Eleven Steps for Overcoming Alzheimer’s and Other Chronic Infectious Diseases

If Alzheimer’s is due to bacterial infection, as I suggested yesterday (https://perfecthealthdiet.com/?p=126), then it can be treated by diet, supplements, and antibiotics.

Here are eleven steps that can help defeat chronic bacterial infections, including the infections that cause Alzheimer’s. (Note:  I will justify each of these eleven steps, and cite to the scientific literature, in follow-up posts.)

1. Normalization of Vitamin D Levels.

Vitamin D is needed for the transcription of anti-microbial peptides, such as the cathelicidin LL-37 and beta-defensin, which are essential for defense against intracellular bacteria and viruses. Vitamin D deficiency is a risk factor for every chronic infection, and chronic infections tend to increase in frequency with latitude and progress most rapidly during the winter when vitamin D levels are low.  In general, a serum 25-hydroxyvitamin D3 level of 40 ng/ml (100 nmol/L in SI units) is a good target. (Some people, such as Dr. John Cannell of the Vitamin D Council, believe there may be benefits to higher levels, but this is speculative.)

2. Restriction of Carb Intake to 400 Calories Per Day.

Eating a carb-rich diet is doubly bad:  it increases blood glucose levels and triggers insulin release, both of which promote bacterial infections.

Intracellular parasitic bacteria need glucose or its glycolytic products to obtain energy. Abundant cellular glucose, caused by high blood glucose levels, enable them to reproduce and generate immune-impairing proteins more prolifically.

Insulin represses immune defenses against parasitic bacteria, by blocking production of antimicrobial peptides.

To keep both blood glucose and insulin levels low, carbohydrate consumption should be restricted to about 400 calories per day – the amount in 0.3 pounds of cooked white rice, or 1.3 pounds of sweet potatoes.

3. Restriction of Protein.

Eating minimal protein helps in two ways: it deprives bacteria of amino acids necessary for growth, like tryptophan; and it promotes autophagy, the primary means by which cells kill intracellular pathogens.

Indeed, the body’s primary defense mechanism against C. pneumoniae is tryptophan deprivation. This is why people with chronic brain infections have symptoms of serotonin deprivation, including depression, anxiety, insomnia, fatigue, impaired ability to concentrate, and low self-confidence. It’s important not to relieve this by tryptophan or 5-HTP supplementation, both of which promote bacterial growth. If symptoms are intolerable, selective serotonin reuptake inhibitor (SSRI) antidepressants, like Prozac, Paxil, or Zoloft, might be able to provide symptomatic relief. (NB: We neither recommend nor disparage these drugs.)

4. Intermittent Fasting

Autophagy is the garbage collection and recycling process of human cells.  When resources are scarce, cells turn on recycling programs and send garbage collectors known as lysosomes to engulf and digest junk proteins and damaged organelles, enabling re-use of their amino and fatty acids.

Autophagy is a key part of the immune defense against parasitic bacteria.  Lysosomes not only digest human junk, they seek out bacteria and digest them. 

Autophagy is strongly turned after about 16 hours of fasting. The longer one fasts, the more parasitic bacteria are destroyed in lysosomes.  Fasting is an easy way to improve the relative balance of power between your body and intracellular pathogens. Fasting strongly promotes autophagy in neurons, and is of therapeutic value for Alzheimer’s.

A simple strategy of intermittent fasting is to confine meals to an 8-hour window each day, thus engaging in a daily 16 hour fast.  On this strategy, one might eat only between noon and 8 pm.

5. Ketogenic Fasting.

Two dangers of fasting are that it can lead to loss of muscle tissue as protein is consumed to generate ketones and glucose, and that neurons may be put under stress by glucose deprivation.

Both dangers can be ameliorated by eating ketogenic fats during the fast.  “Ketogenic” means generative of ketone bodies. Ketone bodies, which are generated from fats or some proteins during fasting, are the only neuronal energy source that bacteria can’t steal. There is a large literature showing that high circulating ketone levels are neuroprotective, and ketogenic diets have been successfully tested as Alzheimer’s therapies.

The most ketogenic fats are the short- and medium-chain fats found abundantly in coconut oil. Taking plentiful fat calories from coconut oil, but no carb or protein calories and few other fats, can enable fasts to be extended substantially longer with minimal loss of muscle tissue or neuronal stress.

On a ketogenic fast, eliminate carbs and protein for a 36-hour period, from dinner one day to breakfast on the second day.  During the intervening day, eat no protein or carbs, but do eat as much coconut oil as you like.

There is no limit on how much coconut oil may be consumed – but 12 tablespoons per day would produce a surfeit of ketones. NB: Always drink plenty of water during a fast. We also drink coffee with plentiful heavy cream.

6. Elimination of Wheat and Other Grains. 

Wheat is a toxic food that interferes with immune defenses and impairs vitamin D function. It also generates antibodies to the thyroid, which damage the thyroid status and further impair immune function.

7. Elimination of Omega-6-Rich Oils and Inclusion of Omega-3-Rich Fish.

A diet that minimizes omega-6 content by replacing soybean oil, corn oil, canola oil, and other omega-6 rich oils with butter, coconut oil, and beef tallow, and gets adequate omega-3 fats by eating salmon or other cold-water fish, optimizes the immune defense against intracellular pathogens.

A high omega-6 and low omega-3 diet weakens immune defenses against intracellular pathogens and re-directs the immune system toward extracellular threats.

Note that the combination of carbohydrate, protein, and omega-6 fat restriction necessarily means that half or more of calories should be obtained from saturated and monounsaturated fats.  It is important not to have a saturated fat phobia if you want to escape or defeat Alzheimer’s!

8. Fructose Minimization.

Fructose is a toxin and is deprecated on the Perfect Health Diet. One of its worst features is that promotes infections. In mice, blood levels of endotoxin, a bacterial waste product, are higher on a fructose-rich diet than on any other diet.

Therefore, sugary foods like soft drinks should be eliminated.  Fruit and berries are OK in moderation.  We recommend no more than 2 portions of fruit and berries per day. Most carb calories should be obtained from starchy foods, like sweet potatoes or taro or white rice.

9. Melatonin supplementation. 

Whereas vitamin D is the “daylight hormone,” melatonin is the “hormone of darkness.”  It is generated during sleep, and is favored by darkness.  Even a little bit of light at night, like the LEDs of an alarm clock or streetlights shining through a window, can disrupt melatonin production.

Melatonin is extremely important, not least because it has powerful antibiotic effects.

To maximize melatonin production, everyone should sleep in a totally darkened room, with windows covered by opaque drapes and all lights extinguished and LCD or LED clocks turned face down.

Unfortunately, people with chronic bacterial infections will generally still be melatonin-deficient, for the same reason they are serotonin-deficient:  melatonin is derived from tryptophan and serotonin. Fortunately, melatonin is easily supplemented.

A melatonin tablet can be allowed to dissolve in the mouth just before bed. High doses will generally produce a deep sleep followed by early waking; this can be remedied by using time-release capsules, or by reducing the dose.

10. Selenium and Iodine Supplementation and Thyroid Normalization.

This is basic for good health in all contexts, but optimizing thyroid hormone levels and maintaining iodine and selenium status are especially important for anyone with an infection.

Both selenium and iodine are required for proper immune function. To get iodine, white blood cells will strip iodine from thyroid hormone; for this reason, people with chronic infections are often somewhat hypothyroid, as indicated by TSH levels above 1.5.

There are too many tricks and pitfalls to thyroid normalization to describe the whole issue here, but a good start is to eliminate wheat from the diet, and to obtain 200 mcg selenium and at least 400 mcg iodine per day. Do not get too much selenium as it is toxic.  Selenium and iodine may be obtained from foods:  two to three Brazil nuts a day for selenium, and seaweed for iodine.

11. Vitamin C and Glutathione or NAC Supplementation.

These are important for immune function. Vitamin C supplementation is an important safety precaution because infections greatly increase the rate of loss of vitamin C, and can generate tissue scurvy with devastating consequences.

Glutathione is destroyed by stomach acid. We recommend buying reduced glutathione and taking it with a full glass of water on an empty stomach, at least 2 hours after and 1 hour before taking food. Alternatively, N-acetylcysteine (NAC) and glycine-rich foods like gelatin may be taken to promote glutathione synthesis.


This is by no means an exhaustive list of dietary and nutritional steps that can help against chronic infections.  However, we believe these are the most powerful and important steps.

Alzheimer’s and other diseases caused by chronic bacterial infections – possibly including multiple sclerosis, Lyme disease, chronic fatigue syndromes, fibromyalgia, rheumatoid arthritis, and many others – are preventable, treatable, and often curable.  These dietary steps, along with appropriate antibiotic therapy, are keys to a cure.

Leave a comment ?


  1. Hi Natalie,

    We do need a recipe sharing board! I’ll try to get one up before the end of the year. In the meantime, I’ll post our recipes / food ideas on the blog, as well as any that readers send in.

    I’m so glad diet and antibiotics are helping you. These chronic infections can take a long time to eradicate, but you are on the right path to a cure.

    Hopefully the knee stiffness will clear up as you get farther along. There’s a good chance the same infections that affected your brain have caused the knee problem. You might also try the mobility exercises at MobilityWOD – it’s in our blogroll under “Fitness.” Getting rid of tightness/adhesions in the tissues that attach to the knee can help the knee a lot.

    Best, Paul

  2. Paul,

    Many alternative health gurus seem very concerned with environmental toxins such as lead, mercury, BPA or fluoride, and use techniques to rid the body of such toxins. I noticed that your book does not touch on these issues. Have you looked into the evidence on whether toxins are a big player in chronic disease and whether there are any worthwhile techniques to get rid of them?

  3. Hi Todd,

    Those toxins are valid concerns. We favor salmon over tuna because of mercury concerns. BPA is also a concern.

    However, I haven’t seen convincing evidence that man-made toxins impact health as significantly as natural toxins. Bruce Ames and Lois Gold have quantified toxin levels and natural toxins are far more abundant in food than man-made toxins. In general, the man-made toxins are at such low levels in food they’re unlikely to do much harm.

    The book does touch on genetically modified foods that have extra, human-introduced insecticides. I think those are probably the most likely man-made toxins to do us harm.

    Best, Paul

  4. Thanks Paul,

    I was very interested by your references to Ames in your book so I read a few of his articles online. Fascinating and makes me less worried about pesticides and chemicals. On the other hand, there are many anecdotal reports of patients getting better after various therapies to eliminate lead or mercury. Eades wrote an interesting article about using olestra to get rid of heavy metals.

  5. Hi Todd,

    Bacterial biofilms concentrate heavy metals, and people with chronic infections may need chelation therapies for heavy metals, else they will be poisoned as the biofilms degrade.

    But healthy people shouldn’t collect too much heavy metals from food alone, except perhaps from carnivorous fish like tuna, swordfish, or shark. I think most heavy metal poisoning comes from non-food sources, like lead paint.

    I suspect an investigation would show that those anecdotal reports concern people with either infections, or environmental (not food) exposures.

  6. I’m wondering if you have a sample meal plan anywhere on your blog…my imagination seems to have been overwhelmed by inflammation, and I just can’t seem to visualize what I could actually eat in a day that would give 60 -70 % calories from fat, etc. I think I just need a sample day to be able to picture it.
    best, marla

  7. A picture really is worth a thousand words.

  8. Very helpful post, thank you. How does your theory of infection connect/correlate with the latest theories about Alzheimer’s as a form of diabetes in the brain (“Type 3”), not to mention the MTHFD1L and apoE genes?


  9. I live in NYC and our windows are too big for blackout curtains so street light comes throught the venetian blinds — and if we open the window for air at night. I’m trying sleep eye masks but find that I feel groggy without the gradual daylight hitting my eyes. How is it natural to sleep in total darkness? What about the stars?? And the gradual lightening of dawn, then morning etc??

  10. Hi Annie,

    Well, humans have slept in shelters for at least 300,000 years, maybe much longer.

    I think that before illumination was invented, people probably slept a few hours after dark and woke up before dawn. (12 hour night, 8 hour sleep.) So they were awake at first light.

    But I do agree that it is pleasant to be woken by the sun.

    For curtains, we bought an opaque cloth and hung it ourselves. We open the window behind it.

  11. Hi Paul,

    I was rereading this post and seeing how it applies to me. I spoke to my doctor about a test for serotonin and dopamine deficiency and he hasn’t heard of anything. I checked out labtestsonline but can’t seem to find anything that pertains to brain infections. I’m wondering if you are aware of any tests out there for this.

    PS Congratulations on finishing the print version of your book. We received ours and it looks great!

  12. Hi,

    My dad has alzheimers and was just put in a nursing home because my mom can’t handle taking care of him anymore. He shouldn’t be there and I believe there’s still hope for recovery in him. Do you know of a doctor in the Colorado area that has experiance here. What are your thoughts in this situation.


  13. Hi Amy,

    I’m very sorry to hear of your father. It must be very difficult for you, especially at Christmas.

    I’m afraid I don’t know of doctors.

    I do think that Alzheimer’s patients can experience substantial improvements of function by providing ketones to eliminate cognitive hypoglycemia and using antibiotics to inhibit bacterial metabolism, and generally providing good diet and nutrition.

    But I don’t see how in practice this can be achieved without a devoted spouse or family member investing a lot of time. Clearly the patient can’t easily do this for himself, and nursing homes aren’t set up for it, nor are doctors equipped to supervise dietary therapies.

    I do hope you can find a way to give your father an opportunity to regain function. Please let me know if I can help with diet and nutritional recommendations.

    Best, Paul

  14. Perfect Health Diet » Chronic Disease: Don’t Ever Give Up - pingback on December 28, 2010 at 9:33 am
  15. How do you consume/eat drink the coconut oil while doing a ketogenic fast?

    I am unable to eat it straight off a spoon. Any tips on consuming it without gagging it down?


  16. Hi Ian,

    Here’s something I was doing while cranberries were in season: http://perfecthealthdiet.com/?p=1296.

    The berries reduce the stress of the fast but they may help improve gut flora.

    Any low-calorie vegetables can be used. Maybe a ratatouille (eggplant, onion, etc.) would be a good choice.

    Best, Paul

  17. Hi Paul

    what’s your thoughts about Jello Brand jello as a source of glycine? Do you know if the processing has rendered it undesirable?


  18. Hi DancinPete,

    When I googled for “Jello nutritional info” I got this:


    It has 1.3 g protein per 92 g serving. So, a low dose.

    I looked at nutritiondata for the powdered gelatin dry mixes, it does seem the protein is 20% or so glycine: http://nutritiondata.self.com/facts/sweets/5480/2

    So 1/5 pound of Jello might have 250 mg glycine, which is about the amount in 1 egg.

    I guess if you like Jello and get sugar-free flavors, and eat a lot, then it’s OK.

  19. 23andMe and Alzheimer’s Risk | Sam Snyder - pingback on June 16, 2011 at 12:19 pm
  20. Is sauerkraut or any raw veg. and apple cider vineger with water good, while doing a ketogenic fast?

  21. Hi Herb,

    Sauerkraut and vegetables are fine. I don’t recommend apple cider vinegar, unless it is very well diluted.

  22. Hi, Paul. I’m new here.

    I’ve ordered your book from Amazon, but it won’t be here until mid-September.

    I’ve been doing a Paleo diet like Cordain recommends, for over 6 years. But I’ve been experiencing problems with depression, fatigue, and occasional hypoglycemia. Someone at Paleo Hacks recommended your diet, so I’m going to give it a shot.

    Quick question for you: Is 10g of fructose per day okay, or should I try to get less?

    I weigh my food, and track it at NutritionData.com. If I eat 400g of sweet potatoes a day, and about 100g of berries, plus some veggies, NutritionData says that provides 6g of fructose and 9g of sucrose. And since half of sucrose is fructose, I’m getting a total of 10.5g of fructose each day. Is that low enough?


  23. Hi smb,

    If you’re low-carb, then I’d say up to 40g fructose is OK. The key is keeping it away from PUFA.

  24. Hi Paul,

    I have just read about your talk at Wise Traditions 2011 where you mentioned about how VLC diets are not great for fungal infections. I found this very interesting and it could be the key to my recovery from yeast infection / ulcerative colitis.

    I did great on a VLC diet (SCD – Specific Carbohydrate Diet) for about a year during which time I believe I was dealing with bacterial issues. Then I had some problems and ended up with systemic yeast candida problems. I’m still on the SCD now but what you’ve said might explain why I don’t seem to be getting anywhere.

    Would you recommend doing the standard PHD or should I make some tweaks bearing in mind my candida/UC issues (loose stools, urgency, fatigue, underweight, anxiety).

    I’m currently VLC with no fruit, dairy, grains or sugar and it just isn’t working any more. Any advice?

    I’ve bought your book but not received it yet so if there is a tweaked diet in that I can follow, please let me know.

  25. Hi Mike,

    Yes, standard PHD is very good for Candida. Some other tips:
    – Eat spinach (for nitrates, helpful for immunity)
    – Olive oil is a good antifungal oil.
    – Traditional herbs and spices are all anti-fungal, and good to use liberally. Oregano, turmeric, thyme are good choices.
    – Acetic acid from vinegar is also good — thus a salad with Italian dressing is an excellent anti-fungal food.
    – Do intermittent fasting but do not do very low-carb. 400 to 600 glucose calories a day.
    – Minimize fructose.
    – Get plenty of vitamin D, vitamin A, and vitamin K2. This is crucial.
    – Get plenty of glutathione and related nutrients (selenium, vitamin C).
    – Eat fermented vegetables and fermented dairy. Sauerkraut is very good for you!
    – But avoid yeast-fermented foods. Favor yogurt over kefir. Do not use sugar when fermenting vegetables; do use copious salt.
    – Do eat plenty of salt and drink plenty of water.

    There are various supplements and therapies you can take which also help, but this will get you a long way.

    Best, Paul

  26. Thanks Paul. Really useful information. Book arrived today so i’ve got everything I need in my arsenal to get back to health. I see in another post you recommend settling on the diet and supps before getting into the antibiotics so i’ll do that too.

    I noticed you mentioned in a comment back in June that you were going to be doing a post on candida probably July/Aug. Did you do this? If so please can you provide me with a link and if not then i’ll keep an eye out for it.

  27. Hi Mike,

    No, I haven’t done it yet but it will be on the calendar after an obesity series. It has taken me rather longer than expected to figure out ins and outs of my own Candida … but that is more material for the posts, when they come.

  28. Hi Paul,

    you mentioned in the 3rd point, that protein restriction is important. What would it mean in grams?


  29. Hi Zsuzsi,

    I think intermittent protein restriction is probably best … ideally – and I know this is difficult or impossible for Alzheimer’s patients – high protein intake would be combined with exercise, especially resistance exercise, and low protein intake with rest.

    As a rule, protein around 10% of calories is a good level to target in Alzheimer’s or other brain infections. You want adequate protein to support wound healing, but not a ready availability of substrates.

  30. Hello Paul,
    My mother has been recently diagnosed with moderate Alzheimer’s. She has been prescribed Riverma by the doctor. I’d really appreciate if you could give me some pointers on the diet she could follow. A little background –
    We are of Indian origin. Both coconut and coconut oil are used highly in vegetables and curries. Lentils form a significant part of the diet. My mother gave up seafood many years back but has recently started eating at least twice a week. She does not like meat or eggs. She takes women’s 50+ supplement. She has no other ailments like heart disease or diabetes. We are very fortunate that my father is still able to take care of her, so if there are food compulsions/ restrictions we will be able to adhere to them. On a side note, my parents are in India where the quality of food is sometimes suspect. They are fairly active but live alone. Would like to know your recommendations.

  31. Hi Wini,

    The best diet for Alzheimer’s is high in fat, especially coconut oil, and low in carbs.

    It would be good if your mother could eat seafood regularly, and dairy (butter/ghee). Lentils should be soaked and well cooked.

    The goal would be something like 25% carb+protein, 75% fat, but low in omega-6 fat. So seafood, coconut oil, and ghee are great foods for her.

    I would recommend intermittent fasting (restricting food to 8 hours per day) with coconut oil and water allowed during the fast.

    Sun exposure is good, for vitamin D. Nutritional supplements are desirable and especially important if she doesn’t eat liver, bone broths, and other sources of animal nutrition. The most important nutrients are minerals (esp selenium, magnesium, zinc, copper, iodine, manganese) and the fat soluble vitamins A and K2. Certain B vitamins, especially B1, B2, pantothenic acid, B6, B12, and biotin will probably help as well. I would avoid niacin and folic acid.

    Then I would suggest trying antibiotics.

    I don’t know what Riverma is.

    Best, Paul

  32. Paul, thank you so much for your response. The name of the prescribed drug is Rivamer, sorry. You recommend white rice, sago etc (which are all used heavily in our cuisine) as safe starches. Typically how much can she have in a meal? She will have a hard time with no rice to go with her curries.
    Also are the mineral supplements in addition to the 50+ multivitamin?
    Again, thanks for your help.

  33. Hi Paul,

    thanks for your answer. Would you modify your recomeendations for someone with RA? Would the same suggestions be appropriate? Also, when candida is also present, can bacteria and candida targeted at the same time? Sorry, if it has already been covered, I ordered your book 3 weeks ago, it hasn’t arrived yet, probably because os Xmas-craze.

  34. Hi Wini,

    At a minimum, even if she is not trying to use the therapeutic ketogenic diet, she should try to keep starches to under 600 calories a day and under 300 calories in a meal. She should get as many or more calories from fat as from starches.

    If she is trying to be in ketosis, which should help her, then I would limit starches to 200 calories per day within an 8 hour window.

    The mineral supplements are in addition to a multivitamin.

    Hi Zsuzsi,

    I think RA is usually bacterial, so similar diet and therapy. She should try antibiotics and an at least intermittently ketogenic diet. See http://roadback.org for more info on RA and bacteria.

    Bacteria and candida can be targeted by drugs at the same time, eg doxycycline and fluconazole, but you can’t optimize diet for both. Ketogenic diets are best against bacteria but worst against candida. So take your best shot, diet-wise, against the more important problem. Usually that’s the bacteria.

  35. Do you know if the metametrix GI effects stool profile can tell if you have the pathogen which causes fibromyalgia?

  36. Hi Justin,

    Since the cause of fibromyalgia is unknown, I don’t know the answer to that question. There are probably multiple pathogens which can cause fibromyalgia, and some of them probably cause infections in the gut which the Metametrix test would detect. Of course, if the cause is viral, the Metametrix test will not detect it. However, it may detect some other problem, and anything that improves your health will be a step forward. So I would give it a try, but I wouldn’t count on it leading to a cure.

    Let me know how things go.

    Best, Paul

  37. Hi Paul,

    Thank you. I will be meeting with my doctor in a couple weeks to try to convince him that this test is worth it. I am a bit overwhelmed at all the things to try: metametrix test, antibiotic protocol from theroadback.com, more ketogenic dieting, staying away from nightshades for joint pain, etc.

    I will say that I have had significant improvements in my health since starting PHD a few months ago. Thank you for the work you and Shou-Ching are doing here. I will also keep the readers here abreast of what I try and what works and does not work.

  38. Met with my doctor. He was less than enthusiastic about the metametrix test. I could not convince him to order it. We found middle ground: blood tests for C. pneumonia, and some other pathogens. Perhaps this will be better in the end than the metametrix stool test?

  39. Hi Justin,

    Well, I support diagnostic testing of any kind, but I predict the results will be hard to interpret. Best of luck to you.

  40. Hi Paul,

    Just an update. I went over the lab work with my doctor. He said I had IGG antibodies for C. pneumoniae, and told me this means I once had the infection, but do not have it anymore. I also had a slightly elevated SED rate, 16 in a normal range of 1-15 (units?). He said this is normal, even though it was flagged barely high by the lab.

    So, the doctor doesn’t think the results are hard to predict, but he also doesn’t seem to buy much into the hypothesis of infectious cause for fibromyalgia.

    That being said, I have been feeling great! I will post my story in the “reader results section”. Feeling good kind of kills my motivation to pursue the antibiotics route. I think I will focus my efforts on following the four steps more closely. If I stop improving, then my motivation will probably come back.

  41. Hi Justin,

    I’m glad you’re feeling well! Please do post in the Reader Results page.

    It’s true that presence of IGG antibodies only proves you’ve been infected in the last ~10 years, it doesn’t prove the infection is persistent. However, C pneumoniae is very effective at establishing persistent infections, so if you have symptoms of a continuing chronic infection then there’s quite a good chance C pn is involved.

    I don’t think an elevated SED rate is normal. Common, perhaps, but not normal.

    But, if your body is healing itself, the SED rate may normalize soon.

    Best, Paul

  42. Hi Paul!

    I’ve been thinking about protein restriction. Would you recommend a near-vegetarian-like diet? With minimal amount of animal food. It is a common belief that in many cases RA improves on a vegetarian diet. I don’t know, but it may be the reason, less amino acids that would feed harmful bacteria…?

  43. I’m curious if you recommend this type of diet for someone with MS?
    I just feel so much better when I’m eating more carbohydrates, VS eating low-carb, but I have multiple sclerosis, and I don’t want to do anything that would be bad for me.

  44. Hi Sile,

    We don’t really know the cause of MS well enough to know what level of carbs is optimal, so I would go with a neutral level of carbs, say 30% of energy, but do intermittent fasting to enter ketosis occasionally. If you feel better with carbs, then that would be a sign to eat them most of the time.

  45. Thanks for your reply!

    I’ve been doing a lot of reading on the Chlamydia pneumoniae – MS connection, and I believe that I saw you mention the http://www.cpnhelp.org website here somewhere.

    Do you think that Cpn is a major factor in causing MS? It appears to be pretty hard to test for.

    I’m seeing more and more evidence for the infectious theory of MS, but so far I’m kind of at a loss as for what to do about it. Antibiotics are the obvious choice, but if you don’t know what the pathogen is (or can’t accurately test for it), how do you figure out what to use? I wish I could find a good doctor around here…:-)

  46. Hi Sile,

    If you read Pubmed the answer would be no, but on the other hand plenty of people with MS at http://cpnhelp.org have gotten help from antibiotics. I think it’s an open question.

    In any chronic disease of unknown cause, antibiotics may be worth a try. I would class MS in that category. But fix your diet first, otherwise it will be hard to tell whether the antibiotics are helping.

  47. Do you think it is worth it to get tested for what type of bacteria it could be? I’ve just heard these tests are notoriously unreliable, so I’m kind of iffy about getting them done, because it would probably cost me a lot of money, that might be better spent elsewhere? Are there any non-prescription antibiotics that you recommend or have experience with that help with MS?

    I read a comment you made on a different post, saying that the modified ketogenic diet would be very helpful for people with MS. Are you referring to the diet outlined in this post?

    I’m also having a little trouble figuring out how to eat my carbs, if they’re going to be honey and rice syrup and fruit. I still can’t eat anything starchy without bloating/gas symptoms (tried white rice the last couple days…nope, not ready yet. Booooo! Because I really crave starches 🙁 ), so I can’t bake anything with them. Any suggestions, aside from just eating them? …which is yummy for like one spoonful, but then not so much after that.

    Oh, and where do you buy white rice syrup? All the stores around here only have brown, and I strangely can’t find it online, either!!!

  48. Hi Sile,

    I do think the tests are unreliable (except for stool tests). If symptoms are similar to a disease that has been specifically tied to a microbe, like Lyme disease, then I would test, but for MS I don’t think it pays off.

    But I do think it’s worth testing an antibiotic, AFTER you’ve fixed your diet. Doxycycline is a good one to start with, since it is relatively benign toward gut flora and you may notice an immediate effect due to its protein synthesis inhibition.

    Ketones are neuroprotective and will generally help neurons survive inflammation and infection. They generally won’t help you defeat an infection; you need some glucose for that. Whether to induce ketosis briefly through intermittent fasting with a bit of coconut oil, or more frequently through an actual ketogenic diet, is a tough call. I definitely think one should do intermittent fasting and eat some coconut oil or milk.

    You could make ice cream, or whipped cream for eating with strawberries, using a lot of syrup. They are disturbingly sweet.

    White rice syrup used to be available on Amazon, but isn’t for now. Tapioca syrup is available however: Tapioca Syrup, 22 oz.

    Best, Paul

  49. Hi Paul,

    For those of us with a family history of Alzheimer’s the whole idea of ‘preserving neurons’ by fasting intermittently is, naturally, an attractive theory. I cannot, however, find anything on Pubmed that confirms that autophagy is strongly turned on 16 hrs into a fast. (But then I’m a rookie at that game.)
    Still it would be extremely helpful to know that 16 or so hours is indeed a magic number. And perhaps as importantly: how sure are we that autophagy is not turned off by the consumption of coconut oil and a few berries during an extended fast? If you are familiar with the protein cycling theory of Ron Migerny http://proteincyclingdiet.wordpress.com/article/protein-cycling-diet-2s3nmvrwklbxs-1/ you can see the attraction of the overall concept, especially for those of us looking for another hedge against our unlucky genes.

    So, thanks, Paul. Sorry to revive an old thread. Always love the blog and need to get the new book.


    • Hi Peter,

      Citations for neuronal autophagy during fasting are in our book, and probably also in some old blog posts – try the ketogenic diet category, try also some of the neurological disease categories (Parkinson’s, MS, migraines).

      Basically autophagy is turned on around 12 hours into a fast as liver glycogen is depleted; peaks at maybe 16-20 hours; decreases after 24 hours to conserve protein levels.

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