Q & A
This page as an open thread for reader questions, especially questions about personal health concerns.
I am putting this page up as a way to share knowledge — my knowledge with questioners, but also so that others with similar concerns can read the conversation, and readers with relevant knowledge can chip in with their own thoughts.
Please keep in mind that I can’t research questions in any depth, so my answers should be considered tentative, incomplete, and subject to later correction. Also, I am not a doctor, and nothing I say should be construed as a substitute for medical diagnosis and treatment. I am only sharing opinions about disease origins and general therapeutic strategies which may or may not be applicable in any given case.
To get the page started, I’ll put up a few questions from recent emails. Here is an index by disease, with clickable links:
- Chronic Lymphocytic Leukemia (CLL)
- Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue
- Lupus
- Depression
And here are my answers.
Chronic Lymphocytic Leukemia (CLL)
Paul,
Been following your work on the PHD before the publication of the book and commented on my CLL and the usefulness of Vitamin D once on your blog and you responded to keep an eye on my Vitamin K intake, which I do now.. Am fortunate in a way to have my form of CLL as it indolent which gives me the opportunity to experiment without the pressure of undergoing conventional treatment. The PHD, I think, is helpful in this regard.
Wonder if you could point anything out to me that may be useful. Anything at all. And I will be happy to share with you my results.
Surely you know of the helpfulness of green tea with CLL. You may not be familiar with research that points out that those with low levels of Vitamin D need treatment for CLL far sooner than those with elevated levels.
Feel strongly that your version of a ketogenic diet would be helpful but also feel I need some direction in this area. Do you have any suggestions?
Warmest Regards,
A
Hi A,
I remember your comment, thanks for writing back. I’m glad you’re enjoying our diet and wish you the best.
Thanks for the tips about green tea and vitamin D. Neither one surprises me.
Most likely CLL is caused by a viral infection. So enhancing viral immunity is probably a good idea. Good strategies may include: (1) low-protein dieting, which inhibits viral reproduction and can promote autophagy; (2) maintaining high vitamin D levels; and (3) intermittent fasting, which promotes autophagy.
Some food compounds have been reported to have antiviral effects. An example is green tea catechins, eg http://pmid.us/16137775, http://pmid.us/18313149, and http://pmid.us/18363746, and this could be why green tea is helpful against cancers, http://pmid.us/21595018, which are usually viral in origin.
I might search Pubmed for herbs and spices with antiviral effects, and use them abundantly in cooking, along with antiviral foods. Turmeric / curcumin is a good choice, this needs to be taken with black pepper to enter the body. See http://pmid.us/21299124, http://pmid.us/20434445, http://pmid.us/20026048.
Coconut oil / lauric acid also has some antiviral properties, so inducing ketosis with coconut oil could benefit you even aside from the ketosis. You could also try monolaurin supplements which may enter the body better and which some people have reported to help viral infections.
You might also try HDL-raising tactics as discussed in this series: HDL and Immunity, April 12; HDL: Higher is Good, But is Highest Best?, April 14; How to Raise HDL, April 20.
Another possible tactic is high-dose riboflavin with UV exposure on the eyes. This requires going outdoors at midday and not wearing glasses or contact lenses. Riboflavin+UV is toxic to blood-borne viruses, and the retina is a location where UV can reach circulating blood cells. Sun exposure will also help you optimize vitamin D.
That’s a few ideas, at some point I’ll do some research to come up with more and do a blog post. Do keep me posted on your results!
Best, Paul
Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue
Just came upon your website and had a question for you. I have had some health concerns for the last four years, bloating, acid reflux, anxiety, depression, hypoglycemia symptoms, female complaints (I am in my forties), thyroid antibodies at 333, weight gain around my middle and too tired to work out like I once did. I used to be fikiiled with energy and great health no depression or anxiety. My doctor thinks these symtoms are all from peri-menopause and wants to treat me with Zoloft.
Needless to say I have tried to avoid the Zoloft. I have tired every avenue out there to cure myself. Most recently the Primal type diet. When I eat no grains or dairy I get horrible hypoglycemia symptoms and don’t feel great like everyone else on a low carb diet. I feel weak and more anxious. Do you think your diet would be easier for me with the addition of rice and potatoes?
G
Hi G,
Yes, I do think our diet will be better for you. You should eat enough starches to avoid hypoglycemia.
The key thing for you is treating the infections which are consuming so much glucose and making you glucose-deficient if you don’t eat enough carbs. Whatever pathogen(s) this is, it seems to have infected your gut and caused the various gut problems; circulating pathogen-derived toxins and immune cytokines are probably responsible for the anxiety and depression. Hashimoto’s hypothyroidism may be either due to circulating toxins or a thyroid infection.
I would suspect some kind of protozoal or parasitic infection due to the hypoglycemia, but what I really recommend is getting your doctor to have a stool sample analyzed for pathogens. Metametrix has a good test. Once you know what pathogen to treat, and get on a better diet like ours, you should improve quickly.
Lupus
I am writing on behalf of my mother … We live in Dhaka Bangladesh …
Before her illness, my mom was 105 lbs, 5 feet tall and always 10ft tall in spirit…. When she was diagnosed with Lupus at the age of 30, we were all overwhelmed and out of our depths. My beautiful, athletic mother was in a wheelchair and given 6 months to live….
The doctors has advised her to eat literally nothing, minimum protein (1 small piece of chicken/fish, limited to 20g protein per day), only 2-3 types of vegetable and 2-3 fruits and of course lots of carbs to apparently compensate for her failing KIDNEY and LUPUS. She is on tons of medication, no food except the wrong foods (carbs) and in chronic pain. She currently weighs 139 lbs.
Please advise. — S
Hi S,
I believe lupus is a catch-all diagnosis for a variety of conditions which are probably caused by undiagnosed infections. In the US the infections are usually bacterial. I’ve known several people with diagnosed lupus who were cured by antibiotic treatments – in one case the problem was Lyme disease (Borrelia). I have no idea what the likely pathogens would be in Bangladesh. If she does better on low carb and coconut oil, that indicates bacteria; if she does better on high-carb, that indicates protozoa.
A healthy diet is very important. It is very bad advice to “eat literally nothing,” it is essential to be well nourished. Protein is necessary for healing and immune function, and 20 g/day is too little. Fasting is good, but it should be intermittent – not starvation! She needs healthy fats, more protein, and lots of micronutrients. Eggs, shellfish, seafood, bone broth soups, vegetable soups, and fermented vegetables may all be helpful. Coconut milk is probably good for her. You should basically follow the program in our book.
I would try to put her on a good diet, give her a little time for kidneys and other tissues to heal, and then try antimicrobial medicines. Usually, if they’re not working, then you don’t notice an effect. Any strong effect, good or bad, means they are working. Bad effects mean that pathogens are dying and releasing a lot of toxins as they disintegrate. If this occurs, detox aids (salt, water, and one of cholestyramine/charcoal/bentonite clay; also glutathione supports and vitamin C) will help.
Please stay in touch and let me know how things go.
Best, Paul
Depression
I’ve suffered from depression for decades. A few months ago, I decided to try the Dr. Kruse protocol for jumpstarting leptin sensitivity and 2 interesting things happened.
When I went very low carb – below 50 gm -. I had half-day periods where the depression suddenly lifted (something that has rarely happened otherwise). However, I also suffered from darker than normal periods.
I stopped the Dr. Kruse protocol after 6 weeks, and went back to regular paleo (approx. 200 – 300 gm. Carb/day). I’m now generally more depressed than usual, without the good periods.
These changes seem to indicate that I can have an influence on my depression with diet, but not sure what diet to try. Thoughts?
Hi Jersie,
I think your experience on very low carb is diagnostically telling.
I would interpret it this way:
- Your depression is caused by an interferon-gamma mediated immune response in the brain, probably caused by a viral or bacterial infection. This leads to tryptophan being directed away from serotonin and toward the kynurenine pathway. So you have a serotonin deficiency and kynurenine excess.
- A ketogenic diet is both therapeutic (promotes immunity against bacterial and viral infections) and mood-improving (clears kynurenine).
- However, you are at risk for hypoglycemia in the brain (especially if the infection is bacterial) and hypoglycemia causes irritability/anxiety and can aggravate depression.
So the very low-carb diet had mixed effects (ketosis, hypoglycemia).
What I would do is follow our ketogenic diet advice. Eat at least 50 g/day carbs from starches to get sufficient glucose, plus sufficient protein to reach 600 calories/day protein+carb, but add in large amounts of MCT oil or coconut oil. Also, do intermittent fasting – eat all the carbs within an 8-hour window; eat at least half the MCT oil in the 16-hour fasting window.
Once on a good diet, I might experiment with antibiotics to see if they relieve symptoms.
Please let me know how things go.
via this link:
hello Paul,
Firstly, just want to say its brilliant that you give up your time to answer people’s questions, and there seem to be alot of questions!
I have a condition called cystic fibrosis (CF). There are many gentic variants of CF, i have the most common type called F508. I’m sure you know a little bit about CF as you seem very well read, but i thought i would do a little over view. Basically, My CFTR pump in my cell walls dont work and thus i am unable to pump Cl ions out of the cell. Along with the fact i also pump to much Na into my cells. This leads to a number of problems. Particularly in the mucus lining in my body. My mucus is thicker than normal people’s due to the lack of osmotic pressure from the irregular distribution of ions, which usually forces water into the mucus making into more facile to clear. This leads to bacterial infection, particularly in the lung and slow decline of lung function. However, there is also a problem with increased inflammation in my body, and my body tends to produce more inflammation receptors causing my body to over react to things. My pancrease cant produce enzymes due to the thick mucus, so i need artificial enzymes to digest my food, particularly the protein and fat. I am on constant anti biotics which i fear will result in gut cancer in the future from lack of good bacteria in the gut. With all this said i am actually quite well with total lung capacity in the 85% range.
I really think a diet reducing inflammation will help me. AT present i get terrible! dark patches under the eyes all year around and have done so even when i was super healthy at 15. This is thought to be allergy related which i presume is inflammation related. I hope my change in diet can fix this. But!!!! i have quite a big problem to overcome. i cant simply follow a low carb or even medium carb , high fat diet without getting serious blockages in my gut. I tried just upping my fat for a couple weeks which eventually led to a serious blockage in my gut. The reason for this is my artificial enzymes are only 60% effective! thus lots of fat gets leaft over. Even taking obscene amounts of enzymes still doesnt seem to help, maybe eating fats in smaller portions might help the adsorption rather than in huge loads? I obviously need more fibre because of this, but i think i would need ridiculous amounts to overcome the constipation and beans sprouts are a no go! which i use for a good fibre source. I am just going to try eat good starches and eat as much clean fat as possible and see how that goes. But it is a real conumtrum, that something i think would help my CF is very hard to achieve because of the CF. It does seem unbelievable to me that my medical doctors havent even considered this approach. Surely diet is the starting point for treating anything before satins are introduced.
I am just wondering if you have any ideas about approaching a PHD with CF or any other things that may help? Sorry for the very broad question, it is quite difficult to know what to do.
best wishes,
Rhidian
Hi Rhidian,
Have you tried taking ox bile with meals? That should help fat digestion. Other bile supports are vitamin C and taurine.
Eating low carb can reduce mucus production, this is a negative in normal people but in your case maybe it would be a good thing. NAC is mucolytic and will probably help; it also often helps with constipation. You might see if other mucolytic agents help you. Iodinated glycerol is probably pretty safe, for example. (http://www.thoracic.org/clinical/copd-guidelines/for-patients/what-kind-of-medications-are-there-for-copd/what-are-mucolytic-agents.php)
Usually eating potassium-rich foods like tomatoes and potatoes and taking low-dose lithium (2-5 mg/day) would improve electrolyte balance. However, I can’t find much in the literature on these interventions in CF. There was a trial of lithium but it used very high doses (bipolar disorder doses, 900 mg/day lithium carbonate) and had negative results. Magnesium supplementation seems to help: http://www.ncbi.nlm.nih.gov/pubmed/22648717.
Vitamin K and vitamin E may help.
Dietarily, I would try to be nutrient dense, pretty similar to PHD, but lower-carb.
hi paul, i have a concern with my lipid profile.
first blood test january 18th 2013. second test april 8th 2013. TC was 377 is 347. Trigs was 106 is 70. HDL was 75 is 77. LDL was 281 is 256.
on the good side after supplimenting with 4000iu of Vit D was 26 is 43.
im following PHD plus all suppliments. loving the regular i6 hr fast’s and bone broth, still struggling with constipation, have added NAC.and RAW probiotics.have had some success with and evening drink of 325 mg of magnesium powder. in the past my lipids have only been borderline high, those were the day’s of cereal’s for breakfast, 2 egg/week and no butter. any suggestions?
Hi alfred,
looks like your lipid profile is improving… All markers are moving in the right direction.
I read somewhere that in wintertime LDL can be elevated, as an adaptation to increase Vitamin D production (since LDL is transformed into VitD via UV-B).
For me personally constipation was a selenium deficiency; I have long stopped supplementing it and still everything is moving smoothly 🙂
Wout.
hi wout, thanks for that info and encouragement. my only selenium intake other than PHD food is from 3 brazil nut’s/day. there may be a thyriod connection [ never been tested]i have allway’s had cold hands/feet.i will get a thyriod check in a few weeks when i get back to canada.the big change for me on PHD is the amount of dietary fat, i wonder if i have overdone it.
It’s very possible. Remember that oils have 4,000 calories per pound, PHD plant foods 200 calories per pound, so visually 50% fat calories 30% carb calories is about ten times more plant food to the eye than oil/fat. Also, half of that 50% fat comes from animal foods which provide no carbs. If you see a lot of oil or fat on your plate, you’ve overdone it.
Hi Alfred,
Glad to hear you are making progress, of course there is still a long way to go in LDL and TC.
How many carbs are you eating? Is it possible you are still too low carb? Try to get a kitchen scale and weigh your safe starches to see that you get about one pound of potatoes or cooked white rice per day.
The other potential causes are hypothyroidism and endotoxemia from a gut dysbiosis. If you are eating adequate carbs, then it is safe to take thyroid hormone to treat hypothyroidism. Ask your doctor to test your thyroid hormone levels and ask to experiment with low doses of supplement T4 hormone (levothyroxine) even if any hypothyroidism is subclinical.
If it looks to be an endotoxemia, then a good first step would be to reduce supplementation and focus on nourishing foods, for reasons I just explained to Sue, http://perfecthealthdiet.com/buy-our-book/comment-page-5/#comment-147933. Liver, bone and joint broth soups, and fermented vegetables are especially important. Supplements to continue are (a) vitamin D as needed to maintain 43 ng/ml, (b) vitamin C (500 mg to 1 g/day), (c) iodine (225 mcg/day), and magnesium (200 mg/day or a bit more if it helps your constipation). Maybe vitamin K2, 90-100 mcg/day; maybe silicon or lithium; NAC during your fast is good too. Otherwise I would focus on making food as nourishing as possible.
Then I would try circadian rhythm tactics as described in Chap 42 of our book, and after that get a stool test looking at the state of gut flora.
Best, Paul
thks Paul,i have been having less than 1 pound of starch,i have been enjoying the 16 hr fast every day and its difficult to have that much starch spread over 2 meals while fighting FBG 115-123, so i am reluctantly giving up the fasting to increase the starch.when i get back to Canada they will problbly only approve the thyriod stimulating hormone test, however while i am still here in florida i can without a Doctor get a T3 or T4 Free. which of these or both should i get?.
PS my wife [ type 2 diabetic insulin dep ]is having excellent glucose control on the 16 hr fast every day with no hypo’s. is it safe for a type 2 to continue fasting every day?
Hi Alfred,
Adding more starch typically lowers fasting blood glucose. Your high FBG may indicate you are too low carb.
I don’t think it’s necessary or desirable to give up the intermittent fasting. I think it’s quite easy to eat our recommended amounts of starch in two balanced meals.
T3 or T4 are good to have, given that you have one symptom of possible hypothyroidism (high LDL). If you had other symptoms you might have a stronger case. The high LDL might be due to just eating too few carbs, so I would try the carbs first.
DirectLabs offers their “Thyroid Panel Plus Free T’s & TSH” which includes TSH, free T3, free T4 for $99, https://www.directlabs.com/OrderTests/tabid/55/language/en-US/Default.aspx, if you want to go around your doctor.
Yes, daily fasting is excellent for diabetes, as long as it doesn’t cause adrenal stress. Highly recommended.
Hi Paul and all,
Paul, thanks for the great piece on the red meat study. I was not among those freake out by the study, but your post was fascinating and an excellent opportunity to reflect on the power of the gut biome.
I have a relatively simple question today that I wonder if you or anyone else can help me with. With regard to white rice: if I see some in my stool I it a sign that I’m still by digesting them well enough? There are just specks here and there, but my wife (the healthy one) says she doesn’t see any in hers. I am concerned about feeding bad bugs in my large intestine. I also am on a healing curve from severe Colitis, so maybe I’m just not ready for such complex starch yet?
Thanks, Grayson
Sorry — iPhone typing fail!
– “still *not* digesting them well enough”
-“…*is* it a sign…”
Hi Grayson,
I’ve also never seen white rice in stool. It does seem like a lack of gut flora for digesting some cellulose. I would just add some fermented vegetables/kimchi to the diet and continue eating rice. Also, try chewing rice more thoroughly in your mouth before you swallow and making sure it is well mixed with saliva.
hi Grayson, you could do an experiment, with different types of rices,
i’m thinking a high amylose rice versus a low amylose rice.
of course make sure you do the test a few days apart to make a valid observation.
Amylose is a type of resistant starch.
a high amylose rice is a long grain rice such as basmati rice.
a low amylose rice is a short grain rice, think sticky rice/glutinous rice.
http://en.wikipedia.org/wiki/Basmati
http://en.wikipedia.org/wiki/Glutinous_rice
http://en.wikipedia.org/wiki/Amylose#Recent_studies
If only one type shows up undigested, then that might give you a clue…a clue to what, i do not know, but i’m sure Paul may…
…& for a real test the rice should be prepared & served in same way.
I was reading that the other day (cannot find the link) that the resistant starch (RS) in rice will be higher when served cold/chilled.
& this may happen in short grain rices as well, eg. sushi
Hello Paul, (from Vancouver, BC Canada)
Thank you for all your help, both in the book and on this web site. I have been quite strict PHD for about 10 months and have been practising intermittent fasting for about 2 weeks now (eating in a 6-8 hour window daily). Over the year, I’ve lost 25 pounds and am now at my target weight. I am slowly increasing my safe starch intake to combat a bit of dry mouth, especially during strenuous exercise, and occasional constipation. But generally things are going very well, thanks to you and your wife. I’m very grateful.
Now I want to try to address my HSV1. I get about 4 full lip cold sores per year and sometimes I feel the tingling of one coming on but manage to keep it under the surface somehow.
Questions: Can I ever eliminate the virus? Will intermittent fasting have any effect? Will longer fasts be more helpful or should I just continue with the daily 6-8 hour eating window. (Would a ketogenic diet also be helpful?
I have searched HSV1 plus autophagy using Google, and there seems to be some research, but I quite quickly hit a wall of science that I am unable to penetrate.
Any advice will be much appreciated. Thanks
Cheers,
Gordon
Hi Gordon,
I’m not aware that it’s possible to eliminate HSV-1. But some tactics should help:
– Intermittent fasting
– Vitamin C
– Lysine
– Vitamin D
Best, Paul
Hello Paul,
Want a cool update? And to hear how I made a cardiologist lose a bet?
Recap, low fat diet for 20+ years (age 18-42)
Lipids at age 27 (on low fat diet):
TC:155, LDL 96, HDL 43 TG 82
Fast forward to age 42 (still on low fat diet)
TC:221, LDL 158, HDL 42 TG 105
numbers crept up, same diet, same exercise, etc
Doc says take statin. Research lead me to low carb.
Age 43 (one yr on low carb)
TC:282, LDL 189, HDL 73 TG 98
Doc scared of LDL, prescribes statin. I tear up script.
Age 45 1/2 (~2 more yrs on low carb with last 6 months adding more carbs, perhaps 10-15% and sticking close to PHD with supplements)
TC:292, LDL 209, HDL 69 TG 71
(note LDP-p 2323, with small LDL-p 711, LP(a) 7, LP-IR 10)
Doc sends me to cardiologist as I say I don’t want a statin and I refer to my great HDL and TG numbers and ratio of nearly 1.0, LP(a) of 7, LP-IR of 10, my 7% body fat, and 120/76 BP.
Cardiolist says, do you want to take a statin?
I say No, (of course).
Would you go for a coronary calcium scan?
Sure.
If calcium shows up will you take the statin?
I just say, I’ll take the test.
Cardiologist called today. Seemed quite upset to give me the good news. ZERO. Nada. Nothing on the scans.
I said now what?
Doc says, The right thing to do is take the statin due to high LDL and father who had heart attack at 50 (but smoked 30 yrs and was overweight), the later (family history) being thrown in my face.
But I got a zero, shouldn’t I just be retested in 3 yrs or so.
“yes”
conversation over…..
question: Did I make the right call?
Hi Evan,
Definitely the right call not to take statins. I think you should work on lowering the LDL number – by natural means of course.
Yes Paul I am attempting to correct the LDL-p issue.
As per your advice I:
#1. Added more safe carbs (rice and sometimes potatoes when rice not available).I am up to 2 cups a day which puts me close to 20% by carbs (not including veggies). Sometimes I treat myself to an Atkins bar, with alcohol sugars etc (bad idea?) But this does brings my carbs up a tad more and tastes good for a sweet treat.
#2. I reduced Coconut oil to just for cooking needs or for taste. I WAS adding 2-3 tablespoons a day to my coffee to get my MCTs, but perhaps I don’t need so much of it. I hope the reduction in Coconut oil does not lead to lowering of HDL.
3. I try to not eat excessive cheese and cream
4. I cut down nuts to perhaps once a week, if that.
Any other suggestions??? I am willing to listen.
Oh, before I forget, I implemented the Pauling Protocol (about a month back) C + lysine. Pauling surmised that vit C is the collegen fix the arteries need (due to constant wear and tear from flexing and moving) as all animals who can make their own Vit C do not get CHD. And man lost this ability 10s of thousands of years ago. Also the lysine binds to LP(a), the worst of the LDL, such that is doesn’t ‘stick’ to arterial walls. So I take 1 g Vit C and 1 g of lysine, 4-5 times daily.
Any other suggestions besides PHD, as I am quite close to PHD anyway?
Hi Evan,
Beef or lamb liver weekly, shellfish weekly, 225 mcg iodine per day, 3 egg yolks a day, bone and joint broth soups, yoga breathing exercises, daily exercises for circadian rhythms.
Treat any hypothyroidism, including subclinical.
Hello Paul,
First of all I want to say thank you very much for writing this amazing book. It is such extremely important information that I know I have been missing in my life.
My question is regarding my overall health. I am a long distance runner and have been since I was 18. I am now 45. I have always run to alleviate stress and anxiety which has bothered me some over my life.
About two years ago I started getting really anxious all the time and running just wasn’t getting rid of the anxiety. Other symptoms I developed were fatigue ( I can sleep 10 hours per night ) and very tight diaphragm muscles. This last symptom is particularly troubling because it has become difficult to take breaths because of these extremely tight breathing muscles. It feels like the anxiety and tight breathing muscles are related. I also usually wake up rather stiff.
I have had many medical tests and seen a few doctors and they found nothing that they see as a problem. A naturopathic doctor tested my neurotransmitters and one thing that stood out was that my epinephrine levels were very low, and my norepinephrine levels were very high.
I have been applying your diet for about 2 months now and I do feel better. I have more energy. But my stiffness isn’t improving like I want it too. I can run, but I just feel extremely stiff, especially in my diaphragm and back. I was eating a close to vegan diet for a few years before switching to your diet. I almost feel like I was starving myself for many years. Is there anything you would recommend besides just sticking to your diet? I have a hunch it just may take more time to see some bigger benefits since I have eaten so different for many years. Any advice you can add would be so greatly appreciated.
By the way I want you to know all my friends are amazed that anything could have me eating meat and eggs and fat since just a few months ago I was advocating eating no meat or dairy and little fat. Your book is very compelling and again, much appreciated.
Thanks,
Gary Vale
Hi Gary,
I also have a hunch that your body will heal itself in time. However, maybe we can speed things up a bit.
A few thoughts:
– Running triggers dopamine release and dopamine is a precursor to norepinephrine. Is it possible you are over-exercising? Overtraining can be quite stressful. You might do better with this program: 1 long run per week; 1 intense weightlifting and interval/sprint session per week; on the other 5 days do easy restful runs and yoga/qi gong/tai chi. Make sure the 5 easy days are restful.
– Insomnia also causes dopamine release. It might be good to ask your doctor for a sleep study. Poor sleep affects many aspects of bodily function, and they might be able to trace causes, eg sleep apnea, and treat them.
– It’s possible adrenal dysfunction plays a role. Epinephrine and norepinephrine are both made in the adrenals. This is often associated with thyroid dysfunction which can be treated, and with stressful activity like overtraining.
– A leading potential cause is some sort of gut dysbiosis or infection. This is the most frequent cause of anxiety. A stool test may turn up a cause.
I would focus on good nourishment (to promote healing and immune function) and on the circadian rhythm tactics of chapter 42 to improve sleep, adrenal function, and avert overtraining.
Be sure to eat liver!
Thanks Paul. I ate liver tonight for the first time! It wasn’t that great but I know it is good for me. And I think I can aquire a taste for it in time.
On a quick follow up to my previous question and your answer. Is there anything else you would recommend to help with adrenal fatigue which it sure seems that I have. I still, after two years of feeling like this can sleep for 10 hours or more and could go right back to sleep for a nap! Any additional supplements or herbs or teas you would recommend? Thanks again for all your knowledge!
Gary Vale
Hi Gary,
I’m not that knowledgeable about sleep issues and I’m not sure what might cause excess sleepiness. I would just pursue general health, including circadian rhythm strategies as discussed in Chapter 42 of our book.
Gary, just as a side note to Paul’s excellent advice, I would suggest that you consider the possibility of an airway shape-induced sleep breathing issue as one variable in the sleep equation. http://doctorstevenpark.com/
HI again Paul. A quick follow up question. You mentioned that a leading potential cause of anxiety is some sort of gut dysbiosis or infection and that a stool test may turn up a cause. My question is how do I go about approaching my doctor to ask for a stool test for this reason? This may seem like a dumb question but my doctor has done so many tests already to try to find a cause and I just want to approach her with all my facts correct and in a way that I don’t offend her. Thanks again Paul.
Gary
Gary,
I hope you don’t mind me chiming in, but are you taking Paul’s recommended supplements? I found this link between magnesium deficiency and anxiety interesting! http://www.psychologytoday.com/blog/evolutionary-psychiatry/201106/magnesium-and-the-brain-the-original-chill-pill
My two cents: don’t make the mistake of thinking that because running was once the solution it could not now have become the problem.
Mark Sissin has written about this. here is one post. Look around his site for others
http://www.marksdailyapple.com/overtraining/#axzz2QSYDhSoW
You migh also be interested to read an article in the most recent Weston A price journal written by Christ Masterjohn, titled, Meat, Organs, Bones and Skin : nutrition for mental health. It should go up on The website soon
http://www.westonaprice.org/journal
Or you could become a member / or just buy this issue to read it now
Hi Paul,
Thanks for your great book. I eagerly want to apply the PHD but I am having a hard time with fats. Pure high fatty foods like butter, oils or just a not perfectly strained bone broth cause stomachache and pain in the right upper abdomen (can’t even lay on the right side in bed without getting nausea). But its not that hard if I mix it like a piece of butter into creamed potatoes.
Cheese is okay if gratinated. Otherwise like sour cream will cause a feeling of vomit in the stomach. Currently my fat intake is mostly from dairy but I would prefer not to eat dairy every day because I don’t want to risk to become sensitive to dairy products. Do you have any advice? (Sorry if you wrote about it in the book becauseI haven’t finished reading the book completely yet)
All the best
Chris
PS. I will see if I can get the Metametrix Test (I am located in Europe)
Hi Chris,
It sounds like a gallbladder obstruction, possibly a gallstone.
Vitamin C, citrate (lemon or lime juice), and taurine may help. Citrate can help dissolve stones, and vitamin C and taurine support bile production which might help if you are missing bile components. Lemon juice and olive oil are the components of most “gallbladder cleanses” which sometimes can flush stones.
I’d also check to see if eating less fat helps. It’s OK to increase carbs and decrease fat.
Gallstones are often associated with inflammation, usually due to small intestinal bacterial overgrowth. So general gut health is worth attending to.
Hi Paul,
sorry for the late reply. I had a MRT and sonar which showed no indication of gallbladder obstruction. Still having symptoms of getting painful eyes and fatigue from eating. Fat is the worst and makes my stomach feel sour. Diarrhoe eases the symptoms.
I have some lab results though:
sIgA 2683 (510 – 2040)
Estriol 5,7 (15 – 30)
GI Effects
https://dl.dropboxusercontent.com/u/15813135/GI%20Effects%202.jpg
https://dl.dropboxusercontent.com/u/15813135/GI%20Effects%203.jpg
https://dl.dropboxusercontent.com/u/15813135/GI%20Effects%204.jpg
https://dl.dropboxusercontent.com/u/15813135/GI%20Effects%205.jpg
I have the symptoms for one year and no matter what I eat I don’t recover. Doctors couldn’t help yet (expect diagnosing for IBS). So any idea is highly appreciated.
Thanks and all the best.
Paul
What are your thoughts on this recent release from Harvard University?
http://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/
I think even the authors of that plate must be having second thoughts about it.
Ugh. I’ve had it with potatoes for the moment. I keep under eating carbs (cold hands) and getting too much potassium and low blood pressure. Steel cuts oats work well for me instead.
Hi tam,
Are you undereating salt? Kidney or adrenal issues can also affect potassium status.
I don’t think so. I try to add 1/4 ts iodized salt to every meal with 1/2 lb potatoes. 1 ts vinegar too.
Hmmm, maybe 1/2 tsp salt is more balanced, like a V8.
1/4 tsp twice a day should be enough, but you might try a bit more on high potassium days and see if that helps.
Are you saying it’s a sign of adrenal fatigue?
Paul,
Does shrimp count as shellfish? Safe from china?
As for hypothyroidism, is this best treated by my regular doc, the one who wants me on a statin or do i go to alternative medicine doc or holistic doc?
Below is my Thyroid Panel history, any evidence of Hypo or subclinical – i do get constipated, tired, and cold extremities (real symptoms or just getting old at 45 yr of age).
Aug 2010
(low fat diet 20+ yrs)
TSH is 2.02 (range 0.45-4.5)
T4 7.5 (range 4.5-12.0)
T3 uptake 34 (range (24-39)
Aug 2011
(very low carb diet)
TSH is 3.08 (range 0.45-4.5)
T4 free is 1.37 (range(0.82-1.77)
Oct 2012
(very low carb still, with all PHD suppl and 3 eggs a day and 900 mcg iodine – cant stand liver)
TSH is 1.59 (range 0.45-4.5)
Thyroxine (T4) 6.8 (range 4.5-12.0)
T3 Uptake 36 (range 24-39)
Free Thyroxine Index 2.4 ( range 1.2-4.9)
Since Oct, i added rice 15-20% of calories
i dont see anything out of range, doubt doc will treat.
any other tests?
Hi Evan,
I would count shrimp as a shellfish and a very nourishing food, but they’re not a great source of zinc specifically as oysters and some others are.
I don’t know about safety from China.
The regular doc can prescribe levothyroxine, that is his advantage. The ultimate cure is in diet and lifestyle.
Oct 2012 numbers look good and things should be better with more carbs. When did symptoms (constipated, tired, cold extremities) start? Are they improving?
Paul,
Side note, why don’t you charge $2.99 per Q&A. Or two free with each book purchase! Great book i must say, i already got 2 others to buy and several others to consider (perhaps that is indirect payment).
As for subclinical hypo symptoms appearing:
constipation – entire life, got worse on LC, got better on PHD, but not far from regular
tired – started after the amazing energy burst from LCHF, so about 18 months into LC, so past yr i would say
cold hands – past 6 months (but is has been winter – but hands quite chilled and walking in cold is much more annoying than usual
also, what about irratability?? wife notice it….but then again it could be just a sympton of marriage no?
The mentions of antibiotics in the discussion of carnitine brings up a question for me. I’m on two antibiotics as part of a drug cocktail I take for multiple myeloma. (Key drug is pomalidomide, with dexamethasone once a week.) The antibiotics are Bactrim (Trimethoprim/sulfamethoxazole) once a day, and Biaxin (Clarithromycin) twice a day. In the middle of the day I take a probiotic. I also eat homemade raw milk yogurt. Is there anything I can do in terms of diet to help mitigate, or at least not aggravate, the antibiotic effects?
Perhaps I should mention–I tried the eating within the 6-8-hour window, and did not find it particularly hard, but began to lose weight, which I can’t afford to do. So I’m back to three squares a day.
I would add in fermented mixed vegetables / kimchi. That’s about all you can do.
Wondering if the TMAO thing has anything to do with leaky gut. I am of the belief that if people consume daily non-traditionally prepared cereal grains and legumes (3 and more times per day), veg/seed oils, along with the large amount of sugar that goes with the SAD, they will have some degree of leaky gut. When I wanted a leaky gut test, my doc — midway between general practice and alt med — told me “We don’t need to test for leaky gut because everyone has it.”
At $200, the Cyrex blood test was expensive, but my only wish is that I had a before number so that I could compare my current, “relatively good results.”
I have a question. There are times I need to have a protein shake due to time and other considerations. I am wondering what you think of Gemma non gmo pea protein isolate. they say it is processed non chemically at low temperatures but I wonder if the isolation process removes anti nutrients.
Hi John, In general if it comes from a plant I’d favor hydrolyzed powders as any harmful proteins are more likely to be digested. As long as the proteins are digestible then one source is more or less as good as another. Whey is pretty hard to beat in protein powders.
Hi Paul,
If you did go with a Whey protein for occasional use,
does it matter whether it is
‘concentrate’, ‘isolate’ or ‘hydrolyzed’ ?
I use to think ‘concentrate’ would be the best choice…less processed & closer to a whole food.
But your recommendation of “hydrolyzed powder” for plant proteins makes me query this now.
thx
Check out Pro-Optimal Whey on mercola.com I think it’s the best whey protein I’ve ever seen. Organic, 100% grass fed cows, low heat processed, digestible, etc. You can also read all about whey protein on his site. His products are amazing. He does sell an organic pea protein as well.
Hi Paul,
I’ve been following PHD for about a year now and I’m enjoying it very much. However, I recently had a blood test done (because I wanted to donate blood) which showed high ferritin (254 ug/L). Do you think this is a concern? Does it happen more often to people who follow the PHD? Does it have any diagnostic value?
Thanks in advance
Hi Erik,
It’s desirable to be lower in iron as excess iron supports microbial growth.
Donating blood is highly effective at lowering it so that should be all you need to do.
Buildup of ferritin levels is common on all diets in people who never give blood.
It could have diagnostic value but it need not, as there are a lot of common gene variants that affect iron storage.
Hi Paul,
“Buildup of ferritin levels is common on all diets in people who never give blood.”
I’m not sure I understand, it seems like a no red meat/liver/oyster type diets would be significantly lower in iron. I’m not specifically advocating veganism, but if vegans have trouble getting enough iron in their diets it seems like there is some spectrum of diets that would not require giving blood.
Thanks,
Mark
Hi Mark,
By common I don’t mean universal, just that it is not unusual. About 30% of people have alleles that make them prone to iron overload, and if they never give blood and aren’t losing iron to menstruation or pregnancy, they will tend to develop high ferritin levels on standard diets.
Menstruating and pregnant women and vegans/vegetarians commonly become anemic to iron deficiency, but again it is not universal or even a majority phenomenon.
I don’t think Erik’s ferritin level of 254 is particularly alarming if he has never given blood. It will probably be optimal with regular blood donation.
Best, Paul
Hi Paul:
My mom is going to be 64 this year. Her results from an ALCAT Food Alergy Test suggest a mild intolerance to conconut.
And here are her abnormal blood results: Triglycerides are 108 MG/DL, Hemoglobin A1c test came back as 5.8%, Glucose 104 MG/DL, Vitamin B-12 1111 PG/ML.
Question: would you recommend coconut oil at all for her? If not, what are your thoughts about her eating Expeller Pressed Palm Oil (Organic)?
What are your thoughts about the following stragegies I am thinking about immplementing to help her?
Eat only from 12-8PM. During fasting, supplement with the following: BCAA, Biotin, N-acetyl cysteine, Vitamin C.
Daily supplment routine: Magnesium 250 mg/d, K2 MK7 180 MCG, probiotic (Mercola), krill oil (from Dr. Mercola), Joint Formula (Dr. Mercola), Eye Support (Dr. Mercola).
Drink (2) 25 oz. fruit and veggie shakes/day (blended with Vitamix). Ingredients to include in shake are: green tea, water, collard green, kale, colliflour, broccoli, swiss chard, spinach, lettus, red cabbage, green cabbage, bannana, blueberries.
I plan on switching veggies in and out to mix up ingredients daily.
Eat bone broth soup 2-3 times a week.
eat .5 lbs of meat daily and 1/4 pound of carbs daily (white rice, sweet potatoe, russet potatoe, red potatoe, white potatoe, plantains).
Keep fructose consumption to 20 g/d.
High speed interval cardio in eliptical/bicycle 2-3 times/wk.
One last question: What are your thoughts about Creatine to help establish muscle size and strength for ectomorphs? If you are opposed to it, why? If you support it, why and what dose do you advise?
Any problems with Carob ‘chocolate’ as a snack Paul?
After doing some further research on reflux type issues & ‘rehab-ing’ the lower esophageal sphincter (LES) muscle. I have just given up dark chocolate as a test to see if i can further reduce my silent reflux issues. It is probably the last thing on my elimination list, but i’m sad to say, i do suspect dark chocolate may be causing me issues.
So i was thinking of giving the carob ‘pretend chocolate’ a go if/when i felt the urge for chocolate.
& for anyone interested,
here are two pubmed articles that finally made up my mind to do the elimination test,
‘Chocolate and heartburn: evidence of increased esophageal acid exposure after chocolate ingestion’
http://www.ncbi.nlm.nih.gov/pubmed/3376917
‘The adverse effect of chocolate on lower esophageal sphincter pressure’
http://www.ncbi.nlm.nih.gov/pubmed/239592
Hi Paul,
Thank you for all the work that you do. I have a condition called Hidradenitis Suppurativa. Do you any special experience or knowledge on how to cure this condition? I’m pretty sure it’s an autoimmune disorder and some sufferers have linked it to red meat and dairy consumption. The only common denominator I can see between red meat and dairy is Neu5gc. Could that be it? Please, any advice would be really appreciated as this is a terrible condition to live with. Thank you in advance.
I have suffered from this condition. It is considered autoimmune but also resulting from a hormonal imbalance. Then recommended treatment by my doctor was spirinolactone to block excess androgen production. By going gluten free and reducing the chronic stress that resulted, I have gone into complete remission (this is not insignificant, it was pretty severe). I also eat plenty of red meat and have seen zero effect. Dairy may be a trigger if you have an autoimmune response to dairy. But in general following a PHD diet has been nothing but remarkable in clearing it up.
Thank you for your response K. I’ve been on the paleo diet for a while now and while it’s helped, it has not get rid of the HS completely. I think I will switch to the PHD diet and see how it goes. Perhaps having some glucose will benefit my skin. Does spirinolactone have any side effects? I’ve tried antibiotics and other conventional treatments for HS before with no luck. So I am skeptical.
Paul,
In your book you state: “Direct evidence for the superiority of Paleolithic diets comes from archaeological studies of ancient skeletons. These studies tell us that until the modern era, with our reduced rates of infectious disease, the Paleolithic was the healthiest epoch of human history.”
There aren’t any references for this statement in the book.
Do you or anyone else out there have some references for these archeological studies?
Thanks
Jo
There are references, it’s citations 4-8 of Chapter 2: http://perfecthealthdiet.com/notes/#Ch2.
Hi Paul,
I had a candida antibody blood test and all came back negative.
While this is great news, it leaves me a bit perplexed as to what the cause behind my brain fog and fatigue may be.
I’d like to start a ketogenic CR-paleo diet, would you have any additional recommendations?
Thanks,
Edward
Hi Edward,
We did a series on ketogenic diets, see the “Ketogenic Diet” category in the sidebar.
My basic advice is to eat extra MCT oil and eliminate fructose, but keep starches in. Eat nourishing foods as in regular PHD.
Also, eat fermented foods, because some sort of gut dysbiosis may be behind your brain fog and fatigue.
Is it ok not to rinse or soak beef liver before cooking with it?
In the past, I had been cooking the traditional liver and onions and would always soak the liver in either milk or lemon juice, which seems to draw out some blood.
However, these days, I’ve been hiding the liver in ground beef recipes (grinding up the frozen liver while still partially frozen, then adding it to the ground beef) like hamburgers and meat loaf. So, now I’m not soaking the liver anymore with this new method. Is it healthier to soak it though?
I usually buy frozen beef, calf or lamb liver (grass fed when they have it).
*** By the way, for anyone having trouble with the taste of liver, this method works great! Depending on the ratio of liver to beef you use, you usually can’t even taste any liver!
Thanks!
KH
Hi KH,
I think it’s best to rinse it / soak it, in hot water is sufficient, just to remove blood and surface contaminants which are the most likely carriers of bad microbes. It does improve the taste as well.
Ok, thanks Paul! I thought that might be the case… I’ll go back to soaking it.
Are you aware of risks in taking no flush niacin instead of a statin?
Yes. We don’t recommend niacin of any kind.
Are there any supplements you recommend to lower oxidized LDL? I cannot tolerate red yeast rice extract (joint swelling and pain).
Question 1: Do you recommend coconut oil for those who take an ALCAT Food Alergy Test and show a mild intolerance to coconut? If not, what are your thoughts about her eating Expeller Pressed Palm Oil(Organic)?
Question 2: For Circadian Rythms, is it okay to cover red light bulbs with a white covering most commonly found in some newer homes? The white covering is glass. The light produces a pink/dim red color. Not sure if I need to buy a red cover or paint the existing cover red somehow.
Question 3: What are your thoughts about creatine monohydrate to help establish muscle size and strength for ectomorphs? If you are opposed to it, why? If you support it, why and what dose do you advise?
Question 4: What could be causes of low total cholesterol below 200 (i.e. around the 160-170 range)?
Question 1: Is coconut oil okay to consume for one show a mild intolerance to coconut? If not, what do you recommend?
Question 2: For Circadian Rythms, is it okay to cover red light bulbs with a white covering most commonly found in some newer homes? The white covering is glass. The light produces a pink/dim red color. Not sure if I need to buy a red cover or paint the existing cover red somehow.
Question 3: What are your thoughts about creatine monohydrate?
Question 4: What could be causes of low total cholesterol below 200 (i.e. around the 160-170 range)?
Hello Paul,
I am a newbie to the PHD but am so excited about it! However, I am currently on 50 mg of Zoloft to treat generalized anxiety–My goal is to get off these meds. How would/or when would it be advisable to try tapering off them? Should I be further down the PHD road? Thanks for any suggestions! Blessings, Paula
Hi Paula,
It’s generally a good idea to improve diet and lifestyle first and then taper the drugs. It’s also a good idea to experiment with dose and try to use the minimum dose that is effective for you; doctors don’t necessarily know a good dose.
Ideally, you might find a dose at which you have minor, but noticeable, symptoms, and so you can observe whether things are improving.
If you can reduce dose without negative effects, then you should.
Your doctor can give more guidance, but I think in general natural healing methods work better.
Best, Paul
Thanks, Paul, especially for such a speedy reply! So, it is OK to use the suggested PHD supplements along with prescribed medications? Thanks again, Paula
hi Paul and everyone.check out a very interesting tv show, is on my local pbs at 10pm.
he will swallow a camera and we will follow it on its journey, they will also talk about fical transplants. there are several other shows in the series, i think you can view them again onlone.One notable show talks about 20 seconds of high power exercise x 3. x 3day’s /week that signifacently reduce’s lipid’s in the blood.also a show on fasting. he himself DR Michael Mosely is a pre diabeic and has high cholesterol. it’s a must see
Thanks Alfred. Sounds like a very interesting show.
Hi Paul — Starting last August, I followed the double-your-iodine-each-month program, starting with 225 mcg in August, and reaching 3 mg in December, the level I have maintained since. I used kelp through November, switching to Iodoral (cut into four pieces) in December and since. Oh, and I had been off wheat/etc for many months before August. The object was to move my TSH down from the 2 – 2.5 range to 1 or below.
My TSH the previous September had been 2.29 and all my readings in the preceding decade had been well under 3. Today I learned that a blood test early this month found a TSH value of 3.09.
This is puzzling and concerning, and I’m at a loss as to what I should do next. Option 1 is to continue at 3 mg and test again next September. Option 2 is to back off in some way or other. Option 3, to increase, doesn’t seem like a good idea.
Do you have any advice for this situation?
Hi JBG,
I would agree that you shouldn’t increase. We are now recommending staying below 1 mg for the most part. I have dropped back to 225 mcg myself after being up to 12.5 mg/day.
I would also look into making fermented foods at home, to help improve gut flora. I think inflammation from the gut is a frequent cause of hypothyroidism.
Best, Paul
In dropping back, is it indicated to do it slowly, by stages, as when increasing, or can one just drop back abruptly? From 3 mg/day to 1 mg/day as you advise is what I’m thinking.
Does the body care whether iodine comes in at a more or less steady rate, or is episodic intake likely to be OK?
Reason for asking is that I have a stock of Iodoral to use up. If taking 3 mg twice a week is OK, I can do it that way.
Wait, by citing your own practice, you really are advising dropping back to 225mcg/day.
OK, skip the Iodoral question. But the greater drop accentuates the question about doing the transition gradually or abruptly.
Thanks for your help. Your service to folks is truly amazing!
Paul,
I’m curious – what made you change your recommendation on iodine? I’ve very slowly worked my way up to 1 mg/day, and was going to stay there. But perhaps I should work my way back down a bit?
Hi Frank,
Basically, I discovered that I was getting excess selenium, then looked into the literature and food that food content of selenium is highly variable depending on growing region — it can be far above the levels in the USDA database.
High doses of iodine are thyrotoxic when selenium is in excess, and if we can’t predict our selenium intake, then it’s risky to take high doses of iodine.
I think anything from 200 mcg to 1 mg should be good. We eat a lot of fish and shellfish and seaweed so I figure 225 mcg is sufficient.
TSH increase is a normal and healthy response to iodine supplementation, since TSH upregulates the transport and metabolism of iodine as it becomes available in adequate amounts. This can last for months in some people.
Even TSH levels as high as 100 have been reported in the Iodine Project under close physician supervision with no indications of hypothyroidism. Conventional medicine is wrong to use TSH in isolation as a marker of hypothyroidism.
I don’t believe the physicians of the Iodine Project reported any true hypothyroidism (or any cases of selenosis) caused by the Abraham iodine protocol with iodine at 12.5 mg-100+ mg/day, selenium at 100-400 ug/day, plus the other components of the protocol.
Personally, I would (and do) only supplement iodine at these doses using the complete Abraham protocol, since this is what has been proven so beneficial and safe with thousands of patients under physician supervision.
I know Paul has a different view, but those interested in iodine may want to study the extensive Iodine Project literature for another perspective. Dr. David Brownstein recently said that after 20 years practicing holistic medicine he has found that the iodine protocol has provided far and away the biggest bang for the buck in helping patients, almost all of whom present to him very iodine-deficient. This has been my personal experience as well.
Bill, I wish there were more external validation for the project. I’ve read as much as I could find, including joining the Yahoo! group (http://groups.yahoo.com/group/iodine), but never saw my TSH change even after nearly a year of 12.5mg / day — it remained around 4. Nor did I have any noticeable bromide detox effects (which would have probably spurred me on!).
Now based on Paul’s thinking I’m probably going to cut back to 225mg, and possibly just throw up my hands on TSH overall.
WAP did I thought an excellent job covering the ‘iodine debate’: http://www.westonaprice.org/metabolic-disorders/the-great-iodine-debate
John, I didn’t experience a TSH spike either; not everyone does. Perhaps you and I were less iodine deficient than some.
Nevertheless, I experienced enormous benefit and feel better than I can ever remember. I was extremely toxic in bromine (as shown on repeat iodine loading tests) and my well being tracked the progress of the bromine detox perfectly.
I was also able to dramatically reduce my need for thyroid hormones, something none of my docs had ever seen. Contrary to the warnings one reads about iodine causing hypothyroidism, mine seems to have improved quite a lot.
Not everyone experiences bromine detox symptoms, either. Did you do any iodine loading tests? That’s the only good way I know to determine your level of iodine sufficiency and bromine toxicity.
It’s possible 12.5 mg wasn’t enough. I had to go to 50 mg to get the full benefits of the protocol. This is apparently very common. And did you do the full protocol?
It could also be that a TSH of 4 is normal for you. That’s unusual but not impossible. Have you been diagnosed with hypothyroidism? Why are you concerned about your TSH?
If you are hypothyroid, you probably know that not all of us see our disease respond to iodine repletion. There are undoubtedly several distinct causes of hypothyroidism, not just iodine deficiency. Yet all of us need sufficient iodine for all of our tissues regardless. The cancer preventive potential alone was a significant factor in my decision to to the protocol. If 1/1000 of the resources devoted to mammography, for example, were redirected to iodine repletion (along with Vitamin D), we might finally see some real progress on breast cancer.
As for external validation, I agree we need more. We have it in the form of reports from numerous physicians from outside the Iodine Project who’ve had great results. But who will fund large randomized trials for a cheap, unpatentable nutrient at doses orders of magnitude higher than the RDA?
Hi JBG, just a comment on your TSH tests…
to get an accurate trend in TSH results you need to make sure you take the test around the same time of day & under the same conditions each time.
TSH fluctuates throughout the day, it will be higher in the mornings.
TSH will also be higher when fasted.
So TSH will be at its highest first thing in the morning on an empty stomach.
One study found “The late morning non-fasting TSH tests declined in 97 of 100 subjects by an average of 26.39% when compared to early morning, fasting, TSH test results.”
& note that was just an average, so some subjects would have had an even greater difference in TSH on the same day.
Anyway, none of this will apply if you tested under the same conditions. But thought it worth a mention in case.
I included some refs for this phenomenon in a previous comment here,
http://perfecthealthdiet.com/q-a/comment-page-57/#comment-142397
Thanks for info, Darrin. I didn’t know about diurnal fluctuation in TSH. As it happens, my recent-years measurements were all early-morning, fasting, including the most recent one. But I’m glad to know about the phenomenon. Thyroid management, it seems, is a very complicated business!
no probs JBG.
well you can take some solace from the fact that your body was under maximum stress for the day, high cortisol & no food.
& your measured TSH was likely at its peak for the day.
& could possibly be a whole point lower later in the day, under more relaxed conditions, low cortisol, & fed state.
Hi Paul,
I’ve been eating in a GAPS/Paleo way for the last 2-3 years. Over those last 12 months I’ve been eating more PHD – introduced starches, your supp’s, and I.F.
I started the iodine around a month ago starting at 225mcg, I’m still taking that dose. I was treated for hypothyroidism a year ago (via symptoms) and take natural thyroid meds.
Over the last few days I’ve noticed my body having micro-second twitching while I’m awake. My left arm has also had a strange weak feeling to it as well.
Do you know what could be causing this? Maybe the Iodine?
Straight away I start fearing it could be early symptoms of MS. I hope not.
Thanks
Craig
Hi Craig,
can you describe the twitching a little bit more? I had a sort of startle-reflex triggering on small sounds and sometimes when I was just calm. All the muscles involved in the startle reflex twiched. Is it like that? For me it improved a lot with the daily multi that PHD originally recommended although I still have it from time to time. No idea what causes it or what exactly cures it though.
If you do turn out to have MS, I hope you find solace in the work Dr. Wahls is doing. They’re trying a Paleo-ish diet as an intervention for people with MS with promising results: http://www.thewahlsfoundation.com/category/news-and-updates/
Hi Wout,
The twitching isn’t due to sounds, it happens in quiet situations and noisy situations.
It isn’t noticeable to anyone, but I obviously notice a difference. As well as the twitching I’ve had this odd feeling inside my arm and hand – a weak, tingling feeling. Hard to describe.
Who knows, I might be a little low on sodium or potassium.
I’m currently away from home and had a few days where I was eating food I normally wouldn’t.
I’ve bought myself some celtic sea salt to add to food I’m now cooking and water. I’ll see if that helps at all. I’m going to do some more light exercise too.
It’s just weird, I’ve never had anything like this before.
I’ll report back on any progress.
Thanks Wout,
Craig
I’ve seen my blood pressure go down to 90/70 or so after having too much potassium or sodium.
Good morning Paul,
I’ve corresponded with you a few times about my thyroid test results. I couldn’t locate my most recent Q. to add to it, so here I am.
I am in excellent health (maybe not Perfect, but I allow for some variation).
On ~ 11 mg Nature-Throid 3 days out of every 4 test results read:
TSH 1.38 (0.45-4.50)
T3,Free 2.1 (2.0-4.4)
T4,Free 0.94 (0.82-1.77)
Ferritin is a healthfully low 46.
One drop Iosol 5/7 days, 200 mcg Se 2x weekly.
Thoughts? Your insight and acumen are much appreciated, thank you.
Best, Kathleen
P.S. I’m glad to read that your Coconut Fish Pie was tasty. Man, with all due respect, nothing would encourage me to fast more than a dish by that name. 🙂
Just enjoyed your podcast on paleorunner.org. About avoiding seed oils which can be hard sometimes if you eat out and the restaurant uses canola. Is there a supplement that helps battle Omega 6 – like NAC or ALA?
hi Paul. comments on my thyriod test
TSH 3rd gen 3.19 range 0.27-4.2 uiu/ml
T3 69.97 range 80-200 ng/dl LOW
FREE T4 1.06 range 0.93 – 1.7 ng/dl
might this be responsible for high HDL.
should i wait 2 weeks for treatment in canada, or is it approptiate to get started NOW and what would you suggest.
i have just worked my way up to the 1MG of iodine.
thks alfred
I’m not sure were my comments from yesterday went, but wanted to let Wout know that re-adding a good amount of celtic sea salt seems to have helped my twitching symptoms greatly.
Maybe the lack of sea salt and some bromide detoxing was causing the body twitching.
Still not 100% normal but A LOT better.
Craig
Hi Craig, that’s great to hear!
Your comments from yesterday are here BTW: http://perfecthealthdiet.com/q-a/comment-page-59/#comment-152697
Yes, very good news! =) I feel even better today!!
Funny when I click on Q&A from the top menu and get taken to http://perfecthealthdiet.com/q-a/ i can only see comments posted until the 16th April.
Hi Paul-
for someone over 60,would a shingles vaccine be safe and prudent?
I don’t know.
Hi Paul,
Me again.. Another dovetail off the shingles conversations above. I guess I have a problem with viruses.. as not only did I have a shingles bout at a young age, but I have just been told I have one of the many strains of HPV. Apparently it was just mandated this year that Gynos have to test during a pap. So, I could have had this virus for a long time. My doctor was very blase about the whole thing and basically said it could go away by my next exam.. who knows?
I am wondering how to step up my viral immunity as I am otherwise healthy. I haven’t so much as gotten the common cold in.. years, but I have these weird little silent viruses. I don’t get it. Any ideas? Is ketogenic fasting the only real method?
Looking forward to your thoughts.. I promise I will leave you alone after that! 😉
Lindsay
Hi Lindsay,
Most important are:
1) Vitamins A, D, K2 – so eat liver and get sunshine and eat fermented foods.
2) Circadian rhythms
3) Intermittent fasting – autophagy.
4) Vitamin C (only works for a few viruses)
Ketogenic fasting may be helpful too.
I have CFSIDS (chronic fatigue immune deficiency syndrome)and a high viral load. Have been on anativiral medication for 6 years and am developing a tolerance. I have been on the PH Diet for 9 months but still cannot drop the dose (6 x 200mg daily) – I get spinal/joint/weak muscle/cold sore symptoms and nausea. I would welcome any thoughts / suggestions.
Hi Donna,
My advice to Lindsay immediately above is valid for you too.
You also want to work on gut health:
– Bacterially fermented foods.
– Healthy whole-food fiber sources (potatoes, berries, vegetables, fruit, tomatoes)
– Bone and joint stock soups
– NAC, vitamin C
To anybody: sometimes I get ‘hot flashes’ from aged cheeses like Gouda. Is that vitamin K2 overdose?
More like to be histamines, or other amines, which are common in fermented foods.
I can’t find it, but I remember someone on here reporting something like a racing heart and warm feelings after taking k2 supplements.
Yes, I remember that because I was looking for it myself as I suddenly seem to be having that racing heart.. And flashes .but only during the night. i couldn’t remember what they thought the connection was. So am interested to hear you say k2 and aged gouda as I have recently included aged Gouda and switched K2 brand. Will experiment and report back.
what about mold?
Hi Donna,
Regular PHD with extra vegetables and low-calorie berries and high phenolic olive oil, and extra fiber/starch to help carry out fungal toxins. Possibly an activate charcoal tablet daily to help excrete fungal toxins.
This is good to rid my system of viruses too? I am already doing fermented vegs,berries, EVOO (is that high phenolic?). Can’t take Vit C but recently started IV vitamin therapy including C and malic acid. What is the best form of ‘extra fiber/starch to eliminate viruses? Coconut oil alone irritates my throat but ok in smoothies. Use it or avoid it? I will add the activated charcoal. It doesn’t take of good probiotics, does it? I have trouble keeping them in my gut and take 100Billion CFUs/day + fermented veggies, kefir, & Body Ecology fermented products and enzymes. I tried 3 months of oregano oil x 3 / day; still needed high dose of acyclovir. Just got rid of an 8 year old root canalled tooth that was abscessed still. Hoping that may help?
Forgot to say am already doing NAC (1.5 gm / day) and bone joint stocks. Also gelatin & citrus pectin, organic berries, veggies, tomatoes, potatoes, white rice. OK that I eat some nuts? (macadamias mostly, some cashews for copper; a couple of Brazil nuts/day; recently some liver pate homemade (don’t like liver but can get it down when I make it with sweet onions, sea salt and lemon). Can’t take l-lysine (nausea).
Yes, nuts are good. Duck/goose/chicken liver are usually more palatable than beef/lamb liver, try them.
I noticed that the other livers don’t have as much copper though and my cholesterol (including VLDL)has become even higher than usual on PHD and my iron level tends to run a little high. Have started iodine supplement. IgG&E testing showed I have to limit eggs so will start a choline supplement as well as Zinc. Vit D level is good (I take 5000IUs) but TSH a still a little high even on meds. I think MD is hesitant to raise meds a lot because of severe osteoporosis.Any other comments re VLDL or fighting herpes virus would be appreciated.
Hi Donna,
Here are two good ways to assure you are getting optimal copper:
1) Eat 1/4 lb beef or lamb liver per week; or
2) Eat 30 g dark chocolate per day
Once you are getting enough copper, you don’t want to keep eating more of these or you’ll have too much copper (and an excess relative to zinc). So from that point on you should eat duck/goose/chicken liver in preference to beef or lamb liver.
Hi Doctor Jaminet!
Thanks for the great resource.
I’ve been eating a paleo diet for about a year now and have been experimenting with your book and carbs for the past 7 or 8 months. I’m 18 years old.
This is what I’ve noticed this past month. When I eat fruit and dairy my acne returns within 2 days. When I eat meat, veges, fat, chocolate and NO carbs, my acne clears within a day or so. When I eat carbs I seem to gain wieght instantly and acne develops within a day or so. When I cut carbs out I look lean with clear skin.
But when I eat low carb, I crave chocolate BIG time and will often eat 8 or 9 oz of m%ms in a sitting.
Does this tell you anything? Why do I gain weight and have acne breakouts from carbohydrates? Why am I craving carbs if my body seems to be disagreeing with them? Can a Low carb diet really be sustainable?
Thanks Again
Actually its more of a chocolate craving than carbs.
Hi Jackson,
If by chocolate you mean M&M’s, not bitter dark chocolate, it is probably the sugar you are craving. It’s normal to crave carbs on low-carb diets. I would start by trying dextrose powder in place of M&M’s, this will avoid fructose and will be good for your gut flora.
I am a bit puzzled by the idea that M&M’s don’t give you acne, as acne from fruit and dairy would suggest fructose and lactose malabsorption to me.
Another possibility would be the copper in chocolate. If you eat beef or lamb liver that should go away.
Odds are the acne is due to a gut dysbiosis / small intestinal bacterial overgrowth and our usual steps (fermented foods, collagen, vitamin A/D/K2, stomach acid support, NAC) may help.
Thanks for the info Paul.
Could it be that the weight gain and acne happen because of insulin resistance? if this is the case, what would you recommend that I do?
My naturopath has cautioned me about (even) dark chocolate or cocoa (and nuts) as she says they promote viral activity. I do crave dark chocolate, cocoa and cashews though! That may go away with a few more weeks of liver, but will have to get my iron levels checked as they tend to be high (which they told me is not good for heart health).I know you have reservations about copper supplements as they are inorganic copper (unlike organic in food)- correct?
Hi Donna,
I’m fine with copper supplements except that you only want a certain amount of copper and you can easily get it from food — 1/4 lb beef or lamb liver per week is enough, or 30 g dark chocolate per day. If you don’t eat liver and can’t eat chocolate then supplementation is OK.
It is good to control iron levels.
Paul,
I have been eating 90% dark chocolate everyday the past few months about 40mg per day and supplementing 2mg copper as well. I realize now that I am getting enough copper from chocolate. I will stop taking the supplements but should I refrain from chocolate for awhile? That would be a bummer…what are your thoughts?
Hi SC,
Yes, you’ve been getting a little more copper than is ideal. I don’t think you need to stop the chocolate but you may want to take extra zinc / oysters now to help compensate for the extra copper.
My doctor also said that chocolate and nuts have more arginine, so if you have a viral infection, it’s best to avoid those or at least take lysine to balance it out.
Hi Paul,
Are the links to external websites gone? I don’t know if it’s something on my end, but I don’t see the links that used to be on the right side bar (other health sites, cooking, scientists, etc.). Or maybe they moved?
Thanks!
KH
p.s.– the paperback that you mentioned you will be adding recipes to… will you be editing anything in that edition? Just wondering if you wanted to change my type 1 diabetic story from HbA1c of 5.7 (as is currently in your book) to 5.1 (which I got on my last blood work from doctor in January this year).
Hi KH,
I took the links out to try to speed up page loading, but I’ve put them back now.
OK, I can try to get that HbA1c reading in. Good news, congratulations!
Great, thanks!
I don’t know much about websites, etc but maybe you could make a designated page with external links so it doesn’t slow down page loading for all these other pages, like you said. ?
OK, good idea, I did that. There’s now a Links page under the Resources tab.
Hi Paul,
First off, I just wanted to say I picked up the book last week and couldn’t put it down! This is all so fascinating!
I have two questions for you. The first is regarding bone broth: in the past I’ve made a broth with bones (usually already cooked once, say from a roast chicken, or from a stew or soup of some kind) and frozen vegetable scraps. I would like to start cooking my broths for a longer time and/por multiple times as you suggest, but I wonder if I should leave out the veggies if I do? Does prolonged cooking of the veg do more than good?
I’m also wondering if you know anything about the role of diet in Fabry’s disease? It’s a relatively rare condition, characterized by a deficiency or complete lack of an enzyme called alpha-galactosidase A. Ultimately this leads to storage of fats in organs, especially the kidneys, and so a high carb, low protein diet is recommended if there is kidney involvement (‘m not sure about fat recommendations but assume they’re in line with CW). So far I’ve had trouble finding any other diet suggestions and I’ve been slowly trying to untangle the microbiology on my own , but haven’t gotten very far yet. Mostly I’m wondering how a higher fat diet might affect the disease – I’ve been trying to stay in ketosis to see how that might help my depression, but wonder if it’s safe in terms of the Fabry’s. Basically I’d love to know what the ideal diet is to prevent the degeneration that typically comes with this illness. I’d love to hear your and anyone else thoughts! Thanks!
-Whitney
Hi Whitney,
We usually cook our bones alone to make a stock and then cook the stock again to a soup with vegetables this time.
You can make a joint vegetable-bone stock, but the vegetables will usually disintegrate with long cooking, so you have to like the texture. Also, the stock will go bad more quickly if you include carbohydrates/plants, so you have to use it sooner. But it is a good way to get vegetable nutrients.
I’ve just read the Wikipedia page, http://en.wikipedia.org/wiki/Fabry_disease. I am not sure what diet would be best. Since it involves an excess of a glycolipid it is not obvious that a high-carb diet is preferable, although it may be. There’s almost nothing in Pubmed to guide us, http://www.ncbi.nlm.nih.gov/pubmed/?term=Fabry+disease+diet. I might just try regular PHD.
Hi — I’ve decided to follow the discussion right here at Q&A on the website rather than by getting new things via email. I’ve looked but cannot discover how to turn off the email subscription. Help?
Hi JBG,
Have you already unsubscribed? I can’t find your email in the subscription list so maybe you are using a different email.
You should be able to find the manage subscriptions link below the SUBMIT button in the commenting field below. Or, let me know what email address you are subscribed under and I’ll remove it.
Thanks for quick reply, Paul. All fixed now. Story below.
Working from memory, but I think this is accurate.
I looked for someplace to UNsubscribe. Couldn’t find it.
Saw message I think you’re pointing to:
“Notify me of followup comments via e-mail. You can also subscribe without commenting.”
Clicked the “subscribe” link in hopes of find a choice page. Got (only) an assurance that I was subscribed.
Wrote the note above.
Later went to my email and found a message with a link to my account page (which I previously didn’t know existed). Used the choice there to unsubscribe.
Tried to find the note above so I could say all was fixed. Couldn’t find it. (Realize now that you must be moderating submissions here so it only became findable after you let it through.)
I now realize I made a nominally wrong choice when I unsubscribed, choosing ‘Delete’ rather than ‘Suspend’. Doesn’t matter since I don’t expect to want to go back to following discussion her via email.
Did I miss something obvious when I was looking for how to unsubscribe?
Thanks for maintaining this amazing service!
JBG
Hi Paul,
Question: I take 90mg of Armour and all my thyroid levels are still low. After taking reacted zinc, I’m still not passing the zinc tally test (oral). What am I missing? My doc is at a loss too.
THANK YOU and looking forward to your recipe book!
posted this Q earlier on the supps page, but figure more people may see it on this page…
I am trying to hunt down a 100 mcg Selenocysteine supplement or 100 mcg Se-Methyl L-Selenocysteine.
Anyone found one.
(I know LEF do a 200mcg Se-Methyl L-Selenocysteine).
& i do not want one that includes selenite/selenate.
i’m not sure if such a thing exists, but thought it worth an ask.
i do realise i should be getting from beef/lamb liver, but a supp would be handy as well.
cheers
Hi Darrin… take a multivitamin that has 250mcg selenomethionine (in 4 tablets), so ~60mcg/table. It is from the linked website. I have no financial interest in the company, and they seem reputable.
http://www.drsinatra.com/t
Thanks David,
i’m actually ok for the selenomethionine (already have it),
the 100 mcg (or less) of selenocysteine seems to be a harder find.
Hi Paul,
What do you use for brushing your teeth (toothpaste)?
I’m getting some bleeding gums when I brush my teeth currently. I’m looking forward to them healing.
Thanks
I use a soft bristle ‘Radius’ brush. It has a big head so you can clean your teeth and stimulate all of your gum tissue without scratching away at it from uncomfortable angles.
Put a couple of drops of grapefruit seed extract on the brush, a dab of water, begin brushing gently and your saliva will produce a nice, bacteria killing foam as you brush.
Once per day, every day, is good enough. When your gums heal you can follow it with some natural toothpaste, if you want, for brightening and stain removal, but the GSE should take care of oral health concern as well as any topical treatment can.
Of course, whole body health is important for oral health as well.
Hi Paul, have just finished reading your book. Coming from a Pharmaceutical Industry and market research backgeound, I really appreciated the amount of research done and the scientific approach. I know many of the clinical trials you quote! I have a few questions:
As far as coffee is concerened, can it be decaf or is normal coffee better? Can I use milk in my coffee, or is cream or reduced fat cream when losing weight, better? If milk is okay, 20% or skim?
As far as the coconut oil goes. When doing the intermittent fast, how do you take the cocnut oil in the morning? I cannot swallow anything oily after having been given castor oil to induce labour with my first child, even though that was in the late 60’s! Any suggestions?
Many thanks for a great eating plan and your assistance?? JAN
Hi Jan…I make a cup of green tea in the morning, and put in between 1/2 to 1 tsp of coconut oil, along with a splash of lemon juice. It tastes quite good, not “slippery” at all.