Experiences, Good and Bad, On the Diet

A number of people have now given us feedback after starting the diet, and I think this is a good time to review the effects, good and bad, that people have experienced.

In upcoming posts, I’ll discuss the negative experiences further and explore possible causes.

Positive Experiences

It’s gratifying that most people who have tried our diet have reported very positive experiences. Those who read the comment threads or Amazon reviews will have seen some of them; I get others via email.

Here are two from Amazon reviews:

I have battled Celiac disease for some time and got about 80% better with a Paleo diet… but the Perfect Health Diet was the first book that could finally answer that last 20% with science based logic. (Jordan Reasoner)

UPDATE: Jordan has an e-book, SCD Lifestyle: Surviving to Thriving, which looks great for bowel disease sufferers. He gives us an update on his personal progress in the comments.

I can’t believe how much better I feel!…

I had been eating (very) low-carb and high-protein for the better part of a decade – and I had gotten a lot of practice arrogantly dismissing suggestions (from any source) that I should change anything about my diet….

Results: (after 1.5 months or so.)

  1. I’m no longer “brain-dead” and unable to think in the evenings after work.
  2. I no longer have fruit or chocolate cravings.
  3. I’m much happier, and wake up looking forward to the day.
  4. I’ve been much more social.
  5. The extra starch has not resulted in weight gain. (I always gained weight when eating carbs before.)
  6. It looks like the fasting (which I’ve never tried before) is helping my alertness and also contributing to healthy weight loss.

It took less than a week for me to notice dramatic changes….

I can’t recommend this book highly enough. (gp2x)

Here are two from the last few days’ comments.

Yours is by far, the best Paleo / Ancestral diet that makes sense….  I was very strict Paleo for a good 8 months, and yes felt fantastic and lost 10ks etc.  But then started feeling tired, moody.  Enter some carbs (from the suggestion of your book) in the source of potato and rice and taro – and now I’m feeling a whole lot better.  Did I put on weight.  Of course not!  Essentially now I eat what my body craves.  I can listen to it now and it responds accordingly.  It knows when it needs more carbs (eg., after exercise).  And it knows how much as well. (Lisa Weis)

Since reading Gary Taubes’ Good Calories, Bad Calories my life has been transformed. Who knew that butter was a healthy food.  Previous to reading GCBC I was a fruit fiend.  I ate bowls and bowls of cherries this past summer and wondered by I could not lose weight.  I reached my weight loss goals by eliminating grains and limiting dairy to butter and cream and reducing fruit intake.  That said, over the last month or so, I was wondering why my body seemed to be drying out from the inside out.  I want to tweak my diet to optimum health and found your book. The information about the importance of mucin was helpful.  What was missing in my diet was the carbs that you and the missus recommend.  Sweet potatos, white rice etc.  Maybe less protein than I’ve been eating and more saturated fat.  (I’m alarmed by the stomach and other cancers suffered by long term adherence to the Optimal diet …)  I’m having better results every day.  I am fascinated that I have a laboratory of my own body to put your ideas to a test and have them show positive results.  Thank you both so much for your work and above responses to questions and comments. (Doris)

I think these positive experiences are impressive considering that most of our readers have come from the low-carb Paleo community. Low-carb Paleo diets are far healthier than the Standard American Diet, and so improving health further is quite an accomplishment.

Another group that we are trying to help are people with chronic diseases. Probably most readers who did not arrive from the low-carb Paleo community have come from the chronic disease community. It’s a little early to report results, but at least some people are finding promise in our diet. Natalie wrote:

As someone dealing with chronic disease (a very unfun combination of Lyme, Babesia, and Bartonella), I know I’m always looking to find out more of what has worked and what did not work for others.

This blog along with many of the readers of this blog have been a tremendous help to me personally.  For example, I now know I can avoid the daily “coma naps” if I don’t go crazy on the carbohydrates.  I’ve actually received some excellent diet advice from my doctor, but he never told me to chill on the carbs!  (Natalie)

Ketogenic diets are frequently mentioned by us as potentially therapeutic for many diseases. I’ve blogged previously about Claire’s discovery that ketogenic diets help her gastroparesis and Rob’s suppression of his lifelong migraines through fasting and ketogenic dieting.  

As more chronic disease sufferers try the diet – for instance, Darren who has Lyme disease – we hope to prove that the Perfect Health Diet in conjunction with antibiotic therapies can lead to cures for these difficult-to-treat conditions.

Negative Experiences

So far, all the negative experiences I am aware of have come from low-carb dieters who had difficulty after adding carbs and/or cutting protein.

Don Matesz is an interesting case, because his own diet was already a “Perfect Health Diet.” His diet, if I’m not mistaken, was in the low end of our carb range and high end of our protein range. As a test he reduced protein and added carbs, heading toward the high end of our carb range and low end of our protein range. He didn’t like the results:

Just to experiment, for a couple of days Tracy and I reduced our meat intake by half.  I reduced my meat intake from more than a pound daily to just about one-half pound, and, as the Jaminets suggest, replaced the protein with starchy carbohydrates (potatoes and sweet potatoes).  For both Tracy and I, this resulted in a noticeable decline in mood and a dramatic increase in hunger and intestinal gas, along with a disruption of bowel function….

UPDATE: Don says that he does best eating above the bottom end of our optimal carb range, but that for years he has gotten into trouble whenever carbs reach 100g/day (the middle of our optimal range). It sounds to me like an unresolved gut dysbiosis.

Don’s commenter SamAbroad had a similar experience with reducing protein intake:

But I’ve also been following the PHD, and to be honest, I am so hungry and cranky when I restrict protein.

UPDATE: SamAbroad turns out to be our Sarah, and she says that the Perfect Health Diet “has been one of the best things I’ve ever done for my health.” Maybe we should move her to the Positive Experiences group!

I’m still following the diet, I eat circa 100g carbs from starch a day not including veg and this has been one of the best things I’ve ever done for my health along with including a vitamin C supplement. My low-level depression and anxiety have completely disappeared and the diet is considerably more varied and easier to stick to than VLC.

Sarah’s issue is that she needs to eat at least the midrange of our carb+protein “plateau range,” for reasons as yet unknown.

Chris Masterjohn had trouble with sweet potatoes:

Although sweet potatoes are considered a safe starch on the Perfect Health Diet, they are not very safe for me. When I discovered how yummy sweet potato fries are, I started eating several sweet potatoes per day. Within a few days, I was limping and my neck was stiff. By the end of the week, my limp was extreme. I looked online to see if I was eating anything high in oxalates, and sure enough, sweet potatoes are loaded with them. My symptoms dramatically improved after one day off sweet potatoes and were gone the second day.

Chris’s commenter Lisa also had trouble with sweet potatoes:

I’ve been very achy since I started eating sweet potatoes daily. Why would some of us be maladapted to oxalates?… I’m wondering if after a long stint of LC/paleo eating I’ve become intolerant to oxalates or to starch in general.

UPDATE: We discuss possible reasons for problems with sweet potatoes here.

Several people have gained weight after starting the diet. This Amazon review doesn’t come right and say that the reviewer experienced weight gain, but I’m guessing that was the case:

It is worth emphasizing what another reviewer noted: The Perfect Health Diet is not focused on weight loss. In fact, if you are coming to the diet from a zero-carb or very-low-carb regimen, you can count on an immediate and substantial weight gain if you suddenly adopt the recommended intake of “400 carb calories [100 grams] per day of starchy tubers, rice, fruit, and berries.” (K. Hix)

From the comments, Maggy reported weight gain:

Following your advice, I added back a bit of “safe starch” last week, and decreased protein intake, keeping sat fat and MCF pretty high. Well, I got on the scale today and have managed to put on 5 pounds! I’m trying to figure out what is going on and what I need to tweak. I do need to lose a good 20-30 lbs, and while I don’t want to compromise health, I also don’t want to put back on what I managed to lose doing a VLC diet.

Is this an adjustment period I need to get through? Maybe I’m one of those broken metabolism folks who has to stick with VLC? (Maggy)

These negative experiences will be the subject of my next few posts.

Because individuals are so variable, it is often not possible to figure out what is going on without experimentation with different dietary variations and considerable communication. Therefore, I’m most grateful to people like Maggy who are willing to experiment and share their experiences with us.


It’s interesting that the same dietary change – adding “safe starches” to a low-carb Paleo diet – made some people feel better and others worse.

This series may also lead us into the question of trade-offs in diet. These trade-offs may cause different people to prefer different diets. For instance:

  • Shifting from lean-meat-and-vegetables to starches and fats may increase the pleasure of eating and improve health in some, but promote weight gain in others.
  • Higher protein may promote athleticism and fertility, but shorten lifespan (as it does in some animals).

In writing our book, we tried to present the evidence underlying all of our recommendations, and provide healthy ranges for the various nutrients with explanation why the reader might prefer to be at the high or low ends of the range. Our goal was to empower each reader to find his or her own “perfect health diet,” not to rigidly prescribe a specific way of eating.

But negative experiences on a diet can also have diagnostic value. For instance, when I first adopted a low-carb Paleo diet I developed severe fungal skin infections. The new diet revealed an infection I hadn’t known I had. For this reason, even negative experiences can be beneficial, as they may open a path to curing an underlying but hitherto concealed health problem.

We see this blog as a communal enterprise, in which we and our readers together try to discover the truth about diet and health. Therefore, we hope that anyone who does have negative experiences on the diet will not hesitate to report them in the comment threads and work with us to discover the cause.

Leave a comment ?


  1. Hey Paul and Shou Ching,
    I just wanted to let you know how pleased I am with the “diet”. I started it 1/1/13 and am already noticing amazing results! I have only strayed from the diet probably 4-5 days this entire month, mostly just overeating once a week, but I did eat a few pieces of corn and beans mixed in something one day. Back to the amazing part…I have Hashimoto’s disease and a pituitary cyst which inhibits me from producing TSH. I have been taking 150mcg levothyroxine and 10 mcg cytomel, were my most recent doses(I have only gone up never down). My Free T4 is now at 1.41 (normal .77-1.61) and I am still waiting on my Free T3 results, but that is the highest my FreeT4 has been since the Hashi’s started! I am really excited that maybe I will be able to produce some natural thyroid hormone vs. depending on synthetic. Ever since the hashi’s started I have never felt 100%, but am already feeling much better…THANK YOU!!!
    One last thing…Paul I had written about having joint pain last week..I continue to have strange joint, bone, and muscle pain mostly in my legs, but I do run several days a week. The pain did not start until the second week of the diet/supplements and I have been running for about a year consistently. Any more insight is much appreciated. I notice a HUGE difference if I take 400mg selenium vs 200 in energy, but don’t know if that is a good thing or not?
    Anyways, Thank you again-singing praise for your hard work daily!

  2. Has anyone seen this irritating content-less blog post on a site called Primal North regarding how supposedly pointless the Perfect Health Diet is?


    • Hi Peter,

      Those two are very devoted to VLC, and very hostile to carbohydrates. They have experienced bad effects eating carbohydrates, and reject the idea that this experience may have diagnostic value. The author of that post has improved some things on VLC but has not cured everything, she has written me on multiple occasions to ask for help with her health problems.

      I think many people who found the low-carb Paleo community have experienced health problems and this colors their view of things. Often those personal health journeys are not finished.

  3. Hi Paul,

    I’ve been trying to find your stance on dealing with H. Pylori. One practitioner I’m working with has suggested antibiotics to knock it out. Other sources suggest maybe that’s not so good as H. Pylori may have some benefits too if it’s present but not rampant. I had a stool test which showed high H. Pylori and an unidentified fungal infection so just wondering the best way to go here?

    • Hi Mark,

      I don’t have defined opinions on the best way to treat these things. H pylori commonly does more harm than good, I don’t think it’s easy to restore the digestive environment in which it might have been commensal. So I don’t object to attempting to eradicate it. But antibiotics can have collateral damage, including fungal overgrowth which is a risk for you given your positive fungal test. So I might try treating the fungal infection first. But that’s only an uninformed guess.

  4. I happily lost 27 pounds on PHD in 8 months, with some IF and most of the suggested supplements (going from 165 to 138 on a 60 year old barely 5’5″ frame.) Very suddenly my immune system began to tank. Lyme arthritis dormant for 23 years reemerged in shoulder joints, then I had pneumonia and a sinus infection for well over a month, then HSV1 (also dormant for several years) reemerged as painful blisters in my nose, and now, only weeks later, I am again fighting a sore throat. Could toxins released with fat loss have stressed my immune system? Has anyone had this experience with weight loss? Thanks

    • Hi Susan,

      I haven’t heard of this happening. One thing I would say is that you don’t want to restrict calories too much, as that will suppress immunity. It takes a lot of resources to fight infections. Is it possible you have been too low in protein or carbs?

      • Thanks so much for taking the time to respond individually. It is much appreciated. I will think about this, you may be right, especially about the protein. Thanks

  5. Malassezia furfur is a fungus that feeds of sebum glands in skin and causes seborrheic dermatitis. It feeds saturated fat only, not PUFA, (http://www.pgbeautygroomingscience.com/role-of-lipid-metabolism-in-seborrheic-dermatitis-dandruff.php

    Is there link between the fats we eat and the fats we sweat, resulting in seborrheic dermatitis when switching to high saturated fat diet? I have developed some fungal rash after eating high saturated fat diet (nowhere close to low carb – high in rice and fruits) trying to get rid of it.

    • Hi Martin,

      According to that paper, any saturated fat level from 20% to 100% supports Malassezia growth. Skin and sweat lipids will be around 40% saturated regardless of diet as tissue levels are regulated.

      So I think it is unlikely to be the case that dietary fats are feeding Malassezia on the skin. It’s more likely that the difference is in immune activity.

      Saturated fat-rich diets could increase ROS generation making the immune system more active. Or it could be related to omega-6/omega-3 balance which also modulates immunity. Or non-lipid nutrients.

      I’ve made some notes to look into this, but I don’t see any obvious conclusions.

      • Did you find a solution meanwhile?

        I had the same experience. Saturated fat (animal only, not coconut) worsens seborrheic dermatitis.

        Vitamin A (liver) and Zinc can be helpful to reduce symptoms. However i don’t know how to get rid of it completely.

        • Still fighting. Given up on applying stuff topically and trying to cure the most paleo way: doing nothing – no cream, no water just nothing. Feels dry, improved a little bit but not much.

          • Have you already tried sun exposure during solar noon without sunscreen and without getting a sunburn (so limit exposure time accordingly)?

            Have you checked your Vitamin D/25(OH)D level?

            Are you certain that it is a fungal rash?
            I was diagnosed with Pityriasis versicolor (caused by Malassezia furfur) through visual diagnosis. However, the biopsies and fungicultures turned out to be negative with regard to a fungus. Then they thought along the lines of Psoriasis. In the end they were unable to diagnose the skin condition (having used 4 skin biopsies).

            I tried sensible sun exposure as described above and supplemented Vitamin D, because I was deficient (15 ng/ml) and the skin condition cleared (leaving hyperpigmentation behind at the former red spots). I have been sunbathing in midday sun ever since. So I don’t know whether it returns if I stop the sun exposure and to what extent the immunomodulating effect of adequate Vitamin D levels might have played a role.

            If you haven’t tried it already, it may be worth a shot.

            I can’t tell cause and effect of course. I simply noticed the association.

          • For me sun exposure makes the condition a lot worse. Only some minutes of exposure and i get an itchy scalp the next day.

            I was also diagnosed with Pityriasis versicolor through visual diagnosis, so my dermatologist prescribed MICETAL shampoo, which I’m trying right now.

          • @Max
            I do sun exposure almoast exactly as you describe it for over a year so low vit D is not an option. Was very instrumental in healing my leaky gut and psoriasis I had before disappeared. Did not try skin biopsy and cultures yet.

  6. Hi,
    I´ve got a few questions. I´m from Germany and my English is not good enough to understand everything in your book / on this page…
    I´ve lived low-carb for the last three months. Since I´ve read your book (two weeks ago ), I increased the carbs; three days ago I added sweet potatoes to dinner, the next day potatoes, the next day white rice and today a little teff-flour. I started low-carb to solve my problem with reflux acid and a big belly …now it`s back.What can I do? I don`t think low-carb forever is healthy and I´m hungry when I eat only so little carbs. But now the reflux acid is back, also a very big belly although I´m a thin person. Are there other people with this two problems? What could I do? My belly looks like I´m pregnant. With low carb it was a bit better, but not okay. Thanks for your answer!

    • Schau dir doch mal http://lchf.de/ an. Die Idee ist im Prinzip kein Zucker, keine Stärke. Jeden Tag genug (nicht-stärkehaltiges) Gemüse, keine industriell verarbeiteten Produkte und viel von den richtigen Fetten. Warum das langfristig nicht gesund sein sollte erschliesst sich nicht. Um zu merken dass die herkömmliche Art zu essen langfristig ungesund ist, muss man sich ja nur umschauen. Bei Low Carb sollte man nicht hungrig sein. Der Hunger ist das erste was bei Low Carb High Fat verschwinet. Wenn du hungrig bist, isst du wahrscheinlich zu wenig Fett.

  7. Food is Medicine | samsuska - pingback on June 9, 2013 at 5:32 pm
  8. Hallo Simon,
    Hast Du das Buch gelesen? Aus verschiedenen Gründen wie dem Erhalt gesunder Darmflora wird von low carb abgeraten und der Konsum von safe starches empfohlen. Schau mal unter dem Link rechts danger of Zero carb.
    Ela, kann es sein, dass Du Candida hast? Das könnte das Aufgeblähtsein

  9. Paul
    many paleo dieters develop skin problems, could this be due to impaired skin barrier as a result of low EFA ingestion?
    Does that mean that a small amount of high quality non oxidised omega 6 fats may be beneficial? If so what could be optimal amounts and sources?

  10. I have found that after removing butter and ghee from my already paleo diet, seborrheic dermatitis goes away completely within one week.

  11. Psoriasis is still a problem, gut issues such as bloating and wind are not ideal either

  12. This seemed like an appropriate place to put this comment. I followed this diet with great success in Norfolk, Va for a year. I lost about 50lbs, had a huge reduction in allergies, and felt great. With the exception of sinus issues that would not go away. I then moved to Honolulu, HI, and in the course of the move went off the diet. I gained about 30 lbs back and had a return to a host of problems I had before going on the diet. When we finally moved into a house, I got back on the diet. But this time, I lost no weight, was exhausted, and kept getting sick. Turned out, I was low on salt. Hawaii is much warmer, and A/C is not often run due to the cost of power. I now take two teaspoons of salt on top of what I eat on food (which is honestly not much). I now feel better than ever, and losing weight again, and the sinus issues have finally resolved themselves! I think you might consider addressing the potential of a sodium deficiency on this diet. I don’t remember every feeling this good on a daily basis and salt was the key.

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