1. Kim April 5, 2015 at 6:53 pm

   Paul, do you know what might cause a benign parathyroid tumour? One of the diagnostic signs is an elevated calcium level in the blood, which I have. I would love to hear your take on parathyroid dysfunction. Thanks Paul!

   Reply
2. HEW April 5, 2015 at 8:30 pm

   Hi Paul, Happy Easter to you and your family! My question is about degenerative disc disease. My mom is slowly losing her ability to walk because of it. Is there anything in the form or food or supplements that will help her? With many thanks for your consideration.

   Reply
3. Kannan April 8, 2015 at 12:19 pm

   Dear Paul,

   I have been following PHD diet for the last 6 months. Supplements are the only thing that I have not added to my diet yet. Within 3 months of starting the diet , I got rid of a condition called “Anal Fissure” which was a nuisance for last 15 years. Felt awesome! Thank you!

   I have lost around 5 pounds which has made my 51 year body more nimble.

   Also, my sister and brother-in-law ( who are in theirs 60’s) are following PHD for the last 3 months and their lipid-profile has become fantastic ( as per recent blood test). They feel more healthy than before.

   But I have one problem still lingering…My pollen allergy symptoms start around April and last for two months. Antihistamines(CLARITIN-D) have been keeping them under control for past several years. But I was hoping PHD would take a crack at my pollen-allergy this year. No luck yet. Do you have any suggestions?

   P.S.
   I exercise regularly. My running pace is around “7 min/mile” for 5k runs. Other activities include tennis and strength-training. Generally I get only 6.5 hours sleep. During weekends I take naps to make it 8 hours. Recently I have added fermented vegetables to the diet.

   Thanks for all your service!

   -Kannan

   Reply
   • st April 9, 2015 at 9:27 am

     I read frequently that “healing the gut” eliminates allergies. Go through the articles and comments on gut-healing here and follow some of the links to other blogs, and you will find plenty of guidance toward gut healing. Regular bone broth, consistent use of both fermented food and supplemental probiotics, and increased fiber (including resistant starch) to feed the probiotics are fundamental, but there is always more to it. Best!

     Reply
     • kannan April 9, 2015 at 5:11 pm

       I did not see anything specific to pollen allergies so far. But will check more. Thanks for your idea.

       Reply
       • st April 9, 2015 at 5:32 pm

         Most allergies are said to start with gut imbalance, for example I just googled “allergies” + “gut healing,” and there’s an oversimplified article at webMD (see link). My suggestion is to focus on the protocols Jaminet and similar people recommend for gut healing.

         http://www.webmd.com/allergies/news/20041223/healthy-gut-may-resist-allergies-asthma

         Reply
       • SC April 9, 2015 at 9:51 pm

         Until your gut is healed try cutting out dairy and gluten, if you haven’t already. That worked for me.

         Reply
         • kannan April 13, 2015 at 12:47 pm

           sounds good. cleaning the gut, it is! I feel much better compared to last several years (considering only few days into spring season). will keep you posted as the worst allergy month(May for me) is fast approaching. thank you all.
   • Donna April 9, 2015 at 9:47 am

     Read about the supplement Sterol 117 – it lowers IL4 which is involved in histamine response – which I’ve read can help significantly with allergic response.

     Reply
     • kannan April 9, 2015 at 5:12 pm

       Thanks for your suggestion.

       Reply
4. Sarabeth Matilsky April 10, 2015 at 2:54 pm

   I have a friend with Meniere’s Disease, and I am wondering if you have come across useful dietary therapies for this – GAPS helped some, but not much, and it can be very debilitating…

   Thanks for any thoughts on this!

   Reply
5. Ashley April 16, 2015 at 2:49 pm

   I’ve been following PHD for about 3 years, after doing VLC Paleo for a year. I’ve never had any big health problems – I’ve struggled with acne and constipation (both of which got significantly worse on the Paleo diet). Recently I noticed a decreased frequency in BM, so I tried figuring out why, which lead me to the doctor. I got my thyroid tested and it’s higher now then it was in July (2014)! Not much has changed since then so I’m at a loss.

   July 2014:
   -TSH: 0.97 mU/ml

   April 2015:
   -TSH: 2.85 mU/ml
   -Free T4: 1.04
   -Free T3: 2.4 pg/ml

   I take all of the recommended supplements plus the ones for constipation. I currently take 225 mcg iodine. About 2 years ago, I was up to 1 mg (which I worked up to very slowly), but dropped down after I saw that the recommendation had changed. I eat 3-4 oz of beef liver each week. Eat salmon 1x/week, beef 5-6x/week, 3 eggs/day. Bone broth at least 3x/week. Eat fermented veggies at dinner. We just started eating yogurt 2-3/week.

   Not sure if it matters but I’m 22 months postpartum. I love sleep but have attributed that and the forgetfulness to motherhood. 😉 I all have to urinate frequently but figured that’s because I drink at least 3 quarts of water each day. Oh, and we follow PHD about 90% of the time.

   I thought that I was “doing it right” so I was shocked to see that things had gotten worst. I’m trying to figure out the thyroid issues, and hoping that will clear up the constipation and acne as well. Although, my bowel habits are pretty much the same now vs in July when my TSH was better. So many variables! Any help or thoughts on the thyroid issue would be appreciated, along with the constipation issue. Thanks!

   Reply
   • Ashley August 6, 2015 at 2:40 pm

     So, I just got back lab work that was taken for life insurance and some of those numbers are now out of the range laid out in the book – both total and LDL cholesterol are high, which seems to point back to thyroid issues. If I’m hypothyroid, I can work on that, but I’m genuinely curious as to why everything is getting worse (vs. staying the same). I can’t think of any big changes, so it’s disappointing to feel like I’m going backwards after being on the diet and taking the supplements for so long.

     Reply
     • Donna August 6, 2015 at 5:45 pm

       Yes, I’ve had the same experience. Lipids levels are terrible – even though my TSH (thyroid) #s are pretty much ok now (iodine helped that). I’ve been on PHD for 2-3 years now including IF. Maybe it isn’t for everyone; or maybe it can’t ‘fix’ everyone – and maybe we would be having more difficulties if we weren’t on it….??

       Reply
     • Paul Jaminet August 6, 2015 at 9:14 pm

       Hi Ashley,

       Sorry I missed your earlier comment.

       If you do have hypothyroidism, there’s a good chance it’s Hashimoto’s. This is caused by a bacterial infection combined with red meat consumption, and will be relieved if you cut back on beef/lamb and switch to fish, shellfish, chicken, and duck.

       Drinking 3 quarts of water per day is probably excessive. A natural whole foods diet has a lot of water in food so you shouldn’t need that much. Too much water causes electrolyte deficiencies and that could be an issue.

       Common causes of high LDL are (a) iron excess – get that tested, (b) being too low carb, (c) endotoxemia – tend to the gut, (d) iodine deficiency or hypothyroidism – get that tested for Hashimoto’s autoantibodies and treated with thyroid hormone if appropriate.

       Reply
       • Kim August 6, 2015 at 10:53 pm

         Paul, I also have Hashimoto’s and have managed to significantly bring down my antibodies through diet but my TSH is rising and even though my T4 and T3 are within the ‘normal’ range, I feel like my body fatigue, constipation, cold sensitivity, eats are getting worse. I’ve never been on medication and wondering if I should be. If a bacterial infection is responsible, is it necessary to kill bacteria with antibiotics first? Is there a test to determine if there is a bacterial infection? Thanks for all your hard work helping people!

         Reply
         • Paul Jaminet August 7, 2015 at 7:10 am

           Hi Kim,

           No, antibiotics will often backfire and the problematic bacteria are usually in the gut so it is really an ecological problem.

           You should be taking thyroid hormone – don’t think of it as akin to pharmaceutical medication, it is just normalizing body functions and you need it.

           Are you avoiding red meat (see my Neu5gc series)? That’s the first step in Hashimoto’s. Supplement iodine at 225 mcg/day. Then focus on gut healing.

           Best, Paul
         • Kim August 7, 2015 at 8:14 pm

           Thanks for your reply, Paul. I will look into thyroid meds. I also have adrenal insufficiency so that made me concerned about introducing the thyroid medication. Do you think this is an issue? Thanks for the link to the red meat research. 😃
         • Paul Jaminet August 7, 2015 at 8:31 pm

           Hi Kim,

           Adrenal insufficiency makes it more essential to treat your hypothyroidism.
       • Claire August 7, 2015 at 9:20 am

         What about pork, can that be eaten or best avoided with hashimoto’s? I have family members with hashimoto’s.

         Reply
         • Paul Jaminet August 7, 2015 at 9:22 am

           Pork should be avoided, yes. Fish, shellfish, and birds are good.
       • Ashley August 17, 2015 at 9:50 pm

         Thanks for the reply, Paul. I’m going to the doctor on Friday to get tested for Hashimoto’s. Up until a few months ago, my lab work looked great, so I’m not sure why things have changed, but it does seem to be pointing towards hypothyroidism.

         Your article on Hashimoto’s has me thinking about protein sources. Should I be cutting back on beef or removing it completely? How about beef bone broth, beef gelatin, and liver? Right now we eat a lot of grass-fed beef, so it’ll be quite the change trying to eat more chicken and fish. How much variety should one’s diet have? I’ve always tried to balance cost and healthfulness, so we eat mostly beef, but I’m starting to wonder if the lack of variety is part of the problem.

         Thanks for all that you do Paul! You definitely make me think. 🙂

         Reply
         • Paul Jaminet August 18, 2015 at 9:04 am

           Variety is good, generally. Eating all beef is a risk factor for Hashimoto’s. But, as far as removing it, don’t do that unless you actually have Hashimoto’s.
6. Dennis Paull April 17, 2015 at 2:30 pm

   Hi Paul,
   I recently recommended your book to a friend with chronic mastocytosis with signs confined to the skin. He and I were both really excited about the prospects of the PHD helping with this chronic immune mediated disease. However, upon further research I noted that many of the PHD foods are high in histimine which in theory might exacerbate his signs. Any help would be appreciated.

   Reply
   • Paul Jaminet August 6, 2015 at 9:17 pm

     Hi Dennis,

     Histamine disposal enzymes rely on choline (egg yolks, liver), copper (beef/lamb liver), and molybdenum. So PHD is good for histamine removal, and fresh foods gently cooked generally don’t have much histamine (or other amines, which are generally degradation products of protein), so PHD should be fine for his condition.

     Reply
7. Chris April 19, 2015 at 12:22 pm

   Hi Paul,

   I’ve read some article that from a Danish study it was concluded that the resting heart rate is an indication for longevity. Do you know about and do you think the conclusion is legit?
   I always have a heart rate between 8x-9x which is according this study way too high. Exercise doesn’t bring it down really. Thanks!

   Reply
   • Paul Jaminet April 19, 2015 at 2:24 pm

     Hi Chris,

     Yes, here’s the paper: http://www.ncbi.nlm.nih.gov/pubmed/23595657.

     A high pulse rate is usually an indication of poor VO2max, i.e. a poor ability to deliver oxygen and nutrition to cells; and usually exercise does bring it down. It can also indicate dehydration/loss of electrolytes limiting the quantity of blood, or poor blood return from the legs (so that the brain needs the heart to pump harder); in that case the pulse should drop if you lie down or invert your body. You should ask a doctor to clarify what is going on in your case. Also, eat more green leafy vegetables and beets and get more sunshine, in case you are low in nitric oxide.

     Best, Paul

     Reply
     • Donna April 19, 2015 at 7:28 pm

       Would low blood volume raise VO2max as well? I have read that CFS is often associated with low blood volume and cardiac output, for reasons unknown.

       Reply
8. Webraven May 1, 2015 at 4:24 pm

   Dear Paul ( and anyone else possessing knowledge on the topic)
   If DNA testing shows snps that would predispose a person to be in a state of higher oxidative stress, and organic acids testing shows signs of high oxidative stress, is there anything that can be done in addition to “basic PHD” to increase antioxidant status? I’ve found several snp’s negatively affecting glutathione production, for example, and the only problem I’m aware of is a “mild case of SIBO”.

   The latest thinking on using anti-oxidant supplements ( e.g. ALA, liposomal glutathione, vitamins, asthaxantin, curcumin, resveratrol etc) seems to be that they can actually decrease the body’s own production of substances with antioxidant effects, and decrease the benefit of the hormetic effect of exercise. If this is the case
   (and please correct me if it isn’t) what would be the most effective way to increase one’s own antioxidant status beyond the obvious step of trying to reduce the source(s) of oxidative stress?

   Lastly, is there anything that could be said about dose in this case? Would e.g. a teaspoon of liposomal glutathione potentially normalize an otherwise substandard antioxidant status, but e.g. two teaspoons inhibit endogenous glutathione production?

   Thanks in advance for any pointers you may be able to offer to shed some helpful light on this somewhat confusing topic!

   Reply
   • susan May 1, 2015 at 5:37 pm

     I wouldn’t say that I “possess knowledge” but I’m assuming those are methylation, among other SNPs?
     If so, it’s very complicated. If you’re going to self-supplement you can get a lot of info about it and what products to use at Seekinghealth.org. Seekinghealth.com has a lot of the supplements.
     Thing is, every body is different. All the labs that I’ve run indicated the need for intensive methylation treatment, even after taking one of their products for awhile. After doing a methylation panel (HDRI) and evaluating several other lab test results, my doctor just switched me over from just one of their products to 6 different ones (for 2 months).
     I follow PHD pretty much to a tee, but came to it a year ago very low on B6, B12, and others having been vegan for a few years, so that didn’t help. I’m compound heterozygous for MTHFR and also have methane type SIBO diagnosed twice in a row by lactulose breath test.
     Most of the dosages that have been recommended to me by my current and prior docs were consistent with the recommended doses on the product labels.

     Reply
   • Eric May 1, 2015 at 11:08 pm

     I think you might find it useful to look at the section titled “Antioxidant Deficiency” in Paul’s post about constipation (http://perfecthealthdiet.com/2011/04/causes-and-cures-for-constipation/).

     Reply
     • Webraven May 2, 2015 at 11:12 pm

       Thanks, Eric, that was very helpful. I didn’t remember that list from way back in the day, so I’m so glad you pointed it out to me!

       Reply
       • susan May 4, 2015 at 4:04 pm

         BTW, I’d read that article and incorporated all of those supplements and supplemental foods daily well over 6 months ago, in fact some at even higher doses as I have low WBC and definite methylation SNPs.
         But my very SIBO test results and other lab markers haven’t budged from prior levels.
         I also eat generally with very high focus on antioxidant rich food varieties — dark purple, orange, red, other bright veggies and fruits.
         In addition to making very gelatin rich broths with knuckles, marrow, chicken feet, etc, I also take supplemental Glycine and NAC, etc.
         Only thing I don’t take is selenium. But I eat 2-3 Brazils/day, other nuts, very dark chocolate, and eat only all-pastured meat, and vegetation foods are from near-sea level, non mountainous regions, ie semi-coastal Calif and some from the Central Valley. Based on what I’d read all of those sources should combine to adequate selenium. Am I mistaken and should I supplement anyway?

         Reply
         • susan May 4, 2015 at 4:07 pm

           Sorry, 2nd sentence should read
           “But my very recent SIBO test results…”
     • david5 May 4, 2015 at 2:22 pm

       hi susan,
       I was also diagnosed with methane SIBO. And Im mostly constipated. I was wondering if you followed a protocol that helped you?
       Thanks

       Reply
       • susan May 4, 2015 at 3:36 pm

         Hi david5,
         No, but we’ve just begun and only tried one approach thus far. In Jan, my new doc saw my 06/14 SIBO test plus other labs. He acknowledged the “SIBO methane positive” diagnosis (noted by the GE who ran the test) and further observed that certain key markers in my other labs were consistent/supported that diagnosis.
         So in Feb-Mar he prescribed low FODMAPs, antimicrobial and probiotic protocols for wks. Then we retested in April with the same GE (who follows the Pimentel protocol for testing and diagnosis, i.e. gold standard) and my methane numbers tracked the same as my first test. Very disappointing, but we knew it was only a first attempt and everyone responds differently to different approaches. So we’re exploring other ways to go at it now and running some other more refined testing, focused very much on methylation and nuances.
         BTW, my methane numbers were moderate on both tests: baseline ~80, all others 60-100. We’d doubted that low FODMAPs would make a difference for me as I have no specific food sensitivities as best we can tell. But we still thought it prudent to try it temporarily while doing the supplements. Oddly, my IBS symptoms were worse on low-FODMAPs. My typical GI symptoms were mild-moderate to begin with, not so much bloating or gas, but still some C and D bouts every few weeks, often when I ate too many leafy greens or raw veggies at one time or without chewing well first, or during a stressful time. I’m usually normal for several weeks or a month, and then bam, an episode for a day or few. I even had 1 or 2 episodes while doing low FODMAPs. So we concluded it was not helping me so we stopped after 8 wks.
         I first became suspicious of SIBO when I’d read that there was a very high correlation b/w it and rosacea (which I’d recently developed when I tested the first time). My doctor at the time felt sure that I didn’t have SIBO, but I insisted on testing anyway. She didn’t know how to interpret the results, even though the GE wrote “SIBO Methane Positive” as the diagnosis! All she looked at was hydrogen and that was negative.
         SIBO can be tenacious based on what I’ve read and heard, and very hard to get rid of and even then has a VERY high relapse rate; the GE who ran my testing confirmed that.
         If you’re looking for lots of good info on treatment and protocols, look at siboinfo.com. Also, read Chris Kresser’s article on methane type SIBO (he’s also my current doctor). Reading his article last year was an aha moment. It also made me realize that I needed a more cutting edge doc:
         http://chriskresser.com/sibo-and-methane-whats-the-connection/

         Have you tried any protocols, and have any of them helped?

         Reply
         • david5 May 7, 2015 at 8:52 am

           hi susan,
           thanks for detailed your experience and for orientation. I’ve tried many diets but I relapsed every time. tried herbals and tinctures and helped for some time. Black walnut for example or wormwood or combination of herbs. Cant take any conventional drugs.

           Im now gathering info about how the other gut imbalances I have might influence the increase in methane bacteria. and also found that taking care of sulphur foods helped me.if you search online will find sometimes a relationship between methanogens and sulphur bacteria.

           yeah indeed good article from chris kresser for those like us :). good luck and keep us updated with your progress !
         • susan May 7, 2015 at 1:46 pm

           david5,
           Sulphurs: Onions, mushrooms, etc
           Those are among the highest in FODMAPs as well, which may be related to the problem.
           However I’ve never had any traceable reaction of any kind to alliums or mushrooms, even if I eat gobs of them. It’s amazing how different each of our bodies are, but since there are believed to be several different causes of SIBO (and many people with SIBO have varying other conditions along with it), then I guess it shouldn’t be so surprising that we all respond differently to treatment and protocols.
       • Susan May 15, 2015 at 7:53 pm

         You may be interested in the SIBO Symposium in Portland OR on June 6-7. Non practitioners are welcome and encouraged to attend. You can also attend by webinar. I will be doing one or the other.

         Speakers are all the big guns: Pimentel, Siebecker, Mullin, Sandberg-Lewis and a few others. Focus will be on underlying causes and treatment.

         Reply
9. luiza May 5, 2015 at 2:40 pm

   Blood test..I want to make sure all my minerals and vitamins are ok…does anyone know how to get a blood test for all those? Meaning…what do I ask for? Full blood test?

   Reply
10. Zach May 6, 2015 at 4:15 pm

    Paul, I just sent this to you at your PHD email address, but wanted to post my question here for feedback from other readers as well.

    *Email begins here

    Paul,

    I was curious if you could give me some feedback on this study I read about legumes. I know that correlation is hard to prove from causation, but a lot of the research on longevity is interpreted to suggest that eating legumes is beneficial. I know the PHD’s position on legumes, and have agreed with it with few doubts up until now, but was wondering if you had seen this research. Here’s one study: http://apjcn.nhri.org.tw/server/APJCN/13/2/217.pdf, in the Asian Pacific Journal of Clinical Nutrition, entitled “Legumes: the most important dietary predictor of survival in older people of different ethnicities.”

    Dan Buettner, the writer about Blue Zones of longevity, discusses the importance of legumes as well, for instance, in his book The Blue Zones Solution: Eating and Living Like the World’s Healthiest People. I haven’t read the latter, only read about it online. (And I don’t agree with everything I’ve encountered – he apparently suggests eating wheat bread after noting that Blue Zone people eat little wheat, as a commenter on Amazon pointed out.)

    Given consistent findings that controlling calorie consumption (and thus, presumably, also controlling micronutrient consumption, to some degree) lead to longer life, I wonder if the phytonutrients in legumes might decrease nutrient absorption in beneficial ways (as well as negative ways, in some people), resulting in avoidance of overnutrition. The wikipedia article on longevity also notes that testosterone is an immunosuppressant – do you know of any evidence that legumes, perhaps by binding nutrients, decrease testosterone?

    Part of this curiosity about the role of overnutrition in longevity is due, indirectly, to the work of William Walsh, of the Walsh Institute, who discusses the role of excess (as well as insufficient) nutrient levels in mental illness, which I have the impression also correlates with shorter lifespans in general. As he notes on his website, “After studying the biochemistry of 10,000 persons, we’ve learned that the greatest mischief is usually caused by nutrients that are stored in excessive amounts, rather than those at depleted levels.” (http://www.walshinstitute.org/biochemical-individuality–nutrition.html) He is brilliant on methylation by the way, I think you’d like him.

    All this said, I do think that some people (perhaps including me) don’t tolerate legumes well, and it may be that the longest-lived are simply more genetically inclined to tolerating and benefiting from legumes. Thank you for your work! Though I have questions on this point, I believe the PHD diet has been quite helpful to me, and I appreciate your dedication to the readers of your blog. I hope to hear from you soon.

    Best,
    Zach

    Reply
    • Jenni May 6, 2015 at 4:35 pm

      Hope Paul replies to this. It is something I have wondered. So many long lived (and healthy in their old age!) populations count legumes as a staple. And now we know more about gut flora, surely the resistant starch content of legumes is a good thing?

      Reply
      • Dora May 15, 2015 at 2:53 pm

        Hello Paul,
        I also often wondered about the traditionnaly prepared legumes (soaked, sprouted and fermented). I hope you will find the time to give us your opinion about this topic brought by Zach on May 06.

        Kind regards,

        Reply
      • Dora May 15, 2015 at 3:14 pm

        Hello Paul,
        I also often wondered about the traditionnaly prepared legumes. I hope you will find time to give us your opinion about this topic brought by Zach on May 06.

        Kind regards,

        Reply
        • st May 15, 2015 at 7:19 pm

          Paul has said elsewhere that if you soak them 24 hours and cook them long enough, they are “probably okay.” I think if you google “Jaminet” and “legumes” you might find his further explanation.

          His thing is OPTIMIZING your diet, and that is the reason his method excludes foods that contain more toxins. Soaking them removes some, but not all of the toxins.

          best

          Reply
        • Donna May 15, 2015 at 7:26 pm

          And I think he said the optimal prep is soaking and pressure cooking legumes.

          Reply
          • Susan May 15, 2015 at 7:57 pm

            And I believe he has noted somewhere that properly soaked and prepared lentils may be the least toxic of all legumes.
        • Eric May 15, 2015 at 11:21 pm

          I think that many legumes should be fine if you purchase them hulled, soak them overnight, and then thoroughly pressure cook them. Each of these steps will remove some of the toxins.

          Hulled beans are typically used in Indian cooking; so one good place to find them is an Indian grocery store, or an “Indian section” in a normal grocery store.

          Red lentils (masoor dal) and yellow mung beans (moong dal) are probably among the best options. I would avoid all the legumes which aren’t used in traditional Indian cooking (e.g. which are not on this list: http://en.wikipedia.org/wiki/Dal#Common_varieties) — for example, peanuts, soybeans, fava beans, etc.

          I had a discussion with Paul about this here: http://perfecthealthdiet.com/the-diet/comment-page-16/#comment-1667447

          Reply
    • Tolovana May 15, 2015 at 8:05 pm

      He mentions them in the thread linked below. Search for lentils on the page.

      http://perfecthealthdiet.com/2011/04/hdl-higher-is-good-but-is-highest-best/

      Reply
11. Mary D May 6, 2015 at 8:23 pm

    I just had blood work done and got results from the “Carroll Food Intolerance Test” saying I was genetically lacking an enzyme required to digest potatoes. Same thing for fruit eaten in combination with sugar. I’ve never noticed any problem with either. Does anyone know anything about this test or its accuracy? I’d hate to give up potatoes!

    Reply
    • Eric May 7, 2015 at 6:24 pm

      I don’t have any specific knowledge of this test. However, the results you report make me extremely dubious of its validity: It seems impossible to me for someone to simultaneously be tolerant of fruit by itself, while intolerant of fruit combined with sugar (since fruit already contains sugar!).

      Reply
      • Mary D May 10, 2015 at 8:25 pm

        Thanks, I’m thinking it’s probably bogus.

        Reply
12. Peter May 7, 2015 at 12:08 am

    Hi Paul,
    Was wondering if you have anything that would change in the diet for those of African descent.
    My problem is what I believe to be candida – white tongue, scaly peeling feet and bad breath. The bad breath is a big bummer and wondered if you have some advice on that. I’ve tried virtually everything.
    I’ve been reading a lot about PHD and your own background and I’m thinking a lot of my symptoms started after 6 months of antibiotics for TB in 1997 (17 years ago!).

    Reply
    • erp May 7, 2015 at 8:08 am

      Peter, I don’t pretend to know much about science and don’t have the answer to all your questions, but when my daughter had a similar bad breath problem, she was told to take a teaspoon of Milk of Magnesia every morning. It worked like a charm. She stopped the MoM after a couple of weeks and the bad breath never returned.

      It’s simple, inexpensive and it couldn’t hurt to try it. Good luck.

      Reply
      • Peter May 7, 2015 at 3:23 pm

        Thank you Erp for the tip.

        Yes, it wouldn’t hurt and since I’m eating from 12-8pm, I can try this comfortably in the morning.

        Reply
13. Terry May 7, 2015 at 6:29 pm

    Hi
    Is two hours in the instant pot for frozen oxtails long enough to make a good bone broth?

    Reply
    • Terry May 18, 2015 at 7:58 pm

      Hi Paul, or anyone else

      Is two hours in the instant pot pressure cooker,using frozen oxtail and marrow bones enough time for making a good bone broth. Does it need to be cooked longer.

      Thanks,terry

      Reply
      • Paul Jaminet May 19, 2015 at 8:07 am

        Hi Terry,

        Generally, 40-50 minutes with defrosted bones is good. I’m not sure how using frozen bones changes things.

        Reply
        • Donna May 19, 2015 at 3:48 pm

          Hi Paul, If 50 minutes in a pressure cooker is equivalent to about 3 hours, how come 50 minutes is long enough for bone broth (on the stove takes about 12 hours, yes?). thanks, Donna

          Reply
14. Lori May 8, 2015 at 9:16 am

    I’d be really interested to hear back from those who are working with parasite-elimination. My doctor suggested it (again) to me yesterday, and I’m finally on board. I don’t know how extreme I want to go, it feels like my body has been through too much extreme changes already. But I do have a Standard Process Wormwood formula, along with a whole elimination protocol. My Vit D and iron have also been chronically low. I’ve taken probiotics up the wazoo… and just get more bloated and constipated. I do finally agree that “something else” is going on. (off all gluten for 12 months, minor if any changes.)Do you think we could stay in touch and compare notes? (maybe by email?) LRMilas@Gmail.com

    Reply
15. mike May 10, 2015 at 5:03 am

    have been using PHD for several years & just bought 2 more copies of your book i fast every day for the 16 hours but a couple of days I have a milk coffee between 12- 15 hours is that okay for autophagy

    Reply
16. Harry W May 17, 2015 at 10:20 am

    Hi Paul

    Have you seen Dr. Turhan Canli’s TEDx talk “Is depression an infectious disease?” https://www.youtube.com/watch?v=1dD29XHp6CU

    He seems to be one of the few figures of any medical field who place as much importance as you on pathogenic infections in chronic illness.

    Personally, I’m quite convinced of this chronic infection theory and find it astounding that this hasn’t been taken up by other figures in the Paleo health community, especially given how influential some of your other ideas have been, such as the consumption of starches and the dangers of long-term ketogenic diets.

    If chronic infections are indeed as ubiquitous (you say in one article that you believe up to 20% of the adult population may have a brain infection) and harmful to health as you suggest, the worries about rising antibiotic resistance make the issue all the more pertinent.

    Does it not perplex you that so few alternative health practitioners seem to have recognised their importance, (beyond gut infections)? The other major causes of poor health in your view, malnutrition and toxins, receive so much attention in comparison. Even Terry Wahls, for example, great though her general protocol is (as shown in her clinical trials), doesn’t mention the possibility of brain infections such as C pneumoniae/Borna disease virus in the pathophysiology of multiple sclerosis. Surely, her recommendation of eating 9 cups of vegetables a day and avoiding grains etc isn’t going to solve the problem for everyone?

    Reply
17. Greg Davis May 21, 2015 at 7:10 pm

    Hi Paul,

    I’m interested to know your take on travel and maintaining circadian rhythms. I have a 10 day trip to Australia coming up and I wonder if it is worth trying to stay in local time for the majority of it using blue light blocking glasses and other strategies you talk about, or if it would be more healthful to just make the adjustment while there.

    What are your thoughts on that given that you have traveled to Korea? It would obviously depend on what activities you have planned at your destination but assume having quite a lot of control over my schedule.

    Reply
18. Keven May 21, 2015 at 11:20 pm

    Paul,
    I would love you insight on what should I plan my calories around? I am a very active 30 year old male. I regularly bike 10 miles a day and once a week do a 30 mile ride, work a job I at least walk 2 to 4 miles a day at, plus uselly do a 30 min p90x3 hitt workout a day. I weigh 140 pounds, which is problem a little low, standing 5foot9. I eat 1 pound potato or 12 ounces rice a day, uselly half pound fish or shrimp and 3 egg yokes. I use a ton of vegetables. I uselly push around 2000 to 2400 calories and to do so in use a lot of nuts and such, plus two tbsp oil, 1 butter 1olive oil. I don’t think I am eating enouenough, and would like advice on which nutrient should I up to fill in.

    Reply
    • Keven May 21, 2015 at 11:27 pm

      Sorry, just to add on to this
      I uselly have a alvacodo and a can of natural olives a day in my salad. I used to include a lot more saturated fats but have moved to more monounsaturated fats than Sat. Do you think I need more saturated fats to up my calories? I know I can’t lose anymore weight but what can I do to keep calories up and what number should I be shooting for anyways??
      Thank you, Paul.

      Reply
      • Keven May 24, 2015 at 10:40 am

        Dear Paul,
        I know you are a busy man, and I appreciate your time very much. I was just wondering what your thoughts were to what I should fill in my calories with so that I don’t lose anymore weight, and I can keep good health. I have cut some saturated fat out, because I was eating like 4 or 5 tbs a day. My diet is right with what you recommend, just need to know if I should up the fat or carbs to fill in the gap I find myself in.

        Reply
        • Ellen Ussery May 24, 2015 at 12:16 pm

          Kevin,

          Just my opinion, but that sound like too much HIIT,. Don’ t you need to take a day or two off in between for recovery? Do some yoga or other things on those days.

          And add more carbs. There is no exact amount that is right for every one. Experiment.

          Nuts should be in small amounts, not a staple. Look at the apple . In PHD They are a pleasure food:

          http://perfecthealthdiet.com/the-diet/

          try switching back to more sat fat. Some coconut oil perhaps.

          Reply
          • Ellen Ussery May 24, 2015 at 12:23 pm

            You might experiment with other proteins. Beef, lamb, pork, chicken. And perhaps more than a half pound.
          • Ellen Ussery May 24, 2015 at 12:24 pm

            Kevin,

            You might experiment with other proteins too. Beef, lamb, pork, chicken. And perhaps more than a half pound.
        • Paul Jaminet May 24, 2015 at 12:35 pm

          Hi Keven,

          If your problem is underweight, you should be adding foods in, not cutting them out.

          I would just keep to PHD proportions and add more food until you feel well.

          Reply
          • Keven May 24, 2015 at 12:40 pm

            Thanks paul,
            I will try to balance it all out. I just do not want to be pushing more fat or carbs in my body if they are going to cause health issues.
    • Paul Jaminet May 24, 2015 at 12:32 pm

      Hi Keven,

      Why not just eat more food? Keep the proportions the same and eat more.

      The weight recommendations on our food plate are for a reference 2000 calorie diet. Male athletes need more calories than that.

      Reply
      • susan May 24, 2015 at 12:39 pm

        …and worry less and enjoy the healthy pleasure foods more.
        Full fat dairy (cream – heavy, sour or cultured and cheese) and chocolate are great supplemental and pleasure foods that can help add weight significant healthy calories. Most of us wish we could enjoy more of them like you!

        Reply
        • Keven May 24, 2015 at 12:51 pm

          Thanks,
          I was thinking the same, but not sure which nutrient to be more heavy on really. I know some saturated fat is good , but how much is pushing that limit is a great question. I can not wait for Paul’s post on Seth Roberts. Adding more calories is ok but which on should be the safest? I internment fast everyday so eating two meals a day is hard to push more calories if not favoring one over the other. I fell good, just wondering if carbs or fat is safer to go over??
          Thanks for all the help and responses from all

          Reply
19. Claire May 28, 2015 at 1:45 pm

    I have a question about buffered Vitamin C. Some people advise it is better than pure ascorbic acid as better absorbed and less irritating to the digestive tract and easier to take (hide for children). Do you know if the minerals in the ascorbate form (e.g. magnesium ascorbate, calcium a., potassium a.) would count towards your mineral supplementation? Are these ascorabte form minerals absorbable? I’m more worried about this when taking higher doses of Vit C during an infection.
    Paul do you know, or anyone else knowledgable in this area?

    Reply
    • Paul Jaminet May 28, 2015 at 6:10 pm

      Hi Claire, I don’t favor the buffered forms because you’ll usually start overdosing the minerals before you reach the optimum amount of C. A mix of potassium ascorbate and sodium ascorbate would be safest in this regard.

      Reply
      • Claire May 28, 2015 at 6:22 pm

        Thanks Paul. Yes I was worried about the extra minerals but perhaps a buffered form would be ok if taken in an amount that does not exceed PHD mineral recommendations? Perhaps half to 1 g might be OK depending on the brand.
        I just read this article that got me concerned as she quotes some negatives on ascorbic acid: http://wellnessmama.com/35500/vitamin-c-benefits/

        These quotes got me worried especially since I’ve put my whole family on higher doses of ascorbic acid this week due to a cold:
        “(from the Jun 15, 2001 issue of Science) showed that “synthetic vitamin C may contribute to the formation of genotoxins that can lead to cancer”.

        A second study presented to the American Heart Association showed a link between consumption of only 500mg of vitamin C per day and a greater propensity toward thickening of the arteries (Los Angeles Times, March 3, 2000).
        Even more recently, athletes taking 1000mg of vitamin C per day showed reduced endurance capacity from interference with antioxidant enzymes (American Journal of Clinical Nutrition, Jan 2008). ”

        What do you think?

        Is it worth the extra money to use liposomal Vitamin C for times of illness? I have read it is absorbed much better?

        Reply
20. Jonathan Phillips June 1, 2015 at 2:39 am

    Just ordered the book. But from the Diagram I understand to eat 1lb of cooked rice and 1/2 to 1lb of meat. If the bulk of calories is to come from fat is there some guideline as to how much fat to eat?

    Reply
    • Paul Jaminet June 1, 2015 at 7:13 am

      Hi Jonathan, eat 3 egg yolks and 2-4 tbsp oil/fat per day as food flavorings and cooking/salad oils. This assumes normally fatty meats; if you eat very lean meats add something fatty like avocado, tree nut butter, or more egg yolks.

      Reply
21. Bernadette June 1, 2015 at 11:31 am

    Hi Paul,
    Any idea what to do about food cravings? I am trying my best to get my husband to eat the diet. When he is home he usually eats what I give him but sometimes prefers to make his own pizza or toast instead of my PHD meals. He also stocks up on bad quality biscuits and chocolates full of wheat and sugar and tends to eat these in the evenings. He also buys fruit juice. For the past year or 2 I have been trying to educate him on nutrition from what I’ve learnt from you. He is an intelligent man with a PhD himself but so resistant to give up his junk food. I’ve been trying to give him supplements to help clear up deficiencies but he still has these cravings. He believes that sugar and chemicals are not good but will not accept there is anything wrong with wheat as it’s such a staple food. He also likes to stay up late in the evenings. We want to have more children and it pains me that he is not doing his part to help make a healthy baby.

    So he partly aknowledges that some of what he eats is bad (except wheat) but says we all have to die anyway!

    Any idea on what could be causing these cravings or ideas from anyone on what could help change him? He thinks of himself as reasonably healthy and is not overweight. He does not want to read the PHD book as it’s not a topic that interests him and also he says there is so much contadictory advice that know one can know what is best….etc… Is there something more concise to read or a video out there that might grab his attention?
    Any tips would be much appreciated.
    Thanks

    Reply
    • Donna June 1, 2015 at 12:10 pm

      I know my food cravings didn’t stop until I started to eat enough starch (potatoes, rice) throughout the day, and enough protein, especially in the morning, and generally enough calories in my 8 hour eating window. Having said that, motivation to change ones diet has to play a part. I have many friends who just don’t have any interest in modifying their diets, even when they have significant health issues. You being such a good role model might eventually help.

      Reply
      • Bernadette June 1, 2015 at 3:07 pm

        Thanks Donna. My husband has never been low carb, he loves his carbs, and not so much the veg. He also loves meat. He doesn’t eat much breakfast (since childhood) but eats a cooked lunch and dinner.

        Reply
    • Paul Jaminet June 1, 2015 at 2:01 pm

      Hi Bernadette,

      I guess the first thing I’d say is, don’t let the perfect be the enemy of the good – meaning, among other things, don’t let dietary disagreements become a source of conflict in your marriage. Keep in mind that (a) diet is a very personal thing that is hard to change, remember Aristotle said “we are what we habitually do” and what we eat is definitely a habit, so part of our identity, and we don’t give up our identity easily. Also, (b) he is right that most dietary authorities have no strong evidence in support of their positions, so it’s reasonable to suspect we’re not worth his time either. Finally, (c) you should be aware that what he does is much less important to your future babies than what you do. He will create millions of sperm and only the healthiest will win the competition to reach the egg; so even if he is a little unhealthy, it will have little effect on the baby – it will still be his best sperm making the baby.

      So I would probably focus on tweaks to what he’s doing rather than wholesale change. I’d start with circadian rhythms, trying to move his eating to the afternoon from the evening. Then eating more natural whole foods (even if they are wheat) and fewer “purified calorie” industrial products (made from starch, sugar, oil).

      Possibly our weight loss talk from AHS last summer would be a good video for him – although he does not have a weight issue, the science is the same for fertility. My circadian rhythms talk from AHS 2013 would be great but unfortunately there were technical difficulties and it didn’t get recorded.

      Best, Paul

      Reply
      • Bernadette June 1, 2015 at 3:43 pm

        Thank you Paul. That is great reassurance I needed to hear and great advice.

        With regards to tweaking, I did do that a few years back when I discovered WAPF. We stopped the processed foods and started making my own cakes etc.. He actualy likes my gluten free cakes I make with coconut sugar. The problem is I can’t seem to keep up with the baking for amount of sweets he wants to eat, even if it is with wheat. When he buys it for himself he chooses the cheap poor quality stuff even if there are slightly better but more expensive alternatives. He is at work in the afternoon so already eats what he can at that time, a full lunch, rice with stew and lots of fruit later is usual.

        But I guess I should be positive that he does eat better than he did when we first got married. I’ve heard someone say that women are more into prevention but men often don’t want to make lifestle/dietary changes until something really goes wrong.

        Circadian rhythms is something we struggle with and really need to focus on working on. He really enjoys staying up late to relax and watch a movie. I should lead by example but struggle going to bed early when he will be up for 2+ hours.

        Thanks for the video recommendation. Perhaps one day he will want to watch it. He would like something that is scientific with evidence.

        Reply
      • st June 1, 2015 at 5:20 pm

        Paul you are a beautiful soul. Bringing glory. I am thankful.

        Bernadette, bless you. I have a similar situation. He really has eventually started trying to adopt some of my suggestions due to seeing the benefits. And it really is more important to take care of the relationship than it is to get him to “do right” — which could backfire because most of us are resistant when pressured and lectured and watched.

        Reply
        • Bernadette June 1, 2015 at 5:32 pm

          st, Yes, good reminder about the relationship…
          The irony is that my health appears worse than his. It seems to take me much more effort than him to feel healthy. I’ve always been weaker though.
          However, he does ‘blame’ me for losing his ability to tolerate large amounts of sweets. He says he feels unwell after eating too much junk these days, whereas in the past he could tolerate anything. I wonder if that is because he eats the junk food less often now, his body is responding in a clearer way?

          Reply
          • st June 2, 2015 at 8:17 am

            We’ve experienced that as well. Overly much dessert bothers us, eating out (especially fast food), overeating… all things we would have formerly not noticed.
      • Bernadette January 7, 2016 at 5:13 pm

        Hello Paul,
        I’ve been doing what I can with helping my husband to improve his health in a non confrontational way. So far he has not been that willing to change as he feels in excellent health but is now telling me that he realises he should change (after a talk by a chiropractor who gave the link between food and health in a new way….). The problem is he says he gets bad cravings for something sweet in the evenings. Usually his evenings he spends snacking while watching TV. He agrees that he needs to break this habit but enjoys this way of winding down. I was wondering is there anything I can give him to help reduce his cravings?
        He already eats pleanty of carbs, protein and fat. He eats dinner at home which I try to make as PHD as possible. He’s not keen on veg but I make sure he gets some as he will eat veg soup I make. If it wasn’t for the soup he tends to stick to rice and meat for meals.
        Some ideas I heard that might help with cravings would be L-glutamine for blood sugar control, magnesium, reducing possible yeast overgrowth. He takes any supplements I give him but complains that it’s too many and too costly so I cut down to just Vit C and K2, occasional mineral drops or magnesium, occasional B5 and Vit D. I would appreciate any advice to tackle the night eating by reducing cravings.
        Many thanks.

        Reply
22. Bernadette June 3, 2015 at 11:53 am

    Hello Paul,
    My 6 yr daughter suddenly broke out in hives spots on her face (mainly cheeks, chin and neck) area. They ‘move’ around in that area. Isn’t bothering her much but I am worried. What causes it? I’m thinking she may have reacted to something new I gave her today (strawberries, turmeric capsule, probiotic). She’s had these all before but not for some time.
    Does hives mean she has a leaky gut? We already eat well and trying our best on PHD. She’s never had much sugar or grains apart from rice and rarely buckwheat. But I’ve never done tests on her. I wonder if I should, perhaps a stool test?
    Anyone know about hives causes and cures?
    I am worried as she has had similar hives on her face or body a few times over the past few years. First time it happened was just after having coconut water for the first time in her life. But today is the first time it happened in over a year.
    Any ideas?

    Reply
    • Bernadette June 3, 2015 at 12:03 pm

      I should have also said that I’ve been giving her extra doses of Vitamin C today and the last few days as we all have a cold. I doubt that would have anything to do with it though? Helpful if anything?

      My question is, do I need to work harder on healing the gut for her? She does get constipation (slow transit).

      Reply
      • Bernadette June 4, 2015 at 10:18 am

        The hives started again today. All she ate was goats yogurt, rice, potatoes, coconut, raisins, raspberries just before it happened. Later she got very stressed about something and the hives got noticably worse covering her arms and torso.
        I’m wondering why she is suddenly getting it so bad now. We have been battling a cold, so perhaps she’s low on nutrients?
        She had a standard burger at a party a few days ago. We don’t feed her wheat at home. I wonder if this compromised her immune system?
        Any clues on hives would be helpful. Could it be to do with histamine?

        Reply
        • Darrin June 4, 2015 at 12:46 pm

          Just a thought, some people react to coconut products,
          You could try eliminating those in the short term til the hives clear.

          & test coconut in the future

          Reply
          • susan June 4, 2015 at 1:15 pm

            I agree with Darrin, coconut isn’t an unusual allergy.
            Any person could be allergic to any type of food, but another suspect on the list you gave is goat’s milk.
            Dairy of any kind is at/near the top of the list of common allergens.
            All ruminant milks contain casein and lactose (unless they are labeled “lactose free”). For some people (but not all) the fat molecules in goat and sheep are more tolerable than cow milk. But for many, any form of lactose, casein, or both are a problem.
            Histamines may also be an issue, which may indicate lack of DAO enzyme or a condition that is histamine sensitive. Raisins and all dried fruit are very high histamine. Strawberries are too, and I’m not sure where raspberries fall on that spectrum, so that’s may be something to consider.
            These are just some thoughts.
          • Bernadette June 4, 2015 at 1:35 pm

            Thanks for your thoughts. She hasn’t had any hives for at least a year, and before then only a handful of times spread out over 3 years. Throughout this year she has been eating high histamine foods like fermented veg or yogurt. I’m suprised the hives suddenly happened yesterday and again today. I’m wondering if it might be easier to do a food allergy test on her that checks IgA and IgG. Cyrex labs does it.
            Histamines, that sounds complicated to me. Is there a way to check for a lack of DAO enzyme?
            Thanks you.
          • susan June 4, 2015 at 3:28 pm

            Yes, histamines are complicated and controversial too.
            If you were to avoid all high histamine food, the diet would be extremely limited. So like many of these approaches, it still doesn’t address the root cause of the problem. If that is discovered, addressed and corrected, my understanding is that many of the sensitivities can diminish or be controlled more easily.
            For info on histamines, you can checkout lowhistaminechef which is purported to be one of the best international websites/resources for info. I’ve heard the owner/creator of that website speak, and she has expressed that the tests are largely unreliable. Food allergy testing in general is controversial. Some people like Dr. Tom O’Bryan seem very big on it, but many others think it’s largely a waste of time and money due to unreliability, i.e., false negatives and positives, and diagnostic results that contradict what is being experienced clinically. Most doctors/practitioners seem to feel that elimination diets are the only reliable way to identify what foods are causing problems. It’s very tedious and takes a long time and a lot of patience, and in my experience with skin issues actually revealed nothing. But based on what I hear, most people do find it enlightening for immediate symptomatic relief. Frustrating, I know!
          • susan June 4, 2015 at 3:36 pm

            You might also consider expanding your focus to seasonal or other environmental allergies, sensitivities and toxins.
          • Darrin June 4, 2015 at 9:10 pm

            the coconut came to mind because it was present in both instances.

            i seem to recall Chris Kresser saying that the “gold standard” (the only way you can be sure) for food allergy testing is, exclusion followed by reintroduction.
          • Darrin June 4, 2015 at 9:16 pm

            this is where i saw Chris mention the gold standard thing;
            http://chriskresser.com/food-allergy-testing-tricks-for-flu-season-and-exclusive-book-bonuses/
          • Bernadette June 5, 2015 at 11:14 am

            Thanks Darrin.
            I doubt it’s coconut as she had none today but the hives returned mildly after breakfast. It seems to be a pattern. The hives wear off by the end of the day but return straight after breakfast. Today her breakfast was a PHD pancake (yolks, PHD flour, banana, dates, ghee) and blue berries.

            It was very mild but a few hours later she got very stressed about eating her lunch (refusing to eat a soup) and as she got red in the face, spots broke out all over her face.

            Each of the 3 breakfasts was different foods but the hives come straight away. There was no coconut on day 1 of hives either. The coconut water I was referring to was about 2 years ago when she first got hives after drinking it (possibly coincidence?) She has been having coconut water many times since and never had hives. She hasn’t had hives spots for atleast a year or 2 until 2 days ago.

            I feel there is a definite link with stress that makes it worse. But probably a food or histamine trigger. It’s funny how this episode started after eating that unhealthy burger and getting a cold. I feel her immune system must have gone down and her body seems to be reacting to something. By the way, that burger she ate, was the first time she ever had fast food. She has only ever eaten home made food, and wheat only extremely rarely from grandma.
          • Bernadette June 5, 2015 at 11:48 am

            Thanks Suasan.I’ll be checking out her website. I think I read Paul say somewhere that for histamine these might help: molybdenum, copper from beef/lamb liver and choline.

            Will try perfecting those with her. We’ve been a bit low with the yolks since I found out I can’t tolerate eggs (atleast the whites for sure as I get obvious digestive symptoms if I eat them).

            This is my experience with food sensitivity. Egg sensitivity originally got discovered by the cyrex blood test array 4. Up until then I was eating whole eggs daily never realising I had a problem with them. Only after stoppping and eating them again I had bad labour like pains in my tummy, something I never had before! So I know that food reintroduction can be accurate.

            Yes I know there is debate about food sensitivity tests. I’ve also heard Dr Christianson say that elimination diets might not be accurate because once you eliminate a food your gut flora changes and reintroducing it could give you side effects that are to do with the readjustment rather than a sensitivity. Something along those lines from what I understood.

            I was always weary of food test but heard that Cyrex seem to be in the lead with their tests and they are pretty accurate if you are eating the foods at the time. As far as I am aware most labs only test for IgG but Cyrex do combined IgG and IgA which is meant to be more accurate.

            I have some reservation on food elimination/reintroduction because I think sometimes symptoms could be silent. Apparently antibodies can build up in the body to a certain organ for years before you get symptoms.
            There is a study on dilated cardiomyopathy where they removed gluten from the diets of those who were found to be sensitive (not sure how this was checked) and 50% of them had a reversal in the condition! This is incredible since cardiomyopathy is meant to be incurable and causes are usually unknown. If gluten is the trigger for atleast some of these patients then it is likely they do not have heart symptoms they notice until the disease is progressed enough. Just an example but I do hear people saying that food sensitivity symptoms can be silent.

            Anyway just my thoughts while I try my best to understand and improve our health. I will probably go for a stool test for my daughter as I suspect dysbiosis and wonder if she could have a gut infection.
          • susan June 5, 2015 at 12:33 pm

            Egg whites can produce high histamine while yolks do not. That may be why you react to whites, although there are other potential reasons too. Paul says it’s not a bad idea to avoid whites anyway, because they can contribute to autoimmune disease.
            You mentioned strawberries being in her food last year when she had the attack. I know someone who says the exact thing happens when she has strawberries.
            I agree with you about eliminations. Personally, I’ve found them as troubling as food testing. One thing to remember is that many food sensitivity reactions occur 48 hours post-consumption. I think that’s why you’re supposed to eat the reintroduced item for several days in a row at each meal, then remove it for 2 days, then reintroduce again for 2 days at each meal, all without making any other changes to your diet during that entire period.
            I’ve never identified specific food sensitivities with this approach, but many other people have and it’s been very obvious. So I would at least try it in earnest. You could use AIP paleo as your starting point, or some other reasonable baseline diet.
            One of the reasons that I have reservations about it personally is that I too am prone to stress. Since we are not robots and do not live in bubbles, there are many environmental and emotional factors that fluctuate during an elimination testing period (weather conditions, issues at home/school/work, relationships, environmental allergens and toxins in the air and in building, etc.), so who’s to say whether or not the flare-up was due to food or some other influence? The probable answer to that is intuition and patterns that form.
            Stress — yes, perhaps not the initial trigger, but it sounds like your daughter is stress-prone, and she should not eat when she is stressed, only when she’s in parasympathetic mode (relaxed). And yes, in general it will exacerbate any gut issue.
            One key thing to remember about non-allergic food sensitivities, whether it be histamines, gluten, etc, is that very often the poison is in the DOSE and frequency.
            This can often be the case with histamines. If you lack DAO or enough of it, then histamines will build up, and once you hit your limit the bucket overflows. If you back off of histamines for a long period of time, the bucket may wane, providing a little capacity. But then if you build up the histamines again, it will overflow again. It could be just a tiny bit of something that caused the overflow. It’s not that that one food is the problem, it was the sum total of all of them. That’s my understanding of how DAO deficiency works.
            Getting back to autoimmune disease…has it been ruled out? Hashimoto’s, others, etc?
          • susan June 5, 2015 at 2:48 pm

            Actually I was asking about your daughter. There are many different autoimmune conditions, and I’m not saying that she has one, but my only point is that the food may not be the root cause; rather, foods may be highlighting symptoms of a a fundamental underlying problem that isn’t just histamines, or whatever.

            Pretty sure that in their book, the Jaminets talk about how egg whites can promote or contribute to auto immune disease (I may not be saying that technically correctly, but a “potential” (not inherent) cause:effect relationship was implied). So, just as a precaution, while I still eat them since I have no negative reactions, I have reduced how many whites that I eat.

            A starting thyroid panel would include TSH, T3, Reverse T3, T4 and Thyroid antibodies, and as importantly, a medical provider who know how to properly interpret them. I recommend finding a good Functional Medicine type practitioner in your area. Yes, you are correct: TSH of 4 is NOT good normal. Your current doctor is following standard “normal” lab ranges, which include the whole population, including the majority who are unhealthy. The Jaminet’s and most Functional types want to see TSH somewhere b/w .5 and 2, and most ideally at or around 1.
            According to Isabella Wentz PhD, one of the leading experts on all things thyroid and Hashimotos, a TSH of 4 is HYPOthyroid and a potential warning sign that you are headed toward developing auto-immune hypothyroid disease, aka Hashimoto’s Disease. She has an outstanding website and free newsletter program and has written several books on the subject.
            I know many people with Hashi’s (it is actually a lot more common that you might imagine) and most of them have similar issues, including food sensitivities like gluten, eggs, etc, and often rashes and eczema among other symptoms. Suzy Cohen also has an excellent website and free newsletter program and deals with thyroid a lot. Amy Myers Md is another one who comes to mind.
            I’m not trying to suggest that you or your daughter have any type of AI disease, but I’m saying that before you drive yourself crazy trying to figure out what foods are causing problems, you might want to look at some other possible fundamental causes which may be treatable and potentially put into remission.
            Where are you located?
          • Darrin June 6, 2015 at 12:50 am

            good point on the changes to gut flora Bernadette…when removing or adding foods
          • Darrin June 6, 2015 at 12:55 am

            i happen to agree with ‘histamine bucket’ analogy as well susan
        • Bernadette June 5, 2015 at 1:35 pm

          Thanks Susan.
          She was eating strawberries occasionally over the last few weeks and nothing showed up then so I doubt it’s that.
          Is it for me you were talking about checking for autoimmune disease? How would I check for conditions like hashimoto’s? I don’t think a standard doctor would be interested in checking these things for me if I told them I am sensitive to egg whites. My TSH was around 4 last time I checked and they said that was in normal range. I know it’s too high from what I’ve read. Hopefully now that I’ve eliminated some foods I don’t tolerate things will improve as I continue with PHD…

          Reply
23. KH June 4, 2015 at 10:33 am

    Hi Paul,
    Was just wondering if you might consider a post on feeding babies and toddlers anytime soon? Looks like you have a lot on your plate but I’m hoping you might post on this one day. 😀
    Our daughter is 16 months now and I try to feed her the best I can but I find myself constantly worried, is this enough? Too much? Should I give her that? Or wait? Etc etc… She seems to be thriving so I think all is well but I want to make sure I’m not missing anything in her diet.
    Thank you!
    KH

    Reply
24. sylvia June 5, 2015 at 9:05 am

    Hi Paul,
    I was wondering what your thoughts were on Palm or Avocado oil substituting for coconut oil in cooking, baking, frying?
    Thank you

    Reply
    • PeterC June 5, 2015 at 9:50 am

      Hi Sylvia

      Check this page:

      http://perfecthealthdiet.com/the-diet/

      Cheers

      Reply
25. Jon June 7, 2015 at 8:20 pm

    Paul, there are few studies that have stated that glycine “fuels” cancer. When you have time, I’d love to hear your take on it.

    Jonathan

    Reply
26. Ellen Ussery June 20, 2015 at 1:29 pm

    Hi Paul,

    I just found out I have Lyme disease and am exploring alternatives to antibiotics amongst acquaintances who have followed various regimens successfully. So far the one that appeals to me most is using monolaurin to kill off the spirochetes and proteolytic enzymes to deal with the biofilms

    http://www.inspirednutrition.com/store/Disease-Protocols/Lyme-Disease.html

    I am curious if you know of any downsides to this approach..

    Reply
    • Paul Jaminet June 20, 2015 at 7:17 pm

      Hi Ellen,

      I think monolaurin works, but primarily in the small intestine — it is good against enveloped viruses especially. It may have some low-level effects systemically but I wouldn’t consider it a substitute for antibiotics.

      The fibrinolytic enzymes I think are dangerous and I would avoid them. While Lyme bacteria can form biofilms in vitro, I’m not aware of evidence that they are a significant factor in vivo, nor that these enzymes are effective at treating them; moreover the enzymes will cleave human molecules, making them potentially dangerous. My sense is that there have been many negative, few positive outcomes in people using them.

      Best, Paul

      Reply
      • Ellen Ussery June 22, 2015 at 11:29 am

        Thanks Paul,

        From my understanding antibiotics are most successful when used immediately upon being infected. It turns out that I have had this since at least mid March if not before. So that, along with my reluctance to kill off my carefully nurtured gut bacteria, are driving me to find other solutions. There is also the fact that we get a lot of tick bites. So I need to find another way than antibiotics.

        I have also been looking at the .Buhner protocol

        http://buhnerhealinglyme.com/resources/herb-source-list/

        And Dr Zhang’s

        http://www.drrons.com/chinese-herbs/default.htm

        Reply
27. Bill June 20, 2015 at 8:40 pm

    Much is mentioned about beef liver for its nutritional property’s. How does lambs liver stack up ?

    Reply
    • Paul Jaminet June 20, 2015 at 9:15 pm

      It’s almost identical to beef liver nutritionally.

      Reply
      • Claire June 21, 2015 at 4:36 pm

        What about calves liver? Is that also similar to lamb/beef liver? It’s much tastier we find.

        Reply
28. Claire June 22, 2015 at 11:26 am

    Hello Paul.
    I’ve been searching the web for remedies for varicose veins but am struggeling to make sense of it all (Vit C, Vit E, Vit K, cypress oil, witch hazel, ACV…).
    My varicose veins in my legs seem to be getting worse despite doing PHD for a year as best as I can and improving as I go along with supplements. I am suprised recently I have been getting sensations in my legs that feel like my veins are getting worse. I did notice a new vein on my ankle the other day that hurt. I have many spider veins all over my ankles. I would have thought that my supplements of Vit K2 (100mg daily), Vit C (2g daily) and increased exercise would have helped the situation but no sign of improvement and I’m only 30 and not overweight at all. What more can I do? It runs in the family, my mother has very bad varicose veins. What nutrition/lifestyle factors should I focus on, do you know? Thank you

    Reply
    • susan June 22, 2015 at 12:29 pm

      I have the exact same problem, really started getting worse 1 year ago at age 55. I’d like your take on this too Paul! I saw Dr. Tom Cowan last year and he recommended Colostrum and drinking living or “structured” water. I haven’t done either. He also wrote an article on WAPF website recommending horse chestnut and buckwheat greens and very active leg exercise, including jogging. The only thing I tried before seeing him was the jogging, and right after I began jogging is when my veins really starting coming on and physically bothering me! I’ve also heard Vitex suggested by others.
      My internist (she’s also a dermatologist, and she does schlerotherapy on spider veins) says that she has seen improvement with horse chestnut on patients who continuously take it. She also told me that jogging is not necessarily a good thing for varicose veins and she also warned me that any estrogenic compound, including phytoestrogens like Black Cohosh, could potentially make them worse.
      Mine often itch and make my legs feel uncomfortable. Like Claire, a lot of my activity and visibly unsightly veins are between the calf and ankles, but there’s a little on my thighs too. My mother has severe VV and her mother had them less severely too.
      I hate them, not just for how they look, but primarily for how uncomfortable they make me feel. The discomfort includes not finding a comfortable position for my legs in bed at night and frequent interrupt of my sleep.

      Reply
      • Claire June 22, 2015 at 12:35 pm

        My worse ones are behind the knees mainly on one leg and just smaller veins on my ankles. My practitioner actually recommended VeinLite (contains: Salvia, Ligusticum, carthamus, Paeoniae, Cyperus, Ginkgo). Not sure about it though.

        Reply
      • Donna June 22, 2015 at 12:37 pm

        Google varicose veins healthy immunity. It is Lorna Vanderhaeghe’s site (a women’s health expert). She makes a product called VeinSmart and has some other recommendations for this problem. Also, if estrogen dominance is a problem for you (?), google that on her website as well. Her product, EstroSmart,(or EstroSmartPlus which has Vitex in it) is amazing for health conditions related to estrogen dominance.

        Reply
        • susan June 22, 2015 at 12:50 pm

          I do think that it relates to lack of progesterone, and Dr. Cowan said this too. Mine really started coming on after beginning menopause. I’m very hesitant to take any estrogenic compounds for the reason that my Internist/Dermatologist indicated (she also said that in her opinion, there is not enough proof that phytoestrogens or bio-identical hormones are any less risky than straight hormones, w/r/t breast cancer, etc) and she’s a very open minded doctor who does believe in effective homeopathy, etc. Also, if progesterone is 0, thus creating estrogen dominance in menopause, I don’t understand how taking an estrogenic supporting compound would help me (I’m not saying it wouldn’t, I just literally don’t understand how it would — the interactivity of the female and other hormones baffles me).

          Reply
          • Donna June 22, 2015 at 2:47 pm

            Google Life Extension Oct 2009 Bioidential Hormones: Why Are They Still Controversial. An article with about 200 references demonstrating the safety of Bioidentical Hormones compared to conventional/nonbioidentical hormones. Convincing.
    • Paul Jaminet June 22, 2015 at 2:37 pm

      Hi Claire,

      First I’d try stopping the vitamin K2 and changing up lifestyle habits that may induce clotting. If a clot obstructs blood flow one way, it will make an alternative path, potentially a winding one. If you are inactive for long stretches, spend a long time standing, or a long time sitting in an immobile position, try changing things up. Elevating legs, sitting butt on floor in a cross-legged yoga position, moving often, all will help.

      Best, Paul

      Reply
      • Claire June 22, 2015 at 2:45 pm

        Thanks. I’ll focus on the lifestyle factors more. I am generally active but there are times where I stand or sit for longer periods like for cooking or computer time. But I thought Vit K2 could help by eliminating calcium from the arteries. How will I get all the other benefits from Vit K2 especially since I can’t currently eat dairy (so no cheese or fermented milk). Will I ever be able to take VitK2? Sorry but I’m finding the Vit K2 confusing. Is there more I can do to perhaps help strengthen the vein walls? I wonder if this is more tied in to my lowish blood pressure (100/70)? But my GPs/midwives etc have never been concerned.

        Reply
      • Claire June 22, 2015 at 2:56 pm

        On reflection, I feel I am no more inactive than most adults I know who don’t have varicose veins. So I am wondering how do I get to the bottom of what my cause is, a nutritional deficiency or other problem. I first developed more visible veins behind my knee in my teens. Doctors have not been bothered and my practitioner just prescribed a herbal supplement. But I would really want to know how to get to the cause especially since I am young so nothing to do with menapause.

        Reply
        • Donna June 22, 2015 at 2:58 pm

          Google varicose veins healthy immunity. It is Lorna Vanderhaeghe’s site (a women’s health expert). She makes a product called VeinSmart and has some other recommendations for this problem. Also, if estrogen dominance is a problem for you (?), google that on her website as well. Her product, EstroSmart,(or EstroSmartPlus which has Vitex in it) is amazing for health conditions related to estrogen dominance

          Reply
          • Claire June 22, 2015 at 4:31 pm

            Thank you Donna, I’ve had a look. I will try some of these. Just a lot of conflicting info e.g. to take fish oils on PHD.
            How would I know if estrogen dominance is a problem for me? I’ve just checked my recent saliva adrenal results where I had some hormones tested. My estradiol was 1 pg/ml, estriol 2.8 pg/ml and progesterone 155 pg/ml. Looking at the ranges they are all on the lower side, so am I right to assume I don’t have estrogen dominance?
        • susan June 22, 2015 at 3:09 pm

          Claire, I share your frustration. We are genetically predisposed I’m afraid, but like you, I’m still searching for ways to improve and prevent further damage.
          You mentioned midwives…did your’s first pop up during or after pregnancy? My mother’s and other friends who have had them did. I’m not sure if it was the pregnancy as much as the 15+ weight gain over a short span of time that is the issue. Also, a slow progesterone decline does start around your age for many of us. I began experiencing migraines and severe PMS around my cycle in my late 20s, and in retrospect, I believe that female hormonal changes played a large role.

          Reply
          • Claire June 22, 2015 at 4:39 pm

            I have a feeling pregancy has made it worse a bit but if I remember correctly I think it started getting worse right at the beginning of pregnancy so I never thought it was due to weight gain but mor due to strain on the body due to deficiencies…. Just what I thought at the time. I developed swollen ankles in the summer during a pregnancy too. With regards to the Vit K2, doesn’t the body get used to it if I start again and build up the dose very gradually so it doesn’t affect clotting?
          • Donna June 23, 2015 at 2:21 pm

            And my blood hormone levels made not sense apparently. It wasn’t until urine testing was done that my GYN knew what was going on. Unfortunately, no covered by health insurance usually.
        • Donna June 22, 2015 at 8:18 pm

          Susan had mentioned insufficient progesterone, so that’s why I included the comment re estrogen dominance (ED). I’m not sure what it woul look like on blood tests (many do urine or saliva tests for accurate measures of hormones though). I believe ED is also diagnosed clinically – PMS, cycle related headaches, menstrual problems, etc. If you google Dr. Alvin Pettle (OB/GYN) he has conveys information regarding estrogen dominance (ED)and the benefits of using bioidentical transdermal progesterone during the second half of the menstrual cycle for conditions related to ED. Both he and Lorna Vanderhaeghe also discuss the importance of reducing as much as possible, sources of xenoestrogens which contribute to ED.

          Reply
          • Claire June 23, 2015 at 4:58 am

            From what I gather both my estrogen and progesterone are a bit low. But my cycles are better than they have ever been. Regular and right length. And this is the first time in my life this is the case. Not sure if it’s to do with improved diet or that I reregulated after having children. I do sometimes get headaches, not sure if cycle related, possibly. Will pay more attention to when they happen. Thank you for the recommendations. I’ll be looking into it all.
          • susan June 23, 2015 at 1:56 pm

            You can also check out The Hormone Cure by Sara Gottfried MD. She may even be an OB/Gyn. She writes in a non-technical, sometimes cheeky style, so it’s easy to understand. It contains discussions and questionnaires/checklists to help you identify what type of hormonal issue that you have, and it offers solutions to the various issues including lifestyle, etc. I have the book and have read it. It gets confusing because we are not static, and many people like me have symptoms that vary, and have changed over time. So sometimes I’m not sure where I fall in the dominance/underactive realm. And of course all of our hormone systems are interactive and counterbalance each other, or at least they usually try to, so you have to really look at all three hormone systems together: sex, adrenal and thyroid. Other doctors who you may want to consider as resources are Christiane Northrup MD, Amy Myers MD and Jill Carnahan MD. Some of them are more active on the blogasphere and others have books. Gottfried, Myers and Carnahan are very involved in the Functional Medicine movement. Myers is paleo; pretty sure Carnahan is too. Gottfried’s approach has many dietary overlaps (bulletproof, etc), but not sure she’s totally paleo. Northrup appears dietarily neutral.

            According to my LabCorp test, standard reference ranges are:
            Estradiol: <15 is postmenopausal
            Progesterone: <10 is postmenopausal; anything from 10-2555 can occur if you are still menstruating, and will vary dramatically depending upon which day of the 28 day cycle you were on when your blood was drawn, the highest numbers usually occurring in the last half of the cycle
            Estrogen: <50 is postmenopausal

            All of these were accurate for me, blood drawn 4 months after my very last cycle.

            I'm confused because your estradiol of 1.0 pg/mL would indicate that you're in menopause, based on the reference range interval. So either your number is incorrect or I don't understand how to read this report (latter's entirely possible, I'm not a medical professional!), or some other plausible explanation.

            However, based on your progesterone of 155, you fell into the average for a woman tested on day 13-15 of her cycle.

            But remember, the standard lab ranges are averages. None of us track all of the numbers perfectly, and many functional medicine practitioners use a different set of ranges for what they consider normal/optimal. I'm not sure if that's true for the sex hormone ranges. False negative happen frequently on a lot of tests too. I know this is true for thyroid hormones.
          • Claire July 1, 2015 at 11:40 am

            Thanks Susan.
            That’s good news about my progesterone as I was mid cycle at time of testing. Based on my test ranges for mid cycle my estradiol of 1 is a bit low. It should be atleast 3 to 8.
            So it doesn’t seem estrogen dominance is my issue.
            Thanks for those MDs. I’ve recently come across some of them. Great to have such naturally/nutritionally minded doctors around.

            I wonder if I’ve made my issue sound worse than it is. I used the word varicose veins but looking it up I realised I don’t have the bulging out type (like my mother). Mine are still flat but certain areas showing very visibly through the skin with big blue veins. I also have many small spider veins that have been increasing over time. Perhaps the summer heat! I started applying marigold oil (might try cypress or geranium too) to help from what I’ve read online. Will keep up with the exercise and movement and try out some of the recommendations from Lorna and Dr Axe writes about it too. I just didn’t want to try stuff that doesn’t fit in with PHD.
            I did read somewhere on this blog I think Paul suggest that someones varicose veins may have improved due to intermittant fasting. After a year of poor health/weakness I am feeling better in general and more able to do IF for longer periods so hopefully that will help too 🙂
29. nina June 23, 2015 at 6:11 pm

    hi,

    I asked this question before and was hoping for Paul to answer but not sure how to email him. I started to incorporate a bit of starches in my diet but gained 2lbs. I am perimenopausal and have now gained 8lbs in the last year. That’s a lot for me as I am petite and also eat clean and exercise. I was told my thyroid is sluggish and was given a thyroid supplement and xanthi trim but after a month gained 2lbs. Each time I change doctors (mostly holistic) they suggest a new thing and I always end-up gaining weight. I don’t know what to do. Paul can you please address this? thank you.

    Reply
    • Paul Jaminet June 24, 2015 at 7:50 am

      Hi Nina,

      You should check out my AHS talk on weight loss for some of the key factors in weight regulation. Tending to thyroid health and gut health are important. So is intermittent fasting, circadian rhythm entrainment, and overall nutrition. It is hard to troubleshoot what you are doing from afar because so many factors can influence weight. If you have time, consider coming to our health retreat, I’m sure we can work it out.

      Reply
30. Eric June 24, 2015 at 7:00 pm

    Hi Paul,

    A relative of mine (who is not following PHD) has been diagnosed with melanoma, and is asking for advice. Which 3 or 4 (say) aspects of PHD do you think are most important in such a case? (I don’t want to overwhelm with suggestions.)

    Thanks!
    Eric

    Reply
    • Paul Jaminet June 24, 2015 at 7:12 pm

      1) Circadian rhythm entrainment 2) Intermittent fasting 3) Balanced nourishing calorie-minimizing diet

      Reply
    • Darrin June 24, 2015 at 8:50 pm

      I have read that being vitamin D replete can be protective against melanoma…
      Perhaps look in to this to assist with treatment as well…
      & have your friend get their d3 blood level tested

      Reply
    • Darrin June 24, 2015 at 9:38 pm

      Pehaps that should read ‘…could be protective’ (not sure if it’s been proven)

      Reply
31. D June 25, 2015 at 5:04 pm

    Hello, I would be grateful for advice on how to handle familial hypercholesterolemia (heterozygous). My triglycerides are normal, total cholesterol, and LDL particle numbers are very high, beneficial HDL particle number was too low.

    I have never been on medication for it, but my current doctor has me on high dose fish oil, niacin, red yeast rice, and CoQ10.

    I am on a restricted diet do to a combination of factors, including allergy, doctor’s advice, and kidney stones. No dairy, grains, soy, processed food, cured meats, nightshades, or beans. And I’m following a low-medium oxalate diet due to kidney stones (no more shown on CT scan, thankfully).

    Thank you.

    Reply
32. Peter June 26, 2015 at 4:58 pm

    My experience: 2 months of IF – The Good and the Bad
    Hello,
    I started IF on April 28. It was pretty easy – I simply skipped BF and ate lunch around noon. Every so often, work would get in the way and I’d eat between 1-2. Regardless, I did not uncomfortably hungry at any point.
    The Good
    Lost weight – from 192 lbs to 185 lbs. This was effortless!
    Muscle definition – noticeably cut and liking it, belt became loose and pants felt bigger
    Reduced inflammation – i can tell when inflammed by how my feet feel in my shoes. During IF, the shoes felt big for my feet. Also no itching and sweaty feet
    Alertness – My mind felt sharp all through the day
    Less fatigue – not really high energy, but I could stand all day at the office (standing desk) with no fatigue
    No bloating – not flat stomach, but no uncomfortable bulge

    The Bad -started around the 4-5th week
    Low mood – this was rather subtle. By the 4th week or so, I didn’t feel like going out much, just generally coasting by
    Irritability – minor annoyances would get to me
    Dry skin and hair, constipation
    Flat energy at the gym – no strength to push my usual weights and no elation after gyming as I’m used to
    Low libido – even after a week, there was no strong urge as usual. No night time erections either
    Sleep – this is a biggy – Although I maintained by lunch and dinner carb portions (Chipotle rice serving each meal -sorry Paul, I haven’t given up beans), I wouldn’t get sleepy even past midnight. I had the tired but wired feeling. I’d wake up groggy and tired. Also got that tired, huggard look with circles under eyes. I noticed some gyno, which was a definite sign that I wasn’t getting good sleep and my hormones were getting out of whack. That’s when I decided to stop.

    I resumed breakfast this Monday, June 22nd. My breakfast is a simple half a sweet potato and one or two egg yolks. By Wednesday, I was halfway back to my old self. Went to the gym and came out happy and whistling, and literally dozed off at 10:30pm. Morning tumescense is also back. Unfortunately, I’ve also noticed I’m getting tired standing at work and my feet are back to swollen and sweating. Inflammation is back. My weight will likely creep back up too.

    In analysing “The Bad”, I’ve concluded IF pushed me into Adrenal insufficiency – not my first Rodeo. I’ve gotten these same symptoms before on low cab/calorie restriction. Specifically for a one year period when I ate boiled veggies and eggs for breakfast. It seems that I need the breakfast, and carbs at that, to set my circadian clock and also keep my adrenals from working hard to keep up the energy. I hate to lose all the benefits I saw with IF but I cannot risk adrenal insuffiency and the other ill effects above. Could it be as Paul says that dietary restrictions only work so long before they become counter productive. Any thoughts?

    Reply
    • Paul Jaminet June 26, 2015 at 8:56 pm

      Hi Peter,

      You might find that if you ate more during the feeding window, you’d make it through the fast better. Possibly you were undereating.

      Another alternative is, instead of eating breakfast, eat vegetables (for potassium), salt, and water during the fast. This will relieve adrenal stress, but with few calories so it won’t affect the fast much. Say, a tomato with some salt before bed and after waking; celery in the morning.

      Reply
      • Peter June 26, 2015 at 11:22 pm

        Thanks for the tips Paul. I will try this for a couple of weeks, see how it goes with the additional food in the feeding window and the vegetables during the fast.

        Reply
33. luiza June 27, 2015 at 9:27 pm

    Hi Paul, Ive read your book and been following the diet and taking the recommended supplements. My question is..what do you think about Chris “the Kiwi” super greens?? Should I also take it in the morning or following the diet and the supplements (every morning I take magnesium, potassium/iodine and K2 mk7 and once a week panthothenic acid, zinc,biotin and b12). All in the recommended dosage

    Reply
34. Alberta June 28, 2015 at 1:43 am

    First, my apologies for posting my question earlier today with a scallops recipe. At the time I couldn’t find this Q&A section of the site. I want to try the recipe, if I can get past my concern of eating anything that comes out of the Pacific Ocean (I live on the West Coast) which brings me to my question:

    SOMETHING (radiation? pollution? both? other?) has to be causing all the weird die-offs and ocean life-forms affecting issues. If we don’t know what is causing it and/or cannot/have not corrected the problem(s) then how do we know it won’t affect/infect us, too? 😥 Isn’t it better to not eat it rather than take chances?

    Would you please explain why you feel it’s still safe to eat seafood? I really like seafood – fishes & shellfish and seaweeds…used to eat it 5X/wk – but I rarely eat it any more. I really miss it. 🙁

    BTW: found your AHS15 presentation on YouTube – It was great! Thanks to you (and AHS?) for allowing it to be viewed publicly. 🙂

    Reply
    • Paul Jaminet June 28, 2015 at 11:25 am

      Hi Alberta,

      All creatures have internal mechanisms for excreting toxins and maintaining homeostasis — i.e. a normal healthy state of tissues. As long as those mechanisms succeed, the animals are safe to eat, even if their environment has some toxins. Generally speaking, die-offs of oceanic life are rare, and are food is obtained from places that do not and have not experienced them. Transient problems do come up, such as algal blooms or pollution events such as Fukushima, but these are fairly rare.

      I am convinced that most seafood is highly safe. I wouldn’t have top of the food chain seafood like tuna or shark or swordfish very often, but lower food chain species should be fine. I don’t think seafood 5x per week is a problem.

      Best, Paul

      Reply
      • Alberta June 29, 2015 at 2:27 am

        Wow! That was fast! Thank you, Paul for your reply! 🙂

        Scallops are one of my favorites! 😀

        Reply
35. Zoltan June 30, 2015 at 5:07 am

    Hi Paul – I have recently learned that I have a condition called OAT syndrome, meaning reduced fertility due to a combination of low sperm count, impaired motility and suboptimal cell morphology. In my semen sample they have also found the bacterium Staphylococcus aureus, but my doctor dismissed that as contamination. (My semen quality is still good enough for in-vitro fertilization, which is what we are embarking on.) However, I have read that according to recent research, Staphylococcus aureus can actually CAUSE infertility in males (and females too). Given that my doctor thins it’s just sample contamination, he would, of course, not prescribe any antibiotics to deal with the bacterium, and it would be hazardous / irresponsible of me to start taking antibiotics on my own; so I thought I would seek out alternatives and stumbled upon berberine, which is found in goldenseal and Oregon grape root, among other plants. Have you heard of anyone successfully deal with bacterial infections using berberine supplements? If so, which way do I go – pure Oregon grape root powder, extracts in capsules, or tinctures? What would the recommended dosage be?

    Reply
    • Paul Jaminet June 30, 2015 at 10:08 pm

      Hi Zoltan,

      I’m afraid I don’t know much about this. I’ve never looked into natural antibiotics.

      Reply
      • Zoltan July 1, 2015 at 11:41 am

        OK – thanks for taking the time to reply, Paul.
        Much appreciated!

        Reply
36. Susan July 5, 2015 at 4:56 pm

    Hi Paul, I’ve got a dilemma. I went on a very low carb diet for high blood sugar. My blood sugar did indeed come down, but I started getting sicker and sicker. I believe I have a brain infection, which I have started treating for, and it seems to be helping. I read your book, and am trying to add some safe starches back into my diet. However, if I try to add very much, my blood sugar starts going back up. I do add apple cider vinegar and fat to my rice and eat it with protein and veggies, but I still can’t manage very much without my blood sugar going up. Do you have any suggestions for how I might raise my rice consumption without raising my blood sugar too much?

    Reply
    • Paul Jaminet July 5, 2015 at 5:36 pm

      Hi Susan,

      Have you been diagnosed with diabetes or pre-diabetes? These are difficult conditions and it is best to address them with a holistic approach that deals with many important factors. My best advice would be to come to our health retreat. If that’s not possible, address small intestinal health first.

      Reply
      • Susan July 5, 2015 at 7:01 pm

        Thank you, Paul. I haven’t been diagnosed, because I can’t afford a doctor and am trying to do all of this myself. However, before I started low carbing, my blood sugar was consistently around 200, with fasting being the highest. I would love to attend your retreat, but it is not possible right now. Could you maybe suggest how to go about addressing small intestinal health, and maybe just briefly touch on the factors you think are the most important? I really appreciate all that you do!

        Reply
37. Hanna July 6, 2015 at 9:34 am

    Hi Paul,

    I just started the PHD last week with, so far, amazing results. I still haven’t added in all the supplements, but I cut grains and sugar (which I’ve been slowly working up to for a while), starting eating 3 egg yolks a day, doing the intermittent fasting (something that comes naturally to me!), flavoring with the right oils, and creating the right meal proportions (oh, and cooking seaweed). My acne is vanishing, my hair feels softer and is falling less (my most distressing symptom) and I’ve just felt so POSITIVE.

    *I was doing a lot “right” already, but somehow your specific suggestions were the fine-tuning I needed. Thank you!

    My question is about eggs. You may have answered this for someone else but there are a lot of comments on the site that I haven’t scrolled through. What’s the deal with the whites? Can I eat my yolks with my whites too??

    Thanks,
    Hanna

    Reply
    • Paul Jaminet July 6, 2015 at 10:11 am

      Hi Hanna, that’s great to hear!

      We recommend discarding the whites because they provide little nutrition apart from protein, and are a food sensitivity and autoimmunity risk since egg white proteins can act as adjuvants for other molecules. Use a bit of meat or fish to replace the whites if you want protein.

      Best, Paul

      Reply
      • Eric July 7, 2015 at 9:17 pm

        Hi Paul,

        In the past, you said that egg whites were okay as long as they were cooked (http://perfecthealthdiet.com/2011/10/bi-bim-bap/comment-page-1/#comment-34372). Cooking will denature the main egg protein (ovalbumin); however there are other proteins which might survive cooking (e.g. ovomucoid), which are possibly of concern?

        So: Is your caution just towards uncooked whites, or do you now think we should be also be cautious of cooked whites? If so, what level of caution is appropriate? (Do egg whites belong with grains and legumes; or do you just think it is unwise to eat three egg whites along with the three egg yolks every day?)

        Thanks!
        Eric

        Reply
      • Eric August 1, 2015 at 8:12 pm

        Hi Paul,

        Following your comment, I decided to look into egg whites; here is what I learned:

        The only propsed mechanisms for how egg whites could be problematic that I could find were (do you know of any others?):

        * Presence of digestive enzyme inhibitors (ovomucoid, ovoinhibitor, etc.).

        * Certain egg white proteins (ovomucoid, ovomucin) are immunogenic.

        * Lysozyme in egg whites can complex with other proteins (due to its high isoelectric point), leading to autoimmunity.

        * Low nutrient density.

        I think it is clear from the literature that ovomucoid is immunogenic, and resists cooking and digestion. But so are proteins in many other foods we eat (dairy, tree nuts, shellfish, etc.).

        Also, egg whites are generally a low nutrient density food — although they are a good source of selenium; better, in fact, than most meats or fish (per gram of protein). But the missing nutrients could always be obtained somewhere else.

        This leaves the digestive inhibitors and potential for autoimmunity. Concern with these seems to originate from Loren Cordain [3, 4]:

        “Most problematic is the egg white protein, lysozyme… that is also found in many human tissues, including tears… even though lysozyme is a benign enzyme produced in our own bodies, when we eat egg white lysozyme, it comes as a compound attached to other egg white proteins or to gut borne bacterial proteins foreign to our bodies… Because egg white protein contains high concentrations of protease inhibitors (ovomucoid, ovoinhibitor, ovostatin, cystatin), the human gut proteases (trypsin and chymotrypsin primarily) are less effective in degrading egg white proteins, and lysozyme/egg white protein complexes… When these chimeric (monster) molecules breech the gut barrier via their net positive charge and enter circulation, they have the capacity to promote allergy and autoimmune disease.”

        “Lysozyme is heat stable in acidic solutions (ergo the intestinal tract), having been reported to withstand 100 degrees C with little loss of activity… so yes indeed lysozyme would survive any normal cooking procedures used for eggs.”

        First of all, these digestive enzyme inhibitors evolved to protect the egg from bacteria, not to protect the egg from mammals (unlike legume trypsin inhibitors which evolved to protect legume seeds from mammals) — so it is thus unsurprising that the two main egg white inhibitors do not show activity against human trypsin [1]:

        “Human trypsin was strongly inhibited by… lima bean trypsin inhibitor… inhibited to varying degrees by… soybean inhibitor, kidney bean inhibitor, black-eyed pea inhibitor, navy bean inhibitor… essentially uninhibited by… potato inhibitor, chicken ovoinhibitor, and 10 avian ovomucoids including that of chicken.”

        I could not find whether the other digestive inhibitors had activity against human trypsin, probably because their concentration in egg white is an order of magnitude lower than the main ones and so they are less-studied. But the protein digestibility of cooked eggs is around 91% [6]; for comparison, this is lower than almost every other animal protein, but higher than almost every vegetable protein.

        Second of all, the thermal stability of lysozyme is due to its disulfide bonds — but the pH of egg whites exceeds the pKa for the thiol groups of ovalbumin (the major egg white protein), so thiol-disulfide exchange will occur upon heating. From [2]:

        “Lysozyme is remarkably stable to heat in acid solution… [but] it is quite unstable to heat in egg white… the inactivation reaction appears to involve the reduction of one or more of the -S-S bonds in lysozyme by the -SH of ovalbumin… From the foregoing evaluation of available data it is estimated that heating pH 9 egg white for 3.5 minutes at 62 C will alter… 90 to 100 percent of the lysozyme.”

        It might be wiser to make eggs hard-boiled (as opposed to scrambled), since mixing the yolk into the white could lower the pH of the egg white below the pKa for the thiol groups of ovalbumin (making lysozyme more thermally-stable). Use in baked dishes might also be okay, provided the batter is not acidic and is cooked very thoroughly (in particular more thoroughly than eggs are typically cooked in a fry pan); even down to pH 7, the denaturation of lysozyme is irreversible and occurs under 80 C, c.f. [5]. (It is only at acidic pH that the heat-stability of lysozyme is remarkable.)

        Regardless of the above optimism, I would still like to do an elimination trial to see whether eliminating egg whites improves any of my existing health conditions (asthma, acid reflux). Do you think 30 days would be long enough to see an effect, or would longer be better? If so, how long do you think would be advisable?

        Also, I would be curious to hear your general opinion of the above analysis. In particular, do you still maintain that for healthy individuals, the issues with egg whites are of noticably greater concern than the omega-6 fats in poultry or the Neu5Gc in red meat?

        Thanks!
        -Eric

        References:

        [1] http://www.jbc.org/content/244/8/1957.full.pdf

        [2] https://ia801009.us.archive.org/23/items/heatstabilityofe7439line/heatstabilityofe7439line.pdf

        [3] http://thepaleodiet.com/lysozyme-clarification/

        [4] http://thepaleodiet.com/paleo-diet-q-a-29-january-2010-update-on-eggs/

        [5] http://www.ncbi.nlm.nih.gov/pubmed/23774197

        [6] http://jn.nutrition.org/content/128/10/1716.full

        Reply
        • Paul Jaminet August 1, 2015 at 10:06 pm

          Hi Eric,

          Nice analysis as always. However, it’s easy to overlook possibilities. For example, one I’ve written about previously is the possibility of plant lectins such as wheat germ agglutinin acting as adjuvants to induce an allergic response to egg ovalbumin. See Lavelle EC et al. The identification of plant lectins with mucosal adjuvant activity. Immunology. 2001 Jan;102(1):77-86. http://pmid.us/11168640. This is significant because an allergy to ovalbumin is a standard animal model for asthma, see http://www.ncbi.nlm.nih.gov/pubmed/?term=ovalbumin+induced+asthma or http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2590830/ for a specific paper.

          There is also the issue of compounds in chicken feed making their way into the egg white, the Weston A Price Foundation has written about this, http://www.westonaprice.org/health-topics/the-soy-ling-of-america-second-hand-soy-from-animal-feeds/.

          I agree that an elimination trial can be diagnostically helpful if you have overt symptoms like asthma. Yes, 30 days should be sufficient, as long as you have asthma symptoms regularly.

          It is not so much that egg whites are more likely to cause harm, as that they are relatively nutritionally empty so there is not much loss to discarding them.

          Best, Paul

          Reply
          • Eric August 2, 2015 at 4:12 pm

            Hi Paul,

            Thanks for your response!

            I don’t think the article from WAPF really suggests a specific concern with egg whites, as opposed to a concern with poultry products in general; from the article:

            “This team fed Japanese quail rations supplemented with the soy isoflavone genistein, and reported the isoflavone genistein and its metabolites in the egg yolk, but not in the white.”

            The ovalbumin/asthma connection you pointed out is interesting. I’ll have to read more about that, and I might write back to you later if I have additional thoughts about it.

            Reflux symptoms occur regularly, but asthma symptoms are quite intermittent (as a result of daily medication). I haven’t decided yet what to do about the intermittency of asthma symptoms for the elimination trial; I might either extend the elimination period longer, or use biomarkers for the asthma like PEF instead of symptoms.

            Best,
            -Eric
        • susan August 2, 2015 at 1:26 pm

          Grain-free and ancestral diets aside, I wonder if this is why some people find it’s okay to eat bread that contains egg, but not to eat whole cooked eggs. In bread the egg quantity per serving would of course be de minims, but to your point, they would be baked at presumably 300-350F.

          Also, I haven’t seen this book yet, but it’s been touted as excellent by many folks, including MDs, in Functional Medincine: The Elimination Diet by Tom Malterre. I’ve heard him speak on the online health summits, and he’s very smart. That might be a good book to look at if you’re trying to identify allergens. Again, I haven’t looked at it yet, but you might be able to browse it on Amazon to see if it’s on point for you.

          Reply
38. Jessica July 6, 2015 at 3:57 pm

    Thank you for all your amazing work! I have been on the PHD for 8 months and just had my cholesterol levels checked. The results: 6.0, LDL 3.2 and LDH 2.49. In general terms this is considered high. My cholesterol was last checked about 10 years ago and I remember it was a little high then as well. Do you see any concern here? Any need to adjust my diet? Or is my cholesterol level likely to get lower as I continue with the PHD? (I guess I am still a little stuck in the old saturated fat-raises-cholesterol thinking).
    And once I’m at it, any advice on treating a leaky gut and yeast syndrome?
    Thanks a million!

    Reply
    • Donna July 6, 2015 at 4:22 pm

      My cholesterol (total and LDL including oxidized LDL) were high and went even higher (very) on PHD. It’s been 2 years and it still has not come down on PHD, intermittent fasting, supplements, etc. I’ve even stopped eating eggs except for rarely and take a choline supplement instead. I’m on 1,100 Cal / day – I gain weight on 1200…

      Reply
      • Paul Jaminet July 6, 2015 at 6:26 pm

        Hi Donna,

        It’s impossible to diagnose this from afar. It’s possible you are eating too little to maintain gut barrier integrity and have an endotoxemia. Check your iron, make sure you don’t have iron excess, and check for hypothyroidism, if you have even subclinical hypothyroidism get it treated.

        Best, Paul

        Reply
    • Paul Jaminet July 6, 2015 at 6:41 pm

      Hi Jessica,

      Total cholesterol of 6.0 mmol/l = 232 mg/dl is perfectly normal, LDL of 3.2 mmol/l = 124 mg/dl is perfectly normal, HDL of 2.49 mmol/l = 96 mg/dl is a bit high but healthy. You could eat a little less fat to bring down the HDL, but overall this is a normal and very healthy profile. Triglycerides should be low, in the vicinity of 0.6 mmol/l = 50 mg/dl. If you have that too you are perfect.

      General PHD advice and supplements should work for leaky gut and yeast.

      Best, Paul

      Reply
      • Dee July 7, 2015 at 2:02 pm

        Hi Paul,

        Sorry for tacking my question on, but thought there might be a better chance of you seeing it here.

        Strong family history combined with my own numbers has resulted in all my doctors telling me I have familial hypercholesterolemia.

        I’d be grateful for dietary/supplementation recommendations. I don’t use statins or other prescription medications.

        My diet is restricted due health reasons including allergy/intolerance, kidney stones, and my doctor’s advice. No dairy, grains, soy, legumes (other than green peas), processed food, cured meat, or nightshades. And I stick to low and medium oxalate foods. I added coconut products to my diet over the last two years, and now my total cholesterol and LDL are much higher than what was normal for me. Which wasn’t normal to start with.

        Thank you.

        Reply
      • Jessica July 9, 2015 at 3:52 pm

        Thank you so much! My triglycerids are 0,53, so this is all in order :0)

        Reply
39. Elima July 7, 2015 at 1:46 pm

    Hello Paul

    A friend of mine, a 51-year-old woman, has just had surgery for bowel cancer. She has always been extremely thin and has lost a lot more weight because of her illness so now weighs only 48 kg. (She is at least 5 feet 7 inches tall.)
    She has been advised to eat 5 or 6 small meals a day to get her weight up and has been positively encouraged to eat biscuits (cookies) and chocolate. I can’t help feeling this is a very bad idea. She has trouble eating that many meals a day and I suspect that what she does eat consists mainly of sugary foods.
    Do you have any suggestions as to how she can gain weight rapidly in a healthy way, preferably in a way that will stimulate her appetite?

    Many thanks in advance.

    Reply
    • Paul Jaminet July 7, 2015 at 1:54 pm

      Hi Elima,

      I agree with you, that’s a terrible diet for a cancer patient. Circadian rhythm entrainment, including time-restricted eating, is important, as is micronutrient-rich foods and non-processed natural whole foods (especially for bowel cancer).

      It’s also misguided in regard to putting on lean mass, because that depends as much on micronutrients that are lacking in biscuits as on calories.

      She should eat PHD, make it delicious, and try to eat as much as she can during a daily feeding window. Nuts, chocolate, milk, starches, fruit would be good snack foods to keep handy, so that she can be eating steadily through her feeding window.

      Best, Paul

      Reply
    • Donna July 7, 2015 at 3:14 pm

      Go to NutritionFacts.Org and search sweet potatoes colon cancer. He (Dr. Greger) presents very interesting research on the benefits of boiled, skin on sweet potatoes (I use organic ones) for this disease.

      Reply
    • Claire October 21, 2015 at 9:17 am

      Some great cancer help info here: http://www.victory-over-cancer.org/book/

      Seems to be all about micronutrients needed to prevent and eliminate cancer.

      Reply
40. John D. July 7, 2015 at 5:36 pm

    Hi Paul, hoping you have a moment where this catches you. I’ve been “on” the PHD for four years, but have concerns over my thyroid/TSH:

    Since going PHD I’ve had a TSH between ~3 and 4. Last week it measured at 4.17 — highest ever — despite my increasing daily carbs over the past year to at least 150g. A year ago my TSH was 2.91. I’m trying to check all of the boxes, including the supplements (including 1x/week selenium, 225mcg daily iodine down from much higher doses 2-3 years ago); reheated potatoes for RS; egg yolks; daily intermittent fasting. I do not eat fish but take copper, and have fish oil 1-2x weekly.

    I’ve also increased my total calories in the past year out of frustration that, as a 5’10” 165-lb 36-year-old who lifts weights (HIT-style), I could only seem to maintain my weight at 1600-1700 calories a day. I figured that a decade of eating too little was probably terrible for my metabolism. Eating around 1800-2000 calories per day has resulted in 10-15lbs gain over the past six months (I’m now 175+), despite not much noticeable muscle additions or lifting improvements.

    I don’t feel low-energy, but I do:

    * sleep poorly — restless and rarely more than 6-7h (I succumb and take Benadryl regularly)
    * have poor moods/depression and have become an introvert over the past half-decade
    * have infrequent bowel movements (~2-3 times a week)
    * gain wait easily (per above)
    * live a pretty stressful life

    I am making endocrinologist appointments to get a full thyroid lab done, and I assume I will finally try levothyroxine, but from experience I expect very little usable advice from my to-be-endo. (Last time I tried I got “eat a low-fat diet.”)

    I am hoping you can spare two thoughts, specifically:

    * Can levothyroxine be a helpful/temporary assistance alongside PHD? You’ve been pro-levothyroxine in other comments, but I am concerned given the huge variety of opinions on thyroid meds.
    * is there something else I could be doing so that meds aren’t the only thing I’m riding on? Or could a jolt of T4 and continuing to eat an appropriate amount be sufficient over a longer term?

    Thanks so much!

    Reply
    • Darrin July 7, 2015 at 8:50 pm

      I’d be interested to hear comments from Paul on this as well.

      My tsh numbers have followed a similar pattern to yours John.
      I stopped the iodine completely since my last blood test. Tho I do still eat seaweed, via sushi.

      I have not retested yet, & when I do, I will get tested for thyroid antibodies as well.

      Reply
      • John D. July 8, 2015 at 12:01 am

        Darrin, interesting/perplexing. I previously went through long periods of high iodine intake — up to 12.5mg daily, alongside daily selenium — and throughout my TSH was in the 3s. If anything my slow-rising TSH correlates to a decrease in iodine. Hoping Paul can weigh in.

        Reply
        • Paul Jaminet July 11, 2015 at 6:47 pm

          Hi John,

          It’s not uncommon for that pattern to occur. When iodine is scarce, the thyroid grows (goiter), and when it is abundant, the thyroid shrinks. While you were taking 12.5 mg/day, the thyroid shrank. Now it may be a little too small and needs higher TSH to get it to make enough thyroid hormone. Don’t worry, it will grow back. Just stay at 225 mcg/day iodine.

          Reply
    • Paul Jaminet July 11, 2015 at 6:44 pm

      Hi John,

      Well, it seems clear there’s something wrong in your gut leading to inflammation, depression, weight gain, and constipation.

      Most of the keys you are doing, but be sure to eat liver or supplement vitamin A, optimize D/get sunshine, supplement vitamin C, taurine, and eat lots of extracellular matrix or supplement glycine, and include acids like vinegar in your food and water. Circadian rhythm entrainment and intermittent fasting are also important. So are the egg yolks.

      I do think levothyroxine would help you, as you have some symptoms of hypothyroidism and it usually does help at that TSH.

      Best, Paul

      Reply
      • Donna July 11, 2015 at 11:21 pm

        Paul, how much Vit A do you recommend taking, bearing in mind I have osteoporosis and have been advised not to overdo the Vit A.?

        Reply
        • Paul Jaminet July 12, 2015 at 7:58 am

          Our standard recommendation is 1/4 lb liver per week which works out to 40,000 to 50,000 IU per week of preformed A, plus eating lots of carotenoids (green leafy vegetables and orange plants like carrots, sweet potatoes, persimmons) to reach the 100,000 IU/week of animal A that we think most people need. If you don’t eat liver, I would supplement some. It will be safe to go up to 70,000 IU/week or 10,000 IU/day with no liver in your diet.

          Reply
          • Eric July 12, 2015 at 12:49 pm

            Hi Paul,

            At (http://perfecthealthdiet.com/recommended-supplements/), you say that 1/4 pound chicken liver plus chocolate (presumably for extra copper) can replace the 1/4 pound beef liver. But I think that works out to significantly-less preformed vitamin A than 1/4 pound of beef liver; so is there a reason not to eat 1/2 pound chicken liver plus the chocolate (or other copper-rich foods)?

            [I ask because I’ve been tracking my intake of all nutrients, and comparing them to the PHD ranges; I find that with beef liver in the diet, my copper intake averages to around 4–5 mg per day. So recently, I’ve switched to chicken liver to bring copper intake back to around 2–3 mg per day, which I understand is the recommended dose.]

            Thanks!
            Eric
          • Donna July 31, 2015 at 10:08 pm

            Hi Paul. Is your Vitamin A recommendation the same if I have osteoporosis? MDs have warned me not too have too much Vit A as it evidently has been shown to further reduce bone density?
      • Donna July 12, 2015 at 7:30 pm

        I’m allergic to vinegar (anything with mold – lots of stomach pain) and in general have to limit acid (like lemon) in moderation for the same reason. What would you suggest I do because I likely do not have sufficient acid iin my diet?

        Reply
        • Paul Jaminet July 12, 2015 at 7:48 pm

          Hi Donna,

          Get purified white vinegar, there shouldn’t be any yeast fragments in there. Also, support glutathione and bile with glycine, N-acetylcysteine, vitamin C, taurine.

          You can also use vitamin C as an acid, and lemon juice and lime juice.

          Reply
          • Donna July 12, 2015 at 9:21 pm

            It’s not just the mold. The acid in purified vinegar and any vitamin C supplement(even liposomal) hurt my stomach. I take a digestive enzyme with bile, 3,000 NAC / day, taurine, glycine and probiotics daily.
      • John D. July 30, 2015 at 1:04 pm

        Hi Paul, thanks as always for your reply. Will keep on keeping-on with your recommendations.

        I’ve also started a low dosage (25mcg) of lexothyroxine. I’m a few days in and feeling worse somehow — very sluggish, sore throat — but will try it for a couple more weeks to see if I pull through.

        Reply
41. Gustavo July 8, 2015 at 5:46 am

    Hi Paul,

    Quick question:
    How a diet like yours is not fattening since the combination of starches and fats seems to stimulate the most the pathways involved in fat storage, even when there’s no daily energy excess (insulin, asp, gip)?
    And don’t they interfere with each other for the generation of energy?

    Your work is excellent and I learned a lot from it so far.

    Have a great day!

    Reply
    • Paul Jaminet July 8, 2015 at 8:01 am

      Stimulating hormones transiently at a meal is not a cause of weight gain. No, they don’t interfere with each other. Our bodies are not so fragile that we have to avoid eating starches with fats.

      Reply
      • Gustavo July 9, 2015 at 7:48 am

        Paul, the only practical way to thank you for being so thoughtful by answering reader’s questions is by purchasing at Amazon via your page.

        Wish you a great day!

        Reply
42. David July 8, 2015 at 8:28 pm

    Hi Paul,
    What do you think of these store bought sources for liver? Thank you.

    Liver sausage: pork liver, pork, salt, onion, spices, sodium nitrite. 82% fat, 15% protein, 3% carb

    Pate: duck liver, chicken fat, port wine, eggs, corn starch, pepper, salt, sugar, spices. 87% fat, 9% protein, 4% carb

    Reply
    • Paul Jaminet July 9, 2015 at 2:15 pm

      Make sure the pork liver sausage is well cooked (boil in water long enough to raise the internal meat temperature to at least 170 F) as pork liver can carry hepatitis E. Duck liver pate is safer, so far as we know.

      Reply
43. Dee July 8, 2015 at 11:50 pm

    I am wondering if there are alternatives to the “safe starch” items listed on your diet chart? Every item on there is out of my diet, either due to oxalate content (I’ve had kidney stones), or my functional medicine doctor taking me off them.

    I eat butternut and kabocha squash, they seem to be the only starchy items left in my diet.

    Thank you.

    Reply
    • Paul Jaminet July 9, 2015 at 2:12 pm

      Hi Dee,

      I have to question removing all those starchy foods. Oxalate kidney stones are more commonly due to internally generated oxalate from oxidative stress than from food oxalate. I don’t know why your functional medicine doctor would take you off white rice or potatoes. Squashes are good, but they have very few calories per pound, so you would need to eat a lot.

      Reply
      • Dee July 9, 2015 at 4:53 pm

        Hi Paul,

        Thanks so much for the response. I’ll have to eat more squash!

        I realize several factors could have contributed to my stones. My understanding is that endogenous production is usually connected to a B1 or B6 deficiency (commonly caused by oxidative stress). Any more light you can shed on that?

        After cutting gluten from my diet about two years ago, I started eating extremely high oxalate without realizing it. Since I had great success after I lowered the amount of oxalate in my diet (I passed three more large stones on my own within a few months), I am not comfortable going back to high oxalate foods at this time.

        I have wondered if vitamin D3 supplementation also contributed, I was taking from 2000-5000 IU daily for many months. I quit after the kidney stones, but then my doctor put me on 10,000 IU (which includes a small amount of vitamin K2).

        She initially didn’t take me off of rice, but later it was one of the foods she said to eliminate and watch for improvement. I actually don’t like it much, I always preferred brown. But the consensus seems to be that brown isn’t good because of phytates, etc. The only time I ate white rice in any quantity was after the kidney stone diagnosis. It seemed to cause some bloating most of the time, and I always felt as if I needed to eat more of it to feel full (compared to brown rice).

        I’m not sure why she eliminated potatoes, but I wasn’t eating them anyway.

        I have been trying to figure out my diet for quite a while. I’m dairy-free due to allergy, grain-free, soy-free, no cured meat, no processed food, no refined sugar, no white potatoes, no legumes (except green peas), and low-medium oxalate. And I still try not to eat too much cholesterol (even though that flies in the face of all the newer information), because I have familial hypercholesterolemia, and my ratios are many times what they’re supposed to be (other than triglycerides which are normal).

        I am quite thin, my blood sugar is always normal, and my insulin level was just barely above ideal by functional medicine standards, according to my doctor. My rT3 level was too high, so she put me on natural dessicated thyroid, but I couldn’t tolerate the lactose in the pill. I’m going to find out about getting compounded medication.

        Thanks for anything you can add.

        Reply
        • Dee July 11, 2015 at 8:44 pm

          Paul,

          Sorry for the long reply.

          Would you recommend lowering or avoiding the D3 supplementation in light of my kidney stone situation?

          Thank you.

          Reply
          • Paul Jaminet July 11, 2015 at 8:50 pm

            Hi Dee,

            In general, it’s a bad idea to ever take more than 4000 IU/day of vitamin D, and that’s if you don’t get any sun. If you do, don’t take more than 2500 IU/day.

            If you have any doubt about dose, get your serum 25OHD measured. You want to aim for 40 ng/ml (100 nmol/l).

            If rT3 is high, you may be too low carb.
      • Dee July 9, 2015 at 6:30 pm

        I forgot to say the rT3 was tested when I was still eating rice.

        Thanks.

        Reply
        • Dee July 12, 2015 at 12:31 am

          Thank you so much Paul. I was uncomfortable with the 10,000 IU. I did ask to have 25 and 1,25 OH measured, but my doctor saved the lab order for our next visit.

          I’m still trying to figure out carb intake. I’ve been eating quite a bit of fruit since I had to eliminate so many other foods. Trying not to overdo it, though.

          Reply
44. John D. July 10, 2015 at 12:47 pm

    Paul, sorry to bug, just wondering if you have any thoughts on my (overly long) and Darrin’s comments above

    * high-ish TSH (3-4+) even after a few years of PHD
    * value/validity of levothyroxine to guide this back down?
    * any other recommendations?

    thanks as always!

    Reply
45. John D. July 10, 2015 at 12:47 pm

    Paul, sorry to bug, just wondering if you have any thoughts on my (overly long) and Darrin’s comments above

    * high-ish TSH (3-4+) even after a few years of PHD
    * value/validity of levothyroxine to guide this back down?
    * any other recommendations?

    thanks as always!

    (sorry, used wrong email address before)

    Reply
46. David July 11, 2015 at 4:37 pm

    Hi Paul,
    Do you believe there is a sweet spot (range) for leptin, or is lower always better? Thank you.

    Reply
    • Paul Jaminet July 11, 2015 at 6:17 pm

      There’s always a sweet spot.

      Leptin deficient mice are notably unhealthy. http://www.ncbi.nlm.nih.gov/pubmed/17130477. So leptin serves a crucial function.

      Reply
      • David July 11, 2015 at 6:41 pm

        Hi Paul,
        The leptin lab reference range “normal” is 0.2-25.2 ng/ml.
        Have you ever looked into whether the sweet spot is a narrower range? Thanks.

        Reply
        • Paul Jaminet July 11, 2015 at 6:51 pm

          I haven’t looked into it and the optimum probably varies between persons.

          Reply
47. Delphine July 12, 2015 at 4:43 pm

    Hi Paul
    I am not sure I am leaving my questions where it has the best chance to be answered but hopefully you or someone able to help will see it
    I am 41 years old, female, from Europe (diet high in grains and dairy most of my life)
    For years I suffered from depression and compulsive binge eating. Through intense therapy and diet adjustments I am now much better but sadly paying the price of many years of erratic diet.
    I am now stuck with gallstones, severe IBS, water retention, and PCOS.
    The last six months I gained 15 to 20 pounds ( I do not weigh myself) for no rational reason…, mostly around my waists and hips.the PHD completely makes sense to me as my brain and organs seem very depleted in essential nutrients from years of restriction/ binge cycle.
    I am currently taking: a multi vitamin, glutamine, phenylalanine, tryptophan, magnesium, vitamin C, fish oil, b complex and Berberine
    I started the PHD diet two weeks ago ( only cheated twice for a glass of wine) and my symptoms of IBS are virtually gone! My mood is up, water retention subsided quite a bit! I am concerned that I might still be eating too much fructose
    Here is a typical day:
    breakfast by 11 am: three whole eggs cooked in coconut oil, 1 slice of rice bread, a home made fresh squeeze juice with at least three different fruits or vegetables and ginger, or turmeric
    Lunch by 4 pm: organic beef or chicken or fish, a small sweet potato or plantain or 1/2 cup white rice, lots of spice , garlic and onion
    Dinner by 9 pm mostly veggies ( soups, stir fry)and kefir, some raw nuts
    Once a week I have broth with bones and joints.
    On occasion fruit in the afternoon ( a cup of cherries or two slices of cantaloupe or berries). And about two liters of water a day
    Am I having too much fruit??
    I have not seen any noticeable weight loss yet.Although I am very active….

    Reply
48. Mark July 20, 2015 at 4:14 pm

    Dear Paul,

    due to an inflammed gut which responds not very well to pure oils and fat my only fat source currently is from butter and cream which are tolerated fine. I eat only lean meat and my fat intake from butter/cream is about 100-150g per day.
    Do you think this would be diametral to health long term?
    Thank you!

    Reply
49. miek July 20, 2015 at 6:18 pm

    Hi Paul I have on PHD for a few years & fast 16 hours every day & at 69 I have never felt better, my question as I cannot find any reference in your book.

    Black strap mollasis good or bad

    Reply
    • Paul Jaminet July 20, 2015 at 8:18 pm

      Hi Miek, well, we don’t exactly encourage use of sweeteners, but blackstrap molasses is good as far as they go. I’d rate it similar to honey as one of the PHD-approved sweeteners.

      Reply
50. David July 20, 2015 at 8:33 pm

    Hi Paul,
    Is it typical for LDL to increase along with HDL? It seems like both increased from eating more healthy fats. What could be a strategy for lowering LDL while keeping the HDL high? Thanks.
    LDL-HDL-VLDL
    2014 136-51-19
    2015 152-67-15

    LDL 12% higher, HDL 31% higher, VLDL 20% lower

    Apo B increase of 9%, both flagged as high
    97–>106

    Reply
    • Paul Jaminet July 22, 2015 at 6:42 pm

      Hi David,

      The HDL and VLDL are both improved, the LDL is pretty close to normal – we consider 130 optimal, anything above 150 could be a concern, above 160 is definitely a concern. I would just supplement iodine, treat any hypothyroidism, donate blood regularly, tend to gut health, and increase carbs if you are low-carb.

      Reply
      • Donna July 22, 2015 at 10:00 pm

        Been on PHD over 2 years with supplements (a little Cu, 2 Brazil nuts, 250 iodine, etc), sufficient carbs, IF, etc. LDL is 8 in CAnada which is about 310 in US. Oxidized LDL high. Iron not high. Hypothyroidism controlled with compounded meds (TSH, T3 T4 all ok). Changed to only occasional eggs (because when I added, that’s when LDL went really high) and take choline supplement instead. Still eat liver (1 oz / day – 4 oz / wk). Gut issues ok now. What’s up?

        Reply
        • Paul Jaminet July 23, 2015 at 7:36 am

          Hi Donna, Check iron status and donate blood aiming for ferritin 60-100. Supplement iodine 225 mcg/day. You probably still have some gut issues leading to an endotoxemia — so keep working on eating extracellular matrix, extra vitamin C, and other gut-improving tactics like vinegar and green leafy vegetables. Let me know how it goes.

          Reply
          • Donna July 23, 2015 at 12:31 pm

            My iron tests are fine (they won’t take my blood anyway – hx of mono, CFS). I make/consume bone broth regularly. GI won’t tolerate vit C or vinegar (or any alcohol or mold). I do take digestive enzymes and can have a little lemon juice with meals. I have been going for IV vitamin therapy every 6 weeks or so (35+ gm vit C and other stuff). I eat leafy greens daily. Thanks. Any other suggestions are appreciated. BTW, I’m not taking cholesterol lowering meds, (even though my MD repeatedly suggests it) because I have concerns about such meds (as well as osteoporosis meds [I have osteoporosis too]further depressing my immune function (among other concerns about this medication).
      • David July 23, 2015 at 1:31 pm

        Thanks Paul. The other results look good, CRP=0.4, TSH=1.0, HA1c=5.0
        I know you say that hunger is a sign of danger, I seem to be on the other side of the spectrum, sometimes I feel like a bear who could go hibernate for a while. Does it make sense to throttle back the fat intake some?
        I get most fat calories from whole milk plain yogurt, egg yolks, dark chocolate and cooking with coconut oil & ghee. I eat safe starches, fruit and veggies but probably less meat on average for PHD.

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