared to the accepted RDA. I doubt anyone really knows all the effects of doing that.

    On the other hand, the iodine doctors all seem to agree that these high doses are necessary to clear bromine toxicity and achieve other clinically meaningful results. They seem to feel, in general, that 25 mg may now be the normal maintenance dose due to all the ongoing halide exposure we can’t really avoid. For those of us who are toxic in halides, or facing major health challenges such as cancer, they often use far more, with seemingly good results.

    Even on 50 mg, with all the “companion nutrients” and the salt, my progress was very slow as measured by my thyroid medication requirements. My guess is that at 3 mg I wouldn’t have made much real progress at all. I can’t be sure of that, though. I did begin making progress even on 12.5 mg, and before that just by eating a lot of kelp.

    My plan, for now at least, is to continue at 50 mg and repeat the loading tests at least every six months. Once the bromide abates, I hope to be able to try a lower maintenance dose and monitor via the loading test and also via my thyroid status. I don’t know any way to reduce my halide exposure further, short of staring life over with a brand new house, furniture, etc. all made of materials proven to be free of toxic halides. And I don’t know how much difference even that would make. This computer I’m typing on now is full of brominated compounds, too!

    My detox symptoms, including the acne, are quite mild now. If they were gone entirely, I’d probably consider increasing my iodine dose to speed the bromide removal. But I do agree with you that dosing so high as to provoke serious reactions does not seem very wise. The iodine group people seem to feel the same way, and they are extremely hung ho on iodine.

    It could be that a much lower dose of iodine would, overall, be safer, if slower. I don’t know. For now, I’m going with the experience and advice of the docs most experienced with iodine, including Brownstein and Flechas. I hope they’re right!

  46. Hi,

    I’ve recently started suffering symptoms such as acne, skin rash, and stomach pain and digestive upsets. Unfortunately, as far as I understand things, there can be two possible culprits, both of which are a bit tricky to correct due to my hypothyroidism. I’m thinking of either bromine or selenium toxicity, both are plausible.

    I started supplementing with iodine 4 moths ago, building up slowly as per recommendation. 2 weeks into supplementation I had a thyroid test, TSH was 3.46, but 2 weeks later I had another test and TSH was 5.3… I was also feeling more tired and got worried that the iodine was damaging the thyroid (I have since been diagnosed with mild Hashi), so I started supplementing with 200mcg of selenomethionine daily.

    About three weeks ago I had a massive acne flare up. This has subsided somewhat, but I now have a rash on my arm (tiny red bumbs that are moderately itchy), and stomach pain and digestive upsets about two hours after eating. I have reduced my selenium supplementation to 200mcg twice a week, but haven’t seen any improvements yet.

    Does anyone have any comments on the topic of bromine/selenium toxicity? My main concern is to not damage my thyroid any further!

    Many thanks!

    p.s I’m on the PHD since 6 months back, but have perhaps not been the most exemplary follower for all of that time. I’m taking all the supplements though and am starting to get better at it since about 2 months…

    • Hi M,

      We adjusted our supplement recommendations, now we only recommend taking 225 mcg iodine per day. The risk of negative symptoms goes up with higher doses. I would advise stepping back to that.

      Best, Paul

    • Hi M (and others!),

      I would not suggest supplementing with selenium unless you know precisely how much you are getting from food. Here’s a quote from a 2006 article abstract, with the link provided:

      “…dietary intake of about 300 micro g [mcg] of selenium daily may have a toxic effect on growth hormone and insulin like growth factor-1 metabolism, as well as in the synthesis of thyroid hormones.” (

      So, take a low enough dose of selenium to ensure you get less than 300 mcg of selenium daily, including from food. Admittedly, without access to the full article, it is hard to know whether the specific types of selenium they used played a role – the selenomethionine form is probably best for supplements, but kidneys and shellfish are the best sources overall, as noted in the PHD.

      I also want to mention some of my research on beginning iodine for other readers.

      At least one study said that attempting to correct selenium deficiency before beginning on iodide to may cause hypothyroidism. The article from 2006 cited above notes, “In regions where a combined severe iodine and selenium deficiency exist, normalization of iodine supply is mandatory before initiation of selenium supplementation in order to prevent hypothyroidism.”

      Perhaps initially the onset of hypothyroidism is experienced as a temporary relief from the bromide symptoms before the thyroid gets worse again – I’m not sure.

      Another study (2010) says most randomized trials have found no impact of selenium on thyroid metabolism, which seems to indicate that its effects during the iodine protocol may be due to a different mechanism than the thyroid ( However, this 1992 article ( and 1999 article ( disagree.

      This 2005 article, similar to the first article in the paragraph above, suggests a mechanism of selenium’s affects on the thyroid that are indirect – e.g., increasing selenium may have effects that vary from person to person, based on their own health factors: “deiodinase isoenzyme expression independent from altered selenium status… might thus pretend causal relationships between systemic selenium status and altered thyroid hormone metabolism.” (

      At least organic, animal-based selenium seems to have a positive impact on thyroid function, as noted in the PHD (pp. 283-287, 2012 edition); once again, it’s hard to know what these studies used.

      My hypothesis, which I am presently beginning to test on myself, is that three things should be done prior to going on iodide:

      1) Correct nutrient deficiencies, and ideally get peak-health levels, of vitamin A, iron, and zinc to improve thyroid health. The relevance of these nutrients for the thyroid is entioned here (
      2) Avoid bromide exposure by cutting out wheat, not sleeping on bedding or carpet made with fire retardants, and other lifestyle changes doable for you;
      3) Detox from bromide (with the help of step 2) with 3-10 grams (3000 to 10,000 mg) Vitamin C (as suggested by Jeremy and others) and 1 tsp Celtic sea salt daily in 1/2 a glass of warm water, followed by 12-16 ounces of cool water, to hasten bromide flushing.

      Similar recommendations are made for low-carb flu and keto flu recovery in the first couple weeks of transitioning to such diets, but I believe that both flus are partly or entirely bromide-induced. There is similarity in symptoms, and the onset with both is after discontinuation of a product (wheat) conventionally high in bromide.

      I have been off wheat for two to three months, and I intend to follow this modified iodine protocol (see here for a fuller iodine protocol, I do not know if there are others: for bromide-flushing prior to beginning with about 25 mcg. Lugol’s (to be extra convservatives) on weekdays, while taking weekends off.

      Today is the first day of this plan after much research, so it was fortuitous that I found this article. And apologies for such a long post! The information I have found has been useful to me and I hope it will be useful for you as well.


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