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:
Apologies, thaose were not supposed to be question marks at the end of my post, but explanation marks!!
You might try BPA free coconut milk…froths better, and according to Dave Asprey, expert on mycotoxins, the milk as long as it is in a BPA free can is much less likely to have mycotoxins. I hope this helps.
Anyone know a brand of canned coconut oil that has a BPA free can? Organic preferred I assume?
This is what I’ve been buying:
http://www.vitacost.com/vitacost-extra-virgin-certified-organic-coconut-oil-54-fl-oz-9
It comes in a wide-mouth PET (or PETE) plastic jar, which doesn’t contain BPA, but it’s still plastic.
http://health.usnews.com/usnews/health/articles/070726/26petplastic.htm
This is what I use…
http://www.amazon.com/Nutiva-Organic-Virgin-Coconut-15-Ounce/dp/B001EO5Q64/ref=sr_sp-btf_title_1_4?s=grocery&ie=UTF8&qid=1366638638&sr=1-4&keywords=coconut+oil
but it sounds like you’re talking about coconut MILK..in which case, this is what I use…
http://www.amazon.com/Native-Forest-Organic-Classic-13-5-Ounce/dp/B001HTJ2BQ/ref=sr_sp-atf_title_1_1?s=grocery&ie=UTF8&qid=1366638732&sr=1-1&keywords=coconut+milk+organic
If you meant milk, I buy from Amazon, Natural Value organic coconut milk I’m BPA free cans and there is no guar gum or carageenan added. This is the purest I have found.
I cannot find the comment I have in mind, but recently someone asked why you were taking less iodine and you mentioned that it was safer to take less because there is no way to know know how much selenium you are getting from your foods and that too much selenium with higher amounts of iodine can also cause hypothyroidism. I hope I have that right.
I later recalled this discussion about selenium and mercury
http://chriskresser.com/the-truth-about-toxic-mercury-in-fish
So all that good seafood is also a source of selenium that can complicate this issue.
hi Ellen, Paul’s comment is here,
http://perfecthealthdiet.com/q-a/comment-page-59/#comment-157019
“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.” Paul Jaminet
Thanks Darrin
Hi Paul and everyone,
Wondering if you, Paul, or anyone else would recommend mineral and vitamin tests? If so, serum, hair, urine? I like like to track my health and think it might be beneficial to have some baseline numbers rather than just throwing supplements down my throat. Anyone know if these sort of tests are reliable and give a real picture of what is available to cells?
Thanks,
Lindsay
I was just reading a Cheeseslave article and she used this (http://amzn.com/B004GLGYJ0) to test if she was Zinc-deficient. Article in question => http://www.cheeseslave.com/how-intermittent-fasting-caused-my-insomnia-and-belly-fat/
Hi All,
Any ‘experts’ out there on the supplement Quercetin…
Do you know what effect it has on estrogens?
I am seeing/reading conflicting info.
looking for the facts…or as close as possible, if they exist.
thx
For those interested in sleep breathing disorders and their effects on cognitive function, here’s a link to an MP3 discussion hosted by Dr. Steven Park.
https://archive.org/details/Borelli?inf_contact_key=cdd12e13c24ff204eaf15556086aabd612da695276ad3f93f5ad68888cec4fc1
https://archive.org/details/Borelli_201304?inf_contact_key=e65dd06da3a3f3a50f46befde83c75ff546789774d5734b29e97d9cb69ae012a
❓
I orderd the book on my kindle and I am just about finished and very impressed with the information so far. My question is that I have read in many books about food combining. So far I have not seen any reference to that in the book. I have been trying to eat protein and any form of carbs separate and not to eat any fruit with a meal. I am convinced by what I have read in the past of the digestion process that it would be healthier to separate them, but would love a scientif explanation concerning this way of wating as well. Thanks Susan
I think the main reason to food combine on PHD is that it controls insulin spikes (via acids and fat) and increases satiation. More here => http://perfecthealthdiet.com/2011/10/how-to-minimize-hyperglycemic-toxicity/
I think I’m going to consume my carbs in bananas from now on as a last ditch attempt to fix my circadian rhythm.
Hi Paul,
Hope you can comment on this one…
I was just looking through some old blood tests of mine & i was looking at my ‘Red Cell Folate (RCF)’ numbers.
I have not had folate tested for a while (i will ask next time i see my doc),
but my results during 2009/10/11 varied between 1118 & 1615 nmol/L (493 & 712 ng/ml).
Now on the lab sheet reference range there is no upper limit, it just indicates it should be greater than 630 nmol/L (278 ng/ml).
What do you think…should there be an upper limit for the red cell folate number, any ideas what it should be, & what a ballpark optimum number/range might be.
I’m sure this info would be useful to others as well.
ps. if you specify any numbers, could you please include units, nmol/L or ng/ml, for clarity,
many thanks
Hi Darrin,
Medscape (http://emedicine.medscape.com/article/2085523-overview#aw2aab6b2) lists the adult reference range for red cell folate as 140-628 ng/mL, or 317-1422 nmol/L. So you would have been within the reference range once and above it once.
I don’t know if this is anything to worry about. I would just avoid folic acid supplements and let my body regulate it.
Thanks Paul
Regarding Lithium supplement – from what is said the your book, I’m wondering if I should NOT consider taking it as I am on medication for hypothyroidism?? If you think it is good to take it even with this condition, note I am doing the 8 hour eating window, which means I would not be taking it until lunch (as it says to take with food). Would that interfere with sleep / circadian rhythm?
Hi Donna,
Re the circadian rhythm part, I think it’s fine to take lithium any time from waking until noon. It doesn’t need to be taken with food.
Re hypothyroidism, if the dose you are taking is low — 2.5 mg (a half tablet) or less — it will probably have minimal effect on your hypothyroidism, but if you notice any worsening of symptoms, then try stopping the lithium.
Hi Paul,
Couldn’t find a/the way to Unsubscribe from receiving the Q & A responses that are filling my inbox. (I’m sure it’s around here somewhere. .)
Could you please either just do this for me, or pass on what i do?
Many thanks! Sorry for the inconvenience.
Best – Kathleen
hi KKC,
If you still have one emails,
at the bottom of the email there should be a ‘Manage your subscriptions:’ link.
click (open) that link, you should then be sent another email with a link to manage your subscription…so, click (open) that link to change your subscriptions
Hi Kathleen,
I’ve suspended your subscription.
Best, Paul
Hi Paul;
I had a candida antibody/antigen blood test and came back negative.
How reliable are these tests?
Hi Paul
First, many thanks to you and your wife. Your book has been the most in depth diet guide I have had my hands on, and there have been many and it has been a guiding light to feeling better in my body…
I was wondering if you have any specific info on treating blastocystis and giardia. I have been struggling with the symptoms for years and finally was diagnosed last year. The naturopathic herbal treatment didn’t take care of it and there are so many indications online that regular antibiotics don’t work well eighter. I just came across some mention of a 3 part drug regime that is supposed to take care of it. Wondering if you would have more info on that…
My 2 year old daughter is getting retested currently as well. She has reoccurring diarrhea despite her excellent diet. She tested negative last year but I understand that it is pretty easy to miss on a single regular lab test.
Any input is greatly appreciated.
Kind regards, Joy
Hi Joy,
Unfortunately I don’t have specific knowledge about how to treat those parasites. I do think you should see your doctor and pursue medical treatment.
I hope your daughter’s condition can be diagnosed as well. I often recommend the Metametrix Microbial Ecology stool test which is a reliable DNA test for common pathogens. Blood tests are often hard to interpret.
Best, Paul
Hi joy
I can share some ideas to keep giardia under control. Short version: chemical drugs did not help me (I’ve got chronic giardiasis due to water supply). Helped me to keep it in control: acidophilus very clean like kirkman labs, vitamin C (make sure it doesn’t contain any sugars, sorbitol, any -ose), coconut oil with meals, propolis.
Guess you know already your diet should be free of sugars, sweet fruits, white flour, diary, simple carbs, fatty foods…from my readings metronidazole has not expected results a la long and has very strong side effects.
Sorry don’t know a thing about blasto although I’ve read that just a few were solved by so called triple drugs therapy.
Hi Joy
I took Paul’s suggestion and got the accurate Metametrix test and it detected B. Hominis.
If you search you should be able to find some very detailed posts on the site here somewhere by Lana about her treatment history for it. I’m following hers, as well as advice from a Naturopath doc and seem to be improving at this point.
Consult a physician, which I am not, but you may want to ask the doc’s opinion about trying Nitazoxanide, as well as the following herbals:
berberine, monolaurin,goldenseal,mastic gum,artemisinin,grapefruit seed extract,black walnut,nattokinase,serrapeptase,n-acetyl cysteine,interfase plus, A P MAG, and Parabiotic Plus. I would especially ask the doc about the last 5 mentioned here.
Good luck.
Hi Paul,
What are your thoughts on canned BUMBLE BEE Whole Oysters (INGREDIENTS: OYSTERS, WATER, SALT)?
I’ve read filter feeders bioaccumulate heavy metals and other toxins to a much larger extent than other fish. I called Bumble Bee and the oysters come from either Japan, China, Korea, or US. The label on a can says Product of Korea. I can buy these cheap at a local store, but am concerned about the heavy metal content, possibly BPA.
I would prefer fresh over canned and I’m asking because I’m located US inland and shipping alone costs about $30 (2-day air) to ship fresh oysters to me from a US coast. An example is Taylor Shellfish 16OZ MED PACIFIC OYSTERS ~$37 ($7.25 + $29.18 shipping). I’m not aware of any local stores near me selling fresh oysters.
Thanks,
Mark
Hi Mark,
As you say the contaminants are environmental so they’re highly dependent on the location the oysters were obtained from. We don’t trust Chinese products much as there is a lot of pollution in China. But if the source is good, I think canned oysters should be fine.
Hopefully Bumble Bee tests their oyster sources for heavy metals.
Those fresh shipped oysters are extremely expensive! I haven’t searched for alternative sources as we get them fresh around here.
Hi Paul,
I’m a type 1 diabetic who lifts weights and has been following bodybuilding type diets/recommendations for a while. Reading your book I now see that I’ve picked up a lot of bad dietary habits (way too much protein, not enough carbs, never combining fat and carbs, toxic food, etc.) and would like to know your macronutrient recommendation for weightlifting athletes with (pretty well-controlled) type 1 diabetes? How about postexercise consumption? If it matters: 30 years old, male, 210 lbs, 16/8 intermittent fasting schedule.
Thanks
Hi John,
With type I diabetes you tend to want to be a bit lower carb and higher protein. Post-exercise is a good time to take carbs and insulin. I would say 20% carbs and 20-25% protein would probably be good.
Thanks for the response.
I’ve seen you say before that those training should keep all meals balanced in terms of carbs, protein and fat and then eat more food after workouts, but you’re saying type 1 diabetics who train should eat the majority of their carbs postexercise and keep carbs lower (and protein higher) at every other meal?
Also in the book you say those trying to lose weight should keep carbs and protein constant and just lower their fat intake; should diabetics trying to lose weight do the same?
Thanks again.
Hi Paul, Thanks for all your great info and your amazing book.
I have hypothyroid symptoms (cold hands/feet, etc) and I’m using all your rec supplements plus I’m taking some natural thyroid meds as well.
I’m would like to know if you think swimming regularly in cold water (60*F-71*F) would effect my situation positively or negatively?
I thought the cold water would stimulate the thyroid and other glands, but maybe it would just make me feel colder.
Any thoughts appreciated! Sharon =)
Hi Sharon,
Altough only diagnosed a couple years ago, I have had some hypo symptoms all my life. So, swimming on cold water to me is a extremely scary idea! 😯 😥
Swimming on hot water seems much nicer tough! See this post from Matt:
http://180degreehealth.com/2013/04/hot-water-vs-cold-water-thermogenesis
Hi Mario,
Its funny, I dont have a lot of the most common symptoms such as slow metabolism (i can eat whatever I want and not put on weight) but the cold hands and feet when the weather is cold or cool are consistent.
Thanks for the link, nice to get a different perspective on things.
Would your recommendations for Type 1 diabetes apply to Type 2? i.e. lower carbs(20% carbs, best after exercise) and a little higher protein? no starchy carbs alone I assume (which I guess is across the board for anyone on PHD? What about reducing your eating to a 6-8 our window of every 24? Is that to be avoided with diabetes??
Donna, my dad is a Type 2 diabetic who has been doing PHD for almost 2 years. Although he does eat potatoes and rice (and is experimenting with resistant starch), he’s not sure yet what the optimum amount of carbs is for him, so I’m looking forward to seeing if Paul has any updated recommendations along those lines.
He didn’t do intermittent fasting initially, but now he does it probably five days a week and has no problems with it. He’s been able to eliminate all of his medications except for a much smaller amount of insulin than he had been taking, and has recently reintroduced blood pressure medication, because it seems to be stubbornly high at 140. But for someone with as many heath problems as my dad, the PHD has him feeling better than he’s felt in many years.
If anyone has recommendations for reducing his blood pressure, they’d be much appreciated. He has peripheral artery disease and had congestive heart failure four years ago, which he had bypass surgery for. I am pretty sure that without PHD he wouldn’t be alive today.
I was checking out ‘Boosting Your Immunity For Dummies’ in the store. It seemed to have some good stuff, except nobody seems to like white rice and white potatoes except for Paul. 🙂
Hi Paul,
Do you have any recommendations on how to deal with the male version of HPV? It is manifesting as small bumps in the genital area. I’ve been tested and it is definitely HPV, but there seems to be a lot of different opinions about it/treatment.
Thank you for your help.
Hi CB,
Lysine and vitamin C can sometimes help against viral infections.
I just received an email and was reading about Zembrin, a patented form of sceletium tortuosum which is an herb used by the San people and touted as a mood relaxer and cognitive enhancer
Paul, have you heard of it or have any thoughts about it?
Sorry, haven’t heard of it.
Hi Paul,
I am going to have a CT scan done on my sinuses (paranasal sinuses) in the coming days.
Is there anything you suggest pre or post scan to mitigate any damage from the scan?
I seem to recall you get a fair bit more radiation from CT scans versus the standard x-ray.
I will ask them to cover/protect my neck (thyroid) during the scan (if that is not standard practice already).
much appreciated & many thanks
I found a great post about adrenal fatigue, which ends up being a sodium deficiency. So I think that’s why potatoes wipe me out:
http://curezone.com/forums/fm.asp?i=1367766
So potatoes lower sodium levels? How? With CFS, it was recommended to me to increase my consumption of sea salt because I was told CFS tends to be associated with low blood volume and low cardiac output – and sea salt increases those measures. It seemed to help; and my bp did not go up.
Potatoes are high in potassium, so sodium and potassium have to be kept in a certain balance.
What do my PHD friends think of this?
Recently, Sean Croxton interviewed Dr. Peter Osborne. Here is that interview: http://tinyurl.com/bw8whha
He’s very much in favor of Metametrix testing and very much convinced that the causes of leaky gut are many and varied. In addition to gluten, the causes of leaky gut are many other things, including stress and rice of any kind — especially the nutritionally depleted white rice.
I suspect that it was a couple PHD followers who called in to confirm. Indeed, he replied that white rice is such an inferior food that everyone is better off without it, and emphatically stated that white rice is one of the causes of leaky gut.
What do you all think?
Yikes! Paul your thoughts please.
Hi Lana, I’ve met Dr. Osborne. He was invited to speak at a celiac group here in Dallas. I’d love to hear what Paul thinks, but my opinion is that he is somewhat singularly focused on his field of expertise, gluten sensitivity and may not focus on the toxicity of foods the way PHD does. Also, Dr. Osborne is a Crossfitter and they are strict Paleo. I spoke to Dr. Osborne after his talk and he is very pro Paleo, like Dr. Loren Cordain advocates. This was almost a year ago so I’m not sure if he is still strict Cordain theory Paleo. I hope this helps and can’t wait to hear what Paul says.
I agree that rice is not nutrient dense and even Paul has stated that numerous times and that potatoes are a better option overall. Other then the southern U.S. and now Asian rice lead concerns, I still liked to eat white rice fairly often. However, I would refrain if white rice is implicated with leaky gut syndrome. Paul do you consider white rice a contributor to leaky gut?
Hi Lana,
I’m not aware of any evidence that white rice contributes to leaky gut, and many PHD’ers have healed leaky guts eating white rice.
In controlled trials, too, eating rice products leads to significantly less gut permeability than eating wheat products. See, eg, http://www.ncbi.nlm.nih.gov/pubmed/23357715.
There have been no studies comparing rice with potatoes, but there’s no reason to suspect that rice is harmful. The compounds in raw rice which are known to disrupt intestinal permeability are known to be destroyed in cooking.
It is true that rice is nutritionally fairly empty, so you do have to eat other foods as well.
Paul, thank you for addressing. Your logic is sound as always. I also appreciate that you have been open to adjust and change your recommendations when you obtain new information that deems it to be warranted. It’s good to know that the PHD diet is always a work in progress.
Indeed, SC. A colleague (master’s level education with admin certification) remarked, “Well, if he had to revise and update the book then the diet wasn’t so ‘perfect’ now, was it?” I read the title much differently. As perfection in anything is a journey, it pleases me that Paul and Shou-Ching are ever on the move and respectful of all the research. It’s reassuring that they will likely have, or be close to, the most updated information.
Thanks for your reply, Paul. I’m off to follow the link.
lana, dede, SC and Paul
Once again my opinion is confirmed…this site is not only run by the best people but has the best contributors as well.
Absolutely! 😉
*thumbs up*
First of all: Thank you so much for your book and for this website!
I’d be very happy if you (or some of your readers) find some time to reply to my message.
I am 35 years old and am taking levothyroxine 75mcg for about ten years now, but I haven’t really felt a difference when taking it.
My TSH tests showed 0.68 (in 2010), 0.21 (in 2011) and 0.38 (in 2012) from a morning blood test without taking the medication. Free T4 was 0.9 (in 2012, not taken before). In your book it says, one sould try to get a TSH about 1.0 – and if I get it right, high numbers are risky. How can I interprete my numbers?
Since 2009 I am experiencing fatigue, feeling exhausted, foggy brain, lethargy, mood swings, cold hands and feet & easily feeling cold in general, menstruational problems, back pain.
Do I actually need to take that medication?
I read about bio identical thyroid medications like Armour, maybe I should try that instead?
I’d be glad for any advice!
Thank you!
Hi Helen,
Give http://chriskresser.com/low-t3-syndrome-i-its-not-about-the-thyroid a read…
Hi Helen,
First, doses of levothyroxine that are too high will make you feel just as bad as being untreated. Doctors can’t guess what dose you need so you need to experiment. Odds are your current dose is too high given the low TSH numbers. Try cutting the dose to see what the right dose is — you can cut tablets into quarters or eighths with a razor blade in order to reach smaller doses.
I can’t tell whether you need it but self-experimentation with different doses will tell you what makes you feel best.
Some people do do better on Armour, but I would start by determining the optimal dose.
Thank you so much for your response! 😛
I am trying that now.
Hey Paul,
Do you have any thoughts on Suppversity’s take on eating fat with your starches to ameliorate the high gi effects?
http://suppversity.blogspot.de/2013/03/true-or-false-adding-fat-to-carby-meal.html
Oh wait, he is focusing on the effect on insulin vs glucose – right? Are we less worried about the insulin spike vs the glucose?
That’s right. High glucose is dangerous, high insulin is not. We want to tamp down glucose. Eating starches with fat does that. We don’t care about insulin levels.
To confuse you even more, Stephan Guyenet has mentioned that protein spikes insulin as well.
http://wholehealthsource.blogspot.com/2013/04/glucagon-dietary-protein-and-low.html
Hi Paul,
Was wondering what you and Shou-Ching think about SENS and the prospects for life extension in the coming decades. Do you think significant longevity gains could become possible within the next 50 years?
Hi observer,
I’m not optimistic about the engineering approach to life extension, but I do believe that natural methods — good diet and lifestyle — plus antimicrobial medicine should be able to raise life expectancy to more than 100 years, with almost all of it healthy.
For anyone. Ack! I have 3 cavities. Could it be the vinegar? It’s true I haven’t been brushing after each and every meal, or rinsing with mouthwash daily.
Hi tam,
That’s not good. I suppose the vinegar could contribute but the main issue is probably some nutritional defect. Are you in good shape with all the bone-teeth nutrients — bone and joint broth, liver, sunshine/D, fermented foods/K2, magnesium, vitamin C, silicon, boron?
Make sure any vinegar you take is well diluted. It shouldn’t be obviously acidic.
I take supplements and get sun, but I really don’t do much bone broth, liver, or fermented foods except cheese as yet. I thought I was overdosing on k2 and cut back on older cheese. The dentist wants to put in a silver filling too and insists that there’s no scientific basis not to do it, and I’ll get a cavity below if I get the white one.
Vitamin C (was trying to get it from cruciferous vegetables).
I have just discovered your website and have purchased the Kindle version of your book. I really appreciate your thoughtful approach to the very complicated subject of nutrition. I am looking forward to implementing the PHD.
My question: Do you have any advice for how to tweak PHD to feed teenage boys? Should I keep the carb/fat/protein ratios the same but just provide more of each? Also, what would be some PHD-healthy but teenager-friendly snacks to have around? My son and his friends have bottomless appetites!
Many thanks for all your great work.
Tam, I would seek out a different dentist. I had to go to considerable trouble to have all my metal fillings removed and replaced with the newer materials several years ago, and haven’t had any problems with the new ones.
The inertia of the American Dental Association notwithstanding, it doesn’t take much scientific prowess to understand why amalgam fillings are inadvisable.
These cost as much as a used car, but are very well designed and constructed and provide the most enjoyable way to get total body exercise that I’ve experienced. A great conversation starter and way to meet people, too.
http://rowingbike.com/site/EN/
😳 Jack, I replied to this post but was rushing and managed to misplace it after James post re his wife’s oils.
Saw it, and enjoyed it as usual. I already drive a 2005 Corolla ha! but live just down the I-5 from you in Vancouver USA. Contact me anytime, as we have some similar health issues and interests. cronkjohn@hotmail.com
By the way, just watched a very nice movie on Netflix called The Suicide Tourist about an ALS sufferer ending his life – very moving and well done.
Sure nice to know there’s another PHDer out here on the “best coast.” Don’t get down that way much, but hoping to attend the Weston Price regional conference in Portland in September.
Will send you a greeting via email later. Short weekend and now I need to put my PHD lunch together for tomorrow. 😀
My wife has been taking Udo’s Oil, 3.6.9 blend, “based on the ideal ratio of Omega Fatty Acids,” and I was wondering what you thought of that.
Amount per serving: Calories 120, from fat 120, total fat 13g, Sat. Fat 2.5 g, Polyun. 8g, Mono 3g, Omega 3 fatty acids 5g, Ala 5g, DHa 100mg., EPA 3mg, Omega-6 (linoleic acid) 3g, GLA 40mg, Omega 9 3g.
Ingredients: All Organic: Flax seed oil, sunflower seed oil, seseme seed oil, evening primrose seed oil, algal oil, coconut oil, rice branoil, soy lecithin, rosemary leaf extract, high oleic sunflower oil, tocopherols, ascorbyl pamitate, oat bran oil.
Thanks!
Jamie
Cool! I want one, and…I have a used Corolla for sale. Shall we deal? I ride a good bit of the summer to prepare for the DoubleDay in Mount Vernon, WA. Benefit for ALS, and this would be a fun change of pace.
😀
Hello!
Anyone know if the Metametrix stool testing is reliable for detecting H. Pylori? A friend wanted to do it, but a Naturopath was trying to convince her that it is not a reliable method bc H.Pylori can ‘hide,’ in the mucosal lining. Anyone heard this?
Help!
Lindsay
I had the GI profile done last July — 4 pages of results. The most significant was the H. pylori at a concentration of 720,000 per gram of collected specimen. That surely translates to trillions of them in my gut.
I agree that H. pylori builds biofilm where it spends much of its time, however, as long as a person is not taking a substance that is toxic to H. pylori, I think enough of them will be out swimming about, dying and ending up moving through the gut, that enough will show up in the test. Your friend needs to make certain she is taking no bismuth, or other products that send H. pylori indoors.
Here is a link to Amy King’s site: http://amyking.wordpress.com/2009/02/20/im-so-happy-i-have-h-pylori/
I strongly suggest that, if your friend tests positive for H. pylori, she contact Dr. Ettinger in San Diego.
Amy’s protocol worked for her, but nothing worked permanently for me until I took the biofilm disruptors that Dr. Ettinger recommends. Then, as he says, it was easy. Your friend can do a search on Amy’s site for “elena,” and she describes very well what she did, and she followed Ettinger’s protocol, as well as Amy’s.
I should mention that after two months on an herbal Thorne product I tested negative with a breath test, but I am certain they were hiding in their biofilms, as my symptoms came back with a vengeance.
Good luck and blessings to her.
Yes, this also makes logical sense to me. I mean, we could theorize a lot of things are causing this or that, but without some semblance of proof you’re just chasing a ghost. I think a stool test is good enough. Thanks for your thoughts.
Hi Paul — do you have any advice about dealing with fructose malabsorption? I am sorry to say that over the winter I developed digestive problems while following the PHD; before that I was lower-carb mostly Primal for several years. I have Hashimoto’s but that has seemed stable and nonproblematic for years, and am otherwise healthy at 50, with perfect bloodwork. Anyway the fructose malabsorption has been diagnosed by a hydrogen breath test; the breath test for SIBO was deemed “nondiagnostic” or “inconclusive.” Stool test was also negative. But I do seem to be getting some heartburn and gas from safe starches. I am sort of at a loss as to what I should be eating since I’m supposed to be doing an elimination diet for FM which greatly limits the amount and variety vegetables for now, and if I can’t eat starch, what am I supposed to eat? (It was also suggested to me that rice syrup contains resistant starch, is this true?) I am pretty horrified and depressed by the onset of this problem when I felt I was eating in the best way. (I have not to my knowledge been exposed to any weird bacteria nor have I taken antibiotics; I have been under some serious stress FWIW.) Thanks for any insight!
Hi Paul,
Really appreciate your book. Eliminating wheat has greatly lessened digestive issues with my fibromyalgia – thank you!
Question: I am currently getting over tonsillitis, taking antibiotics (for which I am very thankful). Are there any particular dietary suggestions for someone taking antibiotics? How about when the course is finished – how best to repopulate the gut in a healthy way?
Thanks,
Karen
Look up and make our recipes for kimchi and fermented mixed vegetables, and start eating a little bit every day.
You’ll want to eat liver and make sure vitamin D status is optimal to support gut immunity through this time, you are vulnerable to infections as the antibiotics reduce the protective barrier of probiotic flora.
hi Paul, i am about to have a colonoscopy.
is there any thing about that procedure that damages the gut flora and are there any things to help befor or after. thks alfred
I’ve read that fermented vegetables (which I make / eat) have something like 10 times the # of CFUs (colony forming units) of bacteria than most supplments – and also a greater variety of probiotics. I also take Dr. Mercola’s probiotic supplement (70B CFUs in 2 capsules), 4 / day as I had been tested by a naturopath and was shown to have zero (yes zero) lactobacillus in my gut even though I was eating yogurt and taking a 15B CFU supplement daily.
Hi Paul: Do you know anything about biofilm in the gut? I’ve been on large doses of an antiviral medication (acyclovir) for quite some time and have been on your PHD diet for close to a year and the 8 hour version for many months now. Still not able to reduce the meds (I’m actually needing more – spinal pain & gut symptoms beside cold sores) and have read that gut biofilm may be an issue?? or possibly there are ‘die off’ issues I’ve read?
Hi Donna,
Read my reply to lindsay, dated May 5. Dr. Ettinger has nailed the biofilm busting protocol. You can find him in San Diego and does work with distance patients. Check for “elena” on Amy’s site.
Good luck to you.
Hi Paul; I am allergic to vinegar (the mold). Is lemon juice with meal sufficient for the acid? Thanks, Donna
I’m not Paul, but the answer is yes…or lime juice, for that matter! All vinegar, or just the apple cider vinegar. There are lots of other ones to choose from.
Hi Paul, Can you recommend a nutritional strategy to raise a naturally low total cholesterol level (138). The constant round-robin of infections is taking a toll. Many thanks, Irene
Hi paul,
I asked a question a few weeks ago but I couldn’t find the answer you gave looking back(had to work away for a fortnight), sorry to ask you again. Basically I have a few different issues – constipation and taking 10 – 15 minuts to pass a stool, red cheeks (that I’ve had since adolescence), feeling drained and tired all the time (low energy), a sort of achey clogged up feeling in my throat and just a constant tenderness that feels like it comes from my digestive tract in my abdomen. Last time you mentioned hypothyroidism and rosacea and recommended bone broths I think but what else do you recommend food, supplement and lifestyle wise? thanks again Tim
Hi Paul,
I have a few problems that I believe are interrelated but I can’t really relate them. I recently weaned my son from extended nursing and learned that I was deficient in iron and very low in vitamin D. I got the vitamin D up easily but it’s taking longer to get good iron stats despite the fact that I eat red meat and follow your diet.
I have a TSH of 1.5 and no thyroid antibodies, so I am guessing my sluggishness was from deficiency and motherhood (ha). I have always been healthy and a normal weight but my son was born early and the stress of that event, plus waking to nurse him all night for several years, definitely messed with my circadian rhythm. To complicate problems, in the winter I was overly medicated with strong doses of T3 by a doctor who didn’t check (or care about) my low iron levels or underlying adrenal stress. She didn’t totally wreck my adrenals but she came close. I spent a few months on the couch shaking with varying cortisol levels during the day, and slowly recovered health and strength with acupuncture, getting my nutrients up and keeping to your diet (Bless you both for your diet). I am tentatively living again but have a few lingering problems, the chief of which is insomnia. I have trouble falling asleep and tend to wake very early — between 4-5. I have recently started wearing amber glasses at night. Should i also try melatonin? For how long is it safe to supplement? Is there something else I should do to modulate cortisol?
I also learned recently I have two vaginal infections — one bacterial and one fungal (not the typical candida but another that doesn’t respond to fluconazole). I wonder if they might be stealing iron and contributing to my subclinical hypothyroidism? I was not symptomatic with either infection so I didn’t know I had them. Should I treat the bacterial infection first and then the fungal infection? Do you think they relate to insomnia and disrupted circ rhythm?
I also wanted to thank you — because of your book I was able to convince my husband to have parasite testing. He was positive for a nasty amoeba, was successfully treated and is heading back to health. I’d like to follow him!
Long question, I know! I’m quite desperate.
thank you.
KrissyR
Hi Krissy,
It’s good that you discovered the deficiencies — too bad it took so long. I think both iron and vitamin D levels should be routinely monitored during pregnancy.
Melatonin is pretty safe. You usually want to use much lower doses than are commonly found in supplements — say, 1/4 milligram. Get a 1 mg tablet and cut it into quarters with a razorblade. Take shortly before bed. Taking too much will also lead to early waking.
Make sure you have enough magnesium, and eat enough carbs at dinner. A little bit of honey and lemon juice in water before bed might help, or some milk.
I don’t see any evidence of a brain infection in what you’ve said. It sounds like the excess T3, low iron, and low-D are sufficient to explain your troubles.
It’s generally better to treat the fungal infection first. If you take antibiotics the fungal infection will spread. You need bacteria to keep the fungus in check. Unfortunately, if fluconazole doesn’t work you may not have good choices.
The insomnia and disrupted circadian rhythms will impair immunity and make you more prone to those infections. It’s also possible the infections might be contributing to the insomnia. But good nutrition is the key to breaking this. Be sure to get plenty of liver and vitamin D, some vitamin K2, and I would take NAC also. Make sure zinc and copper are good also, see our book for advice.
Focus on being well nourished and you should recover steadily. Keep me posted.
Best, Paul
pauljaminet KrissyR Thank you so much for your input, Paul. I will let you know how it goes for me.
Best Wishes to you and Shou-Ching.
Hi Paul,
You asked me to keep you posted and I am really happy to report that when I treated my two infections my insomnia went away in two days ❗ and hasn’t returned. My experience definitely bolsters the idea that one should first discover and treat underlying infections. I believe the gardnarella bacteria was probably stealing iron (lots of studies on this) and that, in combination with depletion of nutrients must have knocked out my thyroid.
Having rid myself of the bacteria and candida, I think my iron levels will be normal again soon. My TSH is now 1.4, down from 1.8 in the winter. My ferritin is now in the low 30s, up from 20 in the fall. All other blood work is now normal, too. I have no food cravings, brain fog or mood swings. I can work, concentrate and take care of my son. I feel no anxiety.
This is an extremely common bacteria for women to “host” and I was totally asymptomatic. I wonder how many other women’s health goes off the rails in the manner mine did. I hope they find your site!
I recommend your diet to everyone I know and have bought your book for four people. My father follows the diet now and his mood is better than I ever remember. My brother replaced wheat and corn with rice and potatoes and his lifelong psoriasis is totally gone.
Thank you again and best wishes to you and Shou-Ching. I cannot tell you how grateful I am to you for your work.
Krissy,
this is so interesting. How did you find you you had these infections? Just a routine pap or did you need to get your doctor to do some special test?
thanks,
Elizabethe
Hi Elizabethe,
My doctor did a routine bacterial culture and a special yeast culture. Or at least one that she said was particularly sensitive. It went through Enzo labs. I didn’t have candida albicans but another strain. My pap was normal and I don’t have HPV so I had to push a little for the cultures — meaning it required a conversation since she saw no evidence of infection and I had none of the normal symptoms.
I am guessing the candida took hold after I adopted low carb in an effort to get thin again after having my son. It was fairly easy to treat with probiotics. I used FemDophilis and Dr Ohhira’s probiotics.
That’s fantastic Krissy! Thanks for the update, and for recommending us to others!
this is a test. I have not been receiving notifications
I put in the wrong email, let’s try this again.
Hi David,
Are you getting notifications now?
Optimal Blood Selenium levels?….
Hi Paul,
The reference range for Selenium from my local lab is 0.80-1.90 ?mol/L. It does not define whether this is serum or plasma as it just reads ‘serum/plasma’.
Anyway, i was just wondering whether the Selenium lab ref range was a bit like the TSH lab ref range, where the ref range is too large & in the case of TSH, the optimal number is at the bottom end of the lab range.
So in all your research have you come across anything regarding optimal Selenium levels, ie. which may be better…bottom, middle or top of lab ref range.
hope you have some info to share, thanks Paul
?mol/L should read ?mol/L (micro-mol/L)
i see the it does not like the ‘micro’ character, it should be ok with this variation tho….umol/L 😎
I think i may have an answer for my question,
A good plasma selenium range is 130 – 150 ug/L.
(or 130-150 ng/dl, or 1.65-1.91 umol/L).
source,
http://www.medicalnewstoday.com/articles/242329.php/
Doctor Jaminet
The results of a recent blood test I had show that my TSH level is 0.79
I experience symptons similar to someone with hypothyroidism. Is this TSH number cause for concern?
Thanks a million
The TSH number is fine but the symptoms are concerning. Do you eat sufficient carbs and protein?
Another factor is that many of the symptoms of hyperthyroidism and hypothyroidism are similar. And you can have disturbed thyroid function that is variable through the day — improperly high sometimes and improperly low others — with normal TSH.
So it’s best to have a doctor evaluate your symptoms.
I’m doubtful that there are many doctors (including endocrinologists) who would investigate TSH / thyroid function so carefully e.g. diurnal variations, etc.
Paul (and PHD friends)- wondering if you can share your thoughts. I have been dealing with ‘something’ for about a year. My doctor thinks either Crohn’s (mostly external manifestations as I don’t have digestive urgency) or Ankylosing spondylitis.
I am not on meds. I gave up gluten about a year ago. Tired paleo about 2 weeks over xmas and then discovered PHD and have been sticking to PHD since. My symptoms fluctuate with my biggest complaint joint pains and dry/irradiated/inflamed eyes. I seem to have systemic inflammation which worsens and then improves. Diet has helped a lot but not 100%.
Recently, I decided to experiment and increase my carb portions. i was eating about 30% and have increased to 50%. As a result my protein has decreased to about 20% or less. To by surprise, I feel that my joint pains has improved!? I don’t feel that the extra carb diet has been beneficial as my sugar levels are out of sync. I find i get hungrier at meals and eat more. I am also getting reflux more regularly. However, I do find it interesting that my inflammation has improved… wondering what your take is on this? and how should i continue to eat??
do you think it’s from lowering protein? or if this is an infection (like you believe for most autoimmune issues) would i require more carbs/starch for some reason??
Thanks in advance,
Christine