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 ?

9,620 Comments.

  1. Paul,

    First, thank you for suggesting stool testing when there is gastro issues, and the Metametrix in particular. I did get the GI Effects test done and I finally have the results. I would so appreciate your thoughts on what was found before I see my doc next week.

    They found high levels of H. Pylori (reference range is less than 1.0E and mine was 6.0), positive for parasite present taxonomy unavailable, and they said that this found often, likely indicates an ingested protozoan and does not necessarily require treatment, also low total short chain fatty acids and n-butrayte, high fecalIGA, which represents immune system reactions to antigens, low Escherida Coli. No clinically significant levels of opportunistic bacteria or yeast/fungi, no evidence of maldigestion/malabsorption, IBD, no blood/mucous, or celiac disease. I was really surprised by the H. Pylori as it was negative with endoscopy bioposy in the fall of 2009.

    My symptoms for the past two years are still ongoing: acid reflux, nausea, fiber intolerance, food intolerances, occassional headaches/rashes, anxiety, hypoglycemic symptoms with too much starch/sugar, bloating, and pain at the top of my stomach. I have been following PHD for the past year, I seem to do okay with potatoes as a starch source–fruit causes bloating and the fiber in it is challenging, except for a banana sometimes. Probiotics are the only thing that seems to be helping. Im now in a gastritis flare and have stopped all supplements, yet feel I need to begin again to start healing. I was sure this was yeast related and I feel like Im starting from scratch. Im sorry for the long post!

    Thanks again for your help and empowering us to be in charge of our health–I pushed my doc for this test.

    Devi

  2. Hi,

    Im starting to have a pletty clear picture of my acid reflux symptoms and I’d like to share it here.

    If I eat a fat rich diet (like PHD) I can’t eat any fruits at all and only a little sweet potatoes, potatoes, broccoli, sauerkraut and other vegetables.
    However, I can eat things like honey, rice and cocoa.

    But if I eat a low fat diet (say max 10% of calories) I suddenly can eat all the fuits, berries, root vegetables and vegetables I want without any heartburn.

    So what’s going on in here? What’s common between fruits, potatoes and most vegetables and is not found in honey, rice or cocoa? And it only matters if I combine these foods with fat.

    Some foods I haven’t completely figured out yet are coconut products and different spices. Coconut oil and milk are pretty safe but coconut butter and flour seems to trigger the symptoms. Maybe these fits nicely in the equation if someone wiser can solve it.

  3. @ Devi.

    For helicobacter, Vitamin C megadose is very efficient.

    See my collection of papers: http://goo.gl/hxLSO

  4. BTW, if you do, let me know how it went.

  5. Hi Paul,
    I began implementing the PHD a few weeks ago and after reading your book have been following it strictly for 2 weeks. Before, I (39 yo female) was eating only paleo foods with high fat, low starch (occasional sweet potato) and 300-400 calories of fruit per day in Zone proportions for a couple of years with noticeable improvements in mental and physical health. I tried GAPS earlier this year to clear up 2-year vaginal itching and was VLC for about 3 months but I had very low energy and mental health was fairly poor – impatience, irritability, negativity, and mood swings increased – although I did wean off Zoloft during this time with little to no noticeable change. So I went back to eating 300-400 calories/day of fruit as my main carb source and although my mood improved to previous state it still wasn’t great.
    When I began implementing PHD a few weeks ago I cut fruit back to about 80 calories/day and upped starch intake with sweet potatoes, potatoes, sourdough buckwheat pancakes, and white rice. Within a couple of weeks chronic health issues such as itchy, flaky scalp, tense painful neck and shoulder muscles, and cyclical vaginal itching had disappeared, my mood had improved noticeably, and I was able to do a little weight-lifting without it wiping me out physically and mentally.
    2 weeks ago I cut out fruit entirely and began getting all my carbs in PHD proportions from white rice, sweet potatoes, sourdough buckwheat cakes, and potatoes and saw a dramatic improvement in mood and ability to work-out without negative effects, and the fuzzy-headeded/blurry-eyedness that I’ve felt intermittently throughout the day for as long as I can remember disappeared. For the first time in my life I felt happy, relaxed, patient, care-free, clear-headed/eyed, and not hungry (I’ve always noticed being hungry in my head, not my belly).
    That lasted for about a week, and now I’m feeling extremely sleepy/low energy, my old mood issues are back, I have little to no appetite, I’m not sleeping well, and I’m not recovering well from weight-lifting in which I do one type of lift 2/week. I thought it might be due to undereating so today I forced myself to eat more than 390 calories protein/500 calories carbs/1600 calories fat to try and rebuild energy reserves. Yesterday I tried a simple dextrose/whey protein drink and felt an immediate boost in energy and spirits but the two (one with berries) I had today didn’t have the same results. The one good thing is that the fuzzy-headeded/blurry-eyedness and hunger feelings in my head have not returned – the only other time I was free of these issues was when I was VLC on GAPS.
    So, I’m wondering if this is just a transition period after being glucose-deprived for so long in which my body has to adjust to the starchy carbs so I just need to ride this out? I experienced 2-3 days of bloating/constipation a week ago after eliminating fruit, but since then I’ve actually been more regular than when I was on high-fruit/low-starch. I’m also feeling a slight craving for something really sweet/rich-tasting, as if it will wake me up and give me a boost.
    Or is it something bigger? 10 years ago I had upper jaw surgery and 2 years ago an infection around a screw in the jawbone was diagnosed and treated by removal of the screw and a less than 10-day course of antibiotics. Doc said it may have been infected since the surgery. I stopped the antibiotics short of 10 days d/t itchy skin and that’s about the time the vaginal itching began. I’ve not had any further symptoms of this infection although the feeling in that part of my face has never returned completely.
    I’m taking Vit D, pantethine, Vit C, CoQ10, and adrenal health herbal formula, and Natural Calm daily.
    Thanks for your help!
    jtl

  6. Hi Paul,

    I recently purchased your book at a talk you did at Wraparound Porch. My family and I really enjoyed your talk. We are slowly removing cereal grains from our diet and increasing our Omega 3 intake. I’ve started to use coconut oil for all my cooking. Luckily for us we love eating lots of grass fed meat. The rest of my family is not big on sardines and animal organs but I love it all. I think the hardest part will be giving up hearty wheat breads. If anyone has any good bread recipes please do share.

    I’m curious about how you feel about fermented cod liver oil. Do you recommend it? If so, how much? It is my understanding it is a good source of A, D, and Omega 3. Any thoughts? I have so many questions but thought I would start with this one seeing I have 2 big bottles of Green Pasture fermented cod liver oil.

    Sincerely,

    Deb

  7. Is having more omega 3 than 6 unhealthy?

    What if a diet supplied about 2 grams of omega 6 daily and 4 grams of omega 3. Is this cause for concern?

    What is the minimum amount of Omega 6 and Omega 3 that a diet should supply?

  8. Hi Paul —

    I love your approach to nutrition (PHD) but wonder how you would explain the good health and physical stamina of individuals in the raw food movement like Doug Graham and Gabriel Cousens, neither of whom eat any fat to speak of. It seems, from the perspective of the PHD, that they must be either on the wrong track or missing something, yet they seem to thrive. Your thoughts?

    Thx
    TC

  9. Wasn’t sure where to post this but I thought I would share an update on my antifungal therapy.

    I have been taking 200mg of Diflucan along with 2 caps of Kolorex for almost 2 weeks now… so not much time but I have seen some very significant changes in that time period.

    I am eating a diet high in sweet potatoes and lower in fat/protein. Probably anywhere from 50-60% carbs, 20-30% fats and 10-20% protein.

    Before when attempting this high carb diet, my digestion went to hell. 3-5 bowel movements a day, starting with 1 good one and then each one after got worse. Never diarreah but not well formed, etc (sorry to be TMI). My sebhorreic dermatitis would flare up even though my skin was more moist and healthy (maybe increased oils flared this). Allergies seemed to be worse. Sleep was sometimes better and easier, sometimes worse.

    I went high carb because I seemed to develop some thyroid symptoms on low carb that were easily erased with a high carb PHD.

    Now, two weeks into Diflucan, my digestion is almost perfect. 1-2 solid bowl movements a day all well formed. No IBS like urgency at all anymore. Better athletic performance, smoother healthier skin (the seb derm redness has vanished but there is still some minor flaking… upping the bone broths, vit C, vitamin A to speed healing). Congestion is much much better and my gums have stopped bleeding!

    I plan to continue the Diflucan for at least 3 months, maybe longer if needed. My goal is to completely erase all signs of Seb Derm (flaking, redness, dry skin), and keep what I have gained in digestion and other areas.

  10. Hi Sweet Feather,

    Hemochromatosis is an interesting disease, thanks for providing the link, I hadn’t realized it is so common (1%).

    The obvious steps are reducing dietary iron and bloodletting. I’m not sure it’s a great idea to reduce dietary iron much. Some of the healthiest foods, like red meats, shellfish, and seafood, are moderately iron rich. You might increase starches a bit and reduce animal meats a bit, rather than changing the ingredients you use.

    Bloodletting might be a better way to control iron levels.

    I would have to research how other micronutrient needs, like copper or sulfur, might alter in this disease. It is possible our supplementation recommendations might get adjusted.

  11. Hi Devi,

    It’s great that you had the stool test, it’s really hard to guess what causes gut problems since so many different pathogens can produce similar symptoms.

    H pylori is interesting. Not everyone gets ulcers from it, and it can infect other sites besides the stomach. It’s a known cause of acid reflux. In the stomach, it suppresses acid production. Have you tried betaine hydrochloride supplementation and does it improve your reflux?

    If you’re low in SCFA and butyrate, you would seem to have a deficiency of normal bacteria, especially of the resistant starch digesting types. Probiotics are good, but the species you need may be more common in fermented foods.

    For treatment, it looks like the candidates are H pylori and parasites. I might try a parasite treatment, like mebendazole, for a week and see if it has an effect. Since H pylori is treated with antibiotics and probiotics help, H pylori treatment might set you back temporarily, that’s the main rationale for trying the other one first.

    But since your symptoms seem to be primarily stomach and small bowel, H pylori may be a more likely culprit. I believe they use a combination antibiotic therapy for something like 6 weeks. You want to get an abundant probiotic like the Critical Care brand, take several a day, plus eat fermented foods like kimchi daily throughout the antibiotic treatment.

    If fecal transplants were routine, I might suggest one to do a better job replenishing the missing flora. But I think going the natural route is probably the most practical.

    Hi majkinetor, thanks for your help!

  12. Hi jnv,

    The key here is that the flux of endotoxins from the gut depends on both carbs (which feed gut bacteria and increase endotoxin production) and fat (which carry the endotoxins into the body). So eating low-carb decreases endotoxin production and eating low-fat decreases endotoxin entry to the body.

    Normally the immune system adjusts to control endotoxin entry into the body, so if you eat a mixed fat-carb diet (which would bring the most endotoxins in) the gut barrier and the immune system tighten up to reduce gut flora populations and endotoxin influx.

    So I would guess that in your case, for some reason, the gut is too leaky or the immune system too suppressed to achieve this, and mixed fat-carb diets bring high toxin levels into the body.

    As far as specific foods you are sensitive too, that’s a good question. The SCD and GAPS diets have long lists of foods that IBS sufferers tend to be sensitive too, another common sensitivity pattern is FODMAPs. You can find some lists of FODMAP foods online (eg http://ibs.about.com/od/ibsfood/a/The-FODMAP-Diet.htm). I would check out SCD, GAPS, and FODMAP sites and see if your pattern matches up with others’ sensitivities.

    So it’s looking like: (a) some kind of gut dysbiosis maybe producing a sensitivity to some class of nutrient such as FODMAPs, (b) a leaky gut or suppressed gut immunity possibly due to the gut dysbiosis, leading to (c) uncontrolled entry of endotoxins to the body.

    The first step is to use probiotics, fermented foods, enzymes, and other tactics to try to fix the dysbiosis. I would look for lactobacillus reuterii supplements and other supplements known to help with leaky gut.

  13. Hi jtl,

    Well, it’s great that you were able to experience improved symptoms for a few weeks, that really directs us toward the gut as the source of the problem.

    Unfortunately gut pathogens can evolve and adapt to different types of carbs to some degree. So if you don’t have enough “good” bacteria to outcompete the bad bacteria, they can learn to flourish on the new foods.

    I think the switch from fructose to starch is an improvement, and your improved regularity is a good sign. Trying the dextrose powder drink was a good idea. Does the dextrose drink relieve or promote your craving for sweets? You might try a bit more of the dextrose to test this question.

    I definitely think your jaw infection may be connected. The itchy skin and vaginal itching while on antibiotics suggests a fungal infection.

    A fungal issue might be compatible with some of your gut experiences, as (a) fungi tend to be slower adapting to dietary changes than bacteria and can easily take several weeks to adapt to starches, (b) sleepy / low energy / mood is consistent with circulating toxins esp with circulating cell wall components from dead fungi, and (c) the extra starch probably aids fungal immunity and would have helped push back the vaginal infection.

    So what I would do is ask my doctor for cholestyramine (if you can’t get it, use activated charcoal or bentonite clay, both available over the counter) and take that regularly once a day. This will help excrete fungal die-off toxins and I would expect it to relieve your symptoms.

    I would stick with starches and dextrose or rice syrup as carb sources, and follow an anti-fungal diet with foods like spinach and lots of vegetables and traditional herbs esp fermented vegetables (eg kimchi, best made at home).

    If the cholestyramine works I would ask my doctor for anti-fungal drugs like nystatin or fluconazole.

    Also, you might try our recommended supplement program. Minerals like copper, selenium, iodine, and chromium may be important. I recommend getting the copper from 1/4 pound beef liver per week, selenium, iodine and chromium from supplements.

    Please let me know how things develop.

    Best, Paul

  14. Hi Deb,

    It was great to meet you at the talk! I’m glad to see you here.

    Fermented cod liver oil is a great food that may be a suboptimal part of the diet. The reason is that you can easily get an excess of pre-formed vitamin A or of fish oil. We think liver and eggs are better sources of A than cod liver oil, and salmon or sardines are better sources of fish oil. So I would suggest eating the liver, egg yolks, salmon and sardines and skipping the fermented cod liver oil.

    We discuss the issues with too much A or fish oil in Step Three of the book, and also in places on the blog.

    You might give the fermented cod liver oil to the other family members who don’t like sardines or organ meats.

  15. Hi monte,

    It’s OK to have more omega-3 than omega-6, but it’s not OK to have excessive amounts of omega-3.

    I would try to keep omega-3 + omega-6 below 5% of energy, and each one below 3% of energy.

    2 g omega-6 and 4 g omega-3 daily would be fine. But to get omega-6 that low would probably require a starch-rich high-carb diet with relatively few fats.

    Minimum — probably about 1 g/day omega-6, 0.5 g/day omega-3. It’s not necessarily optimal to go that low, but that should be enough to prevent overt deficiency symptoms.

    Hi tom,

    Well, we do have an appendix to our book on “How to be healthy vegetarian.” So I think it’s possible to vary macronutrient ratios and plant:animal ratio and still be healthy.

    Also, good health is a relative term. Most Americans get 60% of calories from toxic food sources. It’s not hard to improve on that.

  16. Hi Bill,

    Thanks for the update! That’s great news. I bet you’re wondering why you didn’t try the anti-fungals earlier.

    A few suggestions:
    1) Get a prescription for cholestyramine and take about 1/3 the normal dose upon waking. This will help clear fungal die-off toxins. Cholestyramine has been a huge help for me, and I’ve run into problems every time I’ve taken anti-fungals without it.
    2) You might be able to get by with a smaller dose of antifungals. Some people go as infrequently as once a week. Reduced dose will help minimize side effect risks. You can play around to try to find a good dose that enables continued progress.

    Congratulations, I hope all is well soon!

    Best, Paul

  17. Thanks, Paul, for responding to my question about Hereditary Hemochromatosis. I hope you have time some day to do a blog post on it.

    Vitamin C greatly increases iron absorption. Because HH is such a common genetic disorder, anyone wanting to start with high dosage supplements of Vit C and/or iron would be very wise to have an iron panel done to assess iron status BEFORE doing so. You can be anemic and still have HH!!!!

    The tests you need to assess your iron status are NOT done in a typical so called “complete” blood test.
    http://www.irondisorders.org/tests-to-determine-iron-levels/

    Hemochromatosis is also called the “Celtic Curse.” People with Celtic ancestry have an especially high probability of carrying genes for this disorder. Not Irish, Scottish, or Icelandic? The iron thrifty genes spread further than you’d think!
    http://americanhs.org/celtic.htm

    More info:
    http://www.irondisorders.org
    http://www.irondisorders.org/iron-library1/

    Diet recommendations, exact tests to ask your doctor for, and a form to help you monitor your lab results:
    http://www.irondisorders.org/Websites/idi/files/Content/763195/HHCstarterkit2009.pdf

    BTW, slightly elevated liver enzymes can be an early sign of HH. That is how our family was clued in and luckily we had one of the few doctors who know HH is not just found in overweight middle aged alcoholic men!

    Thanks for helping to get the word out.
    My best, Sweetfeather

  18. For Shelley (Sept 9. 2011)

    Intermittent vertigo-like symptoms can be caused from POTS. Postural Orthostatic Tacchycardia Syndrome.
    http://www.dinet.org/symptoms.htm

    Tilt-Table tests are expensive but you can do a “Poor Man’s Tilt Table” (test your BP and pulse with a cuff after lying down five minutes then standing up after five minutes and then every five minutes for 20 to 30 minutes. Don’t lock your knees but stand in place without moving butt or leg muscles or shifting weight. Have someone with you or have a soft surface behind you in case you faint. If your pulse goes up over 30 beats a minute AFTER you’ve been standing for five minutes and you’ve had symptoms for over 6 months you might have POTS.
    http://www.dinet.org/symptoms.htm

    Another easy way to see what your heart rate is doing is to buy a heart rate monitor watch (kind with band you wear around your chest) and keep track of your heart rate. If you notice your heart rate goes up more than 30 points after being upright you might want to get tested for POTS. Many doctors think POTS only happens to teenage girls so educate yourself.
    http://www.dinet.org/symptoms.htm

    Up to 80 percent of those with Ehlers-Danlos (hypermobility connective tissue disorder) may have POTS symptoms.

  19. Paul,

    Do you think transdermal magnesium “oil” is a good alternative to oral magnesium? An anecdotal article at WAPF recommended it, since many folks have absorption problems with oral supplementaion.

    http://www.ancient-minerals.com/products/magnesium-oil/

    http://www.westonaprice.org/vitamins-and-minerals/magnificent-magnesium

    Also, do you know whether daily swimming in the ocean would provide enough magnesium?

    Thanks!

  20. Hi Paul,

    Thanks for your reply. I’ve read about SCD, GAPS and FODMAPS before but none of these exactly matches my experiences. Partly yes, but then I have these exceptions like honey and rice which I can eat as much as I want whether Im on a low or high fat diet. And none of these considers food combining as a problem, which makes me wonder how many people who think they are sensitive to fruit for example (like I thought I was), are sensitive to them only with fat.

    I can eat a very high carb diet (like 80% of calories) rich in fruits, rice and potatoes as long as I keep my fat intake minimal. If I eat too much fat, even a smallest piece of fruit gives me horrible heartburn after about 2-3 hours.

    I always thought to myself that something starts to ferment in my gut after a couple of hours of eating and causes the acid reflux symptons. And it would start to ferment only if I eat too much fat because fat slows down the absorption of food. Couldn’t something like this be the cause?

    Myabe I should just stick with high carb low fat diet since Im doing fine with it. I could eat high fat diet but It would be very nutrient poor compared to high carb diet.

    Ive been eating paleo diet for two years and during this time I’ve already eaten plenty of probiotics, sauerkraut and kefir, so I suspect these don’t help much further. I’ve eaten digesting enzymes and betaine hcl for half a year daily. Im also taking, D3, magnesium, chrome, selenium, zinc+copper, k2, msm, activated charcoal and bentonite clay daily. Ive build my iodine dosage to 30mg over the past six months. Anymore suggestions?

    A little offtopic but I’ve wanted to ask this for long time. How do you see the evidence that all the healthiest populations (like Okinawans and Kitavans) eat a high carb low fat diet and there is not a one population eating diet high in fat? Shouldn’t we just look at these healthy people and copy what they are doing? Thank you for your help!

  21. Hi Sweet Feather,

    Thanks for all the info!

    Hi Sal,

    I think transdermal is a good way to get magnesium, but I’d probably favor epsom salt baths as this provides sulfate too.

    Hi jnv,

    Your pattern is rather mysterious, but there’s a lot we don’t know about gut dysbioses.

    I would expect that it has more to do with odd pathogens and the nature of the good bacteria you have present. For instance, some pathogen may infect intestinal cells and downregulate absorption of some nutrient type in some part of the gut, or infect immune cells and alter gut defenses locally. This might affect specific types of digestion.

    I think you should get the Metametrix GI Effects stool test that Devi had, that would give us some guidance.

    Re the healthfulness of high carb low fat, I don’t dispute that it can be healthy, but I don’t believe it’s optimal. If you’ve read our book you know my main response: What about all the mammals who thrive best on high-fat diets? What about the infants of all mammalian species including humans who thrive best on a high-fat diet (breast milk)? It defies reason that adult humans, but not adult mammals or infant humans, would do better on high carb.

  22. Paul,

    Thank you for the reply. I have tried Betaine HCL and it caused discomfort, yet that may be because there is so much sensitivty in my stomach, right now sea salt and lemon is causing extreme pain. I am going to up my probiotics and see if that helps as well, Im a little nervous about antibiotics for the reasons you mentioned about lack of good flora–thinking about natural antibiotics. Unfortunately, I get terrible headaches from fermented anything, so I cant do those foods.

    I also recently tested positive for HHV-6 IgG antibodies (positive greater that .99, I tested at 5.42). Could this have anything to do with my symptoms or more likely from a primary infection in childhood? I do have a history of a fever of unknown origin in 2001 (for which I was given tons of antibiotics for 4 months to no avail.

    In terms of diet/supplements, I was wondering which version of PHD would be best to address the H pyplori bacteria/possibly virus/low SCFA–ketogenic, high/low protein/carb? I took out the potatoes and seem to be feeling better–following more of a full GAPS approach with carbs from winter squash, banana..though maybe need the resistant starch–im quite confused. Im taking D and K2 right now.

    Thank you, your insight is much appreciated.

    Devi

  23. Hi Devi,

    I do think HHV-6 could be important. It seems like it would be much easier to explain your symptoms if there is a systemic co-infection that alters the body’s response to other pathogens like H pylori.

    Here’s a paper showing what I have in mind: http://www.ncbi.nlm.nih.gov/pubmed/12868990. People who had HHV-6 infection and were positive anti-H pylori antibodies were much more likely to develop idiopathic interstitial pneumonia. IIP involves disruption of the epithelial surface of the lungs. You could have something similar in the small intestine.

    Re diet, I think you have to experiment. I would probably start with a ketogenic diet: I think this would help against the viral and H pylori infections but hurt against the unknown parasitic infection. Protein-wise, I’d probably start with a bias toward low muscle meat protein but high collagen/gelatin/bone broth protein, to help promote epithelial tissue healing. (Also vitamin C and epsom salt baths.)

    You have a rather mysterious condition so I think you’ll have to feel your way slowly. Don’t make more than one change at a time, and give any particular diet a month so that you can have confidence you know its effects.

  24. Hello-
    I just finished reading the Perfect Health Diet book, although I have been incorporating some of its principles into my diet for a while. I have been following a traditional foods diet fo 2-3 years, slowly ramping up in fat intake from years of lowfat dieting, and went low grain/legume almost 1 year ago, trialing low-carb for 2 weeks to start a stint of Whole30 paleo (just finished that).

    An interesting thing happened while on the paleo elimination diet (which, by my estimates, was about 60-65% fat, mostly saturated and monosaturated, along with about 25% protein and 15% carb.) My menstrual cycle while on Whole 30 was more intense, with more intense spotting than usual, and more lower back pain than I have experienced in years. I am concerned that the level of fat intake was somehow related. Or maybe there is another component of the diet change that is related…

    A little over one year ago, after five years of being either pregnant or nursing, I started to develop some health problems:
    a) a series of sudden, small dental cavities despite good hygiene and supposed good diet
    b) light spotting before menstrual cycle (up to five days)
    c) fatigue, particularly in the second half of my cycle, along with some depression, anxiety, anger

    January 2011, after a consult with my doc, my hormones were tested and were in the normal range. My free T3 was slightly low, and my thyroid antibodies were in range, so my doc told me to add seaweed to my diet. Also, I tested as deficient in vitamin D, so I increased my supplement (I had been taking fermented cod liver oil). At that time, I decided to go low grain/gluten free/low legume and to make other diet changes to see if it helped. My fatigue has improved somewhat, but the spotting continued. I decided to go full paleo to see if it helped, but doing the Whole30 was correlated with a more intense spotting and pain during menstruation.

    Do you have any ideas on what could have caused this?

    Thanks for any ideas.
    Tania

  25. Hi Paul,

    You reference several times in this thread ‘cooked collagen’. Why specify cooked?

    The reason I ask is that I find making bone broth laborious, and it’s hard to find bones from beef and lamb, most butchers around here don’t ‘butcher’ any more but rather re-sell packaged meat. I do make chicken broth but again not every day. I want the extra collagen as I feel I am getting premature wrinkles and have a clicking in my knee that would indicate a collagen production deficiency. I am vitamin C replete for some time now.

    I was looking for a more reliable source of collagen so purchased Neocell type I and III collagen powder. Do you think this is raw collagen? The reason I ask is the first time I tried this with a glass of orange juice I experienced some of the worst gastric upset I have ever had about 6 hours after. It may have simply coincided with an brief bug as others had similar recently, but the almost immediate rumbling in my stomach after taking it would lead me to think otherwise.

    I tried to see if anyone has had a similar reaction to this but to no avail.

    So my question is this:

    1. Is it feasible for collagen to cause this level of extreme reaction? I’m too afraid to try it again!

    2. Could the fact that the collagen be uncooked be a factor, in which case would dissolving it in hot water resolve this?

    3. Are there any brands of stock or collagen that I could buy that you would recommend?

    Thanks again for all you do!

    Sarah

  26. Hi Tania,

    I have some ideas but they’re primarily ideas for further diagnostic testing.

    One possible cause of spotting is endometriosis. That can be evaluated through imaging, eg ultrasound.

    A leading possibility to consider is hyperparathyroidism. This is when the parathyroid glands, which are next to the thyroid glands, produce too much parathyroid hormone, PTH. That causes cavities and weak bones, elevated blood calcium and 1,25alpha vitamin D, fatigue, and depression. Here is a list of symptoms: http://www.mayoclinic.com/health/hyperparathyroidism/DS00396/DSECTION=symptoms. Your doctor can test PTH, 1,25D, calcium, phosphate, and other hormones.

    Looking a bit earlier in the causal chain, one possible cause is circulating toxins. Ask your doctor for a prescription for cholestyramine and see if it helps (take once a day while fasting, preferably first thing in the morning). Or try bentonite clay or activated charcoal instead (both are sold over the counter). If that helps, it will be a good clue. Also try drinking lots of water and eating extra salt.

    I think if you try these tests / experiments we’d have a much better idea how to go forward.

    Hi Sarah,

    I saw cooked because uncooked collagen is largely indigestible and unusable.

    You can buy powdered gelatin in bulk, but the only good cooking use I’ve found for it is mixing into bone broth soups. The only thing it goes well with is other collagen!

    In addition to the proteins, sulfur is needed to make collagen, so you could try MSM or epsom salt baths.

    #1, I have no idea what may have caused your reaction to the Neocell product. I don’t think pure natural collagen would cause a reaction, but if it contains animal proteins. I would try gelatin or natural bone broths.

    #2, Dissolving the Neocell in hot water might solve the problem. It’s worth a try.

    #3, Our recommended supplements page lists some gelatin products.

    Best, Paul

  27. Hi Paul,
    Thanks for your response! I’d like to get clearer about a couple of things you mentioned:
    1. am i understanding this correctly – the fatigue and mood issues are being caused by fungal die-off which is being caused by my switch from fructose (their food source) to starch? but the fungi could adapt to starch and begin to thrive again which will then bring back my currently resolved symptoms?
    2. for an anti-fungal diet (which i have tried many times and couldn’t continue d/t being too low-carb) should i just follow your diet (300 cal protein, 400 cal carbs, 1300 cal fat) with all my carbs being from starch, rice syrup, and dextrose (no fructose at all)? or do i need to decrease carbs?
    3. i have bentonite clay and am taking that 2/day – you’re saying that if that works to relieve the fatigue/mood, then that’s proof that it’s fungal and i should go on anti-fungal meds? if so, for how long? until the fatigue/mood resolves without my needing bentonite?
    4. have you done a post on anti-fungal treatment with herb/diet recommendations? if so, then no need to answer my above questions!

    thanks!
    jtl

  28. I too would love, love, love your take on acne and what to do about it. It’s the main thing wrong with my health and since it’s so visible, I can never be happy with my health before it’s cleared.

  29. Hi jtl,

    1. I think the fatigue and mood issues are caused by die-off toxins (eg fungal cell wall components) circulating in the blood and lymph, and by cytokines which can trigger remote inflammation.

    Switching from fructose to starch doesn’t cause fungal die-off. Fungal die-off is probably larger with the fructose because that feeds the fungi better, causing them to reproduce more, causing the immune system to kill more, producing more die-off toxins. The more fungi you have in your body, the more toxins you’re likely to have.

    There’s no diet you can eat which will starve fungi. They can eat you, they can eat glucose, they can eat ketones. So you have to promote immune function which starch does. Fructose is not a good nutrient for you.

    2. Yes. That’s a good anti-fungal diet. It’s a mistake to go too low-carb, you’ll do better on moderate carb. I often recommend 600 carb calories a day for fungal infections, but 400 should be adequate.

    3. I’d say evidence rather than proof, but it’s good evidence. Take it until you have cleared the infection from your body, as reflected by lack of symptoms. That will probably take a while (a year?).

    4. Coming up.

    Hi Johan,

    I’ll post something soon, either on this thread or in a post.

  30. hi paul,
    wonderful, thank you! coming from years of trying to follow anti-candida/gut-healing diets, your suggestions are creating a paradigm shift for me and it’s taking me a while to wrap my brain around it. it seems that basically everything i’ve done off and on for 15 years including the most recent in following the GAPS diet (no starch, lots of fruit) have been wrong for me. what you are saying here -that you can’t starve fungi, that you need to eat higher carb to boost immunity to overcome the fungi – is the opposite of what my understanding of the majority of anti-fungal protocols are (eat low-carb to starve the fungi). the intense craving for starch that i struggled to ignore because i was under the impression that it was the pathogens’ cravings for food was actually a healthy nutritional need….argh. anyhow, i so appreciate your help and all the work that you’re doing here.
    thanks!
    jtl

  31. Hi jtl,

    Yes, you’ve got it.

    One point of terminology: I don’t recommend high-carb, just moderate carb. 600 calories a day is ~30% of energy for a sedentary person, I consider that moderate. The key is you don’t want to starve your body of glucose. Glucose needs are significantly elevated when you have a fungal infection. That is probably why you were hungry for starch.

    Best, Paul

  32. so then, wouldnt the primary goal be boosting the immune system? (as vague as that sounds…) and that glucose needs would only be one part of that strategy… hmm, i don’t know anymore lol.
    paul, could you elaborate and also: when would you recommend taking chlorella? use it like bentonite clay in between meals to see if the supposed die-off effects diminish, and then there’s a clue?

  33. Hi Paul:

    I’m a 44 year old man who has been suffering from rheumatoid arthritis since 1999. Went through a regular MD for about 3 yrs, but got continually worse, not to mention the drug side affects. I was at the point where I could hardly get out of bed or clothe myself. So I ditched the AMA and their drugs and pursued diet, vitamins, exercise, etc. This route provided 85% improvement and considerably slowed down the progression of the disease. When life gets crazy, though, my discipline goes out the door and the disease progresses again. I would like to conquer, get over the top, be done with this disease and wake up without pain and swelling in my joints. Where do I begin?

    Thanks,
    Scott

  34. Paul — what’s the ‘deal’ with cured meat? Like salami?

    The ROF (rest of family) has been slow to migrate, and one of their crutches is salami. How awful is this?

    I seem to recall you mentioning cured meat in the same breath as the other neolithic horsemen, but am unsure why.

    thanks!

    john

  35. Hi Paul,
    Thank you for taking your time to respond to questions from your readers. I have a question that I have searched the web for answers for and have found many differing ones and of course have no idea which may be sound answers. I was wondering if you would have any advice on this. I take most of the supplements you recommend except chromium and copper but my multivite/mineral has some in it and i eat some liver weekly, but it was only three weeks ago that I added the iodine. I take 1 drop daily (not dropperful..just one drop) of the Lugol’s 2% soln. ( In the past (several years ago) I had taken Iodoral 1/2 to 1 tablet and didn’t have this problem…)
    Anyway, for about 5 days now I’ve had a metallic taste in my mouth. It is mostly noticeable when I drink water or coffee and unfortunately when I have my small piece of 85% dark chocolate, or when I’ve gone without eating for a length of time. ( this is apart from the metallic taste of the solution itself)I have been hypothyroid for 14 years. I do not know if it is Hashimoto’s or not. My dose has slowly and continually needed to be lowered over the years and I can tell when it needs lowered because I begin to get heart palpitations (labwork confirms this). As i mentioned I have taken Iodoral off and on in the past and never seemed to have any side effects from it, but it never seemed to do much of anything for me in terms of cold intolerance or low body temp or helping with weight loss.( I have lost weight and kept it off since cutting out processed foods, but I still am always cold, and always have a temp under 96.5 degrees)
    Some sights suggest the metallic taste is that my body is now saturated with iodine so I don’t need anymore but would this be true with such a low dose?? Others sites suggest I’m displacing other metals with the iodine and it is excreted through saliva?? What are your opinions on these or do you have any other ideas?
    Thank you for your time,
    Shelley

  36. Paul,

    Was wondering your opinion on the role of biotin and sebhorreic dermatitis.

    It seems to help infantile cradle cap as shown in studies and there are a few anectodes from people that indicate either improvements or total eradication with biotin supplementation.

    There is some literature online to suggest that antibiotics and Accutane both cause issues with biotin defiency, two drugs which I have been on in the past 5 years.

    For me, I notice I will get a acne cyst literally a day or two after a high dosage or biotin, which I then cease supplementation.

    Do all gut bacteria create biotin? Or is it just some? Since biotin is water soluble, can one overdose? Why would it give me an acne cysts? Many others report cystic acne as a biotin side effect too.

    Why does it help seb derm? Is it anti-fungal or does it have to do with it’s effects on fat and glucose metabolism?

    Also, you mentioned previously that I could reduce my Diflucan dosage to once a week after some time… How long should I wait to do this? I plan on taking it daily for at least 3 months… I still have some flaking with dandruff and on the face. Digestion is still much improved as are energy levels.

  37. Hi Darius,

    I no longer suggest chlorella because I’ve never noticed it having an effect in myself. The other detox aids seem to be more effective.

    But yes, if you use it you’d take it between meals and hope to see a reduction in toxicity effects.

    Hi Scott,

    It’s good that you’re off the drugs, I think RA is usually infectious and almost never only autoimmune, so immune suppressants temporarily reduce symptoms but make the disease progress faster.

    I think it’s usually bacterial, so I would look to (1) antibacterial diet strategies, especially intermittent fasting and coconut oil or MCTs, but with adequate starchy carbs to maintain immunity and mucosal barriers and joint lubricant manufacture; (2) antibiotics. See the Road Back Foundation in my links for info on RA and antibiotics. They favor low-dose antibiotics, I favor higher dose combination protocols, but you and your doctor can judge which. I would say get the diet right first, then you’ll be in a better position to judge if the antibiotics are working.

    Best, Paul

  38. Hi John,

    Well, sugar + PUFA + curing is a recipe for toxin creation. Rather like neolithic agents, only the toxins are man made.

    I don’t think it’s awful, crutches have their value, but hopefully they can transition to fresher meats at a later date.

    Hi Shelley,

    Unfortunately, 1 drop of 2% Lugol’s is quite a large dose of iodine to start with. We discussed this on the recommended supplements page: http://perfecthealthdiet.com/?page_id=1066#comment-18332. One drop is 2.5 mg of iodine, a very large amount. It’s not surprising you had a reaction.

    Especially for someone with hypothyroidism, I would recommend starting at 500 mcg or less, spend a month at that dose, then double the dose and spend a month at the new dose, and so on, never raising the dose faster than a doubling per month. So it would take about 4 months to get to a drop of Lugol’s per day.

    Also, you must supplement selenium 200 mcg/day with iodine, and make sure other key minerals such as magnesium, copper, iron, and zinc are in order.

    I would back off on the iodine toward 500 mcg/day, give yourself time to recover, then raise the dose gradually.

    Bromine toxicity is a possible issue, that can be helped by drinking lots of water and eating extra salt.

    Best, Paul

  39. Hi Bill,

    Those are interesting questions which I don’t have time to research at the moment.

    If biotin does indeed have an antifungal effect, it could generate acne cysts due to raising the levels of circulating die-off toxins, eg fungal cell wall components. This causes inflammatory reactions in the skin.

    I don’t believe you can overdose on biotin, but you may need a little time (days) to adjust to higher levels.

    Re dosage, you have to be the judge. If the current dose is working for you, then stick with it. If you start getting symptoms of kidney damage, like foot swelling, I would cut the dose down. Or if you think you may be cured, cut the dose down, but you might consider with an occasional prophylactic dose. There will probably be a low-level infection even after all overt symptoms are gone.

    I don’t know if 3 months is right or not. You’ll have to judge as you go. It can take a long time to clear fungal infections, but at the same time they can take a long time to grow back, so it’s not necessarily terrible to go off treatment for a while and then re-start.

    I do recommend the detox aids though, I got kidney symptoms and acne when I didn’t use them.

    Best, Paul

  40. thanks paul for your reply – in your mind what are better detox agents than chlorella?

  41. I’m 29 years old. About a month ago, I had blood in my stool while traveling . Back home I did an oral test for H. Pylori and it was + 37 which I understand is high, but that the numbers don’t mean much. I just read what you wrote above, so I think I might go back to my doctor and ask for a different test.

    I just started the gaps diet a few days ago (don’t know if I’ll be able to keep it up religiously for a long time). Today my gastroenterolgist prescribed 3 antibiotics and something to reduce acidity.

    I’m wondering whether to take the antibiotics to eradicate the H. Pylori and then continue with gaps to work on healing my gut, or should I postpone antibiotics for now and see if gaps can solve my problem?

    Thanks, George

  42. One more thing. The doctor prescribed the following:
    Flagyl (metronidazole) 250 mg.
    Klaridex (clarithromycin) 250 mg.
    Moxyvit Forte (Amoxycillan as trihydrate) 500 mg.
    and
    Omepradex caplets 20 mg.

    George

  43. Hi Darius,

    Cholestyramine, bentonite clay, activated charcoal.

    Hi George,

    Personally I would take the antibiotics but not the Omepradex.

    Diet is generally the right approach, but if you have bleeding in the digestive tract, there’s a bit more urgency. Did they do an endoscopy to see if they could find where the bleeding was coming from? If they saw an overt ulcer that would help confirm H pylori as the causal agent.

    It might have been better to do a stool test along with the oral H pylori test to get a more complete picture of what might be going wrong. However, given what you know at the moment, it’s plausible to try treating the H pylori. The antibiotics for H pylori will also work against many of the other likely infections, so I’m not sure that more diagnostic testing at this point is worth it. If the antibiotics don’t work then I would get a thorough stool test.

    Be sure to take a lot of probiotics and eat fermented vegetables and yogurt while on the antibiotics.

    Best, Paul

  44. It’s strange Paul, I don’t seem to be getting any detox symptoms. In the first week of taking it, a few days in, I had a ton of IBS symptoms rage up. But after that, everything just improved. Maybe a few restless nights and some very strange dreams but no acne, seb derm flares, or anything…

    I will get my hands on some benonite or charcoal though. I am having trouble finding a good time to take them though…. As I understand it, it must be on an empty stomach and 2 hours before a meal or supplement?

  45. I don’t think you need to take much. Light sleep could be a toxicity symptom, but in general it sounds like your body is doing a good job of clearing toxins already. Just a little bit of help should be enough.

    So I would take a small dose first thing in the morning on waking. You can eat a little food half an hour later.

  46. Paul,

    I’m not familiar with MCTs. What form and where do I find MCTs? Speaking of IF, I like the idea of the 16 hour fast. If my feeding window is 11am to 7pm, what do I have in the morning before 11am.
    How do you feel about green smoothies? Chard, kale, spinach, cabbage, half apple and a handful of frozen berries?
    What kind of tests do I ask for at the doctor’s office? I haven’t been to an doctor in 10 years.
    I crave sugar – bread, chips, chocolate, catsup, ice cream, thousand island and croutons (with my salad),etc.
    I have been taking Advil, 6 to 10 a day to get by. I have to be able to work. When I fast (fresh squeeze lemon, grade B maple syrup, and water) after about 3-4 days I do not need the Advil, but I have no energy

  47. Paul, Just so you know I came from being bed ridden not able to dress myself with RA. I have ran triathlons since but now I stick to yoga. I have come a long long ways. But I want to feel good when I wake up.
    Thank you So much for your research,

    Scott

  48. Hi Scott,

    You can find MCT oil on our “recommended supplements” page: http://perfecthealthdiet.com/?page_id=1066#Nutritious_Foods, look for “Medium chain triglycerides”.

    If you’re doing IF, during the fast you’re permitted:
    1) calorie-less drinks, eg water, tea, coffee;
    2) calorie-less vegetables, eg spinach or seaweed;
    3) MCT oil or coconut oil;
    4) fiber;
    5) lemon juice in water.

    If you crave carbs during the fast, try MCT oil or coconut oil. If that doesn’t work, eat a banana or a bit of rice.

    I think you may find that antibiotics make your fast more tolerable.

  49. Paul,

    I think my body is handling the toxins well because I am eating quite a bit of fiber from 3-4 lbs of sweet potatoes a day plus lots of veggies.

    Will definitely be giving the activated charcoal a try though, why not!

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