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:
Hi Paul, I recently read a book called “Wheat Belly” which introduced me to the very real health threat that eating wheat, other grains and sugar represent. I then stumbled upon your book and am fascinated by what I am reading and learning. Our family has made some significant dietary changes. My question: In “Wheat Belly”, the author suggests that oats in small amounts are healthful and even includes a recipe for home made granola. In your book you include oats in the toxic grain category. Could you comment on the background for this and on oats’ specific effect on health? Thanks very much and thanks for your amazing work!
Christine
Hi Christine,
Oats are definitely healthier than wheat, but they do have some toxins, including avenin which is the oat counterpart to wheat gliadin. However, oat compounds do not induce allergies, although they can cross-react in people with wheat allergies (eg http://www.ncbi.nlm.nih.gov/pubmed/12889560).
I would say oats are probably second safest to white rice among the major starches.
Thanks very much!
Hi Paul,
I was reading the new book recently, and it mentions avoiding wheat for some time before supplementing iodine. Do you have any thoughts on how does alcohol factor into this? I’ve only had 3 or 4 cheats with wheat over the past year (e.g., bread), but I’ll have nights where I drink a few beers socially- maybe every other weekend. Iodine is the one PHD supplement I don’t take (due to skin issues), but I hope to start taking it soon with a salt-loading protocol. I suppose I can try to become a wine-drinker if iodine and the wheat aspect of beer don’t mix. Thanks for your time and insight.
Hi Thomas,
I wouldn’t avoid iodine because of beer. I haven’t heard of beer causing autoimmune disease.
Hi Paul,
Regarding avoiding the mixture of fructose and PUFAs…
I eat 2 fruits for breakfast. How long do I have to wait before eating lunch (usually a meal containing PUFAs)?
A couple of hours would be plenty of time.
Hi Paul,
sorry I wasn’t clear. I meant to ask what is the *minimum* amount of time I have to wait between fruits and the next meal?
Hi Monnyica,
I don’t think you need to worry about it, fruits can be combined with saturated fat rich meals, for polyunsaturated fat meals just don’t include fruit in the meal.
Hi Paul,
Excuse me for beating this question to death. I read that fruits take 2 hrs to digest. I typically eat chicken or salmon (planning to eat more red meat in future). If I want to avoid mixing PUFA and fructose… after eating fructose fruits is it ideal to wait the full 2 hours before I eat a PUFA meal? Or is 1 hr considered sufficient?
I would consider 1 hour sufficient.
Hi Paul,
What vinegar are you using? Balsamic Vinegar?
Why are you not recommending Potassium? I found 200mg in my supplement, is that too much?
Is it worse to eat 75g of carbs and not being in Ketosis? I mean, at 75g you are not getting enough Glucose but at the same time not getting KEtones.
Hi St,
We generally use rice vinegar, as we like the flavor, but all vinegars are healthful.
Potassium we do recommend, but from food (tomatoes, potatoes, bananas). In the US potassium supplements are limited to 99 mg out of concerns for kidney health from a large dose at once. However, the amount is not a lot compared to daily intake of 4,000 mg or so. Take your supplement with a full meal so that its entry to the body is slowed.
No, it’s not worse to eat 75 g carbs, unless you have some therapeutic need for lots of ketones, which is very rare.
Hi Paul,
What is your view with supplementing with L. Plantarum 299v?
The antimicrobial substances produced have shown significant effect on Gram-positive and Gram-negative bacteria.
I don’t have views on specific strains of probiotic, but it is probably fine.
Hi Paul,
I have read your book, and I’m very impressed with your research, but I have pressing concerns about fish oil. You advise against fish oil capsules, due to their rancidity, but several studies and authors (including Primal Body Primal Mind author Nora Gedgaudas) advise substantially supplementing with fish oils for Omega 3, especially to treat depression and anxiety. I am a neuroscientist, and began taking 2500 mg of fish oil per day (combined DHA/EPA) around three months ago and have experienced a marked positive impact on my mood and focus. Could this be a placebo effect? Am I truly at risk of added toxicity by continuing to take a daily dose of fish oils? Do you think certain fish oil supplement brands are less risky when it comes to rancidity (such as Barleans)?
My n=1 on this: I try to eat salmon or other fatty fish once or twice a week but take no fish oil or other omega-3 supplements. I avoid vegetable oil. A recent Nutreval RBC fatty acid test showed extremely high omega-3 levels and very low omega-6 levels.( The lab physician and my own doc were actually worried that my omega-6 might be too low!)
So, for me at least, sushi seems to be enough. No fish oil supplements needed. I’m not convinced of the safety of the supplements, especially at high doses, but eating the fish feels good.
Hi Sana,
It’s quite likely that the fish oil has been benefiting you, but (a) it’s common for high doses of nutrients to give benefits early on as they remedy a deficiency, but then to become harmful later as they become present in excess, and (b) omega-3s act as partial antidotes to an omega-6 excess which most people have, but it would be better to reduce omega-6 and omega-3 in parallel than to continue with high doses of both.
I think for long term health minimizing omega-6 and eating a moderate amount of omega-3s from fish (perhaps also some ALA) is the best strategy.
I am not in a position to evaluate supplement brands, but I would generally recommend liquid refrigerated oils over capsules.
Hi Paul, in the book you recommend taking certain supplements. I have two questions.
1) You mention that a negative aspect of multivitamins is Vitamin A, but isn’t it true that humans are generally poor converters of beta carotene into Vitamin A?
2) Is it optimal to take supplements in divided doses? For example, if you take Vitamin C once in the morning, does the body use that all up, versus taking it at morning and at night so the body uses it while sleeping since so many processes take place during that time? Thanks.
Hi Alex,
Yes, I don’t think we want to rely solely on plant sources of vitamin A. However, our recommended intake of beef or lamb liver (1/3 lb uncooked / 1/4 lb cooked) provides 10 mg retinol = 40,000 IU vitamin A per week, and our 3 egg yolks per day provide about 5,000 IU retinol per week. I think that 7,000 IU/day retinol plus amounts in other animal foods is plenty. Plant carotenoids are a safe source of additional vitamin A precursors in case the body has unusual needs.
That is a difficult question to answer, it is generally desirable for your body to be starved of nutrients some of the time (for example, this helps prevent the feeding of pathogens, starvation is an immune defense). I would say no, for the most part. The exception would be items like potassium that may have acute toxicity if you take too much at once.
So if I don’t eat liver, then Vitamin A in a multivitamin would not be a concern?
Hi Alex,
I think with adequate vitamin D and K2 status, vitamin A in multivitamins is not a concern.
Hi Paul,
A couple things I’m trying to make sense of regarding beef liver and it’s vitamin A content.
1. I’m getting 10 mg retinol = 33,333 IU. Seems too significant to round up to 40,000.
Vitamin A: 1 IU is the biological equivalent of 0.3 ?g retinol
2. 1/3 lb raw vs. 1/4 lb cooked Vitamin A are not very close?
The cooking method seems to make a big difference, maybe nutrients are absorbed from other foods used during cooking. Your 10 mg retinol reference makes me think you’re using the “cooked, braised” data.
Nutrient data for 13325, Beef, variety meats and by-products, liver, raw
150 g
Vitamin A, RAE µg 7452
Vitamin A, IU IU 25347
Nutrient data for 13326, Beef, variety meats and by-products, liver, cooked, braised
113 g
Vitamin A, RAE µg 10669
Vitamin A, IU IU 35837
Nutrient data for 13327, Beef, variety meats and by-products, liver, cooked, pan-fried
113 g
Vitamin A, RAE µg 8751
Vitamin A, IU IU 29479
Thanks,
Mark
Hi Paul,
sorry if this is trivial but I was just wondering if you are planning on writing an article on vegan/vegetarian diets for your blog?
It would be great to see what the largest scale studies on vegetarians and mortality rates shows.
Hi Marcus,
Funny you should mention that, yes I am.
I look forward to that. As I switched from a mostly vegetarian diet before a very short time on GAPS, now settling on PHD.
My vegetarian diet wasn’t typical though, so I have such a hard time finding real evidence of my former diet being studied. I ate a very hydrating, high raw diet that was grain free, legume free, mostly fruit free. (I occasionally cheated with pasta and hummus or black beans before celiac diagnosis). I also daily vegetable juiced (no fruit). I would love to see something on a veg diet that at the very least included raw vegetable juicing. If that’s possible, that is. Probably a tall order. 😉
Regardless, I look forward to your always informative posts that are so well researched.
Loved the Psychology Today article by the way, I forwarded to everyone I know!
Where did you get your protein from if you weren’t eating animal foods or grains/legumes Dede?
Hi Marcus, I wasn’t counting calories, protein grams, carbs, etc. at all (which was great). I was following Natalia Rose’s Detox 4 Women plan. Honestly, I never felt better when I was following this unusual plan until I “cheated” after about a year of never cheating with pasta, etc., started feeling bad and finally figured out I had celiac. Anyway, the plan was IF with raw vegetable juicing only. 2 meals a day with a light to heavy approach (heaviest meal at night) with strict food combining. Lots of raw (water containing) vegetable salads with both meals. Dinner was usually raw goat’s milk cheese based veg meal, rarely fish and eggs, or it was a starch based dinner (sweet potatoes, cooked veggie soups with the ever present big salad and avocado). Lunch was usually a giant salad with avocado ad some cooked veggies (in the winter to help warm me, a blended raw veg soup in the summer). Natalia Rose’s approach was not macro and micro-nutrient based, rather gentle deep tissue cleansing with juicing and hydrating foods and lots of gravity center (Wood’s method) bowel cleansing that according to her, create alkalinity, remove blockages so a body can “conduct” like it should. It is very difficult to explain to people, so I am sorry for the long reply, but it is just so different from a typical veg/vegan diet since she does not favor processed foods of any kind, soy, nuts, seeds, legumes or grains. She works with mostly women, convinced our digestive tracts are much less hearty than men’s. Many of my female friends are still on the plan, feeling like a “million bucks”! My naturopath has convinced me that I need amino acid activity from quality animal sources because of the brain tissue “attacks” (tissue transglutaminase-6 antibodies, etc.) from the celiac. I conclude also that all of the raw salads were probably not the best thing for a healing celiac’s gut. And Paul and Shou-Ching’s research is VERY convincing as well! Many benefits I experienced from Natalia Rose’s plan were: skin tightening, started to tan in the sun when I always burned before (I am quite fair), energy skyrocketed, never caught a cold, flu or got another sinus infection which I was very prone to before her plan. Again, sorry for the long explanation. 🙂
Fantastic 😀 Can’t wait.
well i’m glad your naturopath told you eat some animal foods for protein (amino acids). If you’re not eating animal foods or grains/legumes i’m not sure we’re you could possibly be getting complete proteins from, the result of which would be death.
I know folks who have been eating like that (it’s gentle, deep tissue cleansing, not just a diet) for 20 years and they bounce off the walls with energy. Nowhere near death’s door! 😉 Like I said, it is not typical veg diet because of the gravity centered colonics and copious amounts of raw vegetable juicing. You should see the skin on some of the long time followers. Beautiful! Also, they NEVER get sick. It is tough to explain to people unless they have studied this work in depth, as I have. I worked with the author of the books’s protegee one on one. If this piques your interest (not that I am recommending it, mind you), it is Natalia Rose’s Detox 4 Women, but works for men too with a few tweaks. The depth of the work is more understood when you Google Gil Jacobs (Natalia Rose’s mentor and teacher). He even talks about when veganism doesn’t work. It’s fascinating. Gil almost died 20 or more years ago from acute poisoning and the doctors didn’t offer him much hope of surviving. That is where his journey began. Anyway, sorry for another long post, just wanted to clear up the death scare you mentioned. 🙂 p.s. I am so very happy to have found PHD for my particular situation (celiac disease), and Paul’s convincing evidence of why we should eat like this. I am also of the belief that that there are many regimens that work for many different people.
A group of Seventh-day Adventists (promote vegetarian diet) in Loma Linda, California is one of the longevity blue zones.
The Adventist Health Studies (AHS) are long term mortality and health studies.
Interesting side note in the BlueZonesStudyGuide.pdf
MarkES Having lived many years in Loma Linda, although I am not Adventist, I have to say they are the most unhealthy looking group of people around. They have very frail looking bodies, pasty skin and oh by the way…they eat lots of sugary, grainy carbs. The LL Market has a huge bakery making cakes, breads, etc. None are organic and they use industrial oils in their products. They also eat lots of Loma Linda brand fake “soy” meat and canned foods with lots of additives. It’s not ‘real’ food.
I think it has to be something else that contributes to their health in a genetic way and lifestyle choices. Yes, throw factory farm meat into the mix and health issues follow. But from what I know, a high carb, high sugar, fake protein diet isn’t made healthy by not eating meat or caffeine.
Lets talk acne.
As a long time acne sufferer, My skin has improved drastically on the PHD.
However there are triggers, for me it is a certain type of sweet potato and grains that really give me problems. Big huge cystic things on my forehead and cheeks.
I am still getting very small pimples. Is this due to die off? Some infection?
I am taking 1g of C and 200mg of magnesium and 20k ius of D3 daily
+ 30mg of zinc 1x a week
I am eating berries and coconut oil for bfast. could it be the fructose?
Would mixing nuts and berries also cause inflammation?
Hi Vinneeee,
I am not sure what is causing the acne. You will have to experiment, but some things to look at are copper status, iodine/selenium status, sulfur status (consider eating more sulfur-rich foods and/or applying a sulfur lotion to your skin or taking Epsom salt baths), vitamin A (do you eat liver once a week as we recommend?), and your vitamin D intake (20,000 IU/day is too much!).
My guess would be you are low in vitamin A and high in vitamin D, but I don’t know if fixing that would eliminate the acne. Try eating 1/3 lb beef liver per week, 3 egg yolks per day, and stopping vitamin D for 3 weeks after which 2,500 IU to 4,000 IU per day should be sufficient.
I don’t believe berries are a problem.
i have been eating 1b of chicken liver (wrapped in bacon) per week.
I am going to have to do the beef liver and epsom salt baths.
also, does mixing berries and nuts (eating at the same time) cause issues? should i space them out?
thanks so much
Hi Vinneeee,
It seems unlikely that small doses of berries and nuts would be a problem. If they are a problem you may be eating too much omega-6. Try low omega-6 nuts like macadamia nuts if you can.
thank you, I will keep you in the loop!
Hi Paul,
Do you have any specific suggestions for teens with acne? I tried removing all wheat from my daughters diet for 3 months and that had no effect. Of course there likely deficiencies that aren’t addressed, but I was wondering if there’s a “most likely suspect” list to concentrate on. Thanks.
Hi Olga,
I’m planning an acne series in February-March so I’ll gather my thoughts then. In general our diet should be good, then try removing common food sensitivities such as dairy.
Hi Paul,
I was afraid you would say that. I have already suggested it to her, but she loves her milk. When she was a baby, I tried removing milk at the time because she had severe eczema, but that had no effect. So I was hoping milk wasn’t the problem, but of course the two are likely caused by different things. Since she has never had acne before puberty, is this likely not caused by hormonal changes rather than milk, or is there a link between the two? Also, if one stops giving a growing teen, milk, is there some other food they need to be eating to get the calcium they need? Thanks again.
Hi Olga,
Well, is she on regular PHD with dairy? Try that and maybe it will work. You can also try to get her to eat extra liver. Bone broth is the best source of calcium.
Hi Paul,
Yes, she is on the regular PHD plus dairy. I have recently convinced her to start eating egg yolks, she has never liked eggs, but seems to be able to eat the yolks. And I am planning to try to get her to eat liver as well. The other thing I’m going to try is a topical sulfur cream. Thanks again.
5000!
couldn’t help myself
site is a testament to PHD
While engaging in IR (intermittent reading) and IHC (intermittent house cleaning) I’ve managed some IL (intermittent listening) re the Wise Traditions recordings from Nov 2012. In Sally Fallon’s day long presentation she states that women need not worry about abdominal fat as we age, for this is where estrogen is produced when our ovaries slow down production in menopause. She even said that if we don’t have this fat, we will experience health problems.
At high school graduation (loooonnnng ago), I weighed 122. By age 30, after babies, I seemed to settle at 136. Wanted to drop ten pounds, but was too busy to think about it. After upping saturated fat over a year ago I did gain four or five pounds, but then things calmed down and I went back to 136, or so. Then, with the HP diagnosis last August, I began daily IF 16/8, with only rare deviations because of schedules. With IF I immediately dropped to 129, and have stayed there with no trouble. My height is 5’6”. I really have very little abdominal fat; recall, I was able to see on my abdomen the imprint of a worm homesteading in my duodenum.
Thus far, I have not read anything about menopause in the new book, and don’t see a notation in the index; so thought I would ask – have you encountered any research that would support Sally’s assertion? I would be hard pressed to add weight, for no matter what I do, it always bounces back to 129.
Hi Lana,
In general I think you should let your body control your weight — just eat a healthy diet to appetite with IF, and your weight should be healthy. So I would think 129 lbs is healthy for you. Your BMI of 21 is considered optimal for women, and is associated with the lowest mortality in studies.
I haven’t looked into estrogen production by adipose tissue, but I don’t think you should worry about how much fat you have.
Thanks Paul. I tend to never worry about my weight, but I seem to be somewhat reactive to the possibility that this chemical change, triggered when I went through menopause, will trip me up, even after the fact.
Rear ended this evening:
It wasn’t a big bump but it rattled me. While we waited for the police officer to complete the paperwork I suggested that there may be some good that could come out of our encounter, and proceeded to tell her about your new book. She wrote down your name, book title, and the cost on Amazon. She is a 60 year old woman who has reinvented herself with training for a brand new career. I told her that after reading your book and learning about and treating my infections, I have renewed hope that I may actually work through my 70’s (80’s?). She was very excited and I expect that she will soon be reading this blog.
Hi Lana,
Sorry to hear about the accident. Thank you for your support, and happy new year!
Hello Paul;
I’ve read that water fasting can cure bacterial infections- is this true?
Thanks!
Hi Marshall,
It can improve gut dysbiosis / bacterial overgrowth, but I wouldn’t consider it a reliable cure for bacterial infections.
Hi Paul,
Many thanks for all your hard work.
I have suffered depression, for the past 5 years, at times severe, requiring a 3 month stay at a rehab facility. More recently mood swings and I suspect that same strange emotional state that you’ve best described as “irritability or anger”.
Recently I’ve incredible success with Dilantin after reading an old book on the subject, unfortunately it is not consistent. So I’m working toward a longterm ketogenic diet w/ daily intermittent fasting. Is this approach a no-brainer considering my positive response to Dilantin?
I see a doctor that suspects lyme, toxo CP and various viruses, viral infections all of them really. You recommend high carb for toxo and low carb for bacterial infections. What if one has both protozoal and bacterial infections?
Also, appreciating your time…
What are your thoughts on the following?
elevated levels of A-N-acetylgalactosaminidase or Nagalase (which I have) and treatment with GcMaf therapy
kryptopyrroluria or KPU/HPU (suspected)
diabetes insipidus (have)
and ehlers danlos assoicated HLA types resulting in a defective antigen presentation (work of Ritchie Shoemaker) I have this condition too.
I hope that wasn’t to much…
Hi Andrew,
I do think at least occasional ketogenic dieting may help you, it would replicate some of the effects of the Dilantin.
With multiple diverse infections, I think regular PHD is usually best. This is a neutral diet which is good against everything. You could migrate it toward a ketogenic diet by eating extra coconut milk/oil/MCT oil and doing more strenuous intermittent fasting.
Your case sounds complicated enough that I would rather leave specific advice to your doctors, but I think it is worth doing some experimenting around regular PHD / ketogenic PHD / fasting durations / MCT oil intake / carb intake to try to find what works best for you.
Also, irritability or anger are often due to low serotonin (caused by the interferon-gamma mediated immune response in the brain) or hypoglycemia in the brain (which can be caused by bacterial or other brain infections). Treating infections can often relieve the symptoms. Something to consider.
Some posts to read:
http://perfecthealthdiet.com/2011/07/how-to-recognize-and-fix-a-brain-infection/
http://perfecthealthdiet.com/2010/12/mice-who-tear-their-fur-out-and-the-psychiatrists-who-treat-them/
Bless you Paul, thank you.
Can whey protein be consumed during a ketogenic fast without stopping autophagy?
Hi Andrew,
All foods reduce autophagy somewhere, but protein is most effective at reducing it.
That said, there’s nothing wrong with taking some whey and lengthening the fast to achieve the same amount of autophagy.
I have one more question about something in the new book. It recommends taking Vitamin D in the morning as opposed to the evening. I’d like to follow that advice, because I’ve realized benefits doing other things that enhance circadian rhythms. But I think D3 is supposed to be taken with food, and if a person does IF, they sometimes don’t eat until 2 in the afternoon. Any thoughts on whether it is best to take a dose with no food early in the morning, or rather a dose mid-afternoon with the first meal? I’d get my D3 from the sun, but it’s too cold right now!
Hi Thomas,
Good question. I take vitamin D with my first meal, even if that is in the afternoon, but I don’t know whether that is optimal.
From what i have read, it does not really matter how you take your D3, as long as its D3 (not D2).
Everyone will absorb/utilise D3 in differing amounts…and supp type, sun exposure, food, gut function etc may well all have an influence to varying extents. The best advise i can give is just to supplement (what ever type you prefer) to a level that results in a D3 blood result (25ohD) of your preference.
Most D3 supps these days include oil as well, usually MCT or Olive.
I also found this article from the Vit D Council, “Does it matter how you take vitamin D?” http://blog.vitamindcouncil.org/2011/11/08/does-it-matter-how-you-take-vitamin-d/
Here’s some of the text;
“…The fact is that the studies are so conflicting, and the 25(OH)D measurement techniques are so variable, that it simply does not matter if you take vitamin D in oil or as a powder, it does not matter if you take food with your vitamin D, or on an empty stomach.
What matters is that you take enough so that you obtain vitamin D levels of 50 – 60 ng/ml.
This means you are no longer suffering from substrate starvation (your vitamin D system has all the vitamin D it needs for all of its many uses and is beginning to store some vitamin D for the future)…”
Hi Paul, I just bought a food scale to help me with getting the PHD plate down for both my husband and me. I can choose weight in any unit also. So you can talk in grams or ounces. I weighed my cooked rice at 7 oz. at lunch today, it seemed like more than I was eating when I measured 3/4 cup for each meal. I generally measure a full cup for my husband. Do you think 7 oz was too much? What is a good weight after cooking for both potatoes and white rice for a female? Also, I think I might still be confused even after finishing the book about bananas, beets, carrots, etc. Before the food scale, I would eat a banana and a handful of berries every day, plus 3/4 cup – 1 cup white rice per meal. So, I guess my question is: do I eat about a pound of rice/potatoes daily AND about a pound of other sugary starches (beets, bananas, berries carrots?), or is it about a pound total of rice,potatoes, banana, beets, etc.? I apologize for the seemingly dumb question, but I am still dealing with a lot of brain fog, so I sincerely appreciate any clarification you can give me.
Hi Dede,
It’s about a pound of rice/potatoes and a pound of beets/bananas/berries/carrots/fruit.
But remember, all of these numbers are approximate, and they should usually be adjusted downward for women and upward for men, downward for older folks and upward for younger folks, in general adjusted for personal desires and tastes. So go with what you like. I think what you were doing before was excellent.
Best, Paul
Hi Paul !
I’m a new french reader of your new published book ! Tremendous thing !! I come from a low low carb diet , and encountered all the problems you’ve mentionned.. It’s hard to solve ^^.
My question is : I do follow all the recommendations you mention (diet inc. supp.) but I remark my safe starches consumption is higher than the one your recommend. It’s about 150 or 200 gr. of carbs coming from safe starches. (rice,potatoes,bananas) and some others coming from sugary plants (carrots, onions, beets) What’s your advice on this , can it be sustainable for a long term diet and could it be damaging for a weight loss goal …? Thanks for your kindness and the time you offer EVERYBODY !! :)) Have a nice happy and nice happy new year’s eve !! July
Hi July,
I think it’s OK to eat more starch and less fat if that is what you like. It may not be 100% perfect but 99.9% perfect and more enjoyable is very, very good!
If you do have trouble losing weight, you could try reducing carbs a bit. I do think weight loss is easier on 30% carbs than 40%, and you’re in that 30-40% range.
I’m working my way through the new edition and am learning so much–thank you!
In the table of Best Plant Food Energy Sources, I was surprised to see that yucca was awarded the mediocre grade of “B”. I rely mostly on yucca for my safe starch since white and sweet potatos have caused troubles in the past. Since yucca is a whole plant food, I assumed that it would come along with more beneficial nutrients than white rice.
Can you please explain why it’s considered inferior to to A items, particularly white rice?
Hi Elyse,
It’s not that it’s bad, it’s that we don’t have data on its healthfulness. It’s less well vetted than rice.
Compare pork and chicken which got grades between B and D depending on part — B is not a bad grade.
Hi Paul, is that correct that MCT oil has more caprylic triglycerides than coconut oil and therefore it is more antifungal?
Or the main benefit is that it has more Medium-Chain Fatty acids?
Can you add MCT oil to soups adn lets say fry eggs in it?
So how can Keto diet be more fungal prone if you are eating mostly coconut/mct oil lets say?
Hi St,
Yes, it’s true. The lauric acid in coconut oil also has good properties, it is antiviral.
MCT oil is more ketogenic than coconut oil, due to it being 100% 8-carbon fatty acids vs 57% 12-carbon fatty acids (more or less).
The MCT oil can act against fungi in the gut but is routed straight from the gut to the liver and never sees the body. Ketones go into the body. Disseminated fungal infections benefit from the ketones.
Hi Paul;
Im at a crossroads right now and would really like your opinion.
I’ve been diagnosed with SIBO after a hydrogen breath test, and my doctor wants to put me on a 2 week anti-biotic course.
This would be fine if I didn’t also suspect that I have Candida, and quite a bad case to. I believe prior usage of antibiotics for unrelated issues were responsible.
I don’t want to do anything to make candida worse, but I don’t want to ignore SIBO either.
I’m thinking, if I already have a bad case of candida, maybe the antibiotics wont make it any worse than it already is, and I should just take them to eliminate SIBO then start on the candida.
Another part of me says maybe the antibiotics are responsible for the SIBO in the first place by disrupting healthy bacteria, so it’s crazy to take even more to heal it, right?
What do you think?
Thanks!
sorry, just two more things
1. i read that Rifaximin/Neomycin might be safe for candida users because they only act in the small intestine where no bacteria should be present, therefore killing good bacteria isnt a problem for those with candida
2. i dont seem to have as many digestive issues as those with SIBO report having…i can eat mostly anything without any abdominal affects or pain…might this suggest that i dont have sibo afterall? is it possible for a breath test o deliver a false positive?
Hi Josh,
It is definitely the case that taking antibiotics will make any fungal infection you have worse.
If your doctor is willing you could try treating the fungal infection first. It’s possible the SIBO would then clear up on its own.
Rifaximin I believe will kill bacteria in the colon too, so I don’t believe it would be safe for those with fungal infections; though it may be safer than other antibiotics.
Re false positives on the breath test, see http://www.medicinenet.com/small_intestinal_bacterial_overgrowth/page4.htm:
Hi Paul,
I am very interested in starting PHD, as I have tried many things for long-standing IBS-C (constipation dominant–actually…more like multiple spasms throughout the day, and if I have a problem, i.e. have eaten too much fat, my colon will ‘lock up’/be gassy, not release the gas/waste…very uncomfortable and that is a huge understatement!). I have tried SCD and GAPS but have lost too much weight quickly, since I cannot tolerate much fat and am fructose intolerant also.(avoid fruits altogether). I do better with more carbs, but know the problems of wheat, sugar, etc. Currently I overuse magnesium citrate (Natural Calm) to solve my problem, but it is not always a solution (can create more gas)and I am training my system to rely on this. What do you recommend? I see that Shou-Ching had issues with constipation, also (though not with IBS necessarily), so I have hopes that you/your diet may be able to help. Thank you, I appreciate your work very much and am hopeful you will have some ideas!
Best to you both for a peaceful, productive New Year!
Susan
Hi Susan,
Shou-Ching’s constipation was due to hypothyroidism. You might get some helpful ideas from our post on constipation: http://perfecthealthdiet.com/category/disease/constipation/
For IBS we commonly suggest a stool test to identify gut infections which may be treatable. The Metametrix Microbial Ecology profile is a good one.
Fructose intolerance and fat intolerance suggest a problem high in the digestive tract, in the small intestine. If you are not producing much bile, that alone could cause constipation; also poor digestion will lead to excessive fermentation of carbohydrates. So I might question whether you have IBS at all, maybe the problem is in the small intestine and the colonic symptoms are due to too much undigested food reaching the colon. So maybe you should ask your doctor for SIBO or other testing too.
I might start with trying to improve digestion starting with vitamin C, taurine, glycine, and maybe bile for fat digestion, possibly carbohydrate-digesting enzyme supplements, and maybe betaine hydrochloride for protein digestion. Try some experiments to see if any of those help you.
Best, Paul
Paul,
Thank you for your reply! I will look into stool testing, have not done that in 5 years or so. I am on Armour Thyroid and that has made no difference, if anything, the bowel activity has worsened, i.e. wants to ‘go’ more often but cannot. I tested for SIBO over a year ago, postive/methane…went on Xifaxin and Flagyl. Helped tremendously at the time! Then, afterwards, no difference. I tested again this fall, but was not positive…I attribute that to my staying fairly ‘cleaned out’ with the Natural Calm?
Regarding your comments re. fat and fructose intolerance, my question is this: in my understanding of IBS, the gastrocolic reflex is exaggerated, causing some people to have diarreah and some to have constipation…colon either speeds up or locks up. What causes this difference? In SIBO, the methane vs. hydrogen production explains that cause well, but if no SIBO is present, then what can one conclude?
Hope this makes sense…thanks once again!
Susan
Hi Susan,
I’m afraid you’re getting beyond my expertise. I wish I knew the answer to those questions, but I suspect most doctors and specialists don’t know either!
The fact that you had SIBO at one point tends to support the idea that you may still have an infection in that area now. When you have SIBO, immune defenses are depleted and you can get additional/multiple infections which can enter nearby organs or the nerves or epithelial cells. Treatment may have eliminated the original SIBO but not other infections that developed while the SIBO was impairing immune defenses like the mucosal barrier.
I’m not sure how to go forward, but experimenting with diet and digestive aids and getting additional diagnostic testing from your doctor seem like sensible steps.
thank you, Paul…I appreciate your SIBO thoughts, gives me good stuff to talk to my doc about…and appreciate your frankness re. my original questions. Sadly, I am afraid you are right, that the scope is beyond most docs/specialists!! Thanks once again!
Susan
Hi Paul,
I just finished reading your book a couple weeks ago. It is very well done and I’m mentioning it to everyone I know! I have a question related to a statement you make that hyperthyroidism can be relieved by lithium supplements (under troubleshooting blood lipids). I’ve read the section on lithium, but I’m still having trouble connecting the dots to hyperthyroidism. Could you elaborate?
Hi Lauren,
Here’s line from a review: “As lithium inhibits thyroid hormone release from the thyroid gland it can be used as an adjunct therapy in the management of severe hyperthyroidism.” (http://www.ncbi.nlm.nih.gov/pubmed/19942149) The review talks about some negative effects of lithium which can occur with high-dose supplementation used to treat bipolar disorder. I think at the low doses we recommend, those negative effects do not occur, or are extremely rare.
There is no question that I need to change the way that I eat; I’m 58 years old, at least 50 lbs overweight and suffer (among many symptoms) from knee arthritis, severe joint pain, depression (only partially relieved by antidepressants), food cravings, embarrassing and miserable hot flashes and night sweats and, almost more distressing than all these other symptoms, memory deficits and brain fog. It is these latter two, however, that are ironically and predictably interfering with my adapting any new food regimen successfully. I have tried reading your book and website and my brain fog is so severe that I cannot really figure out where or how to begin such a major change. I know I have to ease into it (to avoid feeling overwhelmed) but where should I start and how do I proceed? I’ve got a doctorate in my field and I used to feel quite intelligent but that ship sailed long ago. Now I feel dull and lost. Can you give me some advice?
Hi Lisa,
The best way to start is by deleting wheat or products made from it (like bread or noodles), soybean oil and products made with it (including most packaged goods), and products with added sugar.
In their place eat whole foods that you buy from around the edges of the supermarket — things that are recognizably animal and plant parts.
A good way to cook them is in watery stews/curries — eg beef stew or chicken cacciatore — eaten over rice or boiled potatoes.
Try eating that way for a little while and then tweak the diet.
Brain fog is usually the result of high immune activity, which most often arises from food sensitivities / leaky gut. Try doing intermittent fasting and see if your brain clears a little after a 14 hour fast. Also try removing foods that are commonly allergenic.
If it’s not food sensitivities, you probably have a chronic infection causing the immune activity. Your doctor may be able to help diagnose it. The Metametrix Microbial Ecology stool test is one we commonly recommend, it might turn something up.
Best of luck and keep me posted on your progress.
Paul
I’ve been looking for a diet plan that made sense to me and this one was a revelation. I’m excited to get started!
This book is obviously a labor of love for you and contains SO much information, I almost hate to ask for anything else from you, but here goes…
I purchased your book as a Kindle ebook. You have a very thorough index which is always greatly appreciated. However, it lists page numbers, but the Kindle version uses location numbers only (not page numbers) leaving the index of little use for those of us with the ebook version. This may be out of your hands and be an Amazon issue. But if there is anyway the ebook version could be updated to contain page numbers, it would be a great help to us who are reading the Kindle version. Thanks for your consideration!
Where can one purchase the kindle ebook version of the book? I can’t find it on Amazon.
Hi Andreas,
The rights are being sold separately in different countries and the UK rights have been sold but the UK edition is not out yet, so Amazon cannot sell the US Kindle editions in the UK. The Australian Kindle edition comes out Jan 7 and that may be available to you.
Hi Deane,
The Kindle has a search function so you can just search for all occurrences of the word you are interested in.
Amazon does now allow Kindle publishers to put page start and end markings in Kindle editions, but I don’t know if Scribner would be interested in that. I’ll pass along your request to them.
HI doctor, thanks. Thats given me a lot to consider.
I do definitely have chronic bacterial symptoms that I’d love to get rid of. there is a definite temptation to try a 2 week antibiotic course to see if it helps, supplementing with probiotics and anti fungals, and a sugar free diet.
i wouldnt really mind a temporary worsening of candida if the subsequent treatment is the same- id follow up with the candida diet and anti fungals, and if it would take the same 3 months to clear it, then it doesnt matter so much.
then theres always the fact that ive tested positive for SIBO (maybe) , but i dont actually know if i have candida…. i just speculate
so, what do i really risk byu taking a 2 week antibotic course? if i already have full systemic candida, would it really make things THAT much worse and/or more difficult to treat?
Hi Josh,
I doubt a 2 week course of antibiotics will dramatically change your situation — it will help a fungal infection spread in the gut or on other epithelial surfaces (sinuses, ears, respiratory tract, urinary tract, mouth), but it isn’t likely to transform it into a dangerous fungemia.
There are a lot of imponderables here so you have to consult with your doctor and make a judgment call.
Ok, thanks for all of this…it’s definitely helped me thought process.
My gut instinct (and my gut) tells me I should just tackle this with a long term mindset by making permanent health changes.
Is it possible for a bacterial infection to go away on its own? Would SIBO be treated with diet?
Yes, it’s possible. SIBO is mainly treated by improving digestion function, eg stomach acid production, and eating foods which are antimicrobial in the small intestine (eg vegetables, certain oils) rather than calorie-dense water-poor carbohydrates (bread, noodles, cookies, crackers) because the lack of water implies lack of stomach acid and the combination of carb calories to feed the bacteria and lack of stomach acid to kill them is a problem.
Hi Paul, two questions…
Last time I had my period was 2.5 months ago. (History of infrequent periods.) I suspect a hormone imbalance or PCOS. My gyno appt is coming up. What is your stance on The Pill as a way to regulate hormones? Is this my only option? Is something else responsible for throwing off my hormones?
Also, another question regarding PUFA/fructose. ( I am still dealing with gut-skin issues so just want to play it safe.) Since Avocado contains PUFA, do I have to avoid eating Avocado with fructose fruit? Or is the PUFA in Avocado safe unlike the PUFA in chicken/salmon?
Thanks for your
Hi Monnyica,
Avocado is minority PUFA, it’s <20% PUFA so similar to olive oil, chicken, and pork. It's not perfect to mix with fruit but I wouldn't worry much about it.
I'm afraid I don't know much about hormone imbalances and their treatment options.
Paul and Seou-Ching, hi,
Love your book. I’ve been devouring it over the holidays.
I find it interesting that you mention you eat sour cream. Otherwise you don’t say a lot about dairy. I noticed that you have it in the Pleasure Foods in your info graphic. Should we limit dairy products? I know about the benefits of cream and butter. What about other dairy products?
Wendy
Hi Wendy,
We generally recommend eating fatty and fermented dairy, but discourage milk drinking for the most part.
I don’t think it’s necessary to limit dairy fats other than to make sure you get a balanced, well rounded diet. However, be aware that some people are sensitive to either dairy proteins (esp in pasteurized cow dairy products) or to compounds added to dairy products (eg carrageenan in cream). So keep an eye out for sensitivities.
Hi, I loved yout book and I am reading it again 😛
I am also interested in knowing more about your opinion on dairy. I am going to start PHD in 2013 and for breakfast I decided to have organic yougurt. Does it have the same effect on IGF-1 hormone the milk has?
Hi Dani,
It does, but I don’t think that should stop you from eating yogurt. Quantity eaten is more important, so as long as yogurt is not the mainstay of your diet, it won’t generate excessive IGF-1.
Hi Paul;
How long does it take someone to recover their health after eating a poor diet? Would an instant switch yield instant results? Or will it take a long time to start feeling healthy again?
Thanks!
Hi Frank,
Usually people see steady improvements over the first several years, after that they usually have to uncover and treat a new cause (eg an infection) to generate further improvements.
Some problems can be repaired in days or weeks (eg water soluble nutrient deficiencies), others in months (eg fat soluble nutrient deficiencies), others may take years (omega-6 fat normalization), some are only partially addressable by diet (chronic infections). So it varies.
Hello,
What’s your take on apple cider vinegar for candida? Vinegar seems to be on everybody’s list of things to avoid, yet apple cider vinegar is mentioned as a great candida diet subsistence.
thanks
Hi Harrison,
Both vinegar and apple cider vinegar are healthful foods which are good to include in your diet.
I don’t consider apple cider vinegar an effective antifungal, but it certainly does no harm as long as you dilute it enough to avoid any burning of tissue.
I just finished the book and my wife and I are implementing the diet tomorrow, 1-1-2013. I am trying to go back through the book and develop a list of your suggestions that should be done daily, weekly and monthly. Instead of reinventing the wheel I thought I would ask if a list had already been done.
Thanks for doing this. I am going to buy a copy and give it to my doctor.
Hi William,
We don’t have such a list currently. It is a good idea however.
Please give your opinion on:
1) Cooking with SPROUTED GRAIN FLOURS…is wheat still bad for us, if it’s sprouted?
2) RICE FLOURS. If wheat is bad, can we use Rice Flour to bake with instead? Or, should we stay clear of all breads/pancakes regardless of the type of flour used?
Thank you!
Sarah F.
Idaho
Hi Sarah,
Sprouted grains are less bad then unsprouted grains, but we still avoid them.
Yes, we support rice flour, potato starch, tapioca starch, and gluten-free flours made from them for baking. We would recommend making baked goods not too frequently, as snacks or treats rather than regular foods.
Raw milk is OK as long as it doesn’t carry infections. You have to trust that your farmer is carefully cleaning his cows.
One more question I forgot to add:
3) I understand that milk can be bad because it’s pasturized, but is RAW milk from a local dairy cow okay to drink?
Sarah
Hi Paul, and Sou-Ching ! I would be grateful your advice on intestinal problems developped through the years. I do not know doctors here in France, suggesting tools test. So cannot implement it by now. Anyway, I would be interested in your thoughts about the symptoms : no bowel movement,gas, bloating,be gassy, cannot release the gas/waste…it’s like a”huge snake” moving all along my colon ..!), food intolerance (gluten,fructose,diary), some difficulties with omega6 fat (I do much better tolerate coconut oil than any other kind of fat^^), and introducing more carbs (potatoes, bananas) calms down all of those symptoms (excepting constipation..). If you could help me more, t would be great . 🙂 Thanks so much again ! Best and best, July
Hi July,
It sounds like what we call IBS — inflammatory bowel syndrome. It is usually caused by some sort of infection in the intestine which can often be diagnosed by stool tests. So I would suggest that. For constipation, perhaps our constipation post may give you ideas: http://perfecthealthdiet.com/category/disease/constipation/
Thanks a lot Paul ! Best wishes for this new happy year ! May God stay very close to you throughout this year.
So,IBS means the problem is more located in the colon than in the small intestine ? I’ve tried the advice f the page about constipation you mentionned before asking you for advise…So, despite these recs, no bowel movements came back. What would you add or modify in the PHD to be have more normal bowel movement ? Could carbs in PHD come only from starch (I mean potatoes or rice) in PHD diet, when fructose (when eating carrots, or beets or winter squashes : bowel looks like a “snake” as previously mentionned..) have some fructose..?) is not tolerated.? Thanks again a lot ! Best, July
Hi July,
One thing that may help a bit is to compress the colon by doing yoga, squatting, and contracting the butt and stomach muscles to squeeze the abdomen.
But the main thing you have to do is change your gut flora. You can try eating fermented vegetables and other fermented foods, and diagnosing any infections and getting those treated.
The ultimate thing to do would be a fecal transplant from someone with a healthy flora.
Thanks a lot Paul for taking care so closely of each situation !I’ll try your recommendations, and tell if it makes things better. Does a list of “safe” fermented foods (depending on each gut problems : IBS, SIBO, gut dysbiosis..) is available somewhere on your site ?
Here,fecal transplant is not at all easy to access…^^
Best, July
Hi Paul,
Do you happen to know how long it takes to get the results for a Metametrix Microbial Ecology Profile? (I’ve messaged Metametrix, but haven’t received a reply.)
Can you only get this through a doctor? I would assume insurance would not pay for it right?
You can get it through Direct Labs without a doctor. I don’t know how long it takes to get results.
Nevermind, Metametrix replied! Results to GI Effects Stool tests will take 14-21 days.
Hi St, my doctor said they do not order those tests. So I ordered it online through DirectLabs. Sometimes they have coupon codes, so make sure to google for one.
When I finally (!) decided to get the GI profile done, I clicked the Metametrix tab “Patients,” then, in the drop down, clicked “Find a Doctor.” After sending them my zip code, they sent me a long list of doctors, one of whom is only a few miles away from my home. The list included a number of doctors within the local medical clinic system, which was surprising to me because I have not encountered any of these folks who think outside the AMA box.
On the day of my appointment, after he had read my health history, I sat in this local guy’s office with PHD in hand and asserted, “The authors of this (held up book) say ‘everyone gets chronic infections’ and if that’s true, I want to know which ones I have. Are you willing to order a test for me?”
Immediately he nodded and said, “It’s often true that if someone gets rid of pathogenic organisms arthritis goes away, so certainly, we can get that test for you.” I was expecting an argument but got none. Was also expecting a price tag of $800, but he explained that if I was willing to pay up front the cost would be $395. Within days I received the kit from Metametrix. Kit was great quality, with detailed instructions. Be certain to read everything so you follow the diet guidelines before collecting specimen. Good thing I had not decided on a doc in the large local medical clinic system, as they would have supplied me with potent antibiotics to address the infection I had. The guy I saw is an MD with a focus on environmental and integrative therapies, and, since I had no known symptoms, he started me with a natural remedy. He is a bit grumpy and cantankerous, but that’s okay; I just give it back to him. I recently told him the new book was out and suggested he might want to read it; he looked at me askance, and expressed no interest. Too bad. If I need to, I’ll switch horses, but for now, it’s working out. The list of PHD healers is surely going to grow.
Regarding insurance, I called my carrier and they said to submit the non-preferred provider form and they will likely cover a good bit of it. My brother died of colon cancer, so doc gave me the “family history” code to use. I have not sent it in yet, but have it on my list to do this winter break. It is not complicated.
Yesterday, picked up the “Person of the Year” edition of “Time,” and was happy to see that it’s a tie amongst several; but dismayed that “Time” did not agree with me that the Drs. Jaminet should have shared the honor. In my world they get the prize this year.
Happy and blessed New Year everyone!
Hi Lana,
Thanks, you gave me some chuckles! Hope the test is helpful to you, sounds like you found a good doctor!
Happy New Year!
Thanks Lana. I got the list of Doctors as well from Metametrix. I hope I find a good one. The last one I told that I eat 65% fat and mostly saturated, he almost had a heart attack himself. I found a list of Paleo docs as well but unfortunately none in my area.
Paul, but what else is this test would be useful for, to see for example if there are fungal/yeast issues? Would it show any relevant info for SIBO?
Hi St,
It shows mostly the state of the colon, it isn’t a good test for the small intestine. It is good for IBS, ulcerative colitis, and sometimes unknown chronic infections.
Paul,
What is yor take on the dangers of microwave ovens?
Wendy Wayt
Hi Wendy,
I think they’re safe. http://perfecthealthdiet.com/2010/12/do-microwaves-destroy-flavonoids/
Hello Paul,
First, Happy New Year!
The past 6 months for me have meant a lot of travel and a lot of fine dining. Considering such I have gained about 6-7 pounds. In addition to travel and eating I have been exercising much less. I went from being extremely active before June to only exercising about 3 times a week since that time. So, considering it is the first day of a new year I am of course inclined to a reset. I was considering doing the Whole 30 plan, but after reading over it it seems like more of an initial introduction to Paleo than an evolved plan of any kind and considering I have been following Paleo/PHD for a few years now it seems silly to take steps back.So, I thought maybe I would instead follow your fat loss plan, but have a few questions. It seems to me that you essentially recommend being in a calorie deficit and reducing fat intake in oder to lose weight. I am wondering how this applies to an extremely active person as I will be going back to my former active lifestyle with close to no travel.
Figuring out one’s calorie needs proves futile.. so I wonder how can I be sure I am in a calorie deficit and still be nourished enough to support exercise? Also, the Whole 30 plan discourages using fruit as post workout carbs.. do you tend to agree?
Many thanks,
Lindsay
Hi Lindsay,
That’s basically it, do intermittent fasting and reduce the nutrient-poor fats used for flavoring. Eat the same amount of carbs and protein (you can just eyeball this, remember how much you ate), so the total calories reduce a bit. Then restore your activity levels and tend to the circadian rhythm strategies described in the new book. That should do it.
Best, Paul
Hey Paul,
If ketosis supports autophagy and food intake weakens autophagy but supports ketosis, how does one maximize both mechanisms? Fasting on MCT oil? Are you still recommending 10 days fasts? I noticed you left it out of the new edition.
Andrew
Hi Andrew,
Ketosis supports neuronal autophagy but suppresses autophagy elsewhere.
MCT oil therefore supports a fast targeting neurological issues.
No, I don’t recommend 10 day fasts. I recommend repeated fasts of less than 24 hours.
My wife has received wonderful feedback from paul and suggested I post
recently diagnosed with lyme disease based on a lyme ab scr. index of 3.9. although western blot was negative.
might of had it for years. Im sick often and have arthritic like joint pain and soreness but no arthritis. my thyroid panel was normal but my IGG was low at 650 mg/dl. also my total testosterone was about 258 ng/dl but my free was 55. doctor said its fine but i think its an issue. after 3 weeks of Doxycycline, been 2 months into a herbal lyme protocol by Dr. Qingcai Zhang. been sick more than ever and feel horrible with three stomach viruses, a cold and never feel myself. Im moody cranky nauseas poor cognitive function and I feel like a constant low grade fever without the fever. I was also diagnosed with CFIDS in 1989 as Ive always had low energy.
I do workout regularly, eat gluten free and have a good diet.
Thanks
Hi Warren,
It’s great that you got a diagnosis. Hopefully that is the only problem, the risk of antibiotics is that by depleting probiotic flora from the gut they may worsen other infections such as fungal infections.
Be sure to take NAC and vitamin C. You can find some other supplement suggestions and other tips relevant to Lyme treatment at cpnhelp.org. A lot of their Chlamydophila advice is transferable to Lyme.
You may find that posting your symptoms on patient forums like cpnhelp.org will get you more relevant help than I can give, as you’ll meet other people who have gone through similar experiences.
I wish you the best and a quick recovery!
Paul
I don’t do well with magnesium supplements so I’m going the Epsom salt route. Do you have any idea how many would be sufficient? Like 2 or 3 per week? I hadn’t been supplementing with magnesium, only a vitamin d/k combo and started to get really nauseas after a few weeks of 1000 iu/90 mcg. I’m assuming that’s because of a magnesium deficiency?
Hi Alex,
I don’t know what caused the nausea from the D/K. I think that’s odd. Maybe a reader can help out.
I think 2 or 3 Epsom salt baths a week is good. The object is to relieve a deficiency and that should be adequate.
I need help understanding the PHD and essential fatty acids.
Linoleic acid is an omega 6 and linolenic acid is an omega 3. Both are polyunsaturated.
Since the PHD recommends not eating vegetable oils, what is the source for essential fatty acids?
Hi Deedee,
You don’t need a special source for omega-6, every food has some.
For omega-3 we recommend eating 0.5 to 1.0 lb per week marine fish like salmon, sardines, or herring. That will be enough. If you prefer you can substitute linolenic acid eg from flaxseed to some degree, but we would still recommend getting some marine fish.
I am really getting a lot out of your book. I have a question about the Macronutrient Profile Tables for Omega 6 and Omega 3s. Do these table assume conventional raised meats or pasture raised? My understanding is that the omega mix is different depending on how they are raised.
Hi Christine,
They’re generally conventionally raised, since the data is taken from the USDA database.
This can make a big difference for chicken and pork but not so much for beef.
Hi Paul,
Reflecting upon my journey to achieve health, I have been working sum things up in my head during the last week.
My initial goal in changing my diet was to eliminate headaches, geographic tongue, improve energy levels and allergies (I have an autoimmune disease so this is no easy task). I have made huge strides in my overall health and I was successful in eliminating daily migraines, but I still have the challenges of a painful burning geographic tongue and food allergies that seem to get worse all the time. How can I tweak things to help improve these problems and what can I do to continue to improve upon my quality of life? I know that I may sound selfish in continuing to seek perfect health, literally, but I really believe that if I stop the allergies and geographic tongue then my body will truly be healed…This may or may not be true.
Lastly and on another note, I had read about betadine HCL and aiding in balancing low stomach acid. Is this something you recommend? If this was followed how long is recommended to continue with this supplement before acid balance would be restored?
Thank you to you and your wife and your readers for continued support. I would not be where I am today without it!
A happy and HEALTHY new year to everyone!!
Hi Lauren,
Everyone deserves good health so you should absolutely keep seeking perfect health.
Has a doctor diagnosed the cause of your geographic tongue? If it is a fungal infection you can get treatment. If it is leukoplakia then supplements may help. If an oral infection is coupled to an intestinal infection, then digestive aids like betaine hydrochloride may help.
I do recommend betaine HCl with meals in cases of low stomach acid. It should be continued as long as stomach acid is insufficient to adequately digest meals.
Happy new year!
Thanks for making me feel better about my concerns.
A doctor has not been successful in treating it the geographic tongue. All doctors say that it is fine…I do see a nutritionist who recommended using florastor as a rinsing (and then swallowing it) agent and I saw much improved results. A recent trip away for the holidays caused flare ups in the tongue but it may have been due to interrupted sleep (2 year old in a strange place waking a lot) or allergies (warmer weather) so allergies seemed to spring up a bit. I really don;t know the cause. With florastor, my tongue looked pretty good for about a month (longest ever since it started 5 yrs ago -1st child born). I continue to have a thicker coat that looks a little hairy and that’s when my thoughts crept in about low stomach acid. I had been on meds for quite some time for LPR and I think I have some lingering issues. I have had extensive testing and none revealed an intestinal infection although not so sure about an oral one…Only thing I had was positive test for HP but only for antibodies. Breath test was negative. what supplements would help for leukoplakia? fungal infection? I do take NAC and vit C
Hope all is well with you and your family doctor Jaminet.
I had a question about carbs. I’ve read in a few websites that carbohydrates should always be eaten with protein. This is supposedly to avoid sleepiness and other undesirable effects that can take place when they are eaten without other macronutrients.
What is your take on this?
Thanks,
J
Hi Jackson,
I think it’s good to eat carbs as part of a balanced meal. The body of the apple in our food plate describes what we recommend as the content of a meal.
Here’s a relevant discussion: http://perfecthealthdiet.com/2011/10/how-to-minimize-hyperglycemic-toxicity/
Still looking for cute animals?
http://www.youtube.com/watch?v=X3iFhLdWjqc
Yes! Thank you lana.
Hi Paul,knowing your background, I hope you may find this question kind of fun:
Having been emerced in the ancestrial health culture for a while, I’ve noticed that there seems to be a disproportionate number of Libertarians that adhere to this diet/health philosophy. If you agree with my premis, I’d like to know why do you think this is?
Jonathan
Hi Jonathan,
I don’t know the answer, but I would suspect that those who are willing to buck the authorities in politics will also be more willing to buck the authorities in diet.
Maybe because “free thinking” knows no bounds! 😉
Hi Jonathan (or whoever might see this and want to reply),
I don’t want to create a big political discussion here (mostly because I wouldnt be able to keep up!) but I just read your interesting comment and was hoping you might clarify… I don’t actually know who would be classified as Libertarian. I looked it up on wikipedia but only feel further confused– in the history they mention all kinds of ‘libertarian’ movements including one called Libertarian Marxism and then further down, they also mention the Tea Party created in 2009, which seems like the other end of the spectrum. So, who are we talking about exactly? Are we talking about the people who want government not to be in control of so much, like not taking over health care, etc?
Just curious…
Thank you!
KH
Hi Paul,
Thank you for giving the link to Q/A for Gary Tubes on the front page. In few places there he mentioned, “A more important question to me is how much benefit can individuals get from going low-carb, compared to going all the way to a ketogenic diet.”
I understand you would prefer PHD, but for people who are lets say losing weight for long time. What is the point of taking 80g of carbs when you can take 50g of carbs and be in Ketosis.
Hi Stort,
Your question reduces to “what is the point of a ketogenic diet” and that’s a fairly large question. We have a chapter on it in the book.
Paul, I think I have not phrased it correctly. What I am trying to say, what is the point of going lets say 60-100g of carbs, when this will bring you out of Ketosis and at the same time will not provide enough Glucose. So at that range you are not generating Ketones to support the brain.
I think that is what Gary Tubes is asking, why not just go below 50g of carbs and be in Ketosis, instead of just barely be above Ketosis which means not getting enough Glucose for the brain.
So Basically either go below 50g or go with your recommendation of 150-200grams, no point of being in between these two zones.
Hi Stort,
It doesn’t necessarily bring you out of ketosis and it doesn’t necessarily supply an inadequate amount of glucose. It certainly gives you better glucose status than eating less carbs.
You might want to read Tatertots comments on the What’s New in the New Edition 2 post about being in ketosis eating a pound of potatoes per day.
Hi Paul,
This might actually explain it why Tatertots was getting that good Ketoe reading. Take a look at the video by Kiefer, its only 2 minutes.
But basically the Ketostix only show you ketones and not if you are Ketogenic, if you eat a lot of carbs, your body does not have much to do with Ketoes and you pee them out, that is why you get a high reading. But it also happens in the morning and after exercise.
sorry here is the link
http://www.youtube.com/watch?v=JIgLeo9eQLQ
Hi Paul,
I was wondering if you might have any ideas on what might be causing my heat intolerance. I seem to always be warm, and wear light clothing when others around me are wearing winter jackets indoors. If I were to wear a light jacket inside (if i had been using it outside prior to entering a building) I would quickly overheat, become very uncomfortable and start sweating to cool myself down. I can hardly handle when the heat is turned on in cold cars because it bothers me when it hits my face. It is problematic when I want to dress well (usually a couple of layers). I am a 20 yo male and have no other known health problems besides occasional asthma. I eat in line with the PHD. This is typically only a problem in the colder months; I can easily handle the heat of the summer. This has been happening for as long as I can remember and sometimes over heating occurs with some mild urticaria. On a side note, in some social situations or when watching some funny videos I tend to heat up and get mild and sometimes painful hives; not sure if there is a connection. Thank you.
Hi Jack,
This probably isn’t your issue, but one thing readers should be aware of is that PHD should improve the body’s ability to generate heat and make people more cold tolerant, ie requiring less clothing in cold temperatures. Most people are abnormally cold intolerant, because hypothyroidism and inability to burn extra fat for heat are widespread problems.
In your case, I would supplement vitamin C if you aren’t doing that and try to eat a bit less fat and a bit more carbs. Let me know if that fixes the problem.
Best, Paul
Paul –
I have a question about the “Best Fats and Oils” chart on page 173 (Scribner edition). It lists palm oil twice — once as an A (low-Omega-6 plant oil) and then again on the next line as a B (moderate-Omega-6 plant oil). Are there different types of palm oil that have different qualities/properties?
Thanks!
Jim
Hi Jim,
Good find, that’s a typo. It should be classed with olive oil, maybe B+ would be a better grade.
Paul –
Thanks for the quick response. I just wasn’t sure if it was a case of “all palm oil is not created equal”. There’s a lot to “unlearn” about eating!
All the best to you and Shou-Ching for a great New Year!
Jim