Q & A

Q & A

This page as an open thread for reader questions, especially questions about personal health concerns.

I am putting this page up as a way to share knowledge — my knowledge with questioners, but also so that others with similar concerns can read the conversation, and readers with relevant knowledge can chip in with their own thoughts.

Please keep in mind that I can’t research questions in any depth, so my answers should be considered tentative, incomplete, and subject to later correction. Also, I am not a doctor, and nothing I say should be construed as a substitute for medical diagnosis and treatment. I am only sharing opinions about disease origins and general therapeutic strategies which may or may not be applicable in any given case.

To get the page started, I’ll put up a few questions from recent emails. Here is an index by disease, with clickable links:

And here are my answers.

Chronic Lymphocytic Leukemia (CLL)

Paul,

Been following your work on the PHD before the publication of the book and commented on my CLL and the usefulness of Vitamin D once on your blog and you responded to keep an eye on my Vitamin K intake, which I do now.. Am fortunate in a way to have my form of CLL as it indolent which gives me the opportunity to experiment without the pressure of undergoing conventional treatment. The PHD, I think, is helpful in this regard.

Wonder if you could point anything out to me that may be useful. Anything at all. And I will be happy to share with you my results.

Surely you know of the helpfulness of green tea with CLL. You may not be familiar with research that points out that those with low levels of Vitamin D need treatment for CLL far sooner than those with elevated levels.

Feel strongly that your version of a ketogenic diet would be helpful but also feel I need some direction in this area. Do you have any suggestions?

Warmest Regards,

A

Hi A,

I remember your comment, thanks for writing back. I’m glad you’re enjoying our diet and wish you the best.

Thanks for the tips about green tea and vitamin D. Neither one surprises me.

Most likely CLL is caused by a viral infection. So enhancing viral immunity is probably a good idea. Good strategies may include: (1) low-protein dieting, which inhibits viral reproduction and can promote autophagy; (2) maintaining high vitamin D levels; and (3) intermittent fasting, which promotes autophagy.

Some food compounds have been reported to have antiviral effects. An example is green tea catechins, eg http://pmid.us/16137775, http://pmid.us/18313149, and http://pmid.us/18363746, and this could be why green tea is helpful against cancers, http://pmid.us/21595018, which are usually viral in origin.

I might search Pubmed for herbs and spices with antiviral effects, and use them abundantly in cooking, along with antiviral foods. Turmeric / curcumin is a good choice, this needs to be taken with black pepper to enter the body. See http://pmid.us/21299124, http://pmid.us/20434445, http://pmid.us/20026048.

Coconut oil / lauric acid also has some antiviral properties, so inducing ketosis with coconut oil could benefit you even aside from the ketosis. You could also try monolaurin supplements which may enter the body better and which some people have reported to help viral infections.

You might also try HDL-raising tactics as discussed in this series: HDL and Immunity, April 12; HDL: Higher is Good, But is Highest Best?, April 14; How to Raise HDL, April 20.

Another possible tactic is high-dose riboflavin with UV exposure on the eyes. This requires going outdoors at midday and not wearing glasses or contact lenses. Riboflavin+UV is toxic to blood-borne viruses, and the retina is a location where UV can reach circulating blood cells. Sun exposure will also help you optimize vitamin D.

That’s a few ideas, at some point I’ll do some research to come up with more and do a blog post. Do keep me posted on your results!

Best, Paul

Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue

Just came upon your website and had a question for you. I have had some health concerns for the last four years, bloating, acid reflux, anxiety, depression, hypoglycemia symptoms, female complaints (I am in my forties), thyroid antibodies at 333, weight gain around my middle and too tired to work out like I once did. I used to be fikiiled with energy and great health no depression or anxiety. My doctor thinks these symtoms are all from peri-menopause and wants to treat me with Zoloft.

Needless to say I have tried to avoid the Zoloft. I have tired every avenue out there to cure myself. Most recently the Primal type diet. When I eat no grains or dairy I get horrible hypoglycemia symptoms and don’t feel great like everyone else on a low carb diet. I feel weak and more anxious. Do you think your diet would be easier for me with the addition of rice and potatoes?

G

Hi G,

Yes, I do think our diet will be better for you. You should eat enough starches to avoid hypoglycemia.

The key thing for you is treating the infections which are consuming so much glucose and making you glucose-deficient if you don’t eat enough carbs. Whatever pathogen(s) this is, it seems to have infected your gut and caused the various gut problems; circulating pathogen-derived toxins and immune cytokines are probably responsible for the anxiety and depression. Hashimoto’s hypothyroidism may be either due to circulating toxins or a thyroid infection.

I would suspect some kind of protozoal or parasitic infection due to the hypoglycemia, but what I really recommend is getting your doctor to have a stool sample analyzed for pathogens. Metametrix has a good test. Once you know what pathogen to treat, and get on a better diet like ours, you should improve quickly.

Lupus

I am writing on behalf of my mother … We live in Dhaka Bangladesh …

Before her illness, my mom was 105 lbs, 5 feet tall and always 10ft tall in spirit…. When she was diagnosed with Lupus at the age of 30, we were all overwhelmed and out of our depths. My beautiful, athletic mother was in a wheelchair and given 6 months to live….

The doctors has advised her to eat literally nothing, minimum protein (1 small piece of chicken/fish, limited to 20g protein per day), only 2-3 types of vegetable and 2-3 fruits and of course lots of carbs to apparently compensate for her failing KIDNEY and LUPUS. She is on tons of medication, no food except the wrong foods (carbs) and in chronic pain. She currently weighs 139 lbs.

Please advise. — S

Hi S,

I believe lupus is a catch-all diagnosis for a variety of conditions which are probably caused by undiagnosed infections. In the US the infections are usually bacterial. I’ve known several people with diagnosed lupus who were cured by antibiotic treatments – in one case the problem was Lyme disease (Borrelia). I have no idea what the likely pathogens would be in Bangladesh. If she does better on low carb and coconut oil, that indicates bacteria; if she does better on high-carb, that indicates protozoa.

A healthy diet is very important. It is very bad advice to “eat literally nothing,” it is essential to be well nourished. Protein is necessary for healing and immune function, and 20 g/day is too little. Fasting is good, but it should be intermittent – not starvation! She needs healthy fats, more protein, and lots of micronutrients. Eggs, shellfish, seafood, bone broth soups, vegetable soups, and fermented vegetables may all be helpful. Coconut milk is probably good for her. You should basically follow the program in our book.

I would try to put her on a good diet, give her a little time for kidneys and other tissues to heal, and then try antimicrobial medicines. Usually, if they’re not working, then you don’t notice an effect. Any strong effect, good or bad, means they are working. Bad effects mean that pathogens are dying and releasing a lot of toxins as they disintegrate. If this occurs, detox aids (salt, water, and one of cholestyramine/charcoal/bentonite clay; also glutathione supports and vitamin C) will help.

Please stay in touch and let me know how things go.

Best, Paul

Depression


Jersie wrote:

I’ve suffered from depression for decades. A few months ago, I decided to try the Dr. Kruse protocol for jumpstarting leptin sensitivity and 2 interesting things happened.

When I went very low carb – below 50 gm -. I had half-day periods where the depression suddenly lifted (something that has rarely happened otherwise). However, I also suffered from darker than normal periods.

I stopped the Dr. Kruse protocol after 6 weeks, and went back to regular paleo (approx. 200 – 300 gm. Carb/day). I’m now generally more depressed than usual, without the good periods.

These changes seem to indicate that I can have an influence on my depression with diet, but not sure what diet to try. Thoughts?

Hi Jersie,

I think your experience on very low carb is diagnostically telling.

I would interpret it this way:

  1. Your depression is caused by an interferon-gamma mediated immune response in the brain, probably caused by a viral or bacterial infection. This leads to tryptophan being directed away from serotonin and toward the kynurenine pathway. So you have a serotonin deficiency and kynurenine excess.
  2. A ketogenic diet is both therapeutic (promotes immunity against bacterial and viral infections) and mood-improving (clears kynurenine).
  3. However, you are at risk for hypoglycemia in the brain (especially if the infection is bacterial) and hypoglycemia causes irritability/anxiety and can aggravate depression.

So the very low-carb diet had mixed effects (ketosis, hypoglycemia).

What I would do is follow our ketogenic diet advice. Eat at least 50 g/day carbs from starches to get sufficient glucose, plus sufficient protein to reach 600 calories/day protein+carb, but add in large amounts of MCT oil or coconut oil. Also, do intermittent fasting – eat all the carbs within an 8-hour window; eat at least half the MCT oil in the 16-hour fasting window.

Once on a good diet, I might experiment with antibiotics to see if they relieve symptoms.

Please let me know how things go.

Leave a comment ?

9,730 Comments.

  1. Hi, Mary,

    sorry me again,

    ps. bone broth, i’m convinced that it is one of the super foods.
    i could live on it for the whole winter,
    it’s also great for skin too,

    stay healthy!

  2. Thanks for the response, Paul. Weren’t you saying here that candida feeds off cholesterol? I guess ‘benefits from’ is not the same as ‘feed’.

    http://perfecthealthdiet.com/?p=4127

    “In most cases yes, eating cholesterol [eggs] should support immunity, but Candida may be the exception, as Candida seems to benefit from cholesterol.”

    Hi Tam,

    Touche! Yes, Candida feeds on cholesterol, but so do we, so not eating any may be throwing out the baby with the bathwater. I don’t think eating eggs will be a significant factor in Candida infections.

    Best, Paul

  3. George Henderson

    I think the connection may be this; candida can thrive on many nutrients, but the presence of stomach acid and bile salts is inimical to it.
    e.g. http://www.springerlink.com/content/e674nt7412771123/
    candida cannot deconjugate bile salts, it says.
    and this
    http://informahealthcare.com/doi/abs/10.1080/02681218780000351

    Aspects of the effect of bile salts on Candida albicans

    Cholic acid, chenodeoxycholic acid, deoxycholic acid, glycocholic acid, glycodeoxycholic acid, hyodeoxycholic acid and lithocholic acid as their sodium salts, were fungistatic to the growth of Candida albicans. Of the compounds tested, cholic acid, deoxycholic acid and chenodeoxycholic acid were the most active. In combination with other antifungal agents only cholic acid exhibited synergism with amphotericin B, whilst the imidazole antifungal agents inhibited the action of the bile salts. The bile salt minimal inhibitory concentrations were close to the critical micelle concentrations. Even though the compounds are surface active they did not cause loss of intracellular K+ and were without effect on oxygen consumption. The bile salts, particularly cholic acid, produced morphological changes that gave rise to swollen cells.

    So the physiological state produced by digestion of fats and cholesterol is antifungal, whatever these do as substrates.

  4. Mmm…maybe I’ll keep the baby.

  5. Paul,

    We recently started our son on a therapeutic ketogenic diet to aid in seizure control. We want to make certain that we are providing the supplementation that he needs. He is ten years old and we chose to go with the modified Atkins (10g carbs per day) initially. I am really hoping that we can switch to a more PHD style soon, but at this point we are keeping things tight. Which supplements would you recommend in this situation? At what point do you think we can switch to a more PHD style? With additional supplementation and the addition of coconut oil–which I sneak into most of what he eats–do we need to stay below 10-15 carbs? It would be nice to offer him a safe starch occasionally.

    Thanks for any and all advice. I’ve been following your blog/book for a long time and really appreciate your work.

    Hi Lori,

    I would put him on a PHD-style ketogenic diet immediately. It is the provision of ketones which helps him, not the decrease in carbs, and it’s better for him not to be starved of carbs.

    I would have him do intermittent fasting and take MCT oil (or coconut oil or coconut milk) and a BCAA supplement – not a lot, just one spoon per day. Then at least 200 calories from starches or sugars during an 8-10 hour daily feeding window, more if he can without seizures. Experiment with increasing starches and MCT oil (or coconut oil) together and see if his seizure control is as good. You want more starch + more MCT oil at same level of seizure control.

    For nutrition, the first key is whole foods. 3 eggs a day plus 1/4 lb liver per week; bone broth soups with spinach and tomatoes and lemon juice and vinegar; collagen-rich soups.

    The need for supplements depends on the quality of the foods he is eating. A diversity of organ meats, shellfish, and vegetables reduces the need for supplements. Our recommended supplements list is a good place to start, but I would try to get some of them like copper and selenium from food – beef or lamb liver for copper, shellfish and kidneys for selenium.

    Best, Paul

  6. @ Andrea,

    IME, a comprehensive stool test proved helpful. I found a fungal infection which I treated with two bottles of ProEnt-2. I found bacterial overgrowths, which I treated with Natren probiotics. The stool test showed gluten intolerance as well, and seeing the results on paper helped me to take the leap & kiss gluten goodbye.

    I was also positive to toxoplasma, which I have not treated due to cost and efficacy of treatment. Maybe down the line?

    I had a sudden severe arthritis flare and have been on low dose pulsing Doxy for it, successfully, since 2008.

    My thyroid function has improved as I’ve gotten healthier. My guess is improving iodine status and other micronutrient status, plus knocking back infections are the major contributors.

    I’m no longer anemic.

    I used SAM-e successfully, for 2-3 years at 200-400 mg per day, upon waking to help with low mood.

    I was on a low dose of supplemental progesterone for several years to correct estrogen dominance (as seen in saliva test results), and now that I’m transitioning into menopause I’m adjusting the dose and doing more testing.

    All of this to say that I think it can be enormously helpful to have good baseline testing down, and to check your progress with more tests in combo with tracking symptoms.

    It can be frustrating to not feel much better yet you’re trying many different things.

    I can’t tell you how empowering it felt to take steps, and to slowly see my labs improve. In my case, my labs tends to improve a bit ahead of symptoms.

    Good luck to you! There are often many pieces to the puzzle! You may find it helpful, as did I, to minimize your variables, and track your protocol to the best of your ability.

  7. Thanks for the encouraging words, Michelle. It’s very possible that I am improving and just need to keep at it. It is very confusing with all the conflicting information out there! I’m really glad you’re feeling better.

  8. Thanks for your comments, Paul. About the coconut oil: I have trouble consuming the 12 Tablespoons you recommended while doing the ketogenic diet. It makes me nauseous. I ordered your MCT oil as an alternative, but I’m wondering how much to take? Thanks again,

    Andrea

    Hi Andrea,

    Sorry, 12 tbsp is too much. That was based on some early experience with Alzheimer’s but it seems that much less can work in migraines or epilepsy. I think I would try 3-4 tbsp MCT oil and see how that goes.

    Best, Paul

  9. Any tips on shingles? My brother just got it. Maybe I should get him to stop drinking beer and look into the PHD. He didn’t even report to the dr for a week.

    Hi tam,

    Just general healthy dieting and lifestyle. Looking into the PHD would be a good start.

    Best, Paul

    • I got a shingles after 6 months on Paleo/PHD-ish. It was very mild. Went to the doctor, got the medication and it went away.

      From what I read I was somewhat young be to getting it (36) but the mildness makes me hopeful that it will never come back. I like to think that my newly strengthened immune system made it freak out and come out of hiding but that’s probably complete nonsense 🙂

  10. Dr. Jaminet,

    i just had a thought.

    your work is worth spreading out to more people around the world.

    have you any plans of translating into other languages?

    or at least to multi-lingual “food plate”? this shows PHD at a glance.

    I’m tempted to make a Chinese version of your food plate for my overseas friends; (i’m not a professional so that’s about as much as i am capable)

    regards,

    pam

    Hi Pam,

    We do have plans for translations. I’ll have an announcement about that soon.

    I’ll talk to my wife about a Chinese food plate. If she’s not up for doing it herself, then I’d be happy to put yours up on our site. I think that would be great, to have the food plate in many languages. Thanks for suggesting it. Once we have a translation we can have an artist improve the looks.

    Best, Paul

  11. Paul,

    Sorry for all the recent postings, but I forgot to ask you about a very debilitating symptom I’ve had for years, and that is a chronic tension headache, not a migraine, which almost never goes away. Sometimes it’s worse and sometimes less intense, but it’s like a cap on my head, especially my forehead and temples. I’ve done everything I can think of to address it, and now I’m wondering if it could be related to my depression and anxiety as a bacterial brain infection? I also have a fungal infection, which I’m treating now with your diet and Fluconazole, so I’m wondering if that could be it? I started on most of the supplements you recommended, including the NAC. I’m also newly menopausal, to complicate matters even more, and recently had my hormones tested, which were definitely low. I’ll be starting on DHEA per my doc’s recommendation for that. I would be very grateful for any advice/thoughts you have about the headaches. Thank you!

    Hi Andrea,

    I’d suspect some kind of circulating toxins that stimulate immunity, either a food sensitivity or infection, and it looks like the fungal infection would be the most likely cause. Try taking activated charcoal or bentonite clay between meals, extra vitamin C and taurine, and foods that help excrete toxins like raw carrots.

    A brain infection is another possibility, but best to try simple remedies first and see if reducing the level of gut toxins helps things. Circulating toxins might cause depression and anxiety too.

    Best, Paul

  12. Hi Paul,
    I love this site and believe that it will help me with my eczema.

    I have a problem with the bone broths though, they make me extremely tired like I have to go to sleep immediately. Is it known for people to have a reaction to drinking bone broths? I cook them for at least 24 hours, and are organic. I sure would like to know what I could do differently so it doesn’t make me so tired to the point where I actually need to sleep. Thank you

    Hi Carrie,

    I would go to the doctor and ask to get checked for hypercalcemia or hyperparathyroidism (see http://en.wikipedia.org/wiki/Hypercalcemia and http://en.wikipedia.org/wiki/Hyperparathyroidism). Possible tests to do include serum PTH and serum calcium, possibly also vitamin D (both 25OHD and 1,25D), serum phosphate, and kidney function markers.

    I’m not saying that’s what you have, but it’s something that would explain your response to bone broth.

    Best, Paul

  13. Thanks Paul. I will try the charcoal, etc. If it is a brain infection though, how would I treat it? It’s not possible to test for it, is it?

    Hi Andrea,

    The charcoal etc is for symptomatic relief and diagnosis. If it works, you’ve localized the problem to the gut (most likely) and can get a stool test and work on gut ecology remodeling.

    You’re right, there’s no test for brain infections, so then you would optimize your diet, experiment with whether a ketogenic version helps or hurts, and then experiment with antibiotics. If you find gut pathogens with a stool test, it’s possible that that could lead to diagnosis of a brain pathogen — eg many gut parasites/worms have larvae that can migrate to the brain. But mainly, it’s experimental. I like doxycycline as an anti-bacterial antibiotic to try because it doesn’t disrupt the gut flora as much as other antibiotics, and is fairly broad-spectrum.

    Best, Paul

  14. And, Doxy is cheap. Plus, you might be lucky enough to get a rx “for acne” .

  15. Hi Paul, I had said that I get very tired when I drink bone broths and you had mentioned these tests to be taken,(below) do you think possibly it is just my body rejecting the bone broths? maybe it’s too high in glutamate? I have had seizures in the past and I have read people need to watch their glutamate levels until the gut is healed then the brain can heal,so I always make sure to do this and I feel better by doing this.I am very sensitive to many things like certain supplements and this will show up in my brain with swelling and tiredness. I am wondering now why you think that getting tired from bone broths may be an linked to an underlying medical problem? thank you once again

    I would go to the doctor and ask to get checked for hypercalcemia or hyperparathyroidism (see http://en.wikipedia.org/wiki/Hypercalcemia and http://en.wikipedia.org/wiki/Hyperparathyroidism). Possible tests to do include serum PTH and serum calcium, possibly also vitamin D (both 25OHD and 1,25D), serum phosphate, and kidney function markers.

    I’m not saying that’s what you have, but it’s something that would explain your response to bone broth.

    Hi carrie,

    Glutamic acid is another possibility. Again, I don’t know why bone broth makes you fatigued. I was just giving you an idea to check.

    Best, Paul

  16. Hi Paul

    Thanks very much for ans ring my last query. I’ve been re-reading the book and have a few more queries please:

    – is it okay to eats seeds such as pumpkin, flax, sunflower and chia?

    – I take wheatgrass or barleygrass as a health supplement, is this a problem, I realise it is the sprout rather than the grain?

    – are pesticides which are sprayed onto vegetable crops a problem? Should only organic veg be eaten?

    Many thanks again.
    Nessa

    Hi Nessa,

    Seeds, like nuts, should be a small part of the diet, not staple foods.

    I personally am not a fan of wheatgrass or barleygrass. Even the sprouts have toxins and I’m not convinced about benefits.

    If pesticides are just sprayed on, then the doses tend to be low by the time they reach home. A bigger problem may be genetically modified plants which express pesticides internally, there the doses we eat can be much larger. I think organic is better if you can afford it, it’s good to encourage natural farmers.

    Best, Paul

  17. Hi Paul,

    Thank you for your wonderful book and website.

    In 2006 there was some research about a gene for salt sensitivity at the University of Virginia. I could not find an update about the study online.

    My husband has been limiting his salt intake. Recently as an experiment, we took his blood pressure reading before and after he had some food with a very small amount of Celtic sea salt on it. A half hour later his systolic reading went up 14 points.

    Do you have any comments about salt sensitivity or salt dysregulation?

    Thank you.

    Hi Bea,

    My impression is that salt sensitivity is mainly an issue in people who are potassium deficient (ie, don’t eat enough potatoes, tomatoes, and other vegetables), or who are sodium deficient (perhaps he’s limited his salt intake too much) which leads to elevated levels of hormones (renin and aldosterone) that discourage urination in order to retain sodium; or possibly some kind of kidney issue.

    I would eat a proper amount of salt, equivalent to about 1.5 tsp a day (including the salt content of food), and get plenty of tomatoes, potatoes, bananas, and green leafy vegetables in the diet. Then repeat the test.

    Best, Paul

  18. Hi Paul,

    I stumbled upon this fascinating talk by a veterinarian who has many ideas that echo yours:

    http://dogtorj.com/what-is-food-intolerance/food-intolerance-man-and-animal-versus-gluten/

    I was wondering about some of his claims though, like that the problem with gluten and its cousins is that it sticks to the villii of the duodenum, and his ordering of casein as worse than soy or corn.

    Is that mechanism correct? Is casein really something to avoid up to that point?

    Does fermentation reduce casein content or activity?

    Would appreciate your thoughts!

    Hi Wout,

    I think casein is generally harmless in people with good gut integrity, while gluten, soy, and corn can be problematic even to people with healthy guts.

    Fermentation usually improves digestibility, as bacteria make proteases that differ from human proteases, but people with casein sensitivity may still be sensitive to yogurt or cheese.

    Best, Paul

  19. Hi Paul,

    I’ve just recently found your site and have been enjoying it. I have a health question or two to bounce off of you:

    First, a summary of my situation: I have lost weight over the last many years and am struggling to put it back on. I weigh 138 lbs, and am a 5’9″ tall 30 year old male. Before my stomach/digestive problems 5 years ago, which initially spurred the weight loss, I weighed around 155 lbs. I often have cold feet/legs, and my leg muscles fatigue easily. Depression, low energy, anxiety, etc. have been the norm for a long time. However, my eating has steadily gotten better in the last few years, but I still am having trouble gaining back my vitality and weight.

    I am wondering, how important is my caloric intake for gaining back? I just struggle to eat more than say, 2000 calories (often it’s more like 1500) in a day, for fear of indigestion, etc. But do I just have to EAT MORE and buckle down? My diet is pretty darn good, with lots of meat, some veggies, butter and recently added safe starches (maybe 300 cal. a day)

    I guess I am curious if the cold feet/legs low energy could get better if I just forced myself to eat more, hence gaining some weight and speeding up my metabolism.

    Also, strangely, out of the blue some days I feel really nice and warm. I think I am dealing with a damaged metabolism spurred by a period of poor diet, digestive issues, weight loss, not enough nourishment, etc.

    Whew, that was long winded. Any insights quite appreciated.

    Finn

    Hi Finn,

    You may have some thyroid issues causing the coldness, but it sounds like you also have some kind of gut infection which caused your weight loss and still persists.

    I would get a stool test to diagnose the gut issues, I like PCR-based DNA tests for pathogens such as this one: http://www.metametrix.com/test-menu/profiles/gastrointestinal-function/gi-effects-microbial-ecology

    I would get thyroid hormones, esp TSH, tested, and try supplementing iodine and maybe selenium depending on diet (or eat kidneys and shellfish). Start low with iodine.

    Best, Paul

  20. Do you have any clinical evidence that your diet can either prevent or reverse coronary artery disease? Can you refer me to any studies that suggests your diet might be beneficial?

    Hi Upgeya,

    Have you read our book? It presents the evidence for our diet. There have not been clinical studies specifically testing our diet, but nearly all aspects of the diet have been subjects of study.

    Best, Paul

  21. Hi Paul,

    I’m very concerned about the new guidelines the FDA will be using for testing supplements introduced after 1994, which would be treating them much like new drugs (see Mercola’s recent article). I’m wondering if any of the supplements you feel are essential for many of us, like K2, will be impacted by these new procedures, and what you think we can expect with availability if enough consumers don’t cry foul. I’m afraid cost will put many out of reach for those of us on fixed incomes.

    Thanks,
    Deann

    Hi Deann,

    I don’t know much about it but I would expect there to be a similar uproar to last time if it seriously impacts price or availability of supplements.

    Best, Paul

  22. Hello again Paul!
    I ordered my Metametrix test kit as you recommended a few weeks ago for parasites/worms. Since then I found out that I do in fact have SIBO (lactulose breath test). As I just found this out, I was not encouraged by the high reoccurance rates after patients being treated with antibiotics. It is rather distressing!

    Do you have any insights into SIBO treatment or suggestions for me?

    I have heard that the GAPS/SCD diet may work well after antibiotics to deter regrowth of the bacteria, but I am loathe to give up all forms of potatoes and tea (and am already and have been primal for over a year). It doesnt seem all that plausible (to me) that a potato/tea would be that harmful.

    Thank you again for your thoughts and kindness in answering my, and others, questions!

    Hi Jennifer,

    For SIBO I wouldn’t give up potatoes – they feed colonic infections, not small bowel infections – but if something shows up on the Metametrix test it might be worth reconsidering. SCD/GAPS are mostly designed for IBS which is in the colon.

    It’s hard to get rid of the infections with antibiotics, but the antibiotics can beat them back and give you a chance. Just eat good foods, support immune function with good nourishment, gut barrier integrity with bone+joint broths and vitamin C, and eat some fermented foods and drinks to see if you can displace the bad guys.

    Also, pay special attention to oral hygiene. You are constantly swallowing mouth microbes and often the same pathogens infecting the small intestine are infecting the mouth.

    Finally, supporting stomach acid production with salt consumption and possibly bitter herbs or treatments for H pylori or even betaine hydrochloride supplementation at meals may help.

    Best, Paul

  23. Paul,

    I tried your suggestion for taking charcoal to help diagnose whether my constant headache is due to a gut or a brain infection and noticed my headache lessened slightly. However, my chronic anxiety and depression lead me to believe that my brain is definitely being affected by toxins, either from the diagnosed SIBO or the Candida, which I am in the process of treating with your diet and fluconazole.

    For 5 days I took Bactrim at my doc’s suggestion for the bacteria, but got horribly nauseous and flu-like symptoms. It got so bad that I couldn’t function and went off the medicine. My doc said she thought it was all from the die-off reaction, but I think I was also allergic. I’d like to try another antibiotic, but I’m worried about stressing out my liver. How much time do you think I should wait before trying another?

    Also, are neck/shoulder tension and teeth grinding possible symptoms of a bacterial infection? Thanks so much, Paul.

    Hi Andrea,

    I had an allergy to Bactrim but it gave me hives. I think that’s a more typical allergy symptom. I think it’s a fine idea to try another antibiotic, you do want to go slowly so that you don’t get a huge dose of die-off toxins. You can try the Bactrim again later. I think which antibiotic, and the dose, are something your doctor should advise you on.

    Yes, I do believe TMJ/teeth grinding may be due to bacterial infections. I had that also. I got a night guard which helped protect my teeth. Then, after I had done antibiotics, I tried stopping it and noticed I didn’t have TMJ syndrome any more. I’m assuming it was the antibiotics that fixed it, could have been diet also.

    It takes time to get rid of chronic infections, you just have to work your way forward gradually. Best,

    Paul

  24. George Henderson

    It may be relevant that Bactrim contains a glutathione-depleting drug. Even so, I quite like Bactrim after reacting to other antibiotics.
    I would consider whether bruxism relates to low magnesium.

    Hi George,

    Yes, magnesium would be an alternative explanation for the cure of my TMJ syndrome. I started supplementing magnesium maybe a year before trying antibiotics, but I don’t believe I ever experimented with taking out the Night Guard until after the antibiotics.

    Best, Paul

  25. Hi, Paul and Shou-Ching,

    I apologize if you’ve answered questions like mine a million times, but wanted to get an idea of which PHD protocol to begin with (regular/ketogenic/?).

    I just finished your book (awesome) and purchased supplements (multimineral, D3, K2, magnesium, selenium, zinc/copper duo–I’m not eating liver at this time, iodine, and chromium. I also had BCAAs and the gelatin in the house, though not sure how to incorporate those items…

    I have been diagnosed with hypothyroidism due to some unknown (non-tumor) pituitary disorder. I have been on thyroid and sex hormone replacement for about a year now and am still quite hypo (Free T3 and Free T4 barely on the map). Since going on medications, my weight continues to rise and rise. I am ravenous all the time and my most recent labs (a 2-hour oral glucose tolerance test and insulin test) revealed I’m not diabetic, but hypoglycemic, it seems). Actually, the doc is punting me to another as he is unsure what my condition is. I refused the Metformin he just offered me today–would like another opinion about that one, for sure.

    Anyhow, I have been eating Primal/Paleo for over a year now, but didn’t really include any starches as I wanted to keep my carbs low. I purchased a glucometer after reading your book, checked my 1 and 2 hour post prandial readings after having only about 1/3 of a yam. While not crazy-high, after one hour my BG was 149 (and 87 after two hours). Is this too much of a spike to include yams in your estimation? Should I be eating starches at each meal or at all for my “conditions?” I was a bit shocked to see my BG rise over 50 points for such a small amount of starch…

    (As an aside–I have always counted my veggie carbs because I can pack away lots of brussel sprouts, kale, etc. I think it’s great that the only carb calories you count are from starches and fruit, though I hope I still don’t “over-do” it!)

    Thanks for your time and if you have any recommendations as to where to begin, I would greatly appreciate them. Have a great day!

    Hi Laura,

    You definitely want to include some carbs, especially as you are hypoglycemic on VLC. I don’t know why the doctor suggested Metformin.

    I think you should be eating yams with butter and vinegar. See this post: http://perfecthealthdiet.com/?p=4937. And eat more carbs.

    It might not be bad to get some coconut milk/oil too for ketones. That might help stabilize glucose-consuming tissues in the face of fluctuations in blood glucose.

    Best of luck finding the cause of your central hypothyroidism. Hopefully a better diet will help the doctors sort it out.

    Best, Paul

  26. Thanks for your response, Paul! Greatly appreciated. Yeah, I’m not sure why the Metformin was recommended either, except that my test revealed my insulin was normal/low with fasting, then shot way, WAY up and then plummeted my blood sugar way, WAY down. Will see another doc to get another opinion.

    I eat a lot of coconut oil (and probably WAY too much coconut cream, a-hem!) daily. I suppose I eat 3-5 TBSP/day–maybe more. I eat it all throughout the day, actually. I hope that’s fine.

    Okay, if you don’t see a problem with the over 140 BG reading with the inclusion of the yams, then I will continue to eat them as my starch (I eat a cup or so of blueberries daily, too). Good deal!

    You are VERY generous with your time and prompt with your responses. Thank you so much for that.

  27. Hi Paul:
    Hope your doing fine.
    Paul, you might recall, that I wrote to you in the past in the anti-cancer diet section, that I had a MGUS score that was a little high last year. When I came across your book, and blog, I discarded all bread, and wheat products, as well as grain products. I was so pleased last month Paul, that the oncologist told me that my IGM level came down, which was great. It is still a little high, however, not as high as before. So with this good news, I went away for a week down south.

    I met someone, and incredulous of me, had unprotected sex. Ten days later, I started experiencing burning, and pain while urinating. Just three days ago, both my eyes became very red, and was diagnosed with conjunctivitis. The eye doctor told me that I also may have Reiter’s syndrome (also Reiter’s disease)
    which is a medical condition typically affecting men, characterized by arthritis, conjunctivitis, and urethritis, and also caused by an unknown pathogen, possibly chlamydia.

    Paul, I guess, my concern is that with these complications, sexually transmitted diseases, and or urethritis, could the paleo diet at least help with dealing with these problems? I would like to continue the p.h.diet, and have been reading that cranberry juice also helps with infections. Paul what is your take on colloidal silver as well, in terms of aiding someone with these infections? Any help, or suggestions would be appreciated.
    Thanks Paul!

  28. Hello Paul,

    I was wondering whether it was common to feel a little dizzy/sleepy following a starchy carbohydrate meal at times? I am starting to introduce carbohydrate in the form of sweet potatos and white rice following a strict ketogenic diet and periodically feel quite sleepy despite mixing the carbs with fat and protein.

    Thank you,

    Jason.

  29. Paul,

    Lately I’ve been noticing that I get flaking between the eyebrows and on my head (seborrheic dermatitis) in response to food. Some foods seem to immediately cause it (like certain nuts, coconut oil and butter surprisingly) and also correlate with bad cognitive function (forgetfulness while other foods like cashews lead to virtually no flaking (at least around the eyebrows) and also associated with better overall well being (energy, mental clarity etc). Could this be related to a leaky gut/food sensitivities and how would one go about testing for and treating this inconvenience?

    Thank you greatly Paul.

  30. Good afternoon Paul

    I have read you book and the blog and have been taking a number of the supplements for several months. I am dealing with autoimmune issues (PMR)for which I take a number of medications including prednisolone, severe osteoarthritis in both knees, and am 3 years post breast cancer having had all the chemo and radio therapy and am now on aromatase inhibitor therapy. I am over 60 and obese – medications and pain related reduced activity and diet. I have been on paleo / PHD diet for sometime and it does reduce the pain somewhat.

    I have to get my knees replaced to get moving. My question is – can I continue to take K2 when I am approaching major surgery – what sort of anticoagulant effect does it have. I really can’t find an answer. Also omega 3s should be cut our pre-surgery apparently (I recently began supplementation in the wild hope it would reduce inflammation).

    Is it likely I will lose weight while on the medications I am on? It is discouraging but when I try to reduce the prednisone I flare badly.

    Any thoughts appreciated thanks Paul

  31. Hi Paul.
    About 3 years ago I had some wisdom teeth out and took antibiotics. Shortly after that I started having digestive issues. My main symptoms are excessive belching, gas, and loose stools.
    I have tried a number of plans the last few years and really feel like I am getting no where. I have done the strict candida diet / anti-fungals / anti-microbials… and really haven’t seen much change.
    My last couple genova CDSA tests have shown No Growth Lactobacillus species, which I think is my main problem.

    Here are the results from my last test:
    Lactobacillus species NG
    Escherichia coil 4+
    Bifidobacterium 4+

    gamma haemolytic Streptococcus 1+
    Klebsiella pneumoniae 4+

    mycology NG

    Lactobacillus has showed no growth on the last couple tests and Klebsiella has been rising. I had been on VSL3 (up to 2 packets per day) and still saw no growth.

    Loose stools have been a frustrating problem. The only thing that seemed to help this was switching from brown to white rice and minimizing fiber in my diet (your book helped me move to white rice.. thanks!)
    However, generally only the first portion of my stool is formed and then it turns loose.

    After having terrible evening gas the last few weeks (with some mucus) I went back to my integrative Dr who suggested I switch my probotic to Prescript-Assist Pro (2 per day) and add CM Core (Berberine and Grape seed extract – 2 pills 3X day). A couple days after I started taking these I came down with a bad cold and slight fever. Not sure if it was die off or I just happened to catch a cold at that time.
    I stopped these supplements and am now taking homemade cultured veggies and store bought kefir. I am going to start making homemade kefir soon. I am concerned that the berberine supplement will kill good bacteria along with the bad and I have read that soil based probotic’s could potentially be dangerous –> http://www.listen2yourgut.com/blog/bacterial-soil-organisms-hsos-sos-sbos-etc/

    Apologies for the long message wanted to get your thoughts.
    Will homemade cultured veggies and kefir (at high doses) be enough to get my good bacteria growing again and push out the bad stuff?
    Any thoughts on oat/rice bran… read that they will help get good bacteria growing again.
    Are soil based probotics dangerous ?
    Is my daily evening gas caused by the klebsiella overgrowth? Seems to happen regardless of what I eat.

    Thanks for your time and this great website.
    Mike

  32. Hello,
    I just have a quick question regarding alkalinizing the body. I understand the importance of having a slightly alkaline pH versus an acidic pH. Since you are not a huge proponent of green drinks, wheatgrass, or using a large amount of veggies for alkalinizing, due to their potential toxins, how do you recommend bringing the body to a slightly alkaline pH? Also, do you recommend testing the pH of your urine or saliva? Thank you so much for your time!

    Hi Katie,

    1. Eat more plant foods than animal foods by weight – 2-3 x as much. 2. Include some lemon juice (or lime juice, or other citric acid source) regularly in your meals. 3. Get adequate minerals to serve as electrolytes and buffering agents, including potassium, sodium, magnesium, calcium.

    That’s enough. No, I don’t recommend testing the pH of urine or saliva.

    Best, Paul

  33. Mike,

    My son had NG Lactobacillus accompanied with chronic loose stools as well. We did the GAPS diet for him and it worked. I’ve added safe starches to his diet and he’s doing great now.

    Just wanted to share in case it could help!
    Nicole

  34. Can’t seem to get to the recipe thread, and am in a hurry. Don’t know why I easily get that thread sometimes and not at others. Anyway, tried this recipe for Scalloped potatoes and it is wonderful. Never quite certain if white potatoes are PHD okay. The book stresses sweet potatoes.

    Ingredients
    1 1/2 cups heavy cream
    1 sprig fresh thyme
    2 garlic cloves, chopped
    1/2 teaspoon ground nutmeg
    Butter
    2 pounds russet potatoes, peeled and cut into 1/8-inch thick slices
    Salt and freshly ground black pepper
    1/2 cup grated Parmesan, plus more for broiling

    Directions

    Preheat the oven to 375 degrees F.

    In a saucepan, heat up the cream with a sprig of thyme, chopped garlic and nutmeg.

    While cream is heating up, butter a casserole dish. Place a layer of potato in an overlapping pattern and season with salt and pepper. Remove cream from heat, then pour a little over the potatoes. Top with some grated Parmesan. Make 2 more layers. Bake, uncovered, for 45 minutes. Sprinkle some more Parmesan and broil until cheese browns, about 5 minutes.

    Also, have found a nice snack for taking on biking outings — Hail Merry Coconut Macaroons. Anyone have a recipe that would produce a similar product?

  35. Pam,
    We love Hail Merry Macaroons too! I found this recipe, but haven’t tried them yet: http://www.dandelionsonthewall.com/2012/03/gluten-free-raw-vegan-chocolate.html
    I am hoping to give it a shot this coming weekend.
    Nicole

  36. Hi Paul. We just got back from a wonderful pilgrimage to the Holy Land. I was struck down by a horrendous allergic reaction to dust blowing everywhere, and pollen from all the blooms and blossoming olive trees. This was quite severe and debilitating – it segued into a full blown attach of sinus infection, which luckily was treated on the spot with antibiotics supplied by a doctor also on our trip. It is taking me a long time to get over this.

    My question is this: I considered myself quite a healthy person and could not remember the last time I even had a cold. Do you think it unusual for a seemingly healthy person to be so effected by pollen? Why does this happen? Does the body perceive pollen as an alien to be repelled? Does this suggest an impaired immune system? As for the sinus infection, this was such a surprise. Could it have been caused by the allergic reaction? I’m worried about this because I’m afraid it might be a sign that I’m not very healthy after all.

    Any thoughts on why some are so allergic to things and others don’t seem to be effected at all. I never had allergies until I was in my 40’s. As for the sinus infection – does this mean my immune system is compromised? What should I do to strength this – other than eat well, I mean. Thanks.

    Hi Barbara,

    People often get allergies when they move to a new place. The body is sensitive to unfamiliar allergens. It’s possible you were in the Holy Land when a great many allergens were around.

    Sensitivity could indicate either good health or some problem. For instance, low vitamin D levels after a long winter can predispose people for allergies. On the other hand, young people with healthy immune systems tend to be more sensitive. Young people were especially likely to die in the 1918 flu epidemic because their immune system more easily over-reacted.

    LDL particles promote antibody formation so high LDL could be another possible cause of sensitivity.

    Immune responses are complex; the immune system has to react different ways to different pathogens. Allergens provoke a specific immune response, and make you vulnerable to infections which need a different type of response.

    I wouldn’t assume there is a problem. If this is just a one-time thing then I wouldn’t worry about it.

    Best, Paul

  37. Hi Paul and everyone,

    Regarding the LDL-C issue which I have so often discussed here, it seems that no amount of micronutrient supplementation or diet optimization of any sort has had an effect. The only thing which has a very measurable and obvious effect is saturated fat consumption, in particular coconut and dairy fat. If I have significant amounts of either or both coconut oil and dairy fat, I tend to have very high total cholesterol (360+) and high HDL (80+) coupled with an LDL of 250-ish. Once I reduced coconut oil and dairy fat consumption to a reasonable level by replacing some of it with MUFAs like Olive Oil, the levels went down at one point to TC: 280, HDL: 81, LDL: 155.

    Not realizing whether the optimization of my diet via supplementation was responsible or the reduction in SFA consumption, I gradually increased dairy fat and coconut oil intake again at the expense of Olive Oil and some other MUFA sources. The TC and LDL went up again to the same levels (380+, 250-ish), with HDL staying pretty much the same. It seems that beyond a certain level of consumption, these fats tend to reliably increase LDL only while HDL maxes out at 80-ish. The result is that my TC/HDL ratio worsens.

    I tried reducing intake of coconut oil slightly by replacing it with Olive Oil for cooking and again my new levels indicate an improvement:
    TC of 315, HDL of 82, LDL of 195. I’m planning on reducing total SFA consumption slightly more now to get back to a TC of <300 while maintaining an HDL of 80+ so that my TC/HDL ratio is as low as possible. If I decrease the SFA consumption too much, my HDL tends to tank (went to 60-ish) with no further improvement in LDL and hence the TC/HDL ratio actually worsens.

    Maybe there is some truth to the CW that SFAs increase LDL, at least for a subset of the population. I should point out that cholesterol consumption itself has never affected my levels. I routinely have 3 eggs a day and changing this didn't change anything. Is there a possibility that this sensitivity to saturated fat could be indicative of FH? Or is this just how a subset of people react to SFAs contained in dairy and coconut? Similar experiences of other people could shed some light on this.

    Regards,
    Jarri

  38. Hi Jarri

    This is very interesting and helps me to understand my situation. I too have high cholesterol… it’s familial. I am otherwise fit and healthy and am never sure to what extent I should worry about my cholesterol reading. I have not observed matters as closely as you have but one thing is for sure I cannot tolerate much coconut oil. I like it and have tried it many times but it makes me feel nauseous. I have stopped eating it and use only olive oil and ghee. I do eat butter and cream but might be better off sticking to olive oil and ghee. I am currently trying no-flush niacin to see if I can improve my cholesterol reading.

    Thanks for your comment
    Lindsay

  39. Hi Paul…you mentioned previously that you had TMJ, which mysteriously disappeared after a course of antibiotics. Why were you taking them, and which ones?

    David

    Hi David,

    Doxycycline mainly. Experiments with others, but I was on doxycycline for 3 months.

    I had evidence of a systemic, primarily neurological, bacterial infection, and that cleared on the doxycycline.

    I don’t know that the TMJ cleared during antibiotics. I was wearing a NightGuard so I wouldn’t have noticed if it cleared while wearing it. I started wearing that a year before starting antibiotics and tried taking it out a year after antibiotics and found I didn’t need it any more. I had had TMJ/clenching/grinding for about 10 years before getting the NightGuard.

    Best, Paul

  40. Grettings from Liverpool UK! I recently bought your book and converted from paleo (one year) to using your safe starches and more fat which works much better for me – i’m 28, athletic build and live a very active lifestyle so super low carb made me look like i was literally starving – gaunt and not good. I have some colour back in my cheeks now and much more energy! My only problem is with increasing my fat consumption – too much fat makes me feel seriously ill starting with nausea and followed by an extreme need to go to sleep (uncontrollable yawning etc). I used to think it was a lactose/casein intolerance from cheeses/creams but the same thing happens with olive oil and coconut milk. Never happens with meats but i do often get some slight digestion rumbling after eating them. I seem to remember this being a problem through childhood too… Do i need to perservere and increase gradually or could it be an underlying health issue ie gall bladder?

    Thanks

    Hi Billy,

    It’s probably either a digestive problem or a leaky gut and fats are carrying toxins from gut bacteria into the body. I would experiment to try to see what relieves the problem.

    The first thing I’d do is try to improve bile flow by supplementing vitamin C and taurine. Vitamin C you can test what your point of bowel tolerance is – take 1 g per hour until you start to feel queasy. If you never feel queasy then take 10 g/day spread over the day. You could also experiment with ox bile supplements taken with fatty meals. See if that helps.

    The other possibility is toxin load and you can experiment with taking bentonite clay and/or activated charcoal to help clear fat soluble toxins and prevent them re-circulating with the bile.

    Let me know if either of those steps reduces your symptoms.

    Best, Paul

  41. Hi Paul,
    My husband is texting from the Dr.’s office with ‘high cholesterol’ readings. Cholesterol is 6.6 mmol/L, LDL 4.61, HDL 1.65, cholesterol/HDL ratio4.0 and lipid target value of 0.74. They want him on drugs ‘immediately’ which I am dead against. While it’s been a few months since I read your book I would say we follow it 80% ish. We don’t eat as much salmon or organ meats as you suggest mostly organic beef, lamb and chicken, lots of eggs/yolks, and maybe a little more dairy-(but only of the high fat variety- a little cream a little cheese and butter everyday I’d say). We began a much higher fat diet last fall, did away with grains, legumes, we have next to no sugar anymore and we’ve never eaten vegetable oils (except olive on our salads). I understand that cholesterol levels WILL increase eating this way, but my husbands family is really freaked out about it bc their father had a massive stroke years ago that they were told was caused by ‘high cholesterol’. It was devastating for their family and my husband gets incredible anxiety around his health now. Could I trouble you for your opinion on his report? Reassurance from you, if you feel it appropriate would be wonderful, or if there is indeed something to be concerned about it I’d much prefer to follow your advice on this one! He is booking into a specialty clinic Monday with hopes of getting more detail on the LDL reading. My understanding is that the LDL levels can be high as long as its not the dense type. Thank you and your wife so very much for your time and for your wonderful book.
    Tami

    Hi Tami,

    He certainly should not take drugs. First of all, his numbers aren’t even that high – they’re on the high end of the normal range, or what used to be considered the normal range. The range of minimum mortality for total cholesterol is 5.2 to 6.7 mmol/l, and he’s within that range. HDL is great, LDL a bit high. So all he needs is a few minor dietary and nutritional tweaks to bring his LDL down – possibly some thyroid hormone if he is hypothyroid.

    You and he should read all the posts in our cholesterol category: http://perfecthealthdiet.com/?cat=140.

    It’s natural to feel anxious when doctors scare you but remember the cholesterol itself has immune and healing functions, it does as much good as bad, so the key is to get to the bottom of any dietary defect that is causing high cholesterol and fix that. The usual causes are: (1) too low carb, (2) familial hypercholesterolemia or other pathologies generating intolerance to high intake of saturated fat, (3) deficiency of antioxidant minerals such as zinc and copper, (4) hypothyroidism.

    I would try raising carb intake and reducing fat intake a bit if he’s low-carb — try counting calories for a few days and see what his carb intake is, it might be too low. And ask the doctor to test his thyroid hormone levels, TSH especially, and look for any symptoms of hypothyroidism. You can use google to find a list of symptoms. But the first thing to look at is the carb intake.

    Best, Paul

  42. Hi Paul,

    My wife (type 1 diabetic) and I have been following PHD for two months now and are finding it delicious. But I have several issues that might warrant tweaking the diet/testing.

    A brief synopsis: A few years ago I had botched inguinal hernia surgeries, which caused significant nerve damage and have led to chronic pain, depression, insomnia, loss of libido, and at least a doubling of bodyfat percentage from 8%. Also related to surgery (Lasik), and following a bout of conjunctivitis, I’ve developed chronically painful dry eyes severe enough to keep up me at night; extended courses of steroid and antibiotic eye drops haven’t helped. (To my suggestion of trying antifungal eye drops, my ophthalmologist insisted that fungal eye infections are necessarily acute.) Along with dry eyes, I have other more minor recurrent symptoms that might indicate fungal infection: dandruff, jock itch, and white patches on my tongue.

    My recent lipid panel might also indicate infection: Cholesterol 307, Triglycerides 83, HDL 83, and LDL 208. Unfortunately I have no prior data save for recalling a total cholesterol of around 200 several years ago. I also tested as D deficient at 28ng/mL. My thyroid is at 1.7, up from 1.3 six months ago, surprising because I’ve been taking 1mg of iodine since beginning PHD.

    As for your diet, I’ve been close to fully compliant, eating approximately 70g of protein, 100g of carbs, lots of healthy fat, taking all recommended vitamins save for D (I thought my sunny climate would do the trick), and intermittent fasting. I’ve fallen short on omega-3s, eating half the salmon prescribed, and haven’t eaten liver (but am likely copper sufficient with 2mg in my multivitamin). I’ve also been eating yogurt but not fermented veggies.

    Finally to my questions: Would a stool profile test make sense to diagnose fungal infection given the absence of GI symptoms? I suspect that a positive test might help me persuade a doctor to prescribe antifungals should they be appropriate. As for diet, aside from supplementing D and increasing cold-water fish, is there anything else I can do to address the high LDL?

    Shawn

    Hi Shawn,

    I think a stool test is a great idea, given your depression, insomnia, abdominal fat, and loss of libido could all reflect a gut infection.

    Be careful not to go too low carb, fungal infections and dry eyes can be a result of carb deficiency. Also, vitamin C deficiency might be involved, so I would try taking vitamin C to something close to bowel tolerance for a month or so and see if that helps.

    I’ve just replied to a few people about high LDL, check my responses to them and the posts in the LDL / Biomarkers category.

    Best, Paul

    • Hi Paul,

      So glad you mentioned C. I’ve tried titrating up to bowel tolerance with powder, a far tougher task than I’d imagined. Day one was Cathcart protocol, 4g per hour for a total in the mid-sixties, which I repeated on day two. Yesterday I took 110 grams (in 11 doses) and I’m not sure my bowel noticed. Should I keep pushing the dose?

      (These high doses sure are correlated w/some nasty infections, glad I have the metametrix test en route.)

      • Hi Shawn,

        I’d just stick near 100 g/day until your bowel notices. Looks like you really, really needed the C. You might try supplementing related antioxidants in moderation such as NAC, glutathione, and mixed tocotrienols.

        • Will do Paul, thank you. And as for needing C, while my bowel hasn’t noticed, my appetite does seem to have diminished in a good way–I haven’t for example, been hungry at all during the intermittent fasting.

        • Hi Paul, just got back my Metametrix stool test and results are unremarkable. I’d expected fungus given the dry eyes and other issues. I’m still tolerating high doses of C and have also begun moderate antioxidant supplementation.

          My tentative plan is to begin maybe a two-week course of antifungal treatment, probably to include pharmaceuticals, and continue treating if I get relief. Does that sound reasonable? Any other suggestions test-related or otherwise?

          • Hi Paul, upon second look the stool findings do seem to indicate cause for concern, albeit not what I’d been expecting. Mycoplasma for example is above 90% reference range and Prevotella above 80%. Bifidobacter probably low at 40%.

            Obligate anaerobes
            Bacteroides sp. 3.6
            Clostridia sp. 4.3
            Prevotella sp. 5.8
            Fusobacteria sp. 4.6
            Streptomyces sp. 4.7
            Mycoplasma sp. 6.4

            Facultative anaerobes
            Lactobacillus sp. 5.0
            Bifidobacter sp. 3.2
            Obligate aerobes
            Escherichia coli (E. coli) 3.8

            Opportunistic Bacteria
            No clinically significant amounts.

            Pathogenic Bacteria
            Helicobacter pylori <0.01 <=1.0E+005
            E. coli 0157:H7 <0.01 <=1.0E+005
            Clostridium difficile <0.01 <=1.0E+005
            Campylobacter sp. <0.01 <=1.0E+005

            Yeast/Fungi
            No clinically significant amounts.

            Parasites
            No Ova or Parasites

            Adiposity Index
            Firmicutes 62 ® = 20

  43. Thank you Paul – sorry i made a mistake – the 0.74 was his TRIGLYCERIDES, not lipid target value – which is a great # from what I understand. I feel good about his HDL and triglycerides and we will work with the LDL as you suggested. I just read an interesting thing that often LDL is often estimated rather than measured ($) based on a calculation with HDL, TC, Triglycerides – ‘the Friedewald equation’-apparently if your triglycerides are really low as my husbands are, the LDL readings can be grossly overestimated. I will check with the lab to see if this was a calculated or measured #. Thyroid is a good idea to check – he has been complaining of feeling a little ‘fatigue’. We are also pretty low carb now that I really think about it. Maybe 1/2-1 cup rice or equivalent safe starch/day. I will up it for him. Thank you for the link to your HDL/LDL/Cholesterol category – I knew I had read information ono it here before and looked for it on your right menu but couldn’t find anything – I just rechecked and see it under biomarkers now. Again, thank you so very much. Your generosity is an inspiration.

  44. Paul,

    My apologies, but is there a way to remove my comment or otherwise edit out my last name from my post? That’s far more personal health information than I’d like to have on the web.

    Hi Shawn,

    I’ve edited out the last name.

  45. interesting, the report actually says calculated beside the LDL #…

    Hi Tami,

    Yes, the calculated number is higher than the real one. Real LDL is probably still a bit higher than optimal, but he shouldn’t be stressed about it. Just increase carbs, address any hypothyroid issues, don’t be zinc/copper/selenium/iodine deficient, and he should be fine.

    Best, Paul

  46. Awesome Paul, thanks for the speedy response and edit.

  47. Paul, when I calculate my husband’s LDL with the equation I mentioned above I get the 4.61 which the lab reported-in the ‘high’ category – when I use the ‘Iranian’ formula which would be more appropriate for his triglyceride level he drops a whole category to 3.98 – now ‘borderline’. It’s frustrating that his doctor immediately went to drugs without considering his whole profile and without having an ACTUAL test of LDL first. I think you alluded to the fact that on top of it all the ranges have been lowered so more people ‘qualify’ to be put on drugs. This was a great point you made – I am going to search for the ‘old’ ‘normal’ LDL range too. Glad to be able to further reassure my husband!! 😉

  48. How to open pictures on the recommended supplement page?

  49. I have a question about juicing. I tried to find something in the other posts, but nothing came up I could find. I have found that I like juicing vegetables more than eating them whole. I know that anything in mass quantity can become toxic. So, what are your thoughts on vegetable juicing? What time of day? What are the best vegetables? Proper amount I can do in a day before its toxic?

    Thanks,
    Brash

  50. Shelley Wilson

    Hi Paul,
    How would you recommend eating when you actually have a cold? Stick to the diet as usual with 16 hour fasts? Increase any supplements?

    Cheers, Shelley

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