Supplements

This page lists our supplement recommendations with links to products at Amazon. By purchasing via links on this page, you support the blog at no cost to yourself. Thank you for supporting our work!

Supplemental Foods

We recommend eating these “supplemental foods” on a regular schedule:

  • 3 egg yolks daily, 5 yolks daily for women who are pregnant or planning to become pregnant (for choline, folate, vitamin A)
  • A bowl of soup made from bone, joint, tendon, foot, or hoof stock, 3 days per week (for calcium, phosphorus, and collagen)
  • Fermented vegetables such as kimchi, sauerkraut, or fermented mixed vegetables (for nucleotides, probiotic bacteria, and vitamins K2 and B12), and other vegetables such as tomato, avocado, potato, sweet potato, banana, green leafy vegetables, and seaweeds such as dulse, daily (for potassium)
  • ¼ lb beef or lamb liver, weekly (copper, vitamin A, folate, choline). If you like, substitute ¼ lb chicken, duck, or goose liver weekly plus 30 g 85% dark chocolate daily
  • fish, shellfish, eggs, and kidneys, weekly (for selenium)

Daily Supplements

These are supplements we recommend be taken daily:

  • Sunshine and vitamin D3 as needed to achieve serum 25OHD of 40 ng/ml.
  • Vitamin K2 100 mcg or more
  • Magnesium 200 mg
  • Iodine 225 mcg
  • Vitamin C 1 g
  • Pantothenic acid (vitamin B-5) 500 mg
Vitamin D3
  • Seek total dose from sun, food, and supplements of 4,000 IU/day
  • Adjust to 25OHD level of 40 ng/ml (whites/Asians), 30 ng/ml (blacks)
Vitamin K2
  • Recommended dose: 100 mcg MK-7
  • Pharmacological, possibly therapeutic doses: 1000 mcg to 5 mg MK-4
Magnesium
  • Use chelate (e.g. glycinate) or citrate
  • Daily dose 200 mg
Iodine
  • Recommended dose 225 mcg/day (one tablet)
  • Nori sheets have about 50 mcg each; 2-4 per day replaces supplements
  • Supplementation is to prevent lengthy iodine droughts
Vitamin C
  • Low dose: 500 mg – 1 g per day
  • Under stress or viral infections, more may be needed
  • Powder is least expensive way to get large doses
Vitamin B-5 (pantothenic acid or pantethine)
  • 500 mg per day; we suggest daily due to its extreme safety
  • Acne/skin blemishes or low energy/endurance are symptoms of deficiency

Weekly Supplements

These are supplements we recommend be taken once a week:

  • B vitamins:
    • 50 to 100 mg each of B1, B2, and B6
    • 5 mg biotin
    • 500 mcg B12
  • Zinc 50 to 100 mg
  • Boron 3 mg
B1 (thiamin)
  • 50-100 mg weekly
B2 (riboflavin)
  • 100 mg per week
B6
  • For those who don’t take a B-50 complex
  • We recommend 50 mg to 100 mg per week
Biotin
  • We recommend 5 mg once per week
B12
  • We recommend 500 mcg to 1 mg once per week
  • Sublingual methylcobalamin is preferred
Zinc
  • We recommend about 50 mg per week
  • Be sure to follow our copper recommendations as copper-zinc balance is crucial
Boron
  • The 3 mg dose can be taken one to three times per week

Prenatal Supplements

The most important prenatal supplements are:

  • Extra duck, goose, or pastured chicken liver.
  • Extra egg yolks.

The following supplements may also be helpful during pregnancy or in the months leading up to conception. Note: We do not recommend prenatal multivitamins.

Choline
  • Not necessary if you eat enough egg yolks and liver
  • But extremely important during pregnancy, and safe
Inositol plus Choline
  • Not necessary if you eat enough egg yolks and liver
  • If supplementing choline, good to mix in some inositol
Iron (optional)
  • About 30% of pregnant women develop iron deficiency anemia
  • Don’t guess, test; blood tests will indicate if you need iron supplements

Optional Supplements


These supplements may be helpful for a significant fraction of the population. Experiment to see if they help you:

  • Probiotics
  • Chromium, 200-400 mcg per week (not necessary if you cook in stainless steel pots) and (optional) vanadium, 25 mcg per week
  • Lithium 5 to 10 mg per week
  • Silicon 5 mg to 25 mg daily
  • FOR PEOPLE WHO DO NOT EAT LIVER: Copper 2 mg per day
  • FOR PEOPLE WHO DO NOT EAT LIVER: Vitamin A from cod liver oil, 50,000 IU/week
  • FOR PEOPLE WHO DO NOT EAT MAKE BONE STOCK OR DRINK MINERAL WATER: Calcium up to 400 mg/day
  • B-50 complex (as a substitute for individual B supplements if you prefer fewer pills
  • Molybdenum 150 mcg per week
  • Taurine 500 mg to 5000 mg per week (higher doses may be therapeutic for small intestinal or systemic infections)
  • Selenium 0 or 200 mcg per week depending on selenium content of food (if food is produced in dry, flat areas = high selenium, no supplements; rainy, well-drained areas = 200 mcg/wk)
Probiotics
  • Bifidobacterium spp can help with leanness and weight loss.
  • Lactobacillus spp can help with acid reflux, bloating, SIBO, prediabetes, high triglycerides
More Probiotics
  • Bifidobacterium spp can help with leanness and weight loss.
  • Lactobacillus spp can help with small intestinal issues
More Probiotics
  • VSL#3 is a good mix for inflammatory bowel diseases.
  • Prescript Assist includes soil-based organisms that are a little riskier and should be taken only occasionally, not continuously, for therapeutic reasons.
Chromium
  • If you don’t cook in stainless steel, we recommend 200 mcg chromium one to three times per week
  • Stainless steel pots may release 88 mcg chromium per day of use
  • Optional: vanadium 25 mcg one to two times per week
Lithium
  • Best is to take 1 mg per day; 5 mg once or twice per week is next best
  • Caution: too much lithium can exacerbate hypothyroidism and increase potassium excretion
Silicon
  • Up to 25 mg per day
  • Most people would benefit from more silicon
  • Seaweed is a good food source
Copper (Only If Liver Is Not Eaten)
  • Target of 2-3 mg/day can be met by eating 1/4 lb beef or lamb liver per week
  • Do not supplement copper if you eat liver
Vitamin A (Only If Liver Is Not Eaten)
  • Target of 50,000 IU/week with remaining A needs met from carotenoids (green leafy vegetables and orange plants like carrots)
  • Do not supplement vitamin A if you eat liver, unless for therapeutic reasons
Calcium (If No Mineral Water or Bone Stock)
  • PHD foods may fall short of calcium target by up to 400 mg/day
  • Standard PHD prescription is to make up the difference with bone stock and/or mineral water
  • These supplements also replace magnesium supplement; aim for 300-500 mg calcium and 150-250 mg magnesium per day
B-50 complex
  • An alternative to the other B vitamins for those who prefer to take fewer pills
  • Not recommended more than once per week due to folic acid and niacin content
Molybdenum
  • We recommend 150 mcg to 1 mg per week
Taurine
  • We recommend 500 to 1000 mg weekly for healthy persons
  • Supports production of bile salts
Vitamin E
  • Red palm oil is a good food source
  • If supplementing, take mixed tocopherols and tocotrienols

Therapeutic Supplements

These supplements are unnecessary for healthy people but may be helpful in various disease conditions.

N-acetylcysteine
  • Precursor to glutathione
  • Recommended dose is 500 mg
  • Can take more in cases of severe chronic infection
Glycine
  • Supports collagen production, bile conjugation, and glutathione production
  • Desirable if you don’t eat daily extracellular matrix (bones, joints, tendons, skin, hooves)
  • Up to 2 teaspoons (10 g) per day
Creatine
  • Supports muscle growth and preservation; especially valuable for the elderly
  • Up to 1 teaspoon (5 g) per day
Melatonin
  • An important sleep hormone, deficient in many brain diseases, has antimicrobial activity
  • Take 1 mg sublingually just before bedtime
  • For larger doses, combine 5 mg time-release with 1 mg sublingual
Detoxification Aids
  • These can help bind toxins and excrete them in feces, preventing them from being re-absorbed in the colon
  • Likely to be helpful for most people suffering from chronic infection or environmental mold.

Miscellaneous


These items may be helpful in implementing Perfect Health Diet and Lifestyle advice.

Pill boxes
  • Set out pills once per week, aids remembering to take them
Pill cutter
  • For cutting tablets to reduce the dose

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Leave a comment ?

4,434 Comments.

  1. Iherb is one of few companies that ship supplements to Norway. I think it’s the same for other countries in Scandinavia.

    I thought I might save everyone a lite bit of time by posting links to what I think are the best PHD supplements that are available on Iherb.

    Another tip if you’re from Norway: It’s cheapest to order many small shipments. Keep the order <200NOK to avoid customs and tax. Keep the weight below 1814g and you can use the cheap "International Airmail" sending option.

    Multi vitamin woman:
    http://www.iherb.com/Rainbow-Light-Just-Once-Women-s-One-Food-Based-Multivitamin-90-Tablets/1797?at=0

    Multi vitamin menn:
    The Centrum Silver is not available. I don't know what else is good. I use a multi mineral instead

    Multi mineral
    http://www.iherb.com/Country-Life-Gluten-Free-Total-Mins-Iron-Free-Multi-Mineral-Complex-with-Boron-120-Tablets/1742?at=0

    Vitamin D3
    http://www.iherb.com/Carlson-Labs-Vitamin-D3-2000-IU-360-Soft-Gels/8743?at=0
    http://www.iherb.com/Now-Foods-Vitamin-D-3-2000-IU-120-Softgels/8229?at=0

    Now food D-vitamin is much cheap then carlson. Paul i notice you have calson as a first choice is there a quality difference?

    Vitamin K2
    http://www.iherb.com/Life-Extension-Super-K-with-Advanced-K2-Complex-90-Softgels/14619?at=0

    To my understanding K2 MK-4 is most important K vitamin. It's difficult to find MK-4 in low doses. To me Life Extension seems to be the best compromise.

    Magnesium
    http://www.iherb.com/Magnesium-Glycinate-400-mg-120-Veggie-Caps/21315?at=0

    Copper
    http://www.iherb.com/Twinlab-Copper-Caps-100-Capsules/2337?at=0

    Chromium
    http://www.iherb.com/Nature-s-Way-Chromium-Picolinate-200-mcg-100-Capsules/1879?at=0

    Iodine
    http://www.iherb.com/Now-Foods-Potassium-Plus-Iodine-180-Tablets/767?at=0s

    This is the only low dose iodine that is not kelp based. Paul you have also been recommending Potassium. Is this in the correct form and ratio? I plan on taking 4 of these and maybe 8 later. ( I'm currently on 4*150mcg from kelp)

    high dose iodine
    http://www.iherb.com/Optimox-Corporation-Iodoral-90-Tablets/23903?at=0

    Selenium
    http://www.iherb.com/Life-Extension-Super-Selenium-Complex-100-Capsules/4366?at=0

    Vitamin C
    http://www.iherb.com/Source-Naturals-Vitamin-C-8-oz-226-8-g/966?at=0

    I think I might use this one on my next order: http://www.iherb.com/Life-Extension-Vitamins-D-K-60-Veggie-Caps/24605?at=0 The only obstacle is that I normally take my Vitamin D & K in the morning while I have seen people recommencing taking Iodine in the evening. One solution is to take 4 of the Now Foods, Potassium Plus Iodine tables in the evening as well.

    Hi Ole,

    Thanks much, very kind of you to provide all these links!

    Best, Paul

  2. Hi Paul,

    Have you read any research on Magnesium Malate?

    It seems to be offered as a remedy for some symptoms of fibromyalgia as well as other mystery pains.

    If you have any links to the biochemical breakdown of Magnesium in the body I’d appreciate that too.

    Thanks so much!

  3. Walgreens One Daily for Men is the best multivitamin formulation for the recommendations in Perfect Health Diet. Nothing crazy.
    Just add an iron supplement for menstruating women.

    Vitamin A – 3500 IU
    Vitamin D – 400 IU
    Vitamin E – 45 IU
    Folic Acid – 400 mcg
    Calcium – 210 mg
    Zinc – 15 mg
    Copper – 2 mg

    Walgreens One Daily for Men
    http://www.walgreens.com/store/c/walgreens-one-daily-for-men-high-potency-multivitamin/multimineral-supplement-tablets/ID=prod3971647-product

  4. I take a far superior multi-vitamin and it’s liquid which is 98%abdorbed compared to pull forms which are only 20% absorbed. It tastes great too which makes it easier to remember and they r inexpensive compared to most I took because I don’t need a lot of other supplements now. Here’s my website if u would like to heck it out and use my link for others to view

    http://tinakalvelage.vemma.com/

    I guarantee you will love it. It saved my life! Briefly, I was taking a multi from my naturopath and napping once a day. I have crohn’s so I must take supplements. It was too expensive so I found another and was napping 2-3 times a day. I started the vemma and on he 3rd day realized I hasn’t had a nap in 3 days! I was so amazed I decided to take it a month and see how it went. It’s been almost 2 years and i don’t nap anymore 🙂
    Try it and see for yourself – let me know and I will order it for u!
    Thanks!
    Tina

  5. Has anyone ever heard of or had the experience of iodine causing acne? My acne is worse then it has ever been, so I’ve been trying to figure out why. I ran across something on Dr. Mercola’s site suggesting that iodine causes acne so now I’m wondering if that could be the culprit. Could I be getting too much iodine (.75 mg a day plus whatever is in raw milk)?

  6. Ashley wrote:

    “Has anyone ever heard of or had the experience of iodine causing acne?”

    Yes, but it’s not likely to be the iodine, but rather the toxic bromine being driven out of your system. It’s called bromine acne. Not common I think on the low dose you’re on, but possible. It’s not pleasant, but a good sign that bromine is being eliminated.

    You could try taking unrefined (e.g., Celtic) salt, maybe 1 teaspoon daily. That greatly speeds bromine (in the form of bromide) elimination via urine. If that doesn’t work, you may have to reduce your iodine dose for a while, or pulse dose, but given the very low dose you’re on I’d guess the salt will work. It did for me.

    There’s much info about this topic in the Yahoo iodine group and in the writings of Dr. Abraham, Dr. Brownstein, Dr. Flechas, and other iodine literate docs. This is very common.

  7. Bill, thank you for the quick response. I’m glad to know that this is common and that there’s something I can do about it.

  8. Hi Paul:
    Paul your doing a great service helping all of these people with your knowledge, and suggestions both in your blog, and your excellent book.

    Paul, a couple of questions.
    Firstly, I understand your views that soy is not healthy for individuals. Does that also mean fermented soy, such as tempeh?

    In a couple of my supplements that I am taking, I noticed in the ingredients, that for the Vitamin E and Selenium supplement combination from ‘New Chapter’ a company that makes whole food supplements, they have fermented soy in the ingredients.
    Due to your views on Vit E, I have a feeling you might suggest stick with a Selenium supplement only, without the added ‘E’.

    Also, in my Zinc, Vit D3 and Prostrate strength supplements, from ‘MegaFood’ another food based supplement company, they all have rice bran in their ingredients.
    I know that you prefer white rice, to the ‘bran’ however, should I try and find supplements that don’t have the rice bran in it?

    Finally, what is your view on Wheat grass powder to take in the mornings?
    Paul, for protein shakes, what are your views on whey protein powder, and hemp seed protein powder to take after workouts?

    Thanks in advance Paul,
    Looking forward to your response,
    Keep up the good work,
    Lawrence

  9. Hi Lawrence,

    Fermented soy is better than soy. I would generally avoid the foods, but we do use soy sauce and miso.

    A little vitamin E is OK. The more athletic you are, the more you need vitamin E. If the amount is large, hundreds of IU, it should be a mixture of forms, not all alpha-tocopherol.

    Rice bran is not something we encourage eating but again, small doses in supplements are OK. It’s not like gluten which can cause celiacs problems in miniscule doses.

    I don’t support wheat grass powder.

    I’m not a big fan of protein shakes either, I prefer food. Why not eggs? But whey protein is OK.

  10. Any recommendations for improving circulation? I have what I am assuming is extremely poor circulation in my feet and it has gotten worse since my teens (about 6 years ago.) Even when the temperature is over 20 Celsius my feet are cold to the touch and only very hot temperatures and intense exercise warm them up and for exercise the effect does not last.

    I have been tested for hypothyroidism and it come back negative and I m otherwise in excellent physical shape besides being stressed all the time.

  11. Hi Paul,

    I was wondering what you make from this study:
    http://www.ajcn.org/content/80/5/1194.abstract

    “Conclusion: A high vitamin C intake from supplements is associated with an increased risk of cardiovascular disease mortality in postmenopausal women with diabetes.”

  12. Hi Rob,

    For circulation our program and exercise should be good. But there are other possibilities. Check out the Raynaud’s (http://en.wikipedia.org/wiki/Raynaud%27s_phenomenon) results linked in our Reader Results page. Their experiences might be relevant for you.

    Hi Wout,

    I looked at another paper by these authors (http://perfecthealthdiet.com/?p=4895) and found them to be anti-supplement. In that study, looking at the full Iowa cohort, vitamin C supplementation reduced raw mortality by 2.4% and age and energy adjusted mortality by 4%.

    The idea that in diabetics specifically vitamin C could have negative effects is interesting, and their data seems to support it. However, my big problem with the paper is that they don’t show all-cause mortality. Mortality from one cause, eg CVD, can appear to go up even if CVD isn’t worsened, because other causes of mortality go down. Then a larger fraction die of the cause with unchanged incidence.

    There are peculiarities about the study too, like why does Quintile 5 have 667 members, 49% of the study population, Quintiles 1, 2, 3, and 4 only 85, 139, 189, and 279? Given the anti-supplement bias of the authors, I wonder if they chose the quintile sizes in order to make vitamin C look as bad as possible. Quintile 5 basically had everyone supplementing vitamin C, and many who supplemented only with a multi. So a finer breakdown of Quintile 5 would have made more sense than a fine breakdown of the non-supplementers, if you really want to see the effects of C.

    So I would say it’s possible that vitamin C in diabetes promotes CVD, but I would like to see evidence related to all-cause mortality and a more trustworthy analysis before I would advise diabetics to avoid vitamin C.

    Best, Paul

  13. Paul,
    thank you for your generosity and patience with questions. I’m sure you know you’re acting as a rare and invaluable resource for people who have, in vain, saught help through health professionals for years. Lot’s of good karma for
    you :^) !

    Might you have any recommendations for supplementation when unable to tolerate my (big pile of) supplements in pill and capsule form? I’m guessing I’m not tolerating the microcrystalline cellulose due to gut dysbiosis. I’ve also read that magnesium stearate can contribute to biofilms. Who knows what other additives are contributing, but bloating and burping soon follow when I try to follow the supplement recommendations. I do believe I need said supplements, as my diet by necessity at this time consists mainly of meats and fats.

    I’ve tried to find alternatives, e.g. liquid mutlivitamin formulas, but none to date that don’t contain aggravating ingredients. I ordered the liquid D3 per recommendations on this page, so one down! Any suggestions for other necessities would be appreciated, both by myself and perhaps many more, as my problem unfortunately seems to be quite common. I’m guessing any gelatin-encapsulated oil-suspensions might work, but only for oil soluble substances.

    Big thanks for the recommendation for rice syrup in another reply, it’s working great. I was also very happy to find white rice pasta among your resources, ordered it right away and can’t wait to receive it in the mail!

    Warmly,
    Lilian

  14. Hi Lilian,

    I’m glad the rice syrup and rice are working!

    I’m afraid I don’t know much about what could be causing the supplement intolerance or what brands might fix it. Maybe if you try one of the food-based multis?

    Best, Paul

  15. Hey all,

    i was reading recently that beef liver can be a storehouse for a high level of toxic metals, and in fact some have suspected certain brands of Dessicated Beef Liver as having high levels of such metals due to the side effects they started getting http://www.cheeseslave.com/arsenic-in-solgar-liver-tablets/.

    I use the NOW Foods Liver Powder, and i emailed NOW Foods to ask if they test for metals. They promptly replied with the following info:

    “Hello Rob,

    Yes tested specifically for metals:

    <2000ppb Lead; <2000ppb Arsenic;
    <820ppb Cadmium; <400ppb Mercury by
    ICP-MS

    We are one of the few Supplement companies in the country with onsite heavy metal testing. See here for more info:

    http://www.nowfoods.com/Quality/QualityNotes/M102794.htm?cat=NOW%20News

    And of course our Quality Site for more info on our millions of dollars in lab facilities:
    http://www.nowfoods.com/Quality/index.htm

    Thank you for your inquiry,
    NOW Science & Nutrition Group"

  16. Re: Selenium

    You mention a daily limit of 400mcg Selenium is probably best. I take a multivitamin with 200mcg of Selenium, but it’s selenomethionine which is mentioned by a link as being a worse source. Selenium citrate supplements seem to all come in 200mcg, so I can’t figure out what’s best between the options of:

    1) Stick with what’s in the multivitamin
    2) Take an additional selenium supplement every other day
    3) Drop a brazil nut in my vitamin bin.

  17. http://www.nrcresearchpress.com/doi/full/10.1139/y11-100

    Interesting study on multivitamins and colon cancer; something that runs very heavily in my family. How useful is it?

  18. I gather you don’t recommend fish oil supplements.
    Is it the possibility of rancidity???
    Also, is there any risk of losing minerals with the
    Bentonite detox supplement???
    Linda

  19. Hi, could someone recommend me a multivitamin that I can buy off iherb, or in the UK. I have been looking for the optimal form of B12, methylcobalamin.

  20. Hi Linda,

    Yes, rancidity is the issue with fish oil capsules.

    Yes, detox supplements will remove nutrients as well as toxins. They should not be used by healthy people, but can be helpful (and have diagnostic value) in some illnesses. Even in those cases, however, they should be used intermittently and timed opposite supplement use so as to interfere minimally with nutrient absorption.

    Hi Tom,

    The difference between methylcobalamin and cyanocobalamin only matters at high doses (>1 mg), they are equivalent sources of B12 but the cyanide residue can become toxic at high doses. However, at low doses it is harmless. Multivitamins have low levels of B12 so it doesn’t really matter what the B12 form is.

    Best, Paul

  21. Is there any risk to sustained release
    melatonin 3 mg since it’s a steroid hormone.
    Also, the low dose Vit. K – any risk of a brain bleed
    at the lowest recommended dose that you suggest
    in an older but otherwise healthy female?

  22. Hi Linda,

    Yes, melatonin can have drawbacks. Supplementation can disrupt normal circadian rhythms, with wide-ranging consequences. However, melatonin production is reduced to suboptimal levels in brain infections or inflammatory conditions of the brain as a side effect of the interferon-gamma driven immune response, and supplementation should be beneficial in those cases. There’s some reason to think excess melatonin may help in cancer also. One has to weigh benefits against risks.

    Vitamin K2 is pretty safe, since it supports production of pro-clotting factors as well as anti-clotting factors. The low dose supplement shouldn’t significantly change bleeding risk, unless it is repairing a vitamin K deficiency in which case it will help.

  23. What are the ‘risks’ of disrupting circadian rhythms
    with melatonin, if there is no brain infection or
    inflammatory condition???

  24. Hi Linda,

    Nothing serious, but if it were continued long term you’d probably see similar health effects to those who do shift work. Possible things you might notice could include (a) vivid dreams or waking in the middle of the night or (b) being groggy upon waking in the morning.

    Wikipedia has more thorough lists of both possible benefits and side effects: http://en.wikipedia.org/wiki/Melatonin

  25. I have not seen much here about Prions and disease. But this might be interesting http://www.physorg.com/news/2012-02-prions-ozone.html

  26. Lypo-Spheric Vitamin C…hype & marketing, or an important superior product?

    http://www.amazon.com/Lypo-Spheric-Vitamin-Box-30-packets/dp/B000CD9XGC/ref=sr_1_1?ie=UTF8&qid=1329327423&sr=8-1

    Anyone?

  27. Hi Paul,

    I have a question regarding enzymes. I was looking at the one you suggest above, Raw Enzymes, and was thinking about ordering it.

    For background, you might remember from other posts that I’m type 1 diabetic. I was just reading about lipase, protease and amylase (this is all new for me). I read that lipase is a pancreatic secretion. I also read that some diabetics can have reduced lipase enzyme. So, maybe taking lipase would be good for me.

    Are amylase and protease pancreatic secretions as well or do they originate elsewhere?

    If it’s true that I could be lipase deficient due to the diabetes, would that have anything to do with not being able to properly absorb fat-soluble vitamins? (for the past few years my vit D levels have been just below the normal range, but I posted last week about taking the 50,000IU vit D supplement once a week for a few weeks to hopefully raise D levels). Or does fat-soluble vitamin absorption not depend on lipase? If it is dependent on lipase, then it would seem that I could take fat-soluble vitamins til the cows come home and nothing would improve. Is that right? Or am I way off?

    Thanks so much!
    KH

    Hi KH,

    It’s a good question, and you may know more about this than I do. My understanding is that usually in diabetes the immune attack that wrecks the beta cells doesn’t attack the digestive-enzyme producing cells and so digestive enzyme production is retained. However, it makes sense that anyone with one pancreatic dysfunction would be at higher risk of another.

    Amylase is produced in both the mouth/saliva and the pancreas; proteases only in the pancreas. So chew your safe starches well and mix them with saliva.

    I don’t think you can blame fat-soluble vitamins on lipase. Bile is more relevant to fat-soluble vitamin absorption; bile nutrients include vitamin C, taurine, and cholesterol. But your vitamin D levels were not unusual for someone taking 1,000 to 2,000 IU in the winter. So I don’t see any reason to suspect a digestive problem from your vitamin D levels.

    Best, Paul

  28. Hi, Paul.

    I have read through your supplements section and see you recommend iron for menstruating women. I was recently tested for low ferritin– lab value at 33. Two questions:

    1. What do you recommend as an optimal ferritin value?

    2. How much iron do I need in a supplement?

    I read your blog regularly and appreciate the care and thoroughness of your replies. I know the day will come when you can’t answer all these queries as the demand on your time increases. So thank you!

    Claire

    Hi Claire,

    I don’t think it’s possible to name an optimal ferritin value. If you’re healthy, low is better, it’s associated with longevity since excess iron is dangerous, but in any infection and many health conditions the immune system will lock up iron as ferritin and then low values can imply anemia and iron deficiency. Similarly high values can be normal during an infection but signify excess iron in a healthy person.

    So 33 could be a healthy if low-end-of-normal level, but it can also signify a deficiency. For instance, it’s in a range associated with restless leg syndrome in the elderly: http://www.ncbi.nlm.nih.gov/pubmed/21317036. Of course, nearly all elderly people have chronic infections.

    I think something at or below the US RDA of 18 mg is reasonable for a typical menstruating American woman. But if you eat a lot of red meat, then you won’t need as much. It’s not really necessary to finely optimize it, as intestinal absorption will go down as iron status goes up. So I would say you can just take a multivitamin.

    The Linus Pauling Institute has a good discussion: http://lpi.oregonstate.edu/infocenter/minerals/iron/.

    Best, Paul

  29. Thanks. I think I had/have a chronic infection which led to Hashimoto’s 4 years ago and which has been tremendously helped by the PHD over the past 2 years. My recent labs for thyroid all came back normal. The lab value for ferritin was 30-300. Out of curiosity, my WBC count was normal. Does this mean I am no longer dealing with an infection?

    Thanks so much,
    Claire

  30. I was interested in the ‘raw enzyme’ formulation that
    you recommend. Then the assistant in the nutritional
    section of my local WHOLE FOODS pointed out that all
    enzymes are raw. That is how they must be to do their
    job. Is this correct and are there other reasons
    that you recommend that enzyme formula. Should it be
    taken with all meals??? And is it effective with
    meat???
    Thank You,
    Linda

  31. Hi Linda,

    I’m not sure where the “Raw Enzyme” idea came from. For bowel disease, we recommend enzyme formulas that are heavy on polysaccharide digesting enzymes. Wholezyme from Whole Foods is pretty good. For pancreatic insufficiency you would want one more oriented toward digestive enzymes. We don’t really favor any particular brand.

  32. Ok, thanks! I think I will order some. I also have a papaya enzyme which includes amylase and protease, but not lipase.
    Thanks for your input!
    KH

  33. PJ said: “I’m not sure where the “Raw Enzyme” idea came from.”

    Did it come from the brand name of the enzyme you recommend on your supplement page? I believe it’s called Garden of Life Raw Enzymes. I’m late to this discussion, so perhaps I’m missing something about why there’s confusion, though…

    Hi Mal,

    Yes, you’re right! Sorry I forgot that.

    We do recommend that one but we’re not picky about brands. That’s just one available from Amazon that looked good.

    Best, Paul

  34. Hi Paul,
    A friend hooked me up with this website and it is awesome! So much to catch up on. I haven’t gotten through all of this thread, but did a search and am looking for input on Stearic acid and magnesium stearate in supplements. I read it was bad and inhibited the absorption of nutrients. Here is one of several links http://preventdisease.com/news/09/042809_magnesium_stearate.shtml I noticed that several of your recommended supplements have this ingredient. Is it a minor concern? I just got a multivitamin/mineral supplent from Dr. Ron’s Ultra Pure that has none of this, but it is expensive. Here’s a link to the supplement
    http://www.drrons.com/docs-best-multi-vitamin-mineral-antioxidant.htm. The doses are based on 6 capsules, but the lady said that 2 capsules are fine for maintenance since you actually absorb more than from supplements with stearic acid. What do you make of all this?
    Patti

  35. Thanks for writing your book, it has made a huge difference for me and my wife in terms of overall health and weight maintenance. One concern is the use of brown rice syrup for occasional paleo-friendly baked goods. In the media there have been reports of arsenic in rice products, particulary rice syrup. What are your thoughts on this, and would white rice syrup be better? We have been using Lundberg’s Sweet Dreams Brown Rice Syrup.

    Thanks,
    John

  36. John, or anybody who has a basic question like this, I recommend searching the site before asking. The best way to search is to use Google. Here’s an example searching for ‘rice’ and ‘arsenic’

    In the Google search box at Google.com type:
    rice arsenic site:perfecthealthdiet.com

    This can be used for any combination of words or a phrase

  37. To add to what Peter just said about using Google to search, you can also use “control” and “F” to help you search for specific words as you scroll through a long list of comments.

    Just push “control” and “F” at the same time and a box will pop up on your screen, into which you type the word or phrase you are looking for. That word or phrase will then get highlighted.

    I just learned how to do this, so I thought maybe some of you might not know about it either. It’s hard not being a geek!

  38. good advice PeterC & Ellen, i use them all them time.
    (on this site & others).

    & of course, if you need to narrow your google site search further, you can always use a phrase within quotes.

    ie. In the Google search box at Google.com type:
    “food combining” site:perfecthealthdiet.com

    i used that one to assist over at the Q&A section yesterday

  39. Spices ply a role in good health. How important are organic and or non-irradiated spices as opposed to conventional ones

    Hi Rob,

    I doubt it matters much for spices.

    Best, Paul

  40. Insomnia and the Paleo DietYour source for Paleo Diet information - pingback on February 22, 2012 at 6:00 am
  41. Suggestion for rice crackers: Feng Shui brand by Roland. Available on Amazon and at Whole Foods. Ingredients: rice, naturally fermented soy sauce, sugar, tapioca starch, natural paprika color. No gluten, no msg. I really like these crackers. Also available in nori seaweed flavor, but I like original the best. They are fat free, so I eat them with butter or high-fat cheese.

  42. I recently heard of nigari (seawater minus water and NaCl), used as a coagulant in making tofu, as a cheap way to source MgCl and trace minerals. Have you heard of this? It’s used in baby formula and mineral water so it sounds pretty safe dissolved in water as an oral or transdermal supplement.

  43. I am confused by the fact that Paul asserts that selenomethionine is not an acceptable form of selenium, yet provides an Amazon link to purchase the Rainbow Light Women’s Muliple which has selenomethionine as it’s selenium source. Can anyone explain this to me? I am having difficulty finding subjects when I use the search box, so cannot find his statement about selenomethionine.

    Even the selenium he links to Amazon contains the following: Selenium (as Se-methylselenocysteine, SelenoPure™ L-selenomethionine, sodium selenate, selenodiglutathione)

    It is not clear to the layperson whether this complex contains selenomethionine or not. However, an additional problem is that the label does say that it contains soybeans, which I thought were ill-advised.

    Clarification?

  44. Thank you PeterC for this information!

    “In the Google search box at Google.com type:
    rice arsenic site:perfecthealthdiet.com”

    I usually use the search box on the Perfect Health Diet site, but this works so much more effectively. I’m pretty computer savvy, but did not know this!

    I do not like to bother Paul too often, as he is SO busy.

    It is wonderful to see us all helping him and each other in this way. Thanks again!

  45. You have talked about Vitamin A poisoning before so I thought this mental illness unique to Inuit that might be caused by excess Vitamin A belongs here

    https://en.wikipedia.org/wiki/Piblokto

  46. I sent a question on another part of your blog,
    but don’t think you’ve seen it.
    I’ve read that egg yolk and fowl are high in the
    pro-inflammatory arachidonic (sp) acid….
    Do you agree???
    Should those foods be avoided?
    Thoughts about food toxins vs. inflammation caused
    by food sources???
    Hard to avoid all of it and have something to eat…
    I did check to see if you’ve covered this question
    elsewhere on your blog..

    Thank You,
    Linda

    Hi Linda,

    Yes, I agree they’re high in AA. I don’t think egg yolk should be avoided, I recommended 2-3 egg yolks a day plus some liver. The important thing is not the level of AA in individual foods but the level in the diet as a whole. Eating a normal amount of meat (eg 1/2 lb per day, not the up to 2 lb levels of some on very low carb lean meat Paleo diets) is a good way to keep dietary AA in the normal range; also eating low omega-6 meats and plants; and favoring naturally fed-pastured animals that are healthy, not sick and inflamed themselves. Also, balancing AA with fish oil moderates its effect.

    Best, Paul

  47. @Fulton – The below excerpt is from the Q&A section of the blog, where Paul answered my question about selenium.

    My understanding is that it’s best to limit the methionine version of Se to <50 mcg/day and to get some cysteine-type Se because it is the type most likely to successfully bind with thyroid protein (or, if not thyroid protein itself, some protein related to improving thyroid performance). This is based on some blogging by Chris Masterjohn, which you can probably find with a Google search.

    It is hard (impossible?) to find Se-cysteine in a supplement other than the LEF one Paul links to. So I'm not sure if avoiding soy while getting Se-cysteine is possible.

    Paul has also noted in a recent Q&A that Brazil nuts consist of the methionine form of Se, FYI.

    Now, my question is, how long do I need to be on LEF Se-cysteine before starting the iodine protocol? Paul has said "a while." Wondering what that means…?

    "Hi Paul,

    I’m hypo and about to start the iodine protocol. My multi has 200mcg selenomethionine. If I also take 200mcg of the yeast-bound selenium you recommend over selenomethionine, would that be a toxic amount of selenium? I read elsewhere on your site that the tolerable upper intake is 400mcg. Cutting it close…perhaps too close?

    Thanks so much!

    Hi JW,

    Yes, I think it’s cutting it too close. Also I would try to keep selenomethionine under 50 mcg. So maybe change multis and adopt a selenium supplement? My multi has 55 mcg selenium I believe, and I take a 200 mcg supplement.

    Best, Paul"

    Hi JW,

    I think it’s best to start a low dose of iodine, up to 500 mcg, concurrently with the selenium, but wait 2-4 weeks before trying anything more.

    Best, Paul

  48. Paul,

    I was wondering your thoughts on Betaine HCL supplements. I apologize if this has been discussed already on the blog. Im thinking they may be of some use to me at this time as Ive had an exacerbation of digestive symptoms lately, which include immediate nausea after eating in the top part of my stomach, belching, bloating and alternating constipation and loose stools. Ive been metrametrix test diagnosed with H Pylori and slowly taking antimicrobials to address this. Im thinking that perhaps betaine may help I’m just concerned about side effects Ive read about (burning the stomach lining/throat). Endoscopy two months ago showed no ulcers or inflammation. Do you think Betaine is safe? and if so how do you recommend taking it?

    Thanks so much,
    Lissa

  49. Hi Lissa,

    I would take it just before a large meal, with the first bite. I haven’t tried it myself but Shou-Ching found it helped when she had acid reflux and H pylori. I would expect it to help you, H pylori does reduce stomach acid production.

    If it is harmful, I would expect you to notice worsened symptoms immediately, eg burning sensation / nausea. So I think it’s fairly safe to test it, since you should have feedback and be able to stop quickly if it’s doing you harm.

    Best, Paul

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