Q & A
This page as an open thread for reader questions, especially questions about personal health concerns.
I am putting this page up as a way to share knowledge — my knowledge with questioners, but also so that others with similar concerns can read the conversation, and readers with relevant knowledge can chip in with their own thoughts.
Please keep in mind that I can’t research questions in any depth, so my answers should be considered tentative, incomplete, and subject to later correction. Also, I am not a doctor, and nothing I say should be construed as a substitute for medical diagnosis and treatment. I am only sharing opinions about disease origins and general therapeutic strategies which may or may not be applicable in any given case.
To get the page started, I’ll put up a few questions from recent emails. Here is an index by disease, with clickable links:
- Chronic Lymphocytic Leukemia (CLL)
- Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue
- Lupus
- Depression
And here are my answers.
Chronic Lymphocytic Leukemia (CLL)
Paul,
Been following your work on the PHD before the publication of the book and commented on my CLL and the usefulness of Vitamin D once on your blog and you responded to keep an eye on my Vitamin K intake, which I do now.. Am fortunate in a way to have my form of CLL as it indolent which gives me the opportunity to experiment without the pressure of undergoing conventional treatment. The PHD, I think, is helpful in this regard.
Wonder if you could point anything out to me that may be useful. Anything at all. And I will be happy to share with you my results.
Surely you know of the helpfulness of green tea with CLL. You may not be familiar with research that points out that those with low levels of Vitamin D need treatment for CLL far sooner than those with elevated levels.
Feel strongly that your version of a ketogenic diet would be helpful but also feel I need some direction in this area. Do you have any suggestions?
Warmest Regards,
A
Hi A,
I remember your comment, thanks for writing back. I’m glad you’re enjoying our diet and wish you the best.
Thanks for the tips about green tea and vitamin D. Neither one surprises me.
Most likely CLL is caused by a viral infection. So enhancing viral immunity is probably a good idea. Good strategies may include: (1) low-protein dieting, which inhibits viral reproduction and can promote autophagy; (2) maintaining high vitamin D levels; and (3) intermittent fasting, which promotes autophagy.
Some food compounds have been reported to have antiviral effects. An example is green tea catechins, eg http://pmid.us/16137775, http://pmid.us/18313149, and http://pmid.us/18363746, and this could be why green tea is helpful against cancers, http://pmid.us/21595018, which are usually viral in origin.
I might search Pubmed for herbs and spices with antiviral effects, and use them abundantly in cooking, along with antiviral foods. Turmeric / curcumin is a good choice, this needs to be taken with black pepper to enter the body. See http://pmid.us/21299124, http://pmid.us/20434445, http://pmid.us/20026048.
Coconut oil / lauric acid also has some antiviral properties, so inducing ketosis with coconut oil could benefit you even aside from the ketosis. You could also try monolaurin supplements which may enter the body better and which some people have reported to help viral infections.
You might also try HDL-raising tactics as discussed in this series: HDL and Immunity, April 12; HDL: Higher is Good, But is Highest Best?, April 14; How to Raise HDL, April 20.
Another possible tactic is high-dose riboflavin with UV exposure on the eyes. This requires going outdoors at midday and not wearing glasses or contact lenses. Riboflavin+UV is toxic to blood-borne viruses, and the retina is a location where UV can reach circulating blood cells. Sun exposure will also help you optimize vitamin D.
That’s a few ideas, at some point I’ll do some research to come up with more and do a blog post. Do keep me posted on your results!
Best, Paul
Bloating, acid reflux, anxiety, depression, hypoglycemia, hypothyroidism, fatigue
Just came upon your website and had a question for you. I have had some health concerns for the last four years, bloating, acid reflux, anxiety, depression, hypoglycemia symptoms, female complaints (I am in my forties), thyroid antibodies at 333, weight gain around my middle and too tired to work out like I once did. I used to be fikiiled with energy and great health no depression or anxiety. My doctor thinks these symtoms are all from peri-menopause and wants to treat me with Zoloft.
Needless to say I have tried to avoid the Zoloft. I have tired every avenue out there to cure myself. Most recently the Primal type diet. When I eat no grains or dairy I get horrible hypoglycemia symptoms and don’t feel great like everyone else on a low carb diet. I feel weak and more anxious. Do you think your diet would be easier for me with the addition of rice and potatoes?
G
Hi G,
Yes, I do think our diet will be better for you. You should eat enough starches to avoid hypoglycemia.
The key thing for you is treating the infections which are consuming so much glucose and making you glucose-deficient if you don’t eat enough carbs. Whatever pathogen(s) this is, it seems to have infected your gut and caused the various gut problems; circulating pathogen-derived toxins and immune cytokines are probably responsible for the anxiety and depression. Hashimoto’s hypothyroidism may be either due to circulating toxins or a thyroid infection.
I would suspect some kind of protozoal or parasitic infection due to the hypoglycemia, but what I really recommend is getting your doctor to have a stool sample analyzed for pathogens. Metametrix has a good test. Once you know what pathogen to treat, and get on a better diet like ours, you should improve quickly.
Lupus
I am writing on behalf of my mother … We live in Dhaka Bangladesh …
Before her illness, my mom was 105 lbs, 5 feet tall and always 10ft tall in spirit…. When she was diagnosed with Lupus at the age of 30, we were all overwhelmed and out of our depths. My beautiful, athletic mother was in a wheelchair and given 6 months to live….
The doctors has advised her to eat literally nothing, minimum protein (1 small piece of chicken/fish, limited to 20g protein per day), only 2-3 types of vegetable and 2-3 fruits and of course lots of carbs to apparently compensate for her failing KIDNEY and LUPUS. She is on tons of medication, no food except the wrong foods (carbs) and in chronic pain. She currently weighs 139 lbs.
Please advise. — S
Hi S,
I believe lupus is a catch-all diagnosis for a variety of conditions which are probably caused by undiagnosed infections. In the US the infections are usually bacterial. I’ve known several people with diagnosed lupus who were cured by antibiotic treatments – in one case the problem was Lyme disease (Borrelia). I have no idea what the likely pathogens would be in Bangladesh. If she does better on low carb and coconut oil, that indicates bacteria; if she does better on high-carb, that indicates protozoa.
A healthy diet is very important. It is very bad advice to “eat literally nothing,” it is essential to be well nourished. Protein is necessary for healing and immune function, and 20 g/day is too little. Fasting is good, but it should be intermittent – not starvation! She needs healthy fats, more protein, and lots of micronutrients. Eggs, shellfish, seafood, bone broth soups, vegetable soups, and fermented vegetables may all be helpful. Coconut milk is probably good for her. You should basically follow the program in our book.
I would try to put her on a good diet, give her a little time for kidneys and other tissues to heal, and then try antimicrobial medicines. Usually, if they’re not working, then you don’t notice an effect. Any strong effect, good or bad, means they are working. Bad effects mean that pathogens are dying and releasing a lot of toxins as they disintegrate. If this occurs, detox aids (salt, water, and one of cholestyramine/charcoal/bentonite clay; also glutathione supports and vitamin C) will help.
Please stay in touch and let me know how things go.
Best, Paul
Depression
I’ve suffered from depression for decades. A few months ago, I decided to try the Dr. Kruse protocol for jumpstarting leptin sensitivity and 2 interesting things happened.
When I went very low carb – below 50 gm -. I had half-day periods where the depression suddenly lifted (something that has rarely happened otherwise). However, I also suffered from darker than normal periods.
I stopped the Dr. Kruse protocol after 6 weeks, and went back to regular paleo (approx. 200 – 300 gm. Carb/day). I’m now generally more depressed than usual, without the good periods.
These changes seem to indicate that I can have an influence on my depression with diet, but not sure what diet to try. Thoughts?
Hi Jersie,
I think your experience on very low carb is diagnostically telling.
I would interpret it this way:
- Your depression is caused by an interferon-gamma mediated immune response in the brain, probably caused by a viral or bacterial infection. This leads to tryptophan being directed away from serotonin and toward the kynurenine pathway. So you have a serotonin deficiency and kynurenine excess.
- A ketogenic diet is both therapeutic (promotes immunity against bacterial and viral infections) and mood-improving (clears kynurenine).
- However, you are at risk for hypoglycemia in the brain (especially if the infection is bacterial) and hypoglycemia causes irritability/anxiety and can aggravate depression.
So the very low-carb diet had mixed effects (ketosis, hypoglycemia).
What I would do is follow our ketogenic diet advice. Eat at least 50 g/day carbs from starches to get sufficient glucose, plus sufficient protein to reach 600 calories/day protein+carb, but add in large amounts of MCT oil or coconut oil. Also, do intermittent fasting – eat all the carbs within an 8-hour window; eat at least half the MCT oil in the 16-hour fasting window.
Once on a good diet, I might experiment with antibiotics to see if they relieve symptoms.
Please let me know how things go.
via this link:
Hi Paul,
I realized I posted this on an old post earlier, so I will try it here.
I’ve been eating a paleo diet for 1 1/2 years now, but include rice and occasionally buckwheat. I’ve played around with supplements and haven’t consistently taken iodine, but live in New England and ate seafood/sushi/seaweed often.
’m wondering what my next steps should be. My thyroid has been wonky (with some hyper – fast heart rate, feeling hot, sore muscles, anxiety – and a few hypo symptoms – feeling very cold, cold hands and feet, extreme fatigue, brain fog – that come and go, usually after eating a high iodine food) since a CT scan to rule out appendicitis during a terrible bout of fever/diarrhea/cramping in October 2014. I had a pregnancy from Jan-Apr as well that ended at 14 weeks, which I was told could also be affecting my levels. My TSH has slowly been declining since before the pregnancy. It is now 0.3. Free T3 is 3.2 and Free T4 is 1.1 (all normal for the lab’s ranges). TPOab are 6. Should I be tested for Graves? Iodine uptake scan? Pituitary hormone imbalance? We’d like to start trying again for another baby, but is it safe right now? None of my current doctors seem very competent with thyroid issues. I can’t eat iodine rich foods without having hyper symptoms now, either. I could before Oct.
I’m guessing my thyroid has been injured from the very high dose of iodine from the scan and still hasn’t recovered, though it has been many months at this point. I miss eating seafood and seaweed! How does one heal a thyroid injury (assuming that is the case)?
Hi Joy,
I think you are right. The iodine from the scan probably induced a thyroiditis and it will take some time to recover. It probably would be good to be tested for Graves, but that diagnosis might not change what you do. The most important thing is to support wound healing with extracellular matrix, vitamin C, taurine, and other nutrients, and to support gut health since there was probably a gut issue that made the thyroid vulnerable to the iodine in the first place. Intermittent fasting, circadian rhythm entrainment, and other elements of healthy living also matter.
Good Morning Paul,
I get a recurring sinus blockage in my ears (mostly right ear) from time to time although my nose isn’t blocked too much. It really makes me light-headed. This come and goes and I have noticed it comes back when I stop eating eggs (could be coincidence).
Can you make some recommendations diet-wise that might help this? I’ve largely cut out dairy btw. Thanks 🙂
Just wanted to let you know that I am not able to read some part of your website. On the right side of your site there are sections like “Recent Comments”, “Recent Posts”, and “Upcoming Events”. They keep scrolling for ever thus preventing me to click on any links. I am pretty sure other users have the same problem.
Regards,
Koosu
hi Paul
two questions:
1.Two years in a row now i am testing as highly allergic to coconut and related products…including oil! My allergist and immunologist is testing from skin and blood tests, he is an MD with a PhD in immunology and has been excellent so far…but what do I use for my coconut oil and MCT oil (made from coconut oil)?
2. What is your feeling about kombucha (organic) as part of the daily diet?
thank you, i keep referring all of my clients to your wonderful book!
VAN
Hi van,
Most MCT oils are not made from coconut oil, so I would be surprised if they would cause an allergic reaction. Palm kernel oil is another MCT-rich oil you might be able to find. But, it is not necessary to include such oils in your diet unless you are trying to be ketogenic.
I think kombucha is OK but I am a little cautious about fungal-fermented foods.
Paul, have you looked at Michael Greger’s nutrition site? I’d be very interested in your reaction if you have.
Yes!!! I’ve asked Paul a number of times to look at it – even some specific stuff like Dr. Greger’s data on eggs which is pretty damning. Along with comments that the positive data on eggs has been funded by the egg industry. I hope he addresses the compelling data on this website. And I’ve asked Dr. Greger to do likewise. Nothing so far….
Yes. I get his emails and often look at it, he sometimes finds interesting papers. He is very one-sided in his interpretation and often doesn’t mention contrary evidence. But it’s a good resource. I have notes for some blog posts in reaction to some of his items.
Re the reliability of his analysis, you might check out the commentary at Science Based Medicine, https://www.sciencebasedmedicine.org/index.php/death-as-a-foodborne-illness-curable-by-veganism/, or this intro here: http://www.humanewatch.org/hsus_doc_exposed_as_schlock/. It doesn’t mean he’s not worth reading or watching; but keep a skeptical frame of mind.
Interesting (2nd) link, Paul – thanks. (the first link doesn’t open). What do you think of his video challenging the study that egg yolks don’t raise cholesterol – which he reports was funded by the Egg Board. That was one I was particular concerned about given your recommendation to eat so many yolks (and my Total Cholesterol is 10, LDL 8 [Canadian #s]. These readings went up 2 points each on PHD for 3 years now. I persist with PHD because I like it so much, but cut the egg yolks and take choline instead.
Hi Donna,
There have been many studies on cholesterol and in general eggs and other foods have next to no influence on levels, unless they lead to immune activity or the cholesterol is oxidized.
I’m sure you know your LDL is way too high. Make sure your iron levels are normal (donate blood if they are high), any hypothyroidism is being treated, and tend to gut health.
Hmmm…well, I have CFIDS (recovering nicely – but still issues) and my oxidized LDL went high with my TC and LDL high. So maybe in my case, dietary cholesterol IS a problem, you’re saying?
If the oxidation is endogenous, then try taking more antioxidants. Be sure that when you do eat eggs, you don’t subject them to high heat. I think it’s unlikely that the egg yolks are a major problem but in your case, experimentation is probably in order.
I can’t find in your supplement list info re what form, how much,brands, how often for Vit A supplementation? thanks.
Hi Paul,
A year ago I asked you about my symptoms and you suggested I may have klebsiella and advised I do a stool test. No doctor ever found what was wrong with me but your ‘diagnosis’ was correct. I followed your advice to do a stool test and did find I had moderate klebsiella. Thank you for leading me in the right direction to get the test done.
Now a year later I have retested (with a different lab) and found I still have the klebsiella but low amounts and some other commensal flora (in medium amounts) but no dysbiotic flora, yeast or parasites found. What worries me though is that my sIgA is very high, more than 3 times the upper limit. Do you know what this could mean? From my reading it could be an acute chronic infection or allergy (I have already eliminated gluten, dairy and eggs after testing mildly positive on a blood test). I’m not sure what more I can do?
Hi Claire,
Well, treatment is the hard part. The high sIgA shows that you still have some sort of gut infection that your immune system is attacking. Be sure to maintain optimal vitamin A and D status to support immunity, do intermittent fasting, circadian rhythm entrainment, and other gut immune steps. I wouldn’t eliminate egg yolks, just eliminate the whites, mix the yolks with coconut milk and food, and heat them gently.
Doctors can discuss other possible interventions, ranging from antibiotics to fecal transplants.
Do you think it could be another food sensitivity rather than a gut infection? Or would the commensal flora found e.g. klebsiella, be enough to cause this high sIgA. Nothing else bad was found. Or perhaps, it is the gut infection that would cause the food sensitivity?
I rarely have digestive symptoms (and didn’t at the time of the test) but every few weeks or so I start getting lower tummy pains that last a few days. Sometimes it ties in with tight chest sensations. I sometimes wonder if they start after eating almonds or perhaps it’s just a flair up of the pathogen I’m dealing with when I get the digestive symptoms. I can’t quite pinpoint the trigger though.
Hi Claire,
This isn’t really my area of expertise, but I think food sensitivities are more common when sIgA is low. The function of sIgA is to prevent leaky gut and keep germs out of the body: “The main function of SIgA is to exert immune exclusion; that is, by intimate cooperation with innate nonspecific defense factors it decreases penetration of soluble antigens and inhibits epithelial colonization of bacteria and viruses.” http://www.ncbi.nlm.nih.gov/pubmed/3318585. Another source on the functions of sIgA: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723416/pdf/12199_2008_Article_BF02931243.pdf
sIgA is also elevated in Crohn’s and ulcerative colitis, so it could signify an autoimmune issue. It can be elevated in stress. It seems to be elevated most commonly in bacterial and viral infections.
Thank you Paul. I appreciate your comments.
Interesting that it could indicate autoimmune disease. Thankfully my inflammatory markers were all low so it wouldn’t be IBD I think. How would I find an autoimmune issue? I don’t seem to have obvious symptoms. I did have a TSH of 4 when it was tested a year ago but I don’t really have hypothyroid symptoms I think. Do you think it would be worth testing for something like Hashimoto’s?
Hi Paul,
Thank you for all the great work and for being so generous with your time & expertise – and especially for having the Integrity to go where the evidence leads.
Because I’m still having some IBS issues, although much improved after going PHD, my doc just did Specific IgG4 testing on me. Thankfully no evidence of infection and my thyroid levels are great! I was low on N-butyrate, deficient in some probiotics and showed a number of foods that are potentially causing inflammatory changes in my gut – egg whites were very high at 124.99 with yolks lower at 20.70. She wants me to go off all eggs and dairy including yogurt and kefir and start taking probiotics twice daily. What say you, especially about the egg yolks? Is a choline supplement safe?
Appreciate your help!
Susan
Hi Susan,
I personally would discard the whites, mix the yolks with coconut milk and food and microwave or cook them so that they become more digestible. This will reduce the antigens by about 99% and should be enough. If you do decide to go off egg yolks, then yes you should supplement choline.
Best, Paul
Hi Paul, this egg topic interests me too as I tested positively for an egg allergy highly out of range(but whites and yolks were not differentiated). Can I ask why mix the yolks with coconut milk? How does that help?
Do you think adding a raw yolk to hot soup would be enough to make it more digestible?
Previously I thought that raw yolks were more digestible than cooked but I think you are saying semi cooked with food is best?
Many thanks
Coconut milk is an emulsifier that separates the fat into smaller pieces making the embedded proteins more accessible to digestive enzymes. Heating denatures the proteins causing them to unfold making them more accessible to digestive enzymes. Both improve digestion and therefore decrease the number of immunogenic compounds that can enter the body.
Paul,
To me this sounds like a wonderful reason to enjoy some egg yolk-coconut milk custard (or ice cream) with a bit of honey and vanilla. I’m in!
My functional doctor recommends that I try AIP for 2 months (multiple markers for oxidative stress and inflammation and related gut and skin conditions); do you think that preparing yolks this way would qualify for AIP? I’ve been eating all of the foods, including supplementals, in proper ratios and preparations and supplements per PHD for over a year. I am also taking a whole cocktail of Dr. Ben Lynch’s supplements for compromised methylation. The plan is to start on Rifaxamin and Neomycin after one month on AIP. I’ve never had a direct or any known reaction to eggs (or really any specific food) before.
Thanks!
Hi Susan,
The purpose of food restriction on AIP is usually to mitigate symptoms. (Sometimes we have reason to believe that foods actually cause the autoimmune problem, as with red meat and Hashimoto’s, so then it serves a curative purpose; but in most case we have no reason to think the foods are causing the problem and the goal is simply to relieve food sensitivities.) So with egg yolks, you can simply try them. If you don’t notice any negative effects, then I would include them in my diet.
Thanks Paul! As usual, your insights and perspective provide much needed clarity. (BTW, I’m a different Susan from the one who began the question string yesterday.)
Is hard boiling eggs not recommended?
It’s fine, it’s just not how I prefer to eat egg yolks.
Hi Paul,
Thank you so much for sharing your time and expertise on this site. I appreciate your generosity and the generosity of this community. I hope I have not missed an answer to my question somewhere else.
After reading your book, I have adopted the PHD and have been working with a functional nutritionist after a stool test showed moderate candida and high secretory IgA (433). I also have some general anxiety, and trouble sleeping past about 5:30am.
My question is this: after three and half months, I have lost about eight pounds, which puts me at 104lbs. I have been 112 lbs or so for the last twenty years. I am wondering if you still recommend intermittent fasting, or if you have other suggestions about how I should go about gaining back the weight I have lost.
Thanks very much!
Hi Kristin,
It’s important not to undereat, and women are prone to doing that when intermittent fasting. If you can avoid the undereating, then the intermittent fasting will be good for you. Try including more fat and carbs in meals, making larger meals, and snacking freely between the two daily meals. Also make your food more delicious if you can.
Best, Paul
Is the Budwig Diet safe? It uses 6 tablespoons of flaxseed oil blended with cottage cheese (or 2 cups of plain yogurt, which I do because the cottage cheese upsets my stomach) – per day. I have CLL and have eaten that for 4 years now (except a few vacations, etc), and my blood work looks good. Although the “cancer numbers” are not completely down, they are tolerable and maintain (from about 60,000 white count to about 22,000 maintaining),and I’m in better health than ever (I’m 71 years old). I also take certain supplements to combat the cancer and have dramatically changed my diet. Your diet was the final great change (getting rid of wheat,etc, completely, & other changes).
The comments in various places on your site and elsewhere give me pause about so much flaxseed oil (especially since the yogurt has some sugar in it). Is there something about the flaxseed oil blended with cottage cheese or yogurt that is a miraculous cure that can overlook the imbalance of Omega 6 to Omega 3? Or is there something about flaxseed oil that makes this imbalance not a problem? I don’t take the flaxseed oil with the lignans, so that problems is eliminated. Any help on my confusion? Am I making a mistake in the long run?
Thanks,
Sue
Hi Sue,
I haven’t read her book. There’s almost nothing in Pubmed on the diet and what there is is not positive (http://www.ncbi.nlm.nih.gov/pubmed/24403443: “We did not find clinical evidence supporting any of the diets. Furthermore, case reports and pre-clinical data point to the potential harm of some of these diets [by malnutrition]”). Personally, I think 2 cups of plain yogurt is OK, but I would reduce the flax oil to 2 tablespoons.
There’s no miraculous cure, no.
Best, Paul
Thanks for the reply. Your site and book have been very helpful – I greatly appreciate it all. What I really wondered is if YOU know is whether the flaxseed oil in that amount (6 tablespoons a day) is harmful, toxic. Too much PUFA? Or is it compensated by my balancing the Omega 6 with good Omega 3 in other foods?
Thankyou,
Sue
Hi Sue,
I do believe it is too much PUFA, yes. That is 720 calories of oil or probably 40% of calories. It is a recipe for mitochondrial dysfunction and shortened lifespan. Conceivably it could have an anti-cancer effect, but for normal tissue, it’s not healthy.
Paul-
I contracted the alpha-gal allergy over 20 years ago and haven’t been able to eat mammal meats since. (Fellow forum readers, this allergy is caused by a tick bite and is becoming more common. Take precautions when in tick habitats.)
So beef, lamb, pork, bone and joint broths are out. Fortunately I have no reaction to dairy or gelatin, so I include plenty of butter, cheese, cream, half and half and gelatin in my diet. Those are the only mammal sources of fat and protein I eat.
Chicken is the main meat in my diet. The quality of the chicken I can get is ordinary, but I am able to get pastured eggs and eat three most days. I occasionally eat turkey or duck and I eat chicken livers weeklyish.
Do you have any suggestions? I haven’t started to grow feathers yet but I do wonder if I’m eating too much chicken…
Thanks Paul.
Hi Paul,
Recently, my wife was in a major car accident. She is ok for the most part, but she lost her sense of smell, anosmia (and to a lesser degree, her taste). There was a major eye operation a few days after the accident and we believe the anesthesia possibly caused the loss of smell (and not the head trauma from the car accident, although that is a possibility also). I give you this background as the doctors believe the cause of the disorder is important as far as the treatment goes. However, the doctors seem to think we don’t have any treatment options other than to “pray” her smell comes back. Is there any supplement or special diets you could please suggest? We are desperate. Thank you so much for your time and caring nature.
Best, Jerry
Hi Paul,
I stopped eating grains about 2 weeks ago to see if it would help with some low back OA. Before that, my main source of grains was a bowl of oatmeal every morning. Only occasional wheat. I have in the last few days begun to feel achy, mostly in my hands and feet. Could going off grains trigger some kind of inflammatory response? I’ve done some googling and haven’t turned up anything. Maybe it’s the result of a big increase in eggs and/or almonds, which I’ve suddenly been eating every day? Do you have any thoughts? I’m feeling inclined to go back to my oatmeal to see if that helps. Thanks for any thoughts you might have. And thanks for this amazing website. I’ve ordered your book but haven’t read it yet!
Hi Carol,
You can significantly alter the gut microbiome in a few weeks, so there are many possibilities here. It sounds like you significantly reduced carb intake and increased fat, which is another variable that could have done harm. Possibly it exacerbated an endotoxemia. I would say that large doses of almonds may be more dangerous than the oatmeal for many people, particularly if they substantially reduce carb intake; nuts should be eaten in moderation. I’d also eat only the yolks, not the whole eggs, to reduce food sensitivity/allergy risk.
Hi Paul, Just wondering what your thoughts are on swimming in chlorinated water. I’ve heard the chlorine could be damaging, particularly for the thyroid. Since I’ll be sending my children for swimming lessons I wonder what I could do to minimise any harmful effects.
Many thanks
I have been reading the PHD book and implementing stuff as I work through it. I wanted to find out about egg whites. I’ve always eaten a lot of eggs. The book recommends three yokes a day but does/can that include the whites? I feel I wouldn’t like to through them away as that feels wasteful but was wondering if eating three eggs a day could be too much. I haven’ been able to find this information clarified anywhere in the book yet as far as I can see. Thanks
Hi Katherine,
We deprecate eating the whites because they are an allergy/sensitivity/autoimmunity risk and we feel that overbalances the fairly minimal nutrition they provide (selenium, not much else). The yolks are so important that anything that would jeopardize your ability to eat yolks is a problem.
You shouldn’t feel it’s wasteful to discard the whites because the yolks have essentially all the value.
Best, Paul
Paul,
I drink mainly water, and only bottled Spring water (the one from Arkansas in the green glass bottle). For cooking I use reverse osmosis filtered water.
Recently I saw an MD for some health symptoms related to menopause, and one of the 3 things that he suggested to me is to drink “structured” water, i.e. water that I collect directly from a live spring or buy one of those containers that creates and vortex and brings dead water back to life. Of course, the former is unattainable where I live, and the second sounded just plain whacky to me. But evidently, there is some science behind it, and some pretty smart people who believe that it is true.
I am not a scientist and have a very unscientific mind. But since you’re an astrophysicist and all-round brilliant guy, can you give me your opinion on either the validity or ridiculousness of the concept of structured water, and whether or not it adds any health benefits. The MD spoke of it like it was a fountain of youth, bringing life force back into our circulatory and other bodily functions.
Thoughts? Thanks!!!
Hi Susan,
I think it’s ridiculous. I do like mineral water, Kamal did a post on that for us and recommended Gerolsteiner.
Thank you Paul! I’m glad that I’m in such good company on this! It sounded preposterous, but I was also trying to keep an open mind. 😆
I usually drink still Spring, but during the summer I’ve enjoyed sparkling mineral over an “ice cube” of home-squeezed frozen lime or lemon juice and a couple of frozen strawberries; it’s delicious! Now I’ll read Kamal’s post on that brand.
You’re the best!
Hi Paul,
I read that taking L-Tyrosine may reverse grey hair. Are you familiar with this, and what’s your take? Thanks.
Paul, what is your take on quinoa, buckwheat and red rice?
In Finland the authorities strongly promote rapeseed oil, i.e. canola oil. They say it has omega 6 and omega 3 fatty acids in the right proportion. Also sunflower oil is promoted as a healthy oil while e.g. butter of course is said to be harmful. When I say that we do not use canola oil, but olive oil, butter, coconut oil etc people look at me like I´m totally insane. What I would need are the arguments with which to explain our choice of fat (otherwise I don’t feel obliged to explain, but relatives are giving me a hard time).
Thank you for sharing your wealth of knowledge!!!
Hi, I wanted to ask a question about iodine supplements. I’m wanting to add in the iodine as recommended in the book – especially as this is somehting that has come up for me before but which I never addressed. Here in the UK I’ve been struggling to find something with the right mg in liquid form, everything else seems to be in Kelp supplements. I also keep seeing Nascent Iodine but having read up on the internet there seems a lot of conflicting advise about it being either amazing or not useful to the body. Do you know anything about this?
I have ended up buying a liquid that is part iodide and part iodine and this is apparently elemental iodine. Its nearly 6mg a drop in total and I just take a sip and throw the rest away but that seems very unsatisfactory in terms of knowing how much i’m taking. Any thoughts would be much appreciated please?
Katherine
Hi Katherine,
Take the one you have and dilute it 30-fold. It is probably a 1 fluid ounce bottle which is about 1/30 of a liter; if so find a one liter bottle, fill it with water, mix the small bottle of iodine into it, then take one drop per day.
That will bring the 6 mg per drop down to 200 mcg per drop which is what we recommend daily.
Best, Paul
Hi Paul, thanks for the tip, it is a 1 floz bottle so that could work – although I’m going to end up with a huge bottle of mix which will last forever!!
Do you know whether Nascent iodine is a good or bad idea, or is it really just the same as any other iodine supplement? It says it will give a bigger boost to energy.
Katherine
Hi Paul, I finished your book and started immediately. I have completed a few whole 30s and found I’m lactose intolerant and gluten has lingering adverse effects. My question relates to PCOS. I take metformin, and am of average weight (after a 40lb loss and maintence somewhat for the last 2 years), and I am 30. I’ve read conflicting information on intermittent fasting for those with insulin resistance, what would you suggest? Also, what supplements might help with my symptoms? Thanks for all that you do.
Hi Kat,
Generally, intermittent fasting improves insulin sensitivity. Just make sure you are eating during the daytime. The standard PHD supplements should be good for you. Some points of emphasis: iodine; vitamin A, which we normally get from the weekly liver, but if you don’t eat liver you should supplement; and extra vinegar in food.
Best, Paul
Paul, do you think that oil pulling is a worthy effort? I’ve never tried it, but of course I’ve read/heard a lot about it. I unsure if the benefits are real and significant, and it doesn’t sound appealing. I do best with quick and uncomplicated morning and nighttime routines, so it would be a bit of an inconvenience, too. But if the benefits outweigh the negatives, I’d consider it. Thoughts?
Hi Paul, what are you recommendations for Rosacea? Since you had it you probably have some opinion. The more I read the more confused I get. Is it just an immuno response to demodex mites or is it more of just inflammation?
Second question, would be the general recommendations seems to be rediculous, not to be in the sun and not to excersise and not to eat spicy food in order not to increase it?
Hi Spor,
The recommendations to stay out of sun, don’t exercise, etc are wrong. I have been collecting notes on rosacea, and I know it tends to go away on PHD albeit slowly (in my case, ~3 years), but much remains unknown about it and I haven’t really gotten to the point where I feel I have a good story to tell.
Best, Paul
Thanks as usual. Looks like there is finally some kind of medication called Soolantra that definitely showed good promise.
I believe that the new drug Soolantra is a new derma symptom management drug, but doesn’t address underlying cause. Sandy is correct that clinical studies have shown not only a high correlation with SIBO (something like 85% as I recall) but also a cause and effect relationship. There are various drugs used to treat SIBO, in conjunction with lifestyle interventions including diet, but the drugs that have statistically worked best (according to experts like Siebecker, Pimentel, etc) differ for those who have the methane vs the hydrogen type, and in many cases, it’s a cocktail of drugs and/or antimicrobials that have been found most effective. I’ve modified diet extensively and tried several antimicrobials with no improvement (actually worse today than before) and soon I will be trying a Px drug combo. You can check out the webstite “siboinfo” for lots of great info. For the methane type, I believe that the best results have been achieved with a combo of Rifaximin and Neomycin.
Chris Kresser and Michael Ruscio MD have some great articles and podcasts on their websites too. First step is getting the breath test (make sure it’s the right, gold standard test).
Regarding sun, we all need it for Vitamin D and mental well-being, but I do protect my face and other areas affected because in my case, that skin is thinner and more compromised/vulnerable/sensitive. If something bothers your skin or makes it worse, it makes sense to avoid it, and since it’s always exposed, it’s only prudent to protect it from the elements. Even Mark Hyman says to use sunscreen on the face. I hate the stuff, but I use the safest non-chemical types available, ones, that have the lowest score on EWG, brands like Suntegrity, MD Solar, etc., and I always wear wide brim sun hats outdoors.
Hot peppers cause some people grief and others not. I don’t think that there are any rules; it’s very individual to what works and doesn’t work for each of us. For me, I can’t do alcohol any more; makes me too hot and uncomfortable and I don’t methylate well, so I don’t detox efficiently. But others may do fine with it.
Spor, I believe Rosacea to be linked with SIBO/leaky gut. I have SiIBO but have been working very hard to eradicate, and I’d say I’m 50% better. My Rosacea is mostly gone. The worst offender is grains and sugar which you will not be eating on PHD, so you will get better, but will take a long time. Getting on xifaxin/flagyl speeds up process. It may be worth getting tested for it, but you will need to find a physician who knows what SIBO is. Surprisingly they don’t all do.
Sandy, thank you for the info, I think we are all bouncing here between changing diets and trying the atifungals..chris kresser.etc. Then a year goes by and we end up again on PHD. If Paul says that Sun is ok then Sun is ok.
If you have been following PHD for few years, you should be at ideal weight already. Are you eating beef liver and getting bone broths weekly?
Hi Paul,
I have not found answers to a strange symptom I’ve been having so I was hoping you might have some thoughts on it please.
Last week, out of the blue, I developed a sharp pain in my chest at each breath. I would feel the pain if I breath in deeply. If I took shallower breaths there was no pain. The next day the pain was slightly duller and by the 3rd day it wore off (massaging the area helped). But it was constant with every deeper breath. It was very unpleasant. I asked a doctor about it but he said not to worry (since I have experienced the same symptom as a teenager on many occasions, it used to happen in the evenings. This time it started in the evening but continued all day and night for 3 days).
Do you have any idea what it could mean? My internet search led me to believe it is inflammation of the lining of the lung possibly? I don’t have other signs of chest infection with it though. I don’t know what to do.
Hi Claire,
I don’t know. It could be acid reflux. Asthma can produce similar symptoms. You might want to ask for an endoscopy next time to see if there is visible inflammation in the digestive tract.
Thanks Paul.
Would checking for visible inflammation be useful even though my recent Doctor’s Data stool test showed no inflammation (all on the lowest end of the scale: lactoferrin, calprotectin, lysozyme, WBC, mucus). I do have dysbiosis though including klebsiella. You’ve given me great tips for that which I’m trying to follow.
I’m wondering if it’s a virus like Epstein barr. I read somewhere this could be related to pleurisy.
I don’t think it’s acid refulx, I used to suffer from that but this is different.
Interesting you mention asthma. That never crossed my mind but I do occasionally get other symptoms that perhaps could be mild asthma: tight/heavy chest and air ‘hunger’. They are independant of each other though. These symptoms have been ignored by my parents and anyone I told in my childhood. I managed it myself by staying calm and they would go away only to come back another time, sometimes next day, sometimes 6 months later. I thought it may just be stress or magnesium deficiency related.
Hi again Paul, Just an update. I developed the sharp pain on deep breathing again over the weekend. It always starts in the evening. In the morning I decided to try a big dose in one go of Vitamin C. I heard somewhere that if there is an infection outside of the gut you need over 2g Vit C in one go otherwise it just goes to the gut. After 1 hour of taking 3g, my symptoms almost dissappeared! I took another 2g an hour later and then again in the evening (from fear that it would develop again) and have been fine since. Still get a bit of chest tightness but no pain.
So, I was wondering, could this indicate that I need more Vitamin C. Is there a way to find out how much my body needs, e.g. by reaching bowel tolerance. How does this work? Do I take say 10g in one go, or do I take 1g every 15 minutes etc…until bowel tolerance is reached?
Is there a way to check my antioxidant status? Perhaps my body has a higher need of antioxidants at the moement?
Hi Claire,
I see you already got a lot of good leads on this issue. I just wanted to suggest if it happens again, you might want to have a chiropractor or osteopath check to see if your ribs are “out”. My husband had the same symptoms happen several times (I’ve only had it a couple times) and chiropractic adjustment fixed it.
Thanks Dee. Great idea. Been considering a chriopractor for a while but due to cost and fear (hearing stories of how it can go wrong) I haven’t spent the time to look for a chiroprator. Will think about it again.
I don’t know as much about osteopaths but I wasn’t impressed when I got a session for my daughter as it didn’t seem like they were doing anything.
You’re welcome, Claire. I was nervous the first time I went to a chiropractor. You can start out with adjustments anywhere but the neck. That’s what I did, so I didn’t worry so much. 🙂
I haven’t had osteopathic adjustment personally, but one of my close friends loved hers. Se said her doctor was better than any chiropractor she’d ever been to. I suppose it’s like everything else, and depends on how well the practitioner does it. I always like to ask friends for recommendations before seeing someone new.
Hi Claire,
I saw your post this morning and just wanted to mention that In my case , finally a top-ranked neurologist found that the nerves in the front ( anterior) of my thoracic spine were irritating the front of my core: sharp pain just as you are describing.
Best wishes,
Van (Amahl)
Thanks for your reply. Very interesting. I get all these strange symptoms, too mild for anyone to take notice of though as they just come and go in various locations and not bad enough to stop me from carrying on with life as normal. I do have stuff that could indicate I have nervous system involvement: Cyrex labs tests indicated I have sensitivity to milk butyrophilin (apparenelty this is linked to neurological issues such as MS) and gluten sensitivity transglutaminase 6 (also apparently linked to neuro problems). I have since eliminated gluten and dairy. However for the past 7 years, soon after the birth of my first child I get pains in my big toe (not in the joint). Sometimes sharp pain, sometimes tingling, sometimes slight numbness. I’ve always wondered if this was nervous system related. Each doctor I’ve asked about this has not taken it seriously.
So what was your neurolgists recommendation for your problem?
Do you live in the Los Angeles area? There are a couple of people to whom I could refer you. It took years for me to figure it out. I felt really desperate…yes, I still avoid all cow dairy and grains except for occasional raw goat hard cheese and occasional white basmati rice which I soak for a day before I cook it…I eat up to 9-10 cups of steamed veggies per day and good quality proteins. Van
No I’m in the UK.
I’ll just take one thing at the time. At the moment I know I’m dealing with klebsiella infection and trying to get that sorted out. Otherwise it all costs too much.
Hi Claire
Just a suggestion – might it be a pneumothorax? I’ve had two in the past. They were relatively small but produced similar symptoms of not being able to take a full breath without a bit of pain.
I just wondered whether you might have some weakness in the lining of your lung which allows air to release into the pleural cavity intermittently.
Thanks Harry.
What would cause this? and are you doing anything to prevent further pneumothorax? How did this get diagnosed for you?
Hi Claire
The doctors who treated mine say nobody knows the cause of spontaneous pneumothoraxes (those which aren’t the secondary consequence of another illness). But many doctors say that about a lot of things for which more discerning minds, such as Paul’s, have found likely causes. I should do a bit of research on them…
I was diagnosed after going to my GP (NHS – I’m from the UK like you) with a funny rattling sort of feeling at the top of my left lung for a few weeks, coupled with pain at the top of my breath. The doctor agreed to an x-ray but said it was unlikely to show anything. I went for my x-ray about two weeks later and was sent straight to A&E with a pneumothorax (couldn’t pronounce it at the time, I was so scared!). The consultant told me it would go away as it was fairly small. It did after another couple of weeks. I had another one 5 years later (2013). Haven’t had anything since but after my second one I was told I might be gently forced into surgery to staple the lung to the chest wall to prevent it happening again. Wouldn’t want this.
Just as an aside, I wonder if it’s possibly caused by an infection. I’m certain I have a CNS infection similar to the one Paul had. One of the most likely pathogens is C pneumoniae – which often causes pneumonia too. The neurological symptoms appeared at the same time as my first pneumothorax. Possibly c pneumoniae infected my lung and then CNS.
Sorry – the long and short of it is that infection might be one cause.
Please note I’m not even nearly as informed as I might’ve sounded in my previous post – it was just a suggestion.
Thanks so much. I appreciate your reply. I am reluctant to see the GP again as they haven’t been helpful and tell me indirectly that my test results are fine that I shouldn’t worry. That all the random changing location pains I’ve been getting must just be from worry! But if it happens again I’ll let them know.
I too think infection could be likely cause. I never had rattling on breathing like you just sharp pain at deep breath so hoping it was a case on inflammation on the lining of the lung (which sounds less bad than a hole in the lung!). It suprised me that massage seemed to bring the pain out to the surface. It made the pain dissapear from the inside on breathing and then left me with a sore area on the skin. It felt like a bruise to the touch but no bruise to see, which wore off in a couple of days.
When it happened I was on holiday in a flat for a week that had a mouldy shower. I’m now thinking perhaps that could have caused it. Mold seems to be common in houses in the UK as it’s damp and not sunny most of the year.
Interesting about the c pneumoniae as I have gut klebsiella pneumoniae.
Again doctors here don’t seem concerned, they say it could just be a normal part of my gut flora.
You might find this interesting
http://chriskresser.com/dr-ritchie-shoemaker-on-chronic-inflammatory-response-syndrome/
Thank you Ellen. That was interesting. Perhaps I should get myself tested for that gene? Anyone know how?
Overall I feel well, function well and then out of the blue I get strange symptoms ranging from, sore joints, lung issues, gut issues, fatigue, nausea. They all only last for a bit and then I feel fine again, even for a few months before having another symptom reoccur out of the blue. I’ve often wondered if mold affects me but haven’t had time or money to go into this new area. Especially since most of the time I feel well.
I’m hoping it’s the klebsiella rather than something else as well. The thought of Lyme disease scares me as I did have tick bite as a child and was given antibiotics straight away as a precaution.
Thank God I am not as bad as the cases Dr Shoemaker describes. It’s the first time I’ve felt able/strong enough/not too hungry to do intermittant fasting, so that’s a new thing I’m starting now to see if it helps on thop of PHD foods.
I wonder if 23andme tests for that gene, and if so it’s only $99, maybe more if Int’l?
Hi Susan, apparently 23and me don’t test for that gene according to one commentator. This place does: http://www.lifeextension.com/Vitamins-Supplements/itemLC167120/HLA-DR1-3-4-5-DQ-Intermediate-Resolution
Would be interesting to know but again, so costly. In the end it’s the treatment that is more important.
Claire, that’s too bad. Yes, and working with a clinician or doctor who truly specializes in diagnosing, detecting and treating such things is very key, at least from my recent personal experience and from what I’ve heard others attest too.
Susan, I am working with a functional medicine practitioner so I am getting help. The problem is some of the advice or supplements I get is not PHD friendly so it adds to the confusion.
Hi, Paul. Is gelatin a reasonable substitute for bone broth?
Reasonable yes, but not as good.
Hi Paul,
Sometimes, just 3 hours after dinner I do have strong craving for bread-related food.
Recently I tried “banana chips fried in cocoanut oil” (around 10 of them) and it works .
Is this acceptable in PHD?
Thanks
Kannan
Hi Paul,
What is good to clear lungs (bronchitis, asthma,pneumonia)and what not to eat?
and wheezing?
Thank You
Paul,
How often do you have your labs done?? Do you mind sharing numbers with us? Cholesterol ext…
About once a year. For me, LDL 130 mg/dl, HDL 60, triglycerides 50. TSH 1.9.
Thanks, Paul.
Hi Paul,
Have you heard of these and what do you think of using them to improve sleep?
http://www.glotosleep.com/
No, I haven’t heard of them. If you try them, let me know if it works.
Hi,
I have MS and have been doing paleo for awhile without great results. Tried keto and not sure if I ever got into ketosis but it didn’ seem to help. I believe I have candida and just found out we have a mole issue in our house. Now what? Can I still eat rice with candida?
Thanks,
Karen
You should eat rice with Candida. Going too low-carb or keto will flare a fungal infection, and inhibit detoxification of fungal cell wall components.
http://www.nytimes.com/2015/09/12/business/energy-environment/high-tech-lights-to-help-baby-sleep-or-students-stay-alert.html?partner=rss&emc=rss
Hi Paul,
First of all thank you for the amazing Job you and your wife are doing! I am trying to figure out why I`ve been loosing tons of hair lately.I read the book last year and after a hard 10 day period of “getting clean” I was able to see the benefits of a clean eating habit. My diet is pretty healthy right now and so is my routine. I workout frequently, do yoga twice a week and sleep well most of the time. I recently did a full blood test to make sure everything was ok and need your help. The results that are worrying me are the following:
Vitamin D = 27.8 ng / ml (will supplement with D3 but not sure how much I should take daily.
Copper= 65.7 mcg / Dl (will supplement 2 mg/daily)
Potassium= 3.9 mEq / L (supplement??)
Zinc= 103.3 mcg/ DL (will supplement 50 mg/ week)
Magnesium= 2.1 mg/ DL (will supplement 200mg/daily)
Free T3= 2.69 pg/ ml and TSH ultra sensitive = 1.79 uUI/ mL (really not sure about this one)
Cholesterol VLDL= 16 mg/ dL
HDL= 98 mg/ dL
LDL= 181 mg/ dL ( REEEEALY HIGH!)
How can I reduce my LDL?
Any idea about the hair loss? I ve been taking the B-Complex vitamin once a week and my B12 results were 848 pg / ml.
Also,
Ive been eating 2 eggs daily but I am concerned about the cholesterol. I know there is a misconception about its relation to high cholesterol but its so hard to navigate thru all the different opinions…
I dont eat grains, gluten or any processed food and eat enough protein and safe carbs. Lots of veggies and 1 fruit daily whith whole fat greek yogurt. Wine 3-4times a week and only a glass. The only considerations I have are:
I drink 100 ml whole organic milk every morning with my coffee
1 spoon of coconut sugar daily (I want to move to fructose free sweetness..which one you recommend?)
30g cheese every other day (3 times a week)
Please help me figuring out how to solve my hair loss issue. Could it be hard water?
Hi Luiza,
Both hair loss and high LDL are symptoms of hypothyroidism, so I expect you may be hypothyroid despite the normal TSH. Have your doctor investigate this further; ask to be tested for autoantibodies to see if you have Hashimoto’s, and also for some of the pituitary or HPA-axis conditions that can lead to hypothyroidism despite normal TSH. You might benefit from treatment with levothyroxine (you didn’t give me numbers or reference ranges for T4, T3). Some keys:
1. Don’t overdose iodine. Do supplement 225 mcg/day per our recommendations.
2. (Not necessary if you don’t have Hashi’s, but in absence of testing assume you do): Remove mammalian foods (beef, lamb, pork, dairy) from your diet and replace with fish, shellfish, and bird meats.
3. Work on gut health (e.g. vitamin A, vitamin D, intermittent fasting, circadian rhythms) and wound healing (e.g. extracellular matrix rich stocks, vitamin C).
For D, about 2000 IU/day is usually good, but needs will vary by location, season, and sun exposure.
Also, check iron status and donate blood if you have an iron excess.
Don’t stop the egg yolks. Do consider discarding the whites.
Best, Paul
Hi Paul,
I’ve been meaning to ask you about the use of levothyroxine…
how do you see the use of levothyroxine helping the thyroid with the longer term goal of ideally no medication?
What i’m trying to understand, how does the (hopefully) temporary use of levothyroxine help
It can relieve symptoms. It is purely about relieving the systemic deficiency of thyroid hormone so that the rest of the body can function better. It doesn’t fix the underlying issue.
so would it it make sense to test thyroxine levels (t4 or ft4) and only supplement with levothyroxine if thyroxine was below range,
…or perhaps even if thyroxine was within in range, but below the midpoint
Thanks for the help! I will get those tests done as soon as I can and post here again. My T4 its 0.85 NG/ DL. Does that help?
1- Ok Iodine I will take only the 225 mcg/day
2- I already eat a lot of chicken so I will just try to add more fish and remove the mammalian. If I DO NOT have HAshis then its ok to drink my daily cup of milk and now and then some cheese? I will wait to get the test but would like to know
3- Vitamin D I bought the bluebonnet liquid drops at whole foods. Do you recommend this one or any other?I also bought chelated copper from Solgar(tried beef liver but couldnt get used to it).
Iron results were 83 ug/ dl (serum iron) is that ok?
3 eggs a day are ok even with the high LDL?
Hi Luiza,
[I’m not Paul, but I’ll take a stab at answering your question anyway.]
If the T4 you reported is free T4: You might be hypothyroid (?); knowing T3 too would probably be helpful.
If the T4 you reported is total T4: You are definitely hypothyroid; in your position, I would experiment with levothyroxine.
Without Hashimoto’s, I think it’s fine to have milk and cheese (and red meat).
What is the dose on the bluebonnet?
I think ferritin is a more accurate measure of iron excess than serum iron, so I would suggest measuring ferritin rather than relying on serum iron.
I think 3 eggs a day is ok with high LDL, in fact beneficial.
Best,
-Eric
Thank you Eric! The Total T4 is 7.22 ug/dl and the free T4 is 0.85 ng/dl
The dose is 2000 iu per drop and I`ve been taking one a day. Do you recommend chelated copper? I already bough it (solgar brand, 2.5 mg per tablet) but havent started taking it yet..I was doing some research and still cant decide if its safe or not…
Ferritin levels are 28.77 ng/ml (womans reference is 4.6 to 204.00) so I am guessing I do not have excess of iron.
Ok, Ive been eating 2 daily and sometimes 3..I realized I was getting too much sugar from my daily milk and yogurt (Iusually eat yogurt with fruits…) so I am cutting back the yogurt and keeping the 1/2 cup of whole grass fed milk.
Thanks again for all the help.
Thank you Eric! The Total T4 is 7.22 ug/dl and the free T4 is 0.85 ng/dl
The dose is 2000 iu per drop and I`ve been taking one a day. Do you recommend chelated copper? I already bough it (solgar brand, 2.5 mg per tablet) but havent started taking it yet..I was doing some research and still cant decide if its safe or not…
Ferritin levels are 28.77 ng/ml (womans reference is 4.6 to 204.00) so I am guessing I do not have excess of iron.
Ok, Ive been eating 2 eggs daily and sometimes 3..I realized I was getting too much sugar from my daily milk and yogurt (Iusually eat yogurt with fruits…) so I am cutting back the yogurt and keeping the 1/2 cup of whole grass fed milk.
Thanks again for all the help.
Hi Luiza,
The T4 and TSH do not indicate hypothyroidism; but T3 may still be helpful to measure (especially if you are too low on carbs).
The vitamin D is probably a good dose, but measuring your serum 25-OH-D levels could confirm that.
I think getting copper from food is safer than supplements, but chelated copper is safer than other copper supplements. But if you eat enough other copper-rich foods (liver, chocolate, tree nuts, shellfish, etc.), you may not need any supplements. To figure this out, use tracking software like cron-o-meter to see if you’re averaging at least 2mg of copper per day. If not, then I would eat more copper-rich food; or if that’s too difficult, then take the chelated copper.
I would try eating chicken liver; you may like it even if you don’t like beef liver. The chicken liver will provide many of the same nutrients (except not copper). Otherwise, you should maybe supplement vitamin A (as retinol acetate), and molybdenum (chelated).
It doesn’t sound like you have iron excess; if anything, your iron levels are a bit low.
Eric
Hi
What do you think about plaintain chips you buy in the store? I thought these were healthy, but not sure. I am addicted.
thanks,
Karen
Karen, I don’t know how Paul will respond in general, but as pre-packaged fried foods go, it’s probably a lesser evil than other options, especially if consumed in moderation and not regularly (unless calorie restriction is not an issue for you), because they are much higher in calorie and less filling than eating fresh whole plantain. But granted, they are yummy! Have you seen the ones by Tropical Traditions? You can find them online and they’re cooked in coconut oil, which would be your best bet. Kinda like the Jackson’s sweet potato and potato chips (vs. other chips) which are also yummy and cooked in coconut oil. (My husband doesn’t follow PHD, but he says Jackson’s are the best tasting and crunchiest chips that he’s ever had!)
Thanks Susan!
Hello Paul,
Just like many of the others here, my wife and myself have gotten tremendous benefits from reading your book. I had several ‘aha’ moments reading it. We started of with high fat diets but stumbled upon your site/book when searching for high LDL on low-card diets and it was truly a blessing for us :-)…
A quick question. In your book, you mention that if you are not eating liver, dark chocolate could be a substitute? Can you let us know more details on this?
thanks,
Naveen
Hi Naveen,
We recommend getting a bit more dietary copper than most people get. Beef or lamb liver is the best source, and if you eat that then you probably should avoid other copper sources for fear of an overdose; but if you don’t eat liver then you should find other copper sources, such as chocolate.
Hi Paul,
thanks for your response to my levothyroxine query above…
I have a follow up query in case you missed it;
Since levothyroxine is just thyroxine (as far as i am aware),
Would it it make sense to test thyroxine levels (t4 or ft4) and only supplement with levothyroxine if thyroxine was below range,
…or perhaps even if thyroxine is within range, but below the midpoint.
What do you think…
Many Thanks
I wouldn’t go by T4 levels alone. Symptoms, TSH, T4 level, T3 level, rT3 level are all relevant, but the best guide is how you feel – what dose gives the most symptomatic relief – and lab values can just confirm that you’re in the right ballpark. You should be prepared to cut tablets into quarters and test various doses such as 1/4, 1/2, 3/4, 1, 1 1/4, 1 1/2 the prescribed dose (and, of course, 0).
Hi Paul, just got blood results,two items that interest me for possible changes.
Ferritin. 214. Lab range. 22/322. ug/L.
Would you recommend giving blood and how often.
TSH. 3.29. Lab range .30/4.00
I know you would like to see it lower,the only thing they would give me in Canada is synthroid and they will not test anything but TSH .
Would you recommend synthroid or anything over the counter, I will be living in Florida for the next 6 months and there I can get a full panel of thyroid tests if that helps. ( 70 years young, fully PHD for 3 years. including iodine supplement 225 mcg. )Thks alfred
What I would do is, yes, donate blood and yes, get some synthroid and experiment to find the lowest dose that makes you feel better. Possibly that dose is zero. But it doesn’t hurt to find out.
Thanks Paul,
my ‘case’ is a bit puzzling (to me anyways),
i don’t really have any symptoms* that i have noticed, yet my last TSH was 9.0.
FT3 was bang on middle of the lab range.
& FT4 was lowish eg. 12 pmol/L (range: 10-20).
my plasma selenium at the same time was above range, & i stopped supplementing.
my plasma selenium has since dropped to a good number within range (1.54 umol/L range: 0.80-1.90).
I will have not retested my TSH yet to find out if this has made a difference yet.
I did test with 100 mcg Thyroxine on three# separate occasions, but did not notice anything, & did not see any changes to my oral body temperature (# 1.Fri night 2.Sun morn 3.Tue morn).
*possible symptoms are(?);
– lowish body temperate, usually just in the mornings.
– insomnia; sleep maintenance only.
– tinnitus.
…& no thyroid antibodies
Thanks for the help! I will get those tests done as soon as I can and post here again. My T4 its 0.85 NG/ DL. Does that help?
1- Ok Iodine I will take only the 225 mcg/day
2- I already eat a lot of chicken so I will just try to add more fish and remove the mammalian. If I DO NOT have HAshis then its ok to drink my daily cup of milk and now and then some cheese? I will wait to get the test but would like to know
3- Vitamin D I bought the bluebonnet liquid drops at whole foods. Do you recommend this one or any other?I also bought chelated copper from Solgar(tried beef liver but couldnt get used to it).
Iron results were 83 ug/ dl (serum iron) is that ok?
Hi Paul,
I’m having some ongoing joint pain that I’m guessing is some kind of inflammatory or autoimmune issue. I wonder what you think about taking 400 mg of ibuprofen here and there as I follow the PHD. Will it get in the way of healing my gut (or whatever needs to heal), or can it be tolerated? I know NSAIDs are implicated in leaky gut, and I was taking them frequently over the winter because I had sciatica. I know AIP says you have to get rid of them, but can I still heal if I take a low dose?
I would say you should not take them….try a curcumin boswellia combination.
Carol, I’m in Ellen’s camp. I attribute my IBS and leaky gut to monthly use of NSAIDs (for menstrual cramps) over 20+ years. I wish that I’d known then that what I needed was to work with someone to balance my hormones. Now, I avoid them at all costs. Sciatica is said to be horrific, I know. But I think it might be a good idea to work with a skilled physical therapist type — to work on posture and the like. Also, did you happen to know that the functional health Healing Pain Summit is going on right now?! I signed up because the host, Dr. Joe Tatta, is fabulous, and he’s one of the speakers today. I get migraines and saw him speak on another summit and learned that posture is a cause, and I’ve learned now that he is right! It’s free !!!!
http://www.thehealingpainsummit.com
My mother cured her sciatica with deep tissue massage.
Thanks, all. Happily my sciatica is gone. It turned out I had a cyst in my back pressing on the sciatic nerve. Ouch! In April the cyst was removed and pain went away. What I’m dealing with now is a recent onset of pain in my hands and feet. A couple of ibuprofen knock it out, so when it starts to bother me I’m wanting to take some. I know it’s not optimal, but I was wondering if it’s bad, little b, or Bad, big B, and detrimental to healing whatever’s going on with me. I wondered what Paul thought, but it sounds like so far the advice is steer clear.
And there was just a mainstream study discussed on the radio about baby aspirin for heart attacks in which “they” even admitted it can be probelmatic for some. Also Art Ayers at coolinginflammation.com discusses the fact that almost all medecine can reduce your good gut bacteria. So you will not heal your gut…are you beong scrupulous about gluten, grain elimination? Gluten gives me hand pain.
I get sciatica from the shingles virus – even when there are no skin lesions. the antiviral meds clears it up in less than 24 hours. Something to consider if you are prone to cold sores, shingles, etc.??
I have found Thorne AR-Encap (for arthritis and inflammation), Collagen Type II (for joints – Types I & III are for skin, hair, nails, ligaments, tendons) and Sterol 117 (plant sterols for immune support) have almost completely cleared arthritic type symptoms (along with dietary restrictions as per food sensitivities, and meds for shingles as needed – for sure, some of my joint pain is viral and food related).
Hi Paul,
I have MS, is there anything else you can recommend beside your diet? I am just getting started, so excited to eat rice and potatoes again after being paleo for a long time. Also, should fermented foods be added right away if you have candida. Always been confused about this some say eat right away others say wait till candida is under control
Karen
Paul,
I’ve got a long history of vaginal candida infections resulting in inflammation of the pelvic region (vulvodynia, IC, and chronic vaginitis). For many years I took prophylactic flucanozole but finally managed to get it all cleared up by cutting out major food groups and many carbs. For three years I was fine. Unfortunately, I’ve had two rounds of antibiotics in the last eight months, each one retriggering yeast infections that last months, which means I’m back on flucanazole on a regular basis again and feel like crap.
Between the antibiotics and the flucanozole and the long term limited diet I know my gut is a mess, I”m constipated (treated with magnesium), more and more sensitive to histamine, and now I’m getting severe signs of hypoglycemia within 12 hours of cutting back on carbs, literally I get so dizzy and weak I can hardly stand up! (My blood sugars are in the high 60s to low 80s consistently but it feels like they are about 50!)
I’m confused as to where to start at this point. Lower carb seems to help with candida flares but I can’t tolerate being low carb because of the hypoglycemic symptoms. I just tried again to add cold potatoes (about 450 gms which is about 90 grams of starch) but now I’m getting increased yeast symptoms.
Can’t do several of the supplements you recommend, can’t do bone broths because of the histamine (makes me nauseous and shaky)….it’s hard to figure out what to do…I’m frustrated!
…but mostly I’m looking for advice on the starch/carb issue. Do you have any ideas that can start me back on a better path?
Hi Ann,
Sounds like you’re really dealing with a lot. Have you looked into a low oxalate diet, and the VP Foundation? Many have found relief from vulvodynia and IC with a low oxalate diet. The most extensive and up to date list of the oxalate content in foods that I’ve found is at the Trying Low Oxalates yahoo group. They are actively having items tested, and it includes info coming from the VP Foundation as well. Members there are really helpful. There are some dealing with histamine issues as well, sorry I don’t personally know much about that.
For the low blood pressure, have you looked into adrenal fatigue and possible thyroid issues (they tend to go together)? Going too low carb can cause problems for those with adrenal fatigue and thyroid problems.
Good luck.
Dee
Hi,
you said rice was good for candida. well I probably over did it, I got so excited I could eat rice I ate a big amount and the next day I had a bunch of potato chips cooked in avocado oil. I now have a terrible UTI or bladder infection. do you think it is related?
Hi Karen,
I don’t want to sound like a broken record, but have you looked into a low oxalate diet? There’s great info available at the Trying Low Oxalates yahoo group. If you ate lots of rice and potatoes you most likely got a big dose of oxalates, and if you are a person who has problems with them, it can definitely feel like a UTI or bladder infection. The crystals are very sharp. Getting a culture done could let you know for sure if it’s infection.
You can try 50 ml of cranberry juice twice daily along with 500 mg of l-methionine three times daily for UTIs. There was a study done showing that can be just as effective as antibiotics, and then you don’t have to deal with the fallout from antibiotics.
Hope you feel better.
Dee
I can see that cranberry can help with e-coli type uTI’s but how would l-methionine help? I haven’t heard that before. If you know I would love to know.
I’m not sure of everything that it does, but one way is supposed to be that it helps acidify the urine. You can look up the study that used both on pubmed. I believe it was German.
hi Paul,
an Oats query…
in the book you say do not eat Oats,
& rate oats a ‘D’ as a plant energy source.
How about just the Bran, would oat bran be any better or worse?
Hi Paul:
The recommendations outlined in your book call for 1 gram of iodine; the suggestions states to begin with 225mcg and to double the dose every month. Why then do your supplement recommendations within this website state only to take 225 mcg?
Hi Eddie,
We’ve revised our recommendations since the book and old blog posts were written. This page is up to date.
Best, Paul
Why was there a revision even after your latest book edition?
We’re always researching, thinking, and updating. We call it “Perfect Health Diet” and so when we find that perfection calls for an update, we do an update.
In this case, when we realized how variable and unpredictable selenium intake can be, we realized the risk of high iodine intakes was much larger than we had previously suspected. So we cut down the iodine recommendation.
Thanks, Paul. Where can I find a recent post of yours that compelled you to change the recommendations? I would like to learn more of the role in selenium and iodine.
Paul,
What’s your thoughts on herbal teas? My wife has got me into the sleepy time teas and such and I was wondering if this is a ok habit?
Paul,
Do you think that ingredients in herbal tea is ok for health, or should I just cut it out.
Hi Paul,
What are your thoughts on wrapping food (say potatoes or sweet potatoes) in aluminum foil when baking? It reflects radiation and conducts heat well, which decreases the amount of burnt food. On the other hand, I started wondering recently about dangers of excess aluminum. (Why? Well, I just bought a new role of aluminum foil, of a different brand than I had used before. I then used it to bake sweet potatoes, which came out with a distinctly metallic taste! This has never happened before to me.)
Anyway, here’s what I’ve managed to find:
(1) The Joint FAO/WHO Expert Committee on Food Additives has set the provisional tolerable weekly intake for aluminum at 1 mg / kg body weight, which corresponds to a daily intake of 10 mg for a typical individual.
(2) Various sources claim leaching from a couple hundred cm^2 of aluminum foil over an hour at typical cooking temperatures is (order of magnitude):
* 3 mg [1]
* 0.03–100 mg depending on conditions; around 10 mg most of the time [2]. Note that the authors report also report leaching rates of about 0.3, 3, and 30 mcg / cm^2 per half hour for… two different brands of rice vinegar and a solution of 4% acetic acid in water! They further claim the dominant factor is concentration of salts, presence of particular amino acids, etc., and not pH.
* 100 mg [3]
* 100 mg (for meat) [4]
I’m not sure which sources to trust here. At 10 mg or less Al leached, I would be inclined to say it’s worth it to prevent formation of toxins generated by burning food… but if the higher numbers are accurate, I might be more worried about the aluminum!
What do you think?
Thanks!
-Eric
References:
[1] http://cdn.intechopen.com/pdfs-wm/28917.pdf
[2] https://www.jstage.jst.go.jp/article/shokueishi1960/39/4/39_4_266/_pdf
[3] http://www.electrochemsci.org/papers/vol6/6126424.pdf
[4] http://www.scirp.org/journal/PaperDownload.aspx?paperID=55526
References:
[1] http://cdn.intechopen.com/pdfs-wm/28917.pdf
[2] https://www.jstage.jst.go.jp/article/shokueishi1960/39/4/39_4_266/_pdf
[3] http://www.electrochemsci.org/papers/vol6/6126424.pdf
[4] http://www.scirp.org/journal/PaperDownload.aspx?paperID=55526
Hi Paul, please check out YouTube video by Dr C S Yajnik (Pune ) this is new to me information on diabetes and explains that a person with a low BMI can have a problem with abdominal fat. Good video any comments. Thks Alfred
Hi! Are you planning on writing another book with recommendations for people with autoimmune disease and/or leaky gut syndrome? Do you agree with the aip paleo diet that nightshades and eggs can be problematic for leaky gut?
Best, Disa
Hi Paul,
I love referring to your book, over and over again!
Question: Some of my clients cannot eat eggs (including yolks) and 4 of them refuse to eat liver. So with supplementing choline, you write on page 319 of PHD that the “Food and Nutrition Board set the Adequate Intake Level for choline at 425 mg. per day for women and 550 mg. per day for men.” Is it fine to use phosphatidylcholine? And in the powder form ,a heaping tablespoon measure lists as delivering 4 gr. of phosphatidylcholine. Is this too much per day for those who eat no eggs or liver? Or is 1 T. per day safe? Thanks! Amahl Van Halsema/www.vhHealth.com
Hi there Paul, i’m very curious about your opinion on xanthelasmas. They’re cholesterol deposits under the skin around the eyes. Some people eating low fat/high carb diets have had these appear, aswell as some people eating high fat/low carb diets.
The traditional approach to treat them is a diet low in plant & animal fat and moderate in carbs, but a couple people have reported regression with ketogenic style diets.
Xanthelasma isn’t correlated with high TC but does seem to be quite common with lower HDL levels.
I’ve personally had them appear after a year or so of eating a high fat/low carb diet and then regularly reintroducing carbs (often refined), after dropping fat and increasing carbs they actually seem to have gotten worse, which makes me wonder if sticking to a low carb diet would help them regress… my TC isn’t high so my doctor won’t allow me to have a full breakdown of my LDL, even though i’m only 30 y/o with xanthelasmas.
I’d love your opinion on this if you find the time… 🙂
What do you think about a) canned salmon, b) smoked salmon, and c) bread from sprouted grains?
HI Paul- I just purchased your book and so far it is fascinating reading. I’m sure I’ll have many questions, but initially I have one: you specifically recommend white rice but there is no mention in the index of brown rice. Are you suggesting avoidance of brown rice? Thanks!
Dear Paul – I have just read your book and am simply amazed at your insight into how the human body works. I am a 45 year old female who struggles with digestive issues, migraines, sleep issues and low energy. I have had hypoglycemia for many years. My A1C has been climbing and is now 5.8, so I am worried about developing diabetes. I would like to lose 20 lbs, which would put me at my ideal weight. I am going to try your PHD, but was wondering if I should be doing the ketogenic version for my headaches and digestive issues, or if that would be bad for the blood sugar issues? In the book you said low carb diets increase insulin resistance, so I am not sure if it would be okay for me to do the 200 calories per day of carbs or if that would be too low. Also, it seemed that you implied that you can instigate ketogenesis at higher levels of carbs by eating lots of coconut oil – is that the case? Thanks so much for clarifying this for me. Julie
Hi Julie,
I would suggest doing regular PHD first, long enough to make sure you are well nourished, and then if your migraines haven’t gone away, gradually tweaking it toward the ketogenic version to see if that improves things (e.g. by increasing the overnight fast, adding a few tablespoons MCT oil toward the end of the fast, more coconut milk with food). Generally, regular PHD is better for digestion and prediabetes than the ketogenic version.