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. Paul,

    Forgive me if you’ve addressed this elsewhere, but am I right that your views on iodine have shifted somewhat since the early days of the blog?

    My sense is that you used to believe that high supplemental doses — 12.5mg, 25mg, 50mg per day — were fine provided that one worked up gradually and made sure to include key companion nutrients. In other words, you seemed more or less to agree with the “iodine docs”: Abraham, Brownstein, Derry, Flechas, et al.

    Now, however, my sense is that you are wary of doses over 1mg per day.

    If this is true, I am very interested to know what has been behind the shift. First-hand contact with people harmed by high-dose iodine?

    (I ask because I have been working up ultra-slowly for many months now and am now at 12.5mg. I was intending to go all the way up to 50mg, since this is the “magic” dose of the iodine docs.

    So far I can’t really say whether it is helping, hurting, or doing nothing at all. Upon increasing I have sometimes felt strange symptoms — mainly feeling a little too wired — but of course the iodine camp would claim that this is a positive detox response.)

    Thanks for your time.

    • I’m ambivalent about high-dose iodine. I now think it’s easier to screw up selenium status than I did before, because levels of selenium in foods (ie beef) are so variable depending on source. Beef from the Dakotas and Nebraska are very high in selenium, for instance. If selenium intake is wrong, then both high and low intakes of iodine can lead to trouble.

      So I’m more inclined to recommend 1 mg for most people, as that is the least likely to cause trouble, and preserve high doses like 12 to 50 mg as a therapeutic strategy in certain conditions.

      • Any idea as to a good supplement to use? Just one drop of Lugol’s 2% is about 2.5 mg I believe, so that would be well over the limit. I guess Kelp tablets would be an option, but I’ve seen concerns about heavy metals in those.

    • timely question MM, i have been wondering the same thing recently.
      After nearly 18months of gradually increasing iodine supplementation, i am now taking 50mg every other day.
      I have no ill effects that i am aware of.
      I also take lef 200 mcg selenium every other day (plus a few other phd recommended supps).

      • I went to the supplement recommendations page, but am not seeing any reference to the NOW tablets (or any other products for that matter). I used the “Supplement Recs” link at the top of the page. Is that the right link?

        • Hi Frank,

          Yes, it is. Scroll down to “Iodine” and look at the left-most product – that has 225 mcg per tablet.

          If you’re not seeing anything, try turning off Adblocker software.

          Best, Paul

  2. Hi Paul. I’m on about day 4 of the PHD from being Primal for about a year. Mainly I added white rice and sweet potatoes/white potatoes and heavy cream. All added foods are organic. Started out great doing 30/15/55 the first couple of days. Then, I noticed I was eating over the percentage for carbs but under the calories. Also, I was hitting a slightly higher amt of protein and my total calories are always under.

    Should I try to balance each meal by the percentages or do the whole day? I have lots of carbs at breakfast and some protein and then it seems I eat less and less all day to try and juggle the remainder of what I should eat. Fats seem to be fine. Any suggestions?

    Thanks.

    Jan

    • Well, the optimal diet satisfies you at the lowest calorie intake, so if you’re fine with fewer calories than I think you should eat fewer calories.

      It’s OK to eat a somewhat higher fraction of carbs too, especially for women eating fewer total calories. I usually quote a quantity, ~600 calories, rather than a percentage.

      I would advise listening to your body and eating so as to satisfy yourself most efficiently. That will typically be around the PHD macronutrient ratios, but there may be individual variations.

  3. “I’m ambivalent about high-dose iodine. I now think it’s easier to screw up selenium status than I did before, because levels of selenium in foods (ie beef) are so variable depending on source. Beef from the Dakotas and Nebraska are very high in selenium, for instance. If selenium intake is wrong, then both high and low intakes of iodine can lead to trouble.”

    Paul, I’m curious how you think your view squares with the experience of all the docs using Dr. Guy Abraham’s iodine protocol, which as you know includes iodine doses frequently ? 50mg/day (with no gradual ramp up), plus selenium and other “companion nutrients.”

    With thousands of patients carefully followed for years now by multiple doctors, extremely few problems have been seen.

    A very small percentage of people can’t tolerate the iodine, primarily if they have functioning autonomous thyroid nodules. Others (like me) suffer from bromine detox effects, which are manageable with salt supplementation and possibly temporary iodine dose reduction—and of course eliminating the bromine is extremely healthful. I have certainly felt far better as my bromine levels have decreased.

    Some, like me also, need to reduce their thyroid supplementation, or insulin or other hormone medications, but again this indicates health improvement.

    Other thyroid effects, most frequently temporary TSH increases not associated with hypothyroid symptoms, seem to be benign, physiological adaptations to remedying long term iodine starvation.

    I’m not aware of people being harmed as long as they follow the entire protocol and are monitored by their physicians if they have thyroid or other conditions that might be affected by the iodine.

    I think this remarkable clinical record shows that if milligram doses of iodine are dangerous, the effects must be extremely subtle or must take many years to manifest. If we add the extensive experience with milligram and even higher doses of iodine in many decades of clinical practice prior to the advent of “medical iodophobia,” it all seems reassuring, especially when we consider the amazing and wide-ranging benefits, which probably include prevention of breast and other common cancers.

    I do share your concerns, but the record of the Iodine Project reassures me and I am curious what you make of it.

    • Mario Iwakura

      Bill,

      I think we have to understand Paul’s position. He is not a experienced doctor, like Dr. Brownstein, who saw and prescribed iodine + “companion nutrients” to thousands patients.

      Many people, mostly because of bromine, which is omnipresent, have seen serious symptoms. If you’re not knowledgeable or not under the supervision of a profissional that is, you can have serious trouble. So Paul’s advices have to be more on the safe side.

      Having said that, I think that most of selenosis symptoms are related to thyroid disfunction, caused by excess selenium coupled with iodine deficiency. This could explain why some people suffer from selenosis while others not.

      Paul, do you have any evidence that high intakes of both selenium (from diet, not supplements) and iodine can cause any harm?

      • Thanks, Mario. I share your point of view of this.

        Iodine is very powerful, and like all powerful things it can do harm as well as good if not used with care.

        I decided to do my own, highly successful, iodine protocol under careful medical supervision, to be safe. Many do it alone, and if they make use of resources such as the Yahoo iodine group and aren’t already on thyroid supplements, insulin, etc., it’s possible to do it safely that way, too.

        But without a doubt, one has to be careful, especially regarding bromine toxicity reactions and the possible need to dramatically reduce certain prescription drugs. I know this from experience, on both counts. If I continued to take my previous doses of thyroid hormones now, I would be extremely ill, perhaps not even alive. Of course this is a sign of improved health, but careful medical monitoring was needed to do it safely.

        The same is true of other very healthful, powerful changes, such as low carb diets. Here, too, for example, people on insulin could become very sick if they are not medically monitored to see if they need to reduce or eliminate their insulin, as they so often do.

        Of course this is not a reason to avoid low carb diets, just an argument for being careful, and seeking medical advice if you need it. I think the same is basically true of supplementing iodine at doses sufficient to remediate deficiency of this most critical nutrient.

    • Bill/Mario,
      Once ‘high’ doses of iodine supplementation have been successfully achieved (say 50 mg per day).
      Do you just keep going at that level ‘forever’ or reduce the dosage after time.
      In my case i do Not have Hashimoto’s, but have had some mild hypothyroid symptoms, that have all been on the improve with good diet & supps.

      • “Once ‘high’ doses of iodine supplementation have been successfully achieved (say 50 mg per day).
        Do you just keep going at that level ‘forever’ or reduce the dosage after time.”

        I don’t think there’s a simple answer to that question. It would depend on many things.

        Under Dr. Abraham’s iodine protocol, one would use his iodine loading test to evaluate one’s iodine sufficiency, as well as bromine toxicity. That, plus symptoms and overall medical situation, would inform dose recommendations. If one had cancer, for example, high iodine doses, even 100 mg or more, might be recommended long term by some qualified practitioners.

        Due to extremely high bromine levels, I have remained at 50 mg/day for a long time. Perhaps I will be able to decrease the dose at some point, perhaps not.

        My impression is that the doctors most experienced with iodine supplementation have revised upward their estimate of typical “maintenance’ iodine doses, due primarily to increasing appreciation of the prevalence and toll of toxic halide exposure, especially bromine. 50 mg/day may well be an appropriate maintenance Iodoral or Lugo’s iodine dose for many people, though perhaps not for all.

      • Mario Iwakura

        Bill response is great, just want to add some information.

        Indeed, bromine exposure seems to be a worldwide problem, but specially in the USA.

        According to the last study below, the strongers predictors for blood serum levels of bromide are the bromide contents of your sleeping pillows and your vehicle seat cushions (since that study was done in household itens, I would add to that list the cushions of your seat in your working office).

        But, I think that you can adjust your dose of iodine based on your symptoms and thyroid blood tests (TSH, T3, T4, free T3, free T4).

        UK: http://pmid.us/11523434
        China: http://pmid.us/20715770
        USA: http://pmid.us/20049208

        • Thank you—the USA study in particular is very interesting, the best I’ve seen on sources of bromine exposure.

          I’ve been trying to figure out where my enormous bromine body burden might have come from. There seems to be no good way to really tell.

          But you’ve made me very happy, Mario! If that USA study can be believed, the most important things would be to sleep on flame-retardant free pillows and sit on leather seats in your car. I do both. I feel better already 🙂

  4. Chronic Sinusitis and UTI
    I’m from South Asia and I follow the perfect diet natively. Since this diet closely resembles my native diet there is a tendency to overeat the safe starch.
    I wanted some suggestions from you regarding how i should tweak the diet and add supplements to reduce my sinusitis and UTI. I seem to be getting both together very frequently. If i add fermented foods like Kombucha or other water kefir then Symptoms increase. I’m also very allergic to Dairy and coconut milk. I’m suffering from Sinusitis for the last 20 years. Any suggestions will be greatly appreciated.

    THanks
    Tessy

    • Tessy,

      Just a guess, but you might try elimininating yeasts and molds. So no kefir or kombucha, or raw vinegar. Eat only bacterial ferments such as fermented veggies.

    • Tessy, I use to have chronic UTIs too, but not anymore. I take 1-2 cranberry capsules every day (not the juice because usually it comes with sugar – which makes the UTI worse). That should prevent future outbreaks.

      With the sinus problems, sometimes it might not be food-related. If you get sneezing with itchy watery eyes, it’s probably pollen allergy. If you get sneezing with runny nose only (and the mucus is clear), it’s probably mold related – therefore you need to vacuum and dust to get rid of mold, reduce humidity and dampness to stop mold from spreading, use a mixture of white vinegar + cinnamon essential oil + clove oil to wash areas with mold and prevent them from returning. Eucalyptus oil is also really good on blocked sinuses – a few undiluted drops in tissue or warm towel and breath in the vapors.

    • If it’s allergies, I drank 1-2 cupes of nettles tea for about a year and all of my seasonal allergies are gone.
      If it’s chronic bacterial sinusitis it could be a bacteria or a fungus. I had to get professional help from a Chinese herbalist to get over my chronic bacterial/fungal sinusitus. Mary

  5. Hello Paul and everyone,

    I would like your opinion on my wife’s situation. She has recently been to an endocrinologist who gave her a battery of tests. Out of these, only TSH and Testosterone levels were on the higher end.

    TSH: 4.64 uIU/ml
    Free T4: 1.11 ng/dl
    Testosterone: 67ng/dl

    His diagnosis was early thyroid failure and he gave her Evion (Vit E), CoQ10 and Methycobal (Vit B) and asked to get some more thyroid related tests done in six weeks.

    Meanwhile, she had been suffering from ovarian cysts and ultrasounds suggested Endometriosis. We just started trying for kids a few months ago (both are 28yo) and decided to change her OBGYN because the previous one wasn’t taking her condition seriously.

    We just visited a doctor who specialises in fertility and after looking at her ultrasounds, he suggested a laparoscopy to confirm and grade the endometriosis. He says that if it is endo, it’s probably grade 3 or 4 (the more severe kind). He doesn’t want to do anything except grade the endo, check her tubes and drain the cysts (she has one large one and a smaller one, both in her right ovary). He says that surgeons tend to use techniques which damage the eggs in their eagerness to treat and he won’t do that. He also told us that we should go straight for IVF if the endo is found to be really bad.

    My wife’s complained of feeling crappy ever since her teenage years (when she crash dieted to lose a lot of weight). She’s now eating much healthier and maintains a normal weight. Her symptoms are many but I’ll list some: fatigue, cold extremities in winter, struggles to get much done in the morning but feels better at night, psoriasis, painful periods (this is more recent), bloating, painful bowel movements, muscle aches and pains, lower back pain, etc. She also suffers from depression at times and can be very sensitive. She says that she doesn’t know when she actually feels ‘normal’. She has one good day in a month or two when she feels like she can get stuff done.

    She’s scheduled for the laparoscopy procedure on the 18th. In the meantime, I just want to know what she can do from a diet point of view to improve her health, specifically the endo and thyroid. It seems low thyroid function is associated with endo and psoriasis. I have a feeling that improving thyroid function will help her overall health. At the moment, her most pressing concern is doing whatever it takes to get pregnant (she’s very stressed about this) and the laparoscopy will at least give us an indication of the extent of the endo and what our options are. I also plan on getting her endocrinologist to prescribe her thyroid hormone if the TSH doesn’t improve next time we see him.

    Any input would be greatly appreciated. There is so much info out there but it’s conflicting, specifically on dietary recommendations for endo.

    • Hi PHD’er,

      I think it would be really good if your wife would learn to cope with her stress. Chronic stress is really bad for the body, and in many cases simply reappraising your situation can help. It’s not the only thing she has going on (indeed sounds like hypothyroid) but stress is not good.

      She still has almost a decade to go before Down syndrome becomes and issue etc – plenty of time to try to right the body.

      my $0.02…

  6. Paul,
    Thank you for taking the time to answer all of us. Just one more thing that’s been pondering my mind, but I can’t find an aswer to. When you take herbal oils like oregano oil, goldenseal, grapeseed oil etc. do they really affect the bacterial flora in the colon? I see everywhere people warn about damage to the gut flora if taking such oils, but wouldn’t the liquid if taken in water just be absorbed in the small intestine long before reaching the colon?

  7. i would really enjoy a chart that shows what infections/diseases/problems are helped by and hurt by being in ketosis. this way we can extrapolate what problems we may have if ketosis doesn’t work for us.

    also we’d know what problems benefit from more carbs, so people could keep upping their carb dose to see how good they felt, and that would also be a diagnostic.

    i tried getting the paleohacks community to crowdsource one but it did not stick (possibly because the question was not based around not losing weight after being paleo for 2 weeks.)

  8. Connie Warner

    Hi PHD’er,
    Is your wife following the PHD diet and supplements and guidelines and not going too low carb? If it were me, I’d get my health in order first before getting pregnant and having children.

    Something else to consider: avoiding plastics including bottled water – which have hormone disruptors (even BPA free plastics).

    Good luck to you both!

  9. After reading a few posts I was wondering.., how to ensure if my kids dont gave any deficiency. Right now they eat healthy no junk no sugar no Pufa. But still do they need supplements? I use sea salt but we are not into seafood much so how do i ensure they get sufficient iodine ? Kelp doesnt seem safe ti me .., any suggestions

    • Hi Koki,

      The most important supplements are magnesium, iodine, vitamin C, and vitamin K. I would certainly consider the 225 mcg NOW Potassium with iodine supplements for the kids.

  10. Hi Paul
    I am ready to give up on the diet I’m afraid. I am yet to see any benefit from the diet after following it exactly for nearly 4 months. I have tried varying carbs from the 20%, up to around 600g you recommend. I have eaten a lot of good fats. I have cut out dairy for a month as I thought that may be a problem. I can’t afford the stool tests and my doctor isn’t interested, I have had the standard blood test for deficiencies, diabetes, thyroid etc, but no problems there and my digestion seems fine. I am still feeling lethargic and low much of the time and feel worse during my PMS time each month, I tried bio-identical hormones and maca supplements in the past which are supposed to help, but again – no change. I have counselling and theraoy, again to no avail, Today out of sheer frustration I ask three bowls of cornflakes with sugar which didn’t help my frame of mind! I know you can’t give me all the answers, but I am disappointed I have made all this effort for nothing, I am consider cutting out rice and white potatoes which makes the diet more traditional paleo, but I don’t suppose that would make any difference.
    Anyway, thanks for reading!
    Ness

    • Might be candida. You can get an igg blood test for candida antibodies (or mold…)

      • Thanks for the suggestion Tam. I’ve been told Candida doesn’t really exist and it’s a myth, but who knows, may be worth a try.

        • Candida certainly exists.

          I don’t know what you have, but there are other causes of disease beside diet. Infections, and toxins, are leading possibilities.

          It’s too bad you don’t have a cooperative doctor because doctors are best placed to investigate.

          If you can’t get medical help, then you have to experiment a little bit yourself to see if you can get clues. For instance, you could try a lower-carb Paleo or ketogenic diet approach and see if that relieves symptoms. (It could worsen them.) Either would give you clues.

          Best, Paul

  11. Paul and Shou-Ching, you continue to research the optimum internal environment for humans, specifically with regard to food, so I’m hoping you will have a perspective on the following. I have been told that I have exhausted adrenals and that I need to avoid any physical exertion at all. I do ride a bike every summer up to about 40 to 50 miles a day about three days a week. I have been told that even with normally functioning adrenals that we should never elevate our heart rates for more than two minutes at a time, meaning that any aerobic exercise in excess of that would increase cortisol production and all the problems that causes.

    My world has been so rocked this year, and now this is quite a blow. At work I trot upstairs, leaving panting younger colleagues far behind. I had believed this was testimony to some degree of good health.

    I searched for a previous discussion of this and found nothing. Paul…? Or, anyone…?

    • Hi dale,

      I strongly disagree with that advice.

      I think one key to restoring adrenal function is enhancement of circadian rhythms. To achieve that, it’s necessary to engage in some physical activity during daylight hours. It needn’t (shouldn’t) be intense, but it should happen every day.

      So trotting upstairs at work I think is good for the adrenals.

      A good basic approach would be to engage in light outdoor activity for about 15 minutes early every morning, and again in the afternoon (mid-day to early evening). This could be jogging, biking, or whatever you enjoy.

      Also get lots of bright light in the day, little light at night. Try to finish eating food around sunset, and get plenty of sleep.

      Whether 40 to 50 miles of biking is too much is for you to judge, if you feel good doing it then I would expect that it’s good for you. Just don’t let yourself get worn down.

      • Thank you, Paul. Is that 15 minutes of elevated heart rate? This consultant advises primarily anaerobic exercise so the heart rate stays within resting level limits most of the time. Adding that two minutes is the maximum duration for elevated heart rate. I get up our long staircases in only several seconds, but pedaling up the inclines elevates my heart rate for much longer than two minutes. The downhills are more rest than work, of course. She added that humans were created to eat and rest and little else. ?

  12. So I have been following the diet for about two months, here are the results

    Before
    Triglycerides 110
    HDL 104
    LDL 77

    After
    Triglycerides 50
    HDL 110
    LDL 103

    I had improvement in tryglycerides 50 points and
    HDL 6 points. My doctor is now concerned with the LDL which reads high. It’s confusing me, but am I to assume that because the tryglycerides are low now the LDL doesn’t count? Help!

  13. Also wanted to say since following this diet-I have boundless energy. My yoyo hypoglycemic events have ended. Sleep like a rock. Giving up the bad carbs, difficult at first is worth it for the energy and feeling good.

  14. If you want to learn a huge amount about cholesterol, I recommend the 3 part series on Chris Kresser’s podcast with Chris Masterjohn.

    http://chriskresser.com/tag/masterjohn

    One thing to know is that cholesterol can vary quite substantially (>15 points), so I’d guess the only meaningful change in your results is the triglycerides.

  15. Interesting paper on the split personality of hepatic insulin resistance:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712626/
    “In recent years, the idea that the diabetic liver may harbor a noxious brew of insulin resistance and excessive insulin sensitivity has gained a second wind.”

    This model explains why in DM2 we see both elevated glucose AND elevated lipids coming from the liver: a multiplication of energy which seems to contravene the first law of thermodynamics.

  16. I have had geographic tongue for a few years ago. I have ulcerative colitis, allergies, and a very mild asthma. Anyone have any suggestions or experience with geographic tongue? also, another issue I have is lower body temps in the evening. I’m around 98.2 in the morning and run up to 99 during the day. But in the evenings and before I go to bed it gets to about 97.5ish. Any thoughts are appreciated!

  17. Here’s a nice study showing that getting only 20% of your calories from carbs (normal PHD range for the caloric intake in the study) results in better glycaemic control in diabetics when compared to low fat 50-60% of calories from carbs with .

    One thing to notice though is that the low carbers also doubled protein intake and the low fatters avoided saturated fat, so once again we don’t know what helped/hurt most.

    Just thought I’d mention this here… Not the best study in the world but not bad either and it supports PHD macronutrient ratios :-).

  18. Hi Paul,

    Out of curiosity, I started fermenting white (sushi) rice. I soak the rice overnight, give a good stir in the morning and rinse til water runs clear. Then I add fresh water, cover the bowl with a plate and let it sit for another 3 or 4 days. It begins to bubble, forms a sort of scum (sounds bad, but it’s not at all) and has a very slight yeasty/sour smell. When I’m ready to cook it I dump the whole contents (scum and all!) into the pot, add water if necessary and the result is a pleasantly soured rice, the taste of which reminds me of San Francisco Sourdough bread – a stretch, perhaps, but when one is gluten free…. I know this style of rice may not appeal to everyone, but my husband and I find it delicious and have been eating it for a couple of months.I have a very sensitive gut and it gives me no problems, in fact seems soothing.

    My question is, do you know of any benefits to fermenting white rice? Apparently it’s not a very common thing to do, according to my Google searches.
    I have seen that there is an Asian dish (dessert) with fermented white rice to which sugar is added.

  19. Hi Paul,

    Wonder what you think about eating russet potato skins with a baked potato? The potato is organic. I was always told the skin had all the vitamins, like selenium.

    Also, what’s your take on kombucha and coconut kefir for fermented good probiotic strains? Next one, how about raw cheeses? Any risks there if I’m autoimmune thyroid?

    Thanks. Jan

    • Hi Jan,

      As long as the potatoes have been kept in cool and dark conditions since harvest, I think it’s fine to eat the skins. However, if they’ve seen light or heat, best to peel them. I would also check for discoloration of the flesh and remove those spots.

      I think kombucha and kefir are fine for people with good health, or bacterial infections. I worry about yeast-containing foods for people with active fungal infections.

      I think cheeses are generally OK, but watch out for any sensitivity reactions (eg fatigue) after eating them.

  20. does anyone have ideas for a small/compact electric appliance for cooking steaks like this? for a few reasons the kitchen in my apartment is not useful (though i would love to do the stove/burner/le creuset cast-iron griddle combo if it were.).

    i was looking at the george foreman grill but it drains fat and is coated with teflon – though it looks like the table top grills suggested by paul do the same thing… thoughts? if i were to get one of these table top grills with a cover, does anyone know a good brand that’s very small? just to be able to grill 1 large steak at a time., thanks!

    • I have used a Foreman in the past and it always worked well. It drains a little fat, but unless you are grilling chicken breast or something like that, there is still plenty of fat in the meat IMO.

  21. Just reposting this because i never saw any responses–I have had geographic tongue for a few years ago. I have ulcerative colitis, allergies, and a very mild asthma. Anyone have any suggestions or experience with geographic tongue? also, another issue I have is lower body temps in the evening. I’m around 98.2 in the morning and run up to 99 during the day. But in the evenings and before I go to bed it gets to about 97.5ish. Any thoughts are appreciated!

    • I’ve been trying Paul’s tips on curing constipation lately, and have been feeling better and warmer on that (antioxidants, probiotics, thyroid, choline (eggs), fat, …)

      http://perfecthealthdiet.com/2011/04/causes-and-cures-for-constipation/

    • Connie Warner

      Lauren: Are you following the PHD diet and guidelines (enough sleep, exercise, etc.) and taking the recommended supplements? I had geographic tongue years ago when I was having a lot of stress. Are you having a lot of stress?

      • I am following the diet, but I am not sure what supplements you mean, can you tell me? I am definitely stressed, I have had geographic tongue non stop for the last 2 years. I have 2 young kids and I work but my stress levels have dramatically reduced in the last several years (minus the kids). I was thinking it may be some kind of vitamin deficiency…

        • You might want to check out the “Supplement Recs” tab at the top where they list recommended supplements and read Paul’s responses on that page such as:

          Paul Jaminet June 23, 2012 at 10:49 pm

          1. Magnesium, iodine, vitamin K, vitamin D if you don’t get sun, vitamin C.

          • I will look into these, I never noticed the supplements tab! Thanks for pointing it out Connie!
            I have been very stressed so I am sure it is making things worse but thanks so much for responding to me!

    • Lauren,

      Geographic tongue is believed to be caused by a B vit deficiency. This would make sense in your case considering you have gut issues… meaning that the B vits may not be properly absorbed. I am not sure what Paul recommends in this case, if I recall correctly he warns against B vit supplementation (but check in the supp recs section). However, if I were you I would continue to work on healing the gut while eating foods replete with B vits such as animal foods.. all of them; eggs, meats, shellfish, but also leafy greens, nuts and bananas. Your temps don’t sound like cause for concern.

  22. Hi Paul,

    My husband has severe eczema. When I was growing up, my mom had psoriasis covering 95% of her body, and without a doubt his eczema affects him even more than that. His skin is almost constantly infected, but even strong antibiotics only help for a very short term period. And they end up doing considerable damage to his disgestive system.

    We’ve been to countless dermatologists to no avail. The medications they try to prescribe, at best, don’t help and, at worst, cause him a lot of side effects. We’ve tried lotions,creams,different clothing materials, removing detergents, removing soaps, water softener, snake oil in the kitchen sink(okay… not that, but you get the idea).

    About 4 months ago we found out he was allergic to oatmeal (the poor guy took an oatmeal bath to relieve itching) and somehow that sent us down the path to Paleo to GAPS to now PHD. Since then, his skin has gotten better and worse. It got a little better when we first tried paleo, but it wasn’t anywhere close to enough, although we were starting out so our diet wasn’t 100%. It got much worse at first while on GAPS – we believe it was a herxheimer reaction. During this time, he lost considerable weight (he went down to 92 pounds on a 5’4″ frame), was feeling cold and exhausted all the time, so we made the decision for him to eat unhealthily temporarily to gain back some weight quickly. When he hit 97 pounds, I found PHD and we decided to try it (he really needed the extra calories that come easily when you load up the fat on potatoes). He’s now up to 98 pounds or so and is still too skinny, but slowly gaining on PHD.

    We eat everything organic/grass-fed. Bacon and eggs for breakfast generally, leftovers for lunch, and for dinner either lamb, salmon, or dark meat chicken (he’s allergic to beef), along with potatoes and a veggie or two. We do eat veal liver once every other week or so as well (which he tolerates). I make our bone broth and we eat plenty of soup. He also gets homemade “jell-o” sometimes.

    He’s allergic to tomatoes, oranges, oatmeal and potentially some other grains, pineapples, kiwis and beef. These all make his skin flare up. He’s also allergic to tree nuts, but in the more traditional ‘go to the hospital if he eats it’ sense.

    Since we started PHD, his skin has gotten so much worse. We can’t find one particular food trigger – it seems to be a generalized thing. He was constantly red and inflamed over his entire body. I decided to try the anti-oxidant regime you recommended to another person. So he’s taking a small dose of Vitamin E, Vitamin C (though not to bowel tolerance yet, should we try that?), Copper, Zinc, Selenium, and NAC. He’s also taking the Green Acre Cod Liver Oil/Butter Oil Blend. He’s had epsom salt baths which seem to make it worse. He uses bentonite clay, and chlorella to help remove the toxins from his system that seem to want to come out in his skin instead. And temporarily, he’s taking evening primrose oil to up the omega 6, since we don’t get that much in our diet.

    Since he started these two weeks ago, he has broken out in sores all over his face and his backside. We’re putting manuka honey on them, since another round of antibiotics right now would destroy his digestive system again and cause him to lose weight. I breastfeed our son, so sometimes I give him breastmilk to put on the sores too. As some sores heal, others show up.

    I’m guessing this is a herxheimer reaction? But I don’t know. And every dermatologist he’s tried doesn’t help for issues like this. Heck – they probably think we’re crazy even trying to cure eczema through diet at all.

    But we need help right now. He’s so miserable – he can barely move and gets about 2 hours of sleep a day. His blood pressure is through the roof from the constant agitation.

    Any advice you can give on other things we can try or things we should stop doing? It feels like so much experimentation it’s hard to tell what’s working and what isn’t. But he’s so miserable, we just keep trying stuff. I’m willing to go down to trying just one thing, but I don’t know what that one thing is. If it is herxheimer, should we just wait it out?

    • Hi Bel,

      Unfortunately no one knows what causes these conditions, so we’re working blind.

      I think he needs to simplify a bit and then do controlled experimentation.

      A few key experiments:

      Is he worse on very low-carb or ketogenic diets? You may already have done this experiment if your GAPS implementation was low in carbs. Was it rich in honey/sugars or low-carb?

      I would drop the selenium and cod liver oil for a bit. Fish oil often worsens these conditions.

      Another experiment is omega-6 and omega-3. Does fish oil make it worse? Does omega-6 / EPO make it better? You may need to repeat these experiments several times to tell.

      Other experiments are with gut flora. I would as quickly as possible get a stool test to appraise the gut flora (eg Metametrix Microbial Ecology profile) and SIBO/H pylori testing too.

      Stop the chlorella, it is toxic. Bentonite clay and charcoal are good experiments. Do they help or hurt? Help means they’re clearing fat-soluble toxins, hurt means your lipids are being affected negatively.

      What is his blood lipid profile like? Low TC would suggest a protozoal or worm infection. If so, that should be investigated.

      Also test his vitamin D, make sure that’s close to 40 ng/ml, and take vitamin K2.

      It’s not bad to do a high vitamin C test also. That sometimes help calms immunity.

      Also, drink lots of water and try to get some exercise, or else do a sauna regularly to sweat. Sweating and urination are toxin removal pathways, so it’s good to encourage those.

      He might get a hair test for metals and other toxins.

      Circadian rhythm therapies strengthen and normalize immune function, so those are important. Have him get 10-15 minutes of outdoor activity early every morning and in the afternoon. Sun exposure on bare skin for vitamin D. Darken the bedroom at night. Have him try melatonin supplementation. Bright lights and sun exposure during the day. Try to do intermittent fasting — eat in an 8 hour window. Try both high and low carb diets, see which works best.

      We are looking for clues. The goal is to find a good diet that minimizes symptoms, and try to identify underlying infections or toxin overloads that may be causing the condition.

      Stop the epsom salt and avoid sulfur containing foods and supplements. The suggestion is that he has sulfur-metabolizing bacterial infections. Those often cause acne-type skin lesions and can occupy the gut following antibiotics. Try probiotics/fermented foods. But do get a stool test.

      I think he needs a lot of experimentation to narrow down the cause and find the best way to manage it. It will take some time, but what he learns will help him the rest of his life.

      Best, Paul

      • Thank you so much!! We’re going to be starting these things, one at a time, and experiment. Off to go buy low-sulfur foods. I’ll keep you updated on how it goes.

        • Has your husband worked with solvents (e.g. paints or sprays) or metals much?
          Formaldehyde and glutaraldehyde exposure (photography, preserving, carpeting)?

          The probiotics Paul mentions might help.
          L’Oreal have even tested a cream using l. rhamnosus fractions.
          http://www.freepatentsonline.com/y2010/0226892.html
          I would start with a proven line such as LGG.
          Killed probiotics such as Del Immune V are another possibility.
          I don’t know if the l’oreal cream with probiotic extract is available yet.

          • http://www.ncbi.nlm.nih.gov/pubmed/19624730
            this is the L-Oreal paper; the probiotic used was bifidobactrium longum (not rhamnosus)
            “Bifidobacterium longum lysate, a new ingredient for reactive skin.”

          • Thank you for the reply, George. No, he hasn’t worked with those.

            Probiotics in the past have just made things worse (high quality probiotics too). At the time, I thought it was die-off. Now not so sure – the low sulfur diet seems to be helping. The change has been pretty dramatic so far.

    • Have you investigated Helminithic therapy. I have been reading the yahoo groups and people seem to be getting relief from excema among other things. I have been considering it for sinus and hayfever problems. Some universities are carrying out trials particularly for Chrohns disease.

    • Bel might be worth trying rubbing virgin coconut oil on his skin to reduce the dryness and leave a protective (anti-microbial) film over the skin.

      • Thank you, Syl – we’ve tried this before and it didn’t work at the time, but now that we’re doing other things, it may be worth another shot. I appreciate the suggestion.

  23. Hi Bel

    It was my sister who had the eczema which dramatically improved with the regime of anti-oxidants Paul recommended. Her eczema was never as bad as what you are describing but maybe an update of her story may be of help.

    The anti-oxidants worked brilliantly for several months so she decided to reduce them and try to get the anti-oxidants more from food. All went well for a while then she had several physically demanding days in a row and suddenly the eczema came back with vengeance. It has taken her alot longer to get on top of it this time. She finds she gets almost immediate improvement with very high amounts of safflower oil (it has the highest amounts of omega 6) or sunflower oil. She will take up to 100mls a day and then taper. She has also found high doses of B vitamins to work. She takes B-complex plus extra B6, B1 and B3. But as I say it has taken much longer this time for her skin to heal – about 6 weeks. Clearly stress of any kind will cause a flare.

    I don’t know how this fits in with PHD and I look forward to reading Paul’s input. Like your husband, my sister has had no help from dermatologists – they have simply prescribed cortisone. She has had to self experiment and the above is what works for her. I hope it may be of some help in your situation.

    Regards
    Joan

  24. Hi there,
    About raised LDL and being hypo. I have added magnesium and will be adding selenium and copper as suggested. Still confused about coconut oil. Could this be the culprit in higher LDL. I am adding in more carbs as suggested.
    The coconut oil makes me feel better. Confused!

    • Coconut oil is generally good for you, so if it makes you feel better I would take it regardless of its effect on LDL, which is small. It has a bigger effect on HDL.

  25. Hi there,
    About body temps, if it goes down significantly at night (97.3ish), what could that mean? And what can be done? Is it a thyroid issue? Thanks!

  26. Connie Warner

    Hi Lauren, You might want to google “body temperature perfect health diet” and read some of the blog entries that come up. I did happen upon this blog entry that talks about body temperature. http://perfecthealthdiet.com/2011/11/safe-starches-symposium-dr-ron-rosedale/

    Hope this helps! 🙂

    • thanks Connie, for reaching out to me. I will definitely read the link oyu posted. I am also hoping any others with some success in raising body temps will respond as well. Be well

      • I forgot to say that I think my body temperature is higher now that I’m following the PHD diet and eating “safe starches” and not eating too low carb like I did for 10 years. I’m definitely not as cold. I was diagnosed with Raynaud’s a few years ago before PHD and that’s gone now! You might want to look over the reader results section of this website too.

  27. I have two more days of a 4 day qigong seminar, which is turning out to be quite a bit more than qigong. The price was very good and, as I expected, there are books, cd’s, dvd’s, etc. all for much more than the cost of the seminar.

    Lots of nutrition advice and I agree with some of the information, as would you folks, but the speaker is dead set against any kind of beef, regardless how it is raised. Says that organ meats may have a few positives but their negatives outweigh them. When he dismissed us for lunch he cautioned, “Milk is for baby cows not for humans and it has pus in it; while I’m at it, all cheese will go straight to your arteries and clog them.” At the lunch table I took out my white rice, pastured steak strips, gouda cheese, seaweed, and fermented string beans and the 5 people at my table all commented that beef is “too hot” for humans and the cheese is filled with pus. They approved of my seaweed and beans, however.

    One of the books for sale is all about smoothies that include all manner of raw veggies and fruits, including avocado seeds.

    Anyone want to comment? Would love to have something to say tomorrow or Tuesday. Tried to talk about leaky gut and bone broth today, but was shot down because these folks do not consume any beef. They believe that a certain probiotic containing Lp299v is all they need to heal and seal a leaky gut. Don’t think I should mention the name of it but it starts with the letter “G.”

    Thanks if anyone wants to offer anything for me to share tomorrow or Tuesday.

  28. George Henderson

    Lactobacillus plantarum is Lp299. Not a bad thing, but you also need cholesterol…
    Just say “lamb” or “venison” in place of beef, it’s the same thing and less contentious.
    I don’t think that pus and probiotics are so different, actually.
    Grains and legumes are contaminated with rat and mouse and insect faeces – do they know that?

    • Thank you, George. I’ll see what the pus/probiotic comparison does. One of the recipe books has a number of dishes using legumes from a can. Appears that many of the recipes calling for bread specify sprouted grain breads. They are in agreement about fats and calcium, but say nothing of magnesium, only refer to silica being more important than calcium. The thing is, they have blocked out far more time than needed for the qigong, with the obvious hope of selling the books, etc. But, with so much of their information consistent with my present understanding, I find myself pulled in two directions.

      • George Henderson

        Now, qigong comes from China, and dairy ought not to have such a good rap in China. I’d be more concerned about melamine than pus, but dairy hygiene on Chinese farms may not have been all that in the past. Dairy is not a very Chinese food.

  29. I have been breastfeeding one or more children every day for five years. Although I hadn’t had this problem before, after starting the PHD 7 months ago, in the past 6 months I have suffered from recurring blocked ducts in both breasts. I have been clearing them with the help of my efficient nurslings, but the blockages keep coming back, and it’s really tough.

    The advice I have received from a lactation consultant who didn’t know about the diet (I didn’t realise it was relevant when I was talking with her) was to take Lecithin. According to breastfeeding website Kellymom.com:

    The reason why lecithin may help resolve and prevent plugged ducts is not clear. Per Dr. Jack Newman, “It may do this by decreasing the viscosity (stickiness) of the milk by increasing the percentage of polyunsaturated fatty acids in the milk.” Lecithin is an emulsifier (used to keep fats/oils dispersed and in suspension): phospholipid molecules (such as lecithin) contain hydrophobic and hydrophilic elements; the hydrophobic portion has an affinity for fats and oils, and the hydrophilic portion has an affinity for water.

    After reading your book, the idea of adding PUFA to my breastmilk does not appeal! Does anyone here have any experience with this? I would particularly appreciate any information or advice regarding lecithin, or for modifying the PHD to be more breastfeeding-friendly. My husband found a choline-free lecithin supplement made from soyabeans. The recommended dose is 1200mg 4x/day. Should I take it?

    • George Henderson

      It will be the phospholipid part of the lecithin that gives the benefit, not the PUFAs. I don’t think supplementing lecithin will supply over-much omega-6, but there is lots of lecithin in egg yolk and organ meats.

      “there are multiple choline compounds that contribute to total choline concentration (choline, glycerophosphocholine, phosphocholine, phosphatidylcholine and sphingomyelin). In this study, we collected representative food samples and analyzed the choline concentration of 145 common foods using liquid chromatography-mass spectrometry. Foods with the highest total choline concentration (mg/100 g) were: beef liver (418), chicken liver (290), eggs (251), wheat germ (152), bacon (125), dried soybeans (116) and pork (103).”

    • It’s not the PUFA – lecithin is not all that high in PUFA. It’s the choline (and inositol etc). Choline is needed to convert fats from triglycerides which are not water-soluble to phospholipids which are. Milk with too few phospholipids may leave fat deposits.

      Don’t take the one your husband found, instead take one high in choline. Or take a choline-only supplement. Or, best yet, eat egg yolks and a bit of liver.

  30. Does anyone have any good recommendations or recipes for sauces to put over rice on this diet? I’ve been leaning real heavy on potatoes, which is fine, but I’d like to mix it up and have more rice, I just don’t know what to do to flavor and fatten it up.

    • Isaac and everyone else!

      Instead of water use beef broth for the rice.
      Then add coconut milk, or I add coconut oil/butter!
      If you make your rice, put in the fridge and let it get cold.
      Then stir fry it with all kinds of things…eggs, ground beef, onions,
      liver…once you get going its endless. Make sure the rice is cold-hot rice does not work for fried rice!

      A great way to make a “fat” is combine coconut oil, olive, oil and butter in a container blend until smooth and you can use this for cooking etc.

    • I was pleasantly surprised at how wonderful ghee tastes on warm rice.

      Cooking rice risotto style is of course also a great way to flavor rice although since it then becomes the largest part of the meal that may blow through your daily carb allotment quickly. I’ve never run the numbers to check, I just ate my risotto instead 😉

      Finally, try sour sauces or just vinegar or vinaigrette (acid + oil). Both acid and fat dampen the blood sugar spike you get from rice, which is a good thing.

    • I tried this recipe recently and thought it was very good (and easy!):

      Easy Indian Chicken

      • And I meant to add that the above recipe is very good served over rice, since that was the original request 🙂

  31. Hi Paul,
    I’m searching some quotes or post about your thoughts on turkey meat. I can’t find many references to know whether it’s a good and healthy meat to include in the diet . Could you tell if it’s “as bad” as chicken due to its omega ratio or..? Thanks, Best, Maya

    • I believe turkey is about the same as Chicken in terms of omega 6. However I think turkey is one of the leanest meats, so unless you’re really adding a lot of fat to the turkey, you’re going to be burning through your protein allotment really fast.

  32. Dear Paul,

    I bought your book, The Perfect Health Diet. I have done exhaustive research and experimentation on milk alternatives in effort to find the best type of drink to mix a multivitamin and veggies (spinach, lettuce, etc) in for our toddlers age 6 and 2. Chocolate milk seems to work well but the challenge seems to be finding the “right” milk and chocolate.

    Dairy milk–if pasteurized–I hear poses health risks and so does raw milk. Almond milk that I’ve found at whole foods has synthetic vitamins that I’m sure will cause long-term health consequences and also won’t mix well with the whole-food multi-vitamin supplements we will give our kids. Coconut milk is the same in that it is packaged and seems to have the synthetic vitamins in it. And rice milk seems like too much glucose (sugar).

    This has been a difficult search. What milk do you recommend for children and adults and why? What are your thoughts about the healthiest yogurt and why? What are your thoughts on low fat versus NON- low-fat dairy products? What are your thoughts in general, about dairy products?

    Thank you in advance and thank you for helping us all become healthier!

  33. Dear Paul and Shou-Ching,

    I have been following your diet for several months now and love the inclusion of my daily yam/sweet potatoes. I feel better mentally; however, I’m still gaining a load of weight. I do not blame your diet–I blame my hypopituitary and central hypothyroidism (along with indulging in way too many nuts/nut butters/coconut cream). I do have two questions if/when you have time.

    A friend directed me to Chris Kresser’s post about autoimmune hypophysitis. Because we are unable to determine the cause of my pituitary or hypothalamic dysfunction, this topic intrigued me. I thought it wouldn’t hurt to autoimmune-ize the PHD for, say, a month or so and see what happens. Can you direct me to a previous post or offer any advice other then pass on the nuts, dairy, eggs, and nightshades? Maybe I can just eat air? 🙂

    Secondly, said friend suggested my issues may have been because I had been low-ish carb paleo/primal for a long time. Does that even sound plausible? I sure hope not.

    I love the work you both are doing and thank you for giving me the permission to eat my beloved yams again!

    • Hi Laura,

      I think that’s worth a try. Rice and fish are fairly hypoallergenic. A little searching can guide you to other foods.

      I’m not sure why low-carb would cause central hypothyroidism, but there are many mysteries in these conditions. Did the problem develop after you went low carb?

  34. I am sorry for reposting this again but I am hoping it will get a little more exposure…
    I have had geographic tongue for a long period of time and it is really getting worse. I do follow the diet and have for the last three months. I see no change. Perhaps a supplement. I have asked several acupuncturists and doctors and people insist it is harmless. I am desperate to make it better. Also, I didn’t know if it could be connected to a thyroid problem although all my blood work checked out for any thyroid issues. anyone have these problems and solve them?

    • Hi Lauren,

      I’m a little unclear on what you’re eating and supplementing.

      Nutritional deficiencies are a possibility. You might try taking a B-50 complex once or twice a week. Also, leukoplakias can discolor the tongue, those could be fat-soluble vitamins. Or it could be some kind of infection, maybe fungal. What do doctors say?

      • I am eating mostly fish, chicken, eggs rice, some potatoes and some sweet potatoes and wide array of vegetables. I have taken out dairy and am gluten free. I use coconut oil and olive oil for cooking and occasionally use gluten free bread supplements to make a turkey sandwich here and there. I do not cheat but occasionally have some coconut ice cream. I believe I have a yeast issue (thus the limited sugar) and I am starting an anti candida protocol with supplements like syntol, didaclear, cinnamon oil, oregano oil, coconut oil, and a few others. I also did the master cleanse a few weeks ago but did not end up with a pink tongue as I had hoped. I am starting the supplements for candida Wednesday as I have a colonoscopy and didn’t want to start when I could go full throttle. I also was thinking of using some iodine if perhaps it is a thyroid issue but everything checked out with my thyroid (although I don’t recall the numbers). Also, I have some issues with temps in the evening dipping into the 97.5 ish area but mostly 98.1 to 99.0 during the day. I have been on the PHD for the last 3 months in total. Headaches were my original complaint but since these seem to be mostly under contro (one or two a week instead of almost daily) I have moved onto other issues in order of how much it affects me. I feel these are full picture issues and must be helped. I find the geographic tongue the most alarming as it seems it may be a picture of terrible things to come (i can be very negative about these things) I just want to stay healthy so I can take care of my daughters, my husband and myself. Thank you for your help

      • Also Paul these were my numbers for thyroid results

        for thyroid TSH was 1.96
        T-UPTAKE 38.1
        THYROXINE (T4) 7.81
        FREE T4 INDEX 2.98
        ERYTHROCYTE SEDIMENTATION RATE 4
        FERRITIN 12.9

        • Hi Lauren,

          Iron seems very low. Are you anemic?

          • Thanks Paul for answering me. They said that I am not anemic but told me to take an iron supplement. I take soft iron 25mg but stopped when I was doing the master cleanse and now a few days later I am having a colonoscopy. I honestly could be more diligent about taking it but I have been so focused on my tongue and other things that I thought it wasn’t that big of a deal. Could that be causing geographic tongue or just making me feel really tired? I am supposed to go back to the doc in another month (i originally went bc my platelet count was very slightly below normal (139).

          • Hi Lauren,

            It could certainly make you tired, I don’t know about the geographic tongue but the best way to find out is to improve your iron status.

            It’s best to fix the things you know are wrong first. Often other problems will go away.

            PS – Inflammation or soreness of the tongue is an iron deficiency symptom: http://www.mayoclinic.com/health/iron-deficiency-anemia/ds00323/dsection=symptoms

          • I have all of those things listed under symptoms but except the racing heart. I will start with the iron tomorrow after my colonoscopy and be more positive (that can only help). I will also work on the yeast it is definitely a problem. My tongue is all white just from the gatorade I had to drink for the colonoscopy prep and I am pretty diligent about my diet. Thank you for everything Paul. I feel like it is hard to find people to help me! I wonder if this could affect body temp too if it isn’t my thyroid…

          • Paul, sorry, another thing, I saw Frank’s message just now and it reminded me to ask you, does that mean I should not supplement any iodine with my TSH levels being ok and just stick with the iron?

          • I think supplementing some iodine is good, so I would do both. Start low with iodine. Address the iron as quickly as you can.

          • Ok paul thank you very much. Last question, I promise. I just purchased the rainbow one (i think it’s called) multivitamin listed on your supplements section. Will that be too much iron with the supplement and the multivitamin or it’s ok?

          • It’s too much for the long run but for now you need extra iron to recover quicker from your deficiency. So take extra for a month or so, and get re-tested for iron levels. When ferritin is over 50, go back to a normal intake – either the multivitamin or the supplement, but not both.

          • Paul,

            Thank you so much for your help. I truly appreciate taking the time to help me and so many others!

  35. HI, Paul! Thanks for the reply. I had been a vegetarian for about 4 decades and when my daughter was born, I’m embarrassed to admit I was a vegan for the first year of her life. Maybe that’s when the problems started. When I made the 180-switch to paleo/primal, I lost a gobs of weight, stopped menstruating (well, CONTINUED to not menstruate), and the fatigue was insurmountable. It was a year into the lower carb lifestyle that I was deemed hypopituitary and placed on meds. I gained to date 50 pounds (and rising). Size 2 to 10.

    It’s only been the last few months I have been eating PHD and really liking it. I’m unsure if the low-carb transition flipped a switch or what, but it was about that time that I gave up and finally sought medical intervention. After lots of money, tons of medical tests, and fifty pounds of fat, I now have…menses. How lucky am I? So, perhaps the stress of low carb was the final straw in a lifelong, nutrient-starved body.

    I will try to frame your diet around an autoimmune-like paleo diet and see if I feel any better and halt the progression of weight gain. Fingers-crossed. THANKS again!

    • Hi Laura,

      It sounds like you may be malnourished. It can take months or years to replenish nutrients. It’s common for people to become obese after famines — when they get access to food again their bodies try to catch up. Gary Taubes has mentioned how the first “obesity epidemic” in the US was in the Great Depression.

      I would try to supplement and eat nutrient-dense foods like liver, other organ meats, shellfish, bone and joint broth soups, green leafy vegetables, tomatoes, other vegetables, etc. And continue eating safe starches.

      I would also try circadian rhythm therapies. Exercise and sun exposure in the day, darkness at night and prioritize sleep.

  36. oh, I left out ulcerative colitis and reflux…

  37. Thank you, Paul. You are truly amazing and I’m beyond grateful that you took the time to write me and everyone back; Don’t know how you do it.

    I will keep on keeping-on and write you back with my progress. Again, many, many thanks.

  38. Paul,

    I just got my TSH level checked because I had been feeling tired and occasionally light headed. While I was at it I got my D3 and ferritin levels checked as well. Here are the results:

    TSH 2.630 uIU/mL
    Vitamin D, 25-Hydroxy 49.9 ng/mL
    Ferritin, Serum 282 ng/mL

    The TSH is within “normal” range, but reading your book it seems much higher than optimal. I’ll add that earlier this year I was having very bad leg cramps at night (a hypothyroid symptom I understand), but those went away after I started supplementing with 400 mcg of magnesium per your book. I also started following the PHD at that time. I take the other recommended supplements as well, though I only take 150 mcg of iodine (in a multivitamin). I did order the NOW Foods iodide recommended on the Supplements page, but just got it and have not started it yet.

    Thoughts?

    • Hi Frank,

      Well, TSH and ferritin are both high. I’d donate blood to try to get the ferritin down.

      I’d watch the hypothyroidism and try to see if healthy living and nourishment will improve it.

      • Thanks Paul. Am I correct in assuming that I should go ahead and start supplementing iodine (with the NOW Foods 225 mcg Potassium Iodide)?

      • Ferritin’s a tricky one.
        I would suggest getting a full iron panel done before reducing iron by donating blood.
        Technically you can have iron deficiency and a high ferritin level. Although the likelihood of an iron deficiency would likely decline with increasing ferritin levels.

        A few Refs:
        http://labtestsonline.org/understanding/analytes/ferritin/tab/test
        “Ferritin is an acute phase reactant and thus may be increased in people with inflammation, liver disease, chronic infection, autoimmune disorders, and some types of cancer”

        http://www.ncbi.nlm.nih.gov/pubmed/15854860
        “This report describes a patient with iron deficiency in bone marrow examination and iron-responsive restless legs syndrome (RLS), in whom serum ferritin levels were well above the conventional cutoff for considering iron deficiency”
        (full report: http://www.idpas.org/pdf/4176.pdf)

        • Thanks, Darrin. Yes, Frank, Darrin’s is good advice.

        • Thanks Darrin. I’ll get a complete panel done.

        • Here are the iron panel results. The first number is the result, and the reference interval is shown after that.

          Hemoglobin 13.5 g/dL, 12.6-17.7
          GGT 18 IU/L, 0-65
          Iron, Serum 100 ug/dL, 40-155
          Iron Bind.Cap.(TIBC) 331 ug/dL, 250-450
          UIBC 231 ug/dL, 150-375
          Iron Saturation 30%, 15-55
          Ferritin, Serum 269 ng/mL, 30-400

          • I’ll also mention that I got cholesterol numbers at the same time, and I’m not sure what to think:

            Total – 298
            Trigs – 49
            HDL – 126
            VLDL (Calc) – 10
            LDL (Calc) – 162
            Total/HDL Ratio – 2.4

            On the one hand, the total number and LDL are high (though LDL is calculated), but on the other hand HDL, trigs, and the ratio seem good.

            Maybe if I get my thyroid working better (TSH is 2.63), that will bring my total cholesterol (and LDL) down a little? Would the high ferritin number have anything to do with cholesterol?

            Two things i know I can do:

            1. Get back to walking 30 – 45 min at least four or five days a week like I used to, but haven’t been doing lately.

            2. Cut back on the coconut. I love the stuff, but I know it raises total cholesterol and LDL. It raises HDL also, but mine is high enough that I don’t think I need the extra help.

            Paul, would appreciate your thoughts on this and the iron panel results above.

          • Frank,
            here’s my 2c.
            I am no expert & I am not a doctor.
            It looks like your high Ferritin is being caused by inflammation/infection (and Not high Iron).
            May be just wait a month & test again. I notice it has already dropped a little bit, from 282 to 269, so may be the inflammation/infection is ‘being resolved’.
            Assuming this is the case, I think once the inflammation/infection is fixed your Hemoglobin & Iron Saturation % may increase a bit (which are on the low side for men, from what i have read).
            But, do Not supplement with Iron.
            For more info google ‘anemia of chronic disease’.
            here’s one link;
            http://www.irondisorders.org/anemia-of-chronic-disease

          • Thanks again, Darrin. I’m in the process of finding a new Dr, but will get with them on the test results when I find one. I guess it’s possible it could be some sort of low grade infection, as I’ve not been feeling well recently, though it’s been kind of on and off. However I did have CBC done also, and everything was within reference intervals.

          • no problem, good luck with it all.
            you could experiment with a higher D3 level.
            I seem to sleep better, feel ‘happier’ and do not get sick when my D3 level is between 60 & 70 ng/ml.
            I know this is a bit higher than Paul recommends.
            Each to their own i guess.

      • & i should also mention that iron deficiency could lead to hypothyroidism.

        I read somewhere (sorry, don’t have refs) something along the lines that iron deficiency impairs conversion of T4 to T3 conversion and increases reverse T3 levels.

      • oh, & if you do ask your doc for a full iron panel, you may as well try getting a crp and hs-crp while you at it. these should tell you if you have inflammation (which may also be elevating serum ferritin).
        http://labtestsonline.org/understanding/analytes/crp/tab/sample
        http://labtestsonline.org/understanding/analytes/hscrp/tab/sample

        • Hey Darrin,

          That factoid about low ferritn
          could be my borderline low thyroid issue! thanks for the clue
          (I was chronically low for many years due to a fibroid.)
          Also, I must say that I feel 100% better since adding 50 Gm more carbs per Jaminet.
          I realize now running so keto was giving me a constant headache also. (8 months) 😉
          This blog is a goldmine!!!

          • Yep,
            A low ferritin (below lab range) looks to be a good indicator of iron deficiency.
            & iron deficiency is more common in women than in men.
            & i have heard that more women than men have hypothyroid symptoms.
            So maybe iron is an important factor here, get your iron stores up and start helping your thyroid.

      • Frank,
        & if your doc is feeling generous.
        add a Full Blood Count to the list.
        http://labtestsonline.org/understanding/analytes/cbc/tab/test

        I had a test result once that showed a higher then i would like serum Ferritin (141 ng/mL). In the same tests my white blood cell (WBC) count was low (i had low neutrophils).
        My doc said that i may have a possible viral infection.
        One month later, with no change to diet or anything else, my WBC count came back fine & my Ferritin had dropped to 83 ng/mL.

  39. Hi Paul,

    I’ve followed your diet for a year now, and a typical paleo diet for a year before that. But I’m still dealing with some acne. Bentonite clay really helped, almost to the point of it being completely gone. But I started NAC a few days ago and it really threw me back, as I broke out pretty bad on my forehead and chin. Do you know why this is? Am I having a bad reaction and therefore should stop taking it? Or do you think this is my body detoxifying and it’ll be worth waiting it out for now?

    Thanks,
    Jordan

  40. Hi Paul,

    I’ve followed your diet for a year now, and a typical paleo diet for a year before that. But I’m still dealing with some acne. Bentonite clay really helped, almost to the point of it being completely gone. But I started NAC a few days ago and it really threw me back, as I broke out pretty bad on my forehead and chin. Do you know why this is? Am I having a bad reaction and therefore should stop taking it? Or do you think this is my body detoxifying and it might be worth waiting it out for now?

    Thanks,
    Jordan

  41. Thank you for your response, Paul. I could help notice a study that conflicts what you recommend on the low temp pasteurization (below). What are your thoughts, High Temp ST or Low Temp Long Time?

    Front Biosci (Elite Ed). 2011 Jun 1;3:818-29.
    Effect of two pasteurization methods on the protein content of human milk.
    Baro C, Giribaldi M, Arslanoglu S, Giuffrida MG, Dellavalle G, Conti A, Tonetto P, Biasini A, Coscia A, Fabris C, Moro GE, Cavallarin L, Bertino E.
    SourceCNR-Institute of the Science of Food Production, Grugliasco, Turin, Italy.

    Abstract
    The Holder method is the recommended pasteurization method for human milk banks, as it ensures the microbiological safety of human milk (HM). The loss of some biologically active milk components, due to the heat treatment, is a main limit to the diffusion of donor HM. High-temperature short-time (HTST) pasteurization may be an alternative to maintain the nutritional and immunological quality of HM. The aim of the present study was to compare the impact of Holder and HTST pasteurization on the HM protein profile. The protein patterns of HTST-treated milk and raw milk were similar. The Holder method modified bile salt-stimulated lipase, lactoferrin and components of the immune system. The HTST method preserved the integrity of bile salt-stimulated lipase, lactoferrin and, to some extent, of IgAs. Holder pasteurization decreased the amount of bile salt-stimulated lipase and inactivated the remaining molecules, while the HTST method did not alter its activity. Pasteurization increased the bioavailable lysine quantity. HTST pasteurization seems to better retain the protein profile and some of the key active components of donor HM.

  42. Hi Paul,
    I bought your book and I am trying to get into the correct eating plan. Before your book I was eating 1000 calories a day (trying to lose weight) I had hardly any fat, but protein and lots and lots of veg because they are low in calories. Obviously the no fat has caused many issues as addressed in your book. I just want to confirm. I want to lose weight so I am eating 1000 calories a day. That means 150 calories goes to protein, 200 calories goes to carbs and the rest to fat. So 1 medium chicken breast is 145 calories, 1 cup of rice is 205 calories. And then I need to add fat to this. Does that mean that I need to split 1 chicken breast and 1 cup of cooked rice over 3 meals ? That seems very little considering that I do cardio and boxing 4 times a week for an hour at a time? Are my calculations correct or am I missing something.
    Thanks for all your help Paul.

    • Hi Joia,

      No, no. In our Google search box look for “weight loss version”. Try about 500 carb calories, mostly from safe starches; 300 protein calories; and 500 fat calories, mainly from the meat/eggs/liver/shellfish/seafood, but also a tablespoon of coconut milk per day.

      • Thanks Paul. will get onto that immediately. will keep you posted.

        Thanks for all your help :o)

        • Hi Paul, did you mean a tablespoon of coconut oil, not milk?
          Thanks!

          • Either coconut oil or coconut milk, whichever you prefer. The milk is 85% oil by calories … has water and miscellaneous coconut stuff too … so you need more milk to get the same dose of fat.

  43. Hello Paul My lower back started giving me problems in my early 30’s. I studied horticulture and prior to my back becoming a problem was involved in many years of hard physical work. The problem was always left sided with sensations going down my left leg. X-rays did not really show anything. About five years later a neck and shoulder problem started – a terrible tightness, also on the left side. About three years ago the supporting muscles on both sides of my spine started feeling very tight. My calf muscles are also tight. Over the years I have tried many therapies on a very regular basis. Nothing helped or seemed to make any difference at all. I have always walked for exercise and done lots of stretching and some weights. A couple of years ago a physio told me to stop the stretching and the weights because I was over-stretched, but to keep walking. Stopping the weights helped my neck a bit. About a year ago I stopped walking and started running. Running is better for my back than walking – it seems to loosen me up. The worst things for my back are lots of bending and lifting and sitting. I seem to twist when I sit. The best things are continuous movement, hot Epsom salts baths. My GP thought I might have poly myalgia but a cortisone injection and anti-inflammatories did not help, although I could not tolerate the anti-inflammatories for more than 1 day. Blood tests showed inflammatory markers were normal. A bone density scan was also normal.

    I have been following the diet for quite some time now but have not tried fasting – do you think fasting might help? Do you think I could have a viral problem? I take Vitamin C, Vitamin D3, Vitamin K2, Magnesium and Potassium – is there any other supplemnt you think might help?

    With thanks
    Lindsay

    • Hi Lindsay,

      I don’t know what it could be; the left sidedness is puzzling. Maybe something neurological?

      No idea what it could be, but I do thin a 16 hour daily fast is generally healthful and might be therapeutic.

      I would take some iodine daily and maybe a B-complex with some B12, pantothenic acid, and biotin once a week. Low-dose lithium of 1 or 2 mg/day (lowest available dose is 5 mg, try cutting the tablet with a razor blade and hammer) might be worth an experiment.

    • Thanks so much Paul – I will try the fasting and those extra supplements. All best, Lindsay.

  44. Wow, this guy McCombs shows some scary candida pics and videos: http://www.youtube.com/watch?v=9Kk7eKWTdVQ

  45. I know you and Ron have gone back and forth extensively on your discussion of starches, but I have a question regarding Rosedale’s response here: http://drrosedale.com/blog/2011/11/22/is-the-term-safe-starches-an-oxymoron/

    1) The requirement for glucose is much less, even half of what Paul has indicated.

    2) These requirements can easily be met without the consumption of a single gram of glucose in a very low carbohydrate adapted individual.

    3) There is no such thing as a glucose deficiency.

    Do you have research to prove there is a glucose deficiency?

    More specifically regarding “conclusions”
    7) We all have some degree of metabolic derangements including insulin and leptin resistance, and this really should be considered the hallmark of diabetes. We should therefore all be treated as such, especially with a diet known to improve those parameters as much as possible. That would be my Rosedale diet, as revealed in the only research paper that I am aware of (cited previously here) that correlates a particular diet with nearly all of the laboratory parameters associated with and perhaps causative of enhanced health and lifespan in a well known model of this, caloric restriction, though without having to caloric restrict.

    What do you think about insulin resistance and leptin sensitivity in terms of the development of diabetes and what we can do to avoid these occurrences. I can’t find any places where you address these.

    Ron says: Jaminet’s major emphasis in this blog is the significance of fasting and 2 hr post prandial glucose. Unfortunately, that is likely the least important variable pertaining to glucose, insulin, leptin that is influenced by diet. There are many determinants of fasting blood glucose; sleep patterns, cortisol, sympathetic overdrive, growth hormone, to name but a few, that not only raise blood glucose but may increase mortality irrespective of blood glucose.”

    What about those factors?

  46. Just cannot help but mention that Paul suggested I add a bit of carbs (I was on <50 Gms day for eight months)50 Gms of white rice dialed me right in, my FBS and postprandials are consistently ideal and my vague headache vanished. I know it isn't a RCT, but I remain very impressed and grateful! I think people need to be willing to change one variable at a time,and be patient, make a determination, and then move on to a next *most probable* possible variable….

  47. Hi, I have been dealing with two problems the past few months – recurrent gum abscess and inner ear infection. (Both problems areas are on my left side and started within a couple weeks of each other, so I kind of wonder if the infections are related.) From what I’ve read, both could be caused by bacteria. (The two family doctors I saw for the inner ear infection both say it’s caused by a virus, but they didn’t run any tests, so I’m skeptical of their quick diagnose.)

    The endodontist is using a wait-and-see approach for the gum abscess. The bubble has gone down since getting new medicine put in the root canals of the tooth below the abscess and taking a round of antibiotics (strangely, while taking the antibiotics the bubble got bigger, but decreased a few days after the antibiotics were finished), but there is a hard bump still on the gum.

    I am seeing an ear doctor to treat the vertigo caused by the inner ear infection. (Vertigo is what caused me to go to the doctor in the first place, as I had no problems with my ear and hadn’t been sick at all.) Had an ENG test done and am awaiting results (very slow going, as this doctor is super busy). During the test, my left ear responded very differently to the air pressure test – air in right ear produced dizziness but no dizziness came from air blown in left ear. It is also my left ear that has daily pain. Both ears feel pressure at times.

    Sorry for being a windbag. 😳 To get to the point: after reading the “Heal and Prevent Disease” section of your PHD book, I got to wondering, is there a blood test to find out what pathogen is causing my gum abscess and inner ear infection? If there isn’t a test, do you think the PHD will help my problems?

    Thanks for taking the time to read all this.

    • Hi Marie,

      It’s almost certain they are related.

      “It’s caused by a virus” is usually shorthand for “I have no idea what causes it, and I don’t want to prescribe anything.”

      Unfortunately I don’t know what causes it either. And I don’t know what diagnostic tests may be available.

      PHD is designed to enhance immunity and do well against infections, so if you’re not already doing it, I would suggest you try it. Also, our recommended supplements may help, plus the N-acetylcysteine among our therapeutic supplements. NAC supports glutathione synthesis and immune function, and can have a direct antimicrobial effect by breaking disulfide bonds.

      Best, Paul

      • Thanks for your reply. I am just starting with PHD. My thought was to do the ketogenic plan as described in your book. My only concern is that I’ve been battling with dry eyes (and blurred vision) for the past couple of years and don’t want to risk it getting any worse with a low carb diet. I will give it a go though. And I’ll check out those supplements. Right now all I take is vitamin d for a deficiency I had and magnesium to ease daily headaches and leg cramps.

    • Do I understand correctly that you have a root canal? If so, get rid of it; Poison. Do a web search; read read…. never get a root canal.

      • Anita, how to you get rid of root canals? I’ve had some for 60 years?

        I also have trouble with my ears and any number of ENTS haven’t helped. I think I’ll try the N-acetylcysteine and report back.

        • erp, I think the only way is to have the tooth (teeth) removed. I had two removed last year. My holistic dentist didn’t mention any other solutions.

          • Betsy thanks for clearing that up.

            Ah. The teeth were removed and crowns inserted many decades ago. They haven’t given any trouble (that I know of) since then.

    • Hi Marie – I’ve been battling tooth, ear, and sinus infections for years, including many gum abscesses. What helps me are the following:

      Goldenseal root for an acute infection. I don’t take this long term, but if I have an abscess, I’ll take it and it really helps. I do this instead of getting antibiotics (though I take it like an antibiotic for 10 days or so) because many doctors are cautious about prescribing antibiotics. Goldenseal Herb is not as potent.

      Bovine colostrum – I buy the Simbiotics grass-fed Bovine Colostrum. I prefer the powder and I like to chew it and get it on my teeth and gums. My teeth have never been healthier since doing this. It also has repaired my sciatica. I feel no need to stop using this.

      Turmeric – you can take this for awhile to reduce inflammation and it will help with your pain if you don’t want to take advil. Not sure if it can be taken for an extended period of time, but it’s just a spice.

      Oil pulling – I put olive oil in my mouth and swish it around for 10 minutes and then spit it out. My mouth feels so much better.

      Consider a xylitol-based tooth”paste”. It really reduces plaque and helps reduce my tooth pain.

      This diet with plenty of grass fed butter and pasture-raised eggs for the k2. My teeth/ears/sinuses have never been better than on a paleo-type diet. I don’t even need flonase anymore, and I was on a double dose before this.

      I hope this helps.

      • Bel,

        Where does one acquire colostrum? I have heard of athletes supping colostrum to aid in recovery time, but never really thought it an option. I am now intrigued. Any thoughts on this, Paul?

  48. Hi Paul –
    I am just beginning to incorporate your philosophy into my diet and the diet of the folks I live with. I’m somewhat confused as to how to balance the
    20/65/15 calorie percentages with the 65/35 weight percentages. I would love to see an example of a daily menu for a ketogenic diet to give me a sense of whether I’m on the right track or where to tweak it if not.
    Also, I live in the Caribbean and yuca is one of the staples here. Is that considered a safe starch or, possible like cassava, a starch rendered safe by cooking?
    Thanks for all of your work and your help.
    Dipam

  49. Dipam
    Agree this would be most helpful to get a weekly sample menu
    Let me know too cheers Richard

  50. Here’s a blog with some thoughts on fructose and calories vs carbohydrates as drivers of hepatic de novo lipogenesis…
    http://hopefulgeranium.blogspot.co.nz/2012/07/what-does-hypercaloric-actually-mean.html

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