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 ?

4,343 Comments.

  1. Ipurchased red palm oil from two sources. Wilderness naturals was actually pleasant tasting, it seems to be processed as it is not a solid oil. The taste was fresh and not strong. The other brand was Omini which says unprocessed and partially solidified. I believe it is rancid, as I do work with oils…it doesn’t smell or taste right, and I have dealt with rancid oils. It does pay to shop around.

    • you are correct MissBB, it looks like Wilderness Family Naturals red palm oil is not as “crude” as some.

      http://www.wildernessfamilynaturals.com/category/food-oils-natural-red-palm-oil.php#moreinfo

      “Our palm oil is more like olive oil in the temperatures that it will solidify at because its fatty acid profile is more like olive oil.
      All other red palm oils are over 50% stearic acid and not high in oleic acid.
      These other red palm oils solidify at temperatures similar to what beef tallow will solidify at.
      That’s why other companies might tell you that red palm oil is a solid”

      • Interesting to know they vary in fatty acid profile.

        It seems like this one is higher in PUFA than olive oil, which I believe tends to be around 9%. Of course 1T per week is a small dose. Also, probably not quite as good for cooking as a a higher SFA red palm oil.

        Wilderness Family Naturals Palm Oil
        C18:2 Linoleic Acid 13.7 %
        C18:3 Linolenic Acid 0.3 %

  2. Hi Paul-
    I quit taking fish oil capsules since learning from you that they are useless for Omega-3 supplementation…Thank You! But I do have a question: How come cooking wild caught salmon doesn’t destroy the Omega-3s?

    Thanks,

    Tod

  3. Hi Paul,
    This clinical trial reported uridine, DHA and choline combined improved memory in patients with Alzheimer’s: http://web.mit.edu/newsoffice/2012/alzheimers-nutrient-mixture-0709.html

    I don’t have Alzheimer’s and I’m healthy. Do you think consuming food rich in DHA (fish, fish oil), uridine (brewer’s yeast, beets, broccoli, RNA-rich foods) and choline (egg yolks) in combination could have similar effects on healthy people?

    • Hi Ezer,

      Those are all beneficial nutrients which most people are deficient in. DHA (1 lb cold water fish per week) and choline (3 egg yolks per day) are both major points of emphasis for PHD. I’m not aware that there is good data on how much uridine is optimal, but I suspect a natural whole foods diet will provide a healthy amount, and that a junk food soda-and-crackers-and-bread-and-oil diet will not.

  4. Hi Paul!

    Do you have any idea why, in some studies, eggs have seemingly increased LDL oxidation? http://www.ncbi.nlm.nih.gov/pubmed/9001684

    “The susceptibility of plasma [using 100 mM of 2,2′ azobis 2-amidinopropane (AAPH)] as well as that of LDL (using 10 microM of copper ions) to lipid peroxidation was increased by 42% and 34%, respectively, as measured by the thiobarbituric acid reactive substance (TBARS) assay (p < 0.01)."

  5. Hi Paul,

    I recently started taking a B-vitamin complex and I think it gives me cold sores? Has anyone else experienced this? There’s a statement i found that people with histamine reactions (which I presume my cold sores are) should not take b-vitamins! go figure. anyway, any one with experience on this, if you could please comment.

    Thank you.

    • Hi Franny,
      I don’t get cold sores but I do get cramps in my hands and feet anytime I take any type of B vitamin, doesn’t matter what the dose is either. I wonder if this is the same problem just different response.

    • Franny,

      I have also had a hard time with B vitamins. They seem to give me migraines. I am also allergic to penicillin and have respiratory allergies to molds, so I thought perhaps most B vitamins are made from molds, but I haven’t been able to find much information about the source of the vitamins. I just hope I can make it up with my diet.

  6. Hi Paul,

    Can you recommend a B-complex that meets your specs: 5 mg biotin, 500 mg pantothenic acid, 500 mcg B12?

    Thanks.

    -Tim

  7. Hi Paul,

    3 questions that are totally unrelated.

    1) What are your views on copper (from and zinc supplementation changes if someone is on the copper IUD?

    2) Have your views changed on Green Pastures FCLO?

    3) What are your views on using Interfase (enzyme+EDTA) and olive leaf extract as a protocol for fixing gut health?

    • Hi Erich,

      I haven’t looked into how copper IUDs affect copper requirements.

      No, I still don’t recommend fermented FCLO.

      I think Interfase is a risky supplement for gut health. I talked about it in our bowel disease series. It can be appropriate in some cases but is risky. I wouldn’t consider it an early option.

      • Hi Paul,

        So from what I have read, copper toxicity can be a problem with copper IUD. Many sites say to supplement with zinc (50-120 mg a day) and Molybdenum (1mg-2mg a day) to prevent toxicity. I noticed your recommend Molybdenum at 150 mcg a week.

        1) Do you think 2 mg a day may be too dangerous?
        2) Could you recommend a brand of Molybdenum to buy?

        • Hi erich,

          The tolerable daily intake of molybdenum is about 500 mcg, so 2 mg is potentially risky. The main toxicity danger is copper depletion, so perhaps not in this case, but it’s rather uncertain.

          Such high doses of zinc are also playing with fire.

          I really don’t know how to balance these copper-suppressing tactics with the copper risk from the IUD.

          I will recommend a brand of molybdenum when I update the supplement recs page. That’s coming soon.

  8. Paul,

    Great blog, very informative and thought provoking.

    Few supplement questions:

    Selenium: I started 2-3 brazil nuts about a month ago. Are u against this now? I also eat about 3 eggs a day on avg.

    Magnesium: in the morning I take magnesium and potassium aspertate, cause of muscle cramps (been low carb for about 2 yrs. approx 50 net carbs a day). In afternoon I take 400mg of magnesium (blend of aspertate, lactate, citrate). Are these ‘ate’s just as good as just citrate??

    Iodine: about to start. Do I get iodine with potassium or just iodine? Too much potassium can lead to palpitations no?

    Fish oil: i am shocked by our analysis but open to exploring more on this and seeing if i should discontinue. I take two triple strengths a day. Can u briefly give me your reason why?

    Krill oil: what about dha in the krill? No good?

    I did notice my constipation went away when I lowered bit D from 4000 to 2000 (blood work showed it at 18) and added the magnesium.

    Thanks
    Evan

    • Hi Evan,

      2-3 Brazil nuts are fine, but the selenium levels are highly variable depending on the soil they were grown in.

      Those forms are just as good. But you might find it’s better to eat more carbs and take less magnesium.

      The iodine with potassium tablets are the ones I’ve found with the lowest dose of iodine, not from kelp. You don’t need potassium if you find another source. But the amount of potassium is low. Take it with food.

      Search the Google search box or browse the omega-3 category to find our fish oil discussion. It was one of our earliest blog posts.

      Krill oil is fine if it’s fresh. That’s the trouble with pills.

  9. My dad has diabetes, and I’d like to know what supplements could help to control blood sugar levels with no risk, specially bloog sugar spikes after meals. I found a study about green coffee beans (chlorogenic acid), but it seems it may increase blood pressure and homocysteine levels. (http://www.ncbi.nlm.nih.gov/pubmed/22291473)

    • you may want to look for some recent studies on supplemental Chromium.
      I seem to remember that Chromium may help with insulin action/glucose control

    • Our recommended supplements are good for that. Chromium as Darrin says, magnesium is important, vitamin C can help, but in general good nourishment is important in many ways.

  10. Hi Paul,

    I really appreciate you taking the time to respond to so many readers.

    I just received a shipment of grass-fed oxtails from a family-owned ranch, and am excited to attempt my first bone broth tomorrow. I plan on following your advice, from the post “Bone Broth Revisited,” to replace the water several times throughout the cooking process. I was wondering though if you had any specific recommendations regarding how many pounds of bones, how much rice vinegar, and how many cups of water should constitute a ‘bowl’ of bone broth soup (which you recommend should be eaten 3 days a week)?

    Thank you!
    Adam

    • Hi Adam,

      Enough water to cover the bones, and a tablespoon or two of vinegar, should do.

      A bowl is about 375 ml or 12-15 fluid ounces. I think 3-7 bowls per week would be OK depending on how long you cook the bones.

  11. Hi Paul,

    Is the weekly kidney amount 4 oz (like weekly liver)?

    4 oz beef kidney is about 160 mcg selenium weekly or 23 mcg daily. I was hopeful it would be higher.

    I thought this US Wellness Meats Beef Liverwurst was an interesting option to get organs in the diet:

    Liverwurst is a mixture of grass-fed beef trim (30%), liver (30%), heart (20%) and kidney (20%). This is the tastiest way to incorporate healthy grass-fed beef organs into your diet!

    Ingredients: beef, beef liver, beef kidneys, beef heart, water, sea salt, onion powder, honey, white pepper, coriander, marjoram, allspice

    At 1 1b, it would be about:
    4.8 oz beef
    4.8 oz beef liver
    3.2 oz beef kidney
    3.2 oz beef heart

    Eating 1 lb during one week would be a bit high in beef liver and maybe a bit low in kidney. I have a feeling those proportions are good for palatability, though.

    Thanks,
    Mark

    • Hi Mark,

      Yes, a pound of liverwurst a week sounds like a great strategy.

      It’s fine to eat more than a 1/4 lb a week of kidney. The reason you don’t want more (beef or lamb) liver than that is a potential copper excess; one can eat more liver if it is chicken liver.

  12. Paul:
    To be clear for me:
    Are you saying that 1 pound of-liverwurst per week
    from US Wellness will meet the requirement
    for kidney and liver that you recommend?
    Nothing more needed in that category?
    I live liverwurst so it makes it easy for me if
    you have no problem with that source.
    Thanks.
    Linda

  13. Hey Paul. Hope all is well… do you recommend any particular form of zinc over another? Thanks.

  14. Paul,

    Have you seen this Vitamin D paper: http://www.ncbi.nlm.nih.gov/pubmed/19393200 ? It claims that D3 supplementation causes VDR down-regulation and may lead to long-term pathogen proliferation. What are your thoughts?

    • Never mind, I think this paper ( http://www.ncbi.nlm.nih.gov/pubmed/19944755 ) is probably adequate to establish that D3 is generally beneficial for VDR expression.

    • Hi Nathan,

      I have read the Marshall papers and consider them highly speculative and probably mistaken. I do agree that pathogens have probably evolved ways to interfere with the vitamin D – VDR pathway. I’ve seen no evidence at all that vitamin D inhibits VDR activation — only a computer model of protein interactions that is extremely unreliable and no one but Marshall believes in.

      • Thanks for the response, Paul. After more research, I agree with your assessment. I’m always interested in potential autoimmune modalities and am often disappointed when I dig further.

        BTW, your book and website are helping me to normalize my cholesterol numbers without drugs, for which I am very grateful. Looking forward to the new edition!

        • Hi Nathan,

          That’s great! If you get time, please leave more details on the reader results page or in an Amazon review. It’s always great to hear reader results.

          Best, Paul

  15. If anyone’s looking for options for supplementing iodine in the 0-3 mg range, Vitality Works has a liquid potassium iodide where (according to my calculations) 1 drop contains about 125 mcg of iodine, give or take a few.

    I arrived at this estimate by dividing the amount of iodine (24 mg) in the recommended dose (7 milliliters) by 7 to find the amount in one dropper-ful, which contains 1 mL. Then I counted the number of drops in one mL, and there are 27. So I divided the amount in 1 mL by 27 to find the amount in one drop (it’s about 127 micrograms, to be precise).

    So, for example, 8 drops would contain about 1 mg of iodine, Paul’s recommended dose.

    It’s easy to put 8 drops in a glass of water and drink it down, and it’s probably better absorbed and tolerated than tablets. That’s what I’ve been doing, and it seems to work better for me than the NOW brand tablets.

    Here’s a link to one vendor selling it:

    http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=VU-1008

    Hope that helps!

  16. Hi Paul,

    What do you think about this article? It says that Black Walnut Tincture (from green hulls) has a high concentration of organic iodine.

    http://www.naturalnews.com/032028_iodine_black_walnuts.html

    I have a small bottle of it that I bought several months back for intestinal cleansing when I suspected some kind of parasite.

    Do you think it could be a good iodine source? Or do you think it’s too harsh and not good for long term use? Or maybe it wouldn’t be reliable enough if the amount of iodine varied a lot in brands or different bottles…?

    Thanks!
    KH

  17. Hi Paul,

    I came across this K2+D3 supplement on Amazon. It appears to be very concentrated/cost-effective. Does this look like a good product? If so, how might you suggest meeting your recommendations with it?

    http://www.amazon.com/Thorne-Research-Vitamin-Liquid-1oz/dp/B0038NF8MG/ref=sr_1_3?s=hpc&ie=UTF8&qid=1350400426&sr=1-3&keywords=liquid+vitamin+k

    Thanks!
    Mike

    • Hi Mike,

      It looks like a good ratio. I wouldn’t have a problem with using it. Probably 5 drops a day through the winter would be appropriate.

      In the summer you might want to do sun only and get K2 separately.

  18. hi paul,

    what are your thoughts on kelp salt? I have one from maine coast: sea seasoning: organic kelp granules. do you feel the toxicity is probably prevalent in this as well and better to err on the side of safety and use potassium iodine?

    Thanks,
    Erich

  19. Hi. I see that you recommend Lithium Daily as an optional supplement. Could you explain why it is recommended?

  20. Paul,

    In the past you’ve recommended against supplementing niacin and folic acid. With the new recommendation for a once-weekly B-50, have you changed your mind? Or is it just these vitamins once a week are harmless if not actually helfpul (in which case I guess the rest of the B-complex is what you’re after).

    Thanks!
    Ross

    • Hi Ross,

      No, I haven’t changed my mind. But I don’t think a once a week dose is enough to do harm, and a single pill is easier than multiple individual ones for the other B vitamins.

  21. Hello Paul,
    I’ve carefully read Corain, Taubes, Gaudes, Mark of Mark Apple, and others. I just completed Perfect Health Diet book, took copiuos notes and ordered your new book as well. Just want to express my kudos. Of all that I’ve read on diet and health, I most resonate with your pragmatic, science-based and comprehensive work. I’m very much with your program. Here are some questions:

    1) I’m 76 y.o, male, 190 lbs, walk about one mile/day. Based on your “one-size-fits-all” dietary recommendations, do you think I’m justified in reducing by 15-25%, your recs for protein, carbs, fats, in defference to my age and activity level? I seem to do fine on 1400 calories or so.
    2) You object to fish oil caps and for good reason. What are your thoughts as to bottled fish oil, i.e. Carlson’s – for days when not eating Salmon?
    3) You state that once sweet potato or white rice cools, it loses its ability to abate resistant starch factors. Does re-heating it restore that ability?

    Many many thanks for all the wonderful and accurate data.

    Richard

    • Hi Richard,

      Thanks!

      1) Yes. We assume a 2000 calorie reference diet just to simplify writing, but certainly most elderly people will (and should) eat much less than that.

      2) Bottled fish oil is better than caps. Keep it refrigerated and don’t let it get too old. Fish is still better.

      3) Resistant starch is good for you, unless you have IBS. So cooled starches are good for you. Yes, re-heating does make the resistant starch digestible again.

      Best, Paul

      • Hi Paul, about the heating of resistant starch:

        What are the temperatures needed for change and what does the conversion curve look like?

        Since all food will end up at 36-37C pretty quickly, is there a significant difference between eating hot sweet potato and cold sweet potato, resistant-starch-wise?

        Is heating in the microwave to “warm” (so quickly and probably 50-60C) still ok?

  22. Hi Paul, good blog.
    I am surprised. Why but Bs once a week if they are water soluble and do not accumulate?

    • Because (a) more shouldn’t be necessary, (b) they can also nourish pathogens, (c) you can get too much of a few of them, and (d) taking lots of pills every day is a nuisance and an expense. I just think taking them more frequently is unlikely to be of much value.

  23. Hello Paul,

    Unfortunately many of the products that you suggest via amazon links cannot be purchased in Germany because of local regulations.
    I was looking ofr alternatives and found this product
    http://futurebiotics.com/product/55 for chromium and vanadium.
    But I am not sure about teh quantities.
    Woudl you give a look and let me know?

    Thanks

    Ciro

  24. Are you close to getting the updated Supplement Requirements page done and what brands you suggest from Amazon? I’m just out of all my supps and don’t want to purchase anymore until you have updated.
    Thank you for sharing your wonderful research!

  25. Dear Paul 😛

    Thank you for all the information. Your webpage has been an amazing resource and guidance for me. I’m in the process of updating my supplements, but was wondering if it was possible to take a multivitamin once a week instead of the single (weekly) ones. As I understand, the point against them is mostly based on manganese and folate issues?

    Would this one work if I took 1-2 servings a week?
    http://www.lef.org/Vitamins-Supplements/Item01655/Life-Extension-Mix-Tablets.html

    It has only 1mg of manganese, the folate is from lemon extract, the vitamin a is 90% natural beta carotene, vitamin e is low (100iu) and in D-alpha tocopheryl succinate form, and it’s available with copper (1mg) or without.

    Concerning your recommendations, it also provides most of the molybdenum, boron and even taurine. The areas in which it falls a little short are biotin with 3000mg instead of 5000mg, and zinc with 35mg instead of 50mg, and the absence of vanadium.

    Thank you!
    Chris (from Germany)

    • Hi Chris,

      It sounds like a reasonable substitute. Our new edition will have detailed discussions of the pros and cons of each nutrient so you can make your own judgment of whether this is the right solution for you.

      • Dear Paul,

        Thank you. I’m certainly looking forward to the new edition 🙂

        If I might ask one more question, concerning the daily vitamin C recommendation. I remember reading that in low carb situations vitamin C supplementation can be problematic because of its degradation process. I am currently eating between 40-80g carbs daily (vegetables/white rice/sweet potato/blueberries).

        In this context, is it recommended to take 1g vitamin C daily? And if so, would you recommend including NAC daily for better recycling? Would NAC on its own be a better solution as an antioxidant?

        Sincerely
        Chris

  26. should we avoid supplements which use aspartate or aspartic acid?
    http://en.wikipedia.org/wiki/Aspartic_acid

    I ask because i just realised that (from what i can tell) aspartate/aspartic acid is one of the ingredients in Aspartame (the artificial sweetener).
    http://en.wikipedia.org/wiki/Aspartame

    & i think a lot of people would consider Aspartame to be potentially unsafe & to be avoided.

  27. Hey Paul,

    What items would you recommend to take while doing the 36 hour ketogenic fast? Cheers,

    Andrew Pye

    • Hi Andrew,

      I don’t recommend doing such a long fast. I think fasts should be 23 hours or less, with significant food intake at least once a day.

      There are a few foods we have suggested for eating during a fast — coconut oil if you want a neurological more than whole body fast; fiber-rich vegetables or berries; soup/broth for electrolytes and salt. So a vegetable soup (tomatoes, green leafy vegetables in a salted bone broth) and some coconut milk would be good choices.

  28. I’ve come across questions concerning the desirability of vitamin K2 supplements. On the one hand, it seems that MK-7 is not shown to substitute for even the functions we know about that MK-4 is required for, and we don’t know how well humans convert MK-7 to MK-4. Also, synthetic MK-4 apparently contains both right- and left-handed isomers when the natural form is just one. Do you know of data on the effectiveness and safety of synthetic MK-4 and whether MK-7 is as good?

    Right now I’m pregnant and there’s 50 mcg MK-7 in the prenatal I selected and I eat a few tablespoons/day of grassfed butter, and I’ve done both since several months pre-pregnancy. I’d like to get more K2 but I’m undecided as to how.

    • Hi Amelia,

      Synthetic MK-4 has shown good results in Japanese trials. Many of these are cited in our book. I agree the isomer issue is a concern, but odds are the good isomer is beneficial and the bad isomer neutral rather than harmful.

      Natural diets have a mix of MK-7 and MK-4 and it’s likely that would be appropriate in supplements too — perhaps at high doses MK-4 is best.

      Good food sources are aged cheese and other fermented foods, liver, egg yolks (very important in pregnancy for choline), shellfish, and you can also eat spinach as a source of K1 which will be converted to MK-4.

      80% of the benefit will come from the first 50-100 mcg of K2, so you don’t necessarily need huge doses to get most of the benefit.

  29. Hi Paul,

    Is the liver recommendation for 1/4 lb precooked? Also, how much kidney do you recommend?

    I ask this because someone had asked about the us Wellness liverwurst which is 1 lb so the beef liver is 1/4 AFTER cooking. I sent an email to US Wellness to verify their precooked weight.

    Erich

    • Hi Erich,

      That’s cooked, it would be about 1/3 lb uncooked.

      • by “that’s cooked”, did you mean your recommendation for the beef liver or US Wellness beef liver serving?

        so to clarify, your recommendation is for 1/3 lb uncooked beef liver a week. and no hard recommendation for kidney?

        • Hi erich,

          Yes, it’s for beef liver.

          You can eat more kidney because it won’t quickly produce toxicity of anything the way liver can with copper. I would have to check a safe level of kidney intake, probably selenium would be the limiting factor, but it’s well over a pound a week.

      • Thanks for clarifying. I like going by uncooked weight for meat. I naturally think of meat amounts as being uncooked since that’s what recipes would call for and it could be difficult to measure cooked meat weight unless it’s cooked by itself without other fats/foods.

  30. Hi Paul,

    Need help. I started taking copper and selenium low dose daily as I have a thyroid problem hypo and my LDL was rising. I’m not an organ meat eater. Now very confused whether to drop these two or keep. On the Sttm website they recommend selenium for example for those being hypothyroid.

  31. Dear Paul,

    I have a question regarding Interfase Enzyme supplement from Klaire Labs. I understand from previous posts that you recommend it for certain gut issues but not all.

    My metamertics test came back positive for two parasites, and a fungal infection. And it showed that I am also resistant to most antibiotics so I have to go the herbal and nutritional route for my infections including PHD.

    (I was put on a version of the Marshall Protocol for over a year for Chlamydia Pn infection a couple of years ago and ended up with no improvement and in bad shape as a result. So that is also a potential issue.)

    Anyway, I purchased the Interfase from my naturopath and given my issues do you think I would be a good candidate to try it? Or do my issues indicate that I should stay away. I would hate to make things worse!

    I am also going to start NAC as it seems to be a potentially good supplement for me.

    Thank you for your time and knowledge on this. Many many thanks.

    • Hi Amy,

      Have you discussed your situation with a doctor with experience treating parasitic infections? Antibiotic resistance is usually to antibacterial drugs, not antiparasitic drugs.

      I think the Marshall protocol is misguided and can easily worsen most chronic infections, since vitamin D is so important for immunity, and low-dose antibiotics can interfere with the gut microbiome and mitochondrial function.

      Interfase – do you have the version with EDTA or the one without? EDTA can produce significant side effects. I think the one without EDTA is pretty safe, but I don’t know if it would do anything against parasitic infections.

      NAC I think is good. Highly recommended.

      I would try to find a doctor who has experience treating similar cases. The good news is that you have some useful diagnostic information from the Metametrix test.

      • Hello Paul,

        I have the interfase without EDTA so that is good. Yes, I left the doctor that put me on the Marshal Protocol about a year ago and am now getting help through a naturopath who was able to order the lab work for me (my family doctor knows nothing about these things).

        But I will keep trying to find the right doctor for my issues.

        And thank you so much for your time. Your book and blogs have really been a tremendous help in beginning to figure out where to go from here.

  32. Paul,

    For the newly recommended OptiZinc (Zinc Monomethionine), should we take only one 30mg cap per week or two? I’ve read that monomethionine makes the zinc more bioavailable. Is there a risk of taking too much at two per week?

    Thanks,
    Ricardo

    • Hi Ricardo,

      I think either one or two will both work. 50 mg is 7 mg/day, 60 mg is 9 mg/day, 30 mg is 4 mg/day; a typical PHD diet is 11 mg/day from food; we want 15-20 mg/day. So they should all be OK.

  33. ❓ Paul,
    I have been doing a Paleo diet for 3 years. 60-80 grams of carbs, 65 grams protein and 80 grams of fat. For the the past year, I have developed increasing pains in joints and muscles. I have multiple spurs. On no prescription meds. I am 62 years old and female. I found out I was eating high oxalate foods exclusively! Paleo people should be aware of this! I now am on a low oxalate, still Paleo approach. Any comments? I also had my gall bladder removed at age 29, have never been obese.

    • Hi Vicky,

      Some people do have oxalate sensitivity, probably because they lack the normal oxalate-digesting gut bacteria and have a leaky gut that lets excess oxalate into the body. There can be genetic defects in oxalate degradation also. Fungal infections lead to high oxalate since fungi create oxalate biofilms. Finally, oxidative stress can lead increased degradation of vitamin C to oxalate.

      Your gall bladder removal made you vulnerable to oxalate because when dietary fats are not bound to bile, they bind calcium which cannot then bind oxalate, causing it to be absorbed. You may wish to consider supplementing ox bile at meals, taurine daily, and possibly calcium with meals.

      Some more tips for dealing with oxalate can be found here: http://www.greatplainslaboratory.com/home/eng/oxalates.asp

      I think you could eat a bit more low oxalate starches and a bit less fat; with your gallbladder issue this might help you a bit.

      We’ve blogged on sweet potatoes as a problem here: http://perfecthealthdiet.com/2011/01/what%E2%80%99s-the-trouble-with-sweet-potatoes/. You’re in good company, Chris Masterjohn had the same problem.

      Best, Paul

  34. Hi Paul, Since I will not receive the PHD book until it’s release in December, I’m not sure when and with or without food etc. to take your recommended supplements and I want to get started sooner than later. Also, do you recommend taking one supplement at a time to make sure there is no reaction like GAPS diet recommends with their supplements, or can I just start the supplement protocol in total? I was planning on ordering your daily and weekly recommendations (saving the optional supplements for later to save $$). Also, I have fermented cod liver oil, so do you think I am covered on the Vitamin D? I take 1/2 to 1 tsp daily. Thank you!

    • Hi Dede,

      With food is generally best.

      I think these supplements are pretty safe. But if you have a problem when taking them, then you need to back up and test them individually.

      Also, it’s probably a good idea to periodically test each one of them. Each month, pick a supplement and take it out for 2 weeks, then put it back for 2 weeks. Do you notice a difference?

      I don’t think fermented cod liver oil is a great source of D, since it’s so high in A. You want A and D balance. Eating liver and egg yolks is a good source of A, so you should get your D without A for the most part.

  35. Thank you Paul! I was a little baffled when my 25-Hydroxy D came back lower than it was in June. My most recent test was 25.2 and in June I was 31.0. I got a little less sun than normal in September because we had a lot of rain, but supplemented with FCLO, so now it makes more sense. I will add your vitamin D recommendation when I purchase supplements from your site later this afternoon.

    Thank you as always for taking the time to help!

  36. Dear Paul,
    assuming your supplement recommendations are for the generally healthy person, what additions or adjustments would you recommend for someone wishing to support the body in dealing with endotoxoxity from bacteria? In this case from Clostridium sp. predominance; with symptoms of fluid retention and mild-moderate mood changes, all waxing and waning with GI-symptoms of absent persitaltic movements of the colon and abdominal distention. I have recently increased my use of S. Boulardii based on a claim that it helps bind the Clostridium toxins. Is there anything else that could be added to mitigate the effect of the toxins?

    Also, for someone unable (for the above reasons, I presume) to tolerate fruits, vegetables and vitamin C supplements, are there any supplements that would help recirculate what I assume must be very low levels of vitamin C in the body?

    Many thanks!

    • Hi Lilian,

      Some of our detox aids (charcoal, bentonite clay) will help with endotoxin clearance. Don’t overdo it because you don’t want to become lipid deficient, but a low dose over time will help.

      Probiotics may also help; are you intolerant of fermented vegetables? Egg yolks for choline and vitamin D are important.

      Glutathione is the most important thing for antioxidant status, and will protect vitamin C. You can take NAC and maybe glycine for that; and optimize selenium per our recommendations. Taking low dose iodine is also helpful.

      • Hi Paul,
        thanks for the suggestions.

        I use charcoal fairly frequently, but am a bit unsure of what a suitable dose would be. I wasn’t aware that it binds lipids in general, that’s good to know. Do you have recommendations on how to use Bentonite clay anywhere on your site, don’t remember reading that in the book?

        I am using NAC as per your recommendations in the bowel health series. I am very glad to hear that it is protective of vitamin C . Do you find Pycnogenol would be of value in the same way? I eat lots of eggs and supplement with D, so check on those, too. Selenium and Iodine are in my program as well. I will add glycine, thanks!

        As far as probiotics go, I have used them, all types of bacteria, for as long as I’ve had the problem, over 10 years, but I am a bit baffled since they only seem to add insult to injury. Lately I’ve focused on only Bifidobacteria, as they were very low per Metamatrix, but again with only feeling a bit worse as a result. Acipdophilus periodically, when I have additional upper GI symptoms as well. I use very small amounts of Kim Chee or sauerkraut, but they too. lead to lots of bloating if eaten in normal amounts.

        Many thanks for your suggestions!

        • Also, do you think it’s safe it this context to, from time to time, use herbal diuretics to help clear the fluid retention? Would this help rid the body of endotoxons or further load the excretory organs?

        • Hi Lilian,

          You seem well covered and at this point I would guess that less is probably more when it comes to supplements. I’d focus more on food for a while.

          There’s basically two tactics, addition and subtraction. You can try to find something the Clostridium depends on, like carbs/fiber, and restrict it, or try to find things that promote diverse beneficial flora, like fermented mixed vegetables and green leafy vegetables, and add them.

          Seth Roberts yesterday had an interesting story of a woman who recovered from a gut dysbiosis by going on a carb-restrictive ketogenic diet for a while.

          • Thanks Paul,
            since I’ve dealth with this for quite a while I’ve had the opportunity to experiment with both. Cutting out carbs offered symptom modification but not lasting relief. Instead it lead to complete exhaustion. I am hypothyroid (conversion problem, not auto-immune) as it is, and no-carb, or very low carb, makes matters much worse. The additon tactic makes me very symptomatic and is therefore not a viable option. Instead, I balance in the middle, and have inspired by your insights added rice and rice bread and regained my energy. Anything fibrous, though, is a death knell and leads to almost complete GI paralysis, so can’t go there. Due to my limited diet I supplement heavily, but since I can’t tolerate vitamin C supplements even in small amounts I am concerned about that, as well as how to manage symptoms.

            Thanks for your altruism and your generosity with your time and knowledge!

          • there’s an herbal supplement called guggul gold that specifically helps convert t4 to t3 in the body, perhaps that may help you

  37. Going into winter, it gets a bit hard to find pastured eggs in California. Do you recommend supplementing with choline bitartrate powder and eating grassfed liver, in order to obtain choline for a healthy person eating a PHD?

    • Hi Kevin,

      Yes, that’s a good solution. Just limit beef liver to 1/4 lb/week and use chicken liver for the rest, otherwise you risk copper excess. Of course, liver from pastured chickens may be hard to find too …

  38. Paul, I just read your advice to Lilian regarding antioxidant status help (NAC and maybe glycine) which reminded me of a conflict I am having in regards to glutamine powders being prescribed for gut repair (leaky gut due to celiac). The 2 powders I have been “prescribed” were Apex Energetics’ RepairVite and Montiff’s Amino Starter. RepairVite made me feel lousy back in July, but I was eating hardly anything due to an elimination diet, so not sure if it was the RepairVite or not. The Montiff Amino Starter is untouched because I am hesitant about taking these amino acid powders in general. Do you have any thoughts?

    Thank you.

  39. Thanks a million Paul!

  40. I am hypothyroid and have been supplementing with 2-3 Brazil nuts a day. Started 500mcg iodine, but after a couple of weeks, my heart started doing strange things (skipped beats, racing, pounding, high blood pressure). Went down to 300 mcg kelp and that helped a little. After 4 weeks stopped supplementing iodine and heart symptoms have gone away. Now if I have more than 2 pinches of selina celic sea salt my heart problems start up. Any thoughts about what might be happening?

    • Hi Shelly,

      Given that it seems to have been triggered by the kelp, the most likely cause of the palpitations is probably hyperthyroidism; but the sea salt suggests it might be an electrolyte issue. I doubt the sea salt is high enough in iodine that that would be an iodine issue too.

      500 mcg is a fairly large dose of iodine to start with; most people would handle it fine, but with thyroid issues it can be too much.

      Also, although you are hypothyroid when iodine is scarce, you could have thyroid nodules that make you hyperthyroid when iodine is abundant.

      Palpitations can also be caused by abnormal levels of electrolytes — especially potassium-sodium imbalance or magnesium-calcium imbalance. Low potassium causes heart palpitations, and extra salt would exacerbate low potassium. So I would try to balance electrolytes carefully: eat 3-7 bowls of bone broth soup a week for calcium and limit magnesium supplementation to 200 mg/day; eat tomatoes, potatoes, and bananas for potassium and, after eating potassium-rich vegetables, try to get adequate salt (1/2 tsp per day) and water. Also, low doses of lithium (see our recommended supplement list) can help normalize potassium and sodium status.

      Once you get electrolytes fixed I’d revisit the iodine and selenium situation. With iodine, start with shellfish (mussels, calimari, shrimp) and seaweed (not kelp) to see if you are sensitive to the iodine in those. If you aren’t, then buy 225 mcg iodine tablets (not kelp) and cut them into quarters with a razor blade, and see if you can get adapted to 56 mcg/day. Along with testing the iodine, get some selenium supplements and take 200 mcg selenium twice a week.

      Hopefully if you fix the electrolytes both the heart and thyroid symptoms may disappear. If they don’t, and if when you test the iodine you still get palpitations, try to get your doctor to measure your thyroid status and see if you are indeed hyperthyroid on iodine.

      Best, Paul

      • Thanks Paul,
        At the same time of the iodine/selenium supplementing, I was also eating bone broth and supplementing daily Mag glycinate 400-600mg, Vit C 500mg, Vit D 2000IU, B complex every now and again. The day after I stopped supplementing my TSH was up to 8.7 and Free T4 1.27 (high normal, highest for se so far), free T3 2.3 (low normal, expected since I am reduced carbs to lose weight). Question: is it typical for TSH to rise when on iodine? If I start with the dose you recommend, how long does it take TSH to normalize?

        Also, in the same blood test my eGFR (kidney function) drop substantially, still in normal range, but huge drop from 6 mo. prior. Dr. said it is totally normal and probably is just a hydration issue, but am still curious, can supplementing affect kidney function?

  41. Paul:
    Could you review what the value of iodine supplementation would be, please???
    Thanks,
    Linda

  42. I am trying to order Iodine but the NOW brand is not clear on the MCG ….is this the 225mcg starting dose? Also there are only 3 1/2 stars on this brand…any particular reason? I have iodoral but you don’t recommend (and most don’t ) this for hashimotos people but it seems to be the better brand of iodine. Not sure what to do. 🙁
    I ordered the OLD NOW brand from this site but it clearly said 225mcg on the front label. can you advise? thank you.

  43. Hello Paul

    Let me first say i really, really enjoy your blog, and especially how you care to answer nearly every question. I have read every supplement Q@A and trying to fine tune.

    Q1. When are new supplement recommendations coming out? i am trying to balance iodine and selenium. Been 250 mcg of idoine along with 1-2 brazil nuts a day plus generic one a day (CVS brand, 0 iodine and 110 mcg selenium). Is this the right combo of iodine and selenium? Also, how to a ramp up selenium when 500 mcg of iodine next month, or do i cap selenium at 110mcg in the multi and add 200 mcg selenium supplement and ditch the brazil nuts (would prefer this route and seeking guidance). Then at 1000 mcg iodine, do i keep the selenium to where i will have it at 500 mcg iodine or increase selenium more too??

    Q2. My multi has 2 mg of Copper and 15 mg zinc. i take this daily with 2 mg additional Copper (daily) and zinc 50 mg (weekly). (i tried your beef liver pate, couldn’t down it, but wife loved it) this ok?

    in Short, morning: 1000 C, 2000 D, the multi, 100 k2, 250 iodine, B100….then afternoon 400 of mag citrate, then evening the 2 mg Cu. then once a week the zinc 50 (i just cut out the fish and krill oil and lowered C from 4g to 1g)

    Why all my (panicked) questions. Well….. Cholesterol tested 2 yrs ago at 260, of which HDL was a paltry 42. Went super-duper low fat, eating all the SAD ‘right foods”. Always hungry and then retested 6 mths later, TC dropped to 220(?) and HDL to 38! (bummer), TG about 110. Was prescribed Crestor – took for 2 days until I stumbled upon LC websites.

    Gave it a shot.

    1 yr later, dropped 6 lbs (added benefit), Had to have all pants taken in 2 inches. Got leaner – another pluss! But, goal was lipids. TC went to 262, HDL went to 72, TG in 90?s. So ratio of TC/HD went from 5.1 to 3.9 and TG/HDL was great. So, I was not concerned by “high” LDL. Happy as a clam.

    Diet like this:

    breakfast – 3-4 eggs, bacon, cheese on weekend. Weekdays almond milk + scoop of whey protein (snack mid-morning 3 eggs if weekday)

    lunch – steak (8 to 16 oz) or ceasar salad with grilled chicken, or two burgers no buns, or big salad with tuna

    dinner – salmon, or organic burgers, or hotdogs, or steak, or both. light salad, plenty (and mean plenty of broccoli, cauliflower etc (as they are low carb), with cheese and butter of course

    during day or snacks; 4-8 oz of hard cheeses, pork rinds, plenty of almonds

    Food cooked in Coconut oil and organic butter.

    I also mapped my daily intake of everything i put in my mouth. Result, 72-75% fat by calories, about 20% protein, and 5% carbs (so i assume VLC diet infact). No rice, no grains etc. the carbs were just fro cheese and veggies (net carbs), the occasional strawberry etc. Was between 30-50 net carbs a day.

    Then either my body rebelled or i got greedy as i made some changes to diet (where these the changes the cause of what happened next or was i just too low carb that did it…….)

    Changes…..
    1. started cooking eggs and fish etc in pork fat from all the bacon i ate
    2. added 4 oz of heavy cream every day to my almond milk and why shake for post workout – oh sooooo good and creamy (panicked wife of course)
    3. always ate chicken skin (omega 6 concern?)
    4. snacked on alot of commercial pork rinds (need a crunchy food and good for dips when hosting, or sub for nachos, or good as bagel/bread replacement when have lox and cream cheese
    5. ate a lot of almonds and peanut butter
    6. switched to sea salt (OOOOPS!)
    7. more cauliflower and broccoli as standby foods (cabbage too!)

    Anyway. another year passes – some joint paint, tennis elbow quite bad, and i don’t even play tennis. finally slowly going away with help of ibruprofin (sp?) Take potassium for leg cramps. Take MG, as i was quite constipated regularly. And fatigue as well.

    Then went for another blood test, at yr 2 of LC. TC now 363 (freaking everyone out). HDL 64, LDL 260. TG 115. 363!!!!! 363!!!!

    From your site etc, i think i am hypothyroid now.

    Why?
    Sea salt only
    crucifer veggies in abundance
    (added saurkraft too for a week before the test)

    Have early symptoms of:
    cold intolerance, constipation, fatigues, muscles cramps and joint pain, elevated serum cholesterol

    Other bloodwork (me – male, mid 40s in age)
    TSH 1.59
    T4 6.8
    T3 uptake 36
    Testosterone 881

    While i have your attention, and i hope i do

    Pork pellets (skin in natural oils) that you microwave into pork rinds, cooking in own fat. Are these too high in Omega 6 or other TOXINS(?) (Julia’s Pantry pork pellets). I find these terrific substitutes for commercially fried pork rinds and great to be used as a nachos substitute (i surely do miss crunchy stuff), to dip in homemade guacomole etc). Is this the cause of my soaring LDL? Or a Omega 6 issue (nuts, etc).

    Was the addition of 4 oz of heavy cream to my almond mild +whey post workout each morning the contributor to the spike in LDL?

    Could cortisol/stress have anything to do with it. Over the past 6 mths a VERY stressful life (family member illness, but i wont go into it). Cause of LDL?

    Can this cholesterol kill me while i try to make adjustments? DON’T want crestor!

    Thank you for your time. And when is the new book available so i can add to my collection.

    • Hi Evan,

      Q1 – New supplement recommendations are on this page above. Explanations are in the new book. We no longer recommend a multi. 110 mcg in a multi and 200 mcg is too much … 110 mcg/day would be more than enough on PHD which is a high selenium diet.

      Q2 – Again, we don’t recommend a multi and this combination is too much. Even the multi alone is probably too much zinc.

      We’ve done a number of posts on VLC and high LDL. You might as well read our LDL/HDL/Cholesterol category starting from the early posts forward.

      I would add carbs and follow our strategy for hypothyroidism.

      Don’t take Crestor. No, the cholesterol won’t kill you, but you do need more carbs and to fix your thyroid/iodine/mineral status.

      The new book can be purchased now but it will ship Dec 11.

      Q2

  44. oh. forgot to say, been adding 1 1/2 cups a day of white or brown rice to get my carbs up a bit. feeling great with this and the iodine or all mental, not sure yet. Wife and friends freaked out as i ate the rice (first time in 2 yrs).

  45. Paul,
    I tried to find information about why take lithium- can you answer in a nutshell?
    What I read was that it was good for brain health…it has been used for brain disorders, but does one take it as a preventative?

    Also the NYtimes had a big article on longevity but seemed to be down on eating meat. Response?

    Choline? Or is that covered eating eggs everyday?

    • Hi MissBB,

      People with higher lithium intake in water live longer lives and have much lower rates of certain diseases, especially mental health conditions. It seems we evolved in the expectation that a certain amount of lithium would be in our water. It modulates potassium and sodium transport and things don’t work as well when it’s not there (or when there’s too much).

      In the US with our treated water almost no one gets significant lithium, so it should be beneficial for nearly everyone.

      NY Times article — maybe I’ll blog about that, but I think meat has little to do with it (they eat some meat and plenty of fish and dairy) and lifestyle has a lot to do with their longevity.

      Choline – yes, 3 eggs daily and 1/4-1/3 lb liver per week should be enough. I would recommend more choline in pregnancy and obesity however.

      • I just read you mentioned lithium might be problematic for those hypothyroid. Is this at the does you recommended 1/2 tablet. How would it affect you if you at hypo?

        • Hi MissBB,

          I think the dose we recommend poses minimal risk; in papers hypothyroidism starts to appear at doses in the tens of milligrams, so 2.5 mg would only have a marginal effect. But in people who are already getting sufficient lithium from food or water, it could exacerbate hypothyroidism, that’s the reason for our warning and for making it “optional.” In the US, that will mostly be people with well water or who eat a lot of organic vegetables grown in lithium-rich soil.

          If you are hypo it would reduce thyroid hormone activity and so your symptoms would worsen or you would need more supplemental hormone.

  46. Hi Paul,

    What are your thoughts on supplementing with Betaine HCL with pepsin. I am currently taking Now Betaine HCL It is ~600 mg Betaine HCL with 150 mg Pepsin per pill.

    I am using Kresser’s protocol of increasing by 1 pill after every 2 days starting at 1 pill. I am now up to 10 pills (~6 grams) without feeling a warm sensation. Would you recommend an upper limit?

    I have noticed remarkable improvements in my bowel movements and stool. Previously I had quite loose stools and I tried the Interfase/Antimicrobial/Activated Charcoal to not much avail. After stopping that per your recommendation, I decided to try the HCL and I’m really happy, but just concerned about an upper limit.

    • Hi erich,

      I think it’s helpful in cases of low stomach acid, often indicated by acid reflux.

      Probably I should add it to the therapeutic supplements list.

      I would take the Betaine HCl only with meals and take the minimum dose that enables you to digest food well. The goal ultimately is healing and not needing it.

  47. sorry Paul….but the bottle says 30 mg per capsule on the NOW brand of Potassium with Iodide??
    I am not a converter….but if 1 mg equals 1000 mcg than this would not be the bottle that’s 225mcg correct?

  48. mine does too Paul but the one in your new recommendations says 30 mg on the bottle when I try to order through amazon? That’s why i am confused…

  49. Good morning Paul,
    On my Cyrex Array 3 results reported in July, I have tested positive for WGA IgA, Gamma Gliadin 15-mer IgA and Transglutaminase-6 IgG. Are there any additional supplements you would recommend (or foods) based on this? I was avoiding all grains and coming off GAPS Intro until your recent recommendation of adding safe starch, by the way.

    FYI: I ordered your daily and weekly recs yesterday but no optionals yet.

    Thank you so much for any advice/recommendations you may have.

  50. Paul,

    I am a little confused as it seems that iodine supplementation requires the right amount of selenium.

    So i am having trouble interpreting your weekly suggestion of “OPTIONAL: Selenium 200 or 400 mg depending on selenium content of food (if food is produced in dry, flat areas = high selenium, no supplements; rainy, well-drained areas = 400 mcg/wk) and iodine intake (higher iodine = bias toward slightly more selenium)”

    Is it right to assume the diet may only require just 200 mcg of selenium weekly at 225 mcg iodine, but perhaps at 1000 mcg iodine i should have 400 mcg selenium weekly via supplements?

    (i am eliminating the multi vitamin and the brazil nuts….but i do have 3 eggs a day, fish 2-3 times a week…no organ meats)

    *see what happens when the storm keeps us all indoors today, reading and thinking!

    much thanks
    Evan

    • Hi Evan,

      First, our diet is high in selenium to begin with — typically 150 mcg/day — because of the focus on grass-and-algae based food chain items like beef, lamb, shellfish, fish, eggs, and organ meats. So you don’t need much more from supplements. Also, food content is highly variable with less well watered soils having more selenium, so for some people PHD might provide as much as 300 mcg selenium per day. This is why it is optional.

      Taking 400 mcg/week works out to 60 mcg/day which would put just about all PHD dieters at 200 mcg/day which should be sufficient even with high iodine intakes.

      If you’re taking higher doses of iodine, I would either eat kidney regularly or supplement selenium one or two days a week.

      • Thanks Paul for the timely and well as descriptive response – your explanation makes it clear now. I am dropping the multi the brazils and adding 200 mcg twice a week then (instead of 400 at once). Time to place my order. Appreciate your thoughts and feedback.

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