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:
I have a history of about 15 years of eating disorders from age 11 onwards, followed by an incredibly hectic lifestyle, until I had a severe burnout, resulting in 8 months of sick leave, at age 30. All of this has of course undermined my health. For the last 10 years or so, I have worked on improving my diet and lifestyle and have come a long way. My latest step was to try a paleo diet. Leaving out grains felt good, but I missed sugary plants, such as carrots and beets, as well as fruit. In a matter of weeks, I, however, discovered your book and am now in the course of making the needed adjustments to my diet. Before I started reading your book, I had made an appointment with a dietist who cooperates with doctors representing functional medicine. She said that with my history and two recent pregnancies 2 years apart + 1 year and 3 months of breastfeeding of both my children, I am likely to have nutrient deficiencies. She suggested intense supplementation for a few months time in order to replenish my nutrient stores. The plan would include 3 tablets a day of Solgar’s Female Multiples. Since my hemoglobin is 117 and ferritin 9.8 yg/l (couldn’t find the correct character, so I used “y”), she suggested I’d supplement iron and then check my levels in 3 months time. My vitamin D-level is 50.6 nmol/l. She was of the opinion that 80 would be optimal and suggested an increased dosage of vit-D. What is your view on all of this? Would it make sense to use multi-vitamins for a brief period, in order to regain some nutrients or would that be risky? How would you go about the iron and vitamin D? As far as I can understand, my thyroid status is good with TSH 0.75 mlU/l, FT4 14.90 and FT3 3.92 pmol. My insulin was 4.0 mlU/l, glucose 4.7 mmol/l, C-reactive protein 0.44 mg/l and homocystein 5.39 ymol/l, which i think is pretty good (?).
I’m planning to start making bone broth and have had my first portion of liver (yak!). By the way, is it ok to eat beef or lamb liver if one also eats the chocolate (can’t be without chocolate) or do the two not go together as well as poultry liver and chocolate? Just making sure.
I forgot to mention that the reason I feel something needs to be done is that I still do not feel I have completely recovered after the burnout, although it happened 8 years ago. My stamina is not what it used to be, I often feel quite exhausted, have low stress resistance, and sometimes tendencies towards depression. I have had brain fog, but most of that cleared when I removed grains from my diet. Ever since my second pregnancy, I keep getting sores in my nose. They go away for a few weeks, only to re-appear again. My skin is dry, fragile and bruises easily, and my hair is extremely thin. I also get migranes during my monthly period, and have daily cravings (especially chocolate and other sweets). I fare better with the cravings on my current diet, but am not quite there yet. I would like to be more energetic and alert.
I am listening to the book on tape but have been unable to find the site to download the pdf supplemental material. Can anyone help me?
Scribner is looking into that.
I still have not heard.
😛
Hi Paul,
Like you I have rosacea which has greatly improved while on the PHD. As good as my skin has been, my dermatologist just diagnosed me with ocular rosacea and prescribed Oracea saying I may want to be on it the rest of my life to control what my eye doctor thought was recurrent eye infections. He mentioned the work on ocular rosacea by a Johns Hopkins doctor whose name I can’t remember and said most opthamologists don’t diagnosis it properly.
He made the drug sound fairly benign with potentially other good benefits from its tamping down inflammation. He has had other rosacea patients on it since it’s inception about eight years ago with great success. But as we all know, drugs usually carry a downside so I’m wondering if you are familiar with it and would love to get your opinion.
Thanking you once again for your dedication sharing information to help others!
Susan
Hi Susan,
I’m afraid I don’t know anything about that drug.
Hi Susan,
Oracea is simply doxycycline. I take it for ocular rosacea and it has helped tremendously. I think as long as you stay on the PHD and take good probiotics you should be fine. It is a very low dose. It works as an anti-inflammatory, and will help keep your meibomin glands unplugged.
Sandy
Have either of you (Sandy or Susan) been tested for SIBO?
I developed facial rosacea and mild blepharitis out of the blue about a year ago. I got tested 6 months ago and I have the methane type. I’d read that there was a high correlation b/w SIBO and rosacea, plus I’d been having IBS-C and D (fluctuating) symptoms off and on for the prior 2 years, so I asked to get tested. If you do get tested, make sure that whoever is doing the testing is following the Pimentel protocol (Quintron machine, 2-3 hr test, testing for both H and Methane). You also might want to test for H. Pylori (stool), as apparently there is a high correlation with it and SIBO too, although not always (I’ve tested negative twice).
Susan,
I have no doubt I have SIBO, in fact I’ve been treated for it twice
but it keeps coming back. I have a very low tolerance for fructose, and do best on a lower carb diet. I know it would be beneficial to get stool testing done, and I plan on it in the near future. I will talk to my doctor about the one you suggested.
Thank you
Sandy, which SIBO type do you have and do you know what you were treated with? Was it antimicrobial or antibiotic? Yes, I’ve heard that relapse is a major issue, and I think that’s why some doctors recommend a pro kinetic at the end. I haven’t gotten there yet, but I am concerned.
Susan, I was never tested for which type I have, but was treated according to symptoms. I first did a round of Flagyl, then a year or so later tried Rifaxamin. It worked for a while but has crept back. I haven’t been as diligent with my diet as I need to be. I really believe a low fodmap diet is what works best for me. I’m taking oregano oil, along with prescript assist probiotics this time around, but I’m not sure it will be enough.
Susan, I read the article that Chris Kresser wrote..It’s very interesting. I actually have a script for LDN and I’m going to start using it. I have a very good functional doctor who is open to anything I suggest.. I’m going to talk to him about the test you mentioned.
Hi again Sandy (and BTW there’s a different Susan in this thread — the other one asked you about Prescript Assist and side effects).
Regarding the LDN, I understand it to be most effective when used immediately following a course of treatment (either antimicrobial or antibiotic) specifically targeted at your type of SIBO and that has been successful in eliminating the SIBO (even if temporarily) as determined clinically or by proof of a follow up test outcome of negative. The LDN is then used immediately following the primary drug course as a preventative measure to keep the SIBO from returning by stimulating the MMC (migrating motor complex) to keep things moving downward and out of the SI. In other words, it isn’t used on its own to to get rid of the organisms that cause SIBO. In a nutshell, my understanding of the process is 1) diagnosis of SIBO and the specific organism causing it; 2) targeted treatment at that specific organism, simultaneous with gut and flora repair with special probiotics and temporary diet mods (also designed to starve the bad organisms at the same time they’re being eradicated); 3) re-evaluation at the end of the course (30-60 days) with possible retesting; 4) if SIBO is negative at day 30 or 60, then introduction of pro kinetics like LDN to prevent a relapse and slow and methodical reintroduction of healthy FODMAPs that as tolerated.
This website has very good info on treatment and prevention. You can click on the “treatment” drop down menu and read thru all the info, including the info on recommended drugs and other steps for eradication and prevention:
http://www.siboinfo.com/overview1.html
She also has some excellent info on proper testing procedures and interpretation in the “about SIBO” drop down menu. I urge you to take the driver’s seat on insisting that your testing is consistent with what she recommends and to not just follow what your doctor tells you. In my case, my testing was consistent with her recommendation, and even though the GE who conducted the test wrote “methane positive” on the the lab report, my own functional MD told me that didn’t mean that I had SIBO, but rather just meant that I was constipated. It wasn’t until months when Chris Kresser wrote his article on methane SIBO that I realized that my doctor was wrong. So I called the GE’s office and they said that I did in fact have SIBO and confirmed that if I were his patient that I would have been treated for it. (BTW, both that GE and Siebecker are disciples of Dr Pimentel.)
And while many good doctors suggest in-home tests like Commonwealth, IMO it is far more ideal to do the test in person with a highly skilled/trained expert on SIBO –and importantly, one who has a Quintron machine (state of the art) in-house, like the GE who did mine — as there is too much room for error with the former.
Sorry for being pushy and belaboring these points, but I’m just trying to save you some grief, money and aggravation. Best of luck, we all need it!
And here’s a great podcast that was released by Chris Kresser today. It’s title is Parkinson’s disease but very soon into the podcast he talks in detail about the close correlation of SIBO and Parkinson’s and then even talks about the night rate of SIBO relapse and why LDN works so well as a pro kinetic to help prevent relapse. About half of this podcast is actually about SIBO! Later in the podcast he also talks about iron overload and ways to prevent and reverse it.
Highly recommended:
http://chriskresser.com/new-research-and-treatments-for-parkinsons-disease
Sorry, that should have said “…high rate of relapse…” (not “night rate”)
Susan, thank you for all of the information!! I will do some research on the SIBO treatments
I appreciate the feedback Sandy – no side effects? What probiotic do you take?
Susan
Thanks also for your input Susan. I have not been tested but have it on my list to discuss with my Internist. I know from my dermatologist that there is no cure for rosacea but understand that healing everything possible will certainly help curtail symptoms and possibly avoid other complications!
I had what they thought was a gallstone attack right before Christmas although no stones or anything else showed up on the ultrasound. When I mentioned SIBO to my gastro doc he scoffed and said oh that’s the flavor of the month right now.
Can anyone recommend a good functional medicine doctor in the Northern Virginia/Washington DC area?
Sandy, you might find this informative/helpful regarding both types:
http://chriskresser.com/sibo-and-methane-whats-the-connection
Also, I’ve heard Dr Siebecker and others speak about using a pro kinetic at the end of treatment to reduce the incidence of relapse. One type of pro kinetic is LDN which many functional med folks (Kresser, Siebecker and others) say is harmless, even if taken very long-term. Siebecker’s website (siboinfo.com) has a lot of good info about diagnosis and treatment.
I’ve found it very challenging to find the right functional doctor to work with. Many will tell you that they’ve dealt extensively with gut issues, but in my experience, that is not good enough. For example, my prior FM MD told that methane just means I’m constipated; but even the GE who did my breath test knew better than that and he’s not even functional, but then again, he’s specialized and stays very abreast of all the most recent research on SIBO. I wonder if you could get some good recommendations for your area by inquiring about them at either Dr Siebecker’s clinic in Portland, OR or Dr. Pimentel’s group at Cedars Sinai?
Susan, I take Prescript Assist, it is a soil based probiotic.
Susan, I don’t have any side effects from the Oradea, I think because it is such a low dose.
Dear Paul,
I would have a few questions regarding legumes, nuts and seeds.
Legumes are not recommended due to their toxicity. However, you mentioned that you eat peas and green beans. How are they different from other legumes? Dr Perlmutter writes in his book that chick peas are also an exception. Would you agree or would you avoid chick peas? Peanuts are of course not recommended, but what is the case with soy? I understood from your book that soy is better avoided, but there were some recipies in the book that contained soy sauce. Is this a case of the dose makes the poison or is soy safe in certain forms?
You write that seeds can often be toxic, as it is the plant’s way to protect itself, but that most tree nuts are safe to eat. I’m not too familiar with how different nuts grow, so I would like to check whether the following nuts are safe to consume: almonds, pecans, macadamias, hazelnuts, Brazil-nuts, walnuts, pistachios and cashews? What would be a suitable amount and frequency for nut consumption?
Then how about seeds? Many would claim that both nuts and seeds are “packed with nutrients and good fats” and should therefore be included in a healthy diet. However, we know that omega-6 rich vegetable oils are to be avoided. Does this imply that also seeds (sesame, chia, sunflower, hemp, pumpkin, linen) should be avoided or are they healthy to eat as seeds in a natural, unprocessed state? It’s said that it is good to soak seeds overnight in order to remove possible toxins (so apparently they do contain some toxins) and to make them more easy to digest. Would you include any seeds in your diet? How about quionoa and amarant? Some recipies in the book seemed to contain e.g. sesame oil. Is that a low omega-6 and low toxin oil or is it another example of the dose makes the poison? At the moment I am only using olive oil, coconut oil and butter. I do, however, have very dry skin. Might it be a good idea to increase the intake of some type of fat and in that case, what type of fat is most beneficial for the skin?
I would be extremely grateful if you would have the time to answer the above questions. That would help me in building up my new diet.
Hi there,
I had a question about cooking oil. What do you think about Rice Bran Oil? Is pure rice bran oil healthy to use on the PHD for cooking or does it have high omega-6 like other vegetable oils? I do use all the healthy oils like coconut oil, olive oil, butter, and avocado oil, but I was wondering if it is okay to use rice oil to cook with also.
Thank you, Birdy
Sorry if this question is off topic but just want to make healthy choices with all I do so here goes…
Paul, do you have any thoughts on the use of marquina as a recreational plant if it is done through a vaporizer or infused in food? I want to be safe as I eat your diet and love your blog. I don’t smoke because I know that the combustion is the problem.
HI,
I was diagnosed with LPR but do not see much in the way of treatment on the internet or by the ENTs etc. for this ailment – only PPIs. LPR is caused by when the pepsin on the throat is activated by acid…thru diet or by the contents of the stomach. This appears to be a catch 22 situation as it seems as if addressing bacterial issues via low carbs and possibly HCL supplementation will exacerbate the throat issues (difficulty swallowing, throat clearing, coughing and sore throat). I bought your book and am currently reading it. You recommend 3 egg yolds per day and I love eggs but noticed that eggs are highly acidic in the body after eating – which is not good for someone with LPR. Any additional thoughts on how to treat LPR would be very appreciated. Thanks, Susan
My husband recently has started experiencing nausea after eating. It’s usually if he has a supplement with his glass of raw milk (for breakfast). That’s usually all he has for breakfast. Without the supplement (usually seaweed supplement) he doesn’t get nausea. I’m wondering if it’s caused by low stomach acid. He got it again today, after eating a chocolate and chocolate milk for a snack. (He’s not eating full PHD but I’m trying my best to convince him). He doesn’t get nausea after a full meal though.
Hi Paul,
I’m a bit confused about corn. I know you say it is not good but what does that include. You have said corn on the cob is not too bad but what about maize or polenta and corn flour. Are those all under the name of corn?
Thanks
And what about the occasional home-made popcorn?
Hi again Paul, I’d appreciate it if you could just clarify my lack of understanding about different types of corn, especially if homemade popcorn is similar to sweetcorn and therefore not too bad?
Many thanks
This is completely unhelpful and off subject, but did anyone know that wheat is called corn in England and oats are called corn in Scotland? As if there isn’t enough confusion in the world. I was reading a history of Croatia and they kept talking about storing corn (this is in the middle ages, long before anyone had traveled to the Americas), and then found out about the different terminology
.
http://www.answers.com/Q/Why_are_wheat_fields_called_corn_fields
Dear Paul, what is you take on the key factors stoppping autophagy during IF (apart from protein)?
Have seen some info stating that coffee, BCAAs, antioxidants can interrupt with IF therapeutic effects, and suggestions just to drink water during fasting.
Hi Elena,
Any calories will slow down autophagy. Black coffee actually promotes autophagy, but if you add sugar or cream it suppresses it. I suggest black coffee, plain tea, or water flavored with vinegar or lemon juice.
Hello Mr. Jaminet,
My husband is 51yrs old. He is physically fit and has been his whole life. However, he does suffer from Rheumatoid Arthritis. He has high cholesterol as well. My boss is a big fan of your work and has been talking to me about the Perfect Health Diet. Would a high fat, low carb diet be beneficial to my husband. His cholesterol is 276, triglycerides 290, HDL is 44, cLDL is 173 and VLDL is 58. We do not eat a lot of processed foods and lead active lives. Please help! Thank you, Lori
Hi Lori,
I prefer to call PHD moderate-carb and moderate-fat, but I do think PHD would be very good for your husband. The high triglycerides indicate he has a likely small intestinal bacterial growth which puts him at risk for diabetes. Some keys are to eat liver, supplement vitamin D or get sun, do intermittent fasting, circadian rhythm entrainment, eat 3 egg yolks a day, salads and spices on food, black coffee during the fast, extra vitamin C, and the rest of the PHD nutritional advice.
Best, Paul
Thank you Paul!
Paul,
Your thoughts on :
Magnesium – Threonate (ex. Dr’s Best or Mercola)
and
Liposomal Vitamin C
Blessings,
D and J
Hello D & J! Just wondering, does D & J stand for Don and Judith and are you our friends Don and Judith from New Mexico? If yes, hello from Peggy and Herb Mandell! If, no, nice meeting you anyway and blessings to you, too.
Did Paul respond to your inquiry about Mercola MG threonate and Liposomal Vit C?
I know Paul/PHD is not a fan of Niacin supplementation in general but I have just been diagnosed with, along with other deficiencies, a B3 deficiency. I guess the obvious thing would be to take Niacin and some folks advocate a high dose for a three month period but something just makes me uncomfortable, after reading PHD, about high doses of Niacin. Any thoughts how to safely fix a deficiency?
Hi Lorenzo,
Go ahead and supplement if you have evidence of deficiency. You can take high doses of niacinamide to relieve the deficiency more quickly — there are many grams of niacin in the body so higher doses are needed to clear it quickly.
Thanks Paul, you are the best.
Hi Paul,
I tried implementing the steps to deal with bowel diseases with no success. Problems began after VLC, low caloric intake and low vit D levels. Those are managed, but the symptoms persist:
– Starches are very problematic (with the exception of white rice, even cooked and cooled for a long time), not sure if it’s due to the RS or the fructose content of them. They all seem to induce severe diarrhea and extreme bloating.
– Fiber a bit less problematic but still (collards, kale, spinach, etc). They induce a different type of gas than the starch and they constipate.
– Non-starchy roots seem very beneficial and seem to improve the situation (except for Beetroots, which makes the problem much worse).
– Allium genus doesn’t seem to cause problems, they are neutral (except for Onions, which makes the problem worse).
– No signs of fatty stools, no matter the amount of fat consumed or transit time.
– Fasting seems to offer some relief, but when those foods are reintroduced the problems re-start.
– Brassicas are not problematic even in large amounts.
– Fermented foods are also problematic, except for their juice. But they don’t seem to improve the situation at all.
All of the problematic foods where tried in increasing from small amounts without success.
So, Paul, do you have any idea of what this points to? And how to recover?
Paul, when possible, please leave a reply. I really wanted to know your opinion!
Hi Gustav,
It looks you suffered a severe loss of gut flora diversity on VLC and have an overgrowth of a few species. You have to keep trying to increase gut flora diversity, and keep trying to eat a full diversity of foods, perhaps in reduced doses. Consider whether you can get a fecal transplant or enema from someone with a healthy gut (you know animals eat feces in order to increase microbial diversity and get vitamins and nucleotides from the fecal microbes). Do intermittent fasting, circadian rhythm entrainment, and eat liver to improve immunity.
I’ll consider the same diversity in very low doses. And if nothings works, resort to a transplant.
Thank you, Paul!
Hi Paul,
You have noted that humans do not have an innate activity reward system. Do you not consider endorphin release during exercise to be a reward system? I have trained nearly daily for the last 30 years and realize that this is not particularly healthy, however, I certainly enjoy the feeling of euphoria during the training and this euphoria highly motivates me to train. Did I possibly misinterpret your statement?
I’m not sure “reward” is the right word for this. There are bodily changes that occur with exercise and people can learn to like them. But if someone repeatedly doesn’t exercise, then they don’t develop an urge to exercise, the way hunger would drive them to eat if they refrained from eating.
Hi Paul,
On page 131 of the book there is a chart comparing good oils. I see palm kernel oil listed first, above coconut oil. I bought a little bit to try it out, and I really like it. As a layman, I hear very little about palm kernel oil. Is it as nutritious as coconut oil in every way?
Thanks,
Leo
Yes.
Paul,
what are your thoughts on dietary considerations for people, such as myself, who are homozygous for apoE4. It is my understanding that it is a “pre-agricultural” variant, supposedly poorly adapted to Neolithic foods. Are your safe starch recommendations the same for apoE4 folks as they are for everyone else? (Please say yes 😉
Thanks!
Hi Webraven,
ApoE e4 seems to be a problem on energy-excess and micronutrient-poor diets. ApoE e4 holders are more damaged by oxidative stress than the other alleles, and energy-excess antioxidant-poor diets generate a lot of oxidative stress. These are the obesity and diabetes inducing junk food / processed food diets that are so common today.
Any diet that keeps you lean and well nourished is going to avoid the damage from ApoE e4 and will probably turn it into a beneficial allele. I think PHD is an excellent diet for that.
So I would eat PHD, maybe with extra vegetables, do intermittent fasting, and not worry about it.
Great information (and very reassuring, as well). Thank you as always for generously sharing your insights.
Hi Paul,
A friend just found out her daughter has a very large uterine fibroid. She has never paid attention to her diet, but this has gotten her attention and she seems willing to start with some less drastic measures rather than go direct to a hysterectomy.
I understand that was one of the issues that Shou-Ching dealt with. Is there anything in particular that she should emphasize or focus on since it will be a big change to go on the full PHD right off the bat. Your thoughts on this would be greatly appreciated. Thanks.
Hi Ellen,
Unfortunately we don’t know what causes the fibroids so it’s hard to pinpoint what to focus on.
I would say that optimizing vitamins A/D/K2 with liver, sun, and supplements is important, as is dealing with oxidative stress by optimizing zinc/copper/vitamin C and supporting the thyroid with iodine and treatment for hypothyroidism. Then supporting wound healing with collagen/extracellular matrix and lifestyle — circadian rhythm entrainment especially.
Re fibroids – read the website Healthy Immunity by Lorna Vanderhaeghe who is a women’s health expert. A wealth of free info. She also does talks throughout North America as well as some webinars. Consider her supplement, EstroSmart. I and many others (including Lorna) reduced or eliminated fibroids and avoided surgery with this supplement as well as dietary changes.
Dear Paul,
Thanks for such an interesting, well-written and thoroughly researched book. First, are you planning a german translation? Several of my family members would benefit..
Here comes my question: I have been very low carb and high fat (and hence in ketosis) for about 6 months now, and it has worked wonders for my energy levels and significantly reduced my migraines. I have gone from 6-7 migraine days per months, to about one. My mental energy is top – I have been more productive and creative in my work as now, and attribute this to the efect of ketones on my brain. I never want to go back.
But I start feeling that something is missing from my diet, and that I can maybe do even better. Perhaps get rid of those last remaining migraines. I started a few months ago to loose a lot of hair. I also often get constipated now, and I don’t sleep so well anymore as I did in the first months. My physical energy levels are also not as great as in the begining.
So I will try adding back some safe starches and a little bit of fruit to my diet, and combine this with intermittent fasting in mornings, with coconut oil in my coffee. But if I add starches to my dinner, and a bit of fruit, this may very well kick me out of ketosis, at least temporarily… (in fact, I know it substantially reduces ketones post meals).
I read somewhere that you have this type of diet with intermittent fasting. My question is, do you know whether you are in ketosis, and how much of the time? How much coconut oil is needed in order to maintain ketosis? How do you recommend consuming it, are you able to just eat a spoonful pure?
Thanks again. Any further suggestions for migraine reduction and mental sharpness are very welcome.
Best,
Sina
Hello Paul
I have two questions.
Firstly, did you ever write that post about GERD? I couldn’t find it using the search engine, just suggestions that it was forthcoming.
Also, what are your thoughts about differences in starch tolerance as a result of differing numbers of copies of the AMY1 gene? There seems to be good evidence that those with fewer copies of this gene do worse and are more likely to become obese on a higher-starch diet. Bearing this in mind, do you know if it is possible to get oneself tested to find out how many copies of the AMY1 gene one has?
Hi Jessica,
I haven’t done the GERD post yet … too busy with Luke, cookbook, retreats, and some other business obligations. I hope to get caught up this summer.
I don’t think the differences in amylase gene copies makes a lot of difference at PHD starch levels. It does improve tolerance of high-carb diets, such as the 70% carb diets common in Asia and Africa.
I’m not sure if there are commercial tests for that yet.
Best, Paul
Any chance this might be translated into Korean? I’d love for my mother and other Korean family members to have this. Have already given them the Korean appla graphic! Thanks!
It hasn’t attracted interest yet from Korean publishers, so there are no plans at the moment.
A Polish version would be great. I know of many Poles who are now going down the natural diet etc.. route to try and heal health problems. Any plans for a Polish copy?
I only have one question for you Paul:
What color is the dress?
http://www.buzzfeed.com/virginiahughes/why-are-people-seeing-different-colors-in-that-damn-dress
white and gold
Hey Paul,
For convenience, I was wondering if store bought organic bone broth (no other ingredient listed) would be nutritionally “good enough” compared to homemade? Thanks.
Hi Jay, Homemade is always better but store bought should be OK.
Jaybird, where do you get the bone broth?
Different brands. I look for organic, 100%. Just bone broth on the ingredients and nothing else.
It’s the most time consuming part of following PHD.
I’ve had some bad results too. Don’t know if it was bad bones or what.
Good to know to go with the store bought than not have at all.
I’ll figure out a homemade routine that works better eventually.
Jaybird, if you can’t get hooked up with anyone who makes it fresh locally (sometimes you can get that info from local grass fed ranchers), then there are some online sources. US Wellness Meats (grass fed and finished) sells it and will ship it to you. Lots of ancestral diet followers order from them. Checkout their website.
Not sure where you live, but in SF area there’s Belcampo.
In SF, Los Angeles, Brooklyn and New Orleans there’s Goodeggs.com.
I agree, broth making is a time burner, but I do it anyway.
Do you have any idea if peeling and dehydrating cassava neutralizes the natural cyanide and other worrisome toxins? I am looking to make a homemade flour and I was curious as to whether or not I should consider doing additional cooking prior to dehydrating it. I’m having a really hard time finding a legitimate answer to this question and I am afraid to risk it
Do you think it’s suitable as a regular carb? You can make tons of delicious foods with whole food cassava flour.
Hi Shawn, You can get a summary of cassava detoxification methods here: http://www.ncbi.nlm.nih.gov/pubmed/7576161
Sun-drying (peeling and prolonged dehydrating under sunlight) is the best way to start, then grate, soak, and boil.
Hi,
I’m 25 years old male, I’ve been suffering from chronic cold and headache from almost childhood. Recently my doctor advised me to test IGE(Immunoglobulin E) level and it turned out to be too high.(411.7 IU/mL). Now my doctor said that there is no cure for this as this is just like allergy and prescribed a nasal spray for temporary relief. Can you please tell me if that is right?
Are quinoa and amaranth healthful to eat?
Are there any pitfalls to the PHD? I.e. have any of your followers reported any problems and if so, what have the causes been?
Hi Jessica,
I’m not sure I’d characterize these as pitfalls, but some people coming from low-carb will gain weight temporarily when they add carbs back, and some people with gut problems will react because PHD is a generally high-fiber diet, although tweaks can be made to reduce fiber content. Generally however almost everyone reacts well.
Best, Paul
Thank you Paul! I’ve just bought some dried dulse. Can I just throw it into e.g. a soup or do I need to prepare it somehow before adding it?
Soup or eat it plain or mix it with other foods, whatever you like.
Dear Paul,
I have followed your diet and blog with success in many areas but sleep. I work nights 4 on 4 off,and sometimes I lay in bed all day and I might get 2 to 3 hours of sleep during my work days. When I am off I sleep at night and I get a few more hours but it’s still hard. Do you think gaba is a good suppumet to use as I am really have bad chronic insomnia and its really effecting me.
Maybe someone on this blog has a recommendation on good sleep supplements,I make sure its dark,and I’ve tried melatonin but I just wake up less then an hour later,if it works at all… Would love answers from anyone with knowledge in this area.
Thanks
I have chronic insomnia. Either I have trouble getting to sleep or I wake up often during the night. I’ve tried straight l-theanine (1 per hour starting a few hrs before bed) with sporadic results.
I’d like to try this one but haven’t yet, so you might give it a shot. Dr. Jacob Teitelbaum (functional MD) sang its praises on the healthy gut summit a couple of weeks ago and his protocol for sleep and energy problems are outlined on their website. The specific product he recommends for people like you and me is: “Fatigued to Fantastic! Revitalizing Sleep Formula” by Enzymatic Therapy. It’s all herbs (plus l-theanine) and here’s a link to product page:
http://www.enzymatictherapy.com/Products/Energy/Sleep/03233-Fatigued-to-Fantastic-Revitalizing-Sleep-For.aspx
Let me know if it works for you please!!!
Susan,
Thank you soo much,I will try it and let you know asap… I Will look to order it today as I would try anything at this point and if it work right I will even go to order you one, on me ok
It’s a deal, good luck!
Here are the two things that helped me.
****Blood sugar control. It might be worth getting a glucometer to check that your levels. Post meal and fasting levels can reveal a lot that you might not otherwise notice.
****Regular meditation. The best is 20 min twice a day , but once a day on a regular basis works too. It is just hard to keep up
None of those sleep aids such as valarian, passion flower, etc. ever made a difference for me. It would have been so much easier to take a pill or cup of tea. But clearly everybody is different
For some people regular exercise makes the difference.
Cannabidiol might help.
And then there’s this.
http://coolfatburner.com
Apparently it helps some people with sleep.
Just keep experimenting.
Good luck!
My sleep is improving as I work with an alternative practitioner who uses energy work to help me find the source as well as the best protocol.
I have seen conventional health practitioners without great results, although at one point a functional MD recommended maca root for hormonal balance and that helped for a few months.
But the energy work is showing how the combined imbalances within my adrenals, thyroid, and sex hormones are the source of the insomnia (as well as many other symptoms).
Surprisingly, even an afternoon green tea and even a little cocoa or chocolate contribute to my adrenal imbalance presently.
Guessing and taking lots of sleep aids never helped me. Testing is great. Energy work with the right practitioner is great.
Ellen,
Thanks for the tips,my blood sugar is in top shape as I test and practice carb restriction on par with PHD standards.I exercise many times a week and do hit training including p90x. I gave up staying in ketosis to adopt PHD level carbs,but I’m back in ketosis now to see if that helps..
You can also try Sterol 117 which is a megadose of plant sterols. It lowers the cytokine IL6 (inflammatory) which can be too high (especially at night when it normally should go down). I remember reading about this – Dr. Russell Blayock – in the context of intractable insomnia, when all else fails. I take 3 / day and it has helped considerably. Also some HRTs can keep me awake if levels are too high OR too low. Some people are very sensitive.
re the enzymatic therapy formula…
Kevin, if you have tried Valerian in the past with no luck, then this formula will likely not help you, sadly.
Valerian in some people, can actually disturb/worsen sleep & increase bad/weird dreams. < & i am one of those people 🙁
fingers crossed tho, that you have not tried valerian before, & that it helps you.
the full ingredient list is;
Valerian, Passionflower, L-Theanine, Hops, Wild Lettuce, Lemon Balm Extract.
I've tried all of those, except for the Wild Lettuce in the past, without any luck.
Darrin,
I don’t think I have,but I’ve tried many herbs with no luck. I have vaporized cannabis and it seemed to help but I quit because I did not fell that it was really moraly right.
CBD/cannabidial is an extract of hemp, not marijuana, and it is legal. So no moral issues
https://www.bluebird-botanicals.com/CBD__Oil__FAQ.html
Just saw this
Researchers at the University of Southern California conducted a clinical trial in 49 people (average age 66): Half tried mindfulness meditation, while half practiced standard “sleep hygiene.”
The meditators enjoyed substantially greater improvements in sleep quality, as well as bigger reductions in insomnia, depression and fatigue.
http://www.vitalchoice.com/shop/pc/articlesView.asp?id=2246&utm_source=bronto&utm_medium=email&utm_term=Sleepless%3F+4+Habits+to+Kick%2C+and+One+to+Cultivate&utm_content=03%2F05%2F2015&utm_campaign=Sleepless%3F+Habits+to+Kick+%26+Cultivate+✭+FREE+Bonuses+✭+Recipe%3A+Scallops+Scampi+✭+MORE
Re: Ellen’s reply about mindfulness meditation, Sam Harris’ book ‘Waking Up’ is an interesting introduction to that.
Cronkster, that looks like an interesting book, and i am going to read it.
But if one is only interested in getting a good night’s sleep, i don’t think it has to be any more complicated than Herbert Benson’s relaxation response, practised regularly. The regular aspect is the hard part for me.
http://relaxationresponse.org/steps/
Here is another thought for sleep:
B12. ( be sure to get the methylcolbalamin if you try it)
Cronkster,
Am almost finished reading Waking Up and finding it enormously interesting and helpful. So I just want to thank you again for mentioning it here
Re: Methylcobalomin B!2 — I take it (in the form of Seeking Health Homocystex Plus) and it has made no improvements in my sleep. Also, I’m told it’s best to take B’s before 2pm, as taken any later it can contribute to disrupted sleep.
Hi Paul,
I have recently come across your site and the perfect health diet. I have both candida and SIBO. My question is, how would you modify the perfect health diet in someone with both candida and SIBO?
Thanks
Hi Paul. BLood test show LDH and CPK isoenzymes so much higher than normal. The doc assumes it is due to hyperoestrogenism or something more precise he cannot still define about an excess turnover. Anyway,
What could be your point about this , as I’m a PHD’er since a year now ?
One more : he suggests some homeopathic trituration of some specific plants. But it’s made with 99% of lactose or fructose. Which one of those sugar form would you recommend preferably ? Thanks a lot Paul for your help. Be blessed.
Hi Paul,
I am eagerly awaiting you blog post on GERD! I got mine cleared up the first time on Nexium, Ranitidine, cabbage juice, DGL Licorice in that order (Prelief also helped a lot at meals),and by cutting out triggers like coffee and chocolate. I’ve eliminated nightshades now, as I found they are a source of inflammation for me as well. As of last week, however, it’s back! And, I’m back on Ranitidine in the morning and Nexium at night, while also sleeping on a slant pillow. I need to get started with cabbage juice again. I’m giving it until my next doctor’s appointment on April 1st to settle down, but I am totally discouraged. I’d had the H pylori test, which was negative, and an endoscopy which showed some slight remaining inflammation when I stopped the medicine last summer, but have done fine until recently. My surgeon, who did the endoscopy, said that cases often flare up in the spring for unknown reasons, so perhaps I am one of those now. My first problem with it started in early November though! I don’t want to be on medications forever. The side effects are really scary. Life is so busy for me now, even at 62, I hate to be bogged down with this issue. Thank you for all of your help to so many!
hi MU, sorry to hear the GERD is back.
out of interest, did you restart the coffee &/or chocolate after giving it up
Have you read Chris Kresser’s Gerd series?
Or this?
http://gutcritters.com/gerd-series/
Hi, Paul, always love your posts… Here’s a question on baking soda. Have you researched on the effects of drinking baking soda for gut health or for overall health. I’ve read some studies on baking soda and cancer tumor reduction but was just wondering your thought on daily use of it for optimizing gut health and longevity. Thanks in advance!
Hi Jodelle,
Baking soda is healthful in small doses – a fraction of a teaspoon per day. I would take it in an equal balance of baking soda (sodium bicarbonate) with potassium bicarbonate and with a healthful acid like lemon juice, apple cider vinegar, or vitamin c powder, enough acid to neutralize the bicarbonate.
why with potassium bicarbonate?
For sodium-potassium balance. The amounts of sodium are significant if you take only sodium bicarbonate.
If one tends to be acidic (urine), would baking soda alone (no added potassium or acid which hurt my stomach)be helpful? I’m on PHD a long time now and still very acidic. I have read a little baking soda at bedtime might help this and help bone density (I have osteoporosis)
Baking soda can help, also citric acid.
I recently started following PHD and in many ways feel better than when I was trying to eat traditional paleo…more satisfied, less sugar cravings, etc. and the 16/8 fasting transition was much easier than I anticipated. However, I do hit a fatigue wall each afternoon that I find surprising. When I first ate paleo I was amazed at how much energy I had through an entire day (and I homeschool our four kids ages 11 and under so energy is a must).
Am I missing something? Need to add/eliminate something? I’m certainly not opposed to afternoon nap time but it does feel like a step backwards.
Many thanks in advance
Ashley
Hi Ashley, Post-meal fatigue usually indicates a leaky gut, after a meal you have a lot of partially digested food peptides and bacterial cell wall components entering the body, and your immune system takes resources to deal with those, making you sleepy. It’s not uncommon for low-carb dieting to cause a leaky gut, and then for a return of carbs to stimulate growth of the gut bacterial population so you get more toxins coming in.
Work on nourishment for the gut and for immunity (e.g., extracellular matrix, vitamin C, vitamin A / liver, vitamin D / sun, spices, overall good nourishment), and continue the intermittent fasting and circadian rhythm entrainment. It should clear up in time.
Best, Paul
Hi Paul, I’m curious what your thoughts are on supplements that contain elemental iodine (in addition to potassium iodide) — like this one:
http://www.iherb.com/Life-Flo-Health-Liquid-Iodine-Plus-2-fl-oz-59-ml/22640#p=1&oos=1&disc=0&lc=en-US&w=life-flo%20iodine&rc=2&sr=null&ic=1
Would it be safe if mixed with food, or better avoided?
Me too. The reason I take the Life Flo liquid iodine/iodide brand is 1. the very small dose (3 drops is 15p ugm); 2. it has both iodine and iodide – some of the tissue in the body utilize one form, some the other.
It’s OK but unnecessary. Potassium iodide dissociates into potassium and elemental iodine after it dissolves in water. So all forms provide elemental iodine.
Hi Paul,
I’ve been feeling generally pretty healthy in the past couple of years. I’ve read your book and follow your blog as well as Chris Kresser’s and some others. I do still have a couple of specific issues I’m wondering if you have some thoughts or hunches about.
First, I’ve had some gut testing done recently. I don’t have SIBO. I don’t have any crazy parasites that need medical attention. I do have a little more yeast than I should, as well as a little imbalance of good to not as good bacteria. Once a month or so, I get a bout of something I assume to be gut related. My eyes turn really red and irritated, rosacea flares, and I get diarrhea and itching. Sometimes I’ll feel depressed too (or just generally not well). It’s the same symptoms I’ve been getting sporadically for 3 or 4 years. My naturopath told me to take grapefruit seed extract over a period of months. I started this but gave it up quickly, because I didn’t trust that it was a good idea. I’ve heard so many bad things about GSE and also wasn’t convinced it wasn’t going to kill my good bacteria as well. However, apart from just eating well and taking my general health supplements and probiotics, I don’t have any plan of attack here.
Recently I considered using high-dose iodine during flare-ups. Do you have any thoughts about that? I currently take about 12.5mg of iodine daily. I am hypothyroid with no anti-bodies (lab verified many times). I take Naturethroid as well as T3. I would also love to stop or decrease my reliance on thyroid meds. Can increasing my dose dramatically improve the dysbiosis and/or help me wean off thyroid meds?
And one more thing. Do you think a salt flush could be helpful to flush out endotoxins in acute situations? I don’t hear people in the paleo community talk about salt flushes much. Maybe it’s just quacky and dangerous, I don’t know. I’m always afraid of taking charcoal, because I think it might soak up my thyroid meds.
If you have the time or inclination to take a stab at any of this, I would be so grateful!
Thanks!
Robin
Hi Paul:
I hope you are well. Quick question: can you take your suggested dose for zinc in conjunction with Ubiquinol?
Paul, I suffer from Sjogren’s syndrome and have severe problems with apathy and brainfog. I also have a lot of digestive issues. Anyway, I have noted the most curious thing. At first I didn’t put much attention to it, but now that it has happened many times it has really made me wonder.
In short, when I have the flu, or recently a small bout of some diarrheal illness my brother passed me, my mood gets much better! Its not a cure by a long shot, but my apathy is certainly less severe, and my mood brightens. It feels kinda cozy, and it happens every time I get something like that. It doesn’t matter that my energy is less, or that my nose is stuffed, etc., I just feel better than normal! Isn’t that weird?? Do you any idea of why that may happen? Have you heard about something like this before? Has anyone here heard about such a phenomenon? Google isn’t of much help…
Sry, Paul, I think I meant a cold rather than flu in that last comment. English is not my main language, but now I know they are not the same thing.
Hi Juan,
I see that Paul did not yet reply to your question. Hope you don’t mind my feedback. It is possible that during an infection (like a cold or flu) your body’s temperature rises, eliminating some pathogens you do not know you have. A good doctor and blood test should shead some light.
Also, perhaps you should consider the Autoimmune (Paleo) Protocol. Sarah Ballentine’s blog and maybe even Terry Wahl blog are great resources. Sometimes a strit elimination diet -as in AIP – may set your body on a healing path.
Best of luck,
Thanks for your answer, Dora. I’m already doing the autoimmune protocol, taking probiotics, etc. None of that has been enough, sadly.
About the temperature issue, well, I think I have not had evident fevers those times, though I didn’t check. My colds tend to be short lived and not very strong. In fact I think I’m under that very situation right now, with the cold and the better than normal mood, though right now it would be a rather gentle effect if it is happening (a bit hard to tell, since I happen to be taking an antiprotozoal drug too). My temperature is normal, btw.
Well, now that my cold is over, I must add that it definitively seems to be the cold what made me feel better again.
Perhaps you will find something interestiing at this link: https://www.youtube.com/watch?v=Am7kr-vP0Ys&app=desktop
Hi All,
Anyone got any thoughts on a Copper/Zinc imbalance? Also raised Manganese too. I do eat a hell of a lot of nuts which I guess might be an issue.
I am thinking about supplementing zinc x 2 x 15mg a day (no Copper added) but I know Paul recommends Copper in a, I think, 1 in 10 ratio. Anyway has anyone fixed their ratio with supplements and dietary changes?
I have done a lot of research into this recently, and have had many improvements (mental health symptoms) over the past year. I started w/Paul’s suggestions for supps, and adapted after blood tests began to explain my severe intolerance to methylfolate (and need to correct high copper/low zinc), among other issues: http://lifeisapalindrome.com/updates/trajectory-year-or-continuing-my-personal-health-adventures .
Hope this is helpful!
Interesting info, thank you. When you start going down the health rabbit hole it’s amazing what you can find down there. Trouble is when you find what you find no one seems to know what to do with the info. Frustrating, really.
I forgot to mention: I have also adapted my diet a bit, and cut out the highest-copper items (mostly plant foods), such as avocados, nuts, etc.
Hello there,
I’d like to ask for help regarding my hormones.
I have had PCOS since I was 16 (I was diagnosed then, now I’m 33). After years of contraceptives, about 10yrs, with no relevant results, I’ve changed to metformin 5 years ago. I am not overweight, my skin has always been fine, but I suffer from facial hair which proves to be very resilient..(I had two big series of laser treatment in the past 10 years, they seem to work for a couple of years, then its back again) Anyways, I have been following a no sugar no wheat diet for more than 5 years, as I kept having random stomach pains every now and again.
Now my hormones are yet again out of balance, high testosterone, and my doctors want to put me back on contraceptives, which I really don’t feel good about.
Can you recommend anything I could try instead of those, to push back my testosterone level (2.1) and to keep my hormones in check? Also if you could point me into the right direction on where to look for new research maybe, or what could be beneficial for the hair issue. ( I keep being told and find no other explanation either, that I am blessed with an unlucky set of genes)
Thank you,
Sophie
Google / read in LIfe Extention Magazine, Oct 2009, Bioidentical Hormones: Why Are They Still Controversial. Also google / read Lorna Vanderhaeghe (I think it also comes up under Healthy Immunity) on PCOS and hormones in general — a free website; she is a women’s health expert – and go hear here talk or webinar if you can. Look into her supplement EstroSmart to see if suitable for PCOS.
thanks Donna, I’ll look into it
http://www.askdepkewellness.com/2014/04/adrenal-balance-101.html
Apparently adrenals need to be fixed first, hormones later…
Thanks Claire,
tests regarding adrenal functions all came back negative so far.
We will keep looking..
Interesting article here about breast milk banking
http://www.nytimes.com/2015/03/21/business/breast-milk-products-commercialization.html?partner=rss&emc=rss&_r=0
Just wondering what your thoughts are on increased rates of disease e.g. heart disease, cancer, autism etc… I have doctors in the family who tell me that disease rates have not gone up, it’s just that diagnosis is getting better. With thinking like this, they are not open minded to nutrition and preventative measures to stop/slow down onset of disease. Their mentality is we’ll all get something, not much we can do about it. Atleast these days we have medicines to keep us living longer…..
Is there any evidence out there that shows that rates of certain diseases have indeed gone up e.g. cancer, it’s not just better diagnosis.
Any information along these lines would be very helpful to me.
Cancer rates have not gone up (as far as I know) – more people die of cancer because fewer people are dying of other things, but age-adjusted mortality has not increased. Obesity and diabetes, probably autism, allergy, autoimmune conditions have become more common. Certain infections.
In some locations, lifespans have shortened; and overall, the increase in lifespans of the last 150 years seems to be plateauing and will soon end. Once that happens, the number of diseases whose prevalence is increasing will increase.
Dear Paul,
are you aware of any reason women with dysestrogenism/estrogen dominance should modify the PHD recommendations when it comes to their intake of ruminant meat? I’ve come across claims (most recently by Sara Gottfried in conjunction with the launch of her latest book) that this population should avoid red meat and coffee. Besides the obvious contribution to hormonal imbalance from CAFO meat, is there a reason to avoid even grassed/finished organic meat?
Thanks!
Hi Webraven, I’m not aware of evidence against red meat and coffee in that condition, and there is nothing at all in Pubmed linking them, at least for the search terms I entered.
Wonderful, thank you for confirming that, Paul. I couldn’t find any studies that even differentiated CAFO meat from natural, grassfed organic meat, so the recommendation does seem illogical at best, Much appreciated!
Hi Paul,
Thanks so much for the wealth of info here. How would someone approach the diet who has a very limited appetite (ostensibly due to vagus nerve issues related to chronic fatigue syndrome) ? Would it be reasonable to follow the general guidelines for macronutrient proportions but on a smaller scale?
Best,
Karen
Yes, I would continue to follow the diet, but make a great focus on nutrient density. E.g. egg yolks are the best fat, extra vegetables and seafood.
Sounds great, thanks so much, Paul!
Karen,in this video there is information about stimulating the vagus nerve with regard to bowel motility, but it might be worth trying to see if it stimulates appetite
https://m.youtube.com/watch?v=Am7kr-vP0Ys
Fascinating video, thanks so much for sharing, Ellen. His book looks like a good read.
For the last two years I have had re-occurring sores inside my nostrils. Usually they are there for about a week or so, then the situation gets better for a short time, until I get new sores. This started during my second pregnancy. Any idea what this could be related to?
I had that for 5 years – until I went on thyroid medication. It cleared up in a week! a possible reason…..
I have had this too, and it definitely seemed to me to have to do with my body’s ability to fight infection… I did a bit of self-diagnosis and decided it was staph. In my case, after two months the sores cleared up virtually overnight with the application of a few thin layers of raw honey! This doesn’t work for everyone (and a later sore, a year later, did not respond as quickly to a different type of raw honey), but in my case it was very relieving.
Hi Paul,
I just got some new blood test results back.
You commented on my last results back in Mar 2013 here;
http://perfecthealthdiet.com/q-a/comment-page-57/#comment-141013
Could i trouble you to comment on these ones as well please.
My TSH is a concern.
I will post below, lipids first. all my other tested markers are good; liver/kidney/blood panel/ferritin/urea/electrolytes/creatinine/
CURRENT Serum Lipid Studies (Mar 2015);
Chol (3.5-5.4) 5.8 mmol/L
Trig (0.1-2.0) 0.7 mmol/L
HDL (> 1.0) 1.6 mmol/L
Chol/HDL( 1.0) 1.8 mmol/L
Chol/HDL(< 5.0) 3.1
VLDL (0.1-0.9) 0.3 mmol/L
LDL (2.1-4.0) 3.5 mmol/L (i presume calculated-Friedewald).
^ Paul can you delete this comment.
the numbers are incorrect.
thx
(or just ignore it. if u cannot delete).
Something went a bit funny with the numbers above. ignore them. here they are again.
CURRENT Serum Lipid Studies (Mar 2015);
Chol (3.5-5.4) 5.8 mmol/L
Trig (0.1-2.0) 0.7 mmol/L
HDL (> 1.0) 1.6 mmol/L
Chol/HDL(< 5.0) 3.6
VLDL (0.1-0.9) 0.3 mmol/L
LDL (2.1-4.0) 3.9 mmol/L (i presume calculated-Friedewald).
& for comparison, here are my prev OLD numbers;
OLD Serum Lipid Studies (Mar 2013);
Chol (3.5-5.4) 5.6 mmol/L
Trig (0.1-2.0) 0.6 mmol/L
HDL (> 1.0) 1.8 mmol/L
Chol/HDL(< 5.0) 3.1
VLDL (0.1-0.9) 0.3 mmol/L
LDL (2.1-4.0) 3.5 mmol/L (i presume calculated-Friedewald).
Paul,
The number that my Doc will focus on, will be the total chol number;
as you can see this is above lab range at 5.8 and also higher that the prev 5.6 reading (which was also above the lab range).
And here is my TSH number Paul.
20th March 2015;
Current TSH 7.8 mIU/L
(
Prev test March 2013;
OLD TSH 3.5 mIU/L
)
I will follow up with my doc & request;
ft3 & ft4.
& thyroid antibodies.
Anything else…?
Thanks Paul
more info Paul, here are my current ‘thyroid related’ supplements;
Iodine: One (1) drop (1.8 mg Iodine) Iosol every other day. (average 915 mcg per day iodine from iosol).
Iosol contains Iodine and Ammonium Iodide (no potassium iodide).
Selenium: 200 mcg selenium (from Se-Methyl L-Selenocysteine) Twice per week (400 mcg total per week).
as for symptoms…i don’t really have any that i am aware of;
– in fact have been feeling pretty good. in the past i have noticed hypothyroid symptoms, cold extremities etc, but not at the moment. tho it is still warm where i am (Australia). so winter may be more telling.
– my weight is good. been stable for the last few years. i estimate i am around 13% body fat, perhaps slightly less.
– post exercise recovery seems to be getting a bit slower (muscle soreness, aches & pains)…i was putting that down to age…as i close in on 50.
UPDATE:
i have just got my FT3 & FT4 numbers back, taken from the same blood sample as my TSH;
TSH: 7.8 mIU/L (range 0.5 – 4.0).
FT3: 4.1 pmol/L (range 3.5 – 6.0).
FT4: 13 pmol/L (range 10 – 20).
So Paul…any comments/observations on my lipids and thyroid.
I stopped supplementing the Iodine (Iosol) as soon as i got the TSH result.
Thanks for your time again.
Darrin
Hello Paul
I’ve been following the Perfect Health Diet for about two months. I am a 50-year-old woman and am (just) post-menopausal. The main reason I started the diet was to lose weight and improve my digestion and energy levels, and I have seen good results in all these areas. However one thing has got worse – my skin. I have always had unusually good skin and look very young indeed for my age but in the last couple of months I have noticed small white bumps or cysts under the skin, temporary redness and an acute burning, itchy feeling, particularly on my chin but sometimes on my jawline. Sometimes the burning even wakes me up at night. There are a few very small broken capillaries on my chin, too, which I am not sure are related to the bumps. I am wondering if this is rosacea or adult acne. The other thing that has got worse is my hot flushes (which I think you call ‘flashes’ in the US). Could both of these problems be temporary effects of the diet, possibly related to hormonal changes caused by the weight loss? (I started off at 71 kg and am now down to 68 kg so weight loss has not been dramatic.) I have noticed the burning feeling on my chin sometimes occurs soon after I have had coffee.
Jessica,
I will be very interested to read Paul’s reply to your question. But let me share with you that at 55, just one month following what turned out to be my final cycle, I developed the same skin problem, never having had skin issues before. I researched and determined that I had rosacea, confirmed by several dermatologists. Based on everything that I could read about skin and nutrition, I discovered functional medicine and removed gluten from my diet and made some other dietary changes. My skin did not improve, but I kept on with the changes and discovered the PHD which I’ve followed now for a year. My skin situation persists, but I try to remain hopeful that over time it will improve. In my opinion, and my dermatologist says this too, rosacea is just a term used for what are probably many dozens of different conditions that give rise to redness of the skin, caused by many different things in different people. Of course in functional medicine it is believed to always be tied to gut imbalances. I personally believe that is true, but I also believe that the reason that far more women than men are plagued with rosacea and that it typically arises in women aged 30-60 is because of our complex hormonal changes during those years. For you and me, it happened immediately upon entering menopause. I don’t think this is a coincidence. That said, I think that if our hormonal systems had been balanced going into menopause, then perhaps it wouldn’t have had this effect — I know for a fact that mine was very unbalanced based on my migraine history and severe menopausal cramping and clinical hypoglycemia tendencies. I’m no doctor, but this is all that I’ve been able to put together so far on why this happened to me. I do have IBS bouts which began a few years ago, and was recently tested for SIBO and was methane positive (SIBO has high correlation with rosacea). I’m sharing this with you, in case it helps in any way. As far as PHD, IMHO it did not cause your rosacea, it just so happened that you started following it at the exact same time that you entered menopause, and that is often the trigger for women.
Note: I wrote hypoglycemia, but I meant hypothyroid.
Susan,
Thank you for sharing your experience with me – it was very interesting and informative. I’ve never been tested for SIBO but I have suffered from GERD for several years. Do you know about Norm Robillard’s Fast Tract diet? It is intended to treat GERD which he says is caused by SIBO. He does mention the link to rosacea. On his Digestive Health Institute website forum page someone mentions that rosacea takes about four months to improve on the Fast Tract diet. The diet basically involves restricting ‘fermentable carbohydrates’. There is some overlap with the PHD as some types of starchy vegetable and white rice are permitted. I found it very convincing and would be interested to know what Paul thinks of it. I haven’t tried cutting down on fermentable carbohydrates yet as my acid reflux has improved so much on the PHD but I think I will give it a try soon.
Hi Jessica, thanks for mentioning Norm Robillard and the FT diet. I’ve heard about it and meant to take a look at it, and I’ll be sure to now. It sounds very similar to low FODMAPs which is low fermentable fiber.
Here’s my very recent experience with low FODMAPs:
Followed for 8 weeks (ending last week) as a more restricted version of PHD, but oddly, my skin got dramatically worse on low FODMAPs. I was simultaneously on an antimicrobial and probiotic protocol, so it’s unclear whether or not that was due to die-off of bad bugs or what. But my doctor told me to stop low FODMAPs and return to the full PHD spectrum and to retest for SIBO. We didn’t think that FODMAPs were a big issue for me to begin with because I didn’t have the bloating and gas issues that so many people with SIBO experience, but we thought it prudent to try temporarily and see the results.
My IBS symptoms (which began a few years ago) have been typically just short bouts of IBS-C and/or -D that last just a few days or less and only happen once every 4-8 wks. Usually I can associate it with poor habits, like eating too many veggies (especially green and/or raw at one sitting), too much food at one time, eating too many veggies at the beginning of a meal or alone, not chewing enough, not drinking enough water, a stressful event, or all of the above. And actually I had MORE bloating and gas while on low FODMAPs than I’ve had before or since. It’s very perplexing and confusing because all of our bodies are so complex and different!
I’m glad that your GERD has improved on PHD!
Hello again Paul,
I wonder what your opinion is on hormone replacement therapy, either conventional or bio-indentical, after surgical menopause.
Thank you for all that you do!
Irene Cross
If at some point it seems that you may need HRT, you would be interested to read Life Extension Magazine October 2009, Bioidentical Hormones: Why Are They Still Controversial?
Their bottom line is that if you do have to, Bioidentical is the route to go.
What would you do for viral myocardial myopathy?
I cannot recommend the Philips wakeup light. This is the review I just posted on amazon.
“Very disappointed in this product. It’s a good idea but poorly executed. Easy to operate as long as you’re awake, alert, have the instruction manual in front of you with your reading glasses on, try hard to follow the little pictures, and are extremely careful to touch the fussy little buttons on the device just so.
As for trying to interact with this device in even the simplest way during the times it’s supposed to be used, forget it. It will make you too angry and frustrated to fall asleep, and delay you from getting up until you manage to re-set what’s been inadvertently messed up. A real pain in the neck.”