Q & A

Q & A

This page as an open thread for reader questions, especially questions about personal health concerns.

I am putting this page up as a way to share knowledge — my knowledge with questioners, but also so that others with similar concerns can read the conversation, and readers with relevant knowledge can chip in with their own thoughts.

Please keep in mind that I can’t research questions in any depth, so my answers should be considered tentative, incomplete, and subject to later correction. Also, I am not a doctor, and nothing I say should be construed as a substitute for medical diagnosis and treatment. I am only sharing opinions about disease origins and general therapeutic strategies which may or may not be applicable in any given case.

To get the page started, I’ll put up a few questions from recent emails. Here is an index by disease, with clickable links:

And here are my answers.

Chronic Lymphocytic Leukemia (CLL)


Been following your work on the PHD before the publication of the book and commented on my CLL and the usefulness of Vitamin D once on your blog and you responded to keep an eye on my Vitamin K intake, which I do now.. Am fortunate in a way to have my form of CLL as it indolent which gives me the opportunity to experiment without the pressure of undergoing conventional treatment. The PHD, I think, is helpful in this regard.

Wonder if you could point anything out to me that may be useful. Anything at all. And I will be happy to share with you my results.

Surely you know of the helpfulness of green tea with CLL. You may not be familiar with research that points out that those with low levels of Vitamin D need treatment for CLL far sooner than those with elevated levels.

Feel strongly that your version of a ketogenic diet would be helpful but also feel I need some direction in this area. Do you have any suggestions?

Warmest Regards,


Hi A,

I remember your comment, thanks for writing back. I’m glad you’re enjoying our diet and wish you the best.

Thanks for the tips about green tea and vitamin D. Neither one surprises me.

Most likely CLL is caused by a viral infection. So enhancing viral immunity is probably a good idea. Good strategies may include: (1) low-protein dieting, which inhibits viral reproduction and can promote autophagy; (2) maintaining high vitamin D levels; and (3) intermittent fasting, which promotes autophagy.

Some food compounds have been reported to have antiviral effects. An example is green tea catechins, eg http://pmid.us/16137775, http://pmid.us/18313149, and http://pmid.us/18363746, and this could be why green tea is helpful against cancers, http://pmid.us/21595018, which are usually viral in origin.

I might search Pubmed for herbs and spices with antiviral effects, and use them abundantly in cooking, along with antiviral foods. Turmeric / curcumin is a good choice, this needs to be taken with black pepper to enter the body. See http://pmid.us/21299124, http://pmid.us/20434445, http://pmid.us/20026048.

Coconut oil / lauric acid also has some antiviral properties, so inducing ketosis with coconut oil could benefit you even aside from the ketosis. You could also try monolaurin supplements which may enter the body better and which some people have reported to help viral infections.

You might also try HDL-raising tactics as discussed in this series: HDL and Immunity, April 12; HDL: Higher is Good, But is Highest Best?, April 14; How to Raise HDL, April 20.

Another possible tactic is high-dose riboflavin with UV exposure on the eyes. This requires going outdoors at midday and not wearing glasses or contact lenses. Riboflavin+UV is toxic to blood-borne viruses, and the retina is a location where UV can reach circulating blood cells. Sun exposure will also help you optimize vitamin D.

That’s a few ideas, at some point I’ll do some research to come up with more and do a blog post. Do keep me posted on your results!

Best, Paul

Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue

Just came upon your website and had a question for you. I have had some health concerns for the last four years, bloating, acid reflux, anxiety, depression, hypoglycemia symptoms, female complaints (I am in my forties), thyroid antibodies at 333, weight gain around my middle and too tired to work out like I once did. I used to be fikiiled with energy and great health no depression or anxiety. My doctor thinks these symtoms are all from peri-menopause and wants to treat me with Zoloft.

Needless to say I have tried to avoid the Zoloft. I have tired every avenue out there to cure myself. Most recently the Primal type diet. When I eat no grains or dairy I get horrible hypoglycemia symptoms and don’t feel great like everyone else on a low carb diet. I feel weak and more anxious. Do you think your diet would be easier for me with the addition of rice and potatoes?


Hi G,

Yes, I do think our diet will be better for you. You should eat enough starches to avoid hypoglycemia.

The key thing for you is treating the infections which are consuming so much glucose and making you glucose-deficient if you don’t eat enough carbs. Whatever pathogen(s) this is, it seems to have infected your gut and caused the various gut problems; circulating pathogen-derived toxins and immune cytokines are probably responsible for the anxiety and depression. Hashimoto’s hypothyroidism may be either due to circulating toxins or a thyroid infection.

I would suspect some kind of protozoal or parasitic infection due to the hypoglycemia, but what I really recommend is getting your doctor to have a stool sample analyzed for pathogens. Metametrix has a good test. Once you know what pathogen to treat, and get on a better diet like ours, you should improve quickly.


I am writing on behalf of my mother … We live in Dhaka Bangladesh …

Before her illness, my mom was 105 lbs, 5 feet tall and always 10ft tall in spirit…. When she was diagnosed with Lupus at the age of 30, we were all overwhelmed and out of our depths. My beautiful, athletic mother was in a wheelchair and given 6 months to live….

The doctors has advised her to eat literally nothing, minimum protein (1 small piece of chicken/fish, limited to 20g protein per day), only 2-3 types of vegetable and 2-3 fruits and of course lots of carbs to apparently compensate for her failing KIDNEY and LUPUS. She is on tons of medication, no food except the wrong foods (carbs) and in chronic pain. She currently weighs 139 lbs.

Please advise. — S

Hi S,

I believe lupus is a catch-all diagnosis for a variety of conditions which are probably caused by undiagnosed infections. In the US the infections are usually bacterial. I’ve known several people with diagnosed lupus who were cured by antibiotic treatments – in one case the problem was Lyme disease (Borrelia). I have no idea what the likely pathogens would be in Bangladesh. If she does better on low carb and coconut oil, that indicates bacteria; if she does better on high-carb, that indicates protozoa.

A healthy diet is very important. It is very bad advice to “eat literally nothing,” it is essential to be well nourished. Protein is necessary for healing and immune function, and 20 g/day is too little. Fasting is good, but it should be intermittent – not starvation! She needs healthy fats, more protein, and lots of micronutrients. Eggs, shellfish, seafood, bone broth soups, vegetable soups, and fermented vegetables may all be helpful. Coconut milk is probably good for her. You should basically follow the program in our book.

I would try to put her on a good diet, give her a little time for kidneys and other tissues to heal, and then try antimicrobial medicines. Usually, if they’re not working, then you don’t notice an effect. Any strong effect, good or bad, means they are working. Bad effects mean that pathogens are dying and releasing a lot of toxins as they disintegrate. If this occurs, detox aids (salt, water, and one of cholestyramine/charcoal/bentonite clay; also glutathione supports and vitamin C) will help.

Please stay in touch and let me know how things go.

Best, Paul


Jersie wrote:

I’ve suffered from depression for decades. A few months ago, I decided to try the Dr. Kruse protocol for jumpstarting leptin sensitivity and 2 interesting things happened.

When I went very low carb – below 50 gm -. I had half-day periods where the depression suddenly lifted (something that has rarely happened otherwise). However, I also suffered from darker than normal periods.

I stopped the Dr. Kruse protocol after 6 weeks, and went back to regular paleo (approx. 200 – 300 gm. Carb/day). I’m now generally more depressed than usual, without the good periods.

These changes seem to indicate that I can have an influence on my depression with diet, but not sure what diet to try. Thoughts?

Hi Jersie,

I think your experience on very low carb is diagnostically telling.

I would interpret it this way:

  1. Your depression is caused by an interferon-gamma mediated immune response in the brain, probably caused by a viral or bacterial infection. This leads to tryptophan being directed away from serotonin and toward the kynurenine pathway. So you have a serotonin deficiency and kynurenine excess.
  2. A ketogenic diet is both therapeutic (promotes immunity against bacterial and viral infections) and mood-improving (clears kynurenine).
  3. However, you are at risk for hypoglycemia in the brain (especially if the infection is bacterial) and hypoglycemia causes irritability/anxiety and can aggravate depression.

So the very low-carb diet had mixed effects (ketosis, hypoglycemia).

What I would do is follow our ketogenic diet advice. Eat at least 50 g/day carbs from starches to get sufficient glucose, plus sufficient protein to reach 600 calories/day protein+carb, but add in large amounts of MCT oil or coconut oil. Also, do intermittent fasting – eat all the carbs within an 8-hour window; eat at least half the MCT oil in the 16-hour fasting window.

Once on a good diet, I might experiment with antibiotics to see if they relieve symptoms.

Please let me know how things go.

Leave a comment ?


  1. You knew someone was bound to ask…now rice is reported to have high amounts of arsenic and should only be eaten twice a week. Just when we added organic basmati white rice back in and love it! What’s your take on it?

    I don’t have a link but the article is in Consumer Reports current issue.

    • Hi Jan,

      Only rice grown in the southern US, where arsenic was used as a pesticide against boll weevils in the 19th century, has arsenic. Just buy Asian or Californian rice and you’ll be fine.

      • I guess ‘certified organic by Texas’ isn’t a good sign.

      • Here’s the chart from the Consumer Reports testing:


        In brief, while the CA sampled (from Lundberg) is one of the ‘safe’ rices (I use the quotes aggressively), by no means is Lundberg free and clear: their other CA rice is above the New Jersey limit, and their rice syrups (presumably both from CA) are likewise above. Rice syrup is pretty concentrated of course though.

        Paul seems to be right-on about Asian sources: check out the Indian and Thai rices.

        Finally, how has no news source found a way to use the headline “Arsenic and Old Rice?”

  2. I did not have a metametrix test, but I went to a doctor that did a number of blood tests and everything was within normal range except for h pylori Ab., IgM. Since I have ulcerative colitis and have a good longstanding relationship with my doctor I called his office to see what he had to say. The office said that they only use a stool sample or endoscopy to test for h pylori and that blood work is not a reliable way to detect h. pylori. I expect a call back from the dr tomorrow. The result for h pylory Ab., IgM 1.02
    the other 2 listed IgA (0.18) and IgG (0.56) were within normal range.

  3. Hi,

    I have had reflux for 6 or 7 years. Have been doing Paleo happily for the last 1.5 years and I thought the reflux was pretty much gone as I have been asymptomatic for a few months. Just diagnosed yesterday with silent reflux to explain my hoarseness . In any case I was told to give up tomatoes and dark chocolate, 2 items I include regularly in my diet. Tomato season is over soon but its always chocolate season here. Any insight about this?



  4. Paul or anybody – is there a dry cereal that is not so chock full of grain toxins that you can recommend? I just love pouring my coconut milk over dry cereal n the morning, and crunching through breakfast. Help!

    And are traditional pickles ok?,,,the ones from cucumbers?

  5. I am sure this has been covered somewhere but I can’t find it with the search button. What doses do you recommend for copper and boron supplementation?

  6. Dear Paul, re VLC diets and mineral loss etc, this is a question for people like me who can’t eat starch and are doing SCD or GAPS rather than PHD from necessity. Could you please clarify whether you class GAPS and SCD as VLC if the diet includes fruit, beets, squash and carrots. Thank you.

  7. Thanks for the prompt reply Paul. 3-4 lbs is a pretty tall order, especially for someone who doesn’t have a sweet tooth. But maybe it’s worth weighing out a combination of 3lbs or so of fruit, squash, beets and carrots to see what I’m up against!

  8. Paul, can you explain why no selenium in the new recommendations? If on iodine, due to low tested levels, the protocol for thyroid support calls for selenium everyday. Is that necessary to support detox and mineral balance? Thx.

    • Basically I think the risk of selenosis is higher than the risk of selenium deficiency. But I would have no problem with taking it once or twice a week.

      Many people on SAD get 30-70 mcg selenium per day, but PHD intake is more like 150 mcg and can range much higher depending on food source. So the risk/reward ratio is higher.

  9. Hey, what’s your take on Shiritake Noodles or Miracle Noodles? I know you suggest rice noodles, but have you ever tried these types of noodles. And since they are pretty much all fiber, do you think they would have toxins in them?

    Thanks for your insight Paul,

  10. Selenosis? What about iodine and selenium info that was out not long ago? I guess in addition to copper and boron I also need to know what to take of selenium?

  11. Arent miracle noodles made with “some” soy?

  12. Hi Paul and th eother helpful people on here, I’d love any insight you could give…

    I’m 20, fractured my 3rd/4th metatarsal playing soccer 8 weeks ago. I wore one of those boot thingies which simulates the function of a cast but allows for moving, even while immobilising the affected area.

    After taking the boot off a week ago, I noticed that my foot was discoloured (purple)and was cool to when touched. After the temperature did not change for two days (and I was conscious of the coldness from within) I went to the ED oy my hospital. A big factor in this was that I had a DVT last year in my arm and was wary of vascular issues (although the DVT was related to thoracic outlet syndrome, nor any underlying blood disorder).

    I had an atrial ultrasound and thrombus etc was ruled out, and all pulses were strong. Given there was no pain I was sent home with a referall to vasular specialists.

    The physcio I’ve been seeing suggested the discoluration was a sympathic response after immobilsation, like a mild ‘regional pain syndrome’.

    I keep wondering though if it is related to the supplement I took shortly before I noticed the dscolouration. After much rumination I took 250 calcium citrate alongside one of these
    http://www.lef.org/Vitamins-Supplements/Item01224/Super-K-with-Advanced-K2-Complex.html. I planned on doing this once a week, alongside eating sardines, as I seem to have problems with dairy that aren’t lactose related.

    Although I am on aspriin after the dvt (hopefully not permanently), I can’t help but think the vitamin k is related. I eat many greens daily but if much of ingested vimtan k1 is bound to fibre then the dosage of the supplement may have been more than I’ve had.

    There is 1000mcg k1, 1000mcg k2 (mk4) and 100mcg k7 in the softgel.

    One of the main reasons I suspect this is that yesterday my foot returned to a normal hue and termparture, and has been the same since (excepting a couple of period of collness, only in that foot.

    I haven’t taken abother vit k tablet to confirm…

    Any insight? Could the vit k have ’caused’ the discolouration and coldness? What mechanisms would be behind it?

    I’ve searched pretty far and havn’t managed to come up with anything…

    Thanks for reading this if you have.

    • I am not a professional “ANYthing” but recall these symptoms in a friend once a long time ago…it was also called Reflex Sympathetic Disorder I believe. I can’t remember why it happens….but perhaps knowing alternative terminology can help you research it more thoroughly and see if it fits your description.
      Best of luck,

    • Hi Michael,

      I don’t know what happened, but I would say that vitamin K2 is much less likely to cause excess clotting than vitamin K1, so maybe it would have been better to take a K2-only supplement while you had your foot immobilized (which also promotes clotting).

      Fortunately it sounds like it’s cleared up and no lasting harm was done.

  13. Hi Paul,
    I know how useful and necessary it is to eat organ meats, but, although I’ve tried to get familiar with liver and kidneys on PHD, it’s impossible for me to eat them. I’ve tried all kind of recipies and ways to prepare them. But, it’s too hard. I like neither the taste, nor the texture.. disgusting for me. More of this, nausea and vomiting are occasionnaly following the ingestion.. 🙄
    Would you have a helpful answer, or maybe a reason that could explain why I cannot tolerate them ?? And could you give any kind of other advice to replace their useful content ? (selenium,vit.,minerals and so on…?!).

    Thanks for all, best,

    • I don’t know. Maybe a reaction to iron from blood, and cleaning them thoroughly (wash/rinse followed by a boil/simmer again discarding the water, followed by a final cooking? maybe use milk for the rinse so that lactoferrin will bind iron?). If you have excess iron to begin with iron will not be absorbed and it can feed gut bacteria with strange results.

      Just an idea, I really don’t know what’s behind it. Is it the same with chicken liver which has less iron and copper?

      • Thanks a lot Paul…

        What would you recommend for excess iron, and what consequencies are induced with this condition ? Here in France, all the reasearch on nutrient you develop here, are not at all currently tackled in doctors room (!). They seem so far away of this… 😯
        Unfortunately, I’ve tried all those recommendations yet.That’s why I ‘m trying to have some more info on this strange reaction..I wash/rinse/boil/simmer again and discard the water..I’ve even tried chicken liver and heart… It’s not so hard to smell, but the same difficulty occurs when it’s in the mouth. I wonder if a PHD diet can be friendly without “organ meat” ? I would like to minimize the supp. (for budget reason..)as long as it’s possible, and hope Mother Nature allows everybody to find the useful things in the simple things of food.. I guess and hope I can find a substitute food to organ meats, without being nutrient deficient ?..Of course, any suggestions would be appreciated.. Thanks a lot for your careful reading, Blessings, Maya.

  14. I wonder if shellfish can substitute for organ meats; they are complete animals, high in phospholipids, omega 3s and minerals? I’m thinking mussels, oysters, scallops etc…
    I just had lambs brains for dinner. Very seafood flavour, surprisingly digestible. I boiled them for 20 mins in water with vinegar and salt then broke them up and fried with some mixed pork and beef mince, pasta sauce, peas and spices.
    I could get used to them.

    What about chicken livers? they fry up soft, sweet and tasty.

    • Thanks so much Georges for taking great care of my question… I’ll try your suggestions and hope I’ll have some more successful results…
      Unortuunately, the same things happen with chicken liver.. ^^

      Thanks again,Best ,Maya

      • If you were living on a small Pacific atoll you would likely have no land animals; your offal equivalents might be fish heads, molluscs (octopus and shellfish), and maybe the occasional egg of bird or turtle.
        How do you feel about fish head broth?
        These are all low-iron choices too.

        • Georges, Thanks so much !!
          Oh yeahh ! Fish head broth makes the cells shining ! I was avoiding eating molluscs too regularly,even if I love eating them, because of toxins carried out. Don’t know Paul’s and yours’ thoughts or experience about it..(oysters,mussels, and so on..?!) Anyway, these are great and perfectly digestible food.. Maybe my body believes I live on an pacific atoll.. 🙂 😉
          Anyway, Thanks so much for helping so heartfully each of us !! Blessings, Maya

  15. Hi. I contacted you before as I was doing a weekly longer fast of 36 hours with 12 tbs of coconut oil but when I get to about 25 hours I felt very nauseous and usually ended up vomiting and diarrhea. I am completely fine on the daily 16 hour fast and don’t feel any nausea doing that. You replied and suggested that you no longer recommend longer fasts but I should explore my symptons further. I ordered a stool and saliva test which was examined at laboratory. No yeasts or mould were found. No trace of bowel cancer. However my stool test was too alkaline. It was 7.5 which they said shows that there is some putrefaction in the colon. My secretory IgA was very low. (decreased: <20). There was no candida, or parasaties, the leaky gut reading was normal. They recommend a food based liver and gall bladder support, digestive enzymes and beneficial bacteria. They recommend following it up with a nutritionist to explore further. But I think it will be difficult to find a PHD friendly nutritionist and wanted to know if you had any advice.

    • Hi Brett,

      I would suggest just eating a good diet and limiting fasts to 16 hr for a while, probably your digestion will improve.

      Nutrients to pay special attention to are vitamin C and taurine for bile, getting enough salt for stomach acid, adding vinegar and other flavoring acids to food, and making fermented vegetables once in a while. Good fiber containing foods are tomatoes and berries, and potatoes.

      I would expect the digestion to recover by itself over time, as long as you are well nourished and eat the right foods.

  16. So, I am tackling my problems one by one. Your diet helped with acne! It was fluorine containing items.

    Now I am trying sleep. I have fasting blood glucose of 89 g/dL.
    I have been trying to keep food intake to an 8 hr window. Usually lunch around 1230 and dinner around 730 or 8, two meals a day.

    I go to bed around 930 and wake up around 3 or so, to urinate. I have read this is a cortisol issue and that to combat cortisol issues, and my fasting blood glucoaw also seems kind of high, considering I follow PHD. For both problems, I think the solution is one should eat more often. Should I change my eating window in your opinion and only once fixing th cortisol issue while I be able to fix my sleep?

    Unfortunately I found, like Seth Roberts, that eating breakfast also caused sleep problems, with my body waking up in expectation of food. Any advice would be appreciated. Not sleeping is tough!

    Best, LJ

    • Hi LJ,

      Congratulations on the acne!

      A fasting glucose of 89 mg/dl is perfectly normal. However, with adrenal issues you might find that eating a small breakfast, say a banana or bowl of berries, may be better than a pure 16 hour fast. You might experiment to see what you can do without impacting sleep.

      The other thing I would try is working on all aspects of circadian rhythms. Sun exposure and light outdoor activity in morning and afternoon, at least 10 minutes each; dim lights at night, bright lights at day; maybe take a low-dose lithium each morning, 2.5 to 5 mg; maybe melatonin at bedtime.

      • Hi Paul,
        You mentioned lithium in the morning, do you believe the timing is important.
        And, do you believe lithium in the morning will help with sleep in particular (or just circadian rhythm in general).

        • Yes, timing is important; yes, I do think it would help a bit with sleep.

          • Hi Paul,

            I noticed that you’ve been mentioning the benefits of taking lithium lately. Is this the same as the lithium commonly prescribed for antipsychotic purposes? If so, isn’t that only available by prescription? And doesn’t it require regular blood tests to monitor liver function? And aren’t there numerous and common side effects? I’m keenly interested in anything that might help me sleep better! Thanks for helping my confusion!

          • Hi Kevin,

            I’m speaking of much lower doses available on Amazon (5 mg) and actually cutting those in half.

            There can be side effects, eg exacerbating hypothyroidism, so it is not for everyone, but it seems that people do best when they get a bit — we seem to have evolved with a presumption that there is some in the water.

  17. Hi Paul and others,
    Almost two weeks ago I posted that I was worried about some tick bites I had since I found a large red circular area on my back. Anyway, my doctor prescribed 3 week course of doxycycline just as a precautionary in case there was any Lyme or other tick-borne illness involved. Anyway, I haven’t taken many antibiotics before so I’m not too experienced with side effects, but am aware of things to look out for– diarrhea, candida overgrowth, etc.
    Would eating yogurt everyday be enough to combat the negative effects of antibiotics, like candida overgrowth? I noticed the past few days that saliva in my mouth seems thicker than usual and I was thinking of candida. Also noticed some dandruff… isnt that candida related? I havent had diarrhea but I’m worried about candida getting out of control. Is this a valid concern when on antibiotics?
    Should I maybe also consider a daily probiotic (taken at least few hours apart from my doxycycline dose)?
    Thank you!

    • Hi KH,

      Dandruff is usually fungal but not candida – Malassezia (Pityrosporum) usually. http://en.wikipedia.org/wiki/Malassezia

      Usually fungi/candida will not get out of control if your diet is good and your immune system is functioning properly. Still, yogurt or probiotics are probably a good idea. Also fermented mixed vegetables. Be sure to eat enough carbs, and to get key antifungal nutrients like copper and chromium and vitamin C.

      • Ok thanks Paul! My vit C and chromium status should be good, but I suspect I’m low on Copper since I haven’t been good about eating liver and I also haven’t eaten any nuts (good copper source, right?) lately. I might be able to better handle the liver if I’m not the one preparing it. I saw on the updated supplements section that you recommend supplementing Copper for those who aren’t eating liver regularly. I guess I’ll either have to toughen up and make the liver or get the copper supplement.

  18. Oops, what I meant to specifically ask was, will the yogurt and probiotics help only in the digestive tract? So for my head (if dandruff is candida related) would I need to apply something topically?

  19. Paul,
    Two questions
    1) Do you advocate eating potato skins? I like them but recently read arsenic might be an issue
    2) Since adding back 50 Gms carbs or so (rice, potato) I felt perfect again for six weeks or so and then my heartburn returned. Of course I suspect gut flora, but is there any action I can try (dietary)without doing testing? I would just stop eating them but I was one that had trouble with T3, T4 conversion on very low carb.
    I am wondering about VSL #3 or some type of probiotic?

    • Hi Catherine,

      Not sure I’d say advocate. They’re OK if the potato was well-handled but if the potato has been improperly handled they are where toxins are generated. Shou-Ching tends to skin the potatoes, I generally dice them small enough so that I can see if the flesh is discolored under the skin and if so cut that part away.

      Probiotics might help, also B vitamins sometimes help, or there can be deficient stomach acid production leading to SIBO. Eating more salt and bitter herbs may help with the stomach acid; or take betaine hydrochloride with large meals.

  20. Don’t know if my post got lost in the shuffle or maybe no one had any comments, but just in case, I am reposting it. Thanks

    I did not have a metametrix test, but I went to a doctor that did a number of blood tests and everything was within normal range except for h pylori Ab., IgM. Since I have ulcerative colitis and have a good longstanding relationship with my doctor I called his office to see what he had to say. The office said that they only use a stool sample or endoscopy to test for h pylori and that blood work is not a reliable way to detect h. pylori. I expect a call back from the dr tomorrow. The result for h pylory Ab., IgM 1.02
    the other 2 listed IgA (0.18) and IgG (0.56) were within normal range. Is this h pylori or not?

  21. Thanks!

    I suppose you and George will be digging into this study eventually (looking forward to it) 😉


  22. Actually, since *we* don’t eat corn, why worry. :mrgreen:

  23. If I may? Watch this video http://geneticroulettemovie.com/

    According to the experts on this (and there are plenty of GREAT ones!) ANYone can heal from GMO’s and toxic living….
    carmen (a non expert)

  24. Hello!

    What’s your take on parsnips as a source of starch?

  25. Hi Paul,

    What type of autophagy am I inducing on your migraine regimen? I came across this link http://joshwhiton.com/?p=1319 which mentions “CMA (Chaperone Mediated Autophagy) can’t handle some of our cell trash: very large junk proteins, damaged organelles, bacteria and virus stowaways, and more.” which got me confused because CMA is apparently ketone-triggered, which sounds alot like what I’m doing.

    • Macroautophagy clears the larger components.

      The idea behind intermittent fasting is that you trigger all types of autophagy regularly and the trash never builds up (aggregates) to an unclearable degree.

      Also, “can’t handle” in the sense of on or off may be too extreme, it’s probably more like “has trouble handling” and so stimulating autophagy regularly gives you a chance to clear some of them.

      • I see now, thanks. I fast 20/4 (6pm-10pm), so hopefully 120 hours of fasting a week should give me a quite few bouts of macroautophagy!

  26. Exercise: Is Less Better Than More? | Perfect Health Diet - pingback on September 22, 2012 at 9:33 pm
  27. Here in Norway the summer is more or less over and there will not be much sun exposure to be had in the coming 7 months. Do you think tanning beds are a good option?
    I have seen some people talk about vitamin d-3 sulfate and cholesterol sulfate and they seem to claim that it is only possible to get this from sun exposure.


    One problem with most tanning beds is that power and the frequency is not similar to the sun. Are they so different from natural sun light that it is likely that they do more harm than good?

    • just go to a good tanning booth that has higher levels of uv-b light. supplement with never wearing sunglasses so that the light you do get goes in your eyes. also think about getting a “happy light” or similar light therapy device to stare at each morning.

  28. Paul,

    Along with the perfect health diet, is there anything that you would recommend for psoriasis.

    • I would really like to hear more on this too. Aside from the whole infectious disease hypothesis, I have been reading about th1 and th2 dominance.

  29. Rosemary Stockdale

    I have been suffering with chronic pain for nine years – resulting in upper back pain and ulcers in the oesophagus and stomach. I am currently on an anti inflammatory diet – no sugar, caffeine,
    meat,chicken, alcohol, and chocolate. Mainly eating nuts, fruit, vegetables, rye bread. How could I incorporate your diet into mine? Thank you

    • Hi Rosemary,
      Have you read the book? If not, I recommend it immediately. I listened to Paul speak in Dallas and was disbelieving of his assertion that “everybody gets chronic infections.” Then, after reading blog post after blog post telling of readers getting their Metametrix test back to find that they have been housing a pathogen for decades. My test results showed H. Pylori — the ulcer causing bacteria. I did not think it caused me pain, but did have horrible airborne allergies that are much better now that I am midway through the treatment. Also, a back pain that appeared for years and years when I was tired has now stopped. Always associated it with fatigue, but haven’t had it for about three weeks. It was across my back below my shoulder blades. Google H. Pylori and back pain and see the thousands of hits you get. Also, google “Amy King happy I have h. pylori” and see if your symptoms match any of hers. Good luck to you.

      This discovery has triggered much emotional work for me, for it has taken me back to my childhood and the many episodes of unexplained stomach pain which my parents dismissed as childish exaggerations. Many answers, late in life, but still healing. I wonder if Paul and Shou-Ching understand the amount of good the have done for me.

      much care

  30. Hi Paul, I’m hearing on the news and internet about rice and arsenic………….I rinse my rice 3 times before cooking in filtered water, but didn’t realize rice sucks up arsenic like a sponge and may still be in there when I eat it. It is linked to bladder and other cancers, what do you know about this? Is it really safe to eat rice, I like organic rice cakes too, I’m SO thin, I’m running out of stuff to eat, Thanks Laura

  31. Paul,

    My wife has had Eustachion tube blockage on both sides for more than 6 months. It gives a her a lot of pain. The antibiotics does not help.
    How can I help her?

    • I don’t have any expertise here, just chiming in with an idea…
      Could she have a dairy allergy causing inflammation of the tubes? And if not inflammation, maybe excess mucous from the dairy?

      I pasted below what I just read from this site (don’t know if it’s a credible site, but the information below sounds reasonable to me).


      Ear Infections and Dairy Allergies

      Do you ever wonder why some kids get lots of ear infections, often resulting in multiple doses of antibiotics and eventually tubes in their ears? Why don’t the antibiotics ever completely solve the problem?

      Ears require drainage by the eustachian tube, which opens into the back of the throat. In young children this tube is not fully developed and is very susceptible to being blocked by inflammation. Anything that causes inflammation can block the eustachian tube, resulting in a warm moist breeding ground for bacteria in the inner ear.

      Antibiotics kill the bacteria, temporarily, but they don’t change the inflammation of the eustachian tube or the breeding ground. This is when placing a tube through the tympanic membrane is recommended. These don’t solve the inflammatory problem either, but they do get the drainage going.

      The real cause of the problem is the inflammation of the eustachian tube. Usually this inflammation is caused by a food allergy, most often dairy. Children generally drink and eat a lot of dairy. Invariably it’s the very first food introduced into the diet.

      A milk allergy is by far the most common cause of ear infections. Removing dairy from the diet will usually result in complete resolution of this problem. However, occasionally further food allergy testing is required to determine the source of the inflammation.

    • Jacob,
      I’ve had that chronically too as an adult. (No pain, just fluid and muffled hearing.) Has she gone to an ENT? They gave me a nose spray, which I hate and rarely, if ever, use. I’ve had tubes in both ears several times as an adult. (Never had tubes as a child.) Really don’t like having the tubes, but it sure helped with the hearing and the fluid! I think that once the fluid is in there, it’s difficult to get rid of it. They ruled out some other things with an MRI. They said mine was probably allergies. Not sure to what though. Maybe mold, dust, pollen – don’t know. It might be a good idea to keep a diary to see if there’s a seasonal or dietary pattern. Mine did get better and I don’t know why. I’ve been following the PHD for a while now and taking the recommended supplements. Perhaps that has helped?! (Had been doing very low carb for years before that.) I do have some fluid in one ear, but it’s not bad enough that I need a tube again. I have been on and off dairy and do wonder if that affects it. Good luck to her!

  32. Paul, I went with your suggestion and started taking enzymes and HCL for the following symptoms that I experience after eating:
    1. Fatigue and depression
    2. Brain fog
    3. Increased sinus congestion and pressure
    4. Food sits in stomach up to 5-6 hours and causes bloating and feeling of fullness

    Unfortunately, the enzymes and HCL did not provide much relief, if any.

    I’m going to start taking broth, kefir and raw saurekrout soon to support digestion, we’ll see if that helps.

    Two questions:
    1. Should I continue enzymes and HCL (I titrated up to 4 capsules without relief and at four capsules I started noticiing acid reflux symptoms)
    2. Is there a chance my symptoms could be caused by parasites? This may explain other symptoms I have such as chronic feeling of weakness overall and muscle weakness and fatigue, depression, irritability, itchy rectum etc.

    • These sound to me like classic food sensitivity symptoms, such as one might get from gluten, corn, egg white, soy, dairy and so on. The triggers in that case might be identified by elimination or fasting.
      Do you eat any food every day? Do these meals have any common factor?

      Fatigue, muscle weakness and brain fog might respond to acetyl-l-carnitine and co-enzyme Q10. (I am assuming that vitamin D and magnesium are already OK). But of course this is unlikely to be treating the underlying cause. On the other hand, if these supps did help, it might give you some idea of what your diet lacks or what the underlying problem is… I found carnitine or ALCAR relieved brain fog due to Hep C, and Co-Q10 relieved muscle fatigue.

  33. Jon,

    Suggestion: Along with what you have listed, you could try eating one to two garlic cloves prior to going to bed as garlic has anti bacterial, anti viral, and anti fungal properties. Just make sure the garlic is organic and do not take garlic in supplement form as the anti bug ingridient “Allicin” is only active for six hours after the garlic clove has been crushed, therefore, garlic supplements will not offer the same benefits.

    Also, I recommend reading the book, “Your stomach” What is really making you miserable and what to do about it, by Dr. Jonathan V. Wright M.D.


  34. Austin, it’s funny you mentioned the garlic thing, I just started doing that last night.

    I’ll definetly check out the book you suggested. Thanks Austin.


    • Please let me know how this goes. Im avoiding FODMAPs right now so no garlic, but I get similar sypmtoms of tiredness and fatigue after some meals that are heavy in protein and fat, or burning/acid reflux when I begin to eat starches.

  35. Paul had some newsletter or podcast regarding Kefir and Candida. Why Kefir may not work for people with candidasis? Could anyone forward me the link please? Also supplement recommendations for candidasis.

  36. Fungal Defense and Yeast Freeze by Garden of Life are the best that I know of.

  37. Does anyone know what I can do to support the digestion of short chain fatty acids?

    I messed up my gut flora quite while ago and it has come to the point where I can’t consume mct oil/coconut oil very well now, I pretty much just vomit or excrete it on the spot.

    Apparently, I don’t have enough “Lingual lipase” or the like. Anyone been in this situation?

  38. Hi,

    I wanted to tell you of my experience with food and the PHD in particular.

    I am a 49-year-old woman who sometimes tried to follow the Food Pyramid, and other times ate junk food and enormous amounts of sugar and dessert.

    I suffer from allergies, eczema, asthma, hives, sleep apnea, IBS, acid reflux, hiatal hernia, chronic headaches, chronic fatigue, depression, anxiety, carpal tunnel, and various aches and pains.

    2 years ago I tried going on the Paleo diet and it was amazing. I lost 19 lbs, my blood pressure dropped to a normal range, my lipid profile improved tremendously, and my acid reflux improved to the point where I stopped taking Aciphex. My IBS tamed way down too, only having occasional diarrhea rather than daily.

    However, I never saw the increase in energy or mood that so many people experienced on Paleo, and I very quickly got bored with eating nothing but meat and vegetables. I can’t look a salad in the eye right now. I added some dairy back in, but I was still bored and had crazy cravings, and I would binge. I also ate a ton of nuts, as I could figure out anything else for snacks. I started gaining weight back and put on 14 of the 19 lbs I had lost, and that weight wouldn’t shift, no matter what I did.

    I went to chiropractor, who has helped ease the headaches. He also said my bloodwork showed I had a “parasite” (we dont know of what sort) and he gave me high doses of something called ADP (tasted like oregano) and Lauricidin, Vit C and D, and I take Betaine Hydrochloride with Pepsin. Oddly, after the next bloodwork panel showed that the parasite was gone, I started getting bloating and acid reflux from time to time, no matter what I ate.

    I read your book a couple times but was scared to try it. I was sure that adding starches would make me gain weight. But one day, I thought, “what the heck, I’m gaining anyway” and jumped right into the PHD.

    It is amazing! I lost 7 lbs in the first 7 weeks. I eat in the 8/16 pattern, between noon and 8 pm, and I just am never hungry! In the past, I NEVER could have gone 16 hours without eating, I was always hungry or craving something. I feel satisfied and certainly not bored.

    I still get intermittent acid reflux and gut bloating, occasional headaches, and the seasonal allergies and hives. I wondered if you could give me any hints to alleviate these problems?

    Thank you so much for your time, and for all the hard work you do!


    • Thank you so much, Sal, I enjoyed your story. Always so great to see others come to the same discovery that starch/carbs aren’t the enemy as we have been told.

    • I guess when it comes to starch it is important that we should stick to safe starch and never introduce wheat. I think wheat, corn, Omega 6 and Fructose is making this countries health problem. In the PHD diet Paul has identified the safe starches and that makes all the difference.

      • I generally agree with that, Tessy. I never was a big wheat eater, but it would be nice to have without guilt on occasion. I am one of those people that never feels even the slightest symptom from wheat consumption. I wish wheat made me projectile vomit or something.. it would then make it easier to hate. Deep fried foods make me not feel so hot, too much fructose makes my stomach rumble, and I don’t think anyone really fully digests corn… but wheat.. nothing. Ah, well.

        • If you miss wheat, you can try using other flours such as rice, coconut and almond, etc. (I wouldn’t use too much almond flour though because of omega 6 though.) Lots of paleo/gluten free recipes out there! I like rice noodles. And I use rice flour to make a roux for gumbo and etoufee and it tastes great! Haven’t tried any of the gluten free breads or other products though. I’d rather stick to whole foods, if possible. Here’s one site that has incredible looking recipes – fun to look at: http://www.elanaspantry.com/frequently-asked-questions/almond-flour/

          • Oh, I have tried just about everything out there. I make my own GF bread, use lots of rice noodles, etc. But there is nothing like real bread. Especially sourdough. I was a foodie before I became interested in nutrition and artisan breads are hard to re-create without gluten. But thank you for your thoughts!

        • Hi Lindsay,
          First, wondering how old you are. I didn’t think wheat was a problem for me until I read that it could be part of my arthritis problem and that getting off wheat for as much as two years might be needed before noticing an improvement. It took less than two months. My recent Metametrix profile showed I am allergic to gluten, but not celiac. As I understand food allegies, when those foods are eaten, they cause systemic inflammation, which causes a host of other problems. Also, apparently gluten feeds H. Pylori. All of this negative can happen without you being aware of it. So, I tend to believe PHD — from the book — that “wheat triggers gut inflammation in nearly everyone.” And “nearly” is close enough for me. I’m pushing 70, have a dismal retirement income to anticipate, love my work, so hope to keep on working for as long as possible. I move easier, more quickly and with more fun than my younger co-workers. So, I remain wheat-free. Yes, I do miss bread, warm with butter, toasted with raspberry jam or cinnamon and honey. But arthritis pain and deterioration is far worse than doing without bread. If you’re young, enjoy it with caution because it just may bite you back one of these days.

          Take good care. 🙂

          • Lana, pretty soon, the smells of a bakery will no longer appeal, especially the smell of yeast — ditto pasta. It’s really very liberating!

            Good luck. 😉

          • Lana,

            I am 30. Before PHD, I rarely ate wheat.. maybe a few times a month as I was a super carb-phobic vegan. Then I moved to Wisconsin where artisan food is commonplace and decided to start eating meat and cheese after nearly 13 years without. That brought me also to bread and my God! I didnt know what I was missing for all those years. I still didn’t eat it much, but it finally made sense when people said they were addicted to bread. Fast forward a few years and I found Paleo and then PHD. I would say I have been totally gluten free for over a year. And really, I made so many changes over the course of 3 years or so that who knows what is the contributing factor to feeling a teensy bit better? I don’t have one of those miraculous recovery stories to share. I still have moderate and random anxiety and cyclical stomach issues. I have just taken a metametrix and am eager to see what is shows.

            I do believe that wheat is a problem for many people, but I also think there has to be some sort of sliding scale. I mean, of course it is a problem when the exposure is huge. Gluten is just so prevalent, as everyone who tries to dine out gluten free knows, that I don’t doubt abusing it has put us in the place we are now. Combine that with the sort of wheat that is being grown these days, sandwich a piece of omega-6 deep fried chicken between it, serve with a side of no exercise and you have there a crisis.

            So, I totally agree with you, and am happy that you have found wonderful health.. that is fantastic! Sometimes, I just like to lament the fact that well made bread is off limits.

            Take care and thanks for sharing.


  39. Just found a free online copy of Brillat-Savarin’s the Physiology of Taste. Part 27 is his low-carb treatment for obesity.

    Interestingly, there are elements of food reward in this part of his prescription:
    “You like bread? well, eat barley-bread. The admirable Cadet de Vaux long ago extolled its virtues. It is not so nourishing and not so agreeable. The precept will then be more easily complied with. To be sure one should resist temptation. Remember this, which is a principle of sound morality.

    “You like soup? Eat julienne then, with green vegetables, with cabbage and roots. I prohibit soup au pain, pates and purees.”

    • I still don’t like the name “food reward”. It doesn’t map correctly to the concept of foods we consider rewarding.

      E.g. a donut has a very high food reward value, in that it makes your body crave more of it, but I don’t actually like it. I feel much more rewarded by a succulent slice of slow-cooked meat.

      Furthermore nobody mentions that food reward is much like marginal utility, in that in a normal body, normal foods get increasingly less rewarding as we become full. Donuts on the other hand are eaten until there is no more room in the stomach or the box is empty.

      So the way I understand food reward and obesity, is that a great way to get obese is to have a broken food reward system. It can be broken on the measuring side (your body not telling you to stop eating) or on the input side (addictive foods) or more likely both.

      I wish it were called the theory of food addiction instead.

  40. Hey Paul, I gotta say its pretty awesome to be able to ask the author and creator of PHD questions. Really cool.

    Anyways, a couple of quick questions for you. Me and my wife have been taking about 1mg of Iodine a day. But i feel my wife’s thyroid is a little slow. What are your thoughts on adding in L-Tyrosine to the mix. Maybe a small about such as 500mg per day?

    Also my wife has been getting these horrible cysts on her inner thigh that have been causing her a great deal of pain. Do you think that a nutritional overload/underload could be causing the rapid rate of cysts? Cause this never was a problem before starting PHD.

    Thanks for your time.

  41. Hi erp,
    I don’t know if you’ll see this, but I saw your comment above and was wondering how your daughter and son-in-law are doing… I hope they’re recovering fully and quickly.
    Will keep them in our prayers,

  42. Hi Paul, I have started the PHD diet two days ago. I was wondering if eating 12 eggs a week will affect my goal of lowering my cholesterol, i am not sure if the yolk is beneficial for this particular situation. Thank you in advance.

  43. I would like to know what you think of grapeseed oil, pecan oil, xanthan gum,amaranth flour and sorghum flour.
    Thank you ❓

  44. Hi again Paul and Sou-Ching,

    I suffer from severe allergic rhinitis and sinus problems. I am following PHD guidelines and supps but not 100% yet.

    You often mention eliminating parasites. I have been reading about and considering Helminthic Therapy for the allergic rhinitis. I have wondered what your thoughts may be as there is encouraging medical research and hospital trials, especially for Crohns disease, with reports of 80% remission rates, and for allergies also. It seems in small studies and anecdotally to work well for a range of autoimmune conditions.

    I have only not gone ahead with a small dose of Hookworm as I thought i would see how PHD went.




    • Hi Shelley, I have also been suffering from Sinus and allergic rhinitis for a long time. I’m trying to follow an antifungal diet, supplements and homeopathic antifungals. It is helping me a lot and as i’m detoxing i lost 10 lbs. Most of the time Sinus is caused by fungal infections. Foods with yeast and mold causes lot of allergies such as choclate, yeast, kefir, nuts, coffee etc. I assumed it was allergies before this but soon i realize it was the mold or yeast in it.

    • Shelly, I have the same problem and it has caused a lot of misery. I asked Paul about it, here was his reply:

      “Rhinitis could be fungal infections which may be due to copper and vitamin A/D/K2 deficiencies.”

  45. What about brown rice and kefir? I just started making my own kefir…have been doing SCD for over a year and still have some inflammation…cut out all dairy, fruit, eggs and nuts for a while…and I am probably eating too many meats to make up for the loss of calories…I eat lots of olive and coconut oil…brown rice and sweet potatoes would be amazing and some fruit for the energy…I seem to tolerate the kefir better than yoguart…I have been using raw milk…could be the difference maker

  46. Couple of quick questions for you. Me and my wife have been taking about 1mg of Iodine a day. But i feel my wife’s thyroid is a little slow. What are your thoughts on adding in L-Tyrosine to the mix. Maybe a small about such as 500mg per day?

    Also my wife has been getting these horrible cysts on her inner thigh that have been causing her a great deal of pain. Do you think that a nutritional overload/underload could be causing the rapid rate of cysts? Cause this never was a problem before starting PHD.

    • I saw your question before and wondered if your wife’s cysts could be some kind of reaction to the Iodine? Or some kind of detox thing going on? I have no idea at all,maybe someone else with knowledge and experience here will chime in, that was just a thought I had since I’ve seen pictures of people having severe skin reactions when they started iodine too high (instead of gradually and slowly increasing). (I think Paul might have responded but on his last post he mentioned that he and Shou-Ching are traveling until next week. If you don’t get some other ideas before then, try reporting after Oct 2 and see if he might respond?)

  47. Some remedial questions about the diet, which I haven’t noticed in the book.

    Is salt OK? Saw one reference, but no detail. How do you feel about alcohol? You mention ice cream as good from a fat standpoint, but isn’t it bad because of sugar/fructose? Are there non-sugar ice creams?

    That’s it for now. Love the book and the plan.


    • Hi Ari,

      Good info on salt from Chris Kresser: http://chriskresser.com/shaking-up-the-salt-myth-healthy-salt-recommendations
      I don’t recall Paul being very specific about salt.

      Alcohol is a toxin and therefore should be enjoyed in small doses.

      Ice cream is a good dessert if it’s made with cream and egg yolks. Vanilla Häagen Dasz in Europe is pretty good in that way but it’s very sweet – I add extra whipped cream to bring down the sugar.

      You can also make great ice cream by melting dark chocolate into coconut milk, sweetening to taste with sweetener of choice and putting that in the ice maker.

  48. Ari,

    I believe the ice cream that paul was talking about is homemade ice cream with real fruit mixed it as the flavoring. I would steer clear from any commercial ice cream that can be purchased from the store as like you said, it will be loaded with sugar and fructose that will simply feed pathogenic bacteria.

    Also, salt is essential for a healthy diet as it contains trace minerals. Salt also has the building blocks for youre body to produce hydrochloric acid which is essential for proper digestion. Celtic Sea Salt and Himolayen salt are the best of quality. Youre regular table salt does not fit in this category.


  49. Caleb your answer to the cyst issue can be located on jonathan V. Wright M.D. Website at wrightnewsletter.com.

    When you go to the site, there will be a search space in the upper right hand corner. Just type in your issue and press the search button.

    He has several articles regarding natural therapies to treat cyst.


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