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:
- Chronic Lymphocytic Leukemia (CLL)
- Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue
- Lupus
- Depression
And here are my answers.
Chronic Lymphocytic Leukemia (CLL)
Paul,
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,
A
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?
G
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.
Lupus
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
Depression
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:
- 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.
- A ketogenic diet is both therapeutic (promotes immunity against bacterial and viral infections) and mood-improving (clears kynurenine).
- 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.
via this link:
Do you think it is beneficial for pre-menopausal women to engage in intermittent fasting? Are you familiar with the divergent effects of IF on males and females? Do you believe it is harmful for women? Thanks
Hi Jenn,
No, I don’t think intermittent fasting is by itself a problem for either girls or women, but I do think calorie restriction / food restriction can be a major problem, and it seems that many girls and women who do intermittent fasting restrict calories too much. So I wouldn’t push intermittent fasting on young women, or if they do it would encourage them to eat plenty of food during the feeding window.
I think women are more sensitive than men to nutritional deprivation and energy deprivation. We see this for instance in the Athlete’s Triad, female athletes are quicker to demonstrate symptoms (eg loss of menstrual cycles) than male athletes.
Paul,
I have had tremendous benefit from following your diet and supplement plan. I have small children who often bring home extra germs. About five or six times a year I will get a cold that is minor in its symptoms with the exception of a dry cough that will persist for 5 days. I have the most difficulty at night where I cough all night long and wake up with a terrible headache. I use a humidifier, cough syrup, and vicks to provide some reilief.
Also of interest is I am able to up my vitamin C dosage to 12 grams a day without any side effects.
Hi Andy,
You might find extra vitamin A beneficial. I assume you have optimized vitamin D per our recommendations?
Yes I have optimized my vitamin d. I take currently eat 4-5 eggs and 2 grams cod liver oil for extra vitamin a. Would you recommend increasing this amount.
@Victoria Forsyth
My LDL history may be of interest to you, maybe a longer time interval is needed to see the trend. Background: I have been on the LC/HF diet since Jul ’10. Weight problems never an issue, weight has been stable. Reason for diet change was periodontal gum disease and it seems in hindsight there were many other correlated problems e.g. lower back pain. There has been a slow but steady healing process. LDL history (in nmol/L):
’10 – 4.4; ’11-5.6 and 4.6, ’12-4.3 and 3.2. The double entries in 2011 and 2012 were taken at 6 month intervals ( I was concerned). Throughout the period, risk ratio has been declining.
Is it healthful to consume 1lb of liver a week. I have 1lb of liver as my primary source of protein one day a week, with other days consisting of beef and salmon. Is this too much liver for a 160 lb male?
Hi Matt,
I think if it all comes from beef, that’s too much — it gives you an overdose of copper. If it’s 1/3 lb beef or lamb liver and 2/3 lb chicken liver, I think it’s OK.
Would mixing honey and glucose into homemade unroasted almond butter be ok on occasion or is the combination as you mentioned in your book pretty detrimental here?
I would try to watch how much honey you consume if you already eat 2 or 3 servings of fruit, since just 1T of honey has 8.6g of fructose. You could be approaching the 25g “cap”. I would recommend using coconut palm sugar instead of glucose due to its low glycemic index and plentiful micro-nutrients. Almond butter should also be limited since 1 oz of almonds contains over 3g of PuFas. Macadamia nuts have very little PuFa which make them a very healthy nut, though they are quite expensive! Both honey and almond butter are great in moderation just watch for the serving size since fructose and omega-6 PuFas can add up easily. Hope this helped!
Hi Paul,
I have been following the perfect health diet for about a month and it has been great! I, however, am still experiencing IBS-D and had a couple of questions:
1) I read that L-Glutamine can resolve this problem in people like me. I started some yesterday (3000 mg) and plan to have one serving a day on an empty stomach. I was wondering if you thought it would be beneficial? And also wondering what an appropriate dosage would be and for what length of time?
2) I am finding it easier and easier to fast on the PHD which is great. However, one thing I am experiencing is, I always have diahhrea a few times after my first meal. Have you heard of fasting making this condition worse?
3) Do you ever recommend using a two week course of an antibiotics for people with a tendency towards diahhrea to see if it helps clear up possible bacterial infections?
Thanks so much for your time!!!!!!!!
Hi CB,
Glutamine can have either good or bad effects. So it’s hard to advise; rather you have to experiment and see if it works in your case. It can nourish both intestinal cells and gut bacteria.
Re the diarrhea, you might want to read our constipation post (http://perfecthealthdiet.com/2011/04/causes-and-cures-for-constipation/) because the biology is the same only in reverse. It could be that your first meal is fat-rich and you are producing either extra bile or failing to digest the fat, and either the fat or the bile is having a laxative effect. You might try making your first meal have less fat, more carbs and protein. … Another possibility is that the bacteria causing your IBS are the ones that cause diarrhea. See the constipation post for more. In this case antibiotics and replacement with probiotics/fermented foods/fecal transplant may be called for.
Antibiotics sometimes work, sometimes they don’t, sometimes they make things worse. The worse your condition, the more it’s worth the gamble. I would try to get a stool test, eg the Metametrix microbial ecology profile, before starting drugs. You at least want to know if you have any overt infection, and if so choose a drug that specifically targets it.
Paul, I see a reference on your site to InterFase Plus (enzyme formulation with EDTA). Is that something beneficial to take during antibiotics? I would think you should not use it daily?
Hi Steven,
I would be very cautious about taking EDTA. They have a version without EDTA which is much safer.
Hi Paul,
Thanks so much for getting back to me so quickly. These are my last questions, I promise!
1) I generally always have a dull (sometimes sharp) pain under my right bottom rib, especially after fatty foods, eating somethings with onions, dairy and coffee. After what you mentioned about fats being poorly digested, I realized that maybe I am having gallbladder problems. I haven’t been to a doctor about it, but I just bought some high quality digestive enzymes to see if that helps the diarrhea and pain. If it is in fact gallbladder related, do you have any additional tips? I am a 25 year old female, so obviously it could be unrelated to the gallbladder, but my symptoms certainly fit the criteria.
THANK YOU SO SO MUCH!!!
Hi CB,
That certainly sounds like liver/gallbladder. You might have gallstones.
Some things that might help:
– Vitamin C and taurine for bile support.
– Citric acid (eg lemon juice, lime juice, citrate forms of supplements) to help dissolve stone materials.
– Choline / egg yolks for liver health, and maybe NAC for glutathione support.
Sometimes people do gallbladder cleanses, you can google those, basically a fast with say olive oil and lemon juice to promote bile/citrate flow and stone clearance.
Sometimes gallbladder problems are caused by infections, so your doctor could check for SIBO, H pylori, etc, and conceivably antibiotics could be warranted.
Best, Paul
Hi Paul,
I suspect that my symptoms (infrequent periods, hair loss, increased pimples) are due to PCOS since my doc informed me that my TSH and FT4 are normal.
I’m reading info on foods that decrease androgens. It said to decrease Fat and Meat, and to increase Soy and Fiber. This would go against my current Almost-PHD diet. Assuming that I do have PCOS, shall I decrease the meat/salmon and butter/eggs and focus on tofu/veggies? *confused*
Hi Monnyica,
No, I would follow PHD. Just my belief. Give it a try and see if symptoms resolve over the next six months.
I might try a stool test at some point also.
Best, Paul
Thanks Paul. Will a fungi/yeast stool test reveal something about the infrequent periods?
Also, since I am having period irregularities, should I assume that the acne is hormone related instead of gut related? The acne is bothering me cause they’re leaving red marks! I’ve never had this type of poor-healing acne.
Also an update… my doc said further thyroid testing is unnecessary because it’s highly unlikely that I have thyroid problems since TSH and FT4 are within the normal range, even almost perfect, as you have mentioned before. I did get a Stool Culture, it came back negative for E. Coli, Salmonella, Shigella, Campylobactor. But the test didn’t include testing for fungi/yeast.
Hi Monnyica,
It’s not easy to link symptoms to causes. But if a stool test finds an infection and you treat it, it’s possible that multiple symptoms may go away. The goal is to just keep removing causes of disease and eventually you get rid of enough that your body can heal the rest.
Hi Paul,
I agree with your logic. I am going to reconsider asking for a metametrix test, especially since I have abnormal stools. Sorry if this is gross, but I took a pic of my stool. Would you mind examining it? I can’t tell if the white stuff is undigested food or something else. You can totally pass if this is too gross.
After reading the Reader Results section on PCOS, I can see how diet can actually be the root of it. I started Iodized Salt and Dulse in May 2012, and I had 2 periods in one month. However, I continued to have missed periods after May, so maybe that was just a fluke. I don’t know. I’d love to read more success stories!
Hi Monnyica,
Since I don’t have any experience interpreting stools, I would rather leave that for a doctor or naturopath.
I’d love to read more success stories too!
Don’t forget, Paul, that naturopaths and chiropractic physicians are doctors too. Actually acupuncturists are too but they haven’t challenged that nomenclature yet. For me, a “doctor” is a person who gives healing substances and not suppressive substances. An MD or DO who doesn’t understand nutrition, we chiropractors and naturopaths call “allopaths”.
Hi Cyrus,
Good point. I should have just said a healer with knowledge in that area.
Hi Paul,
The DRI for Potassium is 4.7 grams (adult male).
And DRI for Sodium is 1.5 grams (adult male).
And DRI for Chloride is 2.3 grams (adult male).
A while back i determined that i was likely falling short of my potassium requirements from food alone.
So i decided to supplement with some potassium chloride powder.
Though i am now wondering if this may have added to my night time stomach reflux issues. I was just reading here
http://www.omnimedicalsearch.com/conditions-diseases/gerd-causes-risk-factors.html
that potassium chloride may cause relaxation of Lower Esophageal Sphincter (LES) (various other ‘drugs’ are also listed, including Vitamin C).
Any thoughts regarding supplementing with KCl? esp with regards to reflux &/or LES relaxation.
Also, could excessive Chloride be a problem, again esp with regards to reflux &/or LES relaxation.
I would probably be exceeding the DRI for chloride given that KCl powder is about a 50/50 mix.
& sea salt (which i use) has more Chloride than Sodium.
Thank You, Darrin
Hi Darrin,
I wouldn’t recommend that. Supplement with tomatoes and potatoes instead.
Also, that DRI for sodium is too low. Optimal sodium is about 3.7 g.
Excess chloride could be a problem, it may need sodium along with it. I think it’s safer taken as table salt.
Thanks Paul,
when you say “I think it’s safer taken as table salt”,
do you mean that you think that table salt is safer than sea salt?
I myself have moved away from the “dirty” coloured unrefined sea salts. My current sea salt is fine & white (like table salt), so i am presuming that it has been refined to some extent. But has no flowing agents or additives.
Hi Darrin,
No, I think sea salt is better. I meant as sodium chloride rather than potassium chloride.
Hi Doctor Jaminet,
What is your opinion on dairy? Does it have a place on the Perfect Health Diet?
I recently switched to your PHD from a paleo type diet and was avoiding dairy before switching. Now I find that it relieves my constant hunger. Might there be an obvious reason for this?
Also, I am 18. Could I be hungry for dairy because I am still growing? Might I need more carbs than usual because I am still growing as well?
Many Thanks,
J
Hi Jackson,
We support eating fatty and fermented dairy (eg butter, sour cream, yogurt, cheese) and are dubious about milk.
Dairy is nutritious, but I’m not sure what it is supplying that you were missing before. If you are drinking milk and were very low-carb before, it could be the carbs. I doubt it has anything to do with growth.
Hi Paul! Loving the book! I am about halfway through and things are making sense! I was reading your response re dairy and had a quick question for you. I found a greek style yoghurt that is from a local company, grass-fed cow’s milk, etc. Their greek style is fat free yet they use whole milk. I was told by the company that they drip the whey out and it becomes fat free. Does PHD still recommend a greek style yoghurt like this since it seems not to be fatty anymore?
Thank you so much!
Dede
Hi Dede,
I wouldn’t recommend fat-free yogurt, no. Don’t they offer a normal yogurt too?
This company’s “drinkable” yoghurt, even their plain unsweetened as they call it has added sugar unfortunately.
Hi Paul, How do you add extra eggs to the soup? Lets say you have a bowl of hot soup, do you just crack an egg into it? or do you also microwave it after?
I would assume you do not just add eggs into the soup while preparing it.
Hi St,
That is how I do it: just crack the egg straight into a big bowl of hot soup. I prefer just eating the egg yolks (not the whites). If your soup is hot enough, you will find the soup broth cooks the egg very quickly so it becomes solid rather than runny.
If you look into Asian soups and meals, they add raw eggs and even thinly sliced meat straight into a hot soup broth just before it is served. The Vietnamese Pho soup is an example of raw beef being added, and lots of Korean dishes have raw egg yolks as well!
Good luck, and good eating.
Kristopher
Hi St,
Like Kristopher, I add egg yolks to my soup or to lunch meals. I usually re-heat in the microwave after adding yolks.
Dr. Jaminet,
You’ve said that a ketogenic diet is useful for neurological disorders. Does that apply to arteriopathy? (I have a progressive brain disease called Moyamoya in which the internal carotid arteries are narrowed/ occluded, reducing blood flow to the brain).
Also, is K2 supplementation okay if I’m taking aspirin per my neurosurgeon to prevent post operative clotting (surgery was 5 months ago), but I’m also at risk for hemorrhagic stroke?
Or, can you recommend a doctor in the Boston area to work with me a la PHD?
Thank you!
Hi MC,
As Moyamoya is believed to be a genetic disease caused usually by mutations on chromosome 17q25.3, but the specific gene and mechanism involved are not known, it is very difficult to say anything about what the right dietary response is. I certainly don’t know whether a ketogenic diet would help.
I think K2 is probably helpful; it may help normalize clotting as it supports anti-clotting as well as pro-clotting factors. But you should consult your doctor and if there is a way to test the effects on your clotting rates, do a controlled experiment (blood test, start K2, blood test) to see how your risk has changed.
I’m afraid I don’t know of any doctors I could recommend to you.
Thank you so much. (BTW I can’t believe you answer all these questions!)
Some researchers think moyamoya is a response to an allergen. A 2003 study said: “the etiology of Moyamoya disease may involve allergic angiitis.” If this is true, does that make a difference re. diet?
FYI: I’ve been low carb for 2 months now, but adding a little sweet potato (PHD) has finally made me stop feeling “nutrient hunger”. Thank you!
Hi MC,
It might. Well, we’re guessing, but PHD should be helpful at normalizing immune function and diminishing allergies, and more restricted versions that remove allergenic foods (like dairy, eggs, nuts) might help further. I wish you the best, let me know your progress!
Hi Paul,
I have bought your new book and have been enjoying it a lot so far, lots of good information!
I decided to finally incorporate white rice into my diet, about 120g of carbs each day and today is my 3rd day. Everything has been going very well so far!
I eat a lot of raw carrots and I have a noticeable yellow tint to my skin, on my palms and fingers as well. I decided to cut back on the carrots, but can this because of some other underlying issue?
I’ve read a few different things regarding this:
1. liver is detoxing
2. the excess beta-carotene is being excreted through the skin
3. liver problems
4. adrenal fatigue
I’m 18 and I haven’t had any issues besides some digestive issues and coated tongue. I haven’t been sick for months, not even a cold or sore throat. Not sure if this eliminates the liver and adrenal problems.
As far as adrenal fatigue, in the mornings I have no trouble getting up and feel fairly lively in the early morning, while in school I do tend to get tired but usually this is because of my terrible sleeping schedule as a student, usually 6-7 hours a night. I feel much better after around 5pm where my energy is pretty high. I do get cold hands/feet sometimes but I’ve been fixing this with some selenium, iodine, and adding starches as you recommend.
Thanks for any help you could provide!
Hi dynamik,
Yellow tinted skin is probably due to beta-carotene from the carrots. If the whites of your eyes are yellow it could indicate jaundice, possibly caused by gallstones blocking the bile duct, but carrots seems the most likely explanation. If you are concerned you could have your doctor test for bilirubin levels.
I think following the recommendations in the book — a balanced diet, good nutrition, and a lifestyle with good circadian rhythms — is probably all you need. Based on your own experience, when you follow those steps, you do quite well!
Hi Paul,
I have to say your new book is great.
I have received my Blood tests back and I am trying to makes sense of this with what I have been reading your articles regarding High LDL on Paleo. So your reasoning that it is deficiency in Choline, Copper(Beef Liver) and Selenium right? Increase the carbs to 100g?
I have only been on your program for 3 weeks before the test so I can not truthfully say it is due to this diet. Are these a bit high? What about Thyroid hormones? Any other suggestions?
Total -282
Trigl – 161
HDL – 53
VLDL – 32
LDL 197
TSH 1.97
T3 – 32
Free T4 – 1.3
In your book you say it is best to have TSH closer to 1.00 correct?(At least in the old one, did not get to it in the new one yet)
What do you think of supplementing Pantethine?
Hi Steven,
LDL is definitely high. You should look at our LDL category and at the “High LDL on Paleo” posts. This usually indicates you are too low carb, too low in iodine selenium or copper, or hypothyroid.
For thyroid levels, check the reference ranges on your lab test. Yes, TSH near 1.0 is desirable.
I think supplementing pantethine is fine. We recommend once a week either pantethine or pantothenic acid.
Paul, TSH is in Normal range. Could it be due to the fact that I lost like 4 pounds before the test, so the liver might have been clearing the fat?
Is it still only 400mcg of selenium per week in supplement form if I do not eat Brazil Nuts?
Hi Steven,
Maybe that might affect it. You could retest in a month or two to check.
Yes, I think 400 mcg per week is sufficient.
Paul, i haven’t got a great handle on when to bump up my selenium from 200 to 400 a week.
No idea of where my food is grown, so i don’t know if selenium rich soil etc.
I take all the supplements as suggested, but don’t do the kidney or the liver. I have 3-4 egg yolks a day, take all the daily supplements and weekly (except optional, as suggested). About to bump up iodine to 900 mcg (from 450). So, do I stay at 200 selen or move up to 400?
tx
Hi Evan,
400 mcg should be safe even if your food is selenium rich. 200 mcg should be enough also if you are eating beef and seafood primarily. They both should get you in the peak health range.
Paul, I have 300mg Panthethine. Do you think due to high LDL, I can take it daily for few months?
From which food are we getting in while on PHD?
Also what do you think of Niacin for a couple of months?
Hi Steven,
I think the pantethine is quite safe so nothing wrong with taking it daily. The niacin is a bit more questionable but that’s not very dangerous either.
Paul, just wanted to tell you, I have just listened to a couple of Chris MasterJohns podcasts on cholesterol. So he does say exactly the same thing, that losing weight before the test might skyrocket LDL. Only do the test once weight is stabilized.
I looked at Pantethine a bit for its lipid improving affects and there are some possible interactions to consider:
; Life-Threatening Eosinophilic Pleuropericardial Effusion Related to Vitamins B5 and H; P.M. Debourdeau, et al.; 2001
Thanks Mark. I was also considering Nattokinase, and it looks like it has the same effect. Probably better not to take it with Pantethine together as well.
I will just do a Normal PHD, maybe slightly lower carbs and supplement with selenium, beef liver and iodine. I am up to 500mcg of iodine right now.
I will retest in 3 months and will le you know how it goes.
Steven, I’m surprised that nattokinase would have the same interaction effect. I thought it acted much more as a clot preventing modulator and without the anticoagulation effect problems that the prescription blood thinners can cause.
Thats what google is showing at least.
Hi Paul!
I have been following the PHD for a over a year now and love it! (This is the way I always naturally wanted to eat…now no guilt!) I have just bought everyone in my family a copy of your new book! I have a few questions…
I just found out I am pregnant with my third child…is it safe to continue with everything (supplements)? Is the MK-7 and sodium ascorbate cystals safe? I have stopped the fasting because eating in the late morning has kept away morning sickness. I have increased my egg yolks to four a day (have a hard time eating more than that). When you say eating egg yolks, does that mean discarding the whites? Does cooking the egg yolks destroy the nutrients? Also, I read your section about folic acid in your new book, but what about folate (as in L-5 methyltetrahdrofolate) that you find in high quality prenatal vitamins? Thanks for all your help! Jamie
Hi Jamie,
I believe all of our recommended supplements are safe during pregnancy, but please do be careful — don’t increase iodine dose during pregnancy, and be sure to take supplements with meals.
It’s not necessary to discard the whites if you like whole eggs, but that will reduce the amount of meat you eat. Cooking the egg yolk is desirable, it makes the protein more digestible and helps prevent egg allergy. I think excess folate is a potential problem, I would only take small doses, supplement choline instead for support of methylation.
So regular (raw) egg yolk consumption you would say increases likelihood of becoming sensitive? I though when raw nutrient absorbtion was better than cooked (somehow?) (and of courses tastes better!)
Hi Paul, congratulations on the book, it must be satisfying for you and Shou-Ching… I look forward to reading. In the mean time, I wonder if you would graciously answer another question I have (Your time in this section is very valued, I’ll say again)
I have a query about iodiene supplementation and its effects. I ‘supplement’ with selenium (sometimes drops, sometimes brazil nuts, then there is red meat etc) and have been taking potassium idodie 225mcg for a month. Yesterday I doubled the dose as per your and others’ suggesstions and in the last twenty four hours I’ve subjectively had more ‘energy’ (insofar as I’ve sponatnously done a few sprints when walking). Nothing else was really different (apart from indulging in a fressh fillet of salmon as well…). Do you think this could be related (the iodine increasing t3 and energy production perhaps)?
Cheers
(sorry, this wasn’t meant to be a reply to the above posts…)
Hi Michael,
It could be an improvement in thyroid status, but it’s hard to tell based on one day’s experience. Stay at this dose for a month and see if the feeling persists.
Thanks. I thought so too (perhaps I’m overthinking, in which case thanks for humouring me…)
Hi Paul,
I was reading the series on healing the gut, and a question occurred to me. I’ve been keeping a food diary the last 10 days or so, and one thing I’ve learned is that potatoes, especially sweet potatoes, cause gas and bloating within an hour of eating them (sorry to give too much information). Would you interpret that as data suggesting that my gut has some kind of problem with potatoes, or just an innocent reaction to them? It seems to be fairly common, based on google searching it. I don’t know whether to think it’s bad, because “gelatinized” bone broth has a similar effect on me, but that’s supposedly very good for one’s gut.
Thanks as always for your time. I just got the new book and look forward to reading it.
Hi Thomas,
This post discussed some possible causes: http://perfecthealthdiet.com/2011/01/what%E2%80%99s-the-trouble-with-sweet-potatoes/.
I’m not sure why the bone broth would do it too. Are your bones from grass-finished cattle? Does it also happen with chicken feet?
Hi Paul,
Thoroughly enjoying the new book! Thanks for writing it in such an honest and logical way as to make us part of the discovery process.
I have been on PHD for 5 months now and my intestines seem to like it (I have mild to moderate Crohn’s). I’m also hypothyroid (Hashimoto’s) and after trial and error with T4, then T4 + T3, etc. my doctor and I decided that I was doing best on T3 only. So now I take 87.5 mcg T3. My question is – am I somehow causing long term damage to my body by taking such a high dose of T3 even though it makes me feel good now? It’s mixed with cellulose (avicel and methocel) to make it slow acting.
Hi Vartouhi,
If it makes you feel good I wouldn’t go away from it but I would monitor the dose and try to reduce the dose as you heal. Ideally, your health will improve and you’ll be able to steadily reduce the dose.
Thanks Paul. Also, to avoid food sensitivities, I cycle my food. So I can’t eat eggs two days in a row (for now). So can I eat more egg yolks on the days I eat them to make up for the days I don’t? or, it doesn’t work like that.
Hi Vartouhi,
Yes, that’s fine. You don’t need nutrients every day.
Hi Paul, had asked you before about my significant other. He has mantlecell lymphoma and I asked about K2 and vit D3, you suggested he take 5 mg of k2(You suggested Carlson) I got that( it says Menatetrenone on the label,does that mean mk-4?)& 2000 iu of vitamin D. He also has congestive heart failure and diabetes. I did not tell you about these at that time so with the heart and diabetes are these still what you would recommend? His oncologist thought the k2 was high? I asked his cardiologist about the k2 and she said he is not on any drugs that it would interfere with. Many thanks Syl
Hi Syl,
Those are also good for heart health and diabetes. It’s fine to combine them with aspirin too. The K2 dose is high in the sense that it is higher than dietary doses, but I think that’s what you want, it has strong anti-cancer and pro-vascular effects.
Hi Paul, I forgot to mention that he takes asprin on a daily basis doe that matter with K2? Thanks again, Syl
Hi Paul! Question regarding how to calculate full fat yoghurt. Protein? Fat? I want to make sure when I eat it that I don’t overeat or imbalance my macro-nutrients. I had 3/4 cup today with a banana. Also, is fruit a good combo with dairy fat?
Thank you so much!
This is a great website to calculate macro nutrients. Here is a link for full fat yogurt
http://ndb.nal.usda.gov/ndb/foods/show/104
Fruits can be eaten by themselves or with foods low in polyunsaturated fats such as whole milk yogurt and other full fat dairy foods.
Thank you Anonymous! What a cool tool you found!
Hi Dede,
Reading the label is probably the most reliable way. Yes, fruit is a good combo with full-fat yogurt.
One quick clarification/question if I may again… I read the label on the sheep’s milk (full fat) yoghurt and the protein grams and fat grams are exactly even: 13 grams each, and calories are 194 in an 8 oz. serving. I’m not quite sure how to interpret a 4 oz. serving on my PHD plate. Thank you Paul, I truly appreciate you taking time to help me.
Dede, you’ll be fine. Yogurt is pretty close to overall PHD so you don’t need to fit it on the food plate, eat as much as you want and balance the rest of your diet per the plate.
Thank you!! 🙂 I love the yoghurt with fruit…what a treat, so this is good news! Also, have to tell you how much I am loving your suggestion of vinegar over potatoes! Truly delicious!
anyone here have ‘problems’ with drinking coconut milk (drinking rather than cooking with).
I was just reading this old-ish post by Chris Kresser,
http://chriskresser.com/3-reasons-why-coconut-milk-may-not-be-your-friend
I drink loads of coconut milk daily. Well it’s actually coconut cream that i water down. I started drinking coconut milk after giving up dairy milk (which i still drink occasionally).
After reading the CK article i’m now wondering if my own reflux type issues relate to the coconut milk. So i am going to go coconut milk free for a bit to test.
I should mention that the particular coconut cream i buy does come in cans (tho BPA free ones),
And does contain organic guar gum @ less than 0.5% (before i dilute it down).
So it could well be the guar gum, or a bit of both.
Any personal anecdotes to tell?
Hi Darrin,
I had the same problem concerning coconut milk consumption. I make mine fresh from coconut chips and prefer to avoid canned coconut products. Gluten had slowly deteriorated my gut health and with the addition of coconut milk I had reflux issues. I switched to potatoes for carbs during the PHD transition and added some probiotic foods like sauerkraut and kefir that helped my gut and digestive system heal. I reintroduced coconut milk back into my diet and never had problems since. I would be careful with the guar gum, there have been studies published about thickening agents including guar gum which is derived from “beans” and the studies indicate decreased absorption of carbs, farts, calcium, iron,, zinc, and copper.
Hi Darrin…I think we must use the same coconut milk (Native Forest), and I love it, but you’r right, it does sometimes come out of the can in “clumps.” I use it on my cereal, or just on some white rice.
I can also get raw cow’s milk (from a Massachusetts certified dairy!), and I wonder if that is preferable.
Hi Paul,
I have implemented the PHD with the suggested supplements and I am doing absolutely fantastic! I have one concern though, involving water contaminants such as fluoride (which has been proven to be ineffective for tooth decay, therefore, I use fluoride-free toothpaste) and other detrimental additives. What steps would you recommend for cleaner and healthier water to further benefit my existing success with the PHD? Thank you.
Hi Jordan,
We use a Britta filter and leave it at that, but I don’t claim to know what is optimal.
I’m glad you’re doing well!
Best, Paul
Brita filters don’t remove fluoride. It requires a reversis osmosis filter. I have absolutely found one to be worth the investment (and the water tastes infinitely better!). [I’m glad of this for my animals as well as myself; there is some evidence that fluoride may be linked to osteosarcoma and I have a dog of a breed highly prone to that; fluoride-free water now probably can’t reverse the effects of water she consumed before I had her, but at least I’m not making it worse.]
Steam distillation also works to remove all contaminants, including dissolved salts such as fluoride. I’ve used a one gallon distiller for years for all my cooking and drinking water. Reverse osmosis units are more convenient, but as I understand it the downside to those is the issue of membrane degradation over time. The membrane can be losing effectiveness without your realizing it unless you monitor its condition and replace it when necessary, so I prefer the simplicity and trustworthiness of a distiller.
There’s some criticism of removal of minerals from drinking water, but from what I’ve read it’s more certain and reasonable to obtain minerals from the naturally occurring compounds in food. Given the wide variability of dissolved minerals in various water supplies, it would be a pretty iffy proposition to try to obtain the minerals needed for health from your water. That’s not to say that some water isn’t better for you than other, but eating PHD will give you your minerals, water content notwithstanding, so I use water for hydration, pure and simple.
what about store bought bottled water, does that contain fluoride?
anyone know.
I presume the ‘straight from the tap’ bottled water would.
Hi Paul:
My family and I for a period of one month has only been able to afford chicken and sardines. Question: What are the possible dangers of consuming conventionally raised chicken? What are your thoughts about arsenic in chicken feed from non-organic chicken? There are about 2000 mg for each can of sardines. How many sardines per week do you suggest for adults and children?
Hi Eddie,
About a pound per week of sardines is good for both adults and children.
You may find if you look that it’s possible to get organ meats from animals like cows inexpensively. This would help you diversify your diet.
Hi Paul,
What is your thought of supplementing with oxaloacetate?
This is a question that will be more suited to the forum that Paul is building, but am interested in any hints and tips from those who have successfully implemented the PHD for those about to start.
Hi Caroline,
-If possible, get rid of everything in your kitchen that isn’t PHD-compliant. Then you won’t be tempted.
-Get plenty of sleep and some exercise
-Read the book and Paul’s posts and answers on this website.
-Follow http://perfecthealthdiet.com/the-diet/
-Take the recommended supplements
-Try intermittent fasting. It’s easier than it sounds and simplifies your life!
-Check out the PHD recipes on this site
-Check out other paleo sites for recipes that are in accord with PHD
-Remember “the does makes the poison” and eat a variety of foods
-Favor lower Omega 6 foods per PHD (and don’t eat too much chicken!)
-Cook food on the weekend, freeze, and eat during the week
-Cook food gently
-Bring food to work
-Good luck! I’m very happy with this diet!!!
Thanks Connie. In keeping with the ratio of fats/proteins/carbs, did you count calories initially, weigh the food until you got an idea or something else? I have been on VLC for so long, that introducing starchy carbs and getting used to the ratios seems to be my biggest hurdle at the moment.
Hi Caroline,
I’m afraid I didn’t weigh the food or count calories. I must admit that when I did start eating sweet potatoes and fruit after being LC/VLC/low fat for so long (many years), I didn’t want to stop eating them – ha! I guess I had to go through an adjustment period. I do feel so much better now that I’m eating safe starches (potatoes and sweet potatoes) and some fruit. And also I’m not going too low fat and not having too much Omega 6 fats. Hopefully you’ll notice a huge difference too!
Forgot to say that I’m also eating rice as a safe starch. And can’t stress enough how important variety is and to get enough fat – good fat!
Hi Paul;
I was wondering if I could trouble you by asking about your time with candida. When you had it, did you notice your symptoms (such as fatigue and brain fog) were static and the same constant level consistantly, or would they vary from hours,days, weeks, etc.?
I have periods where I feel absolutely fine, sometimes lasting a few weeks, and times where I can barely move in the morning but overly energetic in the afternoon.
Does this sound like candida or something else?
Hi Michael,
That doesn’t sound like my issues, which were slowly varying but would flare up for periods of months (most commonly in the winter). Fatigue and brain fog I associate more with immune activity, often food sensitivities, which might have Candida as a contributing factor but aren’t necessarily Candida symptoms. Rapid variation on the scale of hours I also associate with food sensitivities or with endocrine issues. If the symptoms follow a circadian pattern then they are probably endocrine.
There could be an infectious underpinning to such problems, eg infections can produce leaky gut and disturb thyroid and adrenal function, but the symptoms don’t enable a specific diagnosis of cause.
So I would suggest further investigation with your doctor, looking at both gut (eg stool test for profile of gut microbes) and endocrine (esp thyroid), maybe some kind of food sensitivity testing or personal experimentation through successive elimination and restoration of specific foods starting with common allergenic foods.
Hi Paul – just wondering if you have come across Nutritional Balancing. There are a lot of similarities with PHD and meeting with a GP who will be recommending a program of nutritional balancing based on the results of a Hair Tissue Mineral Analysis I had done. If you have come across this (or if any of the readers have), I would be intersted in your thoughts.
Hi Caroline,
It sounds interesting and does seem to have a lot of overlap with us, but I haven’t looked into it.
You recommend eating 3 egg yolks a day. Can I eat the whole egg or should I not eat the whites?
Whites are fine, it is a matter of personal preference. The yolks are important for their nutrition, the whites optional.
Hi Paul,
Regarding protein… If I eat the egg whites, will I have to decrease meat intake?
Hi Monnyica,
Yes. You’ll want to reduce it.
Anybody…
Sometimes it is difficult to get a doctor to agree to run lab tests.
What is the etiquette for asking a doctor for a metametrix stool test? Can you simply request one? Or do you need to have severe symptoms? What is the best way to ask to get a “yes”?
Hi Monnyica,
If you’re willing to pay for them yourself, you can try DirectLabs.com.
Thanks Paul!
I need help understanding stool tests… Can you tell me if the following is correct/incorrect?
1. There are 3 types of Bad Guys? Parasite, Bacteria, Fungi. Correct/incorrect?
2. Candida is a type of Fungi.
3. Yeast is a type of Fungi.
4. Examples of Parasites: E. Coli, Salmonella, Shigella, Campylobactor
GI doc said the white jelly stuff in my stool is just mucus.
My Stool Culture for E. Coli, Salmonella, Shigella, Campylobactor came back negative.
5. Does this mean that I do not need a Metametrix stool test for parasites?
Hi Monnyica,
1. There are also viruses, and there are protozoa (Giardia, malaria) as well as parasitic worms (nematodes, trematodes, eg pinworm, whipworm, roundworm, tapeworm, etc).
2. Yes. 3. Yes.
4. Those are all bacteria.
If all they did was test for those 4 bacteria, then it’s no surprise they found nothing. Those are common causes of food poisoning and they cause severe diarrhea. I don’t know why your doctor ordered that test.
The advantage of the Metametrix test is that it would detect a parasitic worm and a number of other pathogens.
(Therefore only need a Metametrix stool test for fungi/yeast/bacteria?)
Hi. I have your new book. In the first book you wrote about weekly longer fasts for people who work out and also for people with health problems. I cant see anything similar in the new book. Do you still encourage longer weekly fasts for people who work out and people with health problems? I notice that the limit recommended for longer fasts is 24 hours.
Hi Brett,
It’s hard to tell at what point a fast stops being beneficial. We decided that there is plentiful evidence that circadian rhythms are important and that food supports circadian rhythms, so if you want to do a multi-day fast, we would do it with reduced food consumption, but eating something every day within a feeding window of at least 1 hour.
Hi, Paul. Did I understand in your book it’s less healthy to bake a potato (at say 400 degrees for 40 minutes) than to boil or steam it? I tried to bake a potato at 210 degrees for 80 minutes, but that didn’t work out well, heh. Maybe I should have cut it up.
Hi tam,
Yes, that’s right.
why would this be the case? I’d have figured it’s more primal to roast than bake/steam.
Gentle cooking = lower temperatures are better. Water keeps things to 212 F.
Hello Paul,
Thanks so much for writing the book and answering questions on here. I’d like to get your opinion on my issues.
I have had dry flaky skin on my scalp areas for years now. A dermatologist diagnosed me as having seborrheic dermatitis on the scalp and ringworm on my chest. I have tried numerous eliminations in my paleo-based diet including eggs, dairy, nightshades, alcohol.. and of course grains. Nothing seems to make a difference. I also wake easily in the night and take awhile to fall asleep normally. I have cold hands and feet (Raynauds), but it isn’t severe. I am now seeing a functional medicine doc and doing an intestinal permeability test this week. Have also done a thyroid panel and comprehensive metabolic panel and they both came back normal. I am thin (6’3″ 165 lbs) and can’t ever seem to gain weight yet I eat a lot. I wonder if I am not digesting my food properly. I will continue to follow PHD and hope for some changes but thought you might have a recommendation.. this all is getting very expensive to diagnose.
I’m also somewhat shy of supplementing in general and was wondering if there are a few supplements that you would consider more important or essential than going into the whole gamut right away — especially in my specific case. By nature I find it hard to accept that such a specific supplement regimen is right for everyone. Do you have recommendations on tests that can be done to determine supplement needs more specifically?
Thanks!
Hi Matt,
Well, I’d suggest trying treatment with fluconazole.
Seborrheic dermatitis is usually a Malassezia (fungal) infection of the skin. Ringworm I think is usually an immune reaction to fungal cell wall components which appears when you’re recovering from a fungal infection flare-up. It suggests some sort of disseminated/internal fungal infection. And I think fungal infections can produce all the symptoms you describe.
There are no good diagnostic tests so you might as well try treatment and see if it helps. Assuming you can get a doctor to prescribe.
Take NAC with it.
Vitamin D is especially important for you, NAC and maybe vitamin C also.
Paul,
I have a small ring worm on my hand just above my wrist. I assumed it was something that I picked up at the gym. I have been treating with Terbinafine Hydrochloride 1% but it has not been effective. It’s not spreading but it’s not going away either. Also, a few weeks ago I went out with some buddies and we consumed a fair amount of adult beverages. I am use to frequent urination during these times but oddly I seemed to have some dull burning pain associated and could feel the pain soreness pretty much through the evening. Since then I have had more frequent urinations than normal. Also, I seem to have one of my large toenails that has some fungal issues which I have had for well over 1 year. Are these all related in some way? Would you suggest I get checked for a UI infection? Can you recommend a more effective topical treatment for the ringworm? Is the toenail fungus anything to be concerned with? Any advise/recommendations would be appreciated.
Thanks,
SC
Those are all symptoms associated with fungal infections. Unfortunately fungal UTIs are hard to detect, I don’t know if they have tests for that — an organic acid test maybe.
The wrist seems an odd place for the ringworm. In my experience topicals usually don’t work, it is immune activation under the skin which is doing it, and they are being activated by something internally. Often you get ringworm near lymph nodes, eg armpits.
I think it’s good to treat fungal infections everywhere you have them, so I would use topical treatments on the toenail.
Thanks Paul, my understanding is that ring worm is very transferable by touch thru equipment, showers etc.. Nearly our entire local HS wrestling team has had it to one degree or another, scalp, arms, legs, chest, back etc…
Yes, there are skin fungi that everybody has and they spread easily. Such a case can be treated by topicals. But equally, an immune system sensitized to fungi by a systemic infection can respond to skin fungi that it wouldn’t respond to in a healthy person and that would be considered commensal/harmless.
If it was contagious then it might be a pathogenic skin infection and so maybe you could try alternative topical treatments, maybe it was just resistant to the one you tried.
I will try another topical. Overall, I think I need to go deeper into PHD just not avoid the toxins but also start doing the organ meats and bone broths, etc… Also, a Metametrix test down the line is probably in order.
Thanks. I was prescribed selenium sulfide but have not used it due to Dr. Google warning me about it being a possible carcinogen. I will ask about fluconazole.
One more question.. if seb derm is usually a fungal infection like you say, do you have any thoughts on the “anti-candida” diets? They seem to be very similar to PHD with the additional requirement of eliminating sugary and high carbohydrate foods like fruits, potatoes, carrots.. essentially a VLC PHD diet. I’ve (briefly) tried diets like this before and struggle to eat enough calories to feel satiated.
Hi Matt,
I think PHD is a better anti-Candida diet, just add extra vegetables and herbs, eg eat a green leafy vegetable salad with onions, garlic, berries, and olive oil (extra virgin / high polyphenol) and balsamic vinegar dressing — those are all anti-fungal foods.
Hi Paul,
I love the new edition of your book! After reading your first edition, I realized that maybe there is something wrong with my gut that can be treated, and not just disregarded as IBS.
So, my Metametrix results are finally back. I did the Gastrointestinal Function Profile and Organix Comprehensive Profile through Direct Labs.
I really would appreciate your insight on three things on the tests. And I don’t know what my stomach acid levels is, probably low, because my food digests better when I take HCL.
Small Intestines:
1) D-Lactate – Very High – Intestinal Bacterial Overgrowth (L. Acidophillus)
No Yeast/Fungal infection
My question is: Will I need antibiotics for the L. Acidophillus overgrowth? Like Neomycin? Or can this be treated with diet and Oregano Oil, NAC, etc. Which probiotic will be the best for me? I presume no yogurt and fermented vegetables.
Large Intestines:
2) Yeast/Fungi: Taxonomy unavailable +4 (highest possible)
3) Parasite present: taxonomy unavailable
Do the Yeast/Fungi and Parasite need to be treated? I grew up in South Africa, could I have picked up something there that is not recognized here? No opportunistic bacteria. Fecal sIgA was on the low side.
Thank you so much!
Hi Erica,
Great! It’s terrific that you sought diagnostic help and are taking steps to cure your IBS.
I think it’s best to consult with a doctor and figure out how to proceed. I do not have experience treating these conditions so my prejudices could easily be wrong.
That said, my prejudices are:
1) Treat the fungi and parasites before the bacteria. This way you don’t kill off probiotic bacteria. It’s possible the fungi and parasites are killing off competing bacteria and causing the distorted bacterial profile; that might clear up by itself if you treat the other pathogens first.
2) Eat fermented mixed vegetables to provide a mix of bacterial species to replace the yeast/parasites as you treat them.
Hi Paul, just a quick follow up, if I may-
thanks for the response, I have an appointment with a top gastro doc out of john hopkins, so I should be able to test for these things
one more question I forgot to ask before-
if one were to feel better during an extended water fast, would indicate the lack of candida? or indicate stronger likelyhood of candida?
thanks!
Hi Michael,
I don’t know. A fast would make you feel better (if the Candida is in the gut) but over a long enough period of time would assist systemic invasion and dissemination, making the infection worse. So it depends on how long “extended” was. But fasting will give temporary relief from symptoms of almost any gut infection, so it’s not a specific indicator of Candida.
Hi Paul! Almost finished with the new book and came across TSH # of 1.0 or below you recommend to be optimal. My TSH is June was 0.82 and in October it was 1.2. Is this considered bad to have risen? Is 1.2 anything to be concerned about? Also, had a low suspicious positive with Cyrex for Hashi’s, but I don’t think am doing too badly based on how I am feeling. I’d love your thoughts on my #’s from June to the rise in October. As always, so grateful for your advice.
Hi Dede,
That too small a difference to be concerned about. It will fluctuate over the course of the day.
If you’re feeling good, that’s the most important thing.
Thank you! 🙂
Hi Paul,
A couple of quick questions…
1. If someone has problem digesting starch (infection/overgrowth in the colon) what do you recommend? I ask because my stools have not been fully solid like normal when having starch (I’ve tried sweet potato and rice… I’ll try white potatoes tonight).
2. In what circumstances would you recommend the use of anti-biotics? I’m paranoid about using them! I feel my past use of them caused some of the issues I’m having now and hearing about people who develop chronic constipation, etc after using them makes me scared.
3. I feel tired and sleepy after eating. Apart from trying out HCl & Pepsin, anything you recommend?
Thanks for the great book Paul.
Judith
Hi Judith,
Well, you’ve diagnosed yourself correctly I think.
The tiredness after eating is an immune response to food peptides that have entered the body, that could indicate impaired digestion earlier in the digestive tract too. You might experiment with betaine hydrochloride at meals, digestive enzymes, oxbile, vitamin C, taurine to see if any of those improve your digestion.
Antibiotics — there’s no clear guideline for when to use them. If you want to stick with food, fermented vegetables in small quantities daily, plus gradually introducing healthy fiber (potatoes, tomatoes, berries) can help gradually reshape the flora over time. Plant food restriction may help reduce symptoms, so you may wish to just focus on a few plants with good fiber (the “Potato and Tomato and Blueberry Diet”) plus meat and fats.
You can also experiment with whether fat digestion is involved, poor fat digestion will create loose stools. If so reducing the fat share of calories may provide temporary help while you try to heal. That could be an indication of gallstones or some other upstream issue.
Best, Paul
Thanks for the reply.
Interesting.
I was on a basically a zero starch/high fat diet (gaps, candida diets) for around 2 years. It seems that only since I up’d my starch on a regular basis through eating Rice did I have loose stools. I thought maybe the fiber was increasing my stool transit time and the large intestine was not able to absorb enough liquid to dry the stools up?
I’m fermenting some more ‘kraut at the moment. I used a probiotic capsule the other day, when I use it at the same time I eat fiber (rice) I get all sorts of things going on (gas, rumbling, cramps, etc)
Maybe I need to do a stool test to see if that picks up anything, thought I’m sure its all coming from the colon.
Thanks, Judith
Hi Paul,
I’ve just been reading a bit about digestive enzyme supplements….& i don’t really “get it”.
Shouldn’t our bodies produce all the digestive enzymes we need, when we need them?
…& could there be risks in taking certain enzymes
Hi Darrin,
Yes, there can be risks in taking them, and yes, in good health we should produce all we need. But there are various ways health can be disturbed, and issues from pancreatic infections to gallstones to nerve infections can impair digestive enzyme secretion.
Hi Paul,
Could you tell or suggest a link about risks when taking enzymes? I have impaired digestion due to candida, parasites and bacteria and have trouble digesting food.
I was intending to take some enzymes to help me but but got this info from your site – with the risks.Would taking them for a period and then a break be a better idea? I have some friends who were taking them even for a year when they had problems with parasites/candida/bacterial infections and told it was helping them.
Many thanks,
Dave
Hi David,
I think it’s good to take them when you have the symptoms & infections you describe.
Enzymes can cleave our own proteins, fats, and carbohydrates, so exposure to them alters the functioning of our own cells. So I think healthy people should rely on their own natural enzyme production, and not take them.
However, the enzymes do help digest food and they have antimicrobial properties (they digest microbes), so when you have impaired digestion and infections, the reward:risk ratio greatly increases.
Aren’t enzymes likely to get broken down in the stomach and small intestine? It seems unlikely that a protein will survive intact for long during that progression.
This is what turned me off to the idea of oral nattokinase – yes, the Japanese eat natto (a disgusting mucosal mix of fermented soy beans), but they ingest the mix, which could promote survival of the protein.
Thanks Paul,
I’ve also seen you mention the oxbile supplement a few times.
Is that a similar story as far as requirement, risks & benefits?
or is a oxbile safer than enzymes
It’s safe in the sense that the negative symptoms of excess would be more obvious, eg diarrhea.
…could not enough bile also result in diarrhea due to too much fat passing through undigested.
or would you just have very soft stools (due to undigested fats)?
My ten books arrived last week. Very busy at school, so still reading the first time through. Loving everything about it. Cholesterol information is fascinating! Love the cover and have removed it to post on my office wall. Will need to do some serious mind work to expose bare skin to our 38 degree mornings and afternoons.
Giving a copy to each family member, but I don’t expect them to get to reading it very soon. I gave them the first book and they still have not read it. One son is committed to the blood type diet — he is “O” and that diet is very paleo. Another son is a peacemaker and eats what’s in front of him — lots of processed stuff, grain products, hf corn syrup, etc. — but would read the book and try to follow it if he were on his own.
My question: Would the Nourishing Traditions recipe book be a good place for them to start? I know that there are differences, but in terms of meal prep, healthy fats and meats, I’m thinking it might work as a nudge in the right direction.
Thanks, Paul.
Hi Lana,
Thanks for your support! I like the cover as a wall decoration!
I like Nourishing Traditions. It would be a nudge in the right direction.
Hi, are the weights described in your book (e.g. 1 lb of safe starches per day, 0.5 to 1.5 lbs of meat) refer to raw or cooked weight? thanks
Hi Matt,
Generally, cooked.
Hello ~ Would you please offer your opinion /feedback on Fake Krab? I enjoy it and it seems relatively okay…just 2 sugars per serving but I suspect, I need to remove this from my menu.
Thank you ~ Doreen
Well, the fish part is PHD approved. Any major trouble would come from the binder: Wikipedia says they commonly use egg albumin or transglutaminase. (http://en.wikipedia.org/wiki/Crab_stick) Some people have a sensitivity to egg albumin and antibodies to transglutaminase are a major issue in many autoimmune diseases (http://en.wikipedia.org/wiki/Anti-transglutaminase_antibodies).
Sugar in the Krab is another negative.
I would say that it’s probably OK in moderation but if you have autoimmune disorders or egg sensitivities then I would avoid it.
Hi Paul,
Have you come across any info about things that might help menopause symptoms? The only think I have seen is that MCT might be of benefit, since hot flashes are caused by an inability of the brain to take up glucose, thereby providing an alternate fuel source, ketones. So I suspect PHD alone will be of benefit, but do you have any other suggestions? Thanks.
Hi Olga,
I do believe PHD is of benefit, but I don’t have enough reader stories about menopausal symptoms to say with confidence.
I would support the liver with glutathione and methyl donor sources: choline (egg yolks), B6, B12, NAC and vitamin C. These may help with removal of excess hormones.
MCT oil is an interesting idea. Thanks for telling me about it.
Hi Paul,
I am still having ongoing issues with leaky gut symptoms (fatigue after eating, an “acidic” feeling around my throat). I am taking NAC in the morning and experimented with HCL for a little over a month taking 1 or 2 capsules with each meal…post-nasal drip went away but the burning never did. It’s unclear to me whether the HCL made it better or not so I am taking a break from it and considering trying bitters instead. What is the correct protocol for taking bitters, and how long can you take them for? Or should I try upping HCL and taking it longer instead? Thank you!
Hi Elyse,
I don’t have experience with bitters myself but the Weston A Price foundation had an article in their newsletter about it a year ago, that may be a better source.
I think your idea of dropping HCl is better than just upping the dose. It’s better to repeatedly add it/remove it to get an idea if it’s helping or not than to add it/ double it which can increase the harm and won’t help you diagnose its value much because the body will produce less of its own acid when you add more.
Hi Paul, so why is it everyone from mercola to chriskresser recommends upping HCL until you feel a slight burn and then maybe dropping one pill to just feel the warmth and continue with that scenario for a couple of months. How is this supposed to restore your own acid production?
Also why do typical grain diets reduce stomach acid production, is H Pylori only responsible or is it something else?
Hi St,
I don’t know why they recommend taking it until you feel a burn; I would think a burn would be clearly too much and you wouldn’t want to continue close to that.
I would have to look back at the literature to answer about the effects of grain diets on stomach acid. They are good at suppressing digestion in general but I don’t know about stomach acid.
Hi Elyse,
I have the same experience with digestion and HCL. I tend to get a pain in my side when I take HCL and yet I have all the symptoms of low stomach acid. I am wondering if the issue could be low bile production and not low stomach acid.
Paul, is it possible to have low bile production, not low stomach acid or are the symptoms totally different? Does pain in the small intestine after eating indicate low bile production (excluding infection of course).
Many thanks
I don’t know. Gallstones can prevent the release of bile into the digestive tract and cause pain. The symptoms are rather different, low stomach acid affects protein digestion and lack of bile affects fat digestion. And the location of discomfort may be different, gallstones on the right, stomach more centered.
Well I’m low in B12 and my stool tests showed I was not absorbing fats so I might both both!
Thank you so much for your time Paul.
This is one of the best articles I have seen on this. Do you have any idea why Poliquin recommends Histidine after finishing HCL?
http://www.charlespoliquin.com/ArticlesMultimedia/Articles/Article/27/Maximize_Your_Progress_with_Hydrochloric_Acid.aspx
I just do not understand, how would it restore your stomachs own ability to produce acid.
Thanks Amy I would love to hear from anyone who has found a way to increase their stomach acid.
Hi Elyse,
Before finding PHD, I was transitioning to eating meat with a naturopath (was mostly vegetarian) and she had me start with literally with 1 TBLSP of ground meat (grass fed) per day. After 3 days, then 2 TBLSP., and so on and so on until the max for me at 1/4 lb. I did try Betaine, but I just didn’t like the burn that I would sometimes feel. My naturopath suspected my having low stomach acid because of not eating meat for over 2 years and a Cyrex test that showed a low suspicious positive result that my parietal cells were under attack (autoimmune from celiac disease).
I hope this helps you.
Thanks Dede that’s interesting…I have never been a vegetarian for long, but my diet growing up was typically low on meat and high on breads/dairy. I’ve been going heavy on the meat for about a year now, I wonder if my body is just still adjusting to the high protein/fat combo or if it’s necessary to go back and reintroduce things slowly again.
Does someone get a prize as the 5,000 post under Q&A?
Hi Evan,
Hopefully we’ll have the forum up before then!
Hi Paul, I’m confused on vit K2, there is the mk4 and the mk7. In an earlier question you had suggested that my significant other take Carlsons 5mg of k2, he has mantlecell lymphoma. I noticed that it is menatetrenone (mk4)with no mention of mk-7.
My questions are:
What is the difference between mk-4 and mk-7?
Should he be taking mk-7 also?
Do you still recommend the Carlson Vit K2 (menatetrenone) for him.
And for myself: I don’t have any issues, but how much and what kind of vitamin K-2 should I be taking?
In your book you recommend MK-7 once per day or Mk4 and Mk7 once per week.
I’m confused on this supplement thing. Any suggestions of what kind to take would be much appreciated. Thanks, Syl
Paul, your book is at the forefront of the new emerging medicine. Just today there was an article about The bacterium – known as enterobacter – encourages the body to make and store fat, and prevents it from being used, by deregulating the body’s metabolism-controlling genes. http://www.ft.com/intl/cms/s/0/0b7af978-493a-11e2-9225-00144feab49a.html#axzz2FS0qfvzu Surprisingly the cure was a diet of whole grains, traditional Chinese medicines and non-digestible carbohydrates that changed the pH in the gut which limited the bacterium’s activity. What are your thoughts on whole grains as a dietary solution? I would think that this would lead to other issues well covered in PHD?
Here’s the paper: http://www.nature.com/ismej/journal/vaop/ncurrent/full/ismej2012153a.html
the diet and protocol are here (sort of):
http://www.nature.com/ismej/journal/vaop/ncurrent/extref/ismej2012153x1.pdf
“This volunteer was given a diet composed of whole
grains, traditional Chinese medicine and prebiotics (WTP diet) for intervention. He was
given 4 cans of gruel per day as staple food contract prepared in the form of cooked porridge (370 g wet weight per can) then canned by a food manufacturer (Shanghai
Meilin Meida Food Co., Ltd.) for 23 weeks. Each can contained 100 g dry ingredients (59
g of carbohydrate, 15 g of protein, 5 g of fat, and 6 g of fiber) providing 336 kcal energy
(70 % of carbohydrate, 17 % of protein, 13 % of fat).”
The herbal intervention may have been Bitter Melon, mentioned as an in vitro experiment. Bitter Melon – as food or herbal extract – is popular treatment for diabetes in Asian medicine; very interesting that it may work by modulating gut flora.
Hi Paul,
Not sure where to post this…. But thank you so much for your quick reply! I am so thankful for getting some explanations and answers after 30 years of gut problems. I definitely want to tackle one thing at a time and just didn’t know where to start. I am seeing a Gastroenterologist tomorrow, but I value your opinion very highly and just needed some pointers in the right direction. To treat the fungi and parasites first makes a lot of sense. Thanks!
HI dr.jaminet. I just finished reading your post on the inuit people. Your findings and conclusions seem to be at odds with the research od Dr.Weston price. Isn’t it true that Dr.Price did in fact live with inuits who were eating a 100% traditional Inuit diet, and that after extensive analysis he found that they were remarkably free of disease and illness? You seem to be suggesting that there is no reliable evidence of the Inuit’s traditional diet producing healthy, chronic disease free people, but doesn’t Dr.Price’s research constitute such evidence? Thanks.
Hi Chris,
In Nutrition and Physical Degeneration, ch 5, he discusses Eskimos living near the mouths of the Yukon and Kuskokwim rivers of western Alaska. Basically he shows that the incidence of dental caries correlates with consumption of modern foods. He doesn’t show that they are free of parasites or that they had normal cholesterol, which were the topics of my post on cholesterol levels in hunter-gatherer populations. Some Inuit did have high parasitic loads and low cholesterol, others lower parasitic loads and normal cholesterol, but in general we know that parasitic infections were fairly common among the Inuit.
Price himself acknowledges that health problems were widespread among the Inuit/Eskimo of his time (“It is a sad commentary that with the coming of the white man the Eskimos and Indians are rapidly reduced both in numbers and physical excellence by the white man’s diseases.”).
I don’t see any conflict between Price’s observations and the studies I reported on.
Ok, but didn’t price say that the widespread health problems were only associated with the inuit who had strayed from their traditional diet and begun to eat the ‘white man’s food’? Just to clarify, are you saying that Inuit on a 100% traditional diet have high cholesterol or that they may actually have had coronary heart disease?
He said that Eskimos on their traditional diets were healthier than Eskimos who were eating western foods. But the only exams he conducted were looking at their teeth and counting cavities. He didn’t measure blood or serum cholesterol, he didn’t test for parasites, or do any standard medical exam.
I’m not saying anything about Inuit on traditional diets except what is stated in my post. Basically, that is (a) some of these populations were healthy so far as we know, but (b) some Inuit on more-or-less traditional diets had a high burden of parasites, which is no surprise considering the seafood in that area is loaded with parasites and they often ate it raw.
Having parasitic infections doesn’t prevent you from having great teeth, so I see no conflict. In any case the populations Price looked at were totally different than the populations others looked at, and some of Price’s populations lived inland and so would have had less exposure to parasites.
ok thanks for the information dr.jaminet. its too bad we don’t have more reliable data on the chronic disease risk of traditional diets, I had been led to beleive they did not suffer from cancer, CHD, stroke etc.
I’ve read about Greenland Eskimo having frequent nosebleeds; this is as we’d expect with a high omega 3 diet, and was there was also a higher incidence of haemorrhagic stroke? Can’t remember offhand.
I follow a PHD diet with most recommended supplements. I include yuca and the occasional white rice as a safe starch (regular and sweet potatos dont’ work for me). Liverwurst is a breakfast staple I’m working on increasing broth.
My problem is that over the past year I’ve developed food sensitivities to nearly everything. I’m working with a naturopath NP and have had numerous blood and Metametrix tests over this period. Many of the issues have been addressed via antibiotics and supplements and I’m waiting for results of recent Metametrix test to confirm. Based on self-experiments, I have slowly eliminated many foods that cause reactions (back pain and numbness at night, rash on face in am).
The latest class of suspect foods is fruit. A few consecutive nights of pineapple a while back(just a few bites) did not go well. My recent re-introduction of bananas resulted in no back pain or rash, but sleep was awful. Yesterday I had a small apple, and while sleep was good, my face was a mess this morning.
My question is… Where does this lead me? FODMAPS? Fructose malabsorption? Any suggestions (from Paul or community) would be greatly appreciated. I eat approx. two sautéed onions most days in an effort to make my very limited food choices more palatable. Do I need to reconsider this?
Hi Elyse,
That’s a puzzle. May I ask how long you’ve been following PHD?
One thing you might try is stopping all supplements for a month – go food only. Maybe something in the supplements is triggering this.
Fruit is generally pretty safe so something is definitely wrong.
I’ve been eating PHD for about two years. I should also mention that my husband had a health crisis last year and perhaps now that things have settled my body is demonsrating the effects of this stress.
I’ve been going with the assumption that I need to address the items uncovered by Metametrix and then give my gut time to heal.
My frustration is that for the past 3 months I have been super strict about what I eat, documented everything and tested foods methodically. Unfortunately, all I’ve done is eliminate more rather than add back.
Thank you for your suggestion of eliminating supplements. I had not considered that route.