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 ?

4,321 Comments.

  1. HI Paul,

    Thank you for the recommendation. I will look into the stool testing to see what’s going on. I believe PHD is a great foundation. Thank you!

    Janis

  2. What do you think about taking PS-100 for people with Adrenal Fatique and stuff like that?

    • Hi Katie,

      I think it’s very powerful stuff. Harmful to healthy people, but potentially beneficial in some. If you try it, don’t persist if it doesn’t feel right. Personally I would recommend eating phospholipid rich foods like liver, brain, marrow which have a natural balance of phospholipids rather than supplementing with a single one. If you do supplement phosphatidylserine, it might be good to supplement also with phosphatidylcholine and maybe phosphatidylinositol.

  3. What would you recommend replacing 1/4 cup of raw almonds (6x week) with in my low carb morning smoothie? Almonds provide a nice amount of magnesium, potassium and Vitamin E that seems hard to get from other smoothie-compatible foods.

    • Hi Erich,

      1. The antioxidant parallel is off base. The antioxidant lesson is that you want to optimize nutrients like zinc, copper, selenium, iodine, iron, manganese from which the body builds antioxidants, but not provide too many extra antioxidants yourself. In other words, supplement nutrients, not compounds that substitute for nutrients by performing similar functions. … Vitamin D is a nutrient in its own right so it is in the appropriate category to supplement.

      2. Correlation is not causation, but when it comes to nutrients that is the way to bet. We know we need them, so consistently observed correlations are not likely to be due to chance.

      3. He doesn’t actually give links to his studies. If I’m not mistaken, that “2010 double-blind, placebo-controlled study, published in the Journal of the American Medical Association, [that] found that older women who received annual oral high-dose vitamin D had an increased risk for falls and fractures” gave a huge dose of vitamin D2, not D3, once a year. D2 may have toxicity concerns D3 doesn’t, D3 has circadian rhythm effects and a daily dose is far superior to a once a year dose, an annual dose may generate an excess for 6 months and a deficiency for 6 months even if it provides the right annual average amount of D. You cannot build a case without considering all the issues.

      4. Vitamin D can be a biomarker of health status, but it is also a nutrient that one can become deficient in. This is extremely well attested.

      5. The Marshall hypothesis that vitamin D suppresses immunity has essentially no evidence behind it.

  4. Do you believe that all vitamin makers put everything they claim into their pills? Or what about a company that claims they are the only company that uses an factory that is certified to make drugs as well as vitamins and so their vitamins are better than anyone elses? I know someone who works for Melaleuca Co. that makes this claim. It seems fishy to me.

    • Hi Cathi,

      I don’t know. As far as I know the independent tests generally find that supplements closely resemble their claims, whether or not the factory also produces drugs.

  5. Paul,
    What are your thoughts on the following:
    1. Vitamin C from a whole source, e.g. acai berry powder rather than a synthetic ascorbic acid.
    2. B12 from methylcobalamin rather than cyanocobalamin.
    Is it always better when taking supplements to obtain them from a more natural whole form rather than synthetic?
    Thanks for your dedication to people’s health! 🙂

    • Hi Kim,

      Vitamin C from whole foods is adequate for healthy people but under sickness or stress higher doses are beneficial.

      Methylcobalamin is better than cyanocobalamin but it only matters at high doses (> 1 mg).

      Natural sources are usually better but often it doesn’t matter.

  6. When I eat raw egg yokes there is a white stringy part that sticks to the yoke after the clear white part separates from the yoke. What is this clingy, non-clear stuff. Should I eat it with raw egg yoke or try to get it off. Thanks.

  7. Hi Paul

    If NAC should be taken during a fast could one take it upon rising, couple hours before you break your fast and if you take it and have some green tea after is that fine?

    Also about the rash I had, I’v been taking the anti histamine loratadine which made it subside although not completely which suggests it couldn’t have been iodine causing it. I’m not sure what i should take from this ? Maybe it suggests its a food sensitivity related rash? The doctor I checked with said it could be environmental ( detergent etc) and advised to keep taking loratadine until its gone.

  8. Hi Paul. Itchy red watery eyes have always been a mildy annoying issue for me, along with plugged up ears. Recently this has gotten worse, and after some experimentation, I have reluctantly concluded that vegetable ferments are the main culprit for the increased severity. I thought I would give them a rest and switch to probiotics for a while, but I see you no longer have any recommended ones. Do you no longer recommend any probiotics?

    • Hi Kate,

      There’s not much evidence for probiotic effectiveness when taken by healthy people (they’re good for food poisoning), we don’t have a strong feeling about which products are best, and we don’t think probiotics are necessary if you eat fermented foods, so we just decided not to make a recommendation any more.

  9. Hi Adam, My research trying to figure out why vegetable ferments aggravated my itchy eyes turned up the possibility that I might be sensitive to dietary histamine. I mention this because skin rashes and NAC could possibly be related. Apparently NAC inhibits DAO function in the intestine. DAO being one of two enzymes that breakdown histamine.

    • Kate, where did you get that information about NAC inhibiting DAO? I looked on google quickly, but didn’t see anything. Just someone on another forum.

        • Yeah, I’ve seen that post, but there is no source, and he either copied that from somewhere else, or someone else copied him, as I have seen that list (including the foods) in other places.

          The Maintz and Novak 2007 paper does have a list of medications shown by prior research that either release histamine or inhibit DAO, and unless I missed it, NAC is not listed.So, I would sort of doubt it, unless there is some other evidence provided.

          • You could be right. There certainly is no shortage of sketchy and contradictory information about histamine.

          • Chris Kresser has a new write up about histamines at his website.

            The list of histamine foods is depressing – all my favourites!
            he does still have plenty that aren’t, and I haven’t tried his meal plan generator, but that sounds like a good way to create say, a 3day or one week menu of low histamine foods and see if it makes any difference.

          • Good point Naomi. I also haven’t seen significant evidence on that. This paper: http://www.ncbi.nlm.nih.gov/pubmed/22180025 says that serum DAO is lowered by taking NAC, but that serum DAO is a marker of intestinal injury — basically injured guts let more stuff leak in which needs degradation by DAO, and NAC heals the gut.

            I would like to see some specific evidence before indicting NAC.

          • Hi Paul,

            I had this same info and at that time you suggested that I stop taking NAC. I’m confused now. Should I begin taking it again? Thank you.

            http://perfecthealthdiet.com/recommended-supplements/comment-page-20/#comment-119298

          • Hi Janis,

            NAC is mucolytic, meaning that it can degrade the mucus that protects the intestine. So even though I don’t think it inhibits DAO, it may still cause intestinal problems. It’s never a bad idea to stop supplements for a time if you think they may be causing you problems.

            If you think the NAC is doing you good but maybe causing digestive problems, then coming it with DGL before meals may help. DGL promotes mucus production.

    • Hey Kate, that’s an interesting point you made there. Although I’m more confused now and unsure what to do.

      If histamine intolerance is the cause of the rash, itchiness, anxiety and stomach pain which I’v also experienced mildly then should one try stopping NAC if it’s true it inhibits DOA, or cut down histamine foods which make up a big part of PHD, fermented dairy and veg, eggs, dark chocolate/cocoa, spinach and tomatoes!?

      OR

      Is it just caused by a common food allergy like Paul said to toxic proteins like egg white or maybe dairy. In which case I understand you’ll be able to digest once your gut has been healed fully.

      Paul, any advice on this. Is the problem histamine foods which PHD contains a lot of 🙁 which possibly means to avoid NAC if it inhibits DOA needed for histamine breakdown or probably just a food intolerance?

      Love the support from all of you. The forums are gonna be rocking once up I bet!

      • the abbreviations are killing me and I’m a doctor. What is DOA?
        **** DOA Date of Arrival
        **** DOA Duration of Action (pharmacology)
        *** DOA Dominant Optic Atrophy (ophthalmology)
        *** DOA Dutch Occultation Association (astronomy; Roden, Netherlands; est. 1946)
        *** DOA Degenerative Osteoarthritis
        ** DOA Dynamic Obstacle Avoidance
        * DOA Denrée d’Origine Animale (French: Food of Animal Origin)
        * DOA Drug of Abuse
        * DOA Day of Application

        • Adam, Sorry about the rash, that’s an aggravating condition. Here are a couple links I found that actually attempt to quantify the histamine in foods. http://www.reverta.com/blog/histamine/top-10-histamine-containing-foods/ and http://web.archive.org/web/20070830124324/users.bigpond.net.au/allergydietitian/fi/amines.html (scroll down to the bottom on this one)

          I had been eating homemade sauerkraut nearly every day, and I confess I do drink red wine several times a week. So I stopped both and the itchy eyes got better. That suggests to me it might be a histamine problem, particularly since champagne, aged sausages, tinned fish and cheese have never agreed with me. But my problem is not so severe that I’m looking to expunge every bit of tomato or spinach et. al.

          If I were you I would play around with it, see if dropping certain foods helps. As for NAC, after looking at the pig study Paul mentioned and a similar rat study, I’m guessing that is a red herring. Good luck.

      • this time I spelled it correctly!!

        ****** DAO Double Action Only (handguns)
        ***** DAO Dessin Assisté par Ordinateur (French: computer assisted design)
        *** DAO Dynamics of Atmospheres and Oceans
        ** DAO De-Asphalted Oil (refinery)
        * DAO Designated Area Order (UK; fisheries)

      • looked up the link and got it. sorry to bother.
        diamine oxidase (DAO) was used as a marker of intestinal injury.

        • My bad, I misspelled, DOA is ment to be DAO! Just another comment: loratadine subsides the rash greatly although not fully, so doesnt this suggest it is caused by histamine tolerance rather than a food allergen as loratadine is a anti histamine. Unless the food intolerance itself causes histamine intolerance and it’s not histamine from foods but histamine intolerance via a food intolerance

      • Hi Adam,

        You just have to experiment, remove histamine rich foods like fermented foods and see if that helps, or remove common allergens like eggs or nuts and see if that helps.

  10. Hi Paul,

    I think the most difficult of your revised supp recs for me to wrap my head around is the taking of b-vits once a week. Your reasoning makes sense though. I’ve become somewhat dependent I suppose on the-taking-of the pill (irrationally consider myself deficient if I’m not taking a B-right or
    Thorne #5 each morning). I’d love to find an RDI only B-complex to take 1/2 daily, then bring out the big cat once a week. Know of one?

    Question regarding thyroid. Taking 1/4 grain WestThroid daily has brought my TSH down from 3.5 to .689 (I have never had symptoms of hypo-t – just the numbers) .

    I’ll be having the TSH, ft3, ft4 test soon; ought I go off the little amt. to see what my numbers “really” are? If so, how long would you suggest is a good wash-out period?

    Many thanks! Cool to read your off-handed statement that the venerated EVOO is a 2nd tier oil.

    Best, KKC

    • Hi KKC,

      Food has B-vitamins around the level of the RDI so I don’t see why you would need a low-dose daily supplement. I’m not aware of a low-dose B-complex that would be suitable.

      I’m not sure going totally off is prudent as it might make the upcoming test not very useful. You might try dropping the dose to 1/8 grain and seeing if you feel just as good at that dose. If that works then at some point try eliminating it and see if you still feel good.

  11. Hi Paul,
    I was looking for/at Vanadium and Chromium supplements and saw that my choice is between the natural factors and source naturals brands. The source naturals has a whopping 1mg of vanadium. Though it is in the form of bis-glycinato-oxo-vanadium. I don’t even know where to start with this compound. Is all 1mg of it vanadium? In other words, would one absorb 1mg of vanadium or is most of that weight made up by the other molecular groups in the compound?

    Thanks,
    Allan

    PS – You helped me discover a B1 deficiency and many other things and now I feel a world better. Thank you.

  12. Hi Paul, I recently heard about detoxified iodine drops from my friend at Whole Foods. Are you familiar it and it’s differences between regular iodine? I pasted a link of one company that makes it below, but there are dozens that make detoxified iodine. One drop from this company’s detoxified iodine gives you a 200 mcg dose. From what I read, it may be stronger since it is not potassium iodide, sbut I could be misunderstanding. I would love your opinion before considering it. It would be nice to eliminate some pills. I like drops for that reason. 🙂

    http://www.naturalalternativepath.com/Edgar%20Cayce/Iodine.aspx

    • Hi Dede,

      The “detoxified” just means that it has not been purified, the iodine is concentrated compared to its source but it still has impurities.

      I would favor the potassium iodide which has been purified but I think the detoxified iodine is probably fine also.

  13. Hi Paul,
    A question regarding melatonin. I’m 40 year old female with a 5 year history of waking between 3 and 4 am most nights. It takes me a few hours to get back to sleep I which I don’t always do. I’ve been taking it for 2 months now, staring at 2 mg, time release up to 6 mg . I go to bed around 9.30 pm. The melatonin doesn’t seem to have made any difference . 3 questions,
    1. Should I increase it beyond 6 mg to see if that works?
    2. Should I cut back slowly to avoid any side effects?
    3. Any ideas as to what else might work? I suspect it is something hormonal , as it seems worse premenstrally. I also get a hot lower body and legs at this time. It’s much worse if I drink alcohol or caffeine. It’s much better when I’m on holidays,away from home. Though in saying that I don’t think my life is very stressful. I also take magnesuim( Natural Calm) , GABA and holy basil.
    Thanks so much for your help. It’s just amazing to be able to have someone to ask these questions.
    Evie

    • Hi Evie,

      If it’s not working then I wouldn’t take it.

      I think you can just stop and you’ll adapt within a few days.

      I would try the circadian rhythm strategies in the book, maybe extra carbs at dinner.

  14. Paul, in your opinion can you still heal a leaky gut while eating safe starches? I know the GAPS diet eliminates them but I feel I need them for energy. Don’t want to hinder healing the gut though.
    🙂

  15. Are these recommendations the same for prenatal supplementation?

    • Hi Eve,

      Yes. The differences are:
      (1) In pregnancy take extra care to get enough choline. You might eat extra chicken or duck liver.
      (2) In pregnancy you are more likely to need iron supplements. It’s good to have your doctor monitor iron status and supplement as needed.

      • Thanks!! I am on GAPS now – H Pylori, Autoimmune antibodies. Been on it 3 months, and not sure if it is good to be on while pregnant.

        Do you know if the iron will feed the pylori?

        • Well, iron can feed pathogens, but you need it in pregnancy. I would suggest getting iron status tested regularly and if it is high then reducing iron intake.

          • Thanks so much for your time!

          • Just wondering if you have heard of supplementing with lactoferrin while pregnant? Symbiotics makes one and I read something about it binding to iron to increase levels in your body while fighting pathogens. Do you know about this? Does it seem like something harmless in pregnancy?

  16. Paul…

    What are your thoughts on P-5-P (Pyridoxal-5-Phosphate) active coenzyme form of Vitamin B6 in preference to Pyrodoxine HCl which most B50 complex seem to use…???

    Nick

    • Hi Nick,

      I think in healthy people there should be no difference as P-5-P can be made from pyrodoxine. There may be pathological conditions in which P-5-P is more helpful, but I’m not sure we have enough data to speak to that.

      • As I mentioned to you before I had Hep B at 20 followed by Hep C 2 years later that remained asymptomatic for 30 years (as lots of viruses and pathogens seemingly do)… and recently tested and found H.Pylori was also in there for probably as long… so I guess I’ll go for the P-5-P form as it’s a fairly decent assumption that I may still have ‘pathological conditions’

        Cheers

  17. Hi Paul. Curious if you have thoughts on the following:
    “Use of vitamin C (ascorbic acid) supplements is associated with development of kidney stones in men,… “: http://firstwatch.jwatch.org/cgi/content/full/2013/205/3
    Thank you,
    Brennan

    • Hi Brennan,

      The issue is discussed in our kidney stones post, http://perfecthealthdiet.com/category/disease/kidney-stones/.

      Basically, under oxidative stress vitamin C degrades to oxalate which can create calcium oxalate stones. But regularly taking vitamin C helps preserve other antioxidants, reducing oxidative stress. So vitamin C has mixed effects and most studies find no association with kidney stones. But even if there is a minor effect, I don’t think it is a good reason to avoid C (in moderation), but rather to remove the other causes of stones. Good kidney function and electrolyte/fluid/citrate intake will prevent stones.

  18. Paul,
    Was wondering if you had an opinion on emulsified Vit D. Ok to take?

  19. Hi Paul,

    In the book you have either k2 100 mcg per day or k2 mk4+mk7 at 1mg weekly. on this page, i don’t see a mention of weekly for the k2. is that still the recommended suggestion (page does not reflect that information) or is this page more updated?

    Erich

  20. Hi Paul,

    Besides Magnesium, are there any other supplements you recommend taking at night? I ordered all the supplements, including the optional ones (except selenium & copper), so I am curious on your opinion on timing of both the optional & recommended supplements. I heard zinc is better at night.

    Secondly, are there any supplements you recommend to be stored in the refrigerator? or freezer? I heard vitamin D and k2 should be in fridge.

    Since once a week (say Sunday), we will be taking a lot more vitamins, is it okay to take them all with the first meal of the day (Sunday) or is it better to split it between meals?

    Erich

    • Hi erich,

      For the most part I recommend taking supplements with food whenever it’s most convenient for you. Since we recommend intermittent fasting, there are only two meals and usually one will be easier than another.

      It’s possible that keeping some vitamins in the fridge helps them last longer, but it tends to leave some condensation every time you open the bottle, and water is a thousand times worse than air. So I don’t store anything in the fridge unless the label recommends it.

      I don’t think it matters whether you split the Sunday supplements or not. Note that you don’t need to take them all the same day, although that may make it easier to remember.

    • i must admit, i store all my ‘gelcap’ & ‘softgel’ type capsule supplements in the fridge.

      the contents of which are all liquids supplements.
      examples of the ones i have of this type are, D3, K, & natural vitamin A (not PHD).

      i just kinda theorised that these are sealed & water & air tight, but i have no evidence of that.
      It gets hot were i live, so i’m thinking the heat will probably hurt these more than the fridge?

      All other caps & tablets i keep out of the fridge, ie. gelatin caps, “veggie” caps & solid pills/tablets. These are definitely not air or water tight.

  21. Study Confirms Folic Acid Supplementation Unlikely to Increase Cancer Risk

    http://www.pslgroup.com/news/content.nsf/MedicalNews/852571020057CCF685257AFD0075053D

  22. Hi Paul,

    I recently started Crossfit and they recommend the paleo diet, but a friend of mine told me about the PHD and now I’m hooked (I don’t think I could live without cheese). Anyway, As you may already know, Crossfit is a pretty intense and I would like to to take full advantage of the strength benefits that come with it by eating the right foods/supplements after the workout (when protein anabolism is peaking). What do you, as the PHD guru, recommend I should eat/supplement after a workout (or perhaps the pre-workout meal is more important)? Would a Whey protein isolate shake made with coconut milk be a bad idea or is it better to go with branch chain amino acids and put that in coconut milk instead?

    Thanks for your help!!!
    Matt

  23. Dear Paul,

    After a week of taking 30mg zinc/day I got a metallic taste in my mouth which lasted for a couple of days after I stopped taking the zinc. I realize this is not your prescription but I did this a while ago.

    In your opinion would this be a sign of too much zinc (or enough zinc) in my system or does it indicate too much copper that the zinc was detoxing from my body? Or is it just different for everyone.

    If a person is having difficulty detoxing everyday toxins from there system do you advise anything else besides your supplement recommendations, NAC and taurine? Epsom salt baths?

    I seem to have developed more severe intolerances to so many healthy foods (even fish and meat and fermented foods!) and I’m trying to see if I can connect the underlying issue to something.

    Many many thanks,
    A

    • Hi Amy,

      I would take it as a sign of zinc excess, yes. A metallic taste in the mouth is a standard symptom of excess zinc.

      I don’t think you need to “detox” important nutrients like copper, unless you are really sick from poisoning. Your body will normalize levels itself as long as the dose coming in is within normally dietary ranges.

      Foundational nutrients for detox include salt, potassium, fluids, and adequate protein for kidney & urinary detox; salt, potassium, fluids and activity or saunas for detox through sweat; glutathione or glutathione precursors like NAC and glycine and/or glutathione recyclers like vitamin C and adequate selenium for liver detox; vitamin C, taurine, and glycine for bile production; possibly bentonite clay, 1 tbsp per day taken fasted, to aid fecal excretion.

      Other than that I’d be cautious. Chelation of metals can easily backfire and I would suggest doing that only under the supervision of a doctor/naturopath and with regular testing for levels of key metals.

  24. Hi Paul,

    You mentioned in the book that cataracts block blue light and is extremely dangerous to health. My dad is having surgery tomorrow for that and I just found out about it. Is there an alternative or should he avoid it all together?

    Erich

    • Hi erich,

      Cataract surgery makes the lenses more transparent and therefore is good for health. I don’t know why he would want to avoid the surgery.

      • ohhh okay great thanks paul! i had thought you meant the surgery yielded blockage of blue light, but you had meant the condition 🙂

        thanks paul!

        Erich

  25. Paul,
    Sorry if this question have already been answered. Is krill oil an acceptable replacement for fish. I’m not a fish eater. Maybe tuna (canned) or kipper snacks once in a blue moon. The krill oil is a smaller capsule and seems to have mostly the good omega 3 oil.

    Thanks for all of your hard work
    Sandy

  26. Hi Paul

    If you were not eating nuts, shellfish, or much fruit,

    would you supplement with manganese?

    How about during pregnancy?

    I’m a bit concerned about soil quality and low concentrations of minerals in modern soil.

    Thank you! Alex

  27. Using a razor blade on lithium orotate pills works better than a regular pill-cutter (which tends to crush them) but is still rather awkward. Is it important to get a constant Li dose on a daily basis, or would it work as well to take a whole pill every second day?

  28. Are there any supplements you would recommend specific to women (like more B’s, folic acid, Vitex, Evening Primrose..?)

    • Hi Jessica,

      I don’t generally recommend any of those except the B’s once a week.

      Women are more likely to become anemic, so iron supplementation may be warranted. The best thing to do is get iron status tested.

  29. Hi Paul,

    Is it harmful to supplement Vitamin D/K2 without eating/supplementing Vitamin A? Is beta-carotene from veggies enough?

    I got a skin reaction from organic grassfed beef liver, so I stopped eating it. (I may be dealing with a Leaky Gut. I tested positive for SIBO and low beneficial bacteria.)

    My Vitamin D level is 35 ng/mL. What dose would you suggest I take?

  30. Hi Paul…
    Quick question :

    If I adopt EVERY recommended micronutrient supp (including the optional ones)that you recommend… along with the PHD macro nutrient ratio that is already in full swing for the past month… what is the timescale for my body to reach the peak health range of all essential nutrients..?

    And would any current unwanted pathogenic invaders that are resident in my system have a negative effect on the absorption of those nutrients…?… or would there still be an overall adjustment to optimum returning my immune system to maximum effectiveness and thereby evict all the unwanted guests…?… I don’t want to feed the pathogens… just my immune defence system…

    Nick

    • Hi Nick,

      Probably about a month, though it can take a year to fully remodel tissue.

      You can’t help but feed gut microbes, so if you do have gut infections then you may want to reduce supplements somewhat.

      • Thanks Paul…

        Hmmmm…. I guess the priority is to get a comprehensive stool test done and see what lurks… but then how does one destroy any pathogens if not by trying to boost ones immune function health…?

        Seems like a catch 22… you need an optimum immune function to keep order but trying to resolve that actually feeds the very pathogens you want to eradicate…

        …so is there an easy answer to clear the decks and reinvigorate ones gut with all the right stuff and slam the door shut so you don’t get any more taking charge…???… healthy fecal transplantation seems to have had good results with C.diff

        Nick

  31. Paul, what are your thoughts about using Pantethine instead of Pantothenic Acid as you recommend. I’ve read that the best dosage would be 300 mg 3x a day, which is very different from taking a 500 mg tablet once a week. Why are the recommendations from two reputable sources so different?

    Thanks,
    Judy

    • Hi Judy,

      Well, both pantethine and pantothenic acid are quite safe. Our advice is based on the principle that one should relieve deficiencies but in general keep to physiologically normal levels of nutrition. 900 mg pantethine per day is far above what anyone would ever obtain from food.

      So it is more of a therapeutic dose and I guess I’d ask what condition is being treated here.

  32. Hi Paul,

    Three quick quesitons
    1) After using the same bones for bone broth many times over, the bones start to disintegrate. Would I be consuming an excess of nutrients if I eat these disintegrated bones? If not, approximately how much is safe without going over the plateau range for nutrients? Should I just stick to the broth to be on the safe side?
    2) You mentioned inorganic copper to be toxic in the book. From a quick google query, it seems that supplements harbor inorganic copper. Do any of the recommended above supplements possibly have inorganic copper?
    3) I”m particularly concerned since my girlfriend has a copper IUD which i imagine will increase inorganic copper in the body. You had mentioned before you are not an expert in this area, but do you know of ways to decrease inorganic copper load on the body? And should she still be consuming “organic” copper from beef liver or should she convert to chicken liver .

    Erich

    • Hi erich,

      The risk is an overdose of calcium. I do think it would be better to stick to the broth, and moderate amounts of it.

      Re your girlfriend,there are blood tests for copper status and that may be the best way to proceed. If her copper levels are high she may be best served by getting extra zinc and avoiding copper-rich foods like beef liver. She could substitute chicken or duck liver.

  33. Hi Paul…

    A small contradiction… your chapter on Iodine recommends that supps should be from an inorganic source yet you recommend seaweed as a nutritious food…?

    I currently have Solgar ‘Kelp’ supps which are dehydrated North Atlantic seaweed.

    So I’m a bit confused as to whether I should ditch this product and go for potassium iodide…?

    • Ooops…

      I answered my own question by reading the Iodine/Selenium archive article.

      The potential thyrotoxic contaminants in kelp outweigh any beneficial iodine uptake.

      Note to self: Check the archives for answers to questions…. 🙄

  34. If you can not make beef bone broth with grass fed beef is there a concern of drinking bone broth made from conventional beef? I live in a rural area in Ontario and our cows are fed grains. I was wondering if the benefits of the broth would still be nourishing for me. I was also wondering if beef bone broth would have a higher level of b6 if it is made from beef that has been raised on grains.

    • Hi Julie,

      Well, the major components of bone will still be collagen, calcium, and phosphorus, so conventional beef bones will still provide those nutrients. It’s more a question of what else may be in the bones. And that is hard to say because it may vary with the specific source of bones.

  35. I’d love to support you on Vitamin C but it’s just too expensive in pill form. Buying ascorbic acid in a powder is just so much less money and easier to vary. Sorry.

  36. You need to review the supplement recommendations. Some items are no longer available from Amazon.

  37. I noticed many of the supplements you recommend contain magnesium stearate, which I have read is a dangerous filler that actually suppresses the immune system and causes cell walls to collapse. What are your thoughts on this?

  38. Do you have a basic needs “grocery list” to help us begin your diet?

    • Hi ski,

      a meal plan is in the book, but from personal experience you’ll most likely want to go to an asian supermarket and buy coconut oil (any will do but I prefer the virgin oil that tastes like coconut) and rice noodles (buy a bunch that you think you may like and try them so you know which ones to get next time).

      For the rest you just need to shop where you usually shop, but more fresh produce and almost nothing from the middle of the supermarket. You’ll especially need to buy more safe starches than you’re used to if you’ve just stopped eating bread – there’s twice or more the carb calories per weight in bread vs cooked potatoes or rice.

      Look for a good source of eggs.

  39. Hi Paul,

    Both silicon (bio sil (capsule) and jarrow sil(the liquid)) have choline and boron respectively.
    1) I noticed the silicon biosil has 100 mg choline for each 5 mg serving. Should we lower our egg, liver, etc intake if we take this daily?
    2) The JarroSil has about 0.5 mg which will lead to an intake of around 6-6.5 mg of boron per week. Does that mean we should not take the weekly boron recommendation of 3mg if we decide to buy this brand and take it daily?
    3) Also the jarrosil has zinc at around 7 mg a week. I assume this is benign even if we take the 50 mg of zinc already weekly?
    4) A bunch of the B vitamins (I am not buying the complex because in the book you mentioned the extra intake of niacin and folate to be unnecessary, potentially harmful) have calcium. This will result in about 150 mg of extra calcium a week. Is that a concern?

    • Hi Erich,

      Neither choline nor boron are toxic until much higher doses, so I wouldn’t be concerned about their presence. Consider it a bonus.

      Since 7 << 50 it doesn't matter much. Calcium could be a concern. If you're eating bone broth then you don't want supplemental calcium. If you are not then it's probably beneficial.

  40. What do you recommend for those who cannot follow PHD perfectly due to allergies? I have anaphylactic allergies to all fish, shellfish, and seafood. What can I do to get the nutrients found in fish/seafood, etc? Thank you for all your work with the book!

    • Hi Heather,

      I would recommend replacing them mainly with beef and lamb — low omega-6 meats. Eat a variety of organ meats for micronutrients, not just muscle meats.

      Occasional zinc, iodine, and selenium supplementation becomes more important if you can’t eat seafood; but the normal PHD recommendations are sufficient.

  41. What do you recommend for those with allergies to fish/seafood, etc? I cannot have any form of shellfish, seafood, fish, etc due to an anaphylactic allergy. I’ve also been recommended to avoid Iodine due to having Hashimoto’s Thyroiditis, though then she recommended a vitamin/mineral supplement that contained Iodine! :/
    Any suggestions are much appreciated. Thank you for all the work that went into your book. It has already made a huge difference in my life with hormone imbalance, cancer, etc. Many thanks!

  42. Hi paul,

    one of my friends is thinking of picking up PHD/paleo. But she claims to be allergic to eggs. She’s not sure if she is allergic to the yolk however, but she does not want to test it. What would be a good replacement for that? Chicken liver/ choline? Any other sources? I doubt she will eat chicken liver, so supplementation in this case may be more useful unfortunately.

    Erich

    • Hi Erich,

      Yes, liver is the solution, also brains and marrow. 1/3 lb beef or lamb liver per week plus chicken or duck or goose liver (or pate) to avoid additional copper, brains, and marrow.

  43. Paul…

    I’m struggling to get my fats ratio to 65% of calories… forgive my naivety but is it all a matter of adding butter cream olive/coconut oil.

    I currently weigh 88kgs and would like to drop about 8 of those to get my BMI down from 28 to 25 so I’m now trying to calculate and only consume 1500 calories per day.

    Is there an example on here of a constructed PHD ratio food intake for a given day that would show me how to get the ratio right… then I could simply adjust portion size to get my required calorie intake

    Nick

  44. Hi Paul — When I click on the Life Extension choice of selenium supplement in your list, the result is:
    = = = = =
    Looking for something?
    We’re sorry. The Web address you entered is not a functioning page on our site

    Go to Amazon.com’s Home Page
    = = = = =

    In any case, given your comment (p285), “Very high intakes of selenocysteine by Greenland Inuit were not found to be toxic”, wouldn’t it make sense to replace that choice with this one:
    Life Extension Se-Methylelencystine [sic] Vegetarian Capsules, 200 Mcg, 100 Count
    http://www.amazon.com/Life-Extension-Se-Methylelencystine-Vegetarian-Capsules/dp/B00A8K9K6M/ref=sr_1_4?ie=UTF8&qid=1360796269&sr=8-4&keywords=life+extension+selenium
    ?
    (Although the Amazon site scrozzles the spelling, the LE label is correct.)

    John

    • Hi Paul — I note that the non-functioning link is gone from the supplement list, but that it is replaced with just a generic Amazon link.

      Does this mean you think the LE selenocysteine product is not good to use? I bought some and intended to start using it as soon as my current Se supplement is used up. –John

  45. HI Paul,

    If you make massive quantities of fermented vegetables, is it okay to freeze them for storage?

    We have been doing that with store bought “raw” sauerkraut. I understand that it may not be necessary, but the question is more if the freezing will remove the benefits of the fermented vegetables as a form of storage.

    • Hi erich,

      Freezing won’t remove the benefits of detoxification and manufacture of vitamins K2 and B12 during fermentation, but it will kill many of the bacteria. So it’s a fine thing to do, but it won’t supply as many species of new bacteria.

  46. Hi Paul,

    I’ve so sad that I’ve been having little effect by eating my frozen sauerkraut this entire time 🙁

    This got me thinking.
    1) What about refrigerating fermented foods?
    2) What are your thoughts on freezing, thawing in refrigerator, and refreezing meat as well as broth? My broths seem to lose some of their gelatinous form when refreezing… I’m assuming meat is okay?

    Thanks Paul!

    • Hi Erich,

      Refrigeration won’t kill microbes, but you will get pathogens proliferating after a while, so fermented vegetables will stay good for maybe a few weeks and then you should boil them and eat them in soups to kill off any bad microbes.

  47. Hi Paul!

    Not sure if you saw this question:

    What are your thoughts on freezing, thawing in refrigerator, and THEN refreezing meat and broth? My broths seem to lose some of their gelatinous form when refreezing… I’m assuming meat is okay?

    Thank you so much for those fermented vegetable suggestions with how to save them if they go bad 🙂

    Erich

    • Hi Erich,

      The freezing-thawing-refreezing cycle is a risk factor for microbial growth, but if it’s always in the refrigerator it’s not such a big deal. Remember the microbes grow mostly on the skin and that thaws first, so all time in the refrigerator is an opportunity for meat to go bad.

  48. Hi Paul,

    In nutritional balancing/hair mineral analysis programs, anywhere from 5-15 mg of manganese are used to help the liver eliminate copper in cases of copper toxicity. iI wonder if manganese supplementation would be safe in this context?

    Thanks so much!
    Alex

  49. Hello Paul,

    Will you please comment on the safety and effectiveness of “Sensa” for weight loss.

    I’m following the PHD, although eating a pound of starch is challenging, and am about 90% compliant. 100% complient on the supplements.

    I will appreciate your input on this product because it sounds so tempting to drop 15 lbs.

    Thank you.

    Mary

    • Hi Mary,

      Well, it sounds intriguing. It is sort of the opposite of the Shangri-La Diet — add flavors to foods (as opposed to eating tasteless calories during a fast on Shangri-La).

      I don’t know if it works. In general I’m not a fan of gimmicks but sometimes the brain’s appetite regulation system needs to be re-set and these tricks might help. I wouldn’t expect a rapid dramatic weight loss though.

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