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)

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

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:

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.

10,274 Comments.

Lynn S January 29, 2013 at 9:02 pm

Here’s my problem: I’m on warfarin, which strips vitamin K. I cannot stop taking it; I had to leave the Native Nutrition email list because Chris Masterjohn would not let up on me to get off it. I have a clotting disorder and a bunch of wires running through a stenosis in my subclavial vein; I just can’t risk managing my clotting with natto, garlic and what have you. So what do I do about vitamin D? I had it tested recently and my doctor raised my supplementation to 2,000 IUs. Do I just need to take more D to get my levels up?

Reply
- daRIUS January 29, 2013 at 11:22 pm
  
  or lots of sunlight. u can even go to a tanning booth that focuses on the uv-b radiation.
  
  Reply
  - Stephie January 30, 2013 at 12:15 am
    
    Datius, I’m the same… Tanning helps me function better too. If I may ask, can specify what ur diet is like per meal and ur macronutrients.
    ?
    
    Thanks
    
    Reply
    - darius January 30, 2013 at 12:25 am
      
      i do not count macros anymore, but my diet is pretty much PHD (i eat lots of offal and weird foods like tendons and stuff – i go way out of my way to find these foods) except instead of starches i eat raw honey, pineapples, and occasional sprouted corn tortillas from “food 4 life” brand fried in kerry gold butter. the reason is that large quantities of starchy carbs screw me up very badly with all sorts of ibs, but simple sugars do not. cyclically i will fruit binge until fruit tastes awful, and white sugar is not a problem, but i prefer raw honey and add it to lots of things throughout the day.
      
      recently i have added back into my diet boiled/steamed/sauteed leafy greens such as arugula and dandelion. for a long time veggies would trigger my ibs, now they don’t as long as i cook them well and include them with a meal.
      
      i try not to eat nuts, seeds, or excessive fermented foods or fibers. cheese is also a problem in more than minimal amount. milk and grains are no-nos, this includes rice and rice derived products, altho a bit once a week maybe won’t destroy me.
      
      the only fronteir i have left to cross in food-land is adding edible insects to my diet. i have literally done everything else and i have come to the conclusion that food cannot cure me from my ills (because soil quality and our environment is really devoid of life force), but it CAN make me worse if i’m stupid about what i ingest.
      
      Reply
Eve January 29, 2013 at 9:36 pm

Hi Paul,

I found you after getting heart palpitations from a Ray Peat inspired diet. (Lots of fruit and OJ with some starch from potatoes). This post really spoke to me regarding the rat adrenaline response to fructose… http://perfecthealthdiet.com/category/diets/ray-peat-diet/.

I have to say that following his diet, I didn’t get any bowel issues. In fact, I had no gas, cramping, etc. and had the littlest gut pain ever.

But, then, I started to get dark circles under eyes, palpitations, nausea and itchy skin. My neck then started to constantly “lock up” and my joints creaked and ached more than ever. (I think this could be from the high amounts of dairy I was consuming.)

I’ve tried so many different plans/protocols trying to get better including an anti-candida diet for 7 months which had under 50 grams of carbs, all from vegetables, and 70% of my diet coming from coconut oil and butter. Didn’t feel terrible on it but didn’t solve my health issues.

My main issues are thyroid, which I currently take a T3/T4 blend, but don’t have any antibodies issues. I have terrible fatigue, almost arthritis-like shoulder pain (feels like a knife in my shoulder blade) and I’m only 37. I have degenerated C7-C8 discs so am hoping the vitamin K will help. My bowel hurts if I eat off of PHD, or too many raw salads, but is relatively OK otherwise. I also have geographical tongue (have you ever heard of this?!) and had a dog while growing up (who licked me a lot) so have always thought there was a yeast/fungal/parasite issue going on. Confusing though because my anti-sugar diets, while taking antifungals didn’t make it go away. Having said that, the higher fructose/sugar diet (a la Ray Peat) made me feel worse, worse, worse. For years, I took clay which makes me feel better, as does charcoal.

Long and short, do you have any sense what could be underlying my issues? Just feel like giving up as I’ve tried for over 12 years and eat clean, clean, clean and yet feel worse than people who eat junk food daily. I pray that God may heal me as nothing I’m doing seems to be helping my condition 🙂

Thanks so much for your thoughts. Just ordered your new book and can’t wait to learn more.

God bless you,
Eve

Reply
Peder January 30, 2013 at 1:37 am

Paul, I have been taking high doses of vitamin D3 to reach what I thought was the middle of the optimal range, 60 ng/ml. Since I weighed 360 lbs I needed 14,000 IU per day. I have tested and was 58.6 ng. To reach your recommended level of 40ng I am dropping to 12,000 (each 1000 IU accounts for 10ng apparently).

Even if I eat liver (very hard to eat for me) as recommended in PHD I will not get anywhere near the 3:1 ratio of vitamin A to D and keep calories low enough to continue losing weight and control blood glucose — I’m type 2 diabetic. Should I supplement vitamin A?

Another issue is K2. I may be in D3 toxicity without enough K2, right? According to Dr. Kate Rheamue-Bleue (The Calcium Paradox) in a video on Dr. Mercola’s site, I should be taking 100ug or more K2 per 1000 IU D3. I know you recommend 200ug OR MORE total, it’s not clear the actual amount you would recommend. If Dr. Kate is right, I would need to take 1800ug K2. If I bought MK-7 I would be in the poor house soon. I’m considering MK-4 such as Thorne Research liquid K2, plus 100ug MK-7 daily. Your thoughts on my issues would be greatly appreciated.

Reply
- Wout January 30, 2013 at 2:59 am
  
  Yikes! The PHD-recommended daily VitD uptake should be 4000 IU from all sources.
  
  Your body actually stores excess VitD in your fat…
  
  Reply
- lolwut January 30, 2013 at 10:57 pm
  
  I don’t know how you calculated your vitamin D intake, because you need to cut it dramatically. I’d stick to 1000 IU a day for a few weeks to clear up some of that excess and then make sure to get `4000 IU a day from all sources once you’ve reached 40 ng/ml.
  
  Reply
  - Peder January 31, 2013 at 12:53 am
    
    I don’t know why you think 4000IU will get me to stay at 40 ng/ml. I would be seriously deficient. There’s a rule of thumb calculation for D3: 1,000 IU for each 25 lbs of body weight to get to the middle of the Vitamin D Council optimal range (50-70 ng) or 60 ng. See my post and note my weight and that I correctly calculated how much I needed when I thought I needed 60 ng (got to 58.6). Supposedly you can increase 10 ng with each additional 1,000 IU. I assumed this works in reverse as well, so reducing my intake by 1000 will drop 10 ng, and so I calculated 12,000 IU. I think this is correct.
    
    Reply
    - Darrin January 31, 2013 at 1:20 am
      
      Hi Peder,
      Are you currently reducing body fat?
      I ask because, i seem to remember that (i am pretty vague on this one, so others please chime in if i’ve got this wrong)…
      …D3 is stored in our body fat, so if we are losing body fat, then we will be getting D3 from our your own fat stores…so you need to factor this in as well.
      
      & for those interested this is probably the Vit D council calculation that Peder id referring to,
      http://blog.vitamindcouncil.org/2012/02/27/body-weight-and-vitamin-d-blood-levels/
      
      & some of the text,
      “Finally, I am comforted by the authors’ calculation of vitamin D requirements.
      They cite data that show, if you want the average person to have a level of 40 ng/ml, that person needs 70-80 IU/kg/day.
      
      If you do the math, the 250 pound man would need 7-8,000 IU/day from all sources, while a 125 pound woman would need 3,500-4,000 IU/day from all sources.
      
      It is difficult to make a general recommendation with vitamin D for adults because you don’t want to get too complicated.
      
      That’s why our almost 10-year-old recommendation is simply 5,000 IU/day, which serves well for the majority of adults.”
      
      Reply
    - Wout January 31, 2013 at 4:42 am
      
      I’m 213lbs and at last measure I was at 38ng/ml by following the PHD recommendations.
      
      Please read the relevant chapter in the book for the details, but know that the body has both mechanisms to defend a shortage as well as disposal mechanisms in case of excess. So 4,000 IU may will be enough to hold you at 40ng/ml while 12,000 IU would be needed to get you at 58.
      
      The PHD philosophy is that when the body tries to get rid of something, you shouldn’t give it more. Hence the 40ng/ml recommendation.
      
      If I were in your shoes I would halt VitD supplementation and measure VitD levels in a couple weeks to see how you’re faring. You should have VitD stored in your body fat; I presume that the body can use it when needed.
      
      Reply
      - Peder January 31, 2013 at 12:54 pm
        
        Wout, thanks for the recommendations, and I have dropped my D3 intake thinking the same thing you sytated. Yesterday I had none for example and today I may take some but not a lot. It’s very hard to calculate how much I have stored and how quickly it comes out with weight loss or if that is used appropriately, etc.
        
        Nobody’s comments get me closer to the answer I need: how to get enough vitamin A for a a 2.5 to 1 ratio of A:D3 (I misstated as 3:1 in my initial post). I’m considering cod liver oil or vitamin A from cod liver oil.
Sumi January 30, 2013 at 1:23 pm

I’m looking for feedback/info from any out there who have dealt with chronic headaches or autoimmuntiy brought on after a virus.

My friend’s child has been diagnosed with New Daily Persistent Headache, which came on after he had a virus back in October. The only thing that’s even made a dent in his pain is Prednisone, which he obviously can’t be on long term.

In the research I’ve done, it seems like this condition doesn’t respond to most pain medications, and reminds me of people’s issues with other chronic inflammatory issues. I recommended that she try out a ketogenic version of PHD, since I know this has helped some who suffer from chronic migraines and epilepsy.

I would like any feedback regarding personal experience and other diet/lifestyle tweaks for this sort of chronic headache.

Thank you so much!

Reply
Jonathan January 30, 2013 at 1:26 pm

Anyone else having trouble finding the Q&A archives?

Reply
- Wout January 30, 2013 at 1:35 pm
  
  Hi Jonathan,
  
  you’re looking at the Q&A archives 🙂
  
  There’s 6000 comments though, and google doesn’t index the individual pages 🙁 So if you want to find something you’ll have quite a bit of clicking to do.
  
  I got around that by subscribing to the comments and archiving all of them on gmail but I’m really hoping that the future PHD forum will copy this comment thread into it.
  
  (Paul, I’m hereby volunteering to help with that… CompSci and all that)
  
  Reply
  - Jonathan January 30, 2013 at 3:04 pm
    
    I guess the pages of previous comments is what I was looking for. For some reason I thought that the site had this feature a few months ago, I could be wrong though. Thanks Wout.
    
    Reply
Dee January 30, 2013 at 5:57 pm

Hello Paul!

I have been on a long road to try to return myself to health and I am just stumped!! Your plan makes a lot of sense and I am working my way through the book and site. Would love your thoughts.

I have migraines (don’t respond to medication), “histamine intolerance”, fatigue, hormonal issues, anxiety. Also, I don’t know what to call it but when I stand up my ears sound like I am underwater (and standing up or laying on my stomach quickly triggers migraines), and this persistent weakness between 11am and noon and 4-6pm that I cannot shake until I have a full meal (not hypoglycemia b/c had blood drawn during an “episode” and my sugar was high (103)). I also run fevers during menses!?

A little history-

Developed migraines (with aura) after low-cal/fat dieting (also strep and mono). Then my weight ballooned (I felt shaky unless I was eating) and developed hormonal issues (absent menses, hair growth issues, carrying weight/fat on my back, basically PCOS symptoms)). I tried a low-histamine/tyramine diet as per Neurologist. Major improvements!! Menses returned despite no weight loss or carb restriction. Doctors didn’t believe me. Then lost 70 lbs on the zone diet but I almost lost my mind and the hormonal issues WORSENED. Switched to WAPF/traditional diet and saw some improvements but starting going lower on carbs as per nutritionist/MDs. (Your site is the only place I have found that correlates low carb with increased hormonal/PCOS issues, and just for that, I cannot thank you both enough. Finally someone who didn’t think I was crazy!!!)

Went to a holistic MD found very very low Vitamin D (I live in Florida for pete’s sake), high estrogen, very overactive immune system and high positive for mycoplasma. (He specializes in thyroid and all my labs and tests were “puzzlingly” normal.)

So I tried GAPS for 18 months (by the book) but kept progressively having issues. GAPS practitioners said it was die-off or I should reduce carbs further. GAPS helped: sleep, “chronic cystitis”, gallbladder pain, anxiety, (at first) histamine intolerance, and now I like more foods. What got worse: fatigue, constipation, histamine intolerance, the weird noise in my ears when standing, migraines, I got more hair on my face but lost loads of hair on my head and what is there is graying (I’m in my 30s!). All of these issues became worse the longer I stayed on the diet. Now coming off GAPS by adding potatoes, having major brain fog and developed an abscess my gums??

I have absolutely no idea where to turn next. If you have ANY insight it would be so greatly appreciated! Ideas, comments, suggestions, anything.

Thanks!!

Dee

PS: wondering what your thoughts are on eczema (seborrheic dermatitis) in an adult. My husband has had this since puberty along with periodontal disease (dentist says imbalanced immune system). GAPS did help eczema, but is back to the curve, it improved and then got worse the longer we stayed on GAPS.

Reply
alfred January 31, 2013 at 8:25 pm

hello paul.
just got to the page on lipids.
i am a 67 years young male, on no meds, exersize daily
struggling with pre diabetes, only measuring morning fasting #s. were 6.2/6.7
added a glucose support fomular with 600 mcg chrom. 300 mg R[+]-lipoic acid etc; 1 tablet half hour befor each meal. Next morning and for the following week 5.4/5.5
checked vitimin D 25-OH was 26 am following your recommendation’s to bring that up above 35.
After reading DR Bernstein and Gary Taubes/Dr dayspring i gave up all bread products except for low carb crackers, and changed breakfast from slow cooked oats to bacon/eggs/some veg no white potatoes, started 3 tblsp coconut oil the use of butter, heavy cream, switched to whole milk to make yogurt. i think i may have gone overboard on fat’s. don’t know my lipid #s from befor Doctor alway said bordering on high no problem. After 6 weeks on new eating plan TC 377. TG 106. HDL 75. LDL 281. today is first day of 16 hr fast with bone broth, thinking of supplimenting per your book, have cut back on what could be excess transfats for breakfast, using salmon to balance against other meats,staying with the coconut oil,comments please. Also can you suppliment D3 at the same time as getting sun exposure. [ the sun is about to reach 50 Degrees altitude where i live ]

Reply
- Paul Jaminet February 2, 2013 at 11:33 am
  
  Hi Alfred,
  
  Your lipids are indeed too high. We call this problem “High LDL on Paleo.” Browse through the posts in this category: http://perfecthealthdiet.com/category/biomarkers/hdlldlcholesterol/. It usually indicates a nutrient deficiency or hypothyroidism along with insufficient carbs. Eating more carbs helps normalize cholesterol, as does repairing nutrient deficiencies and treating hypothyroidism.
  
  Yes, you can supplement D3 as well as get sun, but the more sun you get, the less you should supplement. Monitor serum 25OHD once in a while and find the level of supplementation that gives you good blood levels.
  
  Reply
alfred January 31, 2013 at 8:30 pm

sorry third line from the bottom should be saturated fat not transfat

Reply
Brendan January 31, 2013 at 10:05 pm

Quick question, Paul: is it normal to see a very slight increase in TPO antibodies after an increase in iodine dose? Say, from less than 6 up to 10 or 15?

And is this anything to worry about?

Thanks!

Reply
Joia February 1, 2013 at 3:11 am

Hi Paul,

I must be honest when I started reading you first book I had so much doubt in my mind. On some level what you said sounded right but I have been SO indoctrinated over the years that I could just not believe animal fats are good and over the years I had become so afraid of carbs that a part of me believed your diet would fail. But I just had so many health issues that were getting worse and worse that I needed to try something. So I started your diet plan with stax of doubt in my mind. So I just wanted to provide some feedback after being on the PHD for 6 months. I’m not always sure which countries use which medical measurements so I will include what it should be according to my test sheets. My cholesterol level should be below 5 and it came down from 6.5 to 5.4 (yes with ALL my saturated fats) my insulin levels should be below 8 and it came down from 17 to 12 (yes with all my white rice and potatoes, twice a day every day). For the first time in 5 years my vitamin D level has actually gone up. It should be above 50 mine went from 24 to 26. My thyroid is on track and things are looking SO SO SO much better. The only small issue was that my homocysteine level has gone up. The doctor wants it below 7 and mine has gone up to 11 and my CRP should be below 1 and has gone up to 4. (Any advice on these 2 problems)
I just wanted to say THANKS SO MUCH. For the first time in many many years I am eating good tasty food, feeling satisfied and not starved AND my body is starting to heal.
Thanks for your hard work and dedication to helping us.
Joia

Reply
Eddie Pena February 1, 2013 at 11:53 am

Hi Paul:

A crucial topic not discussed in your book and what I would like to know about includes the relationship between supplementation and adverse effects from those who develop an allergic reaction (i.e. magnesium). What is your analysis on the subject in the broad spectrum of supplements you recommend?

Reply
alfred February 1, 2013 at 10:46 pm

hi Paul i need to correct my statement above.
The chromium of 600mcg’s and lipoic acid of 300MG is the daily dose, divided amongst the 3 meals.

now for some good news, yesterday was my first day of the 16 hr fast and this mornings glucose fasting # was 5.0 [ never been that low ]
fasting again to day, last meal at 3pm then soup at 7.30pm
thks alfred

Reply
Donna Torney February 2, 2013 at 9:06 am

Hi Paul:

Can you say a little about healing crises? I am taking an antibiotic and doing a cleanse with some Dr. schulze products. I am feeling terriblly achy – like my “skin hurts”

Have you seen this before?

Reply
- Paul Jaminet February 2, 2013 at 9:52 am
  
  Hi Donna,
  
  I think you should consult your doctor about this. Sometimes people have allergic reactions to medications, sometimes though this is less common there can be an acute toxic response to an effective treatment (eg Herxheimer reaction), or it may be something else. Your doctor is best placed to advise you.
  
  Reply
alfred February 2, 2013 at 9:26 am

hi Paul, sorry for the repeated updates but im so happy,after second day of 16hr fast morning glucose fasting # 4.7.
thks again alfred

Reply
- Paul Jaminet February 2, 2013 at 11:35 am
  
  Hi Alfred,
  
  It’s good that you are getting your blood glucose under control, you also need to improve your blood lipids, see my answer above. You have experienced diets on both extreme sides of the optimum and seen that you can change your metabolism, now you need to head toward a more balanced diet that is properly nourishing.
  
  Reply
Stephanie February 2, 2013 at 11:46 am

Hi Paul,

Over the past year I’ve reintroduced safe starches to my previously low carb diet. I’ve enjoyed improvements in my hypoglycemia, mood, cravings, and satiation. However, despite all of these improvements, I’ve recently developed bad breath (something I had before eating low carb) and fuzzy teeth. Do you think I could be reacting to rice, the predominant starch in my diet? I’ve noticed in the past that some foods like many dairy products give me instant bad breath but the bad breath I’m experiencing now has a slower onset which makes it difficult to pinpoint the cause.

Reply
alfred February 2, 2013 at 12:04 pm

hi Paul,how long after adding starches should i wait befor another lipid test.

Reply
- Paul Jaminet February 2, 2013 at 12:24 pm
  
  One month.
  
  Reply
  - Stort February 2, 2013 at 8:19 pm
    
    Paul, I think what you are missing in these arguments here is that, LDL will not normalize while people are losing weight. So advising to test after a month is not a great one.
    I agree with all the higher carb recommendations you give. I think most people who try your diet are still limiting the carbs somewhat for weight loss.
    The whole point is to do the new lipid test only after you have lost the weight you need to lose. Otherwise, LDL will remain high.
    
    Reply
    - alfred February 2, 2013 at 8:50 pm
      
      hey Stort, being fare to Paul knowhere did i say i was loosing weight and i have been around 157 lbs 6 ft tall for years. my problem was stuggling with pre-diabetes.Many assume all diabetics are over weight, was and is not the case with my wife a type 2 insulin dependant diabetic for 30 years. alfred
      
      Reply
Erik February 2, 2013 at 12:23 pm

My question: ”Which tests should I ask my doctor for, so as to find the cause (and hopefully a cure) of my acne?”

I have written as much info here about myself as possible – anything I could think might possibly be relevant

I am a 24 year old Caucasian male. I have had acne for about 3 – 4 years, never totally cleared during that period – but varying a lot all the time. I mainly get acne on my face – but also on my legs, and lately chest and upper back.

I went into puberty late at age 15, after several shots of Testosterone replacement therapy. I was always very small and shot as a child and teenager (and I still ain’t big).

I ‘suffer’ from coartatio aorta – meaning that my aorta is narrowed – and I have a stent which extends it (which I got at age 14). As an infant I quickly became weakly – and couldn’t suck hard enough to get milk from my mother – I was formula fed after some months – I don’t know what the formulas contained back then.

I have digestive problems, so does my father – though my father doesn’t seem to think he always had digestive problems – he is affected by stress which can give him a little acne, he also has suffered from reflux disease for a period after a very (psychologically) stressful period – but has very little problems with that now. He has suffered a little bit from acne as a teenager. My mother has never suffered from either digestive nor skin problems. My father’s sister and mother, as well as me and my father all suffer from dry cracking skin (especially on hands) during the winter (the winter is not that cold here but very dark). I have suffered from eczema for many years, which always comes in the winter and last for half a year – but hasn’t arrived yet this winter – which is the first time in at least 5 years. My father and I both get easily irritated skin when shaving – my grandfather suffered from acne when his beard was grew too long.

I have suffered from athletes foot, which I first had symptoms off at age 12 – and was in treatment for for several years.

As a child I didn’t like to eat meat (and thus ate it sparingly), at least partially because I felt compassion with the animals – but now I wonder if digestive problems may have played an unconscious role as well. I have always loved vegetables and fruit.

I currently eat a diet fairly low in fodmaps except lactose (which I don’t seem to have problems with) – before going low fodmap I had a lot of gas and dilated stomach – I have a lot less problems with that now. I mainly eat fermented dairy products, meat, eggs, potatoes, carrots, ripe bananas, olive oil, butter and my homemade saurkraut. I drink about two liters of teas and herbal infusions a day – very varied. I supplement with cod liver oil – both green pastures’ and Nordic Naturals’.

I weight about 68 kg and am 1.77 heigh – giving me a BMI of 21.7 my fat percentage is somewhere between 7 – and 12% (I think) – I have a four pack and everything is pretty ripped – with two exceptions I have some stomach fat from my belly button and down – as well as love handles – and a bit on the chest – all men in my family have very well developed chests – both muscle and a bit breast tissue – with easy fat accumulation there if we gain any fat.

I lift weights 3 times a week, fairly hard and serious. I am trying to gain both muscle and overall weight.

I don’t drink (like) coffee but have noticed that large amounts of black tea and/or dark chocolate make me tired in an unpleasant way (not just relaxed) I prefer green or white tea until evening for this reason.

I have lines in my nails that I can feel (when I move another finger/hand over them) I also have white spots on them.

I easily get cold hands and feet. As does my mother.

My tongue is covered in a thick white coat – I use a tongue scraper – but that seemingly only removes the outer layer. I suffer from a bit of bad breath.

I have eaten some version of a paleo/ancestral diet off/on for 2 ½ years which has helped a little with fat loss and a lot with energy dips throughout the day as well a sugar cravings – I have been more consistent with it the last 8 months or so. I have tried the elimination versions of the paleo/primal – didn’t help at all.

I recently went to an acupuncturist and TCM trained practitioner – he said I was suffering from a deficiency of yang chi. And tried to treat me with some sort of suction therapy as well as acupuncture – I have only been there once so I can’t say if it helped. He also told me to eat garlic, ginger and red meat – and not to have too much sex – I have earlier (but don’t currently) eaten tons of red meat – didn’t feel/look any different. I went there because I have problems with both my knees – which arose in conjunction with training for and running a marathon, almost three years ago – which hasn’t healed completely yet 🙁

I drink alchohol maybe normally twice a month (for a long time – before I became single, I only drank about 4 times a year). I smoke/eat weed once in a while.

I have dark constant dark circles under my eyes – and have had so for almost as long as I can remember (I may not have had before I became conscious of my looks).

I have always had a lot of cravings for sweets – but that isn’t really as much of a problem anymore.

Once in while (seldomly) I suffer from cold sores.

I have tested positive for epstein barr virus – but have never had sypmtoms (that I know of).

Reply
- Stephie February 2, 2013 at 1:29 pm
  
  Erik, ur symptoms scream of zinc deficiency and copper toxicity and pyroluria. I recommend getting these labs done thru Direct health care Access and consulting with Mensah medical. They specialize in this and have helped me out tremendously.
  
  Serum copper
  Plasma zinc
  Ceruloplasmin
  Histamine
  Urine krytopyrolle
  
  U may also want to do a OAT and CDSA.
  
  These doctors specialize in biochemical imbalances. U can read more from the book Nutrient Power By bill Walsh.
  
  Ur diet seems good and I’m sure Paul can chime in more, but if u have these genetic issues, they need to be addressed bc diet can’t fix it. Copper tox causes all sorts of issues, from dysbiosis, estrogen dominance, poor digestion, acne etc. Was a metal used for ur operation?
  
  Let me know if u need more info
  
  Reply
  - Erik February 3, 2013 at 10:55 am
    
    Thanks a lot for your reply – I will just read up on what you wrote, and give Paul and anybody else a chance to reply as well – then I will probably ask you further questions
    Again thanks
    One thing though – As I also wrote, I do take zinc (30mg) daily – and eat a fairly zinc rich diet – but maybe it isn’t enough?
    
    Reply
    - Stephie February 3, 2013 at 11:07 am
      
      Erik
      
      If u have KPU or are very copper toxic, u need a lot of zinc and b6, among others. I can give u more info, but I don’t want to overstepmmy boundaries on the board, so if u want, u can give me ur email and I can tell u more. 🙂
      
      Reply
      - Erik February 6, 2013 at 1:43 pm
        
        I would love to hear more from you Stephie – but I would rather not post my email where everyone can see it – anyway I can give you my email without making it public?
      - Stephie February 6, 2013 at 2:26 pm
        
        Hey Erik
        
        It’s much easier for me to communicate via email than on the website bc my computer broke and I have to rely on my phone, which isn’t very Internet friendly. I understand ur hesitation to give ur Addy out thru the forum. One way to do it is to put spaces between the letters of the address so that no spammers get a hold of it. I doubt anyone on the forum would abuse ur address tho… Everyone seems pretty down to earth here, but I completely understand ur concern. Hope to hear from u. 🙂
      - Erik February 7, 2013 at 6:12 am
        
        f a a c 43 k e r m a 6 n n @ h o t m a i l . c o m
        
        just remove the numbers (and spaces)
      - Erik February 11, 2013 at 3:06 am
        
        I still hope to hear from you Stephie (as well as Paul) – I did provide my email adress – did you write me? – I haven’t received anything – maybe you didn’t remove the numbers in my adress?
lana February 2, 2013 at 2:11 pm

Hi Paul and others,

So busy with today’s youth and their issues, I am waaay behind on my blog reading. You folks come up with the best questions. Here are my current questions:

1. Have searched for PHD info on good ol’ fashioned hash browns. ❓ Are they safe cooked in coconut oil or beef tallow? Or, would this be considered something other than “gentle” cooking?

2. The story: I will take myself through one more month of the multiple enzymes, Lauricidin, Undecylex, mastic gum, zinc-carnosine, and alternate days of Thorne 734. I will also diligently continue daily dose of probiotics (TherBiotic or BioKult), along with daily kefir. Then will plan for enough wait time after the last dose of the enzymes and killing agents to facilitate accurate test results for the H. pylori.
The question: ❓ Is there a priority list for tests? ❓ I’m curious about: mineral balances, lipids (including the omega 6-3 deal), blood sugar, thyroid function, vit A & D, etc.

3. Yesterday my staff was presented with the opportunity to enroll in a longterm health care insurance program (nursing home, etc). I have always declined and now that I am too old to enroll, I’m fearful. I would like to think I can avoid it, but we were told most Americans don’t avoid it. My interest in choosing and prioritizing tests is directly related to my interest in living without that intensive care so many older people experience on their way to the next event. I believe others who participate in this blog have the same concern. Please feel free to boss me around. 🙂

I thought we had a long needed spell-checker, but doesn’t seem to be in place this morning??? It was nice.

Reply
Ann February 2, 2013 at 2:52 pm

Hi –
I wrote last week regarding my abnormally low triglycerides. I did get my throid blood tests back:
TSH – .09
FreeT4- .97 -right in the middle of nortmal range
Free T3 – 2.0 which is low
I have decreased the cytomel I am taking and am seeing an endocrinologist on Monday. I am eating more carbs but worry something else is going on since I am technically hyperthyoid with a low T3. I am not that stressed, exercise according to your recommendation. My ferritan was on the low side.
You seemed against taking the T 3 supplement but I think better and am in a better mood overall on it. I am also wondering about supplements – iodine and Iron and selenium.
I have a feeling the endo will want to take me off the cytomel so am wondering if I should fight to stay and decrease the synthroid or if it is better to go off. the other odd thing is all this is that I have gained 5 lbs in that last few weeks.I needed to gain some back but find this odd considering my TSH.
Thanks for any thoughts!!
Ann

Reply
- Stephanie W. February 3, 2013 at 3:56 pm
  
  Hello, I just saw your post and I have some experience with wacky thyroid bloodwork as I have a pituitary cyst that stops me from producing TSH. Do you have other hyperthyroid symptoms? If not, I really don’t think you are hyperthyroid…I don’t create TSH, but my FreeT4 and FreeT3 were extremely low when they found the cyst as I was having every hypo-symptom in the book. I take 150mcg levothyroxine and 10mcg cytomel. I don’t know how much the cytomel actually does for me…but since I began the diet on 1/1/13 my Freet4 and freet3 have come up significantly and I’m hoping to lessen the synthetic and increase my natural hormone production even more! Let me know if I can help you.
  thanks
  Stephanie
  
  Reply
  - Ann February 3, 2013 at 4:08 pm
    
    Thanks for your response – I have both right now – my temp is 97, I have gained weight, but am feeling anxious/irritable, have had light periods that are spacing farther and farther apart, and I can feel my heart pounding as I fall asleep. My sleep is fine though. I am on 100 of synthroid and was on 15 of cytomel which I know can drive the tsh down. My concern is why my free t3 hasn’t gone up more. I was on the autoimmune paleo diet for almost a year so my carbs were lower which could be the culprit for the low T3 but I’ve been eating closer to the recommendations of PHD for about 2 months.
    I see an endo tomorrow at a major medical academic center tomorrow so will be interesting to hear what he says. Can they do something about your cyst?
    Ann
    
    Reply
    - stephanie w February 4, 2013 at 9:21 pm
      
      Let me know what your endo says..those are all hypo symptoms. This diet has increaded my t3 and t4 in just four weeks!
      My cyst is considered stable at this point so they just repeat an mri yearly and keep check on my prolactin andfree thyroid hormone levels. My ACTH does run low..but my cortisol levels have been normal so far. I look at my diet exercise and life like one big interesting experiment at this point!
      
      Reply
alfred February 2, 2013 at 7:25 pm

hi Paul. potatoe and rice ” WELL I’LL BE DARNED”

Well we gave up on “all things white” to protect my wife who is a 30 years type 2 diabetic on insulin, add myself a pre-diabetic.

So we carried out the following test.ingested 3 OZ of steamed and cooled potatoe with 2 tsp of butter.nothing else, this was in place of a snack which we would normally have given 2 units of fast acting insulin. For this test no insulin was given. At start of test blood glucose was 108 MG/DL. at 30 minutes 99 MG/DL. at 60 minutes 108 MG/DL. at 90 minutes 120 MG/DL.These are unbelievable results. If we had known what the results would have been we would have given half of one unit insulin. The results were the same for white rice and my readings were eaqually as good.
So the safe starch is back in. Paul thank you for what you do.
? do we have to eat the rice cold?. thk alfred

Reply
lana February 3, 2013 at 12:01 pm

So many stories of healing the gut after H. Pylori tell of inclusion of daily supplemental glutamine. This morning I happened upon a number of posts that indicate glutamine can cause irreversible problems in our brains and that it directly feeds cancer, as well as pathogenic bacteria. What have I missed here on PHD about glutamine?

Reply
Lindsay February 3, 2013 at 12:44 pm

I second that. I recently had a naturopath prescribe a supplement to heal my gut lining and it contains glutamine. Should we not be consuming glutamine? And really as the most abundant amino acid does it really matter if we add extra via supplementation?

Reply
Stephie February 3, 2013 at 12:52 pm

Lana and Lindsay I wonder this too. Some say it helps the gut and others say it can feed pathogens. I also read it can cause glutamate-like reactions

What’s the verdict then?

Reply
- Lindsay February 3, 2013 at 1:15 pm
  
  Anecdotally I can say that I have been taking supps which include about 900mg of Glutamine a day (which is much less that I have heard other people take for gut healing) and have experienced a marked improvement in general gut health. Vast reduction in heartburn, huge improvement in bowel issues, overall feeling of well being. Now, of course, I’m not sure if this is because of the glutamine or if it is because of other supps and changes that were made at the same time. Around the same time I started the supps I also stopped consuming any alcohol. Additionally, I really cranked my intake of fermented foods. I didn’t change anything else.
  
  Aside from the great improvement in gut health I also saw a 100% reduction in palpable lymph nodes. I had previously been able to feel lymph nodes in my neck for about 6 months.. the Naturopath felt that this was caused by a bacterial infection that started in the gut and may be circulating throughout the body. Anyway, long story short, I can no longer feel them at all.
  
  So… what to do? Hopefully Paul can shed some light.
  
  Reply
  - Stephie February 3, 2013 at 2:35 pm
    
    LIndsay
    900mg glutamine isn’t much… Most recommend at least 5-10 for gut healing. What other supps are u taking and what specifically are ur meals consisting of
    
    Reply
    - Lindsay February 3, 2013 at 2:45 pm
      
      Right.. that’s why I’m not too concerned. Compared to what a lot of people take. The glutamine is actually a part of 2 different supps: http://www.naturalhealthyconcepts.com/gastro-ULC-K29-90-p-apex-energetics.html
      and:
      http://www.naturalhealthyconcepts.com/cellestim-L2-45-p-apex-energetics.html
      The Naturo also gave me some liquid antioxidants.. both a turmeric based supp and a reservatol based supps. Additionally. a topical glutathione cream and liquid D and a liquid methyl B12 (for numbness and tingling).
      
      Beyond that I continued supps I have been taking for years including magnesium, selenium, copper, k2.
      
      My meals are PHD compliant. Although I prob eat more carb heavy because of my activity level. I also, as mentioned, eat a lot of fermented veg and dairy.
      
      Reply
      - lana February 3, 2013 at 5:33 pm
        
        Here is the first article to give me pause.
        http://dysbiosis.com/l-glutamine/
        
        The words “permanent nerve damage” are still bouncing around in my skull. Those H. pylori folks recommend a half tsp a day (2 grams) to 2 heaping teaspoons, which would be about 4 to 5 grams.
        
        My doc said that glutamine, curcumin, probiotics, and one other thing (but don’t recall what) will heal a leaky gut. He added that if I heal my gut, nearly all, if not all, of my food allergies will disappear. He wouldn’t start me on it until he had done the blood draw for Cyrex leaky gut test. But right after the test I began the glutamine. and kept up the curcumin and probiotics. Need the results of the test, but given the article at this link, think I’ll stop the glutamine. Keeping my brain and nervous system in workable condition is the thrust behind my interest in my health.
      - Lindsay February 3, 2013 at 5:56 pm
        
        It is interesting the different perspectives. My doc said I should not be taking probiotics until the gut is healed… something about the integrity of the organisms might be challenged in transport. In other words some of the bacteria might be dead when ingested and that will cause a sort of autoimmune response in the gut.. or something like that! 😉
      - Stephie February 4, 2013 at 1:05 am
        
        Lindsay and lana
        
        Interesting link. L glutamine always made me constipated too. I have very severe dysbiosis and I’ve always read that It can feed pathogens. I worry about amino acid imbalances too. Plus, I’m sensitive to glutamate so il ratheravoid
        
        B6, zinc, vit c, and aloe can be great for the gut
        
        I’ve only read that probiotics *may* be contraindicated if u have parasites… It honestly, the good of probiotics outweighs the bad. U need to build up ur immune system and probiotics assist in this. Medicinal mushrooms can be another good thing to try, as would be biofilm busters
        
        What is the topical glutathione u are taking? I was looking into taking the brand lipoceutical… It is a liposomal liquid glutathione
      - Lindsay February 4, 2013 at 8:53 am
        
        I guess it really comes down to personal experience. There are success stories galore on Paleohacks of people taking Glut to fix acne and other things that manifest because of a problem in the gut. It seems that if your gut problems are mild you respond better to the supps, but if they’re severe, like you mention, you don’t do well.
        
        As I said, the Glut has been doing me well so I will likely to continue to take it unless Paul chimes in and tells me it is going to kill me.
        
        The glutathione cream I am using is Oxicell-SE by Apex Energetics.
  - Darrin February 3, 2013 at 6:08 pm
    
    & i have heard that some ‘body builders’ swear by it, to aid in muscle recovery, reduce muscle soreness.
    & use it in quite large amounts both pre & post exercise.
    
    i have seen high dose numbers quoted such as 0.44 grams per lean pound of body weight & 0.33 g/kg of glutamine.
    
    i use to use it myself a while back to reduce muscle soreness. i was taking around 1 to 2 tsp per day (4 to 8 grams).
    i think it may have helped reduce muscle soreness from exercise, but then again i think increasing my carb intake worked just as well.
    
    & i never bothered to replace the glutamine powder when it ran out, partly due to expense & partly due to conflicting info on both its effectiveness & safety.
    
    Reply
    - Elyse February 3, 2013 at 10:00 pm
      
      Lana I dont see any links to studies/reliable sources on that page.
      
      Reply
      - lana February 4, 2013 at 11:23 pm
        
        You’re right, Elyse, and I knew it when I posted. Problem was that I could not access whole research articles and was feeling frustrated. I believe the PHD supplements site used to link to L-glutamine to purchase from Amazon, but it doesn’t anymore. I posted, hoping that Paul might have information for us. Please forgive my lapse in stamina to find appropriate scientific documentation. The words “permanent nerve damage” were pretty powerful. Say, it looks like the spell checker is active again. Yeh 😀
      - Elyse February 4, 2013 at 11:40 pm
        
        I’m curious too-I eat a lot of great lakes beef gelatin every day, at least 2-3 tablespoons! 😉
      - alfred February 5, 2013 at 8:37 pm
        
        @ Elyse, im confused is there a problem with gelatin?
        alfred
  - Lindsay February 4, 2013 at 8:59 am
    
    Oh, and Stephie, I think you make a good point… if you have a known pathogen I doubt it is a good idea to supp with glutamine. I had a metametrix stool test and I did not have a known pathogen. My problem is that my population of good guys is way too small. The greatest population of bacterial strands in my gut are actually those that live in the mouth. So, per the docs rec (and also advice I got from a progressive thinking dentist last year) I’ve been brushing after every meal with baking soda toothpaste and also rinsing with a peroxide/mouthwash wash. As I mentioned I am simultaneously trying to rebuild the good by eating a lot of fermented veg and dairy.
    
    A word of warning tho—It is possible to have too much of a good thing. Yesterday for breakfast I ate a pretty big bowl of yogurt and then ate a lot of kimchi.. this produced a weird burning feeling. It wasn’t quite heartburn, but it felt really strange.
    
    Reply
July February 3, 2013 at 6:15 pm

Hi Paul,

Happy Super bowl ! 🙂
One question with it : I’m a little bit confused about green beans and peas in the PHD plate ? Are they a paleo food ? Can we consider them “safe” and can we say they’re part of the green vegetables you recommend to add to the daily ration..?
About bananas (not plantain,variety) do you recommend to eat them alone,or can we mix the type of “starch” in a same meal ?
Can bananas replace a “meal” to lenghten a fast, and have a nourrishing meal at night ? Thanks ! Best, July

Reply
- July February 4, 2013 at 9:02 am
  
  Nobody to help with bananas, green beans, or peas..?:)
  
  Reply
  - Lindsay February 4, 2013 at 9:10 am
    
    Green beans and peas, yes. I’m sure that would be the answer. On PHD you eat veg for flavor and taste. I often add peas to chicken and rice soup or fried rice. So..yah.. eat up!
    
    As for bananas.. if you wanted to eat bananas and potatoes together, that’s your prerogative. In my opinion, bananas are the food of god.. I love them and eat one almost every day. If I recall correctly, they are mostly glucose, so very PHD compliant.
    
    Reply
- Wout February 6, 2013 at 11:15 am
  
  Hi July,
  
  green beans and peas have been declared “fine” by Paul on multiple occasions so I eat them. I suppose they’re the rice of the legume world, low toxicity despite being in a problematic class of food.
  
  Bananas/plantains are a carb source and should therefore best be eaten with fat or acid, although a single banana shouldn’t hurt.
  
  When eating bananas during a fast, you are breaking the fast a little. Better stick to high-volume low-calorie things like soup or mostly-fats like coffee and cream.
  
  Reply
  - July February 8, 2013 at 4:41 am
    
    Thanks to you, both, Lindsay, and Wout ! You made it clear to me ! Great to be helped in such a friendly community ! :)Best, July
    
    Reply
  - George @ the High Fat Hep C Diet February 10, 2013 at 5:19 am
    
    While I’m better off without most legumes I have found a way to include red kidney beans in a non-toxic way. I use Delmaine brand canned beans as these are well-cooked and have soaked in brine for months, and the cans have no BPA lining. I pour the beans into a colander and totally rinse them with water. This removes enough of the lectins, sugars and soluble fibre for my liking. I heat some butter or lard in a pot and cook the beans, mashing them as they cook, and adding cream if they get too dry. Add salt and pepper, and spices too if you like. Cook till it starts to stick.
    Viola, a high-fat, non-toxic, and very tasty refried bean.
    
    Reply
Mark W G February 4, 2013 at 6:26 am

Hi Paul,

Unfortunately I have to take antibiotics due to a chest infection that has plagued me for 6 weeks. Been unable to shake it off despite eating mainly Paleo since Christmas and taking vitamin D daily.

I have transitioned to PHD style eating for the last week or so and am aware of the negative effects of taking antibiotics.

Please could you give me some advice on countering these effects?

Reply
Lucy BH February 4, 2013 at 7:11 am

I have struggled with constipation all my life. Would this diet help with this problem?

Reply
- Lindsay February 4, 2013 at 9:02 am
  
  Paul has address this in an article found here:http://perfecthealthdiet.com/category/disease/constipation/
  
  Reply
victoria forsyth February 4, 2013 at 8:25 am

Hi Paul,

I was just wondering what your opinion is on the absorption of organic vs inorganic minerals was? Do studies show a difference? I have found some articles claiming that organic minerals are more readily absorbed. Also, is there an optimal form? For example minerals may come in the form of ionic minerals, chelated minerals, mineral salts etc…

Reply
Tatertot February 4, 2013 at 11:08 am

Hey, Paul – If it’s not on your radar, could you give Resistant Starch a really hard look and blog about it?

The best thread ever on RS has been running on MDA http://www.marksdailyapple.com/forum/thread76153.html

It’s a really good read, and about midway, a mysterious poster named RSQueen pops in, she is soon busted as a Big Starch Industry worker!

Here’s a re-cap, there are a ton of studies on RS, but it turns out they are nearly all funded by a company called National Starch. National Starch used to make High Fructose Corn Syrup and needs a new market for corn products, so they seemingly have manufactured data on RS.

However, there also seem to be a lot of independant studies done showing the importance of RS on colon and general health.

Many studies say the optimal amount of RS is 20-30g/day, however eating PHD style, even with an ample amount of cooked and cooled starch, only gets us approx 5g/day of RS.

Here’s where it gets interesting…A product on the market, Hi-Maize, is being touted as the best possible path to RS consumption, but potato starch actually seems to be a better source. The only catch is, potato starch would have to be consumed in it’s raw state. That would be do-able, as 3-4 TBS of potato starch in a smoothie or mixed in a potato salad.

The SAD gives people 3-10g/day of RS, Primal/Paleo contains close to 0g/day, while PHD ups that to maybe 5g/day.

If 20-50g/day is best, should we target RS? This is the focus of millions and millions of industry dollars, all aimed at corn. It would be great for someone to cut through the BS and figure out how much we should really eat for optimal health.

When looking at ancestral levels, I would think RS consumption was very high in the form of raw vegetables and raw tubers as well as cooked and cooled tubers and unhusked grains and seeds.

Thanks!
Tatertot

Reply
- Ellen February 4, 2013 at 12:23 pm
  
  I seem to recall her doing the same thing somewhere
  In the comments a while back and Paul very politely outed her.
  
  Reply
- July February 4, 2013 at 5:31 pm
  
  Thanks Tatertot for this links !
  I’ve read RS found in bananas was about 5gr/piece ?! Could eating more bananas and more potatoes be a solution compatible with carbs ratio recommended by PHD ?
  Considering a lot of carbs contained in those high-RS level food is not ‘digestible’; could we, Paul , add more carbs coming from RS , while staying PHD compliant ?
  
  Thanks ! Best to all, Tatertot, and Paul ! July
  
  Reply
  - tatertot February 5, 2013 at 12:24 pm
    
    Here’s a bit on what I’ve found out about RS:
    
    A really green banana may contain about 15g of RS. A raw potato (.5 lbs) may contain up to 35g RS. Cook that same potato and it has 2g RS, cool it and it now has 5g RS.
    
    Really green bananas are pretty nasty. The RS disappears quickly as it ripens. Raw potatoes are hard to eat.
    
    Here’s where I think the money is if one wanted to target RS: Potato Starch.
    
    There are several manufacturers of raw potato starch which is very minimally processed. Only water and centrifuges are used. 4TBS of potato starch contain a whopping 40-50g of RS.
    
    Thus far, I have been eating 1 pound of safe starch/day, mostly in the form of potatoes. Half cooked, half cooked&cooled, and a few slices of raw. I also eat a couple green bananas a week.
    
    Within a week or two of this, I could see profound changes in fecal composition which demonstrates changing gut flora. My daily RS intake is probably 5-10g.
    
    Many researchers use high doses of RS, up to 50g. Many ‘governing bodies’ are now recommending RS in the 20-30g/day range. Unfortunately, the only real way to get there is with a product called Hi-Maize, a corn product. It is used in baking and can withstand heating. This is fine for the SAD folks, but for us PHD’ers a no-go.
    
    I’m going to continue my path for at least 6 months to let things settle out. Maybe this Fall, I will try to add potato starch to cold potato dishes or smoothies to up my RS to 30g and see if there’s a difference.
    
    If you read this and wonder “What the hell is RS”, just Google ‘Resistant Starch Obesity’ or similar terms–you will be surprised what you find!
    
    Reply
    - Stephie February 5, 2013 at 1:02 pm
      
      Tatertot, not to get too tmi, but what changes in ur stool and digestion have u noticed since upping ur RS?
      
      Beans are one of the greatest sources of RS, so it surprises me that legumes are not allowed…. Many other “healthiest” eating styles highly promote legumes
      
      Reply
      - tatertot February 5, 2013 at 1:14 pm
        
        We avoid legumes in general because of the toxins in them. There are ways to prepare them to reduce the toxins, but I don’t think modern processing removes them all. Paul writes about it in the PHD book.
        
        In the ‘changes’ department, I used to be very gassy with fruit and veggies. Not any more! I can eat unlimited sauerkraut or even kimchi without so much as a ‘poot’. Eating those previously would have me banished to the garage for days. This change occured over about 2 weeks, I just noticed an overall reduction in my normal gassiness and have started experimenting finding almost nothing gives me gas now.
        
        As to stool changes, there is a definite ‘bulk’ going on. RS is said to increase fecal weight by approx 25% and they are right. On LC, I would get constipated frequently and stools were small, now, I’m as regular as a clock and have no problems ‘making dooky’.
        
        A kind of ironic twist on the best diet is that many really bad diets, like SAD, could have ample RS in them if the people chose to eat beans, whole grains, and bread with added fiber. I think the PHD is closing in on a truly perfect diet, which is why I hope Paul tackles the RS issue. I am so convinced that gut health is the biggest factor in overall health I’m willing to try almost anything if it has proven benefits.
        
        Here is a thesis a grad student wrote on RS and athletes. You may not be interested in the athlete part, but it talks about RS in depth and has lots of good cites for further research.
        
        http://scholar.lib.vt.edu/theses/available/etd-06282005-175436/unrestricted/ALDfinal.pdf
      - Stephie February 5, 2013 at 6:27 pm
        
        Interesting info tatertot
        
        How would eating foods high in RS affect pathogenic bacteria, like klebsiella, which thrives om starch? Even people with AS need to avoid starch bc of klebsiella.
        
        Lastly, I’m having difficulty transitioning to the phd. U seem to have it down pat. Can u give me a general run down of ur typical daily meals?
      - tatertot February 6, 2013 at 11:31 am
        
        Stephie – I had never heard of Klebsiella, so I read about it…
        
        It looks like a pretty rare condition, if you are affected, I hope you get it under control. I can’t give you any advice, but RS isn’t really starch, it’s insoluble fiber, but in it’s real food source, it’s only found in starchy packages.
        
        As to implementing the PHD, my day is like this:
        
        – Up at 6am, to work by 7am
        – No breakfast
        – A brief morning workout 3X week
        – Lunch at 11am of big salad, can of sardines or oysters, 1 big potato on workout days, none or less on non-workout days
        – No snacks, a more intense workout 3X week
        – Dinner at 6pm of approx 1/2 pound meat (beef, fish, liver, chicken–in order of amounts per week), 1/2 pound of potato (or rice, plantain, sweet potato), then a few or all of these: almonds, frozen blueberries, banana, 100% dark chocolate, cheese, liverwurst, sauerkraut, cooked veggies, eggs.
        
        I don’t eat eggs every day, but I raise chickens so I have a steady supply and eat lots on the weekend. I only supplement with Vit D and Vit K2.
        
        I am thriving on this diet and find it very intuitive. I use butter when cooking and sometimes put sour cream on potatoes. The only thing I ‘count’ is 1/2 to 1 pound of starch and meat daily, the rest just falls into place based on hunger.
        
        Good luck!
      - tam February 6, 2013 at 11:38 am
        
        Unpasteurized sauerkraut?
      - tatertot February 6, 2013 at 12:10 pm
        
        Even better! Homemade sauerkraut! I make a big batch in the summer and freeze it in quart bags.
    - erich February 5, 2013 at 2:16 pm
      
      hi tatertot,
      
      doesn’t raw potatoes have a lot of toxins that are removed from cooking?
      
      erich
      
      Reply
      - July February 5, 2013 at 2:52 pm
        
        Tatertot,Thanks again ! Potato starch is not so easy to find here in France. So why not add more potatoes to the diet ? (Guess RS makes carbs contained in potatoes less digestible,so not so easily transformed in calories? Maybe I’m dreaming ! 🙂 ).
        Anyway, I do believe the first step to improve health is to heal the gut…So maybe, RS is the key.
        Do you know whether RS is safe for all conditions ?
        
        Thanks a looot for your sharing, including the details on your better gut health improvement.
        It would be interesting Paul to join us for this RS issue..
        Best, July
      - tatertot February 5, 2013 at 3:27 pm
        
        I am very careful when eating raw potatoes. There are toxins, but mainly in the skin and green colored flesh. I always peel, and trim anything off-color, but still am very careful and only eat a few slices.
      - tatertot February 5, 2013 at 3:41 pm
        
        July – RS in potatoes is a funny thing. In a raw potato (or potato starch) there is approx 75% RS by weight. If you heat the raw potato or starch, the RS gels and is no longer resistant starch, but ‘soluble’ starch. When cooled, some of the soluble starch crystalizes and becomes ‘retrograded’ RS.
        
        Cooked and cooked&cooled potatoes just don’t have all that much available RS. You’d have to eat 6-10 pounds of cooked potato or 3-5 pounds of cooked&cooled potato to get much over 20g of RS.
        
        The big question is: How much do we really need? I’m sure a zero grain/zero starch diet like LC Paleo which provides no RS is not best, so at least adding in safe starches gets us going in the right direction.
        
        I have seen studies on RS that say it promotes healing of IBS, diverticulitus, Crohn’s disease, etc… If you like to read, this paper outlines about everything that has been studied on RS:
        
        http://onlinelibrary.wiley.com/doi/10.1111/j.1467-3010.2005.00481.x/full
      - July February 5, 2013 at 4:32 pm
        
        Tatertot, I’ve followed the link ! Amazing ! Very strange, the RS fact ! About potato starch, would you eat it “raw” or cooked in a dish ?
        One question again about the cooked and cooled potatoes.. I ‘ve experienced very bad digestion issue when eating cooked and cooled potatoes..:-/ It’s so heavy in the stomach. In your experience, is the cooked and cooled potatoes can be re-heated to be eaten a little bit “hot”..or does “S” definitely loose its ability to be “R” everytime it’s heated ? Or maybe you have a “trick” to make it more digestible ?! lol
        Thanks to answer my weird questions.. and thanks again for sharing. Can we ask Paul to give you my mail address for some potato starch manufacturers where I could buy some ? Blessings ! July
      - tatertot February 5, 2013 at 4:59 pm
        
        The most RS you could hope to get from a cooked potato would be to cool it to about 1degC, then eat it colder than 10degC. As it warms, the RS re-gels and becomes no longer ‘R’.
        
        A good way to eat in this fashion, make potato salad. Cut up cold potatoes, mix with mayonnaise, add some chopped celery, onion, hardboiled egg, and a touch of mustard. If you don’t like mayo, you can make German Potato Salad which is cold potatoes, vinegar, and bacon pieces.
        
        Can you order from Amazon? I’d bet you could find unmodified potato starch easily on the internet. I’ve never seen it in a store where I live, but it’s readily available on-line.
        
        I have never used potato starch as a supplement, but plan on doing it later this year after I’ve given PHD a good while to settle in. I don’t like changing too many things at once, hard to tell what’s happening that way!
      - tam February 5, 2013 at 6:02 pm
        
        Too bad mayo usually has soybean or canola oil.
      - tatertot February 5, 2013 at 6:40 pm
        
        Mayo – I’ve been making my own with 1 egg yolk, 1 cup olive oil, salt, pepper, and a dash of yellow mustard…put all ingredients in a narrow container and blast with an immersion blender for 20 seconds. Not like storebought, but great for potato salad!
      - George @ the High Fat Hep C Diet February 10, 2013 at 5:12 am
        
        The juice of raw potatoes is a great source of vitamin C and I’ve seen it recommended in herbals.
    - Thomas February 5, 2013 at 2:46 pm
      
      Tatertot,
      
      Thanks for your posts here and on other sites- they have provided a lot of food for thought. I think you’re right about the gut and experimenting. The potato starch sounds like it would be a good experiment. I’m curious if you feel different in a mental/emotional way after eating RS? As you probably know, there are some weird studies out there linking anxiety and other disorders to a bad gut.
      
      Reply
      - tatertot February 5, 2013 at 3:31 pm
        
        I’ve never felt any different mentally. I look at RS the same as Vit D or Vit K2…you don’t notice when you are taking it or not, but the health benefits are undeniably there.
      - Dede February 5, 2013 at 6:14 pm
        
        Tam, I just made a homemade mayo PHD compliant and AMAZING! I found a recipe to make it with an immersion blender, so it was so much easier than dripping oil in to a food processor. Use 1/4 cup each olive oil and macadamia nut oil (or all olive oil), juice of 1/2 medium to large lemon, salt and pepper, 2 garlic cloves peeled and smashed, 2 egg yolks (room temp) and 1 tsp dijon mustard and immersion blend it…ready in like 30 seconds! I added dill to mine today, but tarragon would also be delicious, or just plain is great. You can add capers or chopped cornichons and make a tarter sauce to! I hope you will try it.
      - tatertot February 5, 2013 at 6:42 pm
        
        Great minds think alike! I use lemon juice, too.
- Carol February 5, 2013 at 3:41 pm
  
  I wonder why the potato based resistant starch isn’t marketed to consumers?
  
  http://www.penford.com/pdfs/techspecs/penfibers.pdf
  
  There’s a page where one could order a sample – if you ran a gluten free bakery, maybe?
  http://www.penfordproducts.com/91/food_functionality_fiber-enrichment.html
  
  Reply
  - tatertot February 5, 2013 at 4:04 pm
    
    I think if you wanted to use potato starch as an RS supplement, you’d need something like this: http://www.bobsredmill.com/potato-starch.html
    
    The link you provided was to a ‘modified potato starch’. Starch has to be modified to make it a suitable replacement for gluten products in baking, the modification also makes it not as resistant, if RS at all.
    
    Unmodified potato starch starts out as ‘Native Potato Starch’ http://www.solam.com/index.php/production-of-native-potato-starch.html
    
    It’s a very simple process and doesn’t heat the starch, which would ruin it’s value as RS. You can also make your own easily enough, but I don’t know how hard it would be to make enough to keep yourself in steady supply:
    
    http://www.youtube.com/watch?v=aMmXm3p48BE
    
    Reply
- Carol February 5, 2013 at 4:02 pm
  
  I wonder why the potato based resistant starch isn’t marketed to consumers?
  
  http://www.penford.com/pdfs/techspecs/penfibers.pdf
  
  There’s a page where I could order a sample – if I a gluten free bakery, maybe? I wonder if I could just say I was planning to develop some recipies.
  
  http://www.penfordproducts.com/91/food_functionality_fiber-enrichment.html
  
  Reply
  - Carol February 5, 2013 at 4:07 pm
    
    Opps, double post 🙁
    
    Reply
  - tatertot February 5, 2013 at 5:07 pm
    
    To answer the rest of your question; RS isn’t being marketed at all to consumers as a supplement. The only thing close is Hi-Maize, http://www.hi-maize.com/Himaize/USA/Home, which is mainly marketed as an adjunct for the SAD baking industry, although it can be found in specialty shops for baking purposes http://www.kingarthurflour.com/shop/items/hi-maize-natural-fiber-12-oz
    
    Potato Starch would have to be consumed raw/cold as in mixed with water or something else cold, not heated, to be effective, making it a probably pretty small market.
    
    Reply
    - tatertot February 5, 2013 at 6:52 pm
      
      Just wanted to post this study if anyone is interested in increasing insulin sensitivity:
      
      http://jn.nutrition.org/content/142/4/717.full.pdf+html
      
      They used 15 or 30g/day of Hi-Maize Corn Starch, which is about 50% RS.
      
      A TBS of potato starch weighs 12g, which is approx 75% RS by weight.
      
      So, the study with corn starch provided 7-15g/day of RS, this could be easily replicated with 1-2TBS of potato starch.
      
      In the study, insulin sensitivity increased dramatically in both groups (15 and 30g/day of corn starch), so it looks like the minimum requirement for insulin sensitivity may be around 7g/day, or 1TBS of potato starch!
      
      1 TBS of potato starch is like nothing! It’s only 40 calories according to this label: http://www.bobsredmill.com/potato-starch.html
      
      Getting 7g/day of RS from the PHD is still slightly out-of-reach, though, unless most starch was eaten cooked and cooled and some raw, still pretty hard with 1 pound, though.
      
      Reply
      - tatertot February 5, 2013 at 7:11 pm
        
        The study above showed positive insulin resistance results in men only, in this study, using 48g/day, everyone wins!
        
        http://www.ncbi.nlm.nih.gov/pubmed/19857367
        
        Maybe women need a bit more or maybe their test was flawed. The study authors give several ideas but are perplexed why women didn’t fare as well.
      - Carol February 5, 2013 at 7:25 pm
        
        From what I can tell, the PenFibe is 85% fiber. (From the PDF I linked). And it’s got even less calories ( just 0.7 per gram) than regular potato starch.
        
        I don’t know if this link will work, but it’s recent:
        
        http://qa.bakingbusiness.com/Features/Formulating%20and%20R%20and%20D/2012/7/Weight%20control%20via%20resistant%20potato%20starch.aspx?cck=1
        
        They’ve got a site just for the product. http://www.fitinfiber.com/
        
        I can’t find anywhere to buy it, similar to how expandex was two years ago. Bob’s Redmill does carry, in the store, in bulk, Expandex. I might ask if they could source this product, too.
      - Carol February 5, 2013 at 7:36 pm
        
        Found this study using Penfibe:
        
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359707/
      - Darrin February 5, 2013 at 11:36 pm
        
        Carol,
        re your comment,
        “From what I can tell, the PenFibe is 85% fiber”
        
        But are we after fiber (i do not know the answer btw). RS is not fiber (as far as i know).
        
        & I notice that the potato starch that tatertot linked, lists zero grams fiber. It has 10 grams carbs per 12 grams serve, zero sugar & zero fiber. So i presume that the 10 grams carbs is all starch.
        http://www.bobsredmill.com/potato-starch.html
      - tatertot February 6, 2013 at 11:50 am
        
        Concerning PenFibe Potato Starch. It is a modified potato starch, which makes me leery of using it for a supplement. It is designed as a gluten free additive for baked goods. It is also an RS4 type RS (not found in nature). Also notice the study you provided was paid for and done by the same company who makes PenFibe. I have run into this all over the place with Hi-Maize as well.
        
        In this paper: http://onlinelibrary.wiley.com/doi/10.1111/j.1467-3010.2005.00481.x/full
        
        Table 2 shows RS contents of several foods as well as RS4 products. Native (unmodified) Potato starch is 78% RS. The RS4 products listed (Hi-Maize, HyLon, Novelose, ActiStar, and CrystaLean) are 40-50% RS, I can only assume that PenFibe is about the same.
        
        All-in-all, my money is on Unmodified Potato Starch if someone wanted to get a boost of RS. It would have to be used cold, not cooked. 1-2TBS a day should be an optimal amount. Please don’t go off and start doing this because I said so, this is all just talk, but really, what harm could come from 2TBS (80kcal, 20G RS) of pure potato starch?
Nick February 4, 2013 at 1:17 pm

Hi Paul…

Quick question :

If I adopt EVERY recommended micronutrient supp (including the optional ones)that you recommend… along with the PHD macro nutrient ratio that is already in full swing for the past month… what is the timescale for my body to reach the peak health range of all essential nutrients..?

And would any current unwanted pathogenic invaders that are resident in my system have a negative effect on the absorption of those nutrients…?… or would there still be an overall adjustment to optimum returning my immune system to maximum effectiveness and thereby evict all the unwanted guests…?… I don’t want to feed the pathogens… just my immune defence system… 🙄

Nick

Reply
Denise February 4, 2013 at 8:28 pm

Hi Paul,

I am new to PHD and believe it was made for me. As a novice, my question is simply this; because I work and am away from home 8.30am – 6pm, will I still get benefit from delaying my first meal until 11am and last meal by 7pm to accommodate 8hr eating time frame. I understand during winter months I will be eating last meal outside day light hours.
Thank you

Reply
John D. February 4, 2013 at 11:43 pm

Hiya Paul, I’ve mentioned my TSH before and happened to run a new test today. Wanted to run updates past you in case you had a thought:

August 2011: TSH of 3.92.
October 2011: TSH of 3.08.
August 2012: TSH of 3.4
Today (Feb 2013): TSH of 3.11, T3 of 2.70, T4 of 1.06.

I’ve been PHD for 2+ years, full supplements. I ramped down iodine about six months ago from daily 12.5mg to 6mg every other day. I take selenium 2x/week. I get 100-150g of carbs a day with 300g on lifting days (1x/week).

My doc says I’m fine, but I don’t quite trust it.

I’ve managed to lose weight slowly during the past two years through vigilant calorie counting, which my doctor says would be impossible if I was hypo. But I’ve also been cold-sensitive, suffered from depression pretty constantly, and couldn’t lose fat around my midsection even down to 155lbs at 5’10”.

I also have zero trouble gaining weight as soon as I stop monitoring intake. For example, I decided to try and “bulk” for a month to see if it would have impact on my lifting. I added an extra ~2000 calories a week and have gained around 10lbs in a month… with little measurable strength gains.

I know thyroid is a tricky business but was wondering what you thought of these #s. Thank you as always!

Reply
Claire February 5, 2013 at 2:14 pm

Hi Paul!

I have been following the PHD for about 3 1/2 months now. It is a wonderful diet!! I, however, for about 9 months seem to be having what is chronic gallbladder pain along with digestive upset that has maintained throughout beginning the PHD. I was wondering if you had any tips for gallbladder problems (I did a flush with little effectiveness). I may have to remove eggs from my diet, which have become a staple, to see if that eases the pain. Is there anything you suggest eating to replace the nutritious quality of egg yolks in the meantime.

Thank you for your time,

Claire

Reply
- Lynn February 5, 2013 at 2:45 pm
  
  Hi, John D.
  
  You may just have to have it removed. At a certain point there’s not much else to be done–even my naturopath agreed mine had to come out, it was filled with stones. I have no real regrets; I had it out almost 12 years ago with no complications since.
  
  Reply
Peder February 5, 2013 at 2:26 pm

Paul, I would really appreciate you having a look at my post on Jan 30 (I see it on the current page). I did not get any answers that actually answer my questions. I do realize there is more research needed on the vitamin A-D3-K2 balance. Please take a shot at it! THANKS.

Reply
MM February 5, 2013 at 3:50 pm

Paul,

Chris Kresser’s latest post on histamine intolerance makes me want to ask for your take.

I have noticed a pattern of sensitivity to high-histamine foods. But is this really a key insight or simply an epiphenomenon all too common among the chronically ill? I mean, it is hard to find a metabolically challenged person who is NOT sensitive to amines, salicylates, glutamates, etc.

Kresser’s advice, to go on a low-histamine diet, seems not to penetrate to the root of the problem (although I certainly appreciate the wisdom of laying off of an obvious stressor to permit the system to heal).

Still: what is the root, and how should it be addressed? Peatians would probably say hypothyroidism. I am interested in your thoughts.

Thanks!

Reply
Akemi February 5, 2013 at 9:43 pm

Hi, I see this is where I am supposed to ask questions … so here I am.
What do you think about rice lectin?

I read that the China Study shows negative correlation between various health issues and rice. (btw that is what I meant by “statistics” before — sorry for the incorrect way of putting it) That’s great, and rice is certainly convenient, I just want to make sure if I understand it well. Thank you.

Reply
Jon February 5, 2013 at 10:49 pm

I am going on a hiking trip in the Swiss Alps this summer. I have been a practicing paleo for the past few months and most recently a happy follower of the PHD.

Most recommendations from hiking “experts” suggest very high carb foods on the trail such as grains, granola bars, candy, dried fruit, etc. The thinking is apparently fast energy.

My concern is deviating from the diet that has changed my life but also eating what works on what will be a strenuous week in the mountains.

Any suggestions are welcome.

Also, thank you Paul for positively impacting so many lives with your work!

Reply
- Jonathan February 6, 2013 at 2:37 pm
  
  Hi Jon, as a fellow backpacker and PHD follower maybe I can help you out. I eat additional carbs when backpacking as needed and you WILL KNOW when they are needed. I don’t eat candy or anything like that, I prefer to snack on plantain chips(trader joes) as needed throughout the hike. I’ll also eat some rice with dinner which are included in many backpacking meals. The meals are often not fatty enough for me so I add a tablespoon or two of tallow or coconut oil. For breakfast and lunch I usually have a good quality salami and cheese with rice cracker. Your body does require more carbs when hiking but what I would do is work out your meal plan to be compliant with PHD(macronutrients/toxin avoidance) and then add in something like the plantain chips if your hiking and you are feeling like you’ve “hit the wall”.
  Hope this is helps, have fun in the alps!
  Jonathan
  
  PS Dried coconut is a good backpacking PHD compliant snack.
  
  Reply
Darrin February 5, 2013 at 11:15 pm

Hi Paul et al,

Could someone with the new book (i am still awaiting delivery of my Australian edition) answer this one for me please…

I after the latest PHD recommendation with regards to Zinc & Copper intake…
So,
About how much total Zinc should we aim to get (from food & supps) per week?
&
About how much total Copper should we aim to get (from food & supps) per week?

Thanks You all

Reply
- Darrin February 5, 2013 at 11:17 pm
  
  thank you all
  
  Reply
  - Nick February 6, 2013 at 7:22 am
    
    Darrin….
    
    If you go to the Supp Recs tab on this site it lists all your recommended intakes if you are following the PHD macro nutrient ratio.
    
    Copper intake of 2-4 mg per day should be balanced by a Zinc intake of 15-30 mgs per day. The balance is important
    
    So… eat 120 grams of calf liver per week for copper (one of my new favourite foods… delicious 😛 ) or if you don’t like it then supp with 2mg per day
    
    And zinc supp is 50mg once a week on top of your diet
    
    Nick
    
    Reply
    - Darrin February 7, 2013 at 9:45 pm
      
      Thanks Nick
      
      the new book arrives Monday, so that should keep me occupied for a bit
      
      Reply
olio February 6, 2013 at 9:48 am

Hey Paul and others,

I have been on paleo for 2 years and PHD for a year and just had some bloodwork done. Total cholesterol was 8,3 mmol/l (321 mg/dl), HDL: 2,23 mmol/l (86 mg/dl), LDL: 5,9 mmol/l (228 mg/dl) and Trglycerites: 0,5 mmol/l (44mg/l)

This is the first time i measure cholosterol levels, since im 29 and they recommend them here for older people. I had them done on my own initative, not cause of any symptoms. I dont feel sick at all and im happy and energetic. I follow the diet, supplement recs and do intermittent fasting daily for 16 hours. I work out 3 times a week which totals to 2,5 hours high intensity training weekly. I spend time outdoors in daytime daily and walk everywhere in addition to that. I have gained lean mass lately and went from 55kg to 68kg during my year on PHD.

My question is if these results are sth to worry about? My doctor will advice me to cut down fat intake but hopefully not medication. I read all blogposts related to high LDL on paleo but find it unlikely to be nutriotionally deficient since i supplement with iodine and eat 150 gr reindeer liver weekly.

Im thankfull for any answers

Reply
- Paul Jaminet February 6, 2013 at 7:14 pm
  
  Hi Olio,
  
  Your LDL is high, everything else is great. That’s a common problem on low-carb diets, we’ve discussed it extensively as “High LDL on Paleo.” See http://perfecthealthdiet.com/category/biomarkers/hdlldlcholesterol/.
  
  The causes are normally one of (a) nutrient deficiencies such as iodine, selenium, copper; (b) hypothyroidism; (c) being too low carb.
  
  So add carbs, add supplements or foods to eliminate nutritional deficiencies, get any hypothyroidism treated even if it is subclinical, and the problem should go away.
  
  Given your heavy training regimen, it’s quite likely you are eating too few carbs. Your doctor can test for hypothyroidism.
  
  Reply
  - olio February 7, 2013 at 11:06 am
    
    Thanks for the response, ill definately add more carbs and treat any possible remaining malnutrition. I had my thyroid hormones tested as well which were not yet perfect either: tsh: 2,3 mU/l and t4v 16 pmol/l. This presumably means the elevated ldl is caused by hypothyroidism.
    
    Reply
jack cronk February 6, 2013 at 6:56 pm

My IBS is very much improved since implementing PHD but just to be sure of my status I recently had the Metametrix GI workup done. Results showed level 2 saccharomyces, 5.3 E005 Helicobacter and Positive for Blastocystis Hominis. From what I’ve read the last is particularly difficult to rid oneself of. Any suggestions for any or all of these would be much appreciated.

Reply
- Paul Jaminet February 6, 2013 at 7:10 pm
  
  Hi Jack,
  
  We’re not doctors here so we don’t know the best way to treat infections. It’s great that your IBS is improved and great that you’ve gotten a diagnosis for what has been causing it. Hopefully your doctors can help you cross the finish line to a complete cure.
  
  Reply
  - jack cronk February 6, 2013 at 7:35 pm
    
    Thanks. I’m working with my doctor, who’s open to listen to the results of my research, and I wondered whether anyone else had perhaps had success with any particular protocol for any of these. I may need to try more than one before I’m through.
    
    Reply
    - lana February 6, 2013 at 10:41 pm
      
      Hi Jack,
      My Metametrix returned 7.2E+0005 H. pylori. I did not have classic symptoms, so doc put me on Thorne SF734. After a few days itching eyes cleared up and after a few weeks chronic mid back pain disappeared. But after two months of treatment back pain returned very, very badly. Even began having pinches in my stomach. Researched and found Amy King’s “so happy I have h. pylori.” Google that and read her story. Her protocol is summarized by a reader. Also, she refers people to Dr. Marcus Ettinger in San Diego. I am on the third protocol, Ettinger’s, and am much better. Going to stick it out through end of Feb then try a stool test to see if it is gone. Second protocol was Interfase Plus and Undecylex. I believe one or both of them is what dislodged a large, white, banana slug type worm in my duodenum. Never knew it was there. Don’t know anything else but I’ll post in early March if I finally have the h. pylori under control. Most folks seem to believe that small numbers are normal but mine were 7.2 times the “normal.” Good luck.
      
      Reply
      - lana February 6, 2013 at 10:55 pm
        
        Jack, I should add that I finally resorted to Amy’s diet protocol, pretty much. Since beginning PHD I had been loving my white rice, but between treatment protocols it seemed to me that white rice, as well as sweet things such as dates and apples, brought on the back pain. It was so bad after the Thorne product that I couldn’t stand up straight. I think a good probiotic is essential, as well as kefir. Word has it that the organisms in kefir are good HP fighters.
      - Stephie February 6, 2013 at 11:44 pm
        
        Lana
        Thanks for the info. I didn’t do the Metametrix test… I did the cdsa from doctor’s data (it is a culture test) I have the sibo symptoms and have bad yeast/bacterial dysbiosis
        
        Can u explain ur exact diet? It sounds like u can’t do starches, correct? Can u do fruits? If u could, what are ur daily meals specifically like? There are so many theories out there and many don’t give much detail… Or they make it so complex that it’s tough to put into practice. So seeing what udo would help
        
        Are u a ppatient of this doctor in San Diego? If not, how did u know what to do?
        
        I’ve been fighting dysbiosis for so many years and nothing seems to fix it. U give me hope that there r ways of beating it
        
        Thanks lana
      - Stephie February 6, 2013 at 11:49 pm
        
        Lana, also, what brand of probiotics and kefir do u use and how high a dose? (cfu)
        
        When done take it so that it doesn’t interfere with ur natural antibiotics?
        
        Have u read “fast tract digestion”? It is similar to fodmaps, but goes a bit further by figuring out the fermentation potential of carbs and thus helps with Starving h pylori but also allows u certain carbs that don’t feed the pathogens. It is pretty compatible to phd
      - Nick February 7, 2013 at 10:22 pm
        
        lana…
        
        have you seen this research from Taiwan on how effective l.acidophilus TYCA15 is against H.Pylori ?
        
        It’s readily available in Breast milk… I’m now on a pint of fresh expressed Breast milk a week.
        
        http://suppversity.blogspot.de/2012/10/vitamin-educates-t-cells-joins-forces.html
        
        Scroll down and you can read the results… yes these are only in-vivo and in-vitro animal… but that’s good enough marker to give me hope that it’s what is missing in us humans from all the anti-biotic use
        
        Nick
July February 7, 2013 at 8:13 am

Hi Paul,

I’m looking for feedback on pancreatin. The homeopath who has been following me, is about to advise me to take 4 caps per day to improve digestion and assimilation. What’s your thoughts about this, knowing it usually comes from pork ..?Thanks ! Best, July

Reply
Stephanie W. February 7, 2013 at 10:18 am

Hey Paul,
I am really noticing improvments with the diet, the joint/muscle/bone aches are also getting better. But…I was wondering if you had an explanation or hopefully a “fix”…I notice my PMS being worse now on the diet. Much more irritable, jittery inside, difficulty sleeping, strange dreams, chocolate cravings(which I am feeding! lol) continued fatigue, and increased hunger. My BP was 111/56 this morning and HR 67, so I know its now my synthroid needed backed off as if I were hyper, its more an internal feeling. Any suggestions?
Thanks again!

Reply
Shilpa February 7, 2013 at 10:31 am

Hi Paul,

I am really grateful to you for restoring my good health through your research, love and care in Perfect Health Diet. I have been following PHD for more than two years and feel awesome. My skin is like a baby, have perfect digestion and my ideal body. I only eat organic veggies, starches, wild alaskan salmon, 100% grassfed organic meats here in US. Now my problem is that I am going back to India where chemical pollutants are at its peak. People don’t even know about organic grassfed meats and asking for organic eggs will get you in trouble! After being on such purest diet for two years, am dreaded to go back. Could you please advise how I can survive PHD in such environment? How I can optimise good nutrition in a PHD way? I can manage organic veggies but I really need help and advise for meats, eggs and seafood. As I will be in a coastal city, I can get ample of Indian Ocean fish but am really worried about pollutants, PCBs in the Indian ocean and its effects on fish. Even in chemically polluted waters which fish varieties would be safe for daily consumption? Can I eat fish daily and meet all PHD requirements? I am 27 and will be planning for baby in another 2 years so really worried about daily fish consumption. Please advise. Thank you so much!

Reply
Shilpa February 7, 2013 at 10:33 am

Hi Paul and Shou-Ching,

I am really grateful to you for restoring my good health through your research, love and care in Perfect Health Diet. I have been following PHD for more than two years and feel awesome. My skin is like a baby, have perfect digestion and my ideal body. I only eat organic veggies, starches, wild alaskan salmon, 100% grassfed organic meats here in US. Now my problem is that I am going back to India where chemical pollutants are at its peak. People don’t even know about organic grassfed meats and asking for organic eggs will get you in trouble! After being on such purest diet for two years, am dreaded to go back. Could you please advise how I can survive PHD in such environment? How I can optimise good nutrition in a PHD way? I can manage organic veggies but I really need help and advise for meats, eggs and seafood. As I will be in a coastal city, I can get ample of Indian Ocean fish but am really worried about pollutants, PCBs in the Indian ocean and its effects on fish. Even in chemically polluted waters which fish varieties would be safe for daily consumption? Can I eat fish daily and meet all PHD requirements? I am 27 and will be planning for baby in another 2 years so really concerned about daily fish consumption. Please advise. Thank you so much!

Reply
- Shilpa February 11, 2013 at 8:13 am
  
  Hi Paul,
  
  Can I request a reply for my question, what species of fish are safe to eat Everyday? Does it matter if they are coming from polluted ocean? Thanks!
  
  Reply
jack cronk February 7, 2013 at 1:39 pm

Lana, thanks so much for the reply. Like you my h.Pylori of 5.3 E005 seems high to me, even though my doc thinks the B.Hominis parasite is more likely to be causing me trouble. Interestingly, I’ve been having exactly the same symptom you mention; back pain, which I had put down to age related muscle cramps until I took a couple of goldenseal and black walmut caps one evening a couple of days ago to see if they would work on the invaders and was completely surprised the next morning to find the flu-like aches gone. I’ve been told that both H.P. and B.H. can cause some identical symptoms, and some therapies work on both of them. But really curing these longstanding, entrenched chronic low level infections can I guess be a tough nut to crack.
Thanks a lot for this good info. I will for sure delve into it and, like you, re-post.
Best,
Jack

Reply
jack cronk February 7, 2013 at 2:17 pm

Re: Kefir
I get milk kefir grains from this nice lady who keeps goats on a ranch in Ohio and is a kefir nut. For $20 she express mails them to you. From them, you can make the real deal from milk at home with no special fuss or equipment , and unlike some of the kefir grains you can purchase from other sources, these are hardy, self perpetuating creatures. With just a little care, (detailed in the instructions she includes) you’ll never need to order more.
http://kefirlady.com/

Reply
- lana February 8, 2013 at 12:33 am
  
  Jack, Nick, Stephie, and anyone else interested in what I wrote: 🙂
  
  I’ll try to get to each question, but consider I have 77 failing students and spent long hours on my school computer looking up contact info today to call parents. Eyes are tired and ready to close. Will check back on the weekend to see if I missed anything. 🙂
  
  Jack, thank you for the kefir grains link. No I have not made my own. Seem to be sensitive to uncultured dairy so I never buy it. I will try this link from you, however.
  
  I am very glad that I found Amy King and read her entire blog (printed up many pages and read it completely) where she described the mid-back pain and the heart palpitations. I never had the heart palpitations until I began treating the HP. I have my own hunch that my HP figured out that I was fighting them and that they responded with a tenacity to maintain their territory. Check out this link: http://www.ted.com/talks/bonnie_bassler_on_how_bacteria_communicate.html
  
  I read somewhere that there are several species of HP and that only the few with the “island of pathogenicity” cause problems. However, I also read that they can mutate into more virulent species, much like a poodle might turn into a pit bull while you’re out of the house all day. Considering the severity of the back pain when I have gone off the treatments, I suspect my HP has become more aggressive. I have had the back pain since my sons were small. I called it my holiday back pain as I got it after long hours at the counter preparing those holiday meals for my family. In recent years I have gotten it when tired, but, like you, figured it was age and poor muscle tone. I have read something indicating that back pain can result from ulcers. 😥
  
  Stephie, I take the probiotics only sporadically, with the plan to take it at least daily as I stop the Lauricidin; however, that is supposed to kill only the bad guys. Have Ther Biotic powder and take about a quarter tsp to a half tsp, with Biotagen (Klaire Labs). Sort of alternate with BioKult, which has Bacillus subtillus, which is supposed to fight HP. Kefir is from Green Valley Organics from Sebastopol, CA. Coop in western WA state carries it. Water kefir is supposed to be deadly to HP, and I believe it. On three trips across the mountains, before my diagnosis, I packed a couple bottles of the stuff, gulped down a good cup at a time at the hotel and spent each of those three weekends in the bathroom terribly ill. Charcoal and slippery elm is helpful for that kind of stuff, but I was dreadfully sick, and had no idea why. Now, I can drink any amount of water kefir and I’m fine.
  
  My diet — well, I work in a public school and eating regularly is a challenge. I stick with PHD, mostly, 16 hour fast, but worry because I may have adrenal fatigue. I think I should not be fasting if that’s the case. Wake during the night. Don’t know.
  
  Mostly, beef, salmon, shrimp, yams, sweet potatoes, fewer white potatoes, brocolli, spinach, zucchini, yellow squash, green peas and green beans, bone broth, 3 eggs or yolks. Weekends I have a smoothie of blueberries, raspberries, goji, coconut oil, and splash of pomegranite juice. ❓ Waiting for Paul to advise us about glutamine, but used to put a spoonful into the smoothie. During week I have the berris with creme fraiche. (earlier post from me)
  
  Essentially, I try to stick with Amy King’s diet, but absolutely no grain at all. I tried to keep eating white rice, but the back pain persisted when I did. I also take a spoonful of manuka honey (16+) two times a day with “Gastromend.” Amy’s protocol is crazy but I try to do it, along with Dr. E’s.
  
  Whoever asked — no I am not a patient of Dr. Ettinger’s, but wish I had learned of him before I tried other things. “Elena” on Amy King’s site describes what Dr. E had her do, so I got the products and that’s what I am taking now, and will continue through Feb. The Thorne SF734 reduced the HP numbers so that I could drink the water kefir without problems, and the breath test came back negative. But it did not address the likelihood of biofilms, and the back pain returned. The biofilm story was convincing. I think the breath test was too soon after the bismuth in the SF734, and the HP was hiding, undetected, in biofilm. It was three days after starting the Interfase Plus (biofilm disruptor) and the Undecylex (killing agent) that I passed the worm. It was large enough that I really should have named it and written it into my will. Whenever I think of that thing, I feel so grateful to Paul for giving that talk in Dallas, and for all the butterflies that flapped their wings and, eventually, put me in that room. Else I would have carried all these unwelcome intruders to my grave. AMA docs here were prescibing Prednisone for the intensely itching eyes, but I resisted, and am so glad I did. I am certain it was allergic reactions to the stuff leaking through my gut — like dead HP, toxins, worm feces, and large protein molecules from undigested food. I’ll be doing the Metametrix test every year.
  
  Hugs and kisses to Paul and Shou-Ching.
  
  Night-night everyone.
  
  Reply
  - Stephie February 8, 2013 at 4:46 am
    
    Thanks lana. U gave great info
    
    Amys site is Har to navigate. I could find other related posts and she does not say her exact protocols, she only lists some things/items. She also doesn’t really explain the diet. I’m pretty confused as to what to take, when to take it, how much, how long, etc. Can u give more info on diet and supps.?
    
    As for ur diet, why do u think rice bothers u but not potatoes? Can u also post what ur typical meals per day are like…. I’m new to phd a d am having a hard time figuring it out, especially with dysbiosis
    
    I wonder what the worm was…. How gross/awesome lol. What health differences Didbu notice since passing it?
    
    Will u need to be treating the h pylori for life…. Or how do u know when u can stop the supps and strict diet?
    
    Lastly, I forgot…. Did u do the metametrix test and if so, what else showed up?
    
    Thanks so much for helping all of us…. U are really great for doing so 🙂
    
    Reply
    - lana February 8, 2013 at 10:30 pm
      
      I was just about to finish up a reply, answering your questions and something weird happened. The page reloaded and all that I had written disappeared.
      
      Later this week end I will write again replying to Stephie and Jack. But I must end my day. Very sorry.
      
      Reply
  - jack cronk February 8, 2013 at 2:45 pm
    
    Hey Lana
    When I researched the info you gave me I realized it was what I’d found interesting in my own searches a day or two before, and I’d already ordered manuka honey, mastic gum and monolaurin. Really happy to have you confirm that I may be on the right track. I’ll be taking those, plus goldenseal along with pure berberine (the goldenseal to supply any possible cofactors to the berberine) and black walnut, as well as some L-glutamine and N Acetyl Glucosamine for gut rebuilding. Thanks – later.
    P.S. Sorry to hear that you, like all public school teachers, are caught in the system and have to contend with the results of American public school administrators’ ideas of what teaching is: more money and more administration. In Finland they spend little, but let the teachers use their heads and teach, with excellent results.
    Best,
    Jack
    
    Reply
    - lana February 11, 2013 at 12:55 am
      
      Stephie, Jack, and Nick,
      
      I have thought of you off and on all weekend. Unscheduled visit with tiny granddaughters upstaged so many other things and people in my life. 😉
      
      Quickly…If you go to Amy King’s blog “so happy I have h. pylori,” and select all, then search for “ettinger,” you’ll find an October 5, 2009 entry from him that provides very helpful information.
      
      Then, select all again and search for “elena.” She contacted Dr. Ettinger and followed his protocol, including the biofilm busting elements. She tested clean and raved about how well it all worked. Seemed she did a combo of Dr. E and Amy’s. December 17, 2009 is the date she posted the steps she followed, but you will need to read Dr. E’s site, as well. Also, read all of Elena’s posts, as she gives helpful information.
      
      Amy’s protocol can be found easily. Just select all, and then search for “williams.” This will take you to a summary of Amy’s protocol done by one of her readers. Be cautious, however; for Amy does not seem to have done anything to address biofilm, and I am convinced that is a significant issue for people with longstanding infections. It may be that Amy had more of an acute infection and did not have the biofilm problem that others have. Since my symptoms all cleared up on the various treatments, but came back within days of stopping treatment, I have to believe my HP were hiding in their fortresses during the killing phase, then emerged when the coast was clear.
      
      As I have said, I try to follow her diet, with some exceptions. I do not eat chicken, so I was not going to give up red meat, but did switch to more ground beef, thinking it would be easier to digest. Finally, gave up the white rice (for now). Added the kefir and monolaurin (Lauricidin). Bowl of berries or the weekend smoothie is the only fruit I have, but top it with crème fraiche. Everything I do is PHD. Broth days I add egg yolks to it, other days I have eggs for supper. Look in the back of the book for meal suggestions. Paul’s recent inclusion of the pot roast and 3 ways to use the meat caught my eye, so I had a week of pot roast, sweet potatoes, topped with butter and the juice from cooking, along with a veg (broc, zuch, spinach). It was so tasty, I swooned over my lunch.
      
      I have not found out if my HP is gone, so I am not the one to ask. Check Amy, Dr. E, and Elena. If I had it to do over again, I would have contacted Dr. E right away. But I’m very glad that what I did take expelled the worm.
      
      I would like to comment on the issue of asking redundant questions. I always try to find the answers before posting. The l-glutamine search netted me nothing but several “Not Found,” which seemed strange because I feel certain PHD used to link to it on amazon. After searching the PHD site, I go to google and add “Jaminet” to whatever I’m searching and often find an article, interview, or something on PHD. When I post a question, it means I found nothing. I have searched PHD for items about which I know Paul or others have commented, but often get the “Not found.” The reason for my question is that l-glutamine is recommended as a spackle, of sorts, for damaged GI tract, not as a killing agent, as someone had thought. So many people recommend it that I’m wondering about the cost/benefit.
      
      I am generally not inclined to cringe over much. Perhaps I’ve had so many students who think they can pass after neglecting to complete 37 assignments, that my “cringe” response is gone. I am delighted that many people are coming to the site and asking questions. Yes, I wish they would read the book, but if they get enough encouragement from us, perhaps they will. When I explored Amy’s site I was frustrated at not knowing everything that everyone had posted, so I truly did print up the entire blog (nearly a ream of paper) and read the entire thing. I cannot do that with the PHD. If I did, I would have to stop reading anything current.
      
      The most remarkable thing about Paul Jaminet, in my mind, is his patience and truly kind spirit. I have never heard any cynicism or impatience from him. I have posted questions that he has not answered and I have concluded that a) he has answered that elsewhere and would like me to find it, b) he doesn’t know the answer and needs time to research it, or, c) he would like one of his readers to reply (as in the arsenic and rice question).
      
      The last thing I would like to mention is what I will call the fluidity of the PHD research. What I mean is that Paul and Shou-Ching are constantly researching and tweaking their view points. Check the book for the number of times you find the words “may” and “probably.” Many, many times. Which tells me that they are reading the most current stuff and may have a different take on something in the future, which has been the case in the past for them. So, I am not surprised at question repeats. If a forum would make this easier for everyone, then I am in favor of that. If a “FAQ” section would help, then I’m in favor of that. Since the estimate of incidences of H. pylori infection can be anywhere from 50% to 80% in the US, I would guess lots of people are going to ask about that; so perhaps an HP blog would be helpful? Bless Amy’s heart, she answered the same question time and time again; however, her blog is not near so active as PHD.
      
      Jack, I’m a school counselor with 440 students under my care. Finland sounds cool. 🙂
      
      Nick, thanks for the link. I’ve heard about the acidolphilus thing. I think probiotics are very important in keeping HP from coming back.
      
      Okay, it’s way past my bedtime. Peace out. I would love a meet-up in the north Puget Sound area – Snohomish County.
      
      Reply
Sara February 7, 2013 at 3:00 pm

Hi Paul!

I’m just getting started on the PHD mainly for weight-loss & overall health. So far, I love it and feel very satisfied. But, I still question whether or not my portions are correct. In general, I’m not really good with numbers/quantities, and am unsure if I’m eating the correct amount of starches & veggies. Also, doesn’t the weight of an item, like a potato change when it’s boiled? Should it be one pound of cooked starch or raw starch? For someone like me, who’s easily confused by numbers, would you suggest using a food scale? If not, what are some portion-comparisons I might use? I know I’ve heard you mention “fist-size” as a gauge. Meat is easier to portion since hamburger, for instance, is sold in pound packages. So, in that case I know I should eat about 1/2-1 package per day.

Secondly, shortly before starting PHD, I began making water kefir to provide probiotics (my Komboucha habit was getting too expensive). But, I wonder if the fructose content, although lessened by the fermentation process, is providing too much sugar. I thought it would be okay, because I rarely eat fruit. I just mix the fermented kefir with a little bit of grape juice (about 20% of the container). Any thoughts on the fructose level in water kefir, or a suggestion for a healthy dose?

Thanks for your time & knowledge,
Sara.

Reply
- tatertot February 8, 2013 at 12:04 pm
  
  I know you are hoping for an answer from Paul, but it seems this Q&A thread has turnined into an ad-hoc forum, so I will take a stab at your question, if I may…
  
  I found the PHD way of eating became very inuitive when I focused on 2 things: The ‘Do Not Eat’ portion of the apple, and how I respond.
  
  When I was eating LC Paleo, I only counted carbs. That took starch completely off the table. Now, under PHD guidelines, I include starch every day. I don’t think portion sizes and macro ratios are as important as just eating real food, including starch.
  
  At first, I was shooting for 1 pound per day of starch, meat, and fruit/veg. Over the course of 6 weeks, I find some days I eat more/less starch, more/less fruit, more/less meat. My advice to anyone is just to start eating starch (potato, rice, plantain, etc…) and let the amounts come naturally.
  
  Avoidance of the ‘Do Not Eat’ foods will get you 85% of the way, the last 15% will be determined by following your body’s cues toward a diet that includes all the other PHD elements without undereating, overeating, and getting all the proper nutrients.
  
  Good luck!
  
  Reply
  - tatertot February 8, 2013 at 12:21 pm
    
    Love potatoes, but think they are a pain to cook every night? Try this:
    
    On Sunday, fill a large pot with about 5lbs of smallish potatoes–cleaned well, skin on or off–add about 2″ of water, bring to boil, then simmer covered about 20-30 minutes until potatoes on top are fork tender.
    
    Drain and cool. Store in a large ziplock bag or other container in the fridge and use these all week in place of pasta in receipes.
    
    Anything you used to make with pasta, you can make just as well with potatoes. Mac&Cheese, goulash, spaghetti, lasagna, also pizza. But they also make a terrific standalone side dish. Cubed and fried lightly in butter, cut in wedges and baked, mashed and mixed with butter and cream. Potatoe Salad. Or, just muchned cold with salt and pepper,
    
    The drawback with potatoes is they are time-consuming. A bit of pre-planning goes a long way.
    
    Reply
  - Stephie February 8, 2013 at 12:21 pm
    
    What should a person do if she can’t have starch? Due to certain strains of pathogenic gut flora, I need to eat a low/no starch diet. Thus holds true with people who have AS too. Any advice?
    
    Also, why does paleo advocate Low carb/starch but phd says otherwise?
    
    Reply
    - tatertot February 8, 2013 at 12:28 pm
      
      Stephie – If you absolutely can’t have starch, I would aggressively seek out a cure for the underlying condition. If it’s impossible to cure, you will have to live with it.
      
      Starch is not required for a long and healthy life, proof of this is seen in the long-term low-carbers and several groups of people who have lived on meat alone (Inuits, for one).
      
      Paleo advocates low carb because it is a quick path to weightloss. Paleo also has an image problem (with stalls, plateaus, hypothyroidism, high cholesterol. Most of these are cured with the addition of added carbs, namely starchy carbs, to the diet. Paleo is contstantly re-inventing itself and the new paleo emerging is more in line with PHD.
      
      If you absolutely, positively, can’t eat starch, you just need to focus on getting all the nutrients you can from the other foods and avoid the DO NOT EATs like the plague.
      
      Reply
    - Heidi February 8, 2013 at 3:05 pm
      
      Stephie,
      
      One of the reasons PHD advocates starch is because it makes for a more robust diet. Your body needs it to make mucous – for the lining of the gut, and other organs too. Paul has also suggested using dextrose powder if you can’t do starch.
      
      Low/no starch can probably work for the short term,(not sure what AS is) but if you have gut dysbiosis, you should work at fixing it, as has been suggested
      
      Reply
  - Sara February 9, 2013 at 12:21 am
    
    Thanks for the input Tatertot! (Also, your screenname is apt considering all this potato talk 😉 )
    
    As someone who has struggled with overeating in the past, I guess I’m afraid that my portions may slowly begin to increase without me realizing it. Especially, since I like how the foods taste! So, that is the main reason I wanted a more firm grasp of portion size. I’ve been slowly cleaning-up my diet for the past 6 months, and am no longer having trouble avoiding any of the “do not eat” foods.
    
    As of now, I’m fasting in the morning & then I have 3 eggs for lunch. Then my dinner is usually a large bowl of meat, veggies & starch. One side is 1/3-1/2lb meat with onion, usually with a green veggie like kale or chard, and the other half of the bowl is starch. Usually, 1.5 potatoes + 1 carrot + 1 parsnip mixed together with butter. The bowl is a good size & filled to the top. Then, I have water kefir as dessert (about a pint). All in all, I’m very satisfied, and it feels like a good amount. But without a firm grasp of portions, I’m still being haunted by my over-eating past…
    
    Probably just over-reacting a little, too 😀
    Excited to try some of your Italian-style potato suggestions!
    
    Reply
jessica February 7, 2013 at 3:05 pm

hey paul

I seem to be getting lower abdominal pain which keeps coming and going throughout the day, and sometimes my lower back feels quite stiff. Im not sure what could be a possible cause. I eat according to PHD and take vit d/k2, C, magnesium daily, but iv been on and off with iodine. I’ll take 225mcg and get some side effects and stop. Now Im trying 100mcg but stopped that a few days ago thinking it may be causing the lower back pain and abdominal pain. Do you have any ideas?

Sincerely

Jessica

Reply
Peder February 7, 2013 at 5:37 pm

Hi Paul. What do you think of cod liver oil as a vitamin A source vs. liver? Another source might be vitamin A from cod liver oil — there are some vitamin A that are made from cod liver oil only, so are retinol only. I know in the book you are against vitamin A supplements but what if it is extracted from an animal source like this?

I’m asking because I have a hard time eating liver, and my girlfriend downright refuses to. I am getting some A from food (plants like kale and chard and spinach). I would supplement copper also if using cod liver oil or supplement.

Reply
- Jonathan February 8, 2013 at 1:07 pm
  
  Paul has covered this before. He doesn’t like cod liver oil as a supplement because polyunsaturated fats are very fragile and can become rancid very quickly. Also, supplementation of clo will provide too much polyunsaturated fat in the diet.
  
  Jonathan
  
  Reply
  - Peder February 8, 2013 at 1:20 pm
    
    Jonathan thanks for that. It makes a lot of sense, but doesn’t answer the other part of the question: is it OK to use vitamin A “from cod liver oil”, i.e. retinol from an animal source. It’s the same stuff as in liver (minus other good things, yes) so I would think does the same thing. In concentrated form I doubt there’s much PUFA in it. Any thoughts on that would be appreciated.
    
    Reply
    - Jonathan February 8, 2013 at 1:33 pm
      
      That, I don’t know. I do recall him, however, mentioning that he thinks desicated liver tablets would be decent substitute for eating liver. It’s more costly than actually eating liver, however. Personally I’d opt for the liver pills.
      
      Here is another option, used by Chris Kresser. Chop up liver into small pill sized pieces and freeze them. Then take them with water just like you would pills. You get additional benefits of liver considering your taking it raw. Just be sure to leave it in the freezer for a couple weeks to kill the microbes and parasites.
      
      One quick note on eating liver. I’ve heard people say that grass fed liver from young cows taste much better than liver from old grain fed cows. Good luck!
      
      Jonathan
      
      Reply
      - Peder February 8, 2013 at 1:55 pm
        
        Jonathan, thanks again for more info. I did find grass fed beef liver at Whole Foods — still could not stand the flavor. I will look into small “pills” of raw liver. I guess if I’m not sure of unsafe microbes I cook first cook the small pieces. If one of the parasites of concern is hep-c that takes an hour at 160f degrees… not sure if that’s an issue with beef, only pork. Thanks again for the ideas. I will look for Kresser’s info too.
      - Stephie February 8, 2013 at 3:05 pm
        
        What about fermented Cod liver Oil? Gaos and other healing diet recommend it.
        
        Also isn’t liver high in copper?
      - Jonathan February 8, 2013 at 3:10 pm
        
        Yes, definetely look into the ability of cold temperature to neutralize microbes etc. I took liver this way for a while with no problems but that’s just my experience. My thinking is if Kresser uses this method, you can be sure he researched the hell out of it to be sure it’s safe etc.
        
        Stephanie, Paul recommends eating only around 1/4lb of liver for the reason you mentioned, it’s high in copper. See the above for comments on CLO.
        
        Jonathan
      - Thomas February 8, 2013 at 4:40 pm
        
        @Stephie, I don’t want to speak for Paul, but FWIW he spoke negatively of fermented cod liver oil in a response near the bottom of this page:
        
        http://perfecthealthdiet.com/2012/03/paleofx/#comments
      - Stephie February 8, 2013 at 5:21 pm
        
        Thanks…. Sorry, it’s so hard to navigate thru all these pages, especially thru my phone (my computer broke)… This site is not phone friendly old. I agree that we need a forum 🙂
        
        I worry about anything with copper bc I am very copper toxic and zinc deficient. Does he have a preference over beef or chicken liver? I can’t find pastured livers either
        
        Last question…. The only chicken i can find is organic but it is not pastured… It is vegetarian fed. Is this ok to consume daily? Same with fish…. Is it ok to consume sardines and white fish (sole flounder tilapia) or shrimp/acallops daily or twice a day? I think I read that kresser said the selenium in fish was enough to counterbalance any mercury in fish
        
        Another last question (lol) did Paul ever respond to the arsenic and rice scare? And how do the levels of metals and toxins in fish compare to other foods like meats, veggies, starches etc?
      - PeterC February 8, 2013 at 7:20 pm
        
        @Stephie
        
        Have you read the book?
      - Darrin February 8, 2013 at 7:38 pm
        
        Hi Peder, fwiw,
        I have never seen a dessicated liver supplement (defatted or non-defatted), listed as containing any Vitamin A.
        A quick search on iherb.com for ‘desiccated liver’ will show a few examples.
        
        The only natural (not synthetic) Vitamin A supplement i have been able to find (apart from natural CLO) is by Carlson Labs.
        They do a 10,000IU & 25,000IU made from “Fish Liver Oil”. as mentioned Paul does not recommend any supplemental Vitamin A. But if you need to, the 10,000IU could be a good option, i would steer clear of the 25,000IU.
        
        The label info & image does not seem to be working on their web site,
        http://www.carlsonlabs.com/p-249-vitamin-a-natural-10000-iu.aspx
        
        but you can check the info on iherb here,
        http://www.iherb.com/Carlson-Labs-Vitamin-A-10-000-IU-Natural-250-Soft-Gels/15282
        
        Note, carlson labs also do synthetic vitamin A products, so be careful, must say Natural (& from fish oil).
        
        I actually email Carlson about the natural vit A product, & this was their response,
        
        “The Vitamin A -10000 IU Natural product is soy free. No soy!
        
        Vitamin A 10,000 IU- Natural vitamin A from the Halibut fish liver. It is sold in a 100 count bottle or 250 count bottle.
        
        It is in a beef gelatin capsule with glycerin and water, and safflower oil as the contents the vitamin A is in.
        
        It is free from the following allergens: Sugar, starch, salt, preservatives, corn, milk, soy, wheat, yeast, citrus, and gluten.”
- lana February 8, 2013 at 9:25 pm
  
  @ Stephie: Paul came out against fermented cod liver oil and provided this link to an explanation: http://perfecthealthdiet.com/?p=3390
  
  Reply
Elizabeth February 8, 2013 at 8:06 am

http://perfecthealthdiet.com/2011/04/causes-and-cures-for-constipation/

For all of you concerned with L-glutamine. Check out the above link. He has already addressed this, look in the second section.

(If I had a dollar every time someone asked Paul directly about something he’s written about already on his blog or in his book……well, I would have about $39 extra a month.) 😀

Hope this helps!

Reply
- jack cronk February 8, 2013 at 2:53 pm
  
  Thanks for that reminder. I’ll cross the glutamine off my H.Pylori kill regimen.
  
  Reply
lindsay February 8, 2013 at 12:10 pm

Hello readers,

I will likely post the same question on Paleohacks, but you all are way smarter 😉 so I’ll try here first. My very best friend has most recently broken out in to welts and hives all over her body. The hospital staff told her that her H1 and H2 H1 receptors are either all jacked. They have put her on a heavy dose of steroids and armed her with two epi pens until she can get an appt at the allergist. Obviously they will encourage and elimination diet and then likley she will be told to just avoid problem foods for the rest of forever. There is my question… do you think that is good advice? Or should one work to fix the source of the problem? Likely the gut… Seems like she is going to be allergic to lots of things as she confessed to having issues with lots of nuts, dairy, different kinds of citrus, different veg and possibly fish. I think a life of limitation sounds hellish and in my mind it makes more sense to fix the problem from a holistic angle. Thoughts?

Reply
- tatertot February 8, 2013 at 12:32 pm
  
  Of course your ideas would be best, but is she willing?
  
  Reply
  - lindsay February 8, 2013 at 2:41 pm
    
    I don’t know if she is willing, but I do know that she doesn’t want to live a life in a bubble, pumped with drugs. I do know that. But you make a good point, the level of patience and perseverance it takes to identify and then work through medical issues is quite a challenge. I guess I was really asking if anyone knew any studies and what not that had been done linking allergies to the gut. Or if anyone had personal experience tackling a similar issue.Or really, just advice on where she should start. I have been around this Paleo/Nutrition world for a few years and have heard a lot of anecdotal stories, but don’t know much outside of that. She is looking to me for advice..
    
    Reply
- lol February 8, 2013 at 2:10 pm
  
  Obviously it’d be better to fix the source of the problem. Gut bacteria aren’t some magical force that will fix every problem, though. Remember that there are many problems we don’t know how to solve.
  
  So, sure, if you can fix the problem that’s great. But don’t do anything stupid; I’ve seen far too many “holistic health” people completely shirk any mainstream medical advice and suffer as a result.
  
  Reply
- Nick February 8, 2013 at 2:36 pm
  
  Finding the source of any physical dys-function is the ultimate ‘gold medal’ … but being as we are highly complex beings with interconnected systems and that all dys-functional issues will have knock on effects it makes finding the source often very difficult… this is why traditional medics prefer to relieve the symptoms with drugs because they can and it’s far easier. Taking a holistic approach to everything will yield far better results… optimising immune function health by ensuring our micro-nutrient levels are in the peak health range is a perfect base to begin from and to achieve this one must of course ensure the digestive tract is operatng as perfectly as possible to the absorbtion of nutrients is maximised. Any breakdown of the mucosal barrier within the digestive tract can cause leaky gut and all it’s associated dys-function. Pathogens… Parasites and fungii can all help to break down that mucous barrier so getting a comprehensive stool test done is money well spent… you can begin to understand where the root cause of issues lie with information about what invaders are present and flourishing within the digestive system.
  
  I believe anti-biotics over use has a lot to do with how come we end up losing whole specific strains of gut flora that would normally keep everything under control.
  
  Nick
  
  Reply
  - lana February 8, 2013 at 10:38 pm
    
    Thank you, Nick, for the link to info about HP and acidolphilus. Seems I did read something, but don’t remember now. My doc and a few others have said that no one wants any HP lurking around, but others, including Amy and Dr. E say that we want to keep a small number of them. As Paul has said, HP is a complex organism, and the research is still unfolding.
    
    Yes, public ed is not without its challenges. I am a guidance counselor with 440 students on my caseload. It’s all about the testing and passing rates. But the private situations from which many of my student come do not facilitate much success at school. Today, I actually brought up PHD to a student and she was enthralled. Wrote notes, said she did not know how to order from amazon, but would bring money for me to order the book. Well, we’ll see what Mom has to say. First time I have seen this student excited about anything.
    
    I’ll put in for Finland in my next incarnation. 🙂
    
    Reply