Supplements

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

Supplemental Foods

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

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

Daily Supplements

These are supplements we recommend be taken daily:

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

Weekly Supplements

These are supplements we recommend be taken once a week:

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

Prenatal Supplements

The most important prenatal supplements are:

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

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

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

Optional Supplements


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

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

Therapeutic Supplements

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

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

Miscellaneous


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

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

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Leave a comment ?

4,096 Comments.

  1. Paul, thank you for your work and for continuing to answer questions. I found your book after years of low carb and more recently vlc eating have led to many health problems and malnutrition. I’ve started PHD and am slowly getting back to normal. I have to admit that I nearly abandoned it because of weight gain, but after reading and multiple rereadings, I’m going to stick with it and hope restoring good health restores my physical fitness in the long run.

    Now, my question.

    I’m 52 and 10 pounds overweight. I’m deficient in B12 and D and not at optimal range for most micronutrients. In addition, my total cholesterol is low and has been low for many years. Sometimes looking back, as low as 145! (Doctors used to congratulate me on my lipids.) My numbers as of last year are:

    Total Cholesterol 188
    HDL 99
    LDL 75
    Triglicerides 69

    I’m waiting for more recent results on tests last week.

    I’ve been experiencing most hypothyroid symptoms, from weight gain to hair loss to dry skin to constipation, etc., all of which I hope will improve with the diet. I’m writing today though about my tinea versicolor and the cholesterol connection.

    After reading your posts on cholesterol and some other articles about cholesterol sulfate’s role in melanin production, I’m wondering if my low cholesterol and vitamin d suppressed cholesterol sulfate to my skin (because cholesterol was more needed elsewhere in my body), leaving my skin vulnerable to fungi overgrowth, and if so will TV improve with circadian rhythm training + increasing my total cholesterol level and vitamin D?

    I’d like to avoid taking anti-fungal medication recommended by my derm. I’m also worried about the advice to stay out of the sun. I do understand that the spots that have no melanin are vulnerable, but how to temper that with the need for sun on my skin to improve vitamin d.

    Do you have any advice?

    -Sally

    • Hi Sally,

      First, regarding weight, watch my talk on weight loss: http://perfecthealthdiet.com/2014/08/ancestral-health-symposium-tak-weight-loss/. Note that there are health improving causes of weight gain so it’s important to prioritize health over weight.

      Your low LDL is an important clue. Normal is 130. Your levels commonly indicate iron deficiency anemia, less commonly hyperthyroidism or parasitic infections. You should get a thorough checkup including tests of iron and thyroid status.

      Fungal infections are common when too low carb and malnourished, but should go away on their own with better nutrition. Likely to help are carbs, vitamin a, vitamin d, vitamin c, iodine, salt, magnesium, chromium, copper, taurine, glycine, N-acetylcysteine.

      Best, Paul

      • Paul, you’re so on track it’s scary.

        My diagnosis is pernicious anemia. When I think of the many years I’ve been having joint pain, brain fog, depression, extreme fatigue, etc. undiagnosed it makes me sad. I don’t understand why b12 tests aren’t standard.

        So, further testing is happening to learn why I’m not producing intrinsic factor – ie: parietal cell ab, igg – that’s looking for infections affecting gut lining, I believe – gliadin antibodies and tissue transglutaminase, both re: celiac. I’ll be seeing a gastro.

        I’ve also requested DNA testing, as some cousins (celiac) have the MTHRF mutation and nephew (autistic) has a double mutation. The B12 I’ve been taking is cyanocobalamin form, not the methylcobalamin form. I understand people with the mutation can’t utilize the cyanocobalamin form, so could it be that?

        I’m wondering what protocol in the book I can be following? AP is an autoimmune conditions, so will the sections on things like Hashimoto pertain?

        Best,

        Sally

    • Sally your lipids are similar to mine.

      I note you are B12 deficient as I was.

      I have B12 injections every 3 months as I live in UK.

      I am not clever enough to offer advice but getting my B12 up did make a big difference to my health.

      • Hi Marcus, I don’t know why US docs don’t tend to give B12 injections. I would prefer it to having to take vitamins every day.

  2. Thanks so much. I really appreciate your advice.

    I had just read about N-acetylcysteine and have it on order. I was diagnosed with Dupuytren’s and now I’m getting nodules in my feet, rather painful, which would indicate Ledderhose disease – rare in women. No one in my family that we know of had either. I plan to have DNA testing done.

    I’m already supplementing D – 1,000 units a day. I’ll add C and A, chromium, glycine now.

    Re: Iodine, I changed my salt to iodized salt when I first read the book. Is that sufficient? I rarely eat seaweed, but I can make the effort if it’s needed.

    For magnesium, I just started a TBSP of magnesium sulfate every night both to help with constipation (and hopefully it will help with the circadian rhythm training). Is that sufficient for magnesium intake?

  3. Hey Paul! Thank you for all your work. My wife and I have been trying to conceive for quite some time now (2 yrs). We are very disciplined in our eating, however we are dealing with some issues (PCOS) that require even more diligence in our efforts. I would like to know what you might recommend for male supplementation when trying to conceive?

  4. Dr. Paul,

    Is there a relation between copper and estrogen/estradiol? I have high E2 levels and seem to be this way naturally, and have noticed some anxiety and depression with copper (Thorne, 2 mg). After some studies it seems that excessive serum copper could result in anxiety / depression disorders, and even Alzheimer’s. Further reading led me to some studies suggesting that high estrogen may actually increase copper.

    • Hi Andy,

      Copper and zinc need to be in balance, and high copper can induce a zinc deficiency, which is associated with anxiety and depression, see http://www.ncbi.nlm.nih.gov/pubmed/23946656 and http://www.ncbi.nlm.nih.gov/pubmed/23946658.

      So you might try getting more zinc as well as reducing copper intake for a bit.

      Best, Paul

      • Speaking about copper/zinc-balance. This is my main issue as well and I don’t know how to tackle it.

        My lab work shows:
        Low-normal serum copper
        Low-normal serum zinc
        Low-normal ceruloplasmin
        Low RBC-copper
        Normal RBC-zinc
        High hair copper
        High-normal hair zinc

        Other related issues that I have are anemia, fatigue and dysbiosis/yeast overgrowth.

        My diet is similar to PHD with lots of soups and stews made with bone broth but I don’t eat as much carbohydrates and vegetables as you advice because I don’t tolerate them very well.

        With regards to lifestyle practices I try to manage my circadian rhythm as much as possible and do intermittent fasting 14:10 daily.

        I currently take all of the supplements you recommend, although I take vitamin A as palmitate from Thorne weekly instead of vitamin A from Cod liver oil. In addition I also take extra molybdenum, NAC, liposomal glutathione, liposomal vitamin C and probiotics since I don’t eat/tolerate fermented foods.

        Obviously there’s something wrong with the bioavailability of copper but I don’t know how to correct it. I’ve been thinking about adding a copper supplement and/or to start eating liver again but previously when I’ve eaten liver I have felt somewhat anxious and mentally “out of balance”.

        In any case, something needs to change since I’m not going anywhere with what I’m currently doing and I’ve been dealing with this for several years.

        What do you think Paul?

        Any advice would be greatly appreciated!

        • Markus,
          You might want to check your 24h-Urine Copper. Do it 2-3 times. If it is consistently very high then you might have one of several copper-related genetic disorders i.e. Wilson’s Disease.
          I have low serum copper with low-normal ceruloplasmin. Tested for Wilson’s disease several times and came out negative. After 2 months of copper supplementation I managed to increase my serum copper levels to low-normal.
          Since I have some form of GI infection I suspect that opportunistic pathogens are stealing copper away.

  5. Does anyone have trouble with the once a week dosing of the B vitamins? When I do this I seem to be OK on the day I take them, although sometimes they can make me a bit tense and give me trouble sleeping, even when I take them in the morning. The next day though I often feel horrible.

    I’ve done this several times in a row so I know it is the B vitamins doing it.

  6. Hi,

    We recently moved to Okinawa, Japan and no longer have access to pastured liver of any type. We’ve been taking copper and Vitamin A as recommended, but I recently came across grass-fed liver capsules. Since whole foods are better than supplements is there a reason why liver capsules aren’t recommended instead of copper and A? My inclination is that you’d get some of the other nutrients from liver by doing the capsules vs the other way. I’ve looked around and bit and didn’t see an answer so I hope this isn’t redundant.

    If it matters, I’m currently 12 weeks pregnant.

    On an unrelated note, how do people get their yolks in? I hate to throw away food away, so I typically eat a couple of whole eggs each day. I seem to remember reading know that eating eggs regularly increases the likelihood of developing a sensitivity to them.

    Thank you for your help!

    • idk if liver pills are phd acceptable, but I do know there are two types;
      Defatted & non defatted,
      you want the non defatted type, since these should contain the fat soluble vitamins (I think).

    • Egg sensitivity is usually from the whites.

    • Hi Ashley,

      I find mixing egg yolks into hot rice or hot potatoes works really well (easy and delicious).

      Also, yolks mixed in with chicken & rice soup (like Paul has blogged).

  7. Hi Paul i hope you and your family are doing well. Lastly I’ve reading about the gcmaf and its link with the solution or some improving of cancer, Lyme, and a lot of other illnesses
    Has it some merit?
    Thank you

  8. Hello,

    What are your thoughts about Spirulina?

  9. Just returned from a visit to my ophthalmologist because I had sudden and brief partial loss of vision. First occurred in April, bottom half of field of vision went grey for many seconds, maybe 30, then cleared. Decided it was debris in my eye. Then, a couple days ago it happened again, but for fewer seconds. Doc said it was a shot over the bow and is referring me for medical tests to check condition of my arteries. Said it was a TIA in a capillary in the back of my eye. So…”stroke.” He did not use that word, though. Ordered me on fish oils and aspirin. I eat my 3/4 to 1 lb of salmon a week. Realize I have not been taking ubiquinol since spring. Don’t know what happened with that; just careless, I guess. I would appreciate thoughts about this. I haven’t taken fish oil since 2011 when I started making certain to get the weekly salmon.

  10. Dr. Paul Jaminet,

    Andy here again. My question is on vitamin C and iron. My blood work shows a high level of serum iron – in fact, it increased from 65 μg/dL to 171 μg/dL! Coincidentally, per PHD I have been taking 500 mg vitamin C. According to some research, vitamin C may help iron absorption. Any thoughts on possibly cutting vitamin C out?

    Otherwise, my diet is pretty similar to PHD.

  11. Question on the daily vs. weekly supplements. Should I drop the pantothentic acid at 500 mg daily if I am also taking a weekly B50?

  12. Hi Paul,

    I’m confused by the note under “Glycine” that says “…desirable if you don’t eat daily extracellular matrix… up to 2 teaspoons (10 g) per day”.

    The 10 g figure comes from here (http://www.ncbi.nlm.nih.gov/pubmed/20093739), I assume?

    But collagen is 22% glycine by weight, so you’d have to eat 45 g of collagen — which would represent roughly half of the total protein intake recommended on PHD! — to obtain 10 g of glycine.

    So, would glycine supplementation be beneficial even for those individuals who do eat extracellular matrix, but derive less than half their total protein intake from it?

    Best,
    -Eric

  13. Hi Paul,

    I’ve recently seen a number of blood test results from men who have increased their testosterone levels by supplementing with 6mg per day of boron.
    I’ve read, however, that supplementing with boron lowers manganese levels. I know that you are against supplementing with manganese, but do you think it would be safe to take an 8mg tablet of manganese once or twice a week while taking 6mg/day of boron?
    Thanks.

  14. What do you think about Protein Shakes (Whey Protein Isolate) and BCAA´s, Creatin, Glutamin etc. for professional athlets for supplementation around training etc.?

  15. Is it OK to take Kelp pills as an Iodine supplement?

  16. Hi, Someone asked earlier about Spirulina…I have been taking this for years with great results (no colds/sickness, better energy). It seems Spirulina would be a good substitute for seaweed. Would appreciate any thoughts you have on this, Thank you!

  17. Hi. Would anything help a thyroid nodule? My Endocrinologist wants me to have my left side of my thyroid taken out but it’s been biopsied and is non-cancerous. My thyroid levels are normal and I have no symptoms. I’d love to keep my ENTIRE thyroid but just shrink the nodule. I eat very little iodine as I don’t like seafood. Any suggestions? Size is 2.7cm (transverse) x 3.0cm.

  18. Re Lithium.On amazon co.uk:-
    on Amazon for “Liquid Ionic Lithium Ultra Concentrate – 10 Drops Equals 500 Mcg – 100 Servings

  19. Does anyone know Paul’s thoughts on ubiquinol ? Thanks.

  20. Could you elaborate more on what you mean when you say “Prescript Assist includes soil-based organisms that are a little riskier and should be taken only occasionally”

    Thanks

  21. Hi Paul,
    Two questions:
    1) If it’s true that a healthy goat, weighing 155 lbs, produces 16,000 mg of vitamin C each day, why is the PHD recommendation for vitamin C supplementation is only 500 to 1000 mg?
    2) Does PHD comment on supplementing indium?

    thanks!! 🙂

  22. Hello Paul,
    Is taking chromium on a low-carb diet dangerous for a healthy person considering chromium’s insulinogenic action? (dangerous hypoglycemia)
    Thanks.

  23. Michael Vassiliou

    Hi Paul
    My name is Michael Vassiliou I am 56 years old osteopath; I have a special interest in exercise physiology, sports psychology and nutrition. I am an avid follower of the PHD. I recommend your book and the PHD to all my fellow athletes and friends!!
    I am elite masters track athlete that regularly competes at sprints at masters international athletic events. With careful optimized training and the PHD diet I and comfortably walking around at 10% body fat which gives me a big advantage over my fellow competitors with regards to power to weight ratio when competing. I am protein S deficient and have been taking Warfarin an anticoagulant since the age of 37 (19 years) after I had a spontaneous DVT.
    Apart from meniscal knee problems and chronic intermittent tendinopathies. My biggest concern is my chronic elevated LDL’s. I have had elevated LDL’s for years. I recently had a CT coronary angiogram performed reporting a total Agatston score 0.10th percentile showing no coronary artery disease. I have resisted my Dr’s attempts to put me on statins. I recently read your article on elevated LDL’s and the possibility that raised LDL’s I may be caused by chronic widespread vascular injuries that may be due to a lack of chromium in the diet? I’ve been advised not to take Vit K2 to prevent excess clotting? But I do take your recommend dose of Magnesium 200 mg, Iodine 225 mcg, Zinc 50mg a week, Vit D3, Pantothenic acid 500 mg Vitamin C 1g. Would your recommend me taking a chromium supplement? or is there a multi-mineral you can recommend?
    Kind regards.
    Mike

    • Hi Michael,

      Great that you are doing so well!

      I generally think that it may be better to take some K2 even if it means you need to slightly elevate the warfarin dose; but it is understandable to refrain from supplementing. The elevated LDL is a concern, it can commonly indicate iron excess (in which case donate blood as frequently as possible), hypothyroidism (in which case treat it), or small intestinal bacterial overgrowth leading to metabolic endotoxemia. Chromium is generally fine to supplement but supplementation shouldn’t be necessary if you cook in stainless steel pots, as some chromium will leach into foods from the steel. I generally recommend supplementing individually rather than with multi-vitamin or multi-mineral supplements.

      Best, Paul

  24. Hello Paul,
    I’ve been following the PHD for over an year now and my health has improved so much, my gratitude cannot be expressed in words.
    Unfortunately I have something that I can’t seem to figure out. Symptoms are mild skin lesions like paper cuts and occasional nose bleeds. Could it be copper deficiency?
    Kind Regards,
    Stan

    • Hi Stan,

      If you are eating 1/4 lb beef or lamb liver per week, you won’t be copper deficient (unless you are oversupplementing zinc). If you are concerned about that, you can get serum copper and ceruloplasmin tested.

      More likely you are missing nutrition for maintaining skin health. Try eating more extracellular matrix soups and stews (e.g. bones, joints, tendons, chicken feet, ox hooves, etc) and shellfish, plus supplement taurine or N-acetylcysteine for sulfur and vitamin C. Also, be sure vitamin A and D status is optimized. You might want to try the Mother Dirt skin probiotic as well, to help clear any skin infections.

      Best, Paul

  25. Hello Paul,
    Could you please say – what is the optimal serum Vitamin A level? (Given that Vitamin D is optimized to 40ng/dl)

    Thanks so much!
    Pete

  26. Hi Paul, I am unsure as whether to take pantethine or the acid. In my readings they seem to accomplish different things. The acid is so much cheaper. Can you please provide me with guidance? Thank you sir.

  27. Paul,

    I am reading in your book about B vitamins and you say that “Bacteria and other microbes are dependent mainly on B vitamins” so I have concerns since I am working with a functional medicine doctor who knows that I suspect that I have a bad fungal infection despite the fact that my labs from Doctors Data show ‘none’ for detection of yeast.
    I am getting started on a Methylation Protocol which consists mainly of B vitamins – is this then disasterous for a fungal infection?
    Thanks for all that you do.
    Regards,
    Jackie

  28. Hello again Paul. I too have a supplement question. Since I intermittent fast daily I generally wait to take all my daily vitamin with my first meal accept iodine which I take on empty stomach. I have 1 or 2 morning coffee with heavy cream and mct oil daily. Since I’m getting 400 calories of fat with my coffee would you suggest I at least take my D3,K2 with my coffee since they are fat soluble ? Can I take them all with my coffee or should I break them up? D3,K2, C, B5, taurine. Any advise would be helpful

    Bob

  29. HI Paul
    Thank you for your book. I have bought one for our kids too. I have a type 2 diabetic husband and wondered what your suggestion would be regarding him going ketogenic? He is 30 kilos (yes kilos) overweight. Any help would be really appreciated.

    Warmly
    Sheryl

  30. Thank you so much. God bless 🙂

  31. Hey Paul, I read and loved your book a few years ago and was wondering if anything has changed since then in terms of recommendations? Or if following the book to the letter currently is still the best thing. Thanks!

  32. Paul,
    Would you mind sharing what you have been eating lately?? Maybe what you had today??

  33. Hello I just finished reading your book for the first time, plan to re-read it as there is a lot to absorb! Thank you for offering this helpful information! I have a question is there a basis for determining the need for vitamins and minerals prior to taking them? Are there a few factors that contribute a person’s need for vitamins, if so what are they? Thank you!

    • Hi Maria,

      Unfortunately the tests for nutritional status are not very reliable. Fortunately everyone needs a similar diet, so you can almost guarantee a good nutritional status if you eat PHD and follow our supplements. The biggest differences are with age, e.g. young children need more zinc and vitamin K and less protein (relatively).

      Best, Paul

  34. Paul, I’d value your thoughts on this recent health blog and does it persuade you to make alterations in your recommendations. Very many thanks.

    “Vitamin A deficiency is not addressed too often in the US, because it’s commonly thought that a diet filled with colorful veggies adequately provides everyone with adequate levels of Vitamin A. But the adequate conversion of carotenoids to Vitamin A should not be assumed.
    Even nutritional labels are guilty of this, calculating that 1 mg of beta carotene yields 1667 IUs of vitamin A in the body. But, this level of conversion is not guaranteed, and may not even be accurate based on genetic differences in our ability to make the conversion.
    Recent studies have been confirming that the conversion of carotenoids into vitamin A is lower than we originally thought. The Food and Nutrition Board recently reduced its conversion rate of beta carotene to vitamin A by 50% and there is speculation that this standard conversion rate may continue to be lowered as more studies are performed.
    Other papers report that absorption rate of carotenoids is as low as 3% even in optimal conditions, while the absorption of preformed vitamin A from animal products is 70-90%.
    Research has also shown that some people are much better at converting carotenoids to vitamin A compared to others. Many individual factors affect if you are a good or bad converter and why you may be more prone to a deficiency. ,”

    • Hi Elsie,

      I agree with that. In PHD, we try to get a majority of the weekly requirement of vitamin A by eating 1/4 lb liver per week. Carotenoid rich vegetables can provide the remainder. That’s all it takes. If people don’t eat liver, then we recommend supplementation of a similar amount of active vitamin A weekly, see the recommended supplements page.

      Best, Paul

  35. Hi Paul,
    I’m looking for a probiotic recommendation for my 92 year old mother. She is generally healthy except for frequent imbalance in her gut that causes bloating, gas, constipation. She recently had the flu and after a course of antibiotics wants to restore her beneficial gut bacteria. There are so many brands on the market–which are best for elderly people?

  36. Hi Paul and Shou-Ching,

    First of all thank you for your work! I was diagnosed with CFS several years ago. While my energy levels are decent these days, they’re no where near previous levels and the brain fog is still hard to deal with. I’ve also tested positive for HSV-1 and HHV-6, both of which seem to be implicated in CFS. Would you change or add any dietary or supplement recommendations based on that? I’m afraid that if there’s an ongoing infection some supplements might be feeding the bad guys? Considering going on Valgancyclovir to address possible infections, but afraid of nasty side effects. Any advice would be most appreciated!

    Sincerely,
    Mike

    • Hi Mike,

      I would stick to our advice. You could cut down the B vitamins from once a week to occasionally/rarely, and consider adding some of the therapeutic supplements (especially extra vitamin C, taurine, and N-acetylcysteine). Carefully optimize vitamin A, vitamin D, circadian rhythms, and do the intermittent fasting.

      Best, Paul

  37. Paul should I take my vitamins after breakfast since it usually a fatty meal?i intermittent fast so lots of times I’m taking vitamin D etc at 11.

    Thank you

  38. Hi Paul,

    Do you have any opinions on the idea that ascorbic acid (the most commonly sold vitamin c supplement) isn’t ideal because it’s mostly made from GMO corn? I’ve looked into supplements that use cherries, amla, etc. as the source of vitamin c, but they’re very expensive. The argument is that it’s not GMO and that it’s more easily processed by the body since it’s a natural form of vitamin c. I’d love to hear your thoughts on the subject!

  39. First: Thanks for the great book and the very lovely heartfelt ending in the last chapters.

    I am confused about a few things though and hope to find some help.

    1.) I am hypothyroid without Hashi, and already read in the comments, that you switched from a possible higher intake of iodine advised in the book, to a “normal” daily intake. Selenium stays at the “minimum”, and should be obtained via food.
    Yet Germany is very low on both in the soil. I refrain from eating seafood because of heavymetals and cannot afford a lot of quality meat here (beein a student…. yeahy 🙂 )
    So i wanted to ask if i should supplement selenium non the less. I would eat brazil nuts, but can only get some from Bolivia, which would be very low on selenium.

    2.) Basicly same goes for zinc. Due to my fear of eating “cheap meat” i get maybe 200 g of muscle meat every second day, and get the liver of course. But i guess that is not enough zinc for me, if i don’t buy oysters.
    So again, should i supplement daily?

    3.) In general i would love to have a recap on fighting hypothyroid on the micro nutrient side. Maybe that is something for a next article? 🙂
    I know eleminating food toxins is first. Optimizing everything else is second. But it would be nice to sum up your experience with iodine. How and when you got too much selenium. Or what else Matt Farina did or took to help his thyroid.

    Phew. Lots of stuff. Hope this is not too much to read. Cheers, many thanks and greetings from Germany

    • Whoops, wanted to say: Hi to you and your wife too 😉

    • Hi Simon,

      If you stick to seafood that is low on the food chain, the quantities of heavy metals are tiny. For example, eating a pound of oysters (low on the foodchain) every week — enough to provide ample zinc and selenium — would be a smaller dose of mercury than eating a single 5 oz can of tuna (higher on the foodchain) every two months.

      I don’t think you should worry about cheap meat (at least not cheap muscle meat). Paul and Shou-Ching write in their book:

      “…for many cuts of meat or vegetables, including beef and lamb muscle meats and most produce, organic produce and grass-fed meats have only small advantages over conventional alternatives. So if your budget does not permit buying these foods, have no fear…”

      Best,
      -Eric

      • Thank you very much for your reply Eric :). Much appreciated.

        I didn’t know that the amout of mercury would be that low. I read about that, but still i was afraid.

        Yeah i remember what Paul wrote. It is just a personal dilemma for myself, you know? I really don’t want to eat meat which is produced that way and also it is still pricey for me. So i thought it would be a good idea to supplement.

        Best wishes from Germany

  40. Hi Paul – my wife was diagnosed several months ago as deficient in Vitamin B12, and put on weekly, and then monthly, B12 shots. This helped for a while, but lately she has been regressing (despite continuing with the shots, as prescribed), and we’re trying to figure out why. Some of her main symptoms now are brain fog/memory issues, and tingling in her hands/fingers (two of the same symptoms she had initially, though they were worse before any B12 shots). Her serum B12 is over 1200, so she clearly has enough B12 in her blood now. She eats almost no eggs, and no liver (can’t stand the taste of either one), despite my urging to eat some of both. Any advice? Should she be taking a choline supplement, as well as the B12 shots and B-complex capsules? (I noticed that the B-complex capsules have very little choline…….only 50 mg). Her thyroid blood test numbers are fine, as are most other blood test numbers. Thanks…………Robert

  41. g’day Paul,

    what do you make of this quote from Chris Masterjohn below…

    Would you agree with Chris as far selenium supplements go, that selenomethionine would be better than methylselenocysteine ??

    “There’s a methylselenocysteine supplement offered by Life Extension and I believe some other companies are making it now.

    Methylselenocysteine is not selenocysteine. It is a detoxification product of selenocysteine. There is a salvage pathway by which we could use it, but it’s an intermediate in our own detoxification pathway. So I can’t imagine that it has good bioavailability. I’m sure it has some.
    So I would not use methylselenocysteine.

    I think that in someone with glutathione status, selenite is probably fine, but what we’ve seen is that when you’re fixing a deficiency, sodium selenite is probably half as good as selenomethionine.
    So because the availability of the supplements does not include selenocysteine, I would opt for selenomethionine.”

    link to quote source in following comment…

  42. Dear Paul,
    6 months ago my blood test showed very low Vitamin D levels. I started supplementing with 5000IUs of Vitamin D per day and after a month or so my Vit D levels were fine. Unfortunately whenever I take Vitamin D my sleep quality is greatly diminished (very shallow sleep, waking up during the night etc.). I tried taking it early in the morning but it didn’t help. I tried different supplement brands too – no difference. When I stop taking it sleep patterns normalize after a week or so. Any ideas?

    Thanks

    • Hi Roger,

      In general, 4000 IU of D3 is optimal including both sun and supplements, so supplements should be less than that. So I would at a minimum cut back to 2500 IU/day.

      As far as an explanation for your symptoms, the first possibility to consider is that you may have a condition in which your 25OHD levels are depressed and 1,25D levels elevated. See http://perfecthealthdiet.com/2010/08/vitamin-d-dysregulation-in-chronic-infectious-diseases/. If this is the case, your “very low” D levels might have signaled a proper amount of vitamin D3 plus a disease process, and when you supplemented (over-supplemented) your 25OHD became “normal” but 1,25D elevated, possibly leading to hypercalcemia. See if any of these symptoms look familiar: http://www.mayoclinic.org/diseases-conditions/hypercalcemia/basics/symptoms/con-20031513. This could be evaluated by getting tested for 1,25D and calcium along with 25OHD.

      A second possibility is that the extra vitamin D is exacerbating a deficiency of related nutrients like vitamin A or vitamin K. If you don’t eat liver weekly you can easily have a vitamin A deficiency. Likewise supplementing magnesium would help balance calcium excess.

      Best, Paul

  43. When you recommend 3 egg yolks daily, are you talking just the yolk or whole eggs.. what are your thoughts on the egg whites?… I almost always eat whole eggs. Thank you

    • Hi Tyler, we highly recommend the yolks, are indifferent to negative toward the whites. They are almost entirely protein and are an inferior source of protein due to their immunogenic potential as well as the potential of avidin to induce biotin deficiency. No one is protein deficient, so the whites have almost no nutritional value. But, if you like the taste, we won’t try to discourage you.

      Best, Paul

  44. Dear Paul,

    I’ve been on the diet and supplements for almost two years now, but lately I’ve been experiencing major sleep issues. I’ve been experimenting to see which supplements might be causing me insomnia, and it seems that D3, magnesium and possibly iodine are the biggest offenders. They give me a LOT of energy. Even when taken in the early morning, I always end up with a racing mind in the evening. Taking 1 mg melatonin relaxes me but I still remain in a half-awake state throughout the night. I follow most of the recommended circadian rhythm strategies: intermittent fasting, morning and afternoon sun exposure, daytime exercise, eating within daylight period, avoiding blue lights at night, socializing in the day…

    I did a couple months trial where I stopped taking supplements altogether and I was able to fall asleep again, however a new symptom arised: waking up in the middle of the night and not being able to get back to sleep, usually around 1:00 AM, or 4:00 AM when I take melatonin.

    Throughout these trials I have been eating as close as possible to the diet, although I do not eat liver. Tried concentrating carbs into last meal and eating some fruit for dessert. No strategy helps my sleep IF I am taking supplements.

    Some other things to point out while on the diet & supplements:
    – I’ve been experiencing a little bit of weakness in the gym, especially when eating less meat and more potatoes/rice. Lifting weights seems more difficult than it used to be.
    – Some days when I am underslept, I still have energy and I don’t necessarily feel “tired”, but have this sort of lightheaded feeling.
    – I have to urinate more often, even though there isn’t all that much to expel. The urine is a very vibrant yellow.
    – I seem to be a much lighter sleeper these days, getting more easily awoken by certain sounds in the house.

    Any idea as to why these things might be happening to me? I am starting to suspect hypercalcemia or some thyroid problem. I would like to get the extra nutritional benefits from supplements as I cannot get everything from food alone, but it’s just not worth it if I can’t get adequate sleep. What’s really strange is that these things didn’t used to happen to me when I first started the diet.

    I would really appreciate help. Thank you.

    Best regards,
    Patrick

    • To add some things:

      – My “day” is set for 8:00 AM to 8:00 PM.
      – I was taking 1000 IU D3, 200 mg magnesium, 225 mcg iodine.
      – I get calcium from cheese and bone stock, but only occasionally.
      – Eating a breakfast instead of fasting seemed to make no difference.

    • Hi Patrick,

      First, I would try the balancing nutrients to those that give you trouble. If you don’t eat liver, you should supplement vitamin A, perhaps 50,000 IU per week. You should probably supplement calcium, around 400 mg/day. Be sure to get enough salt and drink enough fluids to balance the iodine. Also if you don’t eat liver, supplement copper. Be sure to get 3 egg yolks and 2 tbsp vinegar per day. Also, be sure your plant foods are providing enough potassium. Tomatoes are a good vegetable source; try to favor potatoes over rice.

      Re the circadian rhythms, try getting some early morning sun exposure and light exercise. If your day runs 8 am to 8 pm, try 10 minutes of outdoor exercise at 8 am. Urination at night is a suggestion that your circadian rhythms are off, probably due to delayed triggering of daytime signals.

      For the weakness, you may need a bit more protein and carbs together. More total calories helps. Undereating could be contributing to the insomnia.

      You should have your doctor test for thyroid status routinely. Hypercalcemia is unlikely unless you have been oversupplementing vitamin D, which doesn’t seem to be the case based on your followup post.

      Best, Paul

      • Dear Paul,

        Thank you for the thorough response. I will try your suggestions and report back with the results. Vitamin A is especially one thing that I’ve been missing.

        I think I will also try to up my D3 intake to 4,000 IU on days without sunlight. Is it plausible that the effects I’m experiencing from vitamin D (heightened energy, racing thoughts, insomnia) are linked to deficiency, in that my body is having trouble adjusting? I live in Canada so I get very little sun for many, many months.

        • Hi Patrick,

          Vitamin A and D are both crucial for immunity (especially in the gut), and synergistic, so you have probably been deficient in both, especially in the winter, so it’s possible you’ve developed a gut dysbiosis that is causing inflammation. Or there could be some other mechanism, it is hard to diagnose. But, try this, and see if things improve.

          Best, Paul

  45. What are your thoughts on desiccated beef liver pills as a supplement… probably not as perfect as fresh liver… but is it a better option than taking individual supplements of vit a, copper, choline, folate, etc.
    Would you still need weekly zinc?

  46. Dear Paul,
    I’m training everyday of the year, so I want to ask you what supplements do I need while overtraining beside zinc, Mg, vit.K/D/A, B’s once a week?
    Thank you in advance!

    • Extracellular matrix supports would help — glycine, taurine, vitamin C.

      Best, Paul

      • One more question, Paul:
        Should I stop consuming fruits because I can’t?
        It’s difficult to eat less than 2-3 servings (fruits) per day even while my fat intake is enormous. Is it due my training regimen?
        P.S. I’m taking cold showers daily and quit porn for years so it’s not about will power.

        • Hi Kayle,

          We recommend eating 2-3 fruits per day, so I’m not sure what the problem is. You need some carbs including both fruit and starchy plants like rice or potatoes. The need for carbs is independent of the need for calories, so eating lots of fat won’t eliminate your need for fruit and starch.

          Best, Paul

  47. I have a autommmune renal condition called IGA Nephropathy. There are few know treatments other than using ACE inhibitors or ARBs. Steroids are also used in more severe cases. Fortunately my disease was caught in the early stages and has been kept under control very well since.
    Many researchers have studied the use of fish Oil supplementation as a treatment option for omega3 pufa’s potential of reducing renal inflammation and improving hemodynamics. Studies are not definitive in this area yet a lot of nephrologist recommend taking the fish oil. My doctor included.
    My question is in regards to PHDs view of not using fish Oil supplements. Do you think following a strict PHD lifestyle would have equal or greater health benefits to where fish Oil wouldn’t be necessary. I’ve taken fish Oil daily for the last 3 yrs. I was diagnosed 4 years ago. I’ve been strict PHD for one month and feel great. My disease state is very well controlled. Just not sure about discontinuing fish Oil. Obviously I don’t want to hurt my body one way or the other. Thoughts? Thank you for all that you do and have done.

    • Hi Tyler,

      Regular intake of fatty fish, such as salmon, is always going to be better than fish oil supplements. If you have a sushi place nearby, you could get a small order of sushi daily or every other day for a better quality of fish oil.

      Best, Paul

      • Thank you Paul. It’s like I knew the right answer, but for some reason it is much better coming from an opinion you respect.

  48. Hello Paul,

    Thanks for your work in PHD!
    Do you have any caution for folks with gall bladder issues because of the fat one needs to consume with this eating plan?

    • Hi Natalie,

      Tolerability of fat seems to vary by person after gallbladder removal, some do fine and others don’t, probably depending on the gut microbiome. You might eat a higher carb diet than otherwise, but you probably won’t need to vary too much. If you get steatorrhea, you may want to supplement with taurine, glycine, vitamin C, and egg yolks to support bile production. Optimize your intake of vitamin A, D, and K, plus vinegar and pantothenic acid, in order to help shape the gut microbiome.

      Best, Paul

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