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. Also,

    Paul talks about getting ones iodine needs met by eating sea weed.

    This may be a safer option for you to obtain your iodine needs if your not already doing so.


  2. Hi guys, was wondering what your opinion was on porridge if you have fermented the oats for 24hrs previously?

    • Hi George,

      soaking your oats for 24 hours is not the same as fermenting. For fermentation you need a starter culture, plus that culture needs to be one that produces the result you want, i.e. convert “bad” proteins to neutral forms without adding toxins. Soaking will just leech out substances into the water, possibly taking toxins with it.

      Oatmeal has allergenic compounds just like most other grains. See http://en.wikipedia.org/wiki/Oat_sensitivity . Unless you have a sensitivity, eating it every once in a while won’t do much harm but daily exposure could be problematic.

      Oatmeal remains a grain: a convenient foodstuff that’s not very nutritious compared to other foodstuffs, coupled with a probable toxin load, probable low-grade inflammation and a side chance of allergy.

  3. thanks for your reply,

    I work away from home during the week and don’t have access to very good cooking facilities and am finding it very hard to get safe starches in my diet.

    all microwave rice from the supermarket in the UK has at the very least vegetable oil in it, usually rapeseed.

    • George,

      Don’t know your situation, but if you bring food from home to work, you can just bring your own rice.Rice is one of those perfect foods to make ahead of time. Cook up a big pot on the weekend and put it in individual servings, freeze, and voilla! you can microwave your own rice.

      I bought myself a rice cooker and I do this all the time now. What a time saver!

      Even if you are housed in a rooming house or something during the week, as long as there is a plug, you can make rice in a rice cooker.

      Good Luck

  4. I was quite shocked to be diagnosed with celiac disease since I didn’t have the associated digestive symptoms. I’ve learned that celiac can also cause symptoms of fatigue, brain fog, muscle weakness, etc. (these are the symptoms I had). I also have autoimmune issues with brain tissue, parietal cells, skin and thyroid (not hypo or hyper yet). So, my question is, do I treat or eat the way a celiac patient who has the digestive symptoms like diarrhea, etc. does, or not? I am currently on stage 5 of the GAPS diet and wondering if this might be the best treatment for me, or perhaps something else? I would be grateful for some advice or insight/experience. Thank you, Dede

    • Hi Dede,

      You have clinically diagnosed celiac disease, which means that your gut is currently quite permeable and you have problems absorbing nutrients. This means you should avoid eating things that have no business in your bloodstream as well as eating highly nutritious foods.

      In your position I would
      – avoid all gluten for the rest of your life
      – avoid all allergenic foods like all grains/beans, nightshades, egg white, milk protein etc until your gut has healed (weeks/months), and then carefully add the ones you like back one by one so you can spot symptoms.

      I don’t know much about the GAPS diet, I like PHD 🙂 I had fatigue and brain fog too amongs others (I’m not celiac though) and that cleared up going PHD.

      • Thank you! So, GAPS does recommend fermented dairy (and veggies) if tolerated and I have sourced raw goat’s milk yoghurts and kefirs from a goat dairy practising whole and nourishing methods, etc. So far, I think they are being tolerated. I am that type of celiac that doesn’t have these obvious reactions, so I am not sure what to do. I am avoiding eggs and nightshades, will try egg yolks at some point. Anyway, I really appreciate you taking the time to share and help me. If you have any other advice based on the tolerance testing since I don’t outwardly or obviously react to foods, I’d love to hear it! 🙂

        • If you’re of northern-european descent there’s a good chance you have genetic adaptions to dairy, so fermented raw goat milk sounds awesome! Heat-treating milk will render the protein harder to digest, increasing the chance of protein entering your blood stream and triggering immune reactions. At least that’s my understanding.

          Good luck, staying 100% gluten free is no mean feat but in your case I would definitely pursue that.

  5. You can easily make rice in a microwave using one of these:

    You’ll have to take your chances on the estrogen-lookalikes that may or may not be released by heating the plastic. I like it.

    You can also microwave potatoes but I prefer the taste when they’re cooked in water. Perhaps you could microwave potatoes by placing them in a glass container like http://www.amazon.com/Pyrex-quart-casserole-glass-cover/dp/B0057RRD8S/ref=pd_sim_k_2 with water added.

    My favorite starch source is mashed potatoes: peel and dice potatoes, put them in enough water to barely cover them, cook until most water is gone and the potatoes are soft, drain water, add a couple tablespoons butter, season with nutmeg, pepper and salt and mash with a fork. Simple and oh-so-good.

    Is your kitchen really that limited? All you need is a single electric plate. You can even get induction plates for that high-tech feel and quick cooking: http://www.amazon.com/Max-Burton-6000-1800-Watt-Induction/dp/B000MVN1M6/ref=sr_1_4

  6. thanks for the idea about microwave rice, will definitely start doing that.

    just done a bit of research on it and you could just use a pyrex bowl with a lid instead of something plastic that may have nasties in it.

    • I suppose I should try that. The tupperware has a locking double lid that stops the rice foam from overflowing the pot and keeps much of the moisture inside the container. Maybe adding a weight to the pyrex lid would do the same.

      I haven’t found a 100% glass microwave rice cooker and in fact only one Japanese one that has a glass bowl but plastic lid. Sigh.

  7. or maybe a glass/ceramic bowl inside the plastic steamer, I guess nasties from the plastic could still leach into the steam but it’s possible the amount absorbed by the rice would be less.

  8. I guess we’re exposed to unhealthy chemicals in so many ways, that are beyond our control, as part of modern life. It definitely makes sense to avoid that exposure when it’s within our power to do so.

  9. Starting my weekend off with the usual delving into what is written about H. Pylori, and found this, dated 12/12/11, suggesting an Alzheimer’s connection:

  10. Now to chores, but first I’ll share this link to a podcast with an interesting take on H. Pylori. Good for the young, but bad for the old?
    The link is at the bottom of the second paragaph.

  11. This is a loaded question. Hoping to get some thoughts or maybe other websites to reference for parents whose newborns are just about to eat solid foods and beyond. Not sure how to incorporate the PHD principals with the introduction of solid foods. I know mothers milk is one of the guidelines for PHD. Any websites, experiences, etc. would be appreciated. The idea of balancing PHD with the realities of what kids might eat at school, friends houses, etc. is somewhat daunting… I guess I will just worry about the first few months for now. : )

    • Hi BSG,

      I’m in the same boat 🙂 We recently decided to feed our baby some gluten as part of her first solids (between 4-6 months) so that her immune system learns to recognize it as “food” and not as something dangerous, see above somewhere.

      Other than that, the WAPF has interesting material: http://www.westonaprice.org/childrens-health/recipes-for-homemade-baby-formula and the links therein.

    • My children are grown with their own young ones, but I still follow two great websites for parents of young children. One is thehealthyhomeeconomist.com (Sarah Pope — WAPF spokesperson) and wellnessmama.com. Great recipes and advice for parents. Sarah is not grain or legume free, but very much into the WAPF way of soaking and fermenting, and frequently has grain-free recipes. Wellnessmama is grain free, even rice-free. So, take what you can use and modify where possible. Each of these women frequently link to other sites that are helpful for parents.

      • Isaac Knoflicek

        I’ve been thinking about this a lot lately too, especially because my 3 year old is a complete carb fiend.

        I’ve kind of accepted that I can’t keep her completely PHD without adversely effecting her childhood. I don’t want her to grow up watching other kids eat crackers at day care or church, or birthday cake at parties. It’d be a ton of work, and as sold as I am on the PHD, I’m skeptical that it’d have much of an effect on her development.

        That said most of her meals are at home and I keep those pretty PHD. She loves noodles, but since I got on PHD I’ve quietly switched her to rice noodles. We have a safe starch for every meal, and I quietly sneak coconut oil and butter into everything I can. She doesn’t like salmon but I make her have at least a bite twice a week when I’m eating it. All her meat is grass fed from the farmers market. Lots of eggs, etc.

        I figure I only get to be in charge of her diet for a small fraction of her life. Completely shielding her from soda and cheese curds now seems less important then setting a good example and teaching her good habits. Then all I can do is hope she makes good choices when she’s an adult.

        • Isaac, couldn’t agree more! Our girl loves salmon though 🙂

          There’s no issue with children liking carbs btw, safe starches are exactly that and they need relatively more carbs to feed their relatively larger brain… Plus they need lots of food, again relatively: apparently a 2-3 year old needs 1000-1300 kcal a day!

          • Isaac Knoflicek

            That makes me feel even better about it, thanks Wout!

            How do you prepare salmon for your girls? I’ve tried baked and smoked. Might need to start sneaking it in her mashed potatoes or something 🙂

          • For kids that don’t eat fish, leafy greens like spinach, cabbage, leeks, cress and so on supply enough alpha-linolenic acid to give healthy omega ratios if seed oil and grain intake is low. Our kids eat these if they’re lightly fried in butter or steamed.
            Africans who eat greens, palm oil, and little fish have very healthy 3:6 ratios.

          • I’m excited to find this thread, maybe someone can give me some guidance or ideas?
            We don’t feed our 15 month old grains, mainly because neither of us eat them. She loves meat and bone broth and eats lots of sweet potatoes, bananas and squash, as well as ghee and coconut oil.
            I just had her check up at the dr and although her weight continues to be on the 91st percentile (always been a big baby!) her height has tapered off from 75th at 3 months, gradually down until now she’s at the 2nd percentile at 15 months. The Dr looked at her diet and said she’s not eating enough carbs. We don’t restrict her carbs at all, just don’t offer her grains or processed food at all. Do you think we need to in order to get her carb consumption up? She is otherwise totally healthy and happy. I am only 5″2 so maybe she’s just short! Just wondering if it could be diet related though as the dr has scared me a bit, made me feel like should be feeding her cereal and sandwiches and mini muffins like a normal child!!!

          • Julia, I don’t think being short is a disease. But bad diets have resulted in growth upwards as well as outwards, so your doctor’s “normal” is past generations “gigantic”.
            Plenty of peoples grow to full height without grains; vitamin D levels might be something to think about; but I don’t see how eating grains or junk food is going to make any difference! Does she drink milk or eat cheese? Get omega 3s? Then you’d probably be doing all you can.

          • Thanks for your reply George! Yeah I know being short isn’t really a problem, Just not fitting onto the nice little graph at the Dr’s seems to be pretty important 😉
            She has just started fermented cod liver oil, so that should help with vit D anyway. Doesn’t eat any fish yet though because her dad has an allergy to fish, so we’re going to delay trying. Just started raw milk kefir as well. Nice to have reassurance, just so I don’t feel like I’m depriving her of anything she needs!

          • Would be great to have a PHD for Kids blog post to continue this thread on *hint hint Paul* 😉

          • Julia, as someone who is 6″5′ I can say that being tall can be fun but is also not great for your back and for comfortably traveling.

            Also, I was pretty average height until I started growing in my teens. I live in the northern part of Belgium and we as well as the Dutch have quite a lot of very tall people – we’re also real dairy fiends, drinking lots of cows milk so maybe that is related. Who knows what they did to our cows in the 70s/80s.

          • Our kids were very short for first 10 years, compared to their friends, but now at 12 one is nearly as tall as her 5’2″ mum and getting taller, and neither seems as short as they once did among their friends.

  12. I was wondering your thoughts on the research of Dr. Donald Layman. He seems to follow your general level of starch but feels that at least 30 grams of protein is needed at each of three meals for proper synthesis, especially as we age.

    • Hi John,

      Well, centenarians generally eat quite a bit less protein than that. Not uncommonly they eat 40-60 g per day.

      In ill health people do need more protein. I would say it’s generally appropriate to eat protein to appetite.

      • i REALLY dont understand the whole “well centenarians live a long ass time, so let’s copy their way of eating”. why is “living a long ass time” a worthwhile goal? what is their quality of life? shouldn’t we be focused on quality of life instead of length of life and make our dietary decisions based on that?

        • Yes, but quality of life and length of life are highly correlated. Usually if your quality of life goes down due to health problems, your life expectancy goes down with it.

  13. Hi Paul,

    I just listened to your podcast on SCD lifestyle and was curious as to how you’d recommend curing SIBO and a gut parasite blastocystis hominis? I’m also being treated for very low stomach acid and hashimoto’s. I already did one bout w/ antibiotics for the blasto but a few remain. Now I’m on HCL, pancreatic enzymes and herbs. I’d love to hear your theory and look forward to you new book. Thank you.

    • I’d also like to know how to cure SIBO. I suspect that I also have it – judging by my abdominal bloating (no other telltale symptoms). I’ve been eating low FODMAPS and that has helped a lot but I’d like to know how to cure it.

  14. Hey Paul,

    Since Scandinavians dont have access to grassfed beef or lamb organs, im wondering if we could substitute these for reindeer organs, which can be found and are mostly grassfed. For example the copper values in liver range from 21.8 to 71.0 ?g/g wet wt in reindeers. Source: http://www.sciencedirect.com/science/article/pii/S0048969799004404

  15. Paul,

    I started a kale ferment last wednesday. Within a couple of days it started to smell putrid. My mom blamed the dog but we realized it was the kale. I’ve read some articles saying if it smells bad, it is bad, but others say kale usually becomes stinky. When I pick it up and look at it, I get a stomach ache.
    Have you ever fermented kale? Should I throw this sucker out? It doesn’t seem like it will be delicious…. But I feel like, if this fermented food is good and its going to heal my gut, a stomach ache might be part of that healing, like some sort of bacterial die-off. Could go both ways. Would love your input!

    Nora S

    • If it smells spoiled, it is spoiled. Everyone who ferments vegetables has some that go bad. Smell is the only way to tell if it is bad. A good fermentation will smell sour, but not like something that is rotting. You’d do best to not try to eat something that turns your stomach. Toss it out and try again. Here’s a web page where I’ve put some simple steps to fermenting vegetables. Maybe you’ll find some help there. http://10minutemeal.com/basics/fermented-vegetables/

  16. Dear Paul, or anyone who happens to have expertise in Type 1 diabetes …

    I’m a longtime T1 diabetic and recreational athlete (rowing, strength training, cycling). After years of trying to stabilize my blood sugars following the dietary recommendations of the Canadian Diabetes Association, I’ve discovered that very low carb eating gives me the best glycemic control — not perfect (stress, hormones etc. can still throw me for a loop), but pretty good.

    After a false start with low carb eating, I’ve now been on <50g carb per day for about one month. The blood sugar control has been great, but in other respects I'm not feeling fantastic (general low energy + terrible stamina when working out).

    I'm really torn about how I should be eating. Paul, I've read your articles on the risks of very low carb diets, and your concerns make sense to me. Those concerns, along with my own physical difficulties adapting to a VLC diet, make me wonder if I should be re-introducing carbs and eating something closer to the PHD. At the same time, however, I know from many years of experience how difficult it is to correctly match exogenous insulin to carb intake, and I wonder if the risks of chronically wonky blood sugars outweigh the risks of a VLC diet … and if, by extension, I should just accept the physical limitations of radically restricting my carb intake.

    As an aside, I've been measuring my blood ketone levels over the past month and have yet to register anything above zero, despite keeping carbs very low and protein moderate. I'm wondering if occasional high blood sugars (from stress or whatever) and the insulin I must take to correct them are interfering with my attempt to keto-adapt?

    Any thoughts or suggestions would be greatly appreciated!

    Many thanks for your very interesting and informative website (which I was referred to by J Stanton over at Gnolls). I've ordered the PHD book and look forward to reading it.

    • Hi Heather,
      I was glad to see your comment because I’m also a type 1 diabetic (a little over 11 years) and have an older brother who’s also type 1. I’m certainly no expert on type 1 diabetes, but I thought I’d chime in with my own experience following PHD for a year now. I follow all the what to eat and what not to eat guidelines, but at the moment I don’t know where my ratios are (I get really tired of weighing and counting carbs, etc so sometimes I just give myself a break and eye it because that’s much better for me emotionally). Surely you understand! 😀
      Anyway, I have been doing great on PHD and don’t plan on ever switching to any other eating plan because my numbers have been more stable (generally) and predictable. My last HbA1c was 5.5 in July and I think it would be a little lower now, but I won’t check until later this month. Previous to PHD, I had already been pretty happy with my HbA1c which was sometimes around 6.2 or 6.0. Some things that really helped me were getting rid of most fruit except for bananas. I eat one banana a day maybe 4 times a week? I didn’t eat tons of fruit before but raisins were my correction food for low blood sugars and now I use glucose tablets (the ones without dye) made by Dex and I love them because I know exactly how many to take usually and since they’re glucose they can pass directly into the bloodstream so they act very quickly (which means I don’t over-correct and end up high afterwards,which did used to happen often with the raisins).
      I generally eat one medium potato with butter and with one or two over-easy eggs on top, all mixed up and that is a very good breakfast for me because it is VERY predictable so I usually end up perfectly in range after an hour, two hours, etc. sometimes even a little low. Lunch and dinner are usually very balanced with either rice, potato or sweet potato and a meat and a vegetable (and a high-fat sauce or butter or olive oil). I have found that basmati rice from India has been the best for me. I love Japanese sticky rice, but I usually have to take 2x the amount of insulin for the same quantity of basmati rice). So, I cook the short grain Japanese white rice only occasionally and when I do, I eat it with a higher amount of fat and that seems to help my BS not skyrocket.
      Whenever I do eat a meal with rice, the amount of fat in the sauce seems to make a huge difference as to the outcome of my BS afterward, so I’m never shy about high-fat sauces.
      Does your BS not go high overnight if you’ve had an intense cycling or rowing session the previous day (I mean since you’re VLC right now)? I used to run a lot (too much actually) and row years ago but I changed completely and now I only walk and jog occasionally and hike whenever my husband and I can drive to the mountains on weekends. When we hike 12 miles or so, even though I eat a normal day’s worth of carbs (not low carb at all) my BS usually goes up to 250 by 1am when I wake up to use the bathroom. In those cases I realize I hadnt eaten enough carbs during the day, with so much activity, so my liver was turning out glucose overnight to feed my body. On normal days though with moderate walks/ jogs, I don’t have that problem. So, I’m still trying to figure out the correct amount to eat when we hike so much.
      Sorry to go on, I dont know if anything I wrote is helpful or not, but hopefully!
      Good luck if you try PHD!
      I’m happy to share any other details of my own experience with the diet if you have any questions. For me it was mostly trial and error for a while (as you already are familiar with!) but I’ve got it pretty well figured out (most of the time).
      Another thing I recently switched was my long-acting insulin. I take humalog for fast-acting and now I take Levemir as my long acting (morning and night) and it has helped my overnight BS a lot.
      Good luck!

      • Hi, KH … Thanks very much for sharing your experiences. I’m still playing around with VLC but will likely re-introduce certain carbs very gradually. I’ve been on a pump for the past 6 years, which, on the whole, I prefer to MDI!

  17. Does anyone have recomendations for supplements to take for “post viral fatigue”. Would I be correct in assuming that any immune boosting or anti-viral supplement would be beneficial?

    • Nevermind folks, looked up an article in the archives and got my answer.

      If anyone has personally delt with this however, I’d love to hear the results.

  18. if you kept the Kale below the top of the brine and used a bit of salt there is no reason the Kale should have gone bad.

    Lacto fermented vegetables do smell a little bit like sick so maybe this is all your smelling. Take a good sniff of some live non pasteurized Sauerkraut and you’ll see what I mean.

    That said I find the dark green vegetables are best used sparingly in ferments because there flavour can be quite overpowering.

    Try making a Kimchi: Cabbage, Raddish, carrot, some onion, broccoli, spinach, garlic, ginger, chilli, salt

    make sure the salt hasn’t been washed with chemicals such as iodine or contain anti caking agents as this will stop the lacto bacteria.

    have a look at this website for some great ideas:


  19. Hi Paul and Shou-Ching,

    I’ve really been enjoying sweet potatoes recently, but have found cooking them to be time consuming.

    Do you have any suggestions for cooking them faster? (Ideas from readers would be appreciated as well)



    • Also,

      I think that I recall reading in the book that carbs and protein should not be consumed during a fast.

      I was hoping to fast for 16 hours thorugh the night and morning hours and break the fast at lunch time.

      Do you have any suggestions for a good breakfast while fasting? (Again, any suggestions from readers of the blog would be great as well)

      What are the limits on the amount of Fats, carbs, and protein that could be eaten during a fast without breaking it?

      Thanks again,


    • Nuke ’em! I have baked, boiled and potato-chip-ified my sweet potatoes but nothing beats a 5-minute jaunt in the microwave. Poke a few holes first though.

    • I poke holes in a sweet potato and microwave for about 4 minutes on high, turn over, and then 4 more minutes. Tastes great! I’d like to try them roasted some time because I’m on a roasted vegetables kick. Vegetables are so good when roasted w/ a little olive oil and sometimes w/ salt/pepper. So easy too! So much better than microwaving but a little more time consuming.

  20. I know the question on fish has been asked multiple times, but I want to know your thoughts on White Bass that has been raised naturally in a very large tank. Not farm fed and fresh water added when levels drops. Their food source is smaller fish.

  21. I’ve gone on two separate 36 hour fasts (with just coffee and MCT oil) and at the end of each fast caught a cold that lasted about 7 days and felt like a normal cold. Might the fasts have caused my illness?

  22. Hi Paul! What’s your take on so called “superfoods” like spirulina, maca, acai etc? I’m skeptical of powdered foods and extracts, mainly due to processing and contaminants, although I believe that some supplementation might be necessary for optimal health.

  23. Haven’t read the book just saw your website. I’ll be getting the book shortly but I’m concerned because I’ve been a vegetarian and had been a vegan for a long while, in your suplemen list you list bone broth to get collagen. How can I get this from a veggie diet?


    • Haven’t read the book just saw your website. I’ll be getting the book shortly but I’m concerned because I’ve been a vegetarian and had been a vegan for a long while, in your suplemen list you list bone broth to get collagen. How can I get this from a veggie diet or something that’s a precursor to collagen builder?

  24. Hello. Read your book and love it! Already have your new book ordered from Amazon! Thank you SO much for all that you do to help us improve our health!
    I have a question regarding my husband. He had a stent placed in a cardiac artery in 2005 (he did not have a heart attack…they caught it early enough to avoid that) and was placed on statins. In June of 2011, after problems with side effects, he decided to stop taking the statin. I began to research how to improve his health without meds and stumbled upon this site. We began to implement the diet changes and his GERD disappeared within days, he lost over 50 pounds, and he just feels SO much better overall. We have continued with that regimen for over 15 months now.
    We recently had his cholesterol levels checked by our doctor and his total cholesterol was 303, LDL of 232, HDL of 45, and Triglycerides of 185. I am mostly concerned about his high triglycerides and LDL, of course. He is very faithful about staying lower carb…in the 75-100 grams a day range (from safe starches)… so I do not understand the high Trig.
    He had recently started having a glass of two of white (sweet) wine every evening and I read that it could elevate them. Would it make that much of a difference? He has stopped drinking the wine, but is there something else we should be doing? I do not want him to die of a heart attack!!! 😯

    Thanks so much,

    • Hi Patti,

      I am glad he is feeling better!

      His lipid profile is indeed poor. The alcohol shouldn’t be a problem, it tends to raise HDL and a glass or two a day of wine should be OK.

      I would suspect hypothyroidism as a likely cause. Has your doctor tested a thyroid panel? Does he have hypothyroid symptoms? I would experiment with supplemental thyroid hormone and see if that helps. Also try to optimize selenium status (and magnesium and copper) and get a bit of iodine. Also vitamins D and K2.

      Look into the thyroid issues as soon as you can, and please let me know how things go.

      Best, Paul

      • Thanks so much, Paul. I will look into getting his thyroid levels checked. I don’t really think he has symptoms of hypothyroid though, other than the lipid levels. Well, I guess I forgot that he is bald!!!

        He takes vitamins D3 and K2 along with magnesium and copper per your previous recommendations. We have just started your updated recommendations for supplements and have added the selenium weekly. Should he take it more often? He has never taken iodine, but I do so we can start him on that.

        I will report back after the labs are done. It may take a while to get them drawn. He is a bit of a mess right now. He broke his back on August 25 and then had a total knee replacement on September 25. He is on a lot of pain meds as well as Coumadin (which I detest, but with his history, I didn’t dare argue…), so getting out of the house isn’t too easy right now.

        Thanks again for you reply. I appreciate it so much.


  25. Hello Paul and Community,

    I know that we don’t do much discussion of female hormone testing on this site, but thought I would give it a shot. A friend of mine got me a free blood hormone panel through directlabs.com so I took it! I read that a hormone test should be taken on day 21 of a 28 day cycle because this is when estrogen and progesterone are supposed to be the highest. So, that is what I did. At first glance, my results look very normal, but just wanted to get some thoughts if anyone has any!

    Here are my results:
    Testosterone 20, reference range 8-48.
    Free Test 0.4, ref range 0-2.2.
    Cortisol AM 12.8, ref range, 6.2-19.4.
    DHEA 275.5, ref range, 98-340.
    Estradiol 121, ref range, 44-211.
    Insulin 4.7, ref range, 2.6-24.9.
    Progesterone 13.4, ref range, 1.7-13.7


    • Hi Lindsay – free testosterone could be higher. My MD actually likes to see this number between 2 and 4. My level of free testosterone was literally 0 before bio-identical supplementation. I feel better as my level improves.

    • Hi Lindsay,

      Here’s a link to a site that for men contains extensive guidelines on “ideal” hormonal readings.


      It appears to have the same info for women. In my case the guidelines say my T and E are good but that sex-binding hormone needs lowering and DHEA raising (in part via supplements sold on the site).

      In my case I’ve recently discovered chronic infections and think it’s rather futile to top off various hormonal levels unless and until the infections are resolved. Also as a general matter I think Paul is against at least drugs if not supplements for sex hormones for reasons including downregulation and the lack of solid data such as mortality. Would definitely like to hear more from him on the subject.

      Anyway, hope that helps. I suspect the guidelines at that site will be consistent with Holly’s doctor’s.

    • http://www.lifeextensionvitamins.com/10moimbltepa.html


      Optimal Range: 1.4-2.2 pg/mL

      The site appears to push DHEA supplementation pretty hard. But you’re at the high end there adrenally. Possibly the low free T is related to ovarian production or to sex-binding hormone?

      • Shawn,


        Yah, my DHEA seems fine, as does everything else, but free testosterone. I think you might be on to something with your suggestions. I’ll look into… it does seem pretty easy to supplement testosterone, so maybe I’ll look in that as well.

        Thanks again,


  26. Holly,

    That is interesting. I know virtually nothing about it, but a quick google brings up a lot of studies suggesting higher testosterone in women is correlated with obesity, infertility, PCOS and all sorts of problems. Granted, mine does seem quite low.

    Thanks for your thoughts.

  27. Hi Paul,

    I’m glad to find your website, as after six weeks of a low carb diet I was beginning to feel pretty bad, so it’s been great to be pointed back to safe carbs. Many thanks – I feel better after just a few days of eating carbs again! I note that you mention having rosacea in the past but can’t find anything in your blog to point me in the right direction to heal mine. Mine is definitely linked to gut problems and is better controlled but not healed, when I cut out allergens (grains, dairy, acids, sugars) and use digestive enzymes when I eat. I’m about to buy your book and don’t know if there is anything in it about rosacea but I’d be very glad to hear if you have been able to heal yours by any means.

  28. Hi all,

    I don’t know if this have been discussed before so I’ll just ask, is “liver flush” or “colon cleasing” a good thing or not?

    I would appreciate all kind of thoughts about the subject. Is it a scam, does it do good, anyone has experience it?

    I am reading more and more stuff about the relation between the intestine and the liver.

    Thank you,


  29. I can only share my own personal experience with you. Before coming to a loose Paleo approach because of celiac disease, I was eating a hydrating vegetable centric, yeast conscious diet (Natalia Rose Detox 4 Women to be more specific). Over the year and a half that I followed this protocol, I felt great and received Woods method gravitational method colonics on a weekly basis, I still do, actually. Not only did this method of colonic stengthen my very weak bowel, but my skin was firmer (I’m 47), I had lots of energy, slept better. I could go on and on. The approach is called cellular cleansin, so a whole body, tissue, etc. cleanse that is a way of life, rther than a fast fix. The specific cleanses (like a targeted liver flush, etc.), I am not a fan of. They can be harsh. My cleansing diet consisted of no psylium, no clays, nothing like that; just pure fresh raw vegetable juices, food combining and eating light to heavy (to avoid digestion pile-ups or traffic jams as I like to call them. I took grains, legumes and meat out of my diet (until I switched to a more but loose Paleo approach in June of this year). I sure hope this helps you some. I know if didn’t directly answer your question, but if I can help further, I’m happy to share what worked for me and countless friends of mine.

  30. Paul, I am fascinated with Ray Peat.
    He seems to be a somewhat eccentric genius.
    What would you consider to be his best tenets?

  31. Again, I have spent too much of Saturday morning at my computer and not at my lawn mower.

    I continue to be drawn to learning about H. Pylori. Here are a few links to articles that discuss anemia, B12 deficiency and low stomach acid; and add to the mix the business of stomach atrophy.

    There is also plenty of references ot the H. Pylori being an ancient co-evolver with humans. Also, that it may be good for the young and bad for the aging.

    I would like to not invite stomach acid into my esophagus, but it seems that may be the result of erradicating H. Pylori.

    If anyone is interested, here are this Saturday morning links:

  32. Hi Paul,

    Do you have suggestions or experience on dealing with SIBO?

    Thank you for all the information you put on the blog!

  33. Was diagnosed with antral gastritis (erosions in the antrum of the stomach) after a food poisoning episode. Had a course of PPIs, but after a short while the symptoms seem to have returned.
    Any good way to treat this?
    Gelatin/Bone broth , L-Glutamine supplements, will these help?

  34. Hi Paul,

    Finally got my metametrix results back and to my dismay it revealed basically nothing. There are no clinically significant amounts of bacteria or fungi ( which rules out many theories of mine ). The only thing it showed is positive for a parasite, but the taxonomy is unavailable. The test key states that it is likely an ingested protozoan and not a human parasite and therefore doesn’t require treatment unless there are inflammatory markers.

    I have to say, I feel a little defeated. I was hoping the test would reveal something significant and I could treat it and be done. Thoughts on the unknown parasite or if I should investigate that further? And if so, how?


  35. Paul, I haven’t seen you comment much on CFS, do you believe that infections play a significant/primary causative roll? I have many symptoms of CFS and the whole infection/immune exaustion theory makes sense to me. I was born 6 weeks premature, had a 2-week bout of pneumonia when I was 6 months, had my first outbreak of shingles(VZV) when I was 8(I’ve had 20 or so since) and since elementry school have had terrible environmental allergies(not infection related obviously but immune related). I now have many of the “universally” agreed upon symptoms of CSF. I think that my infections are not as dormant as they should be, my lymph nodes are often swollen and sensitive and I feel like I have the flu much of the time.

    I’m following PFD as well as the infection protocol/10 ways to support immune function. I noticed a few other suggestions you had in the archive and would greatly appreciate some clarification…

    1. I’m taking sodium ascorbate to bowel tolerance(no clarification needed)
    2. Should Vitamin D be increased?
    3. Should K2 be increased?
    4. How much should iodine be increased? (following the titrating steps you outlined)
    5. Selenium? (My understanding is you no longer recomend supplementing with selenium, should I increase liver intake or eat a brazil nut a day?)
    6. Any other supplements that should be increased to fight infections?
    7. Any thoughts on taking colostrum for immune support
    8. Any thoughts on taking “proboost” thymic protein A)for viral support?

    Also Paul, I’d love to get your take on the roll of infections(mainly viral) and CFS.

    Thanks Paul, hope you had a pleasant vacation.


    • Jeff, have a look at this:

      I used to find my CFS cleared when I used amphetamines; I realize now, these were the only times I fasted. It’s hard to say when it went away completely, but it hasn’t recurred since I started low carb, high fat, grain free eating. I used to take lots of immune stimulating herbs and vitamins, but I suspect now that going for immune tolerance is a better idea – and this to me means some exposure to saprophytic bacteria (while taking probiotics); playing in the dirt, swimming in the river, walking in the forest, drinking from the well.

      • @Jeff, for what it’s worth, the folks over at cpnhelp.org have some information about the possible link between infections and CFS.

  36. Dear Paul,

    while reading your book and comparing fat/protein ratios and percentages of Omega6 and Omega 3, I noticed that there is no infomation on lamb. Do you have any information on this? We love to use fatty lamb’s leg but are wondering about the omega 6 and 3…
    Thanks for your work!
    Greetings from Germany,

  37. Paul,

    In the PHD, you recommended against taking folic acid. I’ve come across a few multivitamins that don’t use folic acid, but instead folate or “5-methyltetrahydrofolate” – which is, as I understand it, the form ones body converts all form of supplemental folic acid and folate into. Would 5-methyl… be safe to take in the 800mcg-1mg range then? if folic acid’s toxicity is principally its conversion byproducts (unused folic acid) would a “pre-converted folate” sidestep this issue?

    Also, when you advise against taking vitamin A, I wasn’t clear if you were making a distinction between pre-formed and provitamin A. Would provitamin A pose a risk to bone health and vitamin D status if it is only converted to retinol by the body on as needed basis?

    A shameless plug for the product that inspired the question btw. it seems well formulated. http://www.aor.ca/html/products.php?id=142

    Thanks, and I’ve really enjoyed the book.

  38. Heather Switzer

    Hi, Paul. Chris Kresser directed me to you today. I *think* I may be experiencing selenium toxicity but I am not sure. Chris indicated that you might have some insight on my situation. I have been losing hair for about 11-12 months. In the past 5 months, it has gotten worse, and in the past 2, pretty dramatic (handfuls after every shower, lots left on the pillow in the morning). A few things are/have gone on. Since 2010 I have taken Rebif for relapsing remitting MS but never really noticed any hair loss until about this time last year (Oct 2011). I have not taken Rebif in the past 4.5 months and my hair loss has gotten worse. Neuro says it’s not rebif & he has no ideas. Dermatologist says its not rebif, and both she and my ob/gyn lean toward the fact that I had a miscarriage on Aug 31, 2012, although neither is certain of this connection. My thyroid test reads normal. I follow a paleo diet fairly strictly (90-95% with my weakness being fruit & dairy). A few months ago while looking for a different nut snack instead of almonds or mac nuts, I learned I really like brazil nuts. I have been eating anywhre from 4-8 nuts every day. None of the drs I see asked about selenium supplementation or eating brazil nuts when I expressed my deep concern over hair loss (worried enough about MS–don’t want to be bald too!) but it seems clear to me that excess selenium could perhaps explain at least the recent and dramatic acceleration in the past couple of months. Assuming it is excess selenium, when I stop eating brazil nuts (right NOW!) is this all I need to do to counteract excess build-up? And, in your experience do you think I should I see hair loss lessen or stop? I understand from your recent blog post that you are trying to get to these questions. I very much appreciate your time and insights. –Heather

  39. I used to take 900mcg/day selenium for hep C and didn’t lose hair, but did have some peripheral neuropathy (heat in feet) and ridges on my finger nails. My hair growth slowed down, but it never fell out. I believe selenium would cause it to break easily, not fall out.
    Brazil nuts may have on average 19mcg selenium each. This would only be excessive if you already consumed food grown in a high-selenium area (such as Wyoming or parts of Texas, in the US).
    That you also have MS suggests an autoimmune cause:
    “The condition is thought to be an autoimmune disorder in which the body attacks its own hair follicles and suppresses or stops hair growth.[2] For example, T cell lymphocytes cluster around affected follicles, causing inflammation and subsequent hair loss.
    There is some evidence that alopecia affects the part of the hair follicle that is associated with hair color. Hair that has turned gray may not be affected.”

    Alopecia Areata – like MS – is linked to the loss of helminth parasites in the “old friends” hypothesis.
    I’ve just been reading about it in “an Epidemic of Absence”.

  40. Hi Paul,

    You may remember I commented about a month or so ago that I’d started following PHD after a year of struggling with debilitating hypothyroidism (despite supplementation with compounded thyroid and cytomel), along with low testosterone, low DHEA, underfunctioning adrenals, and a vitamin D deficiency. Less than two months ago, I was unable to drive, and was having trouble walking due to the fatigue and trouble with muscle coordination.

    The results of my most recent blood work are in, and there are great improvements: my vitamin D levels have returned to optimal levels, my DHEA is normal, my testosterone has increased (although its not at a normal level yet), and my free T3 has increased to 3.1. Before, it was so low it wasn’t even on the chart and only my total t3 could be reported (which, obviously, was mostly reverse t3). My adrenals have yet to show any improvement.

    I still have a way to go, but what a huge improvement! Most days, I feels pretty good. I’ll keep at it.

    • Hi Allison,

      Congratulations! That’s great news.

      It does take time to heal, so you can expect continued improvements for some time.

      Best, Paul

    • Congrats Allison. Just in case you haven’t covered this already, and for the benefit of other readers, my testosterone increased by more than 50% after fixing a zinc deficiency.

      I suspect I wouldn’t have been deficient if I’d been fully PHD compliant; but perhaps like others I’d done everything right save for the organ meats.

      • Shawn, that’s interesting info about zinc. Honestly, it wouldn’t surprise me if I had a zinc deficiency. All my problems started after I went vegan for 6 months, and I’ve read that it’s not uncommon for vegans to develop a zinc deficiency.

  41. Thanks, Paul!

  42. What does Paul or anybody think about this?

    A few months after going high fat, low carb, I developed hamstring cramps. Sometimes cramps, sometimes stiffness in those muscles.

    I was already taking magnesium. I suddenly realized that, as I had been drastically reducing processed foods in my diet, I now needed to use more salt in my cooking.

    I started using more salt, and the cramps got better.

    However, what really “closed the gap” and completely resolved the problem was adding more carbs to my daily diet. When I get careless, and don’t have 75-100 grams of carbohydrates per day for a while, the cramps seem to come back.

    Very interesting! I never really went VLC, but 50 grams per day definitely doesn’t do it for me, either. What are your thoughts?

    • Hi Sherry,

      VLC causes excretion of sodium and chlorine. So you definitely need more salt. I think potassium can also be a problem, and calcium.

      So it’s a good idea to eat more salt, potassium rich foods like potatoes, tomatoes, and bananas, and bone broth soups once in a while.

      But as you say, getting adequate carbs is important as well.

      This lack of electrolytes is a very common low-carb symptom. It’s definitely something to avoid.

      Best, Paul

      • i have recently started upping carbs, to try and improve sluggish energy levels, average sleeping and muscle weakness in my legs, tightness aroudn the calves. I ‘THINK’ it has been slowly improving, i hope anyway as i have not been living for the last 2months, rather meerly surviving and not enough thriving which has sucked to say the least.

  43. I have a thought on this and I think it might have to do with having a lesser volume of fluid circulating in the body when on is eating very low carb. It seems that an electolyte imbalance is more likely to happen.. A lower volume of fluid is sort of akin to being dehydrated.

    Just my thoughts.

    • Thank you, Heidi. Definitely, really low carb means less water retention.

      I have also paid attention to other electrolytes such as potassium, because I realize the importance.

  44. Hi everyone,

    Besides good diet, any ideas for preventing catching the flu? I usually try to not get too close to people that I know are sick because I suppose I have a somewhat weakened immune system (from diabetes, blood sugar battles). I don’t get sick often but maybe it’s because I try so hard. Anyway, I’m going to be watching my neighbor’s son today (in her house) because she is sick. She has flu-like symptoms. So, any extra ideas for protecting myself from viruses when I know I will be exposed to it?

    The only thing I can think of is garlic and ginger. I seem to use that as my catch-all defense for everything! I’m boiling chai tea spices right now and I will be having a spicy curry for lunch, maybe that will help? Any truth to these thoughts?

    As for my neighbor, will chicken soup be good? Question about that– has chicken soup been used traditionally for colds etc. because chicken is more inflammatory and that would be advantageous when your body is trying to fight something? Or did I get that all wrong?

    Thanks for any ideas at all! 😀

    • I take a single dose of echinacea when I’m working in such an environment. I haven’t had flu since I started higher-dose vit D last year; I went from half-a-dozen infections including pneumonia last winter to one short cough this winter. The echinacea may be just for extra security.
      If you do get flu, an elderberry extract such as sambucol is the best treatment.

      • Thanks George! I may try the echinacea. I’ve never actually used it even though I’ve heard how helpful it’s supposed to be. I believe I’m in the midst of fighting off the virus as we speak but I’m hopeful that I’ll beat it before it multiplies too much.

  45. I have been a vegetable juicer for over 4 years now and both my husband and I have not caught a cold or flu in 4 years! I make fresh, raw vegetable (no fruit) juice every morning and drink it on an empty stomach. Drinking on an empty stomach is key as it will absorb and go straight to your cells to nourish. I also drink tons of veg juice before I fly, and I never get sick anymore. Most flights, I caught something like a sinus infection or cold, but not anymore. I also do not eat on flights if they are shorter than 5 hours. My secret weapon to a healthy vacation both during and when I get hpme. I hope this helps! 🙂

    • Thank you Dede, sounds good to me 🙂 I’m already working on it. Although, unfortunately at the moment the only vegetables I have on hand are carrots and mustard greens! I don’t do cruciferous vegetables often anymore because of the goitrogens, but I’ll make a small drink and try it.
      Thanks for the idea!

  46. Mustard greens will make a very unpleasant juice. A good one to try is a base of cucumber or celery or romain or a combo), for your dark green, add a little parsley (or cilantro or spinach), a lemon or lime (peeled), then add carrots and I love a little ginger. Have roots be your supporting players in a juice so you don’t get too much “sugar”. I will sweeten an all green veg juice with NuNaturals alcohol free liquid stevia, but most of the time, I drink it “straight” and if carrots are a part of the mix, I don’t need a sweetener. I also love cucumber base with spinach and mint. Lovely!

    • Yes, you are very right– too bitter. I’ll try one of your suggestions after I get back to the store, they all sound yummy– I love all those veggies and herbs. I just happen to have the mustard greens right now because I’m planning to make a potato soup that calls for them. But, yes, I now confirmed that they don’t belong in green drinks/ juices unless you’re just really adventurous 😀

  47. HI Paul,

    first off I want to let you know how much your book PHD has changed my life.

    I have a history of Ulcerative colitis and was able to get symptom releif while on a primarily paleo, meat and vegetables, diet along with using fermented foods.

    However, I still had a terrible time gaining weight and felt bloated all the time. It wasnt until I started adding more saturated fats, monosaturated fats, and yes even safe starches, was I able to actually be releived of the bloating and gain weight.

    Although the UC symptoms have completly cleared up, I still have a mild case of psoriasis.

    I was wondering if psoriasis is infectious, possibly triggered by parasites or bacteria?


  48. Hi Paul,

    I’ve finally discovered the cause of my longstanding (since at least April) high bowel tolerance for C: a raging epstein-barr infection. I suspect that I’ve had the virus since grad school and a series of awful immune-wrecking surgeries four years ago.

    My doctor is giving me intravenous C, 100 grams three times a week. On the remaining days, he wants me to take six grams of lypo-spheric C. So I should be covered in the antioxidant department.

    Symptoms include sore throat, white-coated tongue, blepharitis, insomnia, brain fog, depression. But all other infectious tests have come back negative: stool, serum, tongue culture, and the like. So I’m comfortable assuming that my only infection is viral (though awaiting lyme test results).

    As for viral strategies, I’m thinking of emphasizing: intermittent fasting, circadian rhythm, and possibly reducing protein from 100 to 50 grams daily. Am I in the ballpark here? Any other suggestions?

    Also should add that despite the infection, I’ve dropped at least ten lbs. of bodyfat on PHD while eating a far tastier diet:)

    • Shawn, I too have a viral infection(vzv) and have been focusing my efforts on fighting the virus and supporting my immune system.

      Is there a reason for using lypo-spheric c over sodium ascorbate/ascorbic acid?

      Have you looked into monolaurin(lauric acid) for it’s anti-viral properties?

      I’ve also read that colostrum has great anti-viral components as well as immune support and gut health advantages. I just started taking it, so it’s too soon to assess the results.

      I’ve found that supplements with anti-inflammatory properties tend to help. Our bodies are constantly inflamed when fighting infections and certain supplements such as curcumin have been proven to block the constant cascade of cytokine signaling that occurs in this state. This may give some fairly quick releif with depression and fatigue symptoms due to the infection, although it does not solve the underlying problem which is the infection itself.

      Hope this helps, it has certainly helped me in short order.


    • One more thing, Paul mentioned in a blog post that selenium, k2, d and iodine should be increased when fighting an infection(as well as c). Not sure what the dosage would be for all these but he does discuss increasing dosage of iodine for infections in his book.

      • Jon, thanks for your suggestions and glad to hear you’re feeling better. I want to try lypo-spheric C because of its superior absorption and tolerability. I did bowel tolerance ascorbic acid for a while without improvement and with a good bit of discomfort and inconvenience (averaging 12 separate 8-gram doses). Cost-wise, lypo-spheric is about $1 a gram, so I can handle six grams a day for a while. Long-term hopefully I’ll recover and need less.

        I’ll up the coconut oil during IF and will also look into curcumin and colostrum. D and selenium I’m less comfortable with because of toxicity, maybe Paul will comment on specific doses.

        As for iodine, my TSH doubled despite slow titration from 225mcg to 6mg. My RT3 went really high, although maybe this was less due to the infection and more because of zinc deficiency. Anyhow, I’m a bit leery of iodine now and am holding at 225mcg.

        I’ll be sure to post updates with my progress, really quite glad to have identified the infection.

        • I’ve been looking for info on higher d and selenium dosage as well. It’s definetely something to be careful with. I think that selenium needs to be increased when iodine is incresed and visa versa.

          I’m hoping that some day Paul will write a book which focuses soley on dealing with chronic infections and expands on therepeudic use of supplements, diet and appropriate lab tests etc.

  49. PHD community,

    Does anyone think there would be a connection between chronic infections and an increase in allergies(not particularly talking about food). I think we can say that the immune system is heavily taxed when fighting a viral or bacterial infection. Would it be possible that an immune system in a disfunctional state would react adversely to substances that don’t really present a danger to the body such as pollen, dust mites, rag weed?

    Since I was an infant, I’ve suffered from a variety of immune system related ailments. Pneumonia at 6 months, first shingles outbreak at 6 years(have had many reocurring bouts since) of age and asthma/rhinitis since elementery school. I’m starting to think that I have a weakened immune system and that if I were to only streangthen it and fix the infections then my chronic rhinitis may resolve as well.

    Any thoughts?

    • Read “An Epidemic of Absence” by Moises Velasquez-Manoff. All will be revealed.
      The wrong infections at the wrong times (EBV and HP turning up later), and the near-extinction of the classic paleo parasites, and depletion of evolutionary gut bactera, results in allergy and autoimmunity. The immune cells that would have been busy with worms once can react to allergens if they’ve never been trained to recognize the targets they evolved to control.

  50. yes, i believe that the immune system can under-develop just as many other systems can if they are not supported during key times in childhood. chronic stress, traumas, poor nutrition, and genetic flukes can all combine to create very long lasting problems, such as a “stupid” immune system, or an auto-immune system.
    i know that my “crohn’s” is kept in remission only through tight diet and supplementation, when i run out of certain supplements and then encounter higher stresses, i “get sick” and that sickness can spiral out of control if i don’t fix it fast.

    • Hi Darius,
      Do you have any suggestions you’d like to share for those with Crohn’s? My brother has had it for something like 30 years and has gone through so many procedures, operations, medications, steroids off-and-on all these years. Maybe Crohn’s is different for each individual, I don’t know, but if you have any suggestions, I will pass them on to him.
      Thank you!

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