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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4,321 Comments.

  1. Thank you! How much copper to supplement? How about iron supplementation? Would 1/4 lb of chicken liver a week have enough or should I do a 1/2 a lb?

  2. Hi Paul,

    I was taking R-Alpha Lipoic Acid, which I don’t think you recommend and wanted to boost my antioxidants like you suggested with Vit C, Zinc, NAC, etc. so I didn’t replace that, but someone recommended Pycnogenol. Just wondering your thoughts on that. Plus, since we are about the same age, I believe, I was wondering if you take Ubiquinol? It is fairly expensive and I know CoQ10 depletes over time in our bodies, so I’m wondering if I should replace my empty bottle as well. No statins, no heart issues, BP good. etc. I’d like to just eat the food and not have to rely on supplementation, but, well, we’ve got to now-a-days. Thank you for your time and knowledge!

    Janis

    • Hi Janis,

      I think CoQ10 is likely to be harmless but as you say it’s expensive. I’m not sure there’s any benefit to supplementing it on a healthy diet — the mechanisms by which it would work seem like they would compensate for an unhealthy diet, rather than providing benefits on a healthy one. So I think supplementation is unnecessary, but I could be wrong.

      Same thing with lipoic acid. Antioxidants may do more harm than good. I prefer to let the body’s natural evolved mechanisms work, unless there is really strong evidence to the contrary.

      Pycnogenol may be therapeutic for some infections or other conditions, but I would recommend just food as a rule for healthy people.

      • Hi Paul,

        Thank you so much for your response. I believe I eat a pretty healthy diet, so will forgo the supplementation of CoQ10 for now. Well, that’s disheartening that antioxidants may do more harm than good! We think we are doing our body good, but could actually be harming it instead. Like for instance the fish oil debate that it could actually be oxidize and causing inflammation instead of the reason why you started to take it, reducing inflammation. It’s difficult! So, just eat a variety of good foods and wish for the best! Thank you for taking the time Paul. I know we all appreciate your quick and informative responses!

        Janis

      • Paul, how about those of us that don’t tolerate a healthy diet? For people that can’t eat fruits and vegetables, would the recommendations be different?
        Lilian

        • Hi Lilian,

          I think you should consult with your doctor in such a case. To be unable to eat fruits or vegetables calls for proper diagnosis and treatment. I wouldn’t supplement until you know what is causing the digestive problem.

          • Hi Paul,
            As you know doctors don’t tend to be very knowledgeable in this area. I have sought help for digestive problems for many years to no avail.. I have on my own tried everything I can think of (diets such as SCD, fodmap a etc), antibiotics based on Metametrix testing, herbal medicine, homeopathy, acupuncture, you name it. The digestive problems remain, and I’m trying to find out how to best supplement a diet that consists mainly of meat, fish, dairy and very small amounts (or none, depending on how I’m feeling) of vegetables, starches or berries. Would the aforementioned antioxidants, additional mineral supplementation etc be indicated in such a case?

            Warmly,
            Lilian,

          • Hi Lilian,

            You know, it is hard to say. Biology is complex enough that it’s hard to make inferences without empirical data. Available data are all derived from people eating standard diets (50% carb).

            I think you might try potassium supplements as a first step. I think as far as antioxidants are concerned, the regular PHD supplements are sufficient.

      • Just a note; I started taking A-Lipoic Acid to help with shingles, and it has been made a big difference for me, so I will continue it for that specific issue. Thanks for your blog. I am researching histamine sensitivity, which I “just developed” in a radical way. I am also very low thyroid, but did not respond well to porcine thyroid, so I have been relegated to synthetic which doesn’t seem to do much more than help me get out of bed.

  3. Hey Paul, just letting you know the adrenal fatigue symptoms of lower back pain etc went away once I dropped back down to 225mcg iodine from 450mcg. But now I. Experiencing really itchy skin on my elbows and ankle. There seems to be a rash developing in those areas which are quite red. This must be the bromine detox right? Maybe from the 450mcg I had taken for a few days. It’s really itchy thou, do you think I should stick to 225mcg to help rid the bromide faster or just stope all together until the rashes go away. I’m trying to take a tsp of salt water with my first meal and already am taking about 3grams of C

    • Hi Jessica,

      I think you need to experiment — if you drop the iodine to zero does the itchy skin get better or worse? If it’s just bromine detox I’d stick with the 225 mcg and increase the salt/water/C. If it’s something else like thyroid issues I would investigate with a doctor.

      • Thanks,what really sets your blog apart from the others is that you respond within a day or so and the support really helps. Much appreciated Paul! I doubt its the iodine because iv taken it slowly for about 2 months and would’v probably developed a reaction earlier. I think it is just bromine leaving the body. Will be taking extra C and Salt.

        Just curious, would rock salt be just as good as sea or celtic?

        And could bromide and fluoride in the bodies cause ‘stubborn’ fat around the hips and abdomen and maybe teeth discoloration from flurosis. I’m trying to understand what makes fat so stubborn in those regions. Infections, toxicity of omega 6 or bromide in the fat tissue maybe.

        Jessica

        • Hi Jessica,

          Whether it’s as good, better, or worse depends on what’s mixed in with it. I think it’s an acceptable form of salt, in moderation.

          I don’t think those are normally listed as bromine toxicity symptoms, but maybe, particularly the teeth.

          • Okay great. The rash is coming on my other arm now and is very itchy, and on my leg and hip too. I’m only 19 so am just a bit worried at a young age having this much bromiimago wouldnt imagine the bromine toxicity older people like my parents might have. Maybe I could just discontinue with the iodine supplements and just get it from natural food sources like maybe go to sushi once a week or have 3 nori sheets daily like how was mentioned earlier in the comments as a supplemental food, theirs just a more safe feeling about food.How much iodine would one sheet provide? And if your younger like a kid or in your 18 or 20’s would having seaweed be better. I’m sure one norie sheet daily will eradicate a deficiency.

          • Hi Jessica,

            There’s nothing wrong with getting iodine from seafood and seaweed. It may help you to sort out the cause of the rash to reduce the iodine further.

  4. Hi. Can I have whey protein without sugar during the 16 hour fast?

  5. Hi Paul,
    how safe is it to take 200mcg of selenium in the form of selenium yeast per day when also taking 5mg of iodine per day?
    In this guest post: http://perfecthealthdiet.com/2011/05/iodine-and-hashimotos-thyroiditis-part-2/
    Iwakura said that he takes 200mcg of selenium per day.
    In your book, I had the impression that 200mcg per day was generally beneficial.
    I live in Germany and eat half a pound of beef per day and three eggs (I think those are my major sources of selenium) and fish once a week (but no organ meats).
    Could ths amount of selenium hurt me?

    • Hi Kevin,

      Well, we’ve backed away from recommending higher doses of selenium and iodine.

      I developed symptoms of selenium overdose at 200 mcg/day, such as brittle nails; the nails normalized as soon as I reduced selenium. Whether that’s too much depends on how much selenium you’re getting from food. PHD is a selenium rich diet (ruminant meats, seafood, eggs), so I don’t think one needs to supplement a lot.

      Similarly iodine has risks at high doses so for most people we now favor 1 mg or less, saving higher doses as potential therapies for some conditions.

  6. Hi Paul! Is there a brand of white rice you recommend? Thank you!

  7. Hi Pual,

    Every night, I generally wake up 3 times. 1-2 of those times, I generally have to urinate. The last two are generally random, and I do not need to urinate.

    Sometimes this is accompanied by dry mouth.

    I have stopped drinking liquids before bedtime. I eat PHD with about .5 lb of rice for lunch and dinner.

    From some preliminary research, some report that it may be sleep apnea, others mention a blood sugar imbalance (but I eat plenty of carbs).

    My room is blackout and I use UVEX goggles before bedtime. A bit of light slips through the curtains , but my first awakening is before light even comes through the curtains.

    Erich

    • Hi Erich,

      I might suspect some sort of disruption of thyroid/adrenal hormones. Adrenal hormones being off can lead to extra fluid loss and poor regulation of electolytes leading to waking and urination. Often some sort of thyroid issue leads to adrenal issues.

      Apnea leads to waking and breathing difficulties/snoring, but not necessarily a need to urinate or to dry mouth.

      You might ask your doctor to see if you have any thyroid or adrenal abnormalities.

    • Hey, Erich, how soon after eating 8 oz of rice (65 grams of carbs) do you go to bed (with protein too?)? I’ve had success waiting 3.5-4 hrs first and getting enough water before sleeping.

  8. Hi Paul,

    I had a question on iodine supplementation. It seems substantially cheaper to get the Iodoral and the prolamine. If we want to end up at 1 mg a day, could we take the prolamine 2x a week or the 1/2 an iodoral 1x a week? Or does the iodine pass through the body much faster?

    Erich

  9. Hi Paul,
    Thank you so much for your blog and your new book. My husband and I are finishing up the book now and I have sent a copy to my mother.

    I bought one of the silicon supplements you recommended above, Solgar Oceanic Silica. Each capsule contains 50 mg of silicon and 100 mg of calcium. Since your recommendation for silicon is 5 mg per day, I intend to take one of the these capsules once a week. I wanted to make you and other readers aware of the amount of silicon in these capsules, since it is not mentioned in the product information on Amazon.

    Thanks,
    Donna

    • Hi Donna,

      It’s probably fine to take the supplements more often. As we note in the book (p 330), it looks like optimal silicon intake is over 40 mg/day, and some people get less than 14. So some people might benefit from an extra 30 mg/day. We limited our recommendation to 5 mg/day just because there isn’t a lot of data at higher consumption levels to tell us how much is too much.

  10. Hi Paul. Instead of the iodine supplements you recommend, how do you feel about getting iodine from a Norwegian organic kelp supplement from NOW foods?

    • Hi Judy,

      Kelp is OK if the dose is low but it concentrates metals and impurities so don’t take too much.

      • It’s just so confusing with so many opinions out there. NOWs product is from organic natural sources. I understand that seaweed attracts toxins to it and if you take kelp that comes from polluted waters then you are poisoning yourself. But this product is carefully formulated with kelp from the cleanest sources. How does it differ from the product you recommend that I’m taking now… NOWs Potassium plus iodine?

  11. Hi Paul,
    Do you have any opinion on diatomaceous earth (fossil shell powder) as a dietary supplement. It’s supposed to be good for ridding the body of bacteria and parasites etc but there seems to be mixed opinions about its safety for humans.

  12. Hi Paul,

    What’s your opinion on quercetin as an antihistamine supplement?

    In my efforts to help constipation with gut flora, I started using kefir and fermented veggies, only to discover that I have issues with histamines (flushing, pins and needles, anxiety, headaches, etc). Taking 2-4 tablets of quercetin daily eases my symptoms and lets me drink kefir daily (and its benefits 🙂 ). Any harm to this longer term? Hopeful that someday my gut will heal and make the enzymes I need to break histamine down.

    Thanks!

    • Hi Ginger,

      I think of quercetin as a medicinal substance.

      However, I’m not sure foods that require you to use a lot of quercetin are all that beneficial. Kefir isn’t always beneficial, for example.

      You might benefit by reducing the problematic foods and taking digestive aids.

  13. Thanks for your insight!

    For a long time, I reduced those problem foods and took (still take) HCL or bitters, and sometimes enzymes as well. But had no good luck increasing flora with probiotic supplements.

    I have to say, kefir has made a fast, marked (and welcome) impact on constipation because of its potency. That’s the only reason I’ve kept it up, with the quercetin. I hope I’m not doing any damage with about 800mg. Maybe I’ll try alternating kefir days.

  14. after taking nac for a couple days, 600 mgs, I got diarehha. I read that it could cause that. Its disappointing because it made me feel really good. What do you think about taking glutathione?

  15. I have been reading about Carrageenan, a seaweed derivative that is used as a thickener. What is your opinion of its use? Seems that it is linked to cancer and I found it in my coconut milk ingredients! At the least it is considered an inflammatory agent. Should I avoid it?

    Thanks,
    Judy

    • Hi Judy,

      Many people have trouble with carrageenan and I think it’s better to avoid it. However, it’s hard to find cream without it, and some coconut milks have it too. It’s not easy to get perfect foods so sometimes we have to compromise.

      • I’m surprised that you have trouble finding cream without additives Paul. Here in the UK nearly all cream is just that.

      • SO MUCH FOR THE MYTHS
        CONSIDER THE FACTS ON CARRAGEENAN FOR A CHANGE

        Q. What is Carrageenan??

        A. Carrageenan is a naturally-occurring seaweed extract. It is widely used in foods and non-foods to improve texture and stability. Common uses include meat and poultry, dairy products, canned pet food, cosmetics and toothpaste.
        Q. Why the controversy?
        A. Self-appointed consumer watchdogs have produced numerous web pages filled with words condemning carrageenan as an unsafe food additive for human consumption. However, in 70+ years of carrageenan being used in processed foods, not a single substantiated claim of an acute or chronic disease has been reported as arising from carrageenan consumption. On a more science-based footing, food regulatory agencies in the US, the EU, and in the UN’s Food and Agriculture Organization/World Health Organization (FAO/WHO) repeatedly review and continue to approve carrageenan as a safe food additive.
        Q. What has led up to this misrepresentation of the safety of an important food stabilizer, gelling agent and thickener?
        A. It clearly has to be attributed to the research of Dr. Joanne Tobacman, an Associate Prof at the University of Illinois in Chicago. She and a group of molecular biologists have accused carrageenan of being a potential inflammatory agent as a conclusion from laboratory experiments with cells of the digestive tract. It requires a lot of unproven assumptions to even suggest that consumption of carrageenan in the human diet causes inflammatory diseases of the digestive tract. The objectivity of the Chicago research is also flawed by the fact that Dr Tobacman has tried to have carrageenan declared an unsafe food additive on weak technical arguments that she broadcast widely a decade before the University of Chicago research began.

        Q. What brings poligeenan into a discussion of carrageenan?
        A. Poligeenan (“degraded carrageenan” in pre-1988 scientific and regulatory publications) is a possible carcinogen to humans; carrageenan is not. The only relationship between carrageenan and poligeenan is that the former is the starting material to make the latter. Poligeenan is not a component of carrageenan and cannot be produced in the digestive tract from carrageenan-containing foods.
        Q. What are the differences between poligeenan and carrageenan?
        A. The production process for poligeenan requires treating carrageenan with strong acid at high temp (about that of boiling water) for 6 hours or more. These severe processing conditions convert the long chains of carrageenan to much shorter ones: ten to one hundred times shorter. In scientific terms the molecular weight of poligeenan is 10,000 to 20,000; whereas that of carrageenan is 200,000 to 800,000. Concern has been raised about the amount of material in carrageenan with molecular weight less than 50,000. The actual amount (well under 1%) cannot even be detected accurately with current technology. Certainly it presents no threat to human health.
        Q. What is the importance of these molecular weight differences?
        A. Poligeenan contains a fraction of material low enough in molecular weight that it can penetrate the walls of the digestive tract and enter the blood stream. The molecular weight of carrageenan is high enough that this penetration is impossible. Animal feeding studies starting in the 1960s have demonstrated that once the low molecular weight fraction of poligeenan enters the blood stream in large enough amounts, pre-cancerous lesions begin to form. These lesions are not observed in animals fed with a food containing carrageenan.

        Q. Does carrageenan get absorbed in the digestive track?
        A. Carrageenan passes through the digestive system intact, much like food fiber. In fact, carrageenan is a combination of soluble and insoluble nutritional fiber, though its use level in foods is so low as not to be a significant source of fiber in the diet.
        Summary
        Carrageenan has been proven completely safe for consumption. Poligeenan is not a component of carrageenan.
        Closing Remarks
        The consumer watchdogs with their blogs and websites would do far more service to consumers by researching their sources and present only what can be substantiated by good science. Unfortunately we are in an era of media frenzy that rewards controversy.

        Additional information available:
        On June 11th, 2008, Dr. Joanne Tobacman petitioned the FDA to revoke the current regulations permitting use of carrageenan as a food additive.
        On June 11th, 2012 the FDA denied her petition, categorically addressing and ultimately dismissing all of her claims; their rebuttal supported by the results of several in-depth, scientific studies.
        If you would like to read the full petition and FDA response, they can be accessed at http://www.regulations.gov/#!searchResults;rpp=25;po=0;s=FDA-2008-P-0347

        • Thanks for the information Debbie. According to Dr. Weil, the additive should be avoided. If I have a choice I’m going to choose products without it.

  16. Is the use of vitamin D supplements safe? I got a little confused after reading this:
    http://mpkb.org/home/patients/assessing_literature/palliative

    The claim is that vitamin D supplements are immunosuppressive and will worsen symptoms over time.

  17. Hi Paul,

    What do you think about desiccated pasture-raised beef liver caps for a pregnant woman who cannot remotely think of getting lamb or beef liver down?

    Thanks!

    Kristen

    • Hi Kristen,

      I think it’s fine but expensive.

    • If I may make a suggestion, I was recently pregnant and here’s what I found works. Get frozen grassfed beef liver. Thaw it out and pat it dry. Chop it up into as small of bits as you can swallow (like a pill). Put the bits on wax paper. Sprinkle liberally with lemon juice. The vitamin C in lemon juice helps you absorb the vitamins in the liver, and it masks any residual taste after refreezing. Refreeze the liver on the wax paper. Peel off your “pills” and swallow with water daily. I’ve never tasted any liver just lemon! 🙂 Cheaper than pills too!

  18. I know, no beans, but what about chick peas? I love making hummus without the tahini that store brands have.

    Judy

  19. Chia seeds for Omega 3?

  20. My dexa scan from November shows worsening osteopenia. since i found your book 3 weeks ago I’ve been drinking a cup of bone broth every day that I ordered from Wise Choice Market, 200 mg of magnesium ( should I double that?) and Life Extensions Super K which I’m taking every other day (or should I take it daily?). Have a yearly checkup coming up and will ask to have my D levels checked. If its up to 40, do I stop taking supplemental D or just reduce the dose?i understand higher than that is not good. I reduced the Calcium I was taking to 300 mg a day.

    Thank you for your advice.

    Judy

    • Since I’m drinking the bone broth should I take the calcium supplement at all?

      • No, if you’re eating bone broth regularly you shouldn’t need supplemental calcium. 200 mg magnesium should be sufficient; the K every other day is enough. You will probably have to take vitamin D in the winter every year. If you get enough sun on skin you may not need it other seasons. 40 is perfect so you should keep on whatever you’re doing if that’s what you get.

  21. Hi Paul,

    Almost finished reading the new edition of your book and enjoy it much more than the first edition…probably in part because it’s a bound book but mostly for the additiional material and clear presentation of it. The second time around is better for me.

    1.) I especially enjoyed the “Meal Plan” and wondered whether the only tweaking necessary to make it a “loose weight” (but not ketgenic) meal plan was cutting the fat to 1 Tab/day and eliminating the fruit?
    2.) Would 1/4 lb. chicken liver fulfill the weekly copper requirment? (I dislike beef liver)
    3.) Does the weekly B12 supplement need to be vegetarian or animal sourced? Or does it matter?
    4.) Should the seeds in cucumbers be removed before eating to avoid toxins?
    5.) In the book (pg.334)it lists Molybdenum and
    Boron as weekly optionals but on your website under “Supplements” they are not optional. Which should I follow?
    6.) It’s sometimes hard getting 1 lb of potatoes/day down because it makes me feel so full. Do you think some charcoal might help? Sometimes I take HCL but that’s mainly for protein.

    Thank you in advance for your response. My husband is in pig heaven ’cause he’s back to eating meat, potaotes with butter and veggies. The only battle remaining is that mid-western tradition of desert!

    Warm regards,
    Mary

    • Hi Mary,

      Yes, pretty much reducing fat and a little more strenuous fasting and exercise / adherence to circadian rhythm strategies is the primary change to make it the weight loss version of PHD: http://perfecthealthdiet.com/2011/02/perfect-health-diet-weight-loss-version/

      No, chicken liver doesn’t have much copper unfortunately. Calf liver is milder, also be sure to clean the liver thoroughly to remove blood and other impurities (after rinsing, simmer it briefly in water or milk and then discard the water or milk), then try making pate: http://perfecthealthdiet.com/2012/02/chopped-liver-pate/

      Or eat chicken liver for the other liver nutrients and supplement copper.

      I don’t think it matters.

      Good question about the cucumber seeds. I don’t know.

      Thanks for pointing out the difference between book and page. I would recommend taking them weekly, I think they are low risk and deficiencies can be quite harmful.

      I wouldn’t take charcoal unless you have some evidence of toxicity from something, eg iron or microbial cell wall components. It can induce nutrient deficiencies. You might try eating fermented foods to try to increase bacterial diversity. Also chew the potato thoroughly in your mouth so that it is well mixed with saliva and has no solid particles left.

      Best, Paul

  22. Hi Paul, my question is in regard to K2 supplementation. Unfortunately it seems I can’t take K2 in supplement form as each time I do I experience heart palpitations(Life Extension Super K ) Would eating natto be a good alternative food source? (I quite like the flavour and texture)If so, how much would I need to eat per day /week to get the recommended amount of K2? Thanks I love the new edition of PHD

    • How does K2 cause heart palpitations Paul?

    • Hi Min,

      First, stop the LEF Super K. Second, I think it would be good to visit your doctor and ask for an INR time measurement to assess clotting status. The LEF Super K has a lot of vitamin K1 and this can promote clotting in some people. It would be good to have a baseline here. Then get re-tested after you have been off the supplement a while. (For an example, I just blogged about Jennifer Fulwiler who has the Prothrombin 20210 mutation which promotes clotting by overproducing the vitamin K dependent protein prothrombin: http://perfecthealthdiet.com/2013/01/reader-feedback-a-roundup-with-my-reflections/)

      As far as foods go, natto is good. So is aged cheese, or any fermented food. I am not sure how much you would need to eat to have good K2 status, but just eating fermented foods regularly should help a lot.

      If you decide to try supplementation again, try a lower dose supplement that is purely K2 / MK-7, like 90 mcg or 100 mcg.

  23. Hi Paul,

    Some recents comments have sparked my interest concerning hives and histamine intolerances and found this interesting article: http://thatpaleoguy.com/2011/04/11/histamine-intolerance/

    I also submitted a comment to you about a recent case of hives (which I think I can say after reading this article, could have been from fish that I ate) and you were kind enough to explain a reason for this outbreak. After reading this article though, it did mention that NAC may block intestinal DAO. You recently recommended it for me as well as other antioxidants. I believe that I have a histamine intolerance, especially to red wine, which I (used to) love, all of those fermented foods we are supposed to be eating, but upon learning more information about histamine, perhaps I shouldn’t be taking the extra NAC 600 mg. Oh yes, and plus I just started taking MK7, that is fermented. What are your thoughts? Thank you!

    Janis

  24. Plus, there was an update on histamines as well if anyone was interested.

    http://thatpaleoguy.com/2011/11/14/histamine-intolerance-update/

    • Thank you Janis,

      I was wondering about the NAC and histamine issue as well.

      I too have a histamine intolerance and so many of the foods that are recommended for paleo (eggs, dark chocolate, wine, yogurt, fermented veggies, bananas, nuts) are off limits. Since paleo eating is restrictive anyway this makes things more complicated. And when you are trying to heal gut infections the fermented foods are supposed to be so important.

      I am playing with digestive enzymes and maybe it will take a while to see the effects. Thanks again for the links!

      • Hi Amy,

        You are very welcome for the links, I’m glad that I found them as well and that I could pass on the information. I love all of the foods you mentioned and I am too now finding them to be off limits. It’s kind of a rude awakening after all these years to finally to note of what my body doesn’t really like, especially after being a vegetarian for so long as well. (paleo 2 years and for the most part, it’s been better for me) But, knowing that there are people, like you Amy, that are out there, who are facing the same dilemma. Thank you for responding to my comment! I appreciate it.

        Janis

  25. Hey Janis, Amy,

    I took a food sensitivity test and histamine foods were listed like eggs, pineapple, yeast, mushroom. So I think I have some of those issues too. 🙁 do probiotics from a pill have histamine issues. I seem to crave these histamine foods but also have issues with eating them.

    • Hello Katie,

      Someone else on this site suggested this link: http://lowhistaminechef.com/

      and there is a link on the page that addresses the histamine and probiotics issue. Very interesting. Apparently some strains increase and others decrease histamine levels. I am currently experimenting with yogurts (24 hour homemade).

  26. Hi Paul,

    I recently stumbled upon this http://www.indiegogo.com/ubiome project (microbiome citzen science crowd funded research on your microbiome). I am wondering what your perspectives are on this? Do you think it will help more than just a simple doctor checkup on your microbiome? If so, do you think it is necessary?

    Erich

  27. I love your book! I’ve been mostly Paleo for about a year, mostly very LC. Adding more carbs has been very helpful, but maybe not for my blood sugar. I have been carefully monitoring what happens after eating only a 1/3 cup of mashed sweet potato. A typical meal might look like: 3 oz. ground beef, salad with olive oil/vinegar, 1/2 c. broccoli w/butter and 1/3 c. sweet potato with 1 T. coconut oil. Between 40 minutes to 1 hr. 20 min. after the meal, my blood sugar is 140-155, but by 2 hours, it has dropped to almost 100. I am worried because your research shows that problems arise when blood sugar goes over 140, which mine has been doing after eating a smallish amount of sweet potato.
    Any thoughts?
    Thanks,
    Ashley

    • Hi Ashley,

      Postprandial rises as high as 155 are fairly common in the general population, and are no surprise at all in someone eating as few carbs as you are — a VLC diet causes insulin resistance which means higher postprandial glucose after a carb meal. If you eat more carbs, then over a period of weeks the postprandial blood glucose rise will become smaller.

      I would say your blood glucose response looks perfectly normal, and I think you should continue working more carbs in.

      Best, Paul

  28. Paul,

    Every year for the last few from November to February I get a mucousy cough and a full feeling in my chest. I’m not sure if it is allergic, fungal, bacterial or viral. Do you have any thoughts on what I might try in my diet to banish this cough? Additional information: I’m an active and generally very healthy fifty-year-old woman (play soccer three times a week) and had a bout of pericarditis three years ago. They tested for lupus at the time (my mother had pericarditis and they diagnosed her with Lupus also at the time) and it was negative. Often, throughout the year, about twenty minutes into playing a soccer game, I feel like my blood is not oxygenated enough and my hands start tingling. Thanks for any ideas you have.

    • Hi Melissa,

      I don’t know, but the seasonality is suggestive.

      Do you keep your vitamin D levels up? I would supplement D in the winter up to 5000 IU/day, plus 100 mcg K2 and eat liver weekly for vitamin A.

      Another possibility is that it is related to seasonal germs like the flu. Influenze virus can cause other conditions besides the flu, including ear infections (http://well.blogs.nytimes.com/2013/01/21/really-in-children-flu-vaccine-can-prevent-ear-infection/) and even diabetes. Do you get a flu vaccine? Might be something to consider.

      The other seasonal factor is circadian rhythms — it’s easy to get too little light during the daytime, or too little exercise due to cold, in the winter. Circadian rhythms are very important for immunity and health (see our new book).

      The tingling could have many causes, possibly an orthopedic issue like thoracic outlet syndrome. It is hard to diagnose remotely.

  29. Hi Paul, I am so glad I found this site. Very interesting! The site originally came up when I searched for high HDL (mine is 116) and I was concerned that there might be something else going on besides being over-the-top-good. I think that medical establishment is not ready/capable/willing/interested in in-depth research on the subject. A few authorities suggest a possible link to auto-immune disorders and think that HDL over 70 is associated with higher risk for atherosclerosis. This is all new stuff and doctors are clueless about this new research. But my question to you is not related to HDL at all. The question is about your opinion on taking pro-biotics. I checked your recommended supplements list and did not see them there and was wondering why. Thanks, Jenny

    • Hi Jenny,

      Probiotics are fine, in fact they are a terrific therapy for food poisoning. But we recommend fermented foods such as yogurt and fermented mixed vegetables (http://perfecthealthdiet.com/2011/11/fermented-mixed-vegetables/) which supply a wider range of species. I don’t think a probiotic is necessary as a general practice.

    • Have to say thank you for the book & work you both are doing even though I’ve found it extremely difficult to get through all the scientific stuff, and initials for unknown elements and the shock of the eye-opening info you’ve given. I value your info on arterial calcification re Warfarin. My heart specialist doesn’t know or bother about this. Alarming!
      Question 1: I am trying to boost a slightly low thyroid with sauerkraut (which I am told by the good old “Nature Doctor” of Switzerland) has high value for many issues so should I continue taking kelp tablets or try to eat seaweed (urk!) ?
      Question 2: what is NATTO? Our health food shops here in Down Under seem to be a bit behind your northern world.
      Question 3: should we eat the egg whites or throw them away?
      Question 4: can we eat mung bean sprouts?
      Question 5: are thickened cream and coconut cream OK or not for weight loss?
      That’s all for this newby, and would be most grateful for your answers.

      • Hi Pauline
        Natto is not a health food per se, it’s a Japanese food (fermented soybeans) and is usually available frozen, so if you have a Japanese market, they should have it.
        Best,
        Peter

      • Hi Pauline,

        Seaweed can be tasty, see http://perfecthealthdiet.com/2011/01/homemade-seasoned-seaweed/. I think it’s good to get at least some iodine either from seafood/seaweed or supplements.

        Natto is a foul-tasting fermented soybean which due to the fermentation is rich in vitamin K2. I prefer other fermented foods, eg aged cheese, for K2.

        Eat the egg whites or throw them away, both are fine, follow your taste. If you throw them away you will need meat or fish for protein. If you’re trying to lose weight it may help to keep the whites and reduce meat intake.

        Bean sprouts can be eaten at low doses since the sprouted state is relatively low toxicity, but I’m not a big fan. Consider them a flavoring/texturing agent for other foods rather than the basis of a salad.

        Cream and coconut cream are OK in the sense that they’re non-toxic, but their calories do inhibit weight loss and they are empty calories (not providing any nutrients you don’t already have), so I wouldn’t eat too much of them.

        • Thanks so much for your time and expertise Paul & your answers. Like the seaweed idea, will definitely do that. So should I then also take MK-7 & iodine supplement? At present I’m taking a kelp tab and eating sauerkraut – is that recommended or should I leave them out?.
          I’m very confused about the 3 egg idea – how do you fit these into a daily ration in 2 meals (if fasting) and still get enough meat or other protein? Or is that a silly question & I should just eat MORE meat etc in one meal and 3 eggs in the other?
          Have to say I’m finding all this rather difficult as I’m not one bit scientific, just an artist. Different areas of expertise! Thanks so much for your highly valued answers 😯 😯 !

          • Hi Pauline,

            If you eat seaweed it’s not necessary to supplement iodine but it might be beneficial. Similarly if you eat fermented foods like sauerkraut often it may not be necessary to supplement MK-7, but it might be beneficial.

            Three eggs can provide most of the protein in one meal and meat in another. Or, you can discard the whites and have the yolks with meat or fish.

          • 😛 Wow! That was quick! Thank you so much Paul!
            Only one more thing I’m confused about in this – should I continue taking my kelp tabs along with any seaweed I can make, and on the frequent times I eat sauerkraut? Many thanks once again. 😕

          • Hi Pauline,

            I actually prefer not taking kelp and taking the NOW Potassium with Iodide tablet listed above instead as a low-dose supplement. As far as iodine dose, it is really up to you. There are probably more benefits than risks to low-dose iodine supplementation, but use your judgment.

      • for plenty of (kinda gross) photos of Natto,

        do a ‘google images’ for Natto

  30. Thanks, Paul, that was fast — thanks so much! Yes, I know about fermented foods, try to incorporate them into my diet, eat miso soup pretty frequently, but just to make sure I do take probiotics daily for a few years now. So you don’t think there is any danger of overdoing with probiotics, right? Now, speaking of miso: it’s fermented soy paste, for the most part. Is that an issue? I don’t think I eat any other products containing soy except for very occasional soy sauce in a tiny amounts.

    Thanks again,

    Jenny

    • Hi Jenny,

      It is possible to have trouble from probiotics, but it’s dependent on the particular bacterial genes present in that pill, which is hard to control. In general probiotics are quite safe if you’re not taking antibiotics and eating a healthy diet, but in that case they’re likely to be unnecessary.

  31. Hi Paul,

    Could Trimethylglycine (TMG) be used as a supplement instead of a Choline supplement?

    I have found some 100% TMG crystals (also labelled as Anhydrous Betaine).

    & would the dose recommendations be similar to Choline?
    Each scoop is 650 mg TMG.

    Thank You

    • Hi Darrin,

      Yes, they would at least partially substitute for choline, relieving any deficiency you might have.

    • Hi Darrin,

      I’m curious why TMG instead of choline?

      • Hi MarkES,
        It was just a price per dose (bang for buck) & availability thing really,
        I was using choline citrate powder, but iherb stopped selling it.

        So i went looking for an alternative option, & i had seen Paul mention TMG before in comments.

        iherb is my only option really, due to the expense of shipping to Australia.

        i do eat some eggs and duck or chicken pate, but there maybe a shortfall in choline…i will plug it in to cronometer & check…sometime

  32. Hi Paul, please may ask what your opinion of eating grapefruit is when trying for normal optimal detoxification function (I dont take any medication)? I love grapefruit and ate a whole one most days but stopped eating after reading that the naringenin contained, affected the Phase1 liver detoxification process. I need to foster excellent detoxification pathways as I am autoimmune and about to have mercury fillings removed.
    However I recently came across info stating that
    D gluconate (found in grapefruit) inhibits
    beta glucuronidase an enzyme produced in the colon involved in phase11 liver detox and that elevated beta glucuronidase increases the risk of various cancers. So, may that not suggest that eating grapefruit may be beneficial afterall or is it you win some, you lose some?
    Trying not to over think this but just want to eat what is good for me.
    Thanks for your time, kindest regards
    Lynne

    • Hi Lynne,

      I haven’t investigated but I’ll answer on general principles: I don’t think there’s anything wrong with eating a grapefruit a day. The liver detoxification system will recover from a grapefruit within minutes, I bet.

      I think you’re right not to overthink it. All of those pathways you mentioned are homeostatically regulated so if you perturb them, the body will restore them to normal. Just be well nourished and they’ll do fine.

      • Thank you so much for your reply. I have finished your book but am going to re read to consolidate. So much information to absorb, a wonderful book 🙂

  33. Trying to improve skin, hair, and nails – taking MSM (half teaspoon once a day), Biosil twice a day, and the Biotin only once a week as you suggest. Can I increase the Biotin for this purpose to once a day?

    Thank you!

  34. Hey Paul, Love the new edition of the book! I began the diet on New Year’s 2013 and am already thinking this is going to help me alot. I am taking all of the supplement recs now, but just started the iodine 1/19/12 because I was waiting on the shipment.
    I have noticed for the past two weeks that my knees, tibias, and surrounding musculature is very tense, achy, sore. I have been running 3x/week about 3 miles for the past 6 months with little issue and this joint pain/aching just began? I cannot figure out what the cause could be? I was previously taking 4,000IU vit. d daily, 400mg Mag daily, Indole-3-carbinol, along with my hefty dose of synthroid and cytomel. So I have added the copper(I dont have access to a good liver source),choline, selenium, zinc, b vit, all as indicated? I did just startthe 225mcg Iodine as per your recomendations, but the pain began before that? Do you have an inclination as to what could be causing this? I know I did not get arthritis or bruise my bones overnight? As far as I know I just know that I have hashimoto’s, and a pituitary cyst which prohibits my production of TSH, and have a low ACTH despite a normal cortisol level( at least in the past). If you have any clues PLEASE let me know! Thanks again!

    • Hi Stephanie,

      One possibility is that you lowered carbs and that led to electrolyte loss (potassium, sodium). You could try eating more carbs, tomatoes, potatoes, and salt.

      I’m not sure what supplements could be a problem, but you can try removing them. If you are taking the LEF Super K try dropping that, the 100 mcg MK-7 is safer.

      Another possibility is that you may have had a selenium deficiency and now you are overdosing on the thyroid meds. Hyperthyroidism can cause joint pain, eg http://www.ehow.com/about_5533348_hyperthyroid-joint-pain.html.

      I would experiment with likely causes in a controlled way until you figure out what dietary or nutritional changes are responsible.

  35. Thank you for your input… I have definately upped my carbs since beginning this diet so I know its not that. I am taking a Vit K from Vitacost that I thought was comparable. I wonder about the selenium and the thyroid…I am actually going to UVA at Charlottesville,VA next week for a follow up with my endocrinologist. One thing I thought of last night…I havent had any bone broth this week, and I thought I would look at your recipe for the broth. I don’t think I was doing the broth right anyway, and I am thinking I gave myself a phosphorus defiency?! Thanks for your input!

    • Hi Stephanie,

      Adjusting the dose of your thyroid medicines is probably the first place to look. It’s good you’re seeing your endocrinologist, it will be good to test thyroid levels. I doubt phosphorus is involved. Lots of nutrients, including selenium, copper, magnesium, protein/tyrosine, and others can have a big influence on thyroid function so it would be no surprise if the optimal dose of thyroid hormones is now significantly lower.

      • Thank you for the website, very interesting. I was hyperthyroid for 6 months following the birth of my son and that was what kicked off my hashimoto’s. I was one point away from grave’s disease on my antibodies then and also showed HIGH antibodies for the hashi’s, so I am definately a weird case.
        I will tell my endocrinologist about all that I am taking, but I am not sure how he will respond to that. He is rated one of the top 25 physician’s in the US, and is very open to things, but sometimes you just never know how dr’s take it when you tell them how many supplements you are on, or that you are on supplements that will mess with the dose of medication they have given you.
        I did question the selenium originally, but I didn’t see awhole lot about joint/bone aches or pains. I really appreciate your answers and your time though, I will be extatic if my 150mcg dose drops! Or if I can drop the Cytomel..these are what I was aiming for with starting the diet. I didn’t need to lose weight or start an exercise program, I just haven’t felt good since the Hashi’s began. I hope this is the trick that does it!
        Thanks again,
        Stephanie

        PS. My BP or HR hasn’t gone up if I am hyper- at this point?

  36. Hi Paul,

    I’ve been on your diet since a week or two before the new edition of your book came out.

    I have two questions and one has to do with daily supplementation, so I figured I’d comment here.

    1. Maybe I missed it, but why do you recommend daily supplementation with Lithium? This seems to be a strange supplement if the person does not have mood issues.

    2. Before the Phd I was doing a Primal style diet. I had good energy, but my eyes were dry. Now that I have been on PHD three weird things have happened (they might be unrelated to the diet but I’m not sure)…

    a. I got a bad cough about 3 days after I started adding rice and potatoes to my diet and the cough has stayed with me for about 6 weeks (even after two rounds of antibiotics). I used to get coughs that long when I smoked, but I’ve never had a cough for more than a day after I stopped smoking. So this seemed to be a weird coincidence.

    b. I seem to be more in a fog compared to when I was on a straight Primal diet. My thinking is not nearly as sharp and my writing has more mistakes. This is noticeable and frustrating.

    c. I am tired a lot of the time and can sleep 10 hours and still be tired. This was not the case when I was on Primal alone. Although this might have something to do with the cough?

    Anyway, I was hoping to get your opinion on these issues and the Lithium.

    Thanks.

    -Chris

    • Hi Chris,

      Lithium seems to be something we evolved around, and now that it is no longer present due to water purification we suffer shortened lifespan without it. Lots of aspects of the body seem to function body if there is an appropriate amount of lithium in the diet.

      Tiredness and brain fog indicates usually immune activity. The cough suggests it might be primarily an airway infection.

      Possibly some bad microbes were able to occupy territory while you were a little mucus-deficient on Primal (dry eyes = mucus deficiency, mucus essential for immunity of airways/sinuses/gut) and now that you have carbs to support both immune activity and microbial activity the symptoms of immune activity and circulating microbial toxins have become more obvious. I would focus on optimizing vitamins D and A which are both crucial for mucosal immunity. Vitamin C and zinc/copper/selenium optimization may help too. Probiotics might help.

  37. Hi Paul. What about Dandelion Tea as a way for thyroid help? It was suggested in this new diet book called The Plan. The author suggests drinking it every morning after glass of water with lemon juice. Curious also as to what your opinion is on daily water requirments? I don’t recall reading anything in your book on that.

    Thanks for being so patient 🙂

    Judy

  38. Hi Paul,

    I have ordered the Garden of Life Raw Enzymes that you mentioned for gut dysbiosis on the supplements listed above. I am taking this along with Now Foods HCL. Do you have any recommendations on the protocol to follow? Right now I am taking the HCL right before each meal (about 6 (650 mg) pills).

    1) Do you have a lithmus test for how long to take the enzymes for and how many similar to the HCL lithmus test of acid burning?
    2) Should I take at the beginning of each meal?

    Erich

    • Hi Erich,

      That’s a lot of HCl — am I reading you right that you are taking 6 x 650 mg = 3.9 g HCl? Be sure to calibrate the amount you take to your own needs, use the minimal amount that works. I am very surprised that you need so much.

      I think you have to try to get a read on your reaction to the enzymes. They are a medicinal treatment, they can cause either harm or benefit, so try to judge what is happening. A few weeks ought to be enough to give an indication. You could try alternating two weeks on two weeks off until you get an idea.

      Follow the directions on the label for timing.

  39. To add to that, I am also thinking of adding in the Taurine that you recommended. I am planning on the 1000 mg weekly. Is there any other supplements besides HCL (protein) 3900 mg (6 (650mg) with every meal), taurine (1000 mg per week) for bile salts (fat), enzymes (with each meal? ) (carbs/others) that you recommend?

    Erich

  40. Hi Paul,
    Do you have input on supplements for elementary age and older children? Getting my children to eat optimally all the time can be difficult. I have to wonder if they could be even deficient in vitamins and minerals than the average adult. Thanks!

    • Hi Leah,

      Children are less in need of supplements than adults, because they eat about twice as many calories per pound of body weight, and nutrient needs scale more like body weight than calorie intake.

      So if you can get your children eating reasonably healthy nutrient-dense foods, they won’t need supplements except maybe vitamin D in the winter.

      If they are picky eaters or empty calorie food addicts, then it’s tougher. If you really can’t get them to eat healthy foods, I’d go with something like the PHD recommendations for adults, reduced in proportion to body weight.

  41. Hi Paul,

    I’m not great at keeping track of my eating, so I am hesitant to start supplementing zinc (and maybe copper) because of being uncertain of how much liver I’ve consumed lately and when.

    So, I want to get your thoughts on a possible workaround: What if I added zinc to my liver pate? Does this sound too risky/imprecise/absurd to you?

    If so, do you have any suggestions on how to achieve zinc:copper balance without relying only on supplements or making liver consumption a purely mechanical act?

    Am I vastly overcomplicating this?

    Thoughts from other readers are welcome as well!

    Thanks,
    Mike

    • Hi Mike,

      The basic rule of thumb is that on weeks when you eat beef liver, you either want to eat 4 oysters or 1 zinc capsule.

      They don’t have to be in the same meal, but in the same week is a good rule of thumb.

  42. Paul,

    I just picked up the Solgar silcon through your Amazon link above. I noticed that you recommend 5 mg per day and I just casually looked at my purchase before it arrived and thought I had 5 mg a day. It seems though that the Solgar has 50 mg of silicon in each capsule (200 mg Calcium + 108 mg silica (50 mg elemental silicon).

    Is this too much? And should I be concerned about the added calcium?

    -Chris

    • Hi Chris,

      No, it’s not too much. The 5 mg is for the orthosilicic acid form which is much more absorbable.

      I don’t think the calcium is much of an issue, it’s 100 mg. Neglecting dairy and bone broth, a typical implementation of PHD is about 300 mg/day short. Just reduce bone broth slightly and calcium will still be optimal.

  43. Good morning Paul, After you recommended lithium to me in my last post to you (about my low back pain/stiffness due to lumbar facet arthropathy and spndylosis, etc., I received it yesterday. I apologize if you have answered this, I searched but couldn’t find the answer, but do remember you stating lithium should be supplemented early in the day, but since I do not eat very early, can I take the 2.5 mg dose with my coffee (with 1 TBSLSP. butter and 1/2 TBLSP MCT oil in it)? Or, should I wait until my first meal? Thank you!

  44. Oh great! I’ll take it now. Thanks again!

  45. Hi Paul,

    Is there a planned chinese version of the Perfect Health Diet book? I would like my parents to read it. Or are there any other sources ?

    Thanks,

    Erich

  46. Paul:
    In my effort to lose some weight I haven’t been
    eating the recommended amounts of safe starch…
    Yesterday, I was cleaning my ears with a Q tip
    (a no-no, I know) and noticed some blood on the
    Q tip from one ear, though there was lots of earwax in that ear. I went to the doctor and he said that my ear canal was very dried out and that’s why there was some blood there from Q tipping. He suggested a drop of mineral oil in that ear. But, I wondered why the earwax didn’t
    keep the canal from drying out?? In any event, I
    think I can’t cut down on the safe starches because they protect the mucosa, from what I understand. Any thoughts????

    • Hi Linda,

      Yes, I think you should eat more carbs. You may need carbs in order to be able to produce ear wax or to maintain the integrity of the skin.

      It’s better to restrict fat when trying to lose weight.

      • Hi Paul. Which fats should we restrict or eliminate for weight loss? If I have to eat fat with carbs and vegetables it can’t come from there. Not from egg yolks or the coconut oil. What are your suggestions?

        Judy

        • Hi Judy,

          Keep the egg yolks, but cut down the oils. Just use less. A small pat of butter on potatoes instead of 2 tbsp sour cream. Trim the fat from steak. Simple things like that.

  47. In an attempt to better understand what is the optimal intake of the various nutrients, I ran into the following article titled “The evolution-informed optimal dietary potassium intake of human beings greatly exceeds current and recommended intakes.”

    https://www.ncbi.nlm.nih.gov/pubmed/17275582

    It notes that we should be consuming around four times the current RDA. I’m eating lots of high potassium foods with a total caloric intake around 3600 and I’m only averaging 1.4 times the RDA for potassium. I can only conclude that there must have been some super potassium rich foods way back when or they were voracious eaters.

    Paul, what do you think about this research article?

    I sure wish there was some place I could look to and see the optimal intake of the various nutrients so I could easily compare it to my actual consumption.

    When you create your nutrient tracker in the future that would be a nice feature. 😉

    • Hi Tom,

      Well, I think the specific potassium recommendations are highly speculative, it makes assumptions about the macronutrient composition of Paleolithic diets that we just don’t know. There were certainly times that Paleolithic peoples would have eaten that much potassium, but there’s no real evidence that we need that much.

      I certainly agree that nearly everyone today would benefit by eating more in-ground tubers and roots and thus getting more potassium, and by eating fewer empty calories such as sugar, bread, and such.

      I’m looking forward to having that nutrient tracker too!

      • Hi Paul,

        I’ve recently been looking into SIBO, Gut Dysbiosis, etc. since my recent outbreak of hives and Elaine Gottschall’s work keeps popping up on my searches, Breaking the Vicious Cycle, where she speaks of bacterial overgrowth, etc. It seems that potatoes, sweet potatoes, plantains and rice are to be strictly avoided. These are my carbs that I rely on, especially for some energy! So, will these foods eventually cause some problems with an overgrowth of intestinal floral or bacteria? I don’t seem to have any problems, that I know of, with eating them, for example, diarrhea, gas or bloating. Can you guide me in the right direction?? I believe the build up of histamine (Chris Kresser just did an article on hives and migraines) was perhaps from enjoying the holidays a little too much with food and drinks that I normally do not partake in and caused me so much harm. You also explained what was going on regarding hives as well. Thank you for that. I just want to make sure that I am on the right track and that I am not causing SIBO and everything associated with that! Thanks Paul!

        Janis

        • Hi Janis,

          Gut issues are variable and so it is hard to generalize about what to do. Reducing carbs may help in some cases, and I do believe that eating fewer carbs than the average American (50% of energy) is helpful, but I don’t believe that totally eliminating potatoes etc is desirable as it may diminish bodily functioning, including the immune function and mucus production that you need.

          If you’re already somewhat low-carb as in our diet, then I would focus more in improving digestion. Chew your food thoroughly; brush your teeth after every meal; promote stomach acid production with salt, bitter herbs, possibly betaine hydrochloride supplements at mealtime if you are severely deficient; support mucus production with vitamin C and possibly with DGL; other digestive aids may also be relevant.

          • Hi Paul,

            Thank you for your response! I do eat fewer carbs than the average person, due to adopting to the paleo way of eating two years ago and recently adding in rice. But, in general I am eating potatoes, etc. because if I don’t I feel my energy drop. How does one know if there is a digestion problem and would need those items? I am not experiencing any reflux, GERD, stomach distress or any issues like that, but must have had something going on in the gut, like inflammation, plus, right before finding paleo, I got vitiligo. It hasn’t gotten any worse though since adapting this way of eating, so hopefully the gut issues are ok, but how do we really know? Sorry to be such a pain! I understand that you cannot generalize about what to do, but thank you for listening and giving me your recommendations. Just wondering, do you take digestive aids to improve digestion? I suppose taking them will keep the gut flora healthy in general? The only things that bother me are some FODMAPS, like yummy caramelized onions, leeks, brussels sprouts, etc. (well, and then a build up of histamines too) I’m going to be tested for food allergies in Feb., but I hear that the tests aren’t that reliable. It’s never easy I suppose, because you can’t see what’s going on inside your body. Thank you again for your time!

            Janis

          • Hi Janis,

            It sounds like SIBO isn’t the only issue, maybe not even the main one; it sounds like you have very specific symptoms which might be caused by a specific infection.

            You might consider getting a stool test, like the Metametrix Microbial Ecology test, to see if you can identify any treatable issues.

            I don’t generally take digestive aids but have experimented with them in the past. Betaine hydrochloride is bad for me, but it helped Shou-Ching with acid reflux and digestion. The only digestive aid I ever took that seemed to benefit me was DGL. But as I say all digestive issues are different and you can find people who have been benefited by each of the different digestive aids.

            In the end, you need to experiment. I think PHD is a good foundation.

  48. Hi Paul, any chance you know of a supplement that has vit k2 mk7 but not k1? I’ve been looking but can’t manage to find one… I”ve eliminated dairy (probably casein sensitivity) and don’t have access to natto, so seeking a source of vit k2 that isn’t contraindicated for someone who’s had a dvt…

    Your dedication to these boards is fantastic… Thanks again

    Michael.

  49. Two quick things–

    1) Re: Red Palm Oil
    I had written here a few months back about the very unpleasant taste (understatement!) of the red palm oil I bought. Since it wasn’t so cheap, I hadn’t yet bought another bottle to see if the one I had was just rancid or something… until today. I saw a less expensive brand at Whole Foods (it’s not organic or anything special… hopefully it’s a safe and clean product…). Anyway, it’s absolutely fine! No bad taste at all, I just ate a teaspoon of it without anything else. So, if you had an experience like mine, maybe the oil was rancid. I could use this for almost anything.

    2) To Paul…
    If I suspect I have a copper deficiency (I have been bad about weekly liver! but never got the copper supplement because of my good intentions and freezer full of liver!), could I possibly take twice the daily amount (4-5 mg) for a few days? Or does that sound like a bad idea? Today I bought cheated copper (2.5mg) as copper glycinate.

    Thanks!
    KH

    • Hi KH,

      Unless you have gotten tested and know you have a copper deficiency, I wouldn’t take an excess amount. It doesn’t take long to relieve a deficiency and if you aren’t deficient, taking extra might induce a temporary excess.

      • Ok, thanks Paul. I did go this morning to have blood drawn for routine lab work, but I didn’t think of the copper idea until afterward so I didn’t ask for any specific extra tests. I don’t think a copper deficiency would show up on normal CBC and CMP bloodwork. ?
        Thanks for the input, I’ll stick with the normal dose for now until I get tested further.
        Thanks!

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