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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
  • Use chelate (e.g. glycinate) or citrate
  • Daily dose 200 mg
  • 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
  • For those who don’t take a B-50 complex
  • We recommend 50 mg to 100 mg per week
  • We recommend 5 mg once per week
  • We recommend 500 mcg to 1 mg once per week
  • Sublingual methylcobalamin is preferred
  • We recommend about 50 mg per week
  • Be sure to follow our copper recommendations as copper-zinc balance is crucial
  • 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.

  • 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
  • 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)
  • 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.
  • 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
  • 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
  • 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
  • We recommend 150 mcg to 1 mg per week
  • 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.

  • Precursor to glutathione
  • Recommended dose is 500 mg
  • Can take more in cases of severe chronic infection
  • 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
  • Supports muscle growth and preservation; especially valuable for the elderly
  • Up to 1 teaspoon (5 g) per day
  • 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.


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 ?


  1. Hi Paul,

    Today my girlfriend and I finally received all our shipment of supplements and took the entire list of supplements this morning. We both had extremely bright yellow (lemon-lime gatorade color) urine. Is this something to be concerned about? Are we taking too many supplements at once (perhaps something that our body will acclimate to)? or are the supplements poor quality and we are just “pissing our money away”?



    • Hi Erich,
      I’m not Paul, but I can tell you from personal experience that some vitamins (especially B complex) can cause bright yellow urine. I don’t think it means that it’s just going in one end and ou the other. I think it’s some additive like a non-active ingredient. In my case when I looked at the B complex tablet it was almost the exact color of the urine so maybe it’s dye or a mineral that causes it.
      Hope that reassures you some until Paul gets a chance to respond.

    • yep, could be vitamin B2 (Riboflavin).

      from wiki,

      “Riboflavin is best known visually as the vitamin which imparts the orange color to solid B-vitamin preparations, the yellow color to vitamin supplement solutions, and the unusual fluorescent-yellow color to the urine of persons who supplement with high-dose B-complex preparations (no other vitamin imparts any color to urine).”

      “…any excess at nutritionally relevant doses is excreted in the urine,[26] imparting a bright yellow color when in large quantities”

    • Yes, it’s the riboflavin. It indicates your body had enough riboflavin already and didn’t need the extra.

  2. Do you practice food combining? Like not eating starch with protein? I tend to get gas after meals. Just wondering is I should pratice proper food combining?

    • Hi Katie,

      As BS says, I recommend eating foods together. If you’re not digesting food well, try drinking some extra water with meals, or making soups. Try adding a bit more salt to meals. Other digestive aids that can help are DGL before meals, betaine hydrochloride with meals, digestive enzymes, or bile supports.

      • “If you’re not digesting food well, try drinking some extra water with meals…”

        Paul, can you say a word or two about how drinking extra water helps digestion? I have read the opposite advice more than once, the idea being that extra water dilutes stomach acid and thereby inhibits digestion.

        • Acid and food have to be in solution so that acid and enzymes can diffuse around to all the food molecules. If food is swallowed in a dry state, acid and enzymes may not penetrate dry lumps. This is why flour-based products are often poorly digested.

          Chewing food thoroughly in the mouth so that it is well mixed with saliva is an alternative way to achieve exposure of the proteins to stomach acid.

  3. Paul totally recommends combining starches with meat, I asked this same question and he recommended that starches be consumed with meat/fat/veggies and something acidic like wine to lower the glycemic load of the starch. If you are having problems with digestion it’s probably a good idea to work on your digestion of take an enzyme for big meals like this. I can totally tell the difference between when I do or don’t take an enzyme.

  4. I have read that you shouldn’t drink cold liquids with greasy food as it solidifies the grease in your digestive system making it harder to digest. It seems like the article said that’s why a lot of asian people drink hot tea with their meals. Paul do you believe there’s any truth to that?

    • There is a tradition in Chinese lore recommending against cold drinks. Biology is temperature sensitive and it evolved to work properly at 98.6 degrees F. So I can believe that drinking warm tea with food makes the meal less stressful. There may be more involved than temperature where tea is concerned.

  5. Paul, do you have any therapeutic ideas for a trigger finger? Developed them after being on crutches for 6 weeks. I read in forums that a daily B-50 complex can fix the issue quickly, but I see you only think that ought to be a weekly supplement. Are there any circumstances where it should be taken more frequently?

    • Hi Matt,

      B-50 complexes are fairly safe so if you want to take one daily for a bit as a therapeutic measure it shouldn’t do any harm.

      I would work on bone and soft tissue health: bone and joint broth soups (calcium, phosphorus, collagen, extracellular matrix); bone nutrients — silicon, magnesium, boron, vitamins D, K2, liver for A; vitamin C.

      • Matt,

        My trigger finger flares back up on even small amounts of grains for several meals in a row. You might see if there are any small amounts of non PHD foods you have been able to get away with eating on occasion. If there are, then eliminate them completely.

        Trigger finger is also associated with blood sugar issues. You might check on how your post meal numbers.

        • Paul and Ellen, thanks. Things have improved now that I’m off the crutches and I have been taking the B6 daily as well as the other supplements you’ve noted except I haven’t gotten around to getting boron or K2. And I have been working to get more PHD compliant of late as the winter has been full of lapses so it is quite possible that this has contributed. On top of everything, I’m recovering from a stress fracture in my navicular (back part of the arch in my foot) so I’ve been shading high on bone broth for months. Thanks!

          Searching on trigger finger on this site led me to a post by erp where she noted that surgery on her trigger finger rendered her left hand quite weak so I’m definitely looking to avoid any surgical measures.


  6. Hi Paul,

    I was wondering what your opinion is on fermented cod liver oil and fermented skate oil, such as the ones produced by green pastures? If we can’t get a hold of beef liver. Good sources of vitamin A, D, K2, and some E. As well as EPA and DHA.

    Is choline necessary to supplement if I eat 3 eggs every morning but no beef liver?

    If I can get a hold of beef liver, should liver be cooked and a small portion eaten once a day or should entire portion just be eaten in one sitting? I would think the various nutrients would be more beneficial on a daily basis?

    And last question, If I decide to start taking chlorophyll in the form of sodium copper chlorophyllin (4mg copper), would this put me at risk for copper overdose?

    • Hi Erich,

      I think it’s easy to get too much of both A and omega-3s, and also they’re fragile so freshness is important. I favor liver as a fresher and more nourishing source of A and salmon/sardines/seafood as a fresher and more nourishing source of omega-3s.

      It doesn’t matter how frequently you eat the liver, nutrients are incorporated in tissue and last more than a week in the body, so you can eat liver occasionally.

      Copper overdose — yes, I think that is a danger, I assume that if the chlorophyllin is digested then the copper is released and can be absorbed. There is some copper in food and I would limit any supplements or copper-rich supplemental foods including beef liver to 2 mg/day.

      • Hi Paul! This post has me thinking of the dessicated pastured beef liver supplement. My husband cannot eat liver, so I thought we could supplement with it. I don’t like the idea of supplementing every day with copper from a non food source, so the liver pills seem like a good, albeit expensive substitute. Do you happen to know how much one would need to take to get the recommended PHD daily copper and vitamin A?

        As always, your time and advice are greatly appreciated.

        • Hi Dede,

          I do think the liver supplements are a good idea if he won’t eat liver. Do the supplements have a nutritional label? If so you should be able to calibrate dosage by comparing with liver nutrition at

  7. Thanks Paul! I’m not quite sure how to compute on the website because of vitamin A being listed in a general way as IU, then retinol as mcg. The stats for A and copper are as follows: 1.5 tsp in the powder form (a better value) has 2.9 mg of copper and retinol is 1,484 mcg, then it has vitamin A listed in IU as 5,069.4 I can certainly figure out copper (seems a little high for daily recommendation, so I could decrease perhaps to 1.25 tsp, but the A/retinol computing has this brain fogged lady confused! 🙄

    Your advice would help the lover eating challenged so much. 🙂 Thanks again!

  8. Dear Paul,

    I was wondering if, in your experience, you have heard of low stomach acid causing chronic sore throat. It does not seem to be included in the symptoms of any of the website that address low stomach acid.

    I do get belching and acid reflex symptoms when I eat – especially meats and sometimes starches (not more so meat). But I also seem to have issues with food intolerances (histamine and fodmaps) so I’m not what is causing it and my doctor is not helpful at all.

    Background: My stool tests showed no opportunistic or pathogenic bacteria, 2 parasites and fungus infection (1+), and my total SCFA was low. This issue also seemed to coincide with being on antibiotics (2-3) for over a year.

    I guess my question would be: if this is a symptoms of low stomach acid and took stomach acid supplements, how long should I give it before moving on? I also wonder if fasting or eating just white rice for a day or two might give my some insight into whether it is allergy related or digestion related.

    Any insights you might have are greatly appreciated.

    • I should also mention that I have a very upset digestive system generally (it just doesn’t seem to like food) which is why I have been on various versions of paleo.

    • Hi Amy,

      Acid reflux causes chronic sore throat. Low stomach acid could be a factor in acid reflux, but it’s not the only possible cause.

      If low stomach acid is your problem, you should experience improved digestion the very first time you take betaine hydrochloride with a meal. If it doesn’t improve digestion immediately, don’t keep taking it.

      I would try improving nutrition, improving digestion, and treating gut infections (parasites?).

      Eating just white rice would probably reduce symptoms but I’m not sure what actionable information it would give.

      • Hello paul,

        Thank you for your advise. I will do the best I can with improving nutrition given all my intolerances at the moment.

        The parasites from the metametrix testing came back unknown and the other was endolimax nana (no-pathogenic amoeba) so my naturopath made it seem as though they were likely not the route of problem. However, I will look into treatment anyway.

        Thank you!

      • Hi Paul,
        I have read quite a few anecdotes re using betaine HCL capsules (mostly on paleo-hacks).
        Some people seem to report that betaine HCL alone does not seem to do anything (no warm feeling etc at any dose).
        But they report that betaine HCL with Pepsin does seem to have a positive effect (& they get the warming feeling when trying to find an optimum dose).

        Assuming there is some validity to this, why do you think this is?
        & would you say, if you were choosing to try betaine HCL, choose one that includes Pepsin.

        What might be the risks/downsides (if any) to watch for if supplementing with pepsin.


  9. Hi Paul,

    So now I’m confused. You say getting too much vitamin A can be a problem but if I eat a 1/4 lb of beef liver there is 53,000 IU’s of A? Obviously should be enough to get through the week, but if we drink raw milk and and eat 3 eggs every morning are we going over a healthy limit? There have been studies showing anywhere between 25,000-33,000 IU’s per day of A being fine as long as it’s accompanied by a decent amount of D, since they help regulate each other in the body and prevent one another from becoming toxic. Very well documented by the Weston A Price Foundation. This is why I brought up the fermented skate liver oil and fermented cod liver oil because they contain many different types of D and in the right ratio of D to A so that neither become toxic unless taking absurd amounts. Where as beef liver has almost no D to regulate the large amount of A (we should be getting sunlight anyhow though). Plus I was hoping this would deal with the K2 supplementation since both are very rich in K2, especially the fermented cod liver/butter oil combo.

    Also how long are omega 3’s stored in the body? I mean does eating a lb of salmon per week keep EPA and DHA levels high enough throughout the week for proper brain function?

    I suppose if I did a half teaspoon of chlorophyllin (which would equate to 2mg of copper) I could use that as my copper supplement and still reap the benefits of chlorophyll as a detoxifier, internal deodorizer, increasing red blood cell count, reducing the binding of carcinogens to DNA, etc etc?

    Your thoughts are greatly appreciated.

    • Hi Erich,

      100 g of raw beef liver has 17,000 IU of vitamin A according to

      I recommend getting up to 10,000 IU/day of vitamin A, or 70,000 IU/week.

      I think the A in liver is highly beneficial. Once you go to fish liver oils, the amount of A can pile up quickly.

      I’m assuming you’ll get D as needed elsewhere.

      Yes, I suppose if you’re not eating liver you could use the chlorophyllin as a copper source.

      • Oh I see, Chris Kresser had vitamin A at 53,*** IU’s per 100g, that’s where I got my info. 17,000IU’s isn’t as frightening haha.

        Are you familiar with how long the body stores omega 3’s? I’m wondering if eating salmon once a week is enough. Also omegas in fish liver oils shouldn’t oxidize due to the high amount of natural antioxidants present. I’d be more worried about the omega’s being destroyed by stomach acid. I can’t remember what actually protects omega 3’s present in fish from being destroyed in the stomach? Certain enzymes maybe?

        BTW I wish you would do a post on B12, how it’s assimilated in the body and why meat-eaters still can be deficient. I’m reading gut poor health is the main culprit in B12 deficiency. I found it interesting.

    • for those after more info on green pasture fclo,
      here is their test data page, showing per ml results for A & D content,

      the dates reflect the sample (batch) date.
      & results are per ml.

  10. Hi Pail, I hope you’re well.

    I’ve a question on lithium supplementation and calcium as I finally got around to stocking up on your recommendation. The recommended dose for lithium is 2.5mcg per day – is it not possible to take 5mcg every two or three days to avoid the hassle of cutting the tablet?

    Calcium – I know you discourage this, but I accidentally purchased calcium/magnesium powder instead of straight magnesium. The ratios are identical, 400mg of each per dose – would this really harm?

    Cheers, Dave

    • Hi Dave,

      We prefer daily lithium as opposed to every other day because it has circadian rhythm benefits. It’s not really known what the optimal dose is, it might be 5 mg/day, so you could consider taking a full pill each day.

      400 mg/day calcium is about the amount we want you to get from bone broth. So if you take the powder dose and don’t eat any bone broth or dairy, you’ll be about right in terms of calcium intake. However, we recommend bone broth ahead of calcium supplements. It has other valuable nutrients too.

  11. Pail? Paul of course 😳 iPhone fingers… 🙁

  12. Is gelatin powder a substitute for bone broth in any way
    Other than the amino acids?

  13. Hi Paul-

    This question is about acne. I am so grateful and thankful that I cleared my acne eating pastured beef and eggs, organic fruit and vegetables, coconut oil, supplemental foods, and almost all supplements (and I do mean almost all of them – Vitamin C, zinc, liver, egg yolks, bone broth soup, D3, K2, NAC, Mg, iodine, Silica, chromium, vanadium, boron, molybdenum, selenium, Vitamin E, Branched-chain Amino Acids, liver almost always weekly, and the enzymes! all in the recommended amounts! I take my health very seriously! But really, I just wanted to be rid of acne). in the beginning, bentonite didn’t seem to do much but once I fully changed my diet, figured out what was causing some kind of allergic reaction, etc. then the bentonite has helped to prevent the last few pimples which were coming about.

    What does that mean? what is my next step now- continue taking bentonite? supplement with more probiotic food or a probiotic pill? The only reason I ask is because bentonite makes me very thirsty and it’s hard to remember to take it on an empty stomach.

    • thanks for any help!

    • Hi LJ,

      You do want to reduce your supplementation. Bentonite is a temporary measure which is as useful for diagnosis as actual use. It tells you that some of your problems are originating in your gut.

      I would stop the bentonite and work on continuing to improve nourishment, reduce supplementation, and improve gut flora. It takes time for your gut to heal and for flora to change. You want to just make gradual progress toward normalizing your gut flora and your diet.

  14. Hi Paul
    I have recently started on a paleo diet which I am finding to be fine. I have crohns and it has flared up in the last couple of weeks having read you supplements information i am not sure if I am taking the correct supplements
    I currently take
    a probiotic
    multivitamin and fish oil Is this wrong

    • Hi Morag,

      I would say it’s not known what the optimal supplementation is for Crohn’s. It’s probably safest to do minimal supplementation and rely on foods for the most part, as gut microbes can steal nutrients before you absorb them and excess nutrition can promote microbial growth. Insofar as Crohn’s is infectious, then, excess nutrition may be harmful.

      We recommend against multivitamins and fish oil for everyone. Probiotics are OK but not necessarily helpful.

      Some supplements are definitely worth taking:
      – Vitamin D3 so that serum 25OHD approaches
      – Vitamin K2
      – Supplemental foods like liver for vitamin A
      – At least 150 mg/day vitamin C
      – 100 mg or more magnesium

      These support immune function. You should eat regular seafood/seaweed; if you don’t then supplement iodine.

      But do eat very nourishing foods, including all of our supplemental foods.

  15. Hi Paul,

    I have a question concerning Omega 3’s. I am not a fan of shellfish type seafood or salmon. I am concerned about getting enough of Omega 3’s in my diet however.

    I eat tuna regularly but am unsure about its Omega 3 benefits(if any). Please advise of any options that I may have.



    • Hi Bob,

      Fatty tuna, as in the cuts used for sashimi, is very rich in omega-3s. Canned tuna is mostly lean flesh that is very low in fat including omega-3s. So it depends on the source of your tuna. We recommend salmon over tuna because it is farmed and therefore cheaper and more available, and because it is lower in mercury. Many other fish, including sardines and herring, can provide omega-3s.

      • Paul

        Is it actually OK to eat farmed salmon? I had stopped after reading several articles along the lines of this

        Thanks much,


        • Hi Peter,

          The farmed salmon still have 4x more omega-3 than omega-6, so they shift PUFA membrane profiles in a beneficial direction. Salmon is not a good source of vitamin D so that doesn’t matter. The other paper is comparing farmed salmon fed different diets, not farmed to wild, and in any case all of the different farmed salmon are beneficial, it only shows that farmed salmon fed fish oil improve omega-3 status faster than the farmed salmon fed rapeseed oil.

          So wild are better, but farmed are still good.

          • Hi Paul,
            That’s great news for me as I have access to farmed salmon but had been buying canned wild as I mistakingly thought it better.
            What about smoked salmon? Does the smoking process harm the omega 3?

  16. Any comments on Moringa? Since some of the products contains the leaves and seeds of the plant, would the seeds be toxic?

  17. Hi Paul,

    Every time I take the low dose of copper or eat liver, I experience an acute and dramatic worsening of some symptoms I’ve been experiencing for the past year (debilitating brain fog, cold hands and feet along pain my fingers and toes, acne, night sweats, sinus congestion, headaches, anxiety, and digestive woes). I’ve tested this out a few times over the past five months (since I began the PHD) and it’s scary and exciting: after a long year of testing with doctors and self-experimentation: a connection to something! I believe my symptoms are due to something infectious (bacterial, fungal, or even parasitical…maybe.) Now I have two theories with what the copper is doing and would be so grateful for your thoughts:

    1 – I’m in a copper deficient state, have some kind of infection, and the copper could be going to town on it, with the worsening of symptoms being a die-off reaction. (I’ve read of a few people who used small doses of copper to successfully annihilate their similar brain fog and digestive issues–which they believed to be candida related–and they also reported the nasty detox reaction to copper which gradually went away within a few weeks as their symptoms improved.)

    or 2 – I am copper toxic and supplementing copper is like eating Krypotnite while hanging out on planet Krypton with General Zod. (In this case I should go: high dose vitamin c, b6, zinc to beat it the hell out of body? Maybe even penicillamine if I can prove I’m toxic?)

    I did some preliminary copper tests about 5 months ago after I first tried the copper supplementation and got this bad reaction:

    Cerulophasmin 21 mg/dL (17-54)
    Copper, Serum 87 ug/dL (70-140)
    Copper, Free Serum 0.3 ug/dL (0.0-10.0)

    (Also, my zinc serum was a little high, as I was doing some low-dose daily supplementation then, though not anymore.)

    So this all looked a little low to me…but here’s the rub: A – Those tests aren’t reliable, I’ve heard. And B – That the almighty hair mineral analysis people ( et al) would say I am actually “copper toxic” due to “copper bio-unavailability” (I am getting some hair mineral tests done currently, so we’ll see what they say.) And this scares me. I don’t even know if “copper bio-unavailability” is a real thing, let alone if the science behind hair analysis is credible, but there’s certainly enough people on curezone to scare me into thinking it might be.

    Any ideas for my next move?

    Sorry for the long post, Paul. You’re a saint for what you do for others here and with your research. The book is wonderful. All the best.

    – William

    • the whole copper & zinc testing thing interests me as well.
      i keep thinking i should get tested, then research all the tests available & always end up deciding they do not give a true picture of what is really going on….& could send you off in to a dangerous direction.

      For zinc i have revisited the zinc taste test (zinc tally test) recently.
      I tried one of these tests a few years back & it (zinc sulfate in purified water) just tasted like water to me. I concluded then that the test was worthless & meant nothing.

      But, after ‘googling’ some more & speaking to local naturopaths, i believe there may be some validity to this zinc test.
      So i retested recently, still taste like water to me, maybe a slight ‘fuzzy’ feel if i leave the stuff in my mouth for longer than the 10 seconds test time.
      … so i may indeed be zinc deficient.

      William, since your zinc serum tested as high, it would be interesting if you were able to taste anything when doing a zinc taste, if you could be bothered.
      & i would love to hear what the result was.

      for more info, google,
      zinc taste test
      zinc tally test

      ps. you can buy these tests, no need to try & make, eg.

      • info & instructions on the metagenics test here,

      • Hi Darrin,

        I haven’t done the tally test in a while, but around the time I had the high serum zinc, the tally test tasted like water. Believe it or not, I believe the serum test may be the inaccurate one. But that’s just my gut instinct. I think the tally test may help diagnostically speaking, just like temperatures and pulse rates may help for diagnosing thyroid issues over just TSH. But who knows?! I’ve mostly given up on labs, and go by plain old: “How am I feeling with X added to my diet?” That’s the really nice thing about the PHD, it’s given me a constant foundation from which to experiment with supplements.

        I will say that regular doses of Zinc doesn’t do much noticeable for me other than seriously speed-heal the acne I still get when I have some sugar and it increases my already high libido slightly.

        • i vaguely recall hearing or reading that serum testing for minerals (& vitamins as well possibly?) is of little value…
          it will just be an indication of recent ingestion.

          i believe it has to be ‘whole blood testing’, if such a thing is available, to get a result that ‘may’ be of any diagnostic worth

      • Hi all,
        looking for some feedback on the zinc taste/tally test…

        Has anyone done one of these and ‘scored’ a 3 or a 4 on the taste scale,

        test result definitions,
        number 3 is, “A definite, though not strongly unpleasant taste is noted almost immediately and tends to intensify with time”

        number 4 is, “A strong and unpleasant taste is noted immediately”


    • Hi William,

      The free copper formula is Total Serum Copper in ?g/dl) – (Ceruloplasmin in mg/dl x 3) = Free Copper. Your numbers indicate that your free copper is 24% which is on the higher side but not horrible. Ideal is 5%-15%.

      Zinc serum is by no means a good indicator of zinc levels and typically looks higher than it actually is. (Ever done a B12 blood serum test? Indicates high many times especially if you’ve supplemented in the last year. Methylmalonic (MMA) is more accurate. For example, my dad has very high B12 serum (looks like he has enough) but high MMA which indicates a severe deficiency in B12.) Zinc plasma is a better test but by no means the holy grail. For curiosity’s sake, what is your zinc serum value?

      I used to suffer from extremely high copper which contributes to all sorts of problems. As it turns out, I’m also CBS699++ (double mutation for Cystathionine Beta Synthase) which when expressed can cause copper/zinc imbalances. I also grew up in a household with copper pipes which also contributes to copper load. A typical diet is loaded with copper: coffee, black tea, chocolate, nuts, seeds (not pumpkin), avocado and grains. I was doomed. Even eating a paleo diet didn’t resolve my copper issue.

      Copper and zinc are antagonists. If you were low dose supplementing with zinc, then it could push your copper down if you were eating a diet low in copper. Supplementing with copper will push your zinc down. It is a teeter-tater for finding balance but since your free copper is a little higher than ideal, perhaps you should investigate about supplementing with zinc picolinate. Starting out low and slow is always wise (10 to 15 mg daily working up to 30 mg in your case) until your free copper is with in range. Zinc can cause nausea as you’re probably already aware so take with food.

      Copper dumping can also be a beast and can cause or worsen depression, anxiety, dark thoughts in people. But hey, having high free copper can cause those things in the first place.

      Copper bio-unavailability is a real thing. I’m in a group with people and some have had free copper in the 90%. In a nut shell, when that person consumes copper, they’re so toxic that it’s pulled from their blood (bio-available which is the only place copper should be) and stored in internal organs instead thus causing copper toxicity and copper deficiency at the same time. Low copper is one of the causes for anemia. It seems the problems are never ending with copper/zinc imbalances.

      Copper/zinc imbalances can also cause glutamate/GABA imbalances. PHD is a great diet as it’s pretty low in glutamate. Meat is high in glutamate but most people can consume it without issues. The worst glutamate offenders are wheat and any other gluten, corn, dairy (raw is fine for some people) and soy. Rice can be problematic if this imbalance is severe enough.

      Hair tests reveal the past, not current situation. Personally, don’t think it’s very helpful for copper/zinc issues. I also think the zinc tally test is worthless.

      Molybdeum is also a good mineral to help balance copper/zinc but would not exceed 250 mcg while balancing. Some practitioners recommended higher doses but the research does not support this. Most people end up 50 to 150 mcg maintenance dose. I would try to get your copper naturally from food. Remember it’s about balance and not about eliminating copper. You should continue to get tested to monitor your free copper until it with in a good range.

      Hope this helps. Lisa

      • Thank you so much for your insights, Lisa.

        So you’re saying my high free copper (by the formula) clearly indicates I am high in copper and that I am slightly toxic and that is why I react so poorly to such a small dose? And that this probably indicates “bio-unavailability”? And that I should try lowering my high free copper by using a high dosage of daily zinc? I’ll give it a shot, but I have some serious reservations.

        Firstly, if copper toxicity is such a common issue as most websites discussing it make it out to be, why would Paul recommend a daily dose of copper? And unless I am just undiagnosed with WIlson’s Disease, I don’t see how I became copper toxic while eating Paleo and then PHD with occasional zinc supplementation…

        Secondly, I see a number of people subscribe to this theory, ann louise gittleman being one of the major proponents, Larry Wilson being another. But are people really getting better by dosing themselves with all these copper antagonists? It seems like everyone who self-diagnosis themselves with this problem have this epic battle of “copper dumps” over periods sometimes lasting years…And are you sure “bio-unavailable” copper isn’t just the early stages of Wilson’s Disease? I hope not.

        I guess I’m still unconvinced my reaction to copper wasn’t just pathogenic die-off and part of me wants to see if going through the hell of supplementing it at 2mg has light at the end of tunnel. But I’ll try high-dosing the zinc for a while and see what happens.

        I think Paul might be turned off by long these posts are, cause I’m sure the guy is busy as hell, but scrolling back through all the comments here, I cannot believe I am the only one who reacts so poorly to 2mg of copper…

        • Hi William,

          Your free copper at 24% is higher but not excessively high and I don’t think you have Wilson’s Disease. Those people have extremely high free copper so much so that their hair can have reddish tint because of it. You could look at ferritin levels and if you’re on the low side then you may have some bio-unavailable issues but it typically affects people with higher free copper and wouldn’t be particularly concerned about it especially if you chose to balance copper/zinc.

          If you go back and read my post, I never mentioned high doses of zinc. I think you could resolve the copper/zinc imbalance by working your way up to 30 mg of zinc and keep retesting every few months until you’re in normal range of 5-15%. Going low and slow will keep the copper dumps at a minimum but some people do have a dreadful time with it. People should be aware of it so they don’t think something terrible is wrong with them and that’s why the warning. Some people glide on through. Some practs recommend high doses of zinc (60-over 100mg). My son has pyroluria and even he can’t tolerate a large amount of zinc. Plus the body is changing and as we clear up toxins in his body he needs less zinc so we retest and adjust accordingly.

          All of us are different in how we react to supplements. It actually wonderful that you are cautious and were able to recognize that particular supp was causing you problems. Many people randomly start consuming a bunch at a time and have no idea what’s affecting them.

          I would think that since you’re eating a PHD diet and you supplement with zinc that you should resolve your imbalance in 2-3 months pending that you’re not getting a large dose of copper from somewhere else like copper pipes, swimming pools or lotions with copper sulfate. Monitoring copper food choices to make sure you’re consuming natural copper is still needed for balance. I doubt your copper levels increased while eating paleo or PHD. If anything, your levels may have come down a bit since changing your diet.

          I suffered from an array of problems my entire life until I got copper/zinc in balance. I had already been consuming a paleo diet when I learned of this problem. I was able to get mine in balance in about 4 months granted I have other problems. I had a few rough patches but my copper was much higher (yep, I had red tints in my hair). I know some that have had a terrible time with this (they have other problems though) and others that glide on through it. It really depends but if you’re healthy I wouldn’t think this would be a hard process. Balancing this has improved my life tremendously. High copper caused me so much grief, I can’t even begin to describe the hell I used to be in.

          • Lisa, I am very grateful for your input here.

            I think I am going to continue the copper supplementation and see what happens and if the bad reactions never stop, I will suspect you are correct in that I have too much copper. But as of right now, I am going to continue under the assumption that I actually have a deficiency which has caused an immune suppressed state, and see if that clears things up, as well as look at further testing. As I just wrote to Paul below, I will definitely post the outcome of these ‘copper trials’ as I know I am far from alone researching this issue on the internet. Thank you Lisa.

          • Still here Lisa? I hope so. Because I think you were right.

            I played around with extra liver and copper supplements for a week and things kept getting worse and strange. Felt like death. So I got some new copper tests and things aren’t looking good.

            Serum Copper: 97
            Ceruloplasmin: 20.4
            So that makes my Free Copper: 35.8

            35.8 is a pretty big jump from my previous free copper of 24, from just six months ago, right? Also, from researching Wilson’s Disease, I am pretty sure I have developed some distinct Kayser Fleischer rings. I just checked old photos, and they aren’t there. Also, no kidding, that copper tinting in the hair you mentioned…I’ve recently noticed that too. (Either that or it’s hypochondria overdrive.)

            Speaking of hair, I just got hair analysis back form two separate labs, and they are identical. Basically low in everything, except copper. Which is sky high…

            Oh, and I also had a recent high biliburin levels with no prior symptoms of Gilbert’s Syndrome (i.e. jaundice) so something’s up with my liver, which has to be at the root of all this crap.

            I just sent out the kryptopyrolle test, too. Honestly, at this point, I’m praying it’s pryoluria. Because I’m terrified. I can’t seem to find out if 35.8 is high enough to be worried about Wilson’s Disease. But the symptoms fit.

            So for the last week or two I have been playing with higher zinc dosages (30-90mg) and the occasional days of super high B6 (200-600mg with some p5p too) and vitamin C (2 grams spread out) and some extra magnesium before bed. All day long I have a metallic taste in my mouth, which given that I’m still failing the zinc tally test, I’m guessing is copper. And if copper dumps are anything like the nearly unbearable bouts of depression and despair I’ve been getting, accompanied by unpredictable rage, and intense top-of-the-head migraines…then I’m copper dumping hard.

            I’ve been reading up. And I’ve joined the Pyroluria Facebook group. Lots of uninformed and desperate people, like me, are there. I don’t know what to do from here. When the pyrrole test comes back, even if it’s negative, I’ll do a phone consult with one those docs (Pfeffer trained Mensah Medical) and see what they think.

            I’m so grateful you posted your responses earlier, Lisa. Thank you.

    • Hi William,

      It’s an interesting case. It does seem like you are low in copper. The symptoms you get when you take copper or liver suggest either (a) a gut infection that benefits from copper availability, or (b) a thyroid disorder that flares when the thyroid gets copper.

      If you have a small intestinal or stomach infection that is stealing copper that would explain both the symptoms and why you are low. However, there aren’t a lot of infections known to do that. This paper mentions Mycobacterium leading to long-term copper depletion: I’d have to do a more thorough search to see if there are others.

      The Wikipedia page lists some causes of low serum copper. Overdose of vitamin C is one, so you might stop that if you’re taking it. Genetic disorders can also lead to low copper and they often produce high ferritin.

      Yet another possibility to consider is that copper is antimicrobial, you may be immune suppressed from copper deficiency and this may have let an infection proliferate, and the negative effects you see when you take copper may be due to a sudden upsurge in immune activity or microbial die-off. See for the antimicrobial properties of copper. If this is the case, you could try supplementing copper during a fast along with bentonite clay or activated charcoal and these should alleviate the toxicity.

      So here are some diagnostic tests you might ask your doctor to perform:
      – Iron status: Is ferritin high? If so you might want to do a 23andme test to see if you have genetic variants associated with poor copper status.
      – Thyroid status: Are you hyperthyroid? Hypothyroid? Copper could exacerbate hyperthyroidism. If you are supplementing iodine you might stop for a while or reduce the dose and see if that affects anything.
      – Gut status. You could try testing for gut infections, eg Metametrix stool test or small bowel tests.

      Hope this helps.

      Best, Paul

      • Paul, you are awesome. I like the way you think.

        I will get the GI Metametrix test and further thyroid tests this week. My ferritin was within range and my 23andme test was stellar. Good thinking on that, though.

        I am leaning heavily towards the anti-microbial theory so while I wait for the next round of tests to come in, I’ll be supplementing with 2mg copper and see if I can wait out the bad reactions (die off… hopefully) and come out the other end and into good health. Either that or it kills me. Ha. I will post what I glean from this experiment / future testing, in case others come researching this same copper reaction.

        All the best, William

      • Hey William,

        I understand where you’re coming from. Copper/zinc imbalances are confusing. There’s some good info on the pyroluria page however it’s not the whole picture. Helen from the group is a natural path that healed herself doing Dr. Yasko’s methylation protocol and a group of us went off and started our own group.

        Personally, we did the pyroluria route and spent a lot of money with a Pfeiffer trained practitioner that got us no where. (Got some bad info from Mensah too.) They of course took our money. Personally, I think you’re better off testing 23andme. There’s a good chance you could have a single or combo mutations for CBS, BHMT, and SUOX (23andme doesn’t test for the Yasko SUOX methylation snp). CBS mutations are not that uncommon and following Yasko’s protocol has helped us further.

        If you have a CBS snp then high B6 supping is not a great thing. A regular dose of P5P would be better. Don’t go so high right now with zinc. You’re better off going low and slow. High zinc can also make glutamate issues worse. This is where Yasko disagrees with Pyroluria treatment and from our experience, I agree with her. Zinc/copper imbalances go hand in hand with glutamate/GABA imbalances. It’s another reason most of us have insomnia. Glutamate is an excitotoxin which we end up with too much. We’re typically low in GABA which is the calming neurotransmitter. Going on a low glutamate diet is recommended. Meat typically is not a problem for most people but it can contribute to high ammonia which many of us suffer do to having issues processing sulfur.

        There’s a lot of info to cover. If you’re interested you can friend me on FB (if that’s ok with Paul). Lisa Pittman Bowman

        I belong to a couple other groups that are doing this together and I can add you. There’s also a source of practitioners. I hired a great natural path from Australia who is familiar with this stuff and helped us figure things out. My son is pretty much recovered from autism! He continues to get better and we need to adjust thins as we go. I’m doing great too after years of suffering. This info has been priceless for my family.

        Please don’t hesitate to contact me. Lisa

        • Thanks for the comments Lisa,
          I believe that i may be low in Gaba
          (& also deficient in Zinc).

          But on the Gaba ‘thing’, i have just been doing a bit of ‘googling’ to try & understand the glutamate/gaba balance & your ‘low glutamate diet suggestion,
          but i cannot make sense of it…glutamate seems to be a Gaba precursor ie. we need it to produce Gaba?

          a couple of refs,


          can you help me out a bit on this apparent conflict.

          & also any suggestions on ways to raise Gaba or increase the balance in favour of Gaba…


          • Lisa,

            I know it seems crazy that I keep responding to your replies months later, but I wanted you to know how right you were about everything. I kept blowing off your advice in favor of my alternative practitioner’s and they finally led me down a really wrong road. They had me take some TMG and that, in combo with a quick experiment with methyfolate, has turned me into a giant ball of histamine/glutamate/i-don’t-know-what. I have been having a serious histamine rection now for 36 hours and I almost went insane due to the intense stimulation there for a minute. Terrible migraines now for 26 hours. Intense stuff. I think this is related to the sulphur in TMG or maybe just my inability to handle methyl donors.

            Feeling like hell, I finally put in my 23andme data into geneticgenie and lo: CBS mutation and MTRR and more. So TMG was possibly the worst thing I could have taken.

            I still can’t get this histamine reaction to stop and I’ve taken like 8 Benadryl. I’d go the hospital but I’m not even sure what I’d tell them: I don’t think an ER doc’s going to fully grasp: “I think there’s something wrong my methylation, sir.”

            Reading through Amy’s book, (which seems to connect all the dots: copper/zinc, sulphur, etc.) I saw mention of a charcoal flush (2 charcoal tabs + magnesium) which I downed an hour ago, which I’m praying helps. (Do you know if I can do more of them in the same day?) I’m not sure if it would be wise to start supplementing molyb now or wait till this reaction stops. (I’m terrified because I’ve read that when someone has methylation problems like this, that ingesting sulphur compounds can make it so I’m recycling histamines for a month!)

            Anyway, I tried looking you up on facebook, but couldn’t find you. All roads for me seem to lead to Yasko, so I was hoping you could guide me in the right direction here, since I keep coming back to your responses here and saying: “Jeez, she was right.” My email is:

            Thank you Lisa.


        • (I think I replied in the wrong post a moment ago, Just want to make sure Lisa sees this. Sorry for the double post, Paul.)


          I know it seems crazy that I keep responding to your replies months later, but I wanted you to know how right you were about everything. I kept blowing off your advice in favor of my alternative practitioner’s and they finally led me down a really wrong road. They had me take some TMG and that, in combo with a quick experiment with methyfolate, has turned me into a giant ball of histamine/glutamate/i-don’t-know-what. I have been having a serious histamine rection now for 36 hours and I almost went insane due to the intense stimulation there for a minute. Terrible migraines now for 26 hours. Intense stuff. I think this is related to the sulphur in TMG or maybe just my inability to handle methyl donors.

          Feeling like hell, I finally put in my 23andme data into geneticgenie and lo: CBS mutation and MTRR and more. So TMG was possibly the worst thing I could have taken.
          I still can’t get this histamine reaction to stop and I’ve taken like 8 Benadryl. I’d go the hospital but I’m not even sure what I’d tell them: I don’t think an ER doc’s going to fully grasp: “I think there’s something wrong my methylation, sir.”

          Reading through Amy’s book, (which seems to connect all the dots: copper/zinc, sulphur, etc.) I saw mention of a charcoal flush (2 charcoal tabs + magnesium) which I downed an hour ago, which I’m praying helps. (Do you know if I can do more of them in the same day?) I’m not sure if it would be wise to start supplementing molyb now or wait till this reaction stops. (I’m terrified because I’ve read that when someone has methylation problems like this, that ingesting sulphur compounds can make it so I’m recycling histamines for a month!)

          Anyway, I tried looking you up on facebook, but couldn’t find you. All roads for me seem to lead to Yasko, so I was hoping you could guide me in the right direction here, since I keep coming back to your responses here and saying: “Jeez, she was right.” My email is:

          Thank you Lisa.


  18. Paul:
    I have just been given 7 days of Amoxicillin for an ear infection,also Cipro
    drops for one week.
    When I complete the course of antibiotics, what would you recommend I do
    to restore gut health???
    Thanks for your help.

  19. Would you recommend probiotics while
    while taking the antibiotics?
    I take the antibiotics every 12 hours with food.
    Probiotic or fermented food in the middle???
    By the way, the pharmacist told me not to
    eat yogurt fermented food until I’m done with
    all the antibiotics.
    Thanks for your counsel, Paul

  20. Hi Paul,
    I was wondering if supplementation and diet should differ in any way from the normal PHD recommendations if I have had my gall bladder and six inches of my lower bowel removed? I was thinking that not having a gall bladder especially might effect how my system digests food and supplements.


  21. Dr. Jaminet,

    Could you add a section to the supplements page especially for pregnant woman? The only listed supplements listed seem to be 5 egg yolks and choline. Not sure if one should do both or not. Do 5 egg yolks contain enough folate(not folic acid)? Should one increase their dairy consumption during pregnancy for additional calcium and k2?

    Thanks for all you and your family do!

  22. Hi Paul,
    I would love to get more k2 into my diet but I am allergic to soy and I have trouble with Dairy (Ghee seems to be ok). It seems like the k2 in supplements is always derived from Soy. Do you have any tips for someone in my situation? I’m also interested in figuring out ways to get more k2 into my son’s diet so if you have any kid friendly tips, I’d love to hear them. Thanks!
    – Sara

  23. Hi Paul,

    Do you think N-acetylcysteine is a helpful supplement for those struggling with Candida? I’ve run into some information (or, maybe misinformation) that says it isn’t good to take with Candida.

    Thanks for your kind help!

    • Hi Ginger,

      It’s hard to say since it benefits both your immune system and the Candida’s defenses. I would say if you’re on a low protein diet it’s probably helpful, if you’re eating enough protein maybe not.

  24. Hi Paul,
    I need advice. I’m 51 yrs. old. I have had food, chemical and inhalant sensitivities since I was 28. What drove me to the dr at that age was arthritis. About 5 yrs. ago I found out that I am gluten intolerant( positive blood test). I have tried altering my diet over the yrs. and found some improvement. I’ve done low carb,low fat etc. I’ve tried totally avoiding some foods. My worst food sensitivities are peanut, milk, almond,and eggs. I get low dose allergen shots twice a year which allow me to eat the foods I’m allergic to. I have multiple symptoms including reflux,bloating,constipation,joint stiffness and soreness. I have been a runner for 18 yrs. and also lift weights. I read your 1st edition phd last year. Now I’m reading the scribner addition. I should add that I also have brain fog, nervousness, and poor concentration at times. I’m just confused about how to implement the diet since I’m sensitive to some of the important foods and I don’t know what supplements I really need. I take d3 every day 5000 iu. Also have some numbness and tingling in hands and feet. Help! Adrienne Creath
    P.s. I’m an avid reader of health and nutrition info. Read Weston Price’s nutrition and physical degeneration and many others but feel overwhelmed by all the info.

    • Hi Adrienne,

      Nearly all the foods you are sensitive to can be eliminated. Replace the egg yolks with chicken or duck or goose liver. Gluten and peanuts are forbidden, milk and almonds are optional and can be eliminated.

      I would try to eat a nourishing diet with minimal sensitivities, then do a stool test looking for parasites/pathogens. If you find any, get them treated.

      In the meantime circadian rhythm strategies for immunity should help.

      I think odds are you have some combination of malnourishment from the restricted diet, infections which may be primarily in the gut and diagnosable with a stool test, and food sensitivities which will probably go away once when the gut infections are treated and nourishment helps the gut heal.

  25. Hi Paul. I make my own Kefir from raw milk which I consume every day. Would I still need to eat fermented vegetables as well or is the nutrition sufficient by having raw milk kefir. I am fine drinking Kefir. thanks in advance

    • Hi Brett,

      The fermented vegetables will give you bacteria with genes for digesting plant fiber. Kefir won’t do that. So I think it’s still desirable to eat fermented vegetables.

  26. Thanks Paul,
    I did have a stool test a couple of years ago as part of prep for allergy shot. There was no E. coli present and 3 other bacteria were not at appropriate counts and labeled as potential pathogens. I have to take gastromicin and vibromycin as bowel preps before each allergy shot. I thought that would take care of the imbalance. It’s all so frustrating. I’ve been dealing with stuff for 25 years!
    Thanks for your advice. Also, what do you think of bioidentical hormone replacement?

  27. Hi Paul,
    Thank you and God Bless for all you do…. I am suffering with acne rosacea. I started 1 tab. of MCT oil daily (cannot tolerate coconut oil) and it seems to calm down my face but it has changed my stools to a consistency of thin mash potatoes. Anytime I try probiotics in pill form or fermented vegetables I break out. Do you have any ideas??? I am in the process of ordering your new book and hoping it will help. I currently do no eat dairy, soy, gluten, nuts, sugar as it all seems to make the condition worse.
    Thank you again….

    • Hi Mary,

      I’ll be starting an acne and rosacea series this week. Rosacea is a rather complex condition so the best thing is to start with our book advice and only try more abnormal methods after the generally beneficial dietary and lifestyle tactics are in place.

  28. Hi Paul!

    Do you guys have any recommendations on how best to get supplements or nourishing foods into kids? I had been giving my son 1/4 tsp fermented CLO, 200 IU Vitamin D (in the winter), and a daily multi. I have switched from my daily multi and CLO to your diet and supplement recs, but there is no way my 2 year old is going to be able to do this. His Vit D and Multi are gummy vitamins. He can’t swallow a pill, much less numerous pills.

    This seems like it is even more pressing because it is hard to get sufficient quantities of nourishing foods into him as well. He loves some of the starches, and he likes beef, lamb, eggs, and dairy. I can sneak in some seaweed and stock (by cooking it into rice, mostly) and he will eat fruit and a few veggies. Also, he loves dark chocolate! There is no way I can get enough liver into him, though, if any, and his range of veggies is pretty slim.

    Any advice?

    • Hi carmelite,

      In general children, especially young children, don’t need supplements. The one exception is vitamin D, if they don’t get out in the sun (which they should, 2 hours per day).

      I would just try to get them to eat nourishing foods. It sounds like you’re doing great, and he’s eating really well. It’s not clear that kids need a lot of vegetables — try for tomatoes and potatoes.

      • Hi Carmelite,
        My son is almost 2 and I am much in the same boat, my kid used to be an amazing eater but he has become so excited and distracted by life that I can mostly only get him to eat on the run! I do things like sneak spinach into fruity smoothies and sprinkle dulse on savoury foods in place of salt. I think you are doing a good job getting good foods into your kid! I also like in Edmonton where we only get UVB like 5 months of the year so vitamin D from the sun is not an option. I give my boy a multivitamin daily and he has raw milk plus cod liver oil occassionally for good fats. We get Dr. Mercola’s multi for kids which is very safe and doesn’t contain things like iron that could lead to trouble. As for getting him to eat food I let him use ketchip liberally.. so even though ketchup isn’t great it’s worth it if it gets him some liver:)

        • Oh, one more question! If he must eat some grains, do you think sprouted grain breads are better than conventional? I might be able to talk my Dad into using the sandwich bread and tortillas that I buy for him, at least some of the time! My Dad usually buys the normal whole grain stuff, with all of the additives.

      • Thanks Paul!

        He doesn’t like potatoes much, but he just ate sweet potatoes for the first time yesterday (always has balked at them before)! He does like tomatoes quite a bit (he eats them like apples), although not pasta sauce or ketchup, strangely enough. He likes lacto-fermented pickles, sauerkraut, and carrots as well, and will sometimes eat a soup made of beets or spinach and zucchini. I guess I won’t worry about him getting much more than that as far as veggies go. We will keep up the Vitamin D supplementation until summer. He gets plenty of sunshine then, but it’s harder in winter, even in Texas.

        He doesn’t like fish at all. Do you think I should give up the fermented CLO? I know you’re not a fan, but I can’t see where else he will get Omega 3’s, and, despite my best efforts, some of the other people he spends time with do feed him Omega 6 oils, grains, beans, and peanuts, not to mention processed food and some sugary treats. I am a single mother in nursing school, and so dependent on family help taking care of him, but his grandfather is not amenable to my nutrition desires for him. I think I can manage a PHD diet for him about 2/3 of the time. Luckily, he has no major health issues.

        What do you think about Dr. Mercola’s multi (hope that’s not a loaded question)? I just want to make sure he gets the best nutritional support he can get, considering I can’t always keep him on the diet I would prefer.

        Thanks sooooo much for your time! I just started your diet last week, have not even completely implemented it yet, and am already seeing amazing benefits to my mood, energy levels, and a reduction in food cravings.

  29. Hi Paul:
    You ok with liver- calves and beef- that are not from grass fed animals(tough to get grass fed); and also ok with bones for broth from non grass fed animals?
    I noted in one post that you made broth from bones from BJ’s; am guessing not grass fed.
    If bones come from non grass fed animals, any particular variety of bones to be avoided?

    • Hi Steve,

      Although we’ve eaten both liver and bone broths from conventionally raised cattle, both taste much better from grass-finished animals, and we are pretty sure they are quite a bit healthier also.

      So I would try hard to get bones and liver from grass-finished cattle if possible.

      If you can’t, it’s still probably a good idea to eat them. But I would try for grass-finished.

      I’m not sure if some bones would be worse than others. In the recent chicken paper, it was connective tissue that had gathered the most lead, surprisingly to me.

  30. Hey there.

    Amazing book!

    I’m wondering what your thoughts are on this whole phenomenon of “edible clay”, like bentonite and whatever else is being recommended in certain alternative medicine circles (earthclinic, etc).

    Should people who have chronic health issues of one sort or another all be taking it? Are these various clays the “detoxifying cure-all” they’re often purported to be? If so, why aren’t they more popular in modern scientific approaches?

    Thanks a lot.

  31. Hi Paul. I’ve been taking the Jarrow MK-7 for 2 months now, and am considering switching to the Life Extensions brand you suggest as I have osteopenia, and wonder if the higher dose would be better for me. I have been drinking the bone broth 3-4 times a week since I began eating the PHD way 2 months ago. Is the Jarrow formulation enough, or is the Life Extensions brand better for my needs, which is to build bone fast (I’m 60)? If so, should I take it only once a week as you suggest, or more frequently. I stopped Calcium, and take all of your other supplements.

    Also, can you discuss the food combining debate regarding eating carbs and fat at the same meal? I have been doing that per your suggestion, but every thing I read tells me that I should not mix them because the fat will be stored on my body, as it makes the insulin response worse. Your book says it improves insulin response.

    • Hi Judy,

      I think the Jarrow MK-7 is enough, but if you’d like to be extra sure, you could take the LEF brand 1x per week and continue the Jarrow other days. There is a slight clotting risk with the LEF, so choose a day when you won’t be sitting all the time.

      Combining the fat and carbs improves the glucose response (not insulin), and controlling glucose is more important than controlling insulin. I think we mention in the book that giving people with hyperglycemia extra insulin greatly reduces their mortality.

      Some writers have become overly fearful of insulin. It’s not health-damaging to have some insulin after a meal.

  32. Hi Paul,
    I was excited to discover your book recently and am slowly making my way through it. I am very interested in your supplement recommendations and have a question- do you recommend anything in particular for symptoms of estrogen dominance (irregular periods, weight carried all in lower body, etc)? Or any foods in particular to avoid? Have been trying to search the site for anything regarding this but haven’t come up with much.

  33. John Henderson


    A few questions.

    1. Is Palm KERNEL Oil a good choice for Vitamin E supplementing?

    2. If not, is PKO mainly an oil used for cooking, whilst 1 tablespoon of Palm Oil can be used for Vit E supplementation?

    3. Are there any dangers of too much Palm Oil use?

    Thank you

    John H

    • Hi John,

      I don’t think so. I think you want the colorful oil.

      PKO isn’t readily available in the west. Africa, southeast Asia, maybe Brazil have it. At Amazon it’s sold mainly as a facial lotion / balm.

      Palm oil is very similar to olive oil, PKO similar to coconut oil. Both are OK to use for cooking or as a foodstuff as long as they aren’t adulterated.

  34. One more question: I’m trying to fix up some constipation issues and taking your recommended zinc and copper supplements. I just noticed on the constipation post that you said both zinc (30-50mg) and copper (2 mg) are taken daily. Though on this page, it looks like zinc is just taken weekly. Can you help clear the confusion on this?


    • Ginger,

      Paul updated supplement recs and likely the recs in the constipation post are now outdated. Those that are found on this page are current.. Zinc is 50mg once weekly. Copper still daily.

      Hope that helps.


  35. Hey Paul,

    You mentioned that potatoes discolored should be discarded. Is it okay to cut away the discolored pieces and save the rest of the potatoes? Also does the same apply to yams, sweet potatoes and taro?


    • Hi Erich,

      If the discoloration is dark then I just cut it away; but if it is green then I discard the whole potato. The others don’t have the telltale green color but I generally cut away any discolored part, and if an appreciable part is discolored or hard (taro hardens), then I discard the whole thing.

  36. Hi Paul,

    I have three questions:
    1) Are red radish, turnips, and daikon radish okay to eat raw? Or is it only okay to eat them raw & fermented?
    2)You mentioned that it is generally better to stay away from high sugar vegetables when fermenting. Would turnips be in that category? I assume carrots and parsnips are.
    3) Every morning I have a cup of saurkraut and 2 cups of water in a fasted state. Would you consider that an efficient and optimal form of ingesting probiotics without having the stomach acid killing the bacteria?


    • Hi erich,

      1. I think it’s better to cook them, or at least ferment them.
      2. Turnips are fine, they’re not high in sugar. Even carrots and parsnips can be part of a ferment, but they shouldn’t be the whole thing.
      3. I don’t think that’s necessary but it probably will get you plenty of bacteria.

  37. I apologize if this was asked in other comments. Unfortunately, it is hard to search all comments as they are paginated. ( I plan to compile them into a word document to search at some point.)

    One of the silicon supplements you link to is Sogar, which has 25 mg of elemental silicon per pill (from 54 mg of silica.) You recommend taking 5mg per day in your book. Is there anything negative with taking this higher dose. Should it only be taken once/5 days – does the benefit remain throughout the 5 days if taken that way?


    • Hi YE,

      The 5 mg is for a relatively bioavailable form, orthosilicic acid. The Solgar form is less bioavailable and is not going to produce an overdose. I think you can take either one daily.

  38. what are your thoughts about eating so much meat when the cattle are fed so much nasty stuff, including GMO feed? I try to avoid it by buying organic but that’s not always available.

    • Hi Kate,

      I think it affects different parts of the cattle differently. I try to get liver, bones, and dairy from organic sources but muscle meats I don’t worry about as much.

  39. Linda Seidman

    Thanks for all the detail in your chapter on
    making PHD more ketogenic.
    I’m planning on following it.
    My understanding is that adding MCT, BCA,
    and NAC to the diet while eliminating most fruits and
    fasting 16 hours a day makes it ketogenic.
    Is there anything else you’d recommend???
    Are you familiar with Art DeVany’s work?
    He has a referral for supplemental
    Glutathione purchase. Is that worth a try, do you think?

    • Hi Linda,

      No, I think eating as close to normal as possible is best. Starches but no fructose, and high MCTs via coconut milk/oil or MCT oil, are the two main things.

      I think the glutathione is very expensive for the value it brings. Eating more protein will accomplish much the same thing. But, it can help in some cases.

  40. Hi again Paul. I’ve been reading that animal protein consumption triggers the release of the cancer-promoting growth hormone IGF-1. You don’t discuss this in your book. You recommend approximately 300 calories of protein a day, instead of the lower amounts recommended by the FDA (which would keep IGF-1 levels lower). Do the benefits of eating more protein outweight the cancer risks? Does risk decrease if you eat grass fed/organic animal proteins? You do mention that lower protein intake is associated with longevity. Is this because it lowers the risk of cancers?

    • Hi Judy,

      IGF-1 is not specifically increased by animal protein, it is increased by total calories and by total protein whether plant or animal. But protein is also protective against cancer, it is essential for detoxification and maintenance of bodily functions.

      We believe our recommendations are optimal for most. The FDA’s recommendations are intended as a minimum, not an optimum.

      The mechanisms by which lower protein promotes longevity are not cancer-specific. They have to do with adaptations the body makes to resource scarcity, and a key factor is upregulation of autophagy which has the side effect of upregulating immunity and longevity.

      • The resource for this info is This site presents data which appears to demonstrate that higher levels of IGF-1 are caused by too much animal or soy protein, but not plant based protein. Of course, the site seems biased toward plant based nutrition.

        I know everyone is entitled to their opinion but how are consumers supposed to make informed decisions when everyone presents or possibly interprets data according to their own beliefs? I’m not saying you or anyone else is guilty of this, but if I’m going to put my trust in PHD or any other eating plan, I need to know what the research supports. It can’t be both, can it?

        BTW, my bathroom scale, which monitors my bone density, showed an increase from 5.1 to 5.2 over an 8 week period. I’m a bone broth believer!

        • Hi Judy,

          The first thing you need to keep in mind is that none of these things are villains. They all bring benefits at low doses and can do harm at very high doses.

          IGF-1 evolved for a reason and it wasn’t to give us cancer. Animals lacking IGF-1 fail to grow, have various brain and neural defects, and hearing loss. See

          So the object of eating is not to minimize IGF-1, animal protein, or any other nutrient or hormone, but to find the right balance that optimizes health.

          We have pretty good evidence that eating moderate amounts of meat is good for you. I’ll do some blog posts on this later but if you want evidence for our eating plan, the best place to get it is in our book, which marshals the evidence.

          The book doesn’t discuss IGF-1 because hormone levels don’t tell us the optimal amount of food to eat. But it does discuss how much protein we need, and how much meat/fish/eggs we would have to eat to obtain it.

          • Thank you Paul. Your book has become my bible and I’ve read and reread the evidence for your eating plan. It’s difficult to ignore other sources of information so it helps to check in. It doesn’t help that I’m an info junkie! Again, thank you!


      • Hi Paul,
        My bloodwork shows normal thyroid function but i thought it might be helpful for weight loss to supplement with Sea kelp ( “Natures Way” brand ) this a safe form of iodine?
        Thank you,

        • Hi Mary,

          In low quantities it is.

          • Ty so much Paul-for all the invaluable info, an amazing website.. and for making yourself so available to us all. Much appreciated ..God Bless!

          • Hi Paul,
            I tried a Natures Way kelp supplement, 400 mcg iodine per pill. I noticed the side effects after taking a pill 2 days in a row: flu like symptoms, exhaustion and a metallic taste in the mouth. I stopped taking it when I made the connection. The side effects lasted a few days, now I am only sleeping 4-5 hours and my digestion has kicked into overdrive. I feel good but a bit amped up, very high energy. I stopped taking the kelp supplement about a week ago. I read that kelp supplements may have contaminants, such as arsenic.

            My question for you: does this sound like an allergic reaction to the kelp or to the 400mcg iodine in the kelp? I am considering trying the 200-250mcg iodine amount you recommend next. Thanks.

          • Hi David,

            It sounds like it was just too much too soon. Contaminants are possible but more likely it was just too much iodine. You could try eating a single nori sheet daily or trying the 225 mcg tablets or even a half tablet, and see how they feel.

          • Thanks Paul. I hope you do create a PHD multivitamin at some point, with all the nutrients you recommend.

          • The Calton’s make the best multi I can find:


  41. Paul:
    I am not clear on how NAC aids the ketogenic
    diet. Can you explain it briefly?
    Does it have something to do with neurological
    Also, fructose interferes with the production of
    ketones, but safe starches do not. How does
    this happen? I have read about this in your book
    but still have these questions.
    Thank you.

    • Hi Linda,

      NAC doesn’t aid ketosis, and it is not necessary on a ketogenic diet. However, clinical ketogenic diets, which were poorly designed, caused oxidative stress leading to things like kidney stones, and NAC which is a glutathione precursor is protective against that.

      Also, NAC is supportive of immune function and can have antibacterial effects, so if the reason for the ketogenic diet is an infection, it might be helpful.

  42. Hi Paul! What is your take on liposheric vitamin C? Thank you!

  43. Hi Paul,

    I was watching a video that you went through an Accutane regimen when you were younger. I know a friend that went through this regimen. Do you know how that affected you and what you would recommend to someone that went through it to remove the toxins from their system?


    • Hi Erich,

      I didn’t notice negative effects from accutane. Most of my problems began earlier when I took a year-long course of antibiotics. I don’t know of any way to reverse the effects; healthy living is the best bet.

  44. Apparently being encased in liposphere, the claim is that it goes straight to liver and also many testimonials about strengthened immunity, even cancer benefits? Do you think it is hype? My concern was the shelf life of any fat it was encased in. You can make it yourself with soy lecithin and a jewelry cleaning machine!!??!! Soy lecithin is also a concern, right? My sister just ordered it and it certainly caught my eye since I still showed signs of a chronic viral infection with my last blood panel in January. I already take more than a gram of ascorbic acid powder per day to help me fight the infection.

  45. Hi Paul
    I have been reading the diet cure by Julie Ross. I’m curious what you think about using phenylalanine tyrosine GABA etc. she seems to advocate a primal diet to get those amino acids. But supplement to balance them as needed. You also suggest some amino acids. What do you think about her suggestions. I eat phd but still have Pms issues so am experimenting with dlpa personally. Thanks and love the work you and your wife do. Planning to make Japanese pancakes with green onions and shrimp soon.

  46. Paul:
    Please excuse my asking you if you knew of Art DeVany’s work.
    I have your book and hop around reading different chapters at different
    times depending on what I’m interested in at the moment.
    I hadn’t read the preface where you mention Art DeVany and his
    importance to your personal development…
    I just wanted to let you know that I found my answer.

  47. Hello Paul. I just had a range of blood tests completed and my iron level came back abnormally high. iron, serum 193
    iron saturation
    uibc 79
    iron bind.cap.(tibc) 272

    I’m taking all of your recommended supplements. Could any be causing this? should I be concerned?


  48. Hi Paul,

    My friend was told by her doc that she has low zinc, and is high copper, but it’s “biounavailable.” She was recommended to take some extra supplemental zinc, vitamin B6, C, and molybdenum (I think), and to avoid excess copper foods and copper in supplements.

    She swears that taking a small dose of helps lower her higher blood pressure. Do you think it prudent to still take the recommended dose of copper on a copper detox protocol, especially with the BP in mind?

    Many thanks!

  49. My silicon came in 54mg capsules. Can I take this amount once/week and get the same benefits, or should I reorder a smaller dose?

    Also, my vanadium cam in 1 mg tablets. I can split this into 4ths, but that’s still 250 mcg, quite a bit more than your rec. The book says that there is no known optimal dose, so can I take this once/week, or should I purchase a different one?


  50. Hi Paul,

    I’m enjoying your book and trying to keep on the PHD while training and exercising quite a lot (Marathon-Runner, Crossfit). I was wondering what is your take on blood tests like those offered by (I’m taking the “Performance” one in a couple of weeks) and how the results from such a test would be helpful to personalize a bit your supplement recommendations. Would it still be recommended to supplement all the things you recommend if the test results are ok? It would be also helpful if you would provide may be a table with the values YOU recommend for the different vitamins and minerals. The values you recommend are not always the same as the “normal” values from the NIH or else. I only found concrete recommended values in the book for cholesterol, HDL and LDL. Something like that for the other stuff would be great.

    Thank you for the great work!

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