Q & A

Q & A

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

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

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

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

And here are my answers.

Chronic Lymphocytic Leukemia (CLL)


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

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

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

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

Warmest Regards,


Hi A,

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

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

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

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

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

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

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

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

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

Best, Paul

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

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

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


Hi G,

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

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

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


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

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

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

Please advise. — S

Hi S,

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

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

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

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

Best, Paul


Jersie wrote:

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

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

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

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

Hi Jersie,

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

I would interpret it this way:

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

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

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

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

Please let me know how things go.

Leave a comment ?


  1. Hi Mr. Jaminet;

    i just wondering if you could share your experience with candida? Could you briefly explain what it was like, how you knew you had it and what the symptoms were?

    Thank you!

  2. Hi dr.jaminet. I just read a couple of your articles on obesity, including your discussion of gary taubes vs stephan guyenet.
    Your theory of obesity centering on food toxicity and the lean muscle tissue set point are very interesting.
    I think you could take the ‘food toxicity’ premise a bit further and extend it to its logical conclusion, which is leptin resistance. Fructose and lectins (from grains and ESPECIALLY WHEAT)particular have been strongly implicated in causing leptin resistance.




    These studies tend to indict fructose, serumn triglycerides, insulin and lectins (from grains) in leptin resistance. Wheat seems to be particuarly prone to inducing leptin resistance, presumably due to its higher lectin content.

    With regard to ‘lean mass ssetpoint’ theory, in gary taubes defence i think its worth noting that carbohydrate restricted diets have been shown to increase lean muscle mass without exercise:

    – Harber MP et al. Effects of dietary carbohydrate restriction with high protein intake on protein metabolism and the somatotropic axis. J Clin Endocrinol Metab. 2005 Sep;90(9):5175-81. http://pmid.us/15972575.

    • Thank you Marcus, great stuff. I’m never averse to piling up evidence against fructose and wheat. But I think omega-6 fats are the biggest culprit.

      • Paul , Would you have an idea of the genese of the VLC diet ?
        Carbs are useful and required to maintain optimal health : so much that a body deprived of the necessary amount of carbs do transform some other nutrients in carbs ! i’m wondering why so many theories (CateCallahan, or Rosedale’s ones,etc..) prefer being VLC and creating a huge amount of stress on the body to oblige it creating what he craves for (I mean carbs ! ) inducing so much stress inside the body to fulfill its needs..? I am so grateful to you, Paul and your wife, for the simple and efficient PHD. I feel so much better since I’ve begun PHD, with a correct amount of starch : body temp. arises, no more dry eyes, feeling more energized, IF is very well tolerated (VLC diet made me so dizzy and so craving for food when I couldn’t eat at least 3 or 4 times a day !) I’m feeling so much better. Some complicated issues are still there.. (no bowel movement, and gut dysbiosis, leaky gut..etc..) But ‘im sure time and confidence will help ! Thanks again Paul !Best July

        • Hi july, should try the GAPS (gut and psychology syndrome) diet, but include safe starches into the diet. That is what i’m doing to treat my IBS and it is the first time I have had normal bowel movements in years.

      • I think the new found link between lectin and leptin resistance is very interesting and might be the simplest explanation for the obeseogenic proclivities of grains and especially wheat (as well as gut disbiosis/inflammation).
        Omega 6 is news to me, i’ll have to get a copy of the new PHD edition soon 🙂

        • Thank you Markus ! I’ll take a look on GAPS.. try, and tell you what’s the result for me !! Thanks again !!! 🙂

          • no problem july. If your condition doesn’t improve and you can afford the treatment, then Fecal microbiota transplantation (FMT)is a promising cure for bowel disorders.
            It is currently be used to treat crohn’s, IBS, infections and more.

  3. Hi Paul! I am interested to know if you have come accross any information about the oxidation of the cholesterol in eggs when they are cooked ‘scrambled’? Dr. Mercola (where I was lucky to learn of you and your book!) advises against consuming them scrambled for that reason. For the most part I consume my eggs/yolks raw but I love to have them scrambled or as a frittata as a weeknight meal-now I’m concerned about preparing them this way. Is this just getting neurotic or is it a potential toxin that we should be avoiding? Apologies if you’ve addressed this previously-I’m working my way through your forty-something pages of comments and haven’t come accross it yet!!! Thanks for your incredible generosity.

  4. Sorry about the ‘accross’. My autocorrect is an ‘automistake’ in this case 😉

  5. Hi Doctor Jaminet,

    If I was to eat daily about 1,000 calories from fat, 675 calories from starches, would 1/4 lb of meat or 4 eggs be sufficient for protein intake?



  6. Since mouth sores are viral, Ketogenic Diet should work for it right? or at least IF?

    Would NAC help?

  7. Paul, why is there so much concentration on Glutathione instead of lets say superoxide dismutases?

    • Hi Stort,

      In illness glutathione needs increase significantly, thus it gets more emphasis as a therapy. You can’t supplement SOD directly, you don’t want more manganese, and we do recommend zinc and copper, so we are supportive of superoxide dismutase function.

  8. My husband has recently been diagnosed with Lyme disease. I have received dontradictory responses from doctors as to whether it can be transmitted sexually, in utero, etc…

    Always seems like there is something to stress about…I’m am a little freaked out…

  9. I’m diabetic and morbidly obese. I found VLCing into ketosis to be very uncomfortable from dry mouth and difficulty coughing productively. I can lose weight fast on VLC/ketosis but adding starches seems to plateau me, while alleviating those symptoms. Can you advise the minimum starch needed to avoid ketosis for me, not a specific number necessarily, but maybe a method to figure out for myself? I am also on Metformin (a low dose) which seems to exacerbate the dry mouth thing. Thanks for any guidance!

    • Hi Peder,

      I would eat at least 200 calories per day of starch, and if that is not enough to make your mouth full of saliva, then I would eat more.

      I think 400-600 carb calories is best.

      Ketosis isn’t something to be feared, but insufficient glucose is.

  10. Hello,

    What would you recommend for somebody with COPD? Any modifications to the diet? Supplements? lifestyle?

    Thank you so much,

  11. Hi Paul,

    What’s your take on the Flu vaccine? Is getting the Flu once in a while really that bad?

  12. Hello Paul,

    I seem to do very, very poorly with alcohol and sugars of all kinds. When I try to drink (any different kind), I end up getting fluish/strepish type symptoms for 1-2 weeks afterwards. I know alcohol isnt good, but being in college, its something Id at least like to partake in occasionally. I am also lactose intolerant (not kefir though), and same with gluten. I’ve been on Dave Asprey’s Bulletproof Diet for a while which is quite similar to yours, as I’ve found similar reactions.

    I am very good about omega 3:6 ratios, take magnesium and D, among various other things. Any ideas?

    • Hi John,

      It sounds like some sort of liver infection or dysfunction, or maybe small intestinal infection, that can metabolize alcohol as well as galactose.

      Have you been to a doctor for diagnostic testing?

      • Well, I used to have chronic lyme disease but got rid of it through zapping. Ive blown about $20000 on doctors in the last 5 years and the best thing they could tell me was that I may or may not have depression and everything is all in my head. Is there a certain type of test you would recommend?

        • Just curious…..zapping?

        • Hi John,

          Well, they have tests for hepatitis, SIBO, H pylori, plus stool tests which sometimes catch infections also present in the small intestine.

          I imagine if you’ve spent $20k many of those have already been done.

          You might look at liver support (eg glutathione) and digestive aids for possible help.

  13. I am so happy to find your book Paul- thank you so much for your work!! Do you have any idea why someone would develop profound muscle weakness after doing a cleanse? I did a detox cleanse 10 years ago and have suffered from muscle weakness, fatigue, and insomnia ever since. No one can figure this out. I’ve been Paleo for 3 months and it’s getting worse! Things like artichoke extract and calcium d glucarate also make it worse. Any ideas what is happening? I want to get better but everything I do makes me weaker 🙁

    • Hi Cathy,

      Well, can you describe the cleanse for me?

      Most of these cleanses are forms of fasting, and many forms of Paleo are similar to fasting (eg low-carb). Fasting makes some infections worse. See the discussion in Chapters 38 to 40 of our book, especially the defects of fasts discussed pp 356-361.

      All of those experiences are potential diagnostic clues for what kind of infection you may have.

  14. Hey paul

    I seem to have some trouble with sleep and waking up around 3:30-5 am even though I go to bed around 11. I’v tried the circadian rhythm ideas but maybe I’m doing something wrong. Usually I have NAC and 0.5 tsp sea salt in water during my fast, workout from 8-9 am and break my fast at 11. Have lunch with all the supplements including vitamin d/k2,iodine,magnesium and c around 1 pm and dinner around 7 pm where I stop my fast. Avoid light around 9 and just read a book, meditate 20 minutes and am sleeping in pitch black by 11 !

    Could be:
    – Having Vitamin D at midday deregulates the circadian rhythm and maybe the iodine is energizing also. I don’t get much sun or vitamin d in the morning because I live in the northern hemisphere. Only possible choice would be to take vitamin d in the morning hours?
    – Adrenal fatigue due to fasting too long and under going iodine therapy, slowly increasing from low doses of 110 mcg and 225 mcg. Maybe fasts shouldn’t be too long when repleting the thyroid of iodine as it’s a stressful time for the body.

    I could do and just wanted your opinion on the following :

    1. Could I shorten the fast to 14-16 hours and would it still be beneficial. I think i’ll break at 10 am instead of 11 am. That way I’ll take the vitamin d/k2, iodine, C earlier in they day which are more energizing and maybe take magnesium at night at dinner?

    2. Instead of 1/2 tsp sea salt in water,I could just have it in bone broth which will keep me fasted.And to be able to take the Vitamin D/K2, C, iodine and NAC put in a tblsp of coconut oil to help absorption of fat soluble vitamin D; instead of getting sunshine and activity at 7 am as is in your book, people in northern latitudes lacking the sun, could do this to trick the body into thinking its gotten sun and its daytime via morning vitamin d supplementation.

    3. I could have majority of my carbs at dinner. My only concern is that if i exercise in the morning won’t I need majority of the carbs then, or would 25grams post workout at 10 be just fine to reduce the stress and avoid any negative affect. Followed by 50 grams for lunch. And majority; 100grams at dinner, giving a total 700-800 carb calories for the day.

    Any advice is appreciated greatly!

    Darren Smith

    • Obviously not Paul here, but I do wonder about that daily workout.

      How strenuous is it? maybe you are doing too much too often? Perhaps try just walking outside in the morning a few days and see what happens. give it a week or two. If you see better sleep patterns that would indicate that you have been stressing yourself by over exercising, even if you don’t feel stressed.

      From what I have read we each have our own best pattern for exercise, and the down time is just as important as the workout. Tuning in to your own needs is better than sticking to a rigid schedule because so many other factors come in to play.

    • Hi Darren,

      I think having vitamin D at mid-day is OK. You could try taking it in the morning during your fast. It might help.

      I would take the 0.5 tsp salt with your meals.

      I think the adrenal fatigue is a plausible theory. You could try eating more carbs and maybe a bit of honey in the evening, and then maybe a small snack with protein in the morning upon waking (eg a boiled egg).

      You also might try getting thyroid status tested by your doctor.

      Yes, you can shorten the fast, see if it helps.

      I do think it’s good to eat post-workout.

  15. I am trying to find the best version of a paleo diet for me. Your recommendations in the book seem to go very well with my system and the way I grew up in Mexico City. However, there is a nagging problem that seems to persist in my body. Everytime I get a check up, my blood panel shows me with extreme low levels of iron *9-10 units. I follow the doctors recommendations and take over the counter supplements for a while until the levels are ‘normal’ again. A year later, when I need another panel, it is low again. I also feel it in my energy, and sometimes even suffer vertigo and a sensation of dizziness.
    I have a feeling that this is very connected with my ability to absorb nutrients due to a digestive problem. (I go from constipation to diarrea quite often) I am just not sure what to do because in the past fiber or detoxification products have made my stomach really sensitive. Can you help me?
    Elena Bonifaz

    • Hi Elena,

      Once tactic is simply to try to absorb more iron. Two steps for that:
      – Take vitamin C, say 1 g or 500 mg, with every meal. Vitamin C chelates iron and promotes its absorption into the body.
      – Eat plenty of beef, lamb, and goat including organ meats such as liver.

      You are probably right that you have some sort of gut dysbiosis which is inhibiting absorption or causing theft of iron by gut microbes. The best course in such cases is to get stool testing or other diagnostic testing to see if the condition may be treatable; and to work on various dietary and supplemental tactics for improving digestion and promoting normal gut flora.

      Best, Paul

  16. Hi Paul,

    You mentioned somewhere on the blog that Shou-Ching is allergic to coffee. I was wondering how you determined that? I think I might be because it seems to cause me much more anxiety than it does most people. I’d be grateful for any input you might have.

    Thank you!

    • Hi Kristen,

      I think we said she was sensitive to it, not allergic; it could disturb her sleep even if she drank some in the morning. In Shou-Ching’s case I think it was due to some deficiency in detoxification pathways, as the problem goes away when she is better nourished — it appears when she doesn’t supplement and undereats.

  17. Hi Paul,

    I got into dietary research while looking for help with chronic fatigue syndrome. I had bronchitis, then shingles in 2008 and have not been the same since. Stopped eating gluten the same year and it immediately resolved bad GI issues which I was taking a PPI for. Lots of antibiotics over the years for various things.

    I’ve been enjoying PHD for more than 18 months now, lost over 40 pounds eating lots of great food. But still have chronic health problems, especially excess night time sleeping, daytime sleepiness, fatigue, constipation, etc…

    I could use some help in hacking this to find the root cause, and any dietary or supplement changes that would help. I have numerous tests results and tried many many supplements, too much to list here. Dysbiosis and yeast/fungi are what I’m focused on now based on stool tests.

    I should note that I’ve had complete acute remission on 4 separate occasions. That was from biotin, raw sauerkraut with meals, increased water intake, and undecenoic acid. Each time lasting about a week.

    I have tons of details I could provide, but does anything jump out at you?

    Thank you,

    • Hi David,

      Nothing obvious jumps out at me. At least some things have gotten better. I do believe remaining symptoms are due to infections / gut dysbiosis, and your history of chronic fatigue, bronchitis, and shingles are consistent with that. Dysbiosis and a fungal infection, if they showed up on a stool test, are plausible therapeutic targets. You could try anti-fungal treatment and if that doesn’t fix the dysbiosis, perhaps a fecal transplant.

      Anti-fungal foods include most vegetables, especially green leafy vegetables, sulfur-rich vegetables like onion and garlic, olive oil, and most spices.

      I would try to focus on the most nutrient-dense versions of PHD. Ie potatoes rather than rice, organ meats over muscle meats, shellfish over fish, etc.

      • Hi Paul,

        Oh yes, things have definitely gotten better with PHD. I came from a gluten-free standard american diet (GFSAD :smile:), eating out 3 times a day. I was already off gluten for two and a half years before PHD, but transitioned quickly and almost live in the kitchen now. I’ve lost over 40 pounds since starting PHD and have maintained it easily for quite a while now. Thank you guys so much for your work. Glad I found it first before going on to read books on Paleo and Primal. I’m just about finished with the 2nd edition of PHD, awesome work.


  18. Hi Paul,

    I just purchased and read your book and have decided to adopt the PHD. To do so I need your advice on how to revise the supplement regimen I started 10 years ago at age 50 after being diagonsed with heart disease.

    Each morning I drink a protein shake made of whey protein, almond or coconut milk, ground golden flax seed, a banana or blueberries, and a powder of Red Yeast Rice, CoQ10, MSM and Cholostrum. (The latter two ingredients are included for treaqtment of oteoarthritis.)

    Each afternoon, I take a Tyler multi-plex 2 vitamin without iron, a gram of Tyler Niacinol, 162 mg of asprin, 1 capsule of Tyler lipotropic complex, 300 mg. Vital lipoic acid and 70 mg of Pure l-arginine HCL.

    I belive that the noted regimen, along with increased exercise and a balanced (but not “perfect”) diet has significantly improved my heart health over the last 10 years.

    That said, by my reading of your book it seems I should eliminate from my diet and supplement regimen the whey protein, flax seed and niacin.

    Is that correct?

    Are there any other changes you would recommend?

    Thank you for your help.


    • Hi Grant,

      I think the supplement recommendations in our book are pretty much optimal for heart disease. Extra supplements may be useful as therapies for gut dysbiosis, but also in that case fewer supplements (or lower doses) may be indicated also.

      I would drop the red yeast rice. Whey protein is OK but favor eating whole foods (meat, fish, eggs) for protein because they have a wider range of nutrients. I don’t recommend almond milk, but coconut milk is good. Flax seed is OK in moderation. Banana and blueberries are good. CoQ10, MSM, and colostrum are fine.

      We don’t recommend multivitamins or niacinol (see this post: http://perfecthealthdiet.com/2011/04/how-to-raise-hdl/). I don’t know what the lipotropic complex is. Aspirin is a two-edged sword, I think once you’re on PHD it may be a negative. Lipoic acid, maybe. Arginine HCl, maybe. I think spinach for nitrates would be better, betaine HCl if you need stomach acid.

      It’s mostly OK, I’d probably do away with the Tyler products first and replace them with our supplement recommendations.

      Also, follow the circadian rhythm therapies in the book.

      Best, Paul

  19. Hi Paul,

    Question on diet. For someone with a possible parasitic infection:

    Do I need to avoid
    1. Liver (beef/organic/grass-fed)?
    2. Yolks?
    3. Veg/Fruit (due to the fiber)?

    Anything else I should avoid? Anything I should be eating more of?

    • Hi Monnyica,

      1. No
      2. No
      3. No

      You could try therapeutic supplements like bentonite clay, undecylenic acid, DGL, etc. But I’m not that knowledgeable in these things. I wouldn’t alter the diet unless you find that you are hungry. Then I’d try to add in whatever relieves the hunger.

  20. Hi Everyone,

    Do you any of you smart people know anything about functional B12 deficiencies? Here’s the issues I am having–I have been following PHD/Paleo for a long time. I take all the recommended supps and whatnot. I am generally in good health, but have a few nagging issues and one that is just getting worse as the days pass. The main issue is neuropathy. I have had numbness and tingling in hands and feet off and on for a few months and it is not getting any better. I visited my reg GP and she sort of brushed it off… she ordered a B12 test and then when that came back slightly elevated she just blamed the neuropathy on stress. So, fast forward a few weeks.. I am on longer in the midst of super stress (I moved out of state) and it is not getting any better. I went to see a functional medicine doc and he suggested that the elevated B12 may be due to an inability to either absorb or convert the B12 in my food. So, we ran another blood test… I guess to check organ function and what not. The results have yet to come in.. but as far as I have read the functional B12 deficiency is really hard to determine even with a metabolites urine test. So.. just wondering if anyone has had any experience with this before?

    I should note that prior to going Paleo a few years ago I was vegetarian for 13 years and vegan for 1.5 years. I also have recurring acid reflux which could indicate a problem with absorption of B12? I have read something about the lack of stomach acid inhibiting absorption…. it has come and gone for years. I have maybe once a year a few week bout of what seems like IBS… I am generally irritable, but not to extreme. And thats about it. No fatigue, I’m never sick, etc. I had a stool test which didn’t show anything. That’s all I can think of. Anyone have any thoughts? In the alternative world this functional B12 thing seems like common knowledge and even a quick google search reveals that reg docs just don’t know how to interpret B12 results, but it would be helpful to hear from some actual people about their experiences.

    Many Thanks,


    • What is your exact value? I’d just give 5000 mcg B12 pills a try (you can chew ’em or just swallow them. It doesn’t make a difference despite what many people say)
      B12 is a harmless substance that is hard to absorb. If you have a deficiency, you will see significant improvement very fast.

      I’ve had health problems for years (I wish I knew the cause) and have tried tons of supplements so far. B12 was the one that made the biggest difference. My suicide thoughts and anxiety was gone after 2 weeks and it has stayed that way for 2 years now. Realizing that I had a deficiency I emptied two bottles of high dose B12 in just a couple of weeks. 🙂
      I’ll never be deficient of that stuff again.

  21. Hi Kevin,

    My value was 1257 pg/ml… the upper end of the range was 900. The only problem is I think I had taken about 2000 mcg that week so maybe that affected the result? I think maybe it would be wise to retest before I start. I don’t know.. maybe I will just try the high dose supplement as you suggest. Thanks for your thoughts.


    • Hmm, that is quite high. I think you should check out the book ‘Could It Be B12?’

      You should not have supplemented B12 before taking the test :wink:. I’m not sure if it could have altered the result.

    • Hi Lindsay,

      I don’t know what to make of it. B12 is often high in infections. I doubt the supplements would have raised it dramatically unless they were taken within a day before the test, but maybe.

      Have you updated your supplements to our new recommendations? Manganese excess can cause neurotoxicity. We dropped multivitamins in part for that reason.

      Lithium which we recently added as an option is neuroprotective. We also added B6 once a week which may help.

      I would look to electrolytes (salt, potassium, bone broth, magnesium, lithium) and maybe vitamin A (do you eat liver?).

      You might try supplementing B12 as well. I don’t think it will do any harm. I don’t think high blood readings imply that you shouldn’t supplement.

  22. Thanks for answering my starch question.
    I’m trying to develop recipes and menu plans to help me in the kitchen with PHD. Can you recommend a software program for this nutrition planning? I ASSUME YOU USE SOMETHING AT HOME. I would use it mainly when developing new recipes and daily plans, and obviously it can’t be biased toward any particular diet, and would allow setting my own goals for anything. Also would need to have all micro-, macro- nutrients and details on fatty acids. CRON-O-METER is good but does not have planning/menus. Thanks!

    • Someone needs to get chronometer to combine up with my fitness pal. I’d pay for that.

    • Hi Peter,

      We don’t use any software at home, we just follow the PHD food plate and adjust according to taste.

      However, we do have thoughts of developing an online site or app that would provide meal plans, recipes, and nutritional guidance. That’s a lower priority than our cookbook and we don’t know whether we’ll do it ourselves or in partnership with existing software, but I think eventually we’ll offer something.

    • I am having a lot of luck with Cronometer.com. I find it easy to use once I set up my parameters and entered some foods of my own, and I can see at a glance what my protein/carb/lipid ratios are. It doesn’t forever hound me about calories or so-called “healthy eating,” either. You need to set things up via the website, but there are Android and iOS apps for entering information on the go.

  23. Hey Paul. Any advice for someone with retinitis pigmentosa and macular holes? Doctors have run out of ideas. She will lose vision. She might try a lot of vitamin A and omega 3. Is this caused by a pathogen do you think? Just have as good a diet and supplements as possible?

    • Hi tam,

      I don’t know what causes it, but in general I would treat it like a neurological disorder. The retina is basically a neural structure and it is behind the blood-brain barrier.

      I would:
      – Try a ketogenic diet (the ketogenic version of PHD)
      – Supplement with vitamins B12 and B6 and biotin in addition to the regular PHD vitamins. These are recommended once a week in our new book, i might try twice a week.
      – Do all the circadian rhythm tactics in our book, especially exercise and intermittent fasting.
      – I think extra vitamin A is good, get it from a mix of beef/lamb liver and chicken/duck/goose liver.
      – I would stick with the omega-3 recommendations of our book – 1 lb per week salmon. Maybe some extra flaxseed oil if she wants to go further.
      – I would look carefully into thyroid issues, and treat any subclinical hypothyroidism. Often diseases that benefit from extra vitamin A also benefit from thyroid hormone.
      – Optimize vitamin D and in general follow the advice of our book.

      Best, Paul

  24. Hi Paul,

    2nd try.

    I just purchased and read your book and have decided to adopt the PHD. To do so I need your advice on how to revise the supplement regimen I started 10 years ago at age 50 after being diagonsed with heart disease.

    Each morning I drink a protein shake made of whey protein, almond or coconut milk, ground golden flax seed, a banana or blueberries, and a powder of Red Yeast Rice, CoQ10, MSM and Cholostrum. (The latter two ingredients are included for treaqtment of oteoarthritis.)

    Each afternoon, I take a Tyler multi-plex 2 vitamin without iron, a gram of Tyler Niacinol, 162 mg of asprin, 1 capsule of Tyler lipotropic complex, 300 mg. Vital lipoic acid and 70 mg of Pure l-arginine HCL.

    I belive that the noted regimen, along with increased exercise and a balanced (but not “perfect”) diet has significantly improved my heart health over the last 10 years.

    That said, by my reading of your book it seems I should eliminate from my diet and supplement regimen the whey protein, flax seed and niacin.

    Is that correct?

    Are there any other changes you would recommend?

    Thank you for your help.


  25. Didn’t you post this yesterday? Do you expect an immediate response?

  26. I love the new edition of the book! It’s great to have the expanded table of contents and index. I also like the reader comments mixed in.

    My question is about tuna…I didn’t find it on the list of various proteins and I know there are concerns about mercury. So, to eat or not to eat, that is the question!


    • Hi Deedee,

      Yes, mercury is the reason we don’t recommend tuna. Otherwise sashimi would be a great way to get omega-3!

      Use your own judgment about whether it’s worth the risk. We don’t have any special insight.

  27. Hi dr.jaminet.
    As I told you a while ago I have IBS, which I am currently treating with a modified GAPS diet (I have included safe starches into the diet).
    However I just read your posts about fecal transplant and am intrigued.
    Do you know if fecal transplants are available in australia? I tried to find it on google but had no such luck.

  28. Hi Paul and/or others,
    I know questions about the blood type diet have been asked several times and, in the new PHD, P & S-C indicate it should not be a factor in considering the optimum diet. One of my adult sons continues to follow the type O diet, allowing his new copy of PHD to gather dust on the shelf. The type O diet is very paleo and similar in many respects to PHD, so I’m not overly worried, but am curious.

    I have the original book, “Eating Right 4 Your Type,” which is said to have been updated in “Living Right 4 Your Type.” On the hunt for whatever scientific foundation there may be for this diet program I’ve been reading the first 50 pages, to which I paid little attention when I first read it several years ago. In these pages, the author talks about the evolutionary path of the blood types and the appearance of the different antigens. He also describes the issue of problem foods being associated with lectins that bind to the antigens of the different types, creating problem reactions to certain foods. Apparently, specific lectins from foods can be obtained from labs and then tested on the different blood types and the reactions observed microscopically. Then, he describes the Indican Scale as a “…more direct scientific barometer that can be used to measure the presence of lectins…” (p.27) The claim is that avoiding the foods that contain “toxic lectin proteins or foods that are difficult for your particular blood type to digest, your Indican Scale will be low.”

    My question: I am wondering if “agglutinating lectins” is a fact, and becomes a problem when the gut is permeable.

    Searched for an answer and found this link detailing a debate between D’Adamo and a couple critics, but the scientific details call for more time than I’m going to have for a while. http://www.owenfoundation.com/Health_Science/Pusztai/btd/dadamo_rebuttal.htm

    Here’s another: http://en.wikipedia.org/wiki/Talk:Blood_type_diet

    I know I should digest these myself, before passing them off to others, but if anyone shares this interest and would like to sort through it out of curiosity, I would love to read reactions. Working weekend, so I’m gone for the day.

    • Hi Lana,

      Lectins to bind sugars and can agglutinate cells. However, just because mixing lectins with blood leads to agglutination doesn’t mean that eating the lectins is a problem. Most lectins are destroyed in cooking or in the digestive tract, or don’t enter the body.

      I haven’t investigated the evidence behind Dr D’Adamo’s ideas so I can’t say there’s no basis for them, but I don’t think very many scholars believe in them.

      Best, Paul

      • Thanks for your reply, Paul. I did another search and found a book review on WAPF website, with comments from Masterjohn. Here is that link: http://www.westonaprice.org/thumbs-down-reviews/eat-right-4-your-type

        I have a weird question, and don’t know if you can get to it today. I’m not joking; I’m really serious. Tomorrow is my birthday and I’m thinking of taking a half day of personal leave and going to a spa with an assortment of hot rooms. Thought I would finish off the 1st reading of the book. The price is half off on birthdays.

        My question — I am considering the Swedish body scrub, but have learned that they use Dial soap, which kills stuff. Women love this treatment and I’m ready to “love” something like this, but don’t want to decimate my body flora.

        Do you have an opinion about such treatments? I feel certain they would not allow me to bring my own soap.

        Sorry for the weirdness.

        • Hi Lana,

          I think skin flora is pretty hardy. Even if it is disturbed by the soap, it will recover quickly. Shake hands with someone and you’ll pick up theirs; within days the species will spread along your skin. Other bacteria float through the air shed from others’ skin and land on us.

          So I wouldn’t avoid a spa for that reason.

  29. Paul – Chris Kresser blogged on the ‘safety’ of nitrates and nitrites recently. He seemed to hedge on commenting on sodium nitrate, which is commonly used in ‘country bacon.’ and other ‘cured’ meats. I’m working on having my butcher make some jerky from one of our grass finished beef. The USDA is requiring him to use sodium nitrate in the jerky (which seems to be a misunderstanding of the nature of jerky, but, that aside, do you think sodium nitrate in a grass finished jerky product should be of concern to PHD folks? Thanks for all of your hard work!! (an interesting point: although the cliental for my grass finished meat is health conscious, most everyone prefers our bacon when it is ‘cured’ conventionally with the nitrates over the ‘celery’ ‘cures’ and whatnot)

  30. Doctor Jaminet,

    I was just doing some reading online and came across some articles mentioning that potatoe skins contain toxins.

    What are your thoughts on eating potatoe skins? Should they be avoided or embraced? Are sweet potatoes any different than white when it comes to the skin?



    • Hi J,

      Potatoes do generate toxins in their skin when they feel threatened, for instance after they are exposed to light or warm temperatures or their skin is punctured.

      If you know your potatoes have been properly handled (dark, cool, dry conditions) since harvest, then commercial potato varieties will be low in toxins and it’s fine to eat the skin. If you think they may have been exposed to light etc, then it may be prudent to peel them.

      • Great to know that. Thanks Doctor Jaminet.

        Also, are you saying that most commercial potato varieties have been handled properly and do not contain toxins?

        • No, I’m not saying that. I’m saying that at time of harvest, commercial varieties have very few toxins. What happens between harvest and your eating is highly variable.

  31. Hello,

    I have candida so would like to try a phd.
    I’d like to add some coconut oil , but I’ve seen you say this is bad as it induces ketosis- am I reading that right?

    Surely if I maintained adequate carb levels I could avoid ketosis with a moderate level of covonut oil?

    Thanks, houstin

    • Hi Houstin,

      Coconut oil is fine, maybe beneficial in moderation. I wouldn’t exclude coconut milk from the diet. But I wouldn’t take large quantities either, because yes, ketosis promotes Candida invasion of the body. Maybe 3 tbsp per day coconut milk would be a good amount to limit yourself to.

      High phenol extra virgin olive oil is a better anti-Candida oil.

      It’s also a good idea to maintain adequate carb levels.

  32. Ok, great, thanks!

    How do I know if olive oil is high phenol or not?

    Houstin m

  33. Alas, price is often not a reflection of food value in olive oils. You can find out about high quality olive oils at Tom Mueller’s Truth in Olive Oil website http://www.truthinoliveoil.com/great-oils/north-america

    Tom is a New Yorker writer who published EXTRA VIRGINITY last year. It’s about several things related to this classic food oil. Most memorable to me is the great amt of nutritional substances that are in Real Olive Oil (in fact, it’s conjectured that the benefits of the actual Mediterranean diet may be tied into have access to REAL OLIVE OIL ) which are simply not present in stale or heavily processed commercial olive oils. Another point he makes is that consumers allowing themselves to be fooled into buying low quality oils at high pricess are forcing the old olive groves of Italy out of business! If American consumers don’t get wise to what they are missing not just in taste but in nutrition by buying industrial olive oils rather than real virgin olive oils, high quality olive groves will simply disappear. The website I gave you a link to earlier in this post is the way to get informed about nutritionally valuable brands of olive oil so you can VOTE WITH YOUR FORK for olive oils of high value traditional quality

  34. Hi Paul – love the new book. Have a hard copy and Kindle copy :). I am trying to get a handle on adrenal fatigue, and I know I have some lifestyle issues to deal with (not just nutrition) and am implementing the circadian rhythm recommendations. However, I was wondering about: (a) restricting eating within an 8 hour window – would you recommend this for someone trying to recover from adrenal fatigue/thyroid problems (low calcium, magnesium, potassium and sodium levels) and (b) any recommendations for dealing with the sugar craving. Trying to lose the weight that I have put on over the last couple of years as well.
    Thanks for your thoughts.

    • Hi Caroline,

      I think I would avoid the full intermittent fasting until your adrenals are doing better, but you can partially implement it as you feel able — eg instead of a full breakfast have a small snack, like a hardboiled egg with salt or a banana. The key thing is to listen to your body and give it what it needs.

      I would not work on weight loss until your adrenals feel better.

      Sugar cravings usually indicate you aren’t eating enough starches. I would try to focus on high-fiber starches like white potatoes.

  35. Paul – we spoke of this the other day but I didn’t have my reference at the time. Here it is, From “Vitamin D and the Calcium Paradox” by Dr Kate (who was recently interviewed on Mercola) “Beyong the 40th parallel the sun is too weak to convert any vitamin D in the winter and summer production is blunted, as well. In North America, this encompasses the northern half of the United States and all of Canada, as well” p215 I’ve contacted Dr Kate’s publisher to interview her on this and other issues brought up in her book and in the Mercola interview (she advocates huge doses of K2 if one is supplementing with 10,000iu D3) but I can’t even get the courtesy of a refusal. I cannot find her direct contact info online anywhere. Wish she’d follow the Dr Jaminet example of reader support!

    So, do you rely on sunlight for vitamin D levels there in Boston?

    • Hi Allan,

      Not in the winter but I do in spring, summer, and fall. I calculate one needs about 15 minutes at the summer solstice and 1 hour outdoors at mid-day in the equinoxes with significant skin exposed. So I try to go running shirtlessly for 45 min at mid-day in spring and fall. In spring and fall I supplement 2500 IU on days I don’t run at mid-day. In winter I supplement daily, alternating 2500 to 5000 IU.

  36. Hi Paul,

    I wish you and Shou-Ching a beautiful, healthy, and joyful new year!

    I have a question about GI in metabolically impaired persons. Excuse me if you’ve already covered this somewhere.

    I was reading up on the glycemic index and came across this quote: “…the Glycemic Index does not tell you how much insulin the body had to secrete to process the glucose that resulted from the digestion of this food when it finally did digest”
    from: http://www.phlaunt.com/lowcarb/22168238.php

    I don’t know what to make of it because I know a lot of us have had great blood sugar control with the PHD. I’ve experienced it and so have a number of other PHD eaters.

    Is it possible that ultimately, something around 150g carbs/day can still be toxic to a diabetic even if eaten in split portions, in mixed meals containing fats & an acid?


    • Hi Andrea,

      My belief is that for most (type 2) diabetics, 100-150g per day carbs will minimize toxicity. It should also increase insulin sensitivity and reduce insulin secretion after a carb meal.

      Jenny’s critique of the glycemic index is actually supportive of PHD — some have criticized us for including high glycemic index foods like white potatoes and white rice, and said that “safe starches” may not be safe for diabetics, which I disagree with, as long as the quantity is appropriate and they are eaten in meals with fat, acid, vegetables, and such.

  37. Hi Paul,

    Congratulations on the new book! Its really nice.

    I am being treated for cpn, for an long, unknown chronic illness, maybe caused by a gut infection, which I previously posted about here. My doctor uses a modified Stratton CAP. I am also being treated for hypothyroidism, taking T4 which helps immensely with the food intolerances. I am having negative and then eventually positive reactions to the antibiotics, especially the tinidazole pulses, so I know I am going in the right direction.

    My question has to do with taking “moppers” (e.g., charcoal, bentonite clay, cholestyramine) and I would ask on cpnhelp.org, but there is little response there, and I don’t think anyone would understand the mechanism. I don’t take any of these “moppers” on a regular basis, but I can tolerate charcoal powder just fine when I do take it. I recently tried 1 tsp. of bentonite clay, based on your more recent recommendations to others. However, I had a pretty severe, negative reaction: woke up next day with headache, throwing up bile, sick all day sort of thing. Even a tiny amount a few days later caused a similar, but not as severe reaction. Do you know what the mechanism is for such a bad reaction? I have not found any descriptions of bad reactions to bentonite except constipation, and I am sure it was the bentonite (and it is the ingestible kind). I will ask my doctor, but his explanation of a one-time bad reaction to charcoal was not very satisfactory – or at least my understanding. He said it isn’t exactly like a sponge, but that as it is exiting the system, it can cause problems. Do you have any idea of how this would work? Thanks in advance!

    • To be specific, what I was wondering, is if my negative bentonite reaction might indicate something about my liver’s ability to detox?

      • Hi Naomi,

        Clay isn’t something the liver should normally have to gather and excrete, as it shouldn’t be entering the body. So I would worry more about the state of the digestive tract.

    • Hi Naomi,

      “Moppers” are tricky for several reasons. One, which doesn’t appear to be your problem, is that they not only mop up microbial cell wall components and other toxins, they mop up nutrients and your own molecules that are supposed to recycle, such as bile. So they can easily induce lipid deficiencies and other nutritional deficiencies if overused.

      In your case, it seems like you have some sort of intestinal permeability or lack of mucus (maybe due to antibiotics and NAC which is mucolytic?), and the clay is irritating the cells of your digestive tract or getting into the body and causing the nausea / vomit reflex.

      I would avoid it until your gut heals. You may want to consider reducing NAC or anything else you are taking that may be disturbing your digestive tract.

      I would watch also for reactions to charcoal, eg does it lead to discoloration of urine, as it might be entering your body too.

      Charcoal is porous and has a lot of surface area, and things tend to stick to its surface, especially fats and fat-soluble compounds like microbial cell wall components, bile, and cholesterol.

      • Ok, that makes sense. Also, this helps me with what to work on, which is to somehow decrease intestinal permeability and/or increase mucus. My doctor always says I have a leaky gut. And your explanation about charcoal being porous and things sticking to it is probably what my doctor was telling me, but I didn’t understand it at that time. Given my reactions to clay, I definitely will not be taking it again! Thanks again for clearing things up!

  38. As you’ve written Paul, fecal transplants are very promising.

    A teaching hospital in Canada is doing some trials and talking about having a fecal bank to store healthy samples. I am happy this is in the works!



    I know the initial thought in the medical community is surrounding it as a treatment for UC and recurrent C.diff infection, but I wonder when all bowel disorders (incl.IBS) will be treated this way.

    I know the leading doc in this is in Australia but, a general qn to all PHD readers, has anyone found docs in the States or Canada practicing this?

  39. Hi Paul,

    This may sound silly. I am currently growing a beard. I am interested in improving growth and quality of my beard hairs. Are there foods that you would recommend that could help?

    I have been consuming eggs, salmon and lots of saturated fats to improve health. I figure fats and protein are important for the hairs. I am still following the PHD way of life and enjoy every bit of it.

    Thanks for your time and I hope you are well.


  40. Paul,

    My wife has had eczema her entire life. It improved significantly when she first went GF and then started PHD with me (although we weren’t taking the supplements). During this time she also got pregnant (naturally, which we suspect was due in some measure to PHD, given our long history of fertility issues) and her skin was even better (as it was during her first pregnancy). Since giving birth to our baby girl in June, her skin has not been quite as good. This is perhaps expected with all the changes associated with pregnancy, but over the last 3-4 months, she’s had several extremely severe flare ups without any identifiable trigger. She’s currently in the middle of one and after seeing the post regarding Joan’s sister, we both started supplements yesterday. I was wondering if she should follow your general supplement dosages or if she should take more of anything to help aid her recovery? I’m hopeful that the addition of the supplements will help end this rollercoaster ride. Also, do you have any additional advice regarding stabilizing her eczema long term?

    Thanks again for all you’ve done and continue to do to bring sound science and reason to bear in the upside down world of conventional health/medicine!!


    Brian Priestley

    • Hi Brian,

      Maternal immunity is downregulated in certain respects during pregnancy (see eg http://www.ncbi.nlm.nih.gov/pubmed/8251183, http://www.ncbi.nlm.nih.gov/pubmed/16424182). That could be why her eczema disappeared during the pregnancies.

      Many women become somewhat malnourished during pregnancy and that could play a part in the flare ups since. Am I right that she hasn’t been supplementing for some time?

      I would follow the general recommendations and maybe take a little extra of a few things, but I would have to know what she was doing earlier in order to guess what she might be deficient in now. I wouldn’t oversupplement for long, since you know that she improved naturally just from eating a good diet earlier, it should improve fairly quickly this time with supplements added in.

      For long-term improvement, I recommend all the tactics in our book (diet, nutrition, lifestyle including circadian rhythm tactics), and then just trying to get any chronic infections diagnosed. It may be that whatever conditions she has will disappear on their own if her diet and lifestyle are good enough.

  41. Hi. Had 2 questions.

    1. I usually have 1 beer in the evening which I read contains Silicon. Would the beer negate the need to take Biosil?

    2. I haven’t gotten into the liver habit yet, so I’m taking a copper supplement. I saw someone linked earlier to a study noting copper supplements are dangerous (cognitive problems, Alzheimers). Eventually I’ll try switching to liver, but in the meantime is that a legitimate study regarding the danger of copper supplements?

    Thank you.

  42. Hi Paul;

    Is apple cider vinegar ok to drink if you have candida?

    Thank you

    • To drink? It is a strong acid and can burn tissue. It is OK to use in diluted form as a flavoring agent, eg in salad dressings or cooking.

      • I put about a teaspoon of raw ac vinegar in a glass of water and drink it. Good hot. Some add honey. No aching joints. Put a few drops in my dogs water ……old dogs….jump around like puppies. Google apple cider vinegar. Very enlightening.

  43. Hi Paul,
    Happy New Year and congratulations on the new book. It’s even better than the first!

    I didn’t want to have to bother you about this, but frankly no one else has had any idea what’s going on, and it’s seriously affecting my work and personal life.

    I contacted you a while back asking for a suggestion on what tests to get done. Based off my symptoms, you suggested getting a stool test to check for a bacterial infection.

    I haven’t been able to afford that test, but I have gotten some blood work done since then.

    Some results that stood out to me included:
    High bilirubin
    High cholesterol (258 mg/dl) with an LDL of 154
    Normal triglycerides
    High hemoglobin and high hematocrit
    Negative ANA (for autoimmunity)
    Normal TSH
    Normal C-reactive protein

    Currently, my most predominant symptoms are fatigue, brain fog, memory loss, inability to concentrate, muscle weakness, dry eyes, and bloating.

    I just wanted to know if you think I should still get a stool test based off my lab results.

    Sorry for the long question, and thanks for all that you do. You’re a real life saver.

    • Hi Spencer,

      The short answer is that I don’t know. The reason I recommend it is that if it turns something up, you can trust the result and it is almost always treatable. But I don’t know that it would turn anything up, so if money is tight, I can understand going without.

      It seems like the high bilirubin is somethign a doctor could investigate.

      Search in our search box for “high LDL on Paleo” for some possible causes of that.

      Also, the normal range for TSH is much too broad, you might want to read our hypothyroidism series for that. Hypothyroidism can cause high LDL so that would explain two things.

      Best, Paul

  44. Hello;

    Do you think the more sugary vegatables like squash, eggplant, radish, etc are ok fro somebody treating candida albanicans overgrowth?

  45. Hi Paul and community!

    I am wondering if anyone knows anything about lymph/blood cancers? I know that Paul tends to think that most chronic illness is the product of infection, but is this the same with things such as lymphoma? I know that Hodgkins does have some correlation with EBV, but it’s not always associated. I ask because a family friend was recently diagnosed and apparently the doctor told her that while some cancers can be attributed to life choices and diet, i.e, breast and colon–lymphomas and blood cancers are a different beast and cannot be prevented. Sort of a luck of the draw sort of thing. This of course made my friend more uneasy.. so I am wondering if you have any thoughts on that?

    Are blood and lymph cancers in their own category assuming one doesnt have genetic markers or anything like that? Is there any special nutrient that one with blood/lymph cancers should apply to their diet?



    • Hi Lindsay,

      Wheat sensitivity is strongly associated with lymphomas, see http://perfecthealthdiet.com/2010/10/the-red-sox-usda-diet-lymphoma-and-vascular-malformations/. 10% of all celiac patients develop lymphomas.

      So I would have your friend stop eating wheat.

      Infections or gut dysbiosis are another likely cause.

      Vitamin D and vitamin K2 are good nutrients to get.

      • Hi Paul,

        I read through that post about the Red Sox. How interesting! I am especially intrigued by the affect K2 had on AML. However I noticed the dose was 45 mg. The dose of a common K2 supplement is generally 100mcg. Would it be wise for a blood/lymph cancer patient to way up their dose of K2?


        • Hi Lindsay,

          I would, but there haven’t really been dose-response studies made. Vitamin k2 is considered to be safe in very large doses, but expense is a consideration.

          • So, in consideration of cost I have been brainstorming some food source options of K2 to recommend. I know that natto is a great source of K2, but isn’t really suitable to most western palates. However, shouldn’t miso also be a great source of K2 as well? Is there something different about the fermentation process of miso compared to natto? In my mind something as simple as miso and kale soup eaten a few times a day should be a vit K powerhouse.

          • Hi Lindsay,

            I would suggest aged cheese as the most delicious source of K2 myself. Also fermented mixed vegetables at home. Miso is OK, not sure how much fermentation commercial products have gone through.

  46. Thanks for clarifying!


  47. Hi Paul,

    Quick question.

    I want to order a choline supplement and am not sure if I should get just choline or one with inositol included with it. What’s your take on this?


    • Hi kimanyd,

      I might get one of each and alternate them. A 500 mg choline and 250 mg choline/250 mg inositol supplement on alternate days would average to 375 mg choline / 125 mg inositol which I think is pretty good. If you’re pregnant and don’t eat liver you might look for a little higher dose than that.

  48. Anderson Armstrong

    Hi Paul;

    I’m wondering, what exactly is this “candida die off” I keep reading about? People say that if you start eating a good diet to treat candida, you should start feeling much worse initially or you’re not doing it right. This is is explained by the candida “dying off” and releasing toxins in the process.

    What do you think? Sounds silly to me- surely once you start eating properly to treat a condition that makes you ill, you should feel better right away- right?

    • Hi Anderson,

      Die-off is a known phenomenon and Candida can produce symptoms that resemble environmental mold toxicity, but I don’t think in practice that Candida infections generate very strong die-off symptoms. The treatments aren’t effective enough to make them all die at once, and Candida doesn’t replicate quickly enough to be constantly producing new toxins. Bacteria which replicate quickly and for which we have more effective antibiotics are more likely to produce noticeable die-off effects.

  49. Hi Paul,

    Jus wondering if you have any thoughts for me. I have a chronically stuffy nose. It’s not stuffy because of snot, but its as if the nasal passages swell up and either block the airflow completely or partially. Sometimes both nostrils are blocked or stuffy, but other times its one nostril which is blocked and one is clear and then it flips.

    I’ve had this since I was a kid (now late 20’s).

    Any thoughts on what it might be?

    Thanks, J

    • for the alternate nasal congestion symptom,
      a normal phenomenon known as the nasal cycle could be an explanation.
      see http://en.wikipedia.org/wiki/Nasal_cycle

      “The nasal cycle is the alternating congestion and decongestion of the nasal cavities in humans. It is a physiological congestion of the nasal concha due to selective activation of one half of the autonomic nervous system by the hypothalamus. It should not be confused with pathological nasal congestion.”

      “This cycle, which is controlled by the autonomic nervous system as described above, had a mean duration of two and a half hours.”

    • Hi John,

      First, if you take an antihistamine like a Claritin does it clear the nasal swelling?

      Is it connected to thyroid – eg if you take lithium does the swelling reduce?

      Fungal infections are slow-varying and can cause rhinitis/sinusitis as well as immune reactions and inflammation, so that’s a possibility.

      I don’t know but it should be possible to explore some possibilities and maybe figure it out. What have the doctors said?

      • Thanks guys.

        I’ve never tried an antihistamine or lithium. I’ll try those and see what happens.

        Doctors are clueless it seems. I did see a Ears Nose Throat doctor years ago. He just gave me a nasal spray called Naselnex (its a corticosteroid). It never did anything.

        I’ll have to keep experimenting.

  50. victoria forsyth

    Hi paul, do you have any thoughts about why the unit (and the team of anthropologists who ate their diet for years on end) did/do not appear to suffer from symptoms of carbohydrate deficiency? thanks.

    • Hi Victoria,

      Is “the unit” referring to the Inuit?

      Healthy people will generally be able to tolerate a very low-carb diet, though it might show up in shortened lifespan. However, people will be less able to cope with certain infections and other stresses on that diet. So you don’t necessarily expect health problems to show up immediately.

      • victoria forsyth

        sorry I meant the Inuit, yes.
        Ok, but what about the Inuits who eat very low carb diets for life? Do they suffer from carb-deficiency symptoms? OR have we not had the relevant medical investigations done to determine that? Thanks.

        p.s. I also noted that you didn’t mention some of the more common side effects associated with very low carb or ketogenic diets; such as acidosis, hypoglycaemia, bone fractures and kidney stones.

        • Hi Victoria,

          Yes, for the most part we’re lacking good documentation of Inuit on their traditional diet. We have Weston A Price’s testimony that they had good teeth, but even in his day he had to go to very remote places to find Inuit on traditional diets. He wouldn’t have detected carb-deficiency symptoms if they existed.

          From preserved bodies we know that Inuit a thousand years ago had atherosclerosis and smoke damage from fires within their homes / igloos. So their health was not perfect.

          I think I did mention bone fractures and kidney stones. Eg http://perfecthealthdiet.com/2010/11/dangers-of-zero-carb-diets-iv-kidney-stones/

          • victoria forsyth

            Ah so you did. My thoughts are that the most common side effects of ketogenic diets are likely caused by excessive protein intake.
            I think it would be possible to avoid these side effects on a ketogenic low protein diet, such as dr.Rosedale’s diet.

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