Supplements

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

Supplemental Foods

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

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

Daily Supplements

These are supplements we recommend be taken daily:

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

Weekly Supplements

These are supplements we recommend be taken once a week:

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

Prenatal Supplements

The most important prenatal supplements are:

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

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

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

Optional Supplements


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

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

Therapeutic Supplements

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

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

Miscellaneous


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

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

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4,089 Comments.

  1. Do you suggest your diet for liver disease from hep c – cirrosis? should meat and salt be avoided? as people with liver disease struggle to digest protein and salt..which can lead to toxicity and brain body disfunction…please help would appreciate you advise.. kindly kim

  2. I am loving your book! Thank you both for all you do. My family has loved all the recipes you post too…can’t wait for your cookbook! What supplements, if any, do you recommend for children. Mine are two and six. They mostly follow PHD guidelines. I am mainly concerned about making sure their omega 3s and 6s are balanced, that they are getting enough vitamin A (they don’t eat liver but I give them Dr. Ron’s liver capsules here and there), and enough vitamin D. They get out in the sun plenty but I don’t think in the winter months they get enough skin exposure. I am wondering if, even though you recommend against fish oil, if I should give them cod liver oil for the A, D and some omegas. Thank you for your input!

    • Hi Laura,

      I generally don’t recommend supplements for children. They eat more food per pound of body weight, so their need for supplements is less.

      Vitamin D is the most likely one they would need, if they don’t spend enough time outdoors; but I recommend 2 hours per day outdoors, this is needed to prevent myopia.

      My next choices would be vitamin K2 and magnesium. Some liver would provide enough vitamin A. If they don’t like beef liver then duck/chicken liver is a possible alternative. The beef or lamb liver is good for copper too.

  3. ETA: I forgot to mention that I am still nursing the two year old and am pretty strict PHD myself, including the supplements. By the way, what do you think of this multivitamin (I know you don’t favor multis, but this one seems pretty good to me: http://www.drrons.com/docs-best-multi-vitamin-mineral-antioxidant.htm

  4. Paul, just read your book. I ordered a bunch of the supplements you recommended. I’ve been doing the low-carb thing (for the third or fourth time)and the two things I’ve missed most are potatoes and rice. Your recommended consumption of chocolate doesn’t hurt, either! I have three questions right off. The first is about a supplement, so I guess that fits in this topic. That is potassium. You talk highly about potassium containing foods like tomatoes in your book. Is there something wrong with simple potassium chloride (aka No-Salt)? It is cheap and easily available (and tastes horrible). I know it gets absorbed well because on those occasions when I have consumed an excessive amount of wine, about 1/2 tsp of KCl in 12oz or so of liquid makes an amazing difference in the quality of the hangover (sorry, I ain’t perfekt). And it isn’t just the liquid (water helps, but there is a qualitative difference with the KCl, I assume because it is replacing the potassium excreted with the alcohol breakdown/excretion). I know that that quantity of potassium is vastly more than you would recommend, especially at one sitting, but the effect is remarkable. Atkins (in his Vita-Nutrient Solution book) says basically that it is a simple and effect way to boost potassium. Since it is so easy to get K from KCl, is there something wrong with getting it this way?

    The second question is about the substance that you seemed to expend the most vitriol over in the book — wheat. I find it very difficult to totally eliminate wheat. Minimize it, sure, but never have another piece of pizza, cake, or pie? Tough call. As you mentioned many times in the book, the dose makes the poison. I only have cake and pie a few times a year so I’m not too worried about indulging. I think my body can handle it.

    Pizza is tougher. I typically eat 4.6 oz of high-gluten flour per week in the form of a pizza (I make it myself and weigh it precisely). The dough does spend several days fermenting in the fridge (for flavor and texture) before I use it which might help somewhat. I don’t expect you to condone it. But how bad is this indulgence?

    Lastly, any thoughts on aspartame? It is often vilified, but it seems a whole lot safer than sugar. It’s like its the cool thing to hate, like microwaves. I read some websites talking about how microwaves did weird things to nutrients, making them kink up and such — then (what seemed to be) more rational ones saying that high-freq (thus high-energy, or ionizing, like UV) radiation could indeed damage chemicals, microwave being so much less energetic than standard IR could only heat, and any damage was simply due to the fact that the material was heated (same as in a pan on the stove). Logical. The only reason I bring it up is that it seems sites against aspartame seem dead set against microwaves, too. Is it a new, different, scary, bad reaction — or in the case of aspartame do they actually have a point?

    thanks much for your thoughts!

    Geoff

    • Hello- Gluten/Wheat-free pizza crust is pretty good. Available in health food stores. We have homemade pizza with our own sauce and toppings several times a month. PHD compliant. We don’t miss the wheat version at all.

    • Hi Geoff,

      NoSalt is OK but foods are even better, and they have plenty of potassium, so there’s not much reason to go away from food for potassium.

      As for pizza, we eat gluten-free pizza, in fact we make it at home. I now find wheat-flour pizzas unpalatable because the crust is too tough and chewy. Many pizza chains have gluten-free pizzas now including Domino’s and Uno’s.

      I’m not sure aspartame is safer than sugar, but I would recommend against both. Dextrose powder seems to me safer and healthier than either. Tapioca syrup is a PHD-approved liquid sweetener. I’m one of those who think aspartame should be avoided but microwave cooking is perfectly fine.

      • I’m already waiting for the pizza-recipe! 😛

        • Luke-

          Here’s our recipe if interested:

          2 cans (15 ounces each) tomato sauce (or homemade)
          1 can (12 ounces) tomato paste
          1 tablespoon Italian seasoning
          1 tablespoon dried oregano
          1 to 2 teaspoons fennel seed, crushed
          1 teaspoon onion powder
          1 teaspoon garlic powder
          1/2 teaspoon salt

          Read the label on the tomato sauce can and go with low/no sugar. The recipe makes a lot of sauce. We freeze the rest.
          We will sometimes lightly butter the crust first and bake it before adding toppings. It gives the crust a nice crunch.

          Spread sauce. Add grated mozzarella cheese. Add toppings. Pepperoni and green olive are our favorites. We also sprinkle on olive oil. Bake at a time and temp per crust instructions. Usually 350 for 20 minutes.

          • Forgot this part.

            In a large saucepan over medium heat, combine tomato sauce and paste. Add remaining ingredients; mix well. Bring to a boil, stirring constantly. Reduce heat; cover and simmer for 1 hour, stirring occasionally. Cool.

        • Thanks, Paul. I never add aspartame to things, but I do have a fondness for Coke Zero and a couple powdered drink mixes. Is your idea better-safe-than-sorry, or are there specific objections to it?

          thanks,

          Geoff

  5. How much N-acetylcysteine do you recommend to take each day?

    Judy

  6. Also your thoughts on using Infared Saunas for health.

    Thanks so much for your time.

    Judy

  7. Paul:
    Do you prefer the liquid or tablet Potassium Iodide supplement???
    I will go with your recommendation.
    Any drawbacks to either one???
    Thanks.
    Linda

    • Hi Linda,

      The Now tablets have 225 mcg iodine which I think is an excellent dose. Liquid iodine tends to have higher doses and one can much more easily get too much, but it is cheaper for large doses.

  8. Paul,
    Do you have an opinion on Iron levels ( and oft-recommended iron supplementation) in breatsfed babies? If breast feeding keeps iron levels at a lower level than formula feeding, might it be safe to assume that the iron levels resulting from breast feeding are optimal for a young baby?
    Best,
    Lilian

    • Hi Lilian,

      I think if the mother’s iron levels are good then the breast milk levels should be good. It may be prudent to get iron levels checked during nursing, as well as during pregnancy.

  9. Hi paul,
    Have you changed your mind on your recommendations for adequate sulfur intake (garlic, onion, eggs, MSM, Epsom salt baths)? I don’t see it in your recommendations.

    • Hi Erik,

      I never actually came out in favor of MSM supplementation or Epsom salt baths, just that they were things I was experimenting with and that I was intrigued by Stephanie Seneff’s arguments for sulfur. I do support eating sulfur rich foods and adequate sulfur-containing proteins (cysteine, methionine, taurine). But I’m not sure how much sulfur is optimal. It’s very hard to find evidence on that. And sulfur can feed some bad gut flora. So I’m basically in the whole foods camp for now.

  10. Hi! I bought your book over a year ago and have been slowly working my way to the full adoption of the PHD. I am currently pregnant with our fifth child and would like to know which supplements I should take and if any modifications to the basicc PHD must be made during pregnancy.

    I thank you in advance for your help and would like to congratulate you for the hard work. The book is wonderful.

    Natalia

    • Hi Natalia,

      Be sure to follow supplement recs from the new book, not the original edition. They are summarized on this page.

      The major differences in pregnancy are that you will need more choline/phospholipids and possibly more iron. Good food sources of these are eggs and liver, and red meat and seafood/shellfish.

      I would try to supplement in moderation — pregnancy is not the time to experiment with unusually high doses. Keep iodine low but steady, for instance. Most important are vitamin D or sunshine, vitamin K2, magnesium, and a bit of C.

      Be sure to get adequate carbs — aim for 30% of calories, but if you feel a desire for carbs, eat more — and not excessive protein — 15% is good, 20% at most. White rice and white potatoes are the best carb sources, eat them as part of a meal.

      Most important foods are liver, egg yolks, shellfish/seafood, bone and joint broth soups (3 bowls per week), potatoes, tomatoes, green leafy vegetables. Aged cheese and dark chocolate are good foods. Other organ meats like kidneys are good. Focus on beef, lamb, seafood, and eggs for animal foods; potatoes, beets, carrots, tomatoes, spinach, and berries are among the best plant foods.

      Best wishes for a great pregnancy! Let me know how it goes!

  11. Hey paul, just wanted to get an update on your thoughts for vitamin c supplementation. I think i’v seen you lean more on the lower side recently, like in the above comment you mention a bit of C. Should we take 1 gram or would it be fine for healthy people to maybe just take it 3 times a week giving around 500mg daily over the course of 7 days.

    Also, is 225mcg of iodine a good enough place to stop at and achieve a good thyroid function/avoid hyperthyroidism or hypothyroidism? Is it enoughh to dispalce bromide over the long term, maybe it’ll just take longer than 500mcg or 750mcg iodine would.

    Thanks

    Jessica

    • Hi Jessica,

      I think for routine supplementation in healthy people somewhere between 150 mg and 1 g per day is best.

      In illness, more is appropriate; this could go as high as to bowel tolerance. See our post on Dr Cathcart’s work.

      225 mcg iodine is sufficient for thyroid function. Above that level you are looking at altering functions elsewhere in the body, eg immune function, or to displace bromine. If you have bromine then higher iodine doses are appropriate, along with extra C and salt. However, going above 1 mg/day starts to have greater risk of thyroid or stomach side effects, so it is hard to say what the best strategy is. I might still stop at 1 mg/day and take a year or two to get rid of the bromine.

  12. Paul:
    What about Hashimoto’s Thyroiditis and iodine??
    I’m reading in your book and elsewhere that iodine may be
    contra-indicated. In fact, throwing gasoline on the fire…
    What do you think about it.
    Also, do you think tomatoes, being nightshades, are pro-inflammatory?
    How important is an anti-inflammatory diet?
    Thank you so much.
    Linda

    • Hi Linda,

      Iodine in Hashimoto’s is a controversial topic, some recommend iodine supplementation for its immune effects (since infections / leaky gut / endotoxins are a major cause of Hashimoto’s) and others recommend avoiding it for risks of thyroiditis/nodule formation leading to hyperthyroidism. There are pros and cons to it so you have to form your own judgment.

      We and our guest blogger Mario Iwakura who has Hashimoto’s and supplements iodine have discussed it — try reading in our hypothyroidism category: http://perfecthealthdiet.com/category/disease/hypothyroidism/

  13. Paul,

    Blog and book are awesome.

    As you know I worked my way from LC to VLC to PHD, in an effort to improve my lipid profile. However, I am one of the 30 percenters whose LDL and LDL-P looks horrible in light of great HDL, great TG, great BP, great body fat, great energy….etc

    I have read a lot about the Pauling Protocol, and it makes much sense to me. Besides, Pauling was the only single 2 time recipient of the Nobel Prize, he was for sure a very very smart man.

    As you may know, he says Lp(a) gets stuck onto damaged arteries which have been stressed (perhaps by smoking, perhaps mechanically).

    Vitamin C is his proposed solution, in high doses, to be collagen fix to the arteries, repairing the arterial walls. In addition, he recommends safe amino acids like lysine to bind to and thus inactivate Lp(a) from sticking to arteries.

    Paul, do you see downsides to such supplements?
    Do you think his theory holds merit?

    thanks as always for all your contributions
    Evan

    • Hi Evan,

      Vitamin C supports collagen production, but so does eating collagen (in joint and bone broth soups), and eating a balanced diet providing sufficient other nutrients.

      I don’t see many downsides to vitamin C supplementation, but it shouldn’t be necessary beyond a moderate dose except in illness.

      • Paul,

        Would it be good to take vitamin C away from iron rich meals (liver, beef, oysters) in the context of an iron rich diet like PHD? It sounds like vitamin C enhances iron absorption.

        Thanks,
        Mark

  14. Hi Paul,

    I have a concern about iodine supplementation. As far as I know. the salt we use is iodised salt, isn`t it?

    When this is the case, why do we need to take additional iodine as a supplement? Even though I don’t eat too much salt in my diet, I don`t want to get more iodine than my body needs.

    If possible, can you please give us more info this. Thank you so much in advance.

    • Hi Ugur,

      If you eat seafood regularly, you won’t need iodine.

      Iodized salt doesn’t have much iodine, so I wouldn’t count that for much.

      I would take a 225 mcg tablet on the days you don’t eat any seafood. That won’t be too much.

  15. Hi Paul,

    This is from a previous quote from you back in January and it was quite eye opening for me. “Hives I take to indicate a vicious circle of an inflammatory immune response combined with oxidative stress; white blood cells produce reactive oxygen species to destroy threats, but oxidative stress reacts with omega-6 fats in cell membranes to create inflammatory molecules that promote immune activity. So some combination of an immunogenic agent (such as an infection or food sensitivity) and an antioxidant deficiency is usually involved. You can try taking NAC, vitamin C, vitamin A, zinc, copper, selenium, and other antioxidants to help. But the key thing is to resolve whatever is underneath.” I couldn’t understand where the Omega-6 fats were coming from since I do not use seed oils, etc. Although I have been a frequent visitor to your site, I am just now reading your book. I now see where some of these Omega-6’s are coming from. I have been using lard on occasion and this is our second time purchasing a pastured pig. I’ve cut down on the chicken we eat, just due to the price of it, but didn’t realize the percentage of omega-6’s in there! Thank you for opening my eyes to this. Now, I understand where some of this was coming from and will definitely cut back. I recently had blood work for IgE testing and it came up very elevated. The doc said I was very sensitive to something I am eating and wants me to get evaluated for allergies, etc. So, like you said, probably some food sensitivity and antioxidant deficiency was involved. Now, to figure it all out. I’ll probably have to try an elimination diet for a while too. Thank you for your insight. Also, you were spot on about my question regarding melatonin. Yikes, that stuff makes you groggy in the morning if you produce enough of it normally. I found that I shouldn’t take it. Now, back to your book. Thanks Paul!

    • Hi Janis,

      Glad to hear of progress. One note — it’s not necessarily the case that you were eating too much omega-6; membranes always have some and so they can be oxidized even if you aren’t eating many. It’s good that you’re seeking the source of your inflammation and also addressing any nutritional deficiencies.

      • Hi Paul,

        Oh my! I didn’t expect to hear back from you so soon. I was just about to write that I failed to mention all of the almond butter and “Paleo treats” I was making with nuts! But, now perhaps that may not have been the case? Well, I’ll keep trying to figure all of this out. It isn’t easy is it? I’m 52 years old! You’d think I’d have by now! I’ll keep reading your book and website and hopefully something will click. Thanks Paul.

  16. Paul, there have been a number of comments made here about iodine. In your book you say to increase intake to 1 mg over time, starting with 225 mcg and doubling after each month. Yet on this blog you just mentioned that 225 mcg is enough for most individuals and not to take it at all if you eat seafood on that day. I’m confused!

    Can you clarify? My thyroid is sluggish, morning temp ranges from 97.3 – 97.6 every day. Should I keep my iodine at 225. I doubled it recently but now worry I’m taking too much.

    Thanks,
    Judy

    • hi Judy, is that oral temp?
      i reckon that’s pretty good, especially if you have no other hypo symptoms.
      mine use to be in the 96’s, but with PHD it’s climbed to around 97.5F (oral) every morning. it’s been stable at that for probably a year now.

      I am happy with 97.5F as i do not have any other hypo symptoms now, plus that temp will rise during the day (circadian rhythm) & depending on activity.

      I think once you get to the mid 97’s in the morning, it’s good to go by other symptoms as well & not overly focus the temp. Morning temp seems to vary somewhat even in healthy people with healthy thyroids.

      just my 2c….

    • Hi Judy,

      The 225 mcg to 1 mg is a range we consider healthy and safe. If you are going to go to 1 mg, we recommend starting at 225 mcg and doubling once per month. But no one is obliged to go to 1 mg.

      I think if you have thyroid issues, you have to form a judgment. On the one hand 225 mcg is sufficient for thyroid function and is very safe. On the other hand, if you have bromine toxicity, higher doses will drive the bromine out faster; and there may be other benefits for immune function in higher doses; yet there may also be risks, eg if selenium intake is far off from optimal, which it can be due to the great variability in the selenium content of food.

      I wouldn’t worry too much over it as long as you’re in our safe range because risks are small, but it’s probably prudent to keep iodine intake stable for extended periods so you can be sure your thyroid is not experiencing a reaction to a recent change in dose.

  17. Under my arm…. My doc concurs with all I’ve read that it should be at least 98. I just began monitoring it about 10 days ago. Maybe for women it should be higher than for men? We have all these hormone issues going on at my age…lol.

    Thanks for your input though!

    Judy

  18. Thank you Paul. How do I know if i have Bromine toxicity? I do eat a couple of Brazil nuts every day for the selenium.

  19. Hi

    I get migraines on a weekly basis which can last up to 3 days is there anything you recommend to relieve them

    Thanks
    Morag

  20. I did. I don’t have any of those symptoms. I also have avoided all of the food sand beverages that I see might have bromide. I was big Fresca drinker. So what does that mean in terms of my iodine needs, in light of my sluggish thyroid?

    Judy

  21. Hi Paul.
    I have been using your diet to try and beat my insulin resistance. I have read that caffiene increasing blood sugar throughout the day and after meals. The highest after dinner. What is your expereinece with that? Will quiting caffiene help booast my results? I also try to save my carbs for later in the day like your book says.

    • Hi Katie,

      Caffeine impairs insulin action so it tends to direct more glucose to the brain and less to muscle. In healthy people it doesn’t affect blood sugar levels but in diabetics it does.

      I’m not sure whether quitting caffeine is a good idea, even for diabetics. Caffeine/coffee/tea seem to help prevent diabetes and they might be good even after it develops.

      I think if you don’t regulate glucose well I would be more inclined to distribute the carbs over your meals. If you do intermittent fasting (16 hr fast / 8 hr meal) with 2 meals in the feeding window, then an equal split of carbs is probably good, so you don’t get a huge carb dose in a single meal.

  22. Paul, I eat out a lot and don’t necessarily know what foods I will be eating in advance.

    If you’re currently supplementing with 2mg a day of copper, and you see beef liver on a restaurant menu, would it be okay to eat that and then go off the copper supplements for a week? Or would that be too much copper at once?

  23. Is it me or are people getting a little OCD over this supplement
    Business. I feel supplements are over rated and definitely
    cause more confusion than they prevent.

    • Hi Chris,

      it’s just you ;-). Have you read the book? I think the new version makes a very good case for why to supplement and what.

      Personally I have experienced many tangible improvements from supplementing. I would say that the most eye-opening ones for me were magnesium (relieved muscle cramps and heart arrhythmia), vit C (constipation and colds), vit D (skin), vit K (nails and teeth), and iodine (general energy level and skin/hair).

      If you don’t notice any difference you might not need supplementation but odds are that people are at least mildly deficient in the above.

  24. Lol,your probably correct, I’m not against supplements just concerned
    People get over concerned about amounts and types, losing
    The bigger picture of eating well. I’m glad you found benefits, I take magnesium myself,and bit d in the winter but I don’t worry about doses but I guess
    Something’s like thyroid you have to be more precise so ill meet you half way lol

    • If you’re inclined to orthorexia, it’s easy to be orthorexic over supplements because you can think about dozens of nutrients and worry over doses of each.

      Hopefully the knowledge that our ancestors did without supplements for millions of years can help people relax, and avoid over-supplementation.

  25. Since I’m on the road a lot and often don’t have kitchen access, I end up eating out a lot. I try to minimize how much omega-6 or vegetable oils I get but in practice I may still be getting more than ideal.

    In this case, what would your recommendations be? I was wondering if I should eat oily fish more often than you recommend for most people, in order to try to get the Omega-3 to 6 ratio better.

    Would it also be important to make sure I’m getting enough anti-oxidants like Vitamin C(?) or something else?

    • Hi ash,

      I would say that if you overeat omega-6, a bit of fasting will do you more good than extra omega-3.

      • Can you explain how fasting helps against Omega-6’s? The chapter on blood lipids mentioned that intermittent fasting was ketogenic and helped with HDL levels.

        Was that what you were referring to or were you referring to some other reason that fasting would help for someone who may overeat Omega-6’s?

        • The body preferentially burns omega-6 fats when they are present in excess. However, when an excess of calories are eaten too, then lots of mitochondrial ROS is generated leading to lipid peroxidation. Omega-6 in the presence of an energy deficit are much less dangerous. By creating an energy deficit at least transiently, fasting enables the body to eliminate omega-6 gracefully.

          • That’s fascinating. I guess that’s the reason people lose ‘stubborn fat’ when intermittent fasting. The fitness community believe that working out on a empty stomach helps get rid of stubborn fat via low insulin, increased catecholamines and increased abdominal subcutaneous blood flow, which means that catecholamines will have an easier time reaching those hard-to-get areas.

            Maybe that’s one side of the story, but I’m guessing it’s more to do with omega 6 being disposed of.

      • Regarding fasting being somewhat protective against omega-6 overconsumption, does most of this effect come from fasting longer *before* eating foods possibly containing omega-6’s? Or from fasting a little longer after you’ve had omega-6’s?

  26. Hi Paul,

    Two questions:
    1) What are your thoughts on consuming chicken feet (including skin) instead of just using it for broth in terms of PUFA content. Is its PUFA density similar to other parts of chicken?
    2) Does PUFA harden in the refrigerator? I assume it does not since Olive oil does not seem to harden in the fridge, and if that is the case, even if you make broth with solely chicken feet, would it be hard to separate the fat from the broth?

    Erich

    • Eric, your olive oil doesn’t harden in the fridge? I use extra virgin and mine definitely does. Interesting. Anyway….

      I make stocks of chicken, pork, and beef. I strain the stock through a fine mesh strainer then refrigerate the stock when I’m done. After it is thoroughly cold, I scrape the fat off the surface, put it in a container, then heat it in the microwave until it liquifies again so any trapped water sinks to the bottom and I’ve got reasonably pure fat to use for cooking. Yeah, chicken fat is really high in omega 6 so I don’t use it too often! Tastes great, though. Refrigerating and scraping defats the stock very well. When I make chicken stock I throw the skins in as well so it probably isn’t much different from your chicken feet.

      Another tip for stock — I freeze it in 1/2 cup quantities in a muffin pan. After it freezes solid, I dip the pan in a sink of warm water for a few seconds (not getting any water on top)and the stock ‘muffins’ pop out easily with just a little pressure in the center of each ‘muffin’. I then store them in a gallon zip-lock bag in the freezer. They will keep for a very long time, and I have stock available in 1/2 cup increments for cooking or just eating. Hope some of this might help… geoff

    • John Henderson

      Would love to know about the chicken feet too!

      When cooking up a big chicken stock from chicken feet I end up eating around 4 feet a day.

    • Hi Erich,

      I think chicken feet are a good food. A little omega-6 isn’t terrible. I’m guessing it is similar to the rest of the chicken.

      PUFA is liquid at refrigerator temperatures. But it floats.

  27. Hey Paul

    Sorry for asking too many questions. I was just wondering if NAC would help with the bromide detox?

    Iv been taking NAC and I find that it has helped with acne and my skin in general. The problem is that I know healthy people shouldn’t really need it and would like to stop it without getting acne. If I do get acne does that indicate that maybe I should take NAC until I’m healed (not sure what the NAC is helping with or how) and don’t get any negative reactions when going off it, and if I do get acen when off it is it safe to take NAC indefinitely?

    Thank you, you’v been a great help Paul!

    • Hi jessica,

      NAC is probably helping by improving glutathione status. Antioxidants, especially vitamin A or analogs like astaxanthin, often help in acne.

      NAC is pretty safe so as long as it’s helping the acne I would take it. You might try eating more liver as an alternative.

      • Okay great, Vitamin A as beta carotene and also retinol would help. Is it correct that I can’t overdose on beta carotene, so I don’t need to put limits on carrots, sweet potatoes etc. But do need to track retinol or actual Vitamin A from yolks and liver and not exceed is it 70’000 iu a week?

        • Yes, that’s right, you won’t overdose on carotenoids so eat as many colorful vegetables as you care to and don’t worry; liver you should limit so that A doesn’t exceed 70,000 IU/wk … this is still a generous amount of liver.

  28. Paul, I was looking over lists of omega3/omega6 oils, and high-oleic >70% sunflower oil really stood out to me at 1gm omega6/oz — only twice what coconut oil is, and only a bit over 1/3 as much as olive oil. I usually use coconut oil for cooking, but it isn’t always appropriate — and another source listed the smoke point for refined ho sunflower oil at 450F, way higher than coconut oil.

    Is high-oleic sunflower oil getting a bad rap, or are there other issues with it? I do know that the regular sunflower oil omega6 content is massive (12 times greater than the HO version).

    thanks…

    • Hi Geoff,

      Based on fatty acids, high oleic sunflower oil should be an excellent oil. I haven’t looked into whether there is anything else in it to be concerned about. In processed foods there’s always a chance something gets modified or introduced.

      • I found this study which seems to imply that olive oil has more health benefits than HOSO. The chemistry is way over my head though. http://jn.nutrition.org/content/128/3/570.full

        • Also there is a high oleic safflower oil .

          I am doing a mayo demo on Saturday. I always use a high quality olive oil, but many people find that too strong a flavor for mayo. So I will also recommend macadamia nut oil and avocado oil. But they are expensive.

          So I was wondering if I could recommend either or both of the high oleic oils

          • Walter Bushell

            How about MCT oil? Very low flavor aside from oily stays liquid at 25F or -4 C so liquid in refrigerator.

  29. The book and this forum have been fantastic resources for me — thanks, Paul!

    I’m unable to make regular bone/collagen soups due to travel. I also have a foot injury which is healing slowly and might either be bone or ligament related. Feels like it’s been at 85% for a while.

    I only recently started supplementing with D, K2, and Magnesium but I was wondering if you think calcium or supplements related to gelatin/collagen might be useful.

    (I eat cheese maybe 2 times a week and leafy greens maybe 3-4 times a week)

    • Yes, calcium up to 300 mg/day and gelatin/collagen might help, as might boron and vitamin C. Bone and joint broth would be even better though, when you have time try to fit it in.

      • If I’m supplementing both calcium and magnesium, do you have any thoughts whether you should take them together or at different times of day?

        Some sites on the internet say it’s better to take them together for absorption reasons, but other sites I’ve seen said that they compete with each other for absorption.

        • I think it’s best to take them with food. Food spreads out absorption over a long period of time so there is little competition; it also provides companion nutrients that may improve absorption, such as amino acids that can chelate the minerals.

  30. Hi again Paul, i just posted the question below here,
    http://perfecthealthdiet.com/recommended-supplements/comment-page-22/#comment-140003
    before i realised it was in reply to an oldish comment (on page 22 of comments).

    so rather than it getting lost, i’ll paste the question below, apologise for the duplicate.

    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.

    Thanks

    • Hi Darrin,

      It’s plausible that pepsin might be needed because pepsin production and stomach acid production are correlated. Pepsin only works in a low-pH environment.

  31. Paul, thanks for your replies to my questions. I don’t want to litter the list with content-free ‘thank you’s but I sincerely appreciate them.

    The topic of autophagy sounds fascinating, and I’ve been doing the 16-hour fasts. Some days are a bit easier than others…. Not that I feel intense privation, but I guess it’s more the desire to eat something for the sake of eating rather any any real hunger. I do sort of break the fast in the morning with 2 tbsp of coconut oil (drunk straight — I tried it in (or rather ON) a cup of green tea and the oil slick was quite off-putting to sip through). I find that drinking the oil straight is much more pleasant.

    You said this didn’t disturb the autophagy because the oil was shunted to the liver to be broken into ketones which actually helped the process.

    I’m curious about the effect of alcohol on autophagy — it is broken down by the liver as well. I wouldn’t expect it to help the autophagy, but does it significantly disrupt it? I ask because my wife and I often have a glass or two of wine late in the evening once all the work is done and our son is in bed. I know this likely interferes with the circadian rhythms, but does it sabotage autophagy as well?

    When I searched the web looking for autophagy and alcohol I saw references to studies where autophagy was highly beneficial to the livers of alcoholic rats, so that is something anyway! I didn’t really find was I was looking for, however.

    • Hi Geoff,

      A glass of wine at night is fine. There’s evidence it might be helpful.

      Autophagy is not something you want going on all the time. You want cycles of building up the protein content of cells and then reducing it by autophagy. In each cycle of reduction, microbes are preferentially targeted. This is why intermittent fasting is so powerful.

      But if all you do is tear down without ever building up, you hurt yourself. See our chapter on Fasting in the new edition.

      So, don’t worry, stick to the intermittent fasting but otherwise seek to live a normal, satisfying life.

      Best, Paul

      • Paul, I see nothing about that in the chapter on Fasting in your new edition. The only comment I see about it is in your Takeaway secion “We believe 16 hours is the optimal length for fasts. This is short enough that it is possible to repeat daily….” I see nothing to indicate you would not want to repeat this daily. Did I miss something?

        Also in this chapter, I am somewhat bemused by the section “When Pathogens Fight Back” which says that many pathogens are immune to autophagy or even turn it to their advantage. Is this section merely pointing out that autophagy is not a panacea? The rest of the chapter is dedicated to showing the benefits of autophagy, but this section says the bugs win anyway.

        • You can repeat the fast daily, as long as you eat enough during the daily feeding window to satisfy all nutritional needs. If you don’t, it’s like a long fast which leads to problems.

          • Paul,

            For the definition of “being on a fast” that you are using, I’m still a little confused as to what foods don’t break the fast.

            Based on your examples in the book, it sounds like having coffee + coconut oil, or broth + spinach/tomatoes aren’t considered to be “breaking” the fast.

            But then in the chapter on fasting, there is the example of Kitavans who eat stuff like bananas or mangos during the day. Would eating that be considered to be ending the fast?

          • All foods break a fast in some respect, this issue is whether it is a respect you care about.

            If your concern is neuronal health, then a fast provides ketones and a non-fast glucose, so MCT oil doesn’t break the fast.

            If your concern is diabetes, then an oil does break the fast.

            The other point is that fasts can be total or partial. A partial fast can be as strenuous as a total fast if it is continued longer. So these are alternative strategies. A partial fast with spinach/tomatoes/broth may be superior in healthfulness to a total fast.

  32. Oh, and it may seem like I’m really stressing over this. I’m not. I want to try to understand the why’s as much as possible so that I can make reasoned choices. Most of the time I’ll be good. Sometimes not. I wish to minimize the harm while still enjoying myself. I’m just trying to find reasonable boundaries, and my tradeoffs may not be yours. It’s the engineer in me! Thanks for answering the questions. This is a fascinating way of looking at nutrition….

  33. Hi Paul,

    1) Is there an easy litmus test to determine whether a batch of fermented vegetables is safe to eat. We are on day 6 now following your fermented vegetables post, and it smells a bit like dirty laundry in the pantry.

    2)Recently, I’ve been eating the same amount of japanese sweet potatoes, but I would take half of them, place it in the refrigerator and dress it with vinegar for dessert. This has increased my resistant starch intake. At the same time, I have noticed increased flatulence(gas). Should I cool off less of the RS for my meals and consume them heated, moving slowly to increasing the amount?

    Thanks,

    Erich

    • Hi Erich,

      1. I don’t know. Ours don’t have a strong smell. Try eating a sample and see how they taste. You want the brine to have turned acidic. … We’re going to have another fermented vegetables post tomorrow or Saturday.

      2. I think slowly increasing the RS might be a good idea. You want to build up all the bacteria you need for proper digestion.

  34. Reading the book & the blogs – what I don’t see is what to do dietarily about asthma/chronic bronchitis with a LOT of mucus production and wracking cough. (People at work think I should quit because of this uncontrollable, noisy, disruptive, disgusting, productive cough.) I’ve been told to avoid dairy, but the PHD would be miserable without it, especially since I am allergic to shellfish and hate fishy fish. Any suggestions? I’m drowning here! Thanks for any help you can give. I do think I do okay with butter and processed dairy, but I never drink milk because it does seem to increase mucus production. Thanks!

    • Hi DJ,

      The most important thing you need is vitamin A, along with vitamin D3, K2, and C.

      The best source is liver, too bad you don’t eat it.

      If you can’t force it down then find a cod liver oil supplement that has high vitamin A, and get 7,000 IU/day. Get enough D3 to optimize serum 25OHD, and ~100 mcg K2.

    • If you’re allergic to dairy then you’re allergic to dairy. Giving it all up, even ghee has made a huge difference to me. The PHD is still brilliant without it, it won’t take long for you to adjust. Often we are most addicted to the foods that cause us trouble, it does sound to me that dairy is likely an issue for you.

      • Hi Adam, When you say giving up ghee has made a huge difference to you does that include digestive issues? It never occurred to me that ghee could be one of the things keeping me from healing my gut. I will cut it out for a while and see.

        Thanks!

        • If dairy impacts on your digestion generally then I would definitely exclude ghee. My experience recently was an attempt to reintroduce ghee after 6 months without it. Only cooking my meal with a small amount produced a sore throat. I repeated that again with identical results. So there is still enough milk protein in there to cause me trouble.

  35. P.S. Unfortunately, I find liver and other organ meats to be extremely unpalatable – nauseating and vile. Worse than fish. Doesn’t matter how nicely it is prepared. Would this mean that I must supplement?

  36. Hi Paul-
    I have been using your original supp. rec.,Idoral,and built up to 6 mg a day…How do I work back down to 225 mcg to 1 gr so as to be in that safe zone?…I take 400 mcg selenium per week also.

  37. Hi Paul!

    I recently got your book and I’m halfway through and it is FANTASTIC, and I was greedy enough to ask 3 questions on the Reddit post you were recently on and you answered all of them so MANY thanks to you!

    I know you’re not really an advocate of taking a multivitamin, but for affordability and for the sake of convenience, I found a multi by Rainbow Light (http://www.iherb.com/Rainbow-Light-Just-Once-Women-s-One-Food-Based-Multivitamin-90-Tablets/1797) that seems to include a LOT of what you recommend, and it seems fairly decent. I would still have to supplement a couple things such as Iodine, but is this a viable option? Or should I just buck up and get everything separately?

    Thanks!

    • Hi Kelly,

      I think it’s better to get everything separately, you can trim down the supplement list if you eat well so it’s not bad.

      But, we try to give arguments so that you can form your own judgments. A multi isn’t necessarily bad, but I wouldn’t take it every day.

  38. Hello Paul,

    I’ve been following the Perfect Health Diet along with supplement recommendations for a few years now, but of late find myself confused and worried about the excipients used in the recommended supplements. For a lay-person, it’s almost impossible to separate rejection of flawed mainstream medicine with unfounded paranoia.

    My main areas of concern are the titanium dioxide, magnesium stearate, stearic acid and mono- and diglycerides commonly added to supplements.

    If even saturated fats can breakdown into harmful compounds and become rancid when exposed to heat, light and oxygen, why are the fats and fatty acids processed into supplements any different?

    Does isolating a pharmaceutically pure substance like stearic acid negate rancidity issues?

    There is a lot of confusion about whether magnesium stearate and mono- and diglycerides have been hydrogenated and thus contain trans-fats. What’s your position?

    Titanium dioxide stimulates ROS. Would you be concerned?

    Thank you kindly,
    Anna

    • Hi Anna,

      To be honest I haven’t looked into these issues. The doses are in most cases small, so they are probably not very harmful, but these compounds are a reason to favor food as a source of nutrition. We may continue to lengthen the list of supplemental foods (eg, add oysters for zinc) to help people who want to eat a food-only diet.

      • Hi Paul,

        Thanks for your reply.

        I confess the constancy of my intake still bothers me. I’d be grateful if you could point my rather unscientific self in the right direction for a little independent research.

        • Hi Anna,

          What I would do is just stop supplementing and go food only periodically, and see if you feel better or worse. Then start up again and see if you feel better or worse. Experimentation is the surest guide.

  39. Hi Paul, I started PHD about a month ago in an effort to find a diet that might help my health. I was recently diagnosed with muscular dystrophy, which has also resulted in heart arrhythmia (just got a pace maker put in – I’m only 40). I am desperately trying to find ways to slow down the progression of the disease and am hoping PHD might help. With that, could you offer me your recommendations for how I should tweak the diet/supplements for my situation? Thanks so much. Hillary

    • Hi hillary,

      We don’t have experience with muscular dystrophy, but I do believe that the more things you optimize, the better your body will be able to cope with its genetic defects.

      Do you know what specific form of the disease you have? It might be a good idea to get genetic testing from 23andme to see what specific mutations you have. Knowing the genes that are impaired may help suggest tweaks.

      Best of luck, keep me posted on how things go.

      Best, Paul

      • I have desmin storage myopothy, so I believe it’s just the desmin gene that’s effected. My doctor suggested I take CoQ10, but there aren’t any studies that strongly suggest it helps. I’ve just started on your recommended supplements, although wonder if I should up my dose of magnesium citrate (taking 280 mg/day) and D3 (taking 2000IU/day). There’s not much you can do for this disease, which is why I’ve turned to diet as a possible aid. I really appreciate your feedback, and I can tell you that finding PHD has been life changing (regardless of why I started it!). Thank you very much, Hillary

        • Hi Hillary,

          I don’t know. I would guess that intermittent fasting is a good idea, as autophagy may help clear protein aggregates. Mitochondrial support might be helpful, possibly CoQ10, NAC for glutathione, low omega-6, balanced omega-3. The experience of other patients with the disorder might be helpful.

          May I ask how specifically PHD has been life changing?

          • Super, thanks for the suggestions! Life changing in that it’s the first “diet” I can see being a long term lifestyle, I’ve already lost ten pounds without trying and for once I’m eating healthy because I want to be healthy, not because I want to lose weight (although that’s been a great benefit). It’s much easier to stick with something because it makes your body feel good, not for the fad of it. I’ve got my husband on it as well. We’re eating things we never thought about making before – I’ve recently made goat and oxtail stews, which was a first. I don’t crave sugar anymore, which is amazing and I love that I can still eat chocolate daily (I have a square of 90% topped with a date to sweeten it up) and a glass of wine. I actually just sent your book to my dad, who also has MD, trying to convert him as well. So with that, a big, big thank you, but not just for the information but making yourself available here, offering your time, very cool of you 🙂
            Hillary

  40. Hi Paul,

    Regarding the fermented mixed vegetables post. After 7-10 days, when you open the seal for the first time, what is the procedure?

    1) Do you then transfer all the vegetables onto a different container or continue serving from the same container?
    2) It seems for your second batch, you reused the first batch. Do you only reuse the liquid from the first batch or the vegetables as well?
    3) You mentioned that you shouldn’t let it ferment for more than 7-10 days. If you are reusing the batch, isn’t that fermenting longer?

    Thanks,

    Erich

    • Hi erich,

      We just take out the amount we plan to eat that day, and re-seal the container.

      We haven’t been re-using anything. When a batch gets old, we make a kimchi soup.

  41. I have one instance of the MTHFR gene mutation. Do you think I would need to supplement with methylated folate and methylated B12? I have been told that I should supplement with 5-MTHF 10 mg /day and 5 mg methylcobalamin based on having the MTHRF gene mutation. I try to get as much nutrition through food as possible and these supplements are pretty pricey so I’m wondering if they are really necessary. What’s your take? Thanks!

    • Hi Sara,

      You don’t need to do anything so dramatic. Keys are (a) avoid folic acid, including fortified foods (ie rinse white rice before cooking to remove any enrichment mixture; don’t buy enriched rice); (b) try to get plenty of natural food folate by eating nutrient-dense foods eg organ meats; (c) eat lots of choline rich foods including liver and egg yolks; (d) maybe supplement B12 but not 5 mg. 500 mcg would be good.

  42. Thank you so much for your response, Paul. I appreciate it!

  43. Hi Paul,

    The fermented vegetables were a SUCCESS!!! delicious. We are now starting to eat it on Day 7 of the ferment. A couple of quick questions:

    1) When we are removing the vegetables, the amount of air in the container will increase due to the lowered volume. Should we be adding water and salt to replace the volume so it stays appropriately anaerobic?
    2) How many days on average would you say we have to consume the vegetables (after the 7 day mark)? Is it just 3 since you had said 7-10 days for a ferment?
    3) After the number of days in (2), should we refrigerate it so it will last longer?

    Erich

    • Hi erich,

      1) I don’t think so. This decreases the acidity which changes the species that grow which means you may need to wait a few days – like starting a new ferment.

      2) If you had no added sugar and not too sugary plants, you’ll have at least a week. If it had added sugar, maybe only a day once it sees oxygen.

      3) Once it starts going bad I would cook it to kill bacteria. You can make it into a soup.

  44. Hi Paul,

    That’s good to know that we shouldn’t really add water to the fermented vegetables after taking some out.

    1)Should we be adding salt to the fermented vegetables after taking some out to keep the bad bacteria at bay?
    2) Would you prefer transferring it to a more shallow container to decrease oxygen?
    3) What are your thoughts on immediately refrigerating it after 7-10 days and then consuming as we see fit (of course cooking it if it starts smelling/tasting bad)?

    Erich

    • Hi erich,

      We do transfer to a smaller container as we eat it. But don’t let the ferment touch a plastic or metal lid, as the acids may leach unhealthy compounds.

      Transferring to the refrigerator does slow down microbial change; we do it once it starts getting more sour, typically about day 7-10.

      You can add salt to taste. Ours hasn’t needed it. If it’s acidic you don’t need to.

  45. Hey Paul

    Some weeks I’m unable to make bone broth, and I worry I don’t get enough calcium as I’m also involved in weight lifting. Could I take the following supplement to provide 1g of calcium once a week:

    http://www.jgsupplements.com/products/cal-mag-d3-240-softgels.html

    That would give about 150mg of calcium a day, plus 400mg I obtain from food. Is 550mg of calcium altogether an okay amount. I heard somewhere in the paleosphere that 500-700mg is best.

    Also I’m trying to lose the last few 5-10pouds of fat which I’m finding quite hard and slow whilst maintaining muscle. I’m 5’10 male,71kg;61kg lean body mass (15% bf)trying to eat at around 1500-1700 calories on active rest days and 2500 on training days. I’m just finding it hard to lose the midsection fat. Maybe I need to forget about losing weight and increase calories to maintenance, focus on just putting on more muscle and slowly the abdominal area will recompose itself?

    P.S to cut calories whilst getting more beneficial nutrition from dark chocolate and fermented dairy like yogurt, mix 1-2 tbsp cocoa in yogurt to create a moose and eat with a banana, works great and saves the extra 150 calories from eating store dark chocolate!

    • Sorry I forgot to mention that I’m getting 75g protein from meats, but I get another 10-15g from other sources like starches, dairy and bits from fruit and veg, it all adds up. Do you think 75g is enough for a 5’10 male at around 70-80 kilos?

    • Hi Arian,

      Yes, you can take that calcium supplement. We don’t have to get identical amounts of nutrients every day.

      Around 700 mg calcium per day is optimal.

      15% body fat is optimal for health. That is how your body naturally wants to look, if you optimize everything for health and longevity. To generate that very lean cut look, you have to use specific techniques that are unhealthy. So unless the fat is concentrated at your waist, your bf percentage is fine.

      If the last ten pounds are in the waist, then it probably indicates some inflammation/leaky gut. Try yoga breathing exercises to massage the gut, that encourages healing.

      75 g protein is enough, but if you are seeking a cut look, then you may need more.

      • 15% body fat is optimal for health. That is how your body naturally wants to look, if you optimize everything for health and longevity.

        Hi Paul,

        Do you have additional references, I don’t recall this discussion before in the books/blog.

        Thanks,
        Mark

        • I’m collecting notes on the topic for future blog posts. You’re right, it hasn’t appeared yet.

          • Thanks Paul, and looking forward to that post as well. I’ll try stress reduction and maybe having less fructose and see if it helps with the gut too.

            🙂

          • Woo! I too am excited about this future post! I am interested in the part where you will talk about the unhealthy methods one must take to achieve leanness beyond the 15% you mention above (which I assume is for men and that for women the equivalent would be 22% – 29% or so?).

            I find myself carb cycling a lot and often favoring high protein/low fat in periods of cutting and wonder just what sort of long term damage I am doing. Very interested to hear your thoughts, Paul!

      • Hi Paul,

        If you are carrying a bit of fat around the waist. How do you determine if this is a healthy amount of fat ie. not too much, or not an abnormal distribution of fat.

        Is it just a mirror check of front, sides & back.

        Or may be a pinch test (between thumb & index finger) of front (around belly button), sides (above hips) & back (either side of spine).

  46. Around the Web: Palm Sunday Edition | Perfect Health Diet - pingback on March 24, 2013 at 2:48 pm
  47. Katie Grunhard

    I know you say beer is okay every once in awhile. I’m on a gluten free diet but I like beer. I have avoided it though. Does the brewing help the gluten and make it easier to tolerate? Thanks.

    • Hi Katie,

      Beer is not safe for celiacs, but as a fermented barley product it is much less risky generally speaking than bread or other unfermented wheat products. So if you don’t have overt celiac disease and are just avoiding gluten for general health reasons, I think beer is OK in moderation.

  48. I take 50mg of Zinc once per week as recommended but I need some clarification if you don’t mind. Is this 50mg of zinc monomethionine or elemental zinc? From what I understand, the actual amount of elemental zinc in zinc monomethionine is much lower than 50mg.

    Also, my son is taking 50-100 mg of Niacin a day for acne/acne scars, is this harmful?

    • Hi Janis,

      It’s 50 mg zinc.

      The niacin isn’t very dangerous. Is it working for his acne?

      • Hi Paul,

        My son actually has a question regarding the zinc. He is wondering why companies sell their product containing 50mg of zinc, and the recommended dose is to be taken everyday, when actually this dosage can be harmful? He began to take it everyday until I finally got to that part in your book and told him about it. Also, if niacin is a nutrient for bacteria, then I’m wondering how that could help someone with acne. He just started taking it so I am not sure if it is helping yet. The word online, is that it works. I just wanted to run this by you to see if you’ve had any experience with it. It’s good to hear that it isn’t very dangerous. Thanks Paul.

        • Hi Janis,

          Companies sell what people want to buy. When people are deficient in zinc, they can take 50 mg/day for several weeks and still get benefit from it. This can support immunity, reduce acne, or have other visible benefits. So it’s not uncommon for people to report benefits from this, and to spread the word to others. But if they kept taking it every day, eventually it would begin to do them harm.

          • Hi Paul,

            Thank you for your response. Yes, that certainly makes sense. One more question please, if you don’t mind: I’ve been taking the Doctor’s Best magnesium, but have been taking one in the morning after breakfast and one around 8pm. Since I am not sleeping quite like a baby yet, should I be taking the entire dose at bedtime to help me sleep? I finally finished reading your book! I appreciate all of the research you and your wife have done. Thank you!

          • Hi Janis,

            I think it’s good to spread it out as too much at one time can stress the kidneys. It sounds like you’re getting enough magnesium so I’d look elsewhere for a sleep fix.

  49. What is iosol iodine and how does it compare to the potassium iodide tablets you recommend?
    Thanks for your response.

    Judy

    • Hi Judy,

      The main difference is the dose — Iosol has 1.8 mg iodine per drop, the tablets we recommend have 225 mcg, which is about 1/8 as much. So if you use the Iosol, I would suggest diluting each drop into water that you take over eight days.

      Iodine dissociates from the potassium or ammonium in water, so they really don’t matter.

  50. Any supplement recommendation for fighting a poison ivy rash? I’ve been on the diet and supplement recs for about 2 months now and feeling great…except for this now…happy spring!

    • Thought I should also mention I’ve been itchy (bearable) for 2 weeks and also feel a cold sore coming on now.

      • OK I’ve gone back and read part 4 of the book. Having HSV am I a candidate for extra iodine supplementation? Before starting PHD my lipid test showed a total cholesterol of 170 with an HDL of only 61. Will it take awhile (>2 months) to see improved immune function?

        • Hi Amy,

          I’d just do moderate iodine supplementation — 225 mcg/day if you eat a lot of seafood, at most 1 mg/day if you don’t — for a while. PHD should improve immune function significantly in 2 months. One indication would be a more normal total cholesterol (200-230).

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