Supplements

This page lists our supplement recommendations with links to products at Amazon. By purchasing via links on this page, you support the blog at no cost to yourself. Thank you for supporting our work!

Supplemental Foods

We recommend eating these “supplemental foods” on a regular schedule:

  • 3 egg yolks daily, 5 yolks daily for women who are pregnant or planning to become pregnant (for choline, folate, vitamin A)
  • A bowl of soup made from bone, joint, tendon, foot, or hoof stock, 3 days per week (for calcium, phosphorus, and collagen)
  • Fermented vegetables such as kimchi, sauerkraut, or fermented mixed vegetables (for nucleotides, probiotic bacteria, and vitamins K2 and B12), and other vegetables such as tomato, avocado, potato, sweet potato, banana, green leafy vegetables, and seaweeds such as dulse, daily (for potassium)
  • ¼ lb beef or lamb liver, weekly (copper, vitamin A, folate, choline). If you like, substitute ¼ lb chicken, duck, or goose liver weekly plus 30 g 85% dark chocolate daily
  • fish, shellfish, eggs, and kidneys, weekly (for selenium)

Daily Supplements

These are supplements we recommend be taken daily:

  • Sunshine and vitamin D3 as needed to achieve serum 25OHD of 40 ng/ml.
  • Vitamin K2 100 mcg or more
  • Magnesium 200 mg
  • Iodine 225 mcg
  • Vitamin C 1 g
  • Pantothenic acid (vitamin B-5) 500 mg
Vitamin D3
  • Seek total dose from sun, food, and supplements of 4,000 IU/day
  • Adjust to 25OHD level of 40 ng/ml (whites/Asians), 30 ng/ml (blacks)
Vitamin K2
  • Recommended dose: 100 mcg MK-7
  • Pharmacological, possibly therapeutic doses: 1000 mcg to 5 mg MK-4
Magnesium
  • Use chelate (e.g. glycinate) or citrate
  • Daily dose 200 mg
Iodine
  • Recommended dose 225 mcg/day (one tablet)
  • Nori sheets have about 50 mcg each; 2-4 per day replaces supplements
  • Supplementation is to prevent lengthy iodine droughts
Vitamin C
  • Low dose: 500 mg – 1 g per day
  • Under stress or viral infections, more may be needed
  • Powder is least expensive way to get large doses
Vitamin B-5 (pantothenic acid or pantethine)
  • 500 mg per day; we suggest daily due to its extreme safety
  • Acne/skin blemishes or low energy/endurance are symptoms of deficiency

Weekly Supplements

These are supplements we recommend be taken once a week:

  • B vitamins:
    • 50 to 100 mg each of B1, B2, and B6
    • 5 mg biotin
    • 500 mcg B12
  • Zinc 50 to 100 mg
  • Boron 3 mg
B1 (thiamin)
  • 50-100 mg weekly
B2 (riboflavin)
  • 100 mg per week
B6
  • For those who don’t take a B-50 complex
  • We recommend 50 mg to 100 mg per week
Biotin
  • We recommend 5 mg once per week
B12
  • We recommend 500 mcg to 1 mg once per week
  • Sublingual methylcobalamin is preferred
Zinc
  • We recommend about 50 mg per week
  • Be sure to follow our copper recommendations as copper-zinc balance is crucial
Boron
  • The 3 mg dose can be taken one to three times per week

Prenatal Supplements

The most important prenatal supplements are:

  • Extra duck, goose, or pastured chicken liver.
  • Extra egg yolks.

The following supplements may also be helpful during pregnancy or in the months leading up to conception. Note: We do not recommend prenatal multivitamins.

Choline
  • Not necessary if you eat enough egg yolks and liver
  • But extremely important during pregnancy, and safe
Inositol plus Choline
  • Not necessary if you eat enough egg yolks and liver
  • If supplementing choline, good to mix in some inositol
Iron (optional)
  • About 30% of pregnant women develop iron deficiency anemia
  • Don’t guess, test; blood tests will indicate if you need iron supplements

Optional Supplements


These supplements may be helpful for a significant fraction of the population. Experiment to see if they help you:

  • Probiotics
  • Chromium, 200-400 mcg per week (not necessary if you cook in stainless steel pots) and (optional) vanadium, 25 mcg per week
  • Lithium 5 to 10 mg per week
  • Silicon 5 mg to 25 mg daily
  • FOR PEOPLE WHO DO NOT EAT LIVER: Copper 2 mg per day
  • FOR PEOPLE WHO DO NOT EAT LIVER: Vitamin A from cod liver oil, 50,000 IU/week
  • FOR PEOPLE WHO DO NOT EAT MAKE BONE STOCK OR DRINK MINERAL WATER: Calcium up to 400 mg/day
  • B-50 complex (as a substitute for individual B supplements if you prefer fewer pills
  • Molybdenum 150 mcg per week
  • Taurine 500 mg to 5000 mg per week (higher doses may be therapeutic for small intestinal or systemic infections)
  • Selenium 0 or 200 mcg per week depending on selenium content of food (if food is produced in dry, flat areas = high selenium, no supplements; rainy, well-drained areas = 200 mcg/wk)
Probiotics
  • Bifidobacterium spp can help with leanness and weight loss.
  • Lactobacillus spp can help with acid reflux, bloating, SIBO, prediabetes, high triglycerides
More Probiotics
  • Bifidobacterium spp can help with leanness and weight loss.
  • Lactobacillus spp can help with small intestinal issues
More Probiotics
  • VSL#3 is a good mix for inflammatory bowel diseases.
  • Prescript Assist includes soil-based organisms that are a little riskier and should be taken only occasionally, not continuously, for therapeutic reasons.
Chromium
  • If you don’t cook in stainless steel, we recommend 200 mcg chromium one to three times per week
  • Stainless steel pots may release 88 mcg chromium per day of use
  • Optional: vanadium 25 mcg one to two times per week
Lithium
  • Best is to take 1 mg per day; 5 mg once or twice per week is next best
  • Caution: too much lithium can exacerbate hypothyroidism and increase potassium excretion
Silicon
  • Up to 25 mg per day
  • Most people would benefit from more silicon
  • Seaweed is a good food source
Copper (Only If Liver Is Not Eaten)
  • Target of 2-3 mg/day can be met by eating 1/4 lb beef or lamb liver per week
  • Do not supplement copper if you eat liver
Vitamin A (Only If Liver Is Not Eaten)
  • Target of 50,000 IU/week with remaining A needs met from carotenoids (green leafy vegetables and orange plants like carrots)
  • Do not supplement vitamin A if you eat liver, unless for therapeutic reasons
Calcium (If No Mineral Water or Bone Stock)
  • PHD foods may fall short of calcium target by up to 400 mg/day
  • Standard PHD prescription is to make up the difference with bone stock and/or mineral water
  • These supplements also replace magnesium supplement; aim for 300-500 mg calcium and 150-250 mg magnesium per day
B-50 complex
  • An alternative to the other B vitamins for those who prefer to take fewer pills
  • Not recommended more than once per week due to folic acid and niacin content
Molybdenum
  • We recommend 150 mcg to 1 mg per week
Taurine
  • We recommend 500 to 1000 mg weekly for healthy persons
  • Supports production of bile salts
Vitamin E
  • Red palm oil is a good food source
  • If supplementing, take mixed tocopherols and tocotrienols

Therapeutic Supplements

These supplements are unnecessary for healthy people but may be helpful in various disease conditions.

N-acetylcysteine
  • Precursor to glutathione
  • Recommended dose is 500 mg
  • Can take more in cases of severe chronic infection
Glycine
  • Supports collagen production, bile conjugation, and glutathione production
  • Desirable if you don’t eat daily extracellular matrix (bones, joints, tendons, skin, hooves)
  • Up to 2 teaspoons (10 g) per day
Creatine
  • Supports muscle growth and preservation; especially valuable for the elderly
  • Up to 1 teaspoon (5 g) per day
Melatonin
  • An important sleep hormone, deficient in many brain diseases, has antimicrobial activity
  • Take 1 mg sublingually just before bedtime
  • For larger doses, combine 5 mg time-release with 1 mg sublingual
Detoxification Aids
  • These can help bind toxins and excrete them in feces, preventing them from being re-absorbed in the colon
  • Likely to be helpful for most people suffering from chronic infection or environmental mold.

Miscellaneous


These items may be helpful in implementing Perfect Health Diet and Lifestyle advice.

Pill boxes
  • Set out pills once per week, aids remembering to take them
Pill cutter
  • For cutting tablets to reduce the dose

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4,429 Comments.

  1. Milton Safonidas

    Dear Paul,
    My girlfriend just got diagnosed with Hashimoto’s disease. Can you recommend a good book or a good strategy that addresses the topic?

    Thank you,
    Milton

    • Hi Milton, I looked through Paul’s posts as I too was diagnosed with Hashimoto’s in 2015. According to Paul, it is likely an infection caused by a virus. This was the case for me.

      Vitamin C was instrumental in getting my thyroid working again. Check out Paul’s supplement guide and food list.

  2. Micael Leão Michaelsen

    Hello Dr.Jaminet.
    I’m brazilian, and amused by nutritional science, but I have a good idea of the principles that should guide a healthy alimentation, therefore I have not, yet, bought your book.
    One point on I have more doubts than certainties is the one concerning supplementation, and its worthness.
    I do use whey powder and creatine because of my athletic activities, but besides of them I have the doubt if I should, or not, use other vitamins, probiotics, minerals and nootropics for brain performance.
    I present you 2 doubts:

    a) is there a plan for a new edition of your book? the most recent one is from 2013, if I am not mistaken. Considering the costs of shipment, I don´t think its worthy to buy it now if there is going to be a new edition soon. By the way, I don´t like reading through Kindle. In such a new edition, would there be some athlete-oriented chapter?

    b) This specific topic of supplements, in your website, will have an update soon? I saw you mentioned it would in some comments above, and before I go out and buy some supplements, I would like to be more sure on which of them are really essential, mainly for a good energy availability for daily activities.

    Do you reccomend, besides of that, a specific test to measure mineral or vitamine deficiencies?

    With sincere regards,
    Micael Leão Michaelsen.

    • Hi Micael,

      There won’t be a new edition soon. We are busy with our cancer therapy company, Angiex (www.angiex.com).

      I’ve been very busy, I do want to update the web site generally and the supplements page specifically. The most important supplements are magnesium, vitamin D in the winter if you are far from the equator, and vitamin K2. There are other common deficiencies like vitamin A (if you don’t eat liver), iodine (if you don’t frequently eat seafood), vitamin C, etc.

      Generally, we lack good tests for nutrient status. I think that is an area that needs further research.

      Best, Paul

  3. I believe there used to be a page with all recommended supplement brands, but I can’t find it.

    Can anyone help?

  4. This page lists supplement recommendations with links to products at Amazon. But, if you have ad blocking turned on in your internet browser, you won’t see the links.

    Other than that, i don’t know about any such page on this blog.

    Paul in 2013 said that he has no way of evaluating the quality of vitamin brands: http://perfecthealthdiet.com/2013/03/ask-me-anything-at-reddit-tuesday-noon/#comment-135708

  5. A while back my daughter was getting rashes and had some allergy tests. It came back that she is allergic to lanolin and fragrance. Is it safe to take vitamin d3 if you are allergic to lanolin? Also she did avoid fragrance for a while and uses it now and is fine. I realized that the target brand benzoyl peroxide that she was using for pimples was the cause of the rash.

  6. Hello Paul, Can you please recommend supplements, eating pattern and vital foods for healing chronic pancreatitis and gallbladder pain – started by a series of water fasts and healthy vegetarian/lower fat diet in the past.

    Have had these problems for the last 4 years even though I follow PHD now. Scans show a couple of “benign injuries” on pancreas, occasionally high lipase and normal gallbladder with occasional sludge. I am so confused whether intermittent fasting 8/16 and 2 meals per day are helping or making it worse. Will this ever resolve and get better? Any advice please will be so appreciated. Just got CGM as my h1Bc is 5.4 which seems high considering my PHD diet Thank you

    • Hi Renata,

      The most important supplements are vitamins A and D, which are key for antimicrobial peptide production and mucosal immunity. They should always be combined with vitamin K2 as MK-7.

      Equally or more important are circadian rhythm entrainment and time-restricted feeding. Try to concentrate all calorie intake between 9 am and 3 pm as much as possible; do only social nibbling after 3 pm and no calories at all after 7 pm – ideally no calories after 3 pm, and none before 9 am. For circadian rhythms, have a personal 12 hour day and 12 hour night, I use 7:30 am to 7:30 pm as my day. In the day get morning exercise, bright white light or sunlight, and all food intake, as well as all stress. At night, red/orange lights, no calories, minimal physical activity and stress, it is a time for intimacy, rest, and relaxation.

      Other things are less important but be sure to get plenty of dietary extracellular matrix for healing, and to support immune activity with zinc/copper, iodine/selenium, magnesium; and bile production with taurine, glycine, vitamin C, and choline / egg yolks.

      Best, Paul

      HbA1c of 5.4 is normal.

      Best, Paul

      • Hi Paul,

        I seem to react poorly to supplemental vitamins:

        – A, D, or K2 supplements cause extremely low moods/energy. I’ve tried various forms for a few days now and again and always feel better after stopping.
        – I consistently feel nauseous after eating chicken/beef/lamb liver or taking cod liver oil.

        Any ideas what might be going on? How might you work around this?

  7. Dear Paul,
    When supplementing K2, is it important that the supplement contains a variety of Vitamin K forms (i.e. K1, MK-7, MK-4 etc.) or is it fine if it has only K-2 MK-7?
    Thanks.

    • Hi Kendall,

      No, I would avoid MK-4 which is synthesized chemically in a racemic mixture with an unnatural chirality that may be harmful. K1 is fine but that is best obtained from food (eg spinach). I supplement just MK-7.

      Best, Paul

      • Dear Paul

        I have started using MK-7 as a precaution due to your comment. However I have been unable to verify production methods and/or enantiomer content of common MK-4 supplements. Thorne simply responded mentioning their MK-7 is derived from geraniol. Do you have any more information regarding this issue?

        Thanks a lot and I hope your clinical trials are going in the right direction!

        Best,
        Gorjan

        • Hi Gorjan,

          You want to find MK-7 produced from bacterial fermentation in natto. I have not investigated the safety of MK-7 made from geraniol. MK-4 is synthesized in a racemic mixture and I am concerned that the wrong chirality is toxic. I don’t know what the process is for MK-7.

          Best, Paul

          • Dear Paul,

            Thanks a lot for responding! Unfortunately I made a typo. I meant Thorne mentioned that their MK-4 supplement is manufactured from geraniol. Since I find it very difficult to find any information on MK-4 synthesis methods, I was wondering where you got the information from regarding the racemic mixture of MK-4.

            Sorry for the confusion!

            Best, Gorjan

  8. Dear Paul

    Is there any way to reduce arterial calcification?

    Thanks

    José

  9. Dear Paul

    If I eat ONE egg a day my total cholesterol raise to 300 and more and LDL to more than 170.
    Should I avoid eggs?
    Thanks

    José

  10. Hi Dr. Jaminet, I have sleepiness during the afternoon after 3 pm, and even when I eat a very small snack after 7 pm when I get home, I feel very sleepy. Sometimes when I drive home at around 6 pm, I feel like dosing off. Most nights, I have the same sleepiness even when I don’t even eat at night. But when it comes time to sleep at around 11:30 to midnight, I am wide awake and alert like it is morning at wake-up time. I sleep well all night with good vivid dreaming. I have not heard you address this sleepiness issue in your talks and interviews. Perhaps you can help me understand what is happening to my body to cause this. Thank you.

  11. Hi Paul, Vitamin A supplements appear to disturb my mood and I get nausea consistently after eating liver or taking cod liver oil. Any ideas why this might be the case and how to meet vitamin D/vitamin A needs otherwise?

  12. Hello Paul,

    Do you think it’s necessary to supplement the 50,000iu vitamin A/retinol if you’re eating the 3 pasture raised egg yolks plus 1-2 tablespoons grassfed ghee/butter daily? I’m not eating liver because I don’t like it.

    Also, what are your thoughts on a low oxalate diet like in Sally K. Norton’s book Toxic Superfoods, & or Paul Saladino’s Carnivore Code?

    I’ve been eliminating high oxalate foods like spinach, chocolate, nuts/seeds & sweet potatoes over the last year & my aches & pains that I thought I would have to live with at my age of 46 are disappearing. I believe there’s something to it. My diet is mostly grassfed beef, egg yolks & butter, lemons, limes, & a little low oxalate veggies cooked, & honey, white rice & occasionally gluten free organic oats. Occasionally when it’s fresh & looks good, wild king salmon.

    I learn so much reading your responses to people on here & appreciate it!

    Thank you,
    Holly

  13. Johannes Baur

    One question about selenium:

    You mentioned there are more or less safe
    forms of selenium – inorganic forms worst, selenmethionine better and selenocysteine best. now I found methylselenocysteine as a
    supplement – this is not exactly selenocysteine – what do you think about its safety? Is it useful?

    Best, Johannes

  14. And another one about Iodine: There is kaliumiodine and I2.
    Can the body change one in the other or is it better to take both?

    • Hi Johannes,

      Generally I would recommend potassium iodide, since both potassium and iodine are nutrients, and this is a more stable form for storage. Once in your digestive tract, the iodine will behave the same.

      Best, Paul

  15. My idea: You need oxygen to survive as a human being. But you also need water to survive. It is not sufficient
    to take oxygen only as O2, you also need H2O.

    Could it be like that with I2 and KI?

    Just my idea.

    Best,

    Johannes

  16. Johannes Baur

    https://www.naturalmedicinejournal.com/journal/iodine-and-cancer
    https://aacrjournals.org/cancerres/article/63/16/5065/510332/Nonradioactive-Iodide-Effectively-Induces

    According to the first study, there is a
    difference to tumors as I2 helps but not KI?

    In the second, KI is used and we can see shrinking size of lung tumor in mices – as in the photos.

    Best,

    Johannes

    • Hi Johannes,

      These studies indicate that I2 is more toxic to cells than KI, which is expected given its much greater reactivity. In the first one it is more potent in cells in culture. But what you care about in treatment is not potency, but therapeutic margin. You want it to kill cancer cells better than it kills normal cells. Note that in the second study they mention that I2 is very effective at killing thyroid cells (which have native NIS transporters) but they had to overexpress NIS in (genetically modify) the tumor cells in order to make I2 potent. Then KI works in vivo, in keeping with the iodine being beneficial as a nutrient, not just as a highly reactive toxic molecule.

      I didn’t see any evidence there to favor taking I2 over KI – on the contrary.

      Best, Paul

  17. Johannes Baur

    I agree.

    Personally, I smoked tobacco for a longer time in my past – so I have a higher risk of developing lung
    cancer.

    In this study

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795405/

    it seems to be a bad idea taking NAC in this case. But in the upper one, it seems to be
    beneficial in combination with KI.

    What is your
    suggestion?

  18. Amisu Takoyama

    Hi Paul,
    What do you think about silicon dioxide in supplements?
    Do you think it’s problematic?

  19. Hi Paul

    I am wondering if you might have some suggestions for someone who cannot eat fermented foods due to histamine reactions?

    Best, Peggy

    • Hi Peggy,

      Be sure to eat freshly fermented foods made with fresh ingredients, and consider fermenting them yourself, so that you can minimize amine formation. Amine clearance relies on monoamine oxidase and diamine oxidase, and these are dependent on choline, copper, and molybdenum, so you can increase your egg yolks and chocolate or consider supplementation. Severity of symptoms can be aggravated by antioxidant deficiencies, mainly zinc and copper, secondarily glutathione precursors like glycine and taurine.

      Best, Paul

  20. Hi Paul,

    My brother, who is 26 and fairly tall but not overweight, has been facing ongoing joint issues. Despite having surgery, his shoulder frequently dislocates, and now he is dealing with bone spurs in his knee.

    Until now, he hasn’t led the healthiest lifestyle, but he is eager to turn things around. Could you suggest some strategies or recommendations to help him improve his joint health?

    Thanks a lot.

    • Hi Carlson,

      For joint issues, he should eat lots of extracellular matrix (soups and stews made with bone and joint material, skin, shellfish), optimize vitamins A/D/K2, get extra vitamin C, and tend to circadian rhythm entrainment. Eat a natural whole foods diet with balanced nutrition like PHD.

      The same tactics will help heal the bone spurs. Often a lack of vitamins A and K2 and poor circadian rhythm entrainment are key causes. He should be sure to eat 3 eggs per day, supplement A and K2, and exercise and get sunlight and bright white light during the day, and avoid white/blue/green light at night, or wear blue blocking glasses.

      Best, Paul

  21. Hi, Paul.
    Is your dosage recommendation for vitamin C still 500-1000 mg.?
    Thank you.

    Mary

    • Hi Mary,

      Yes. 500 mg/day can be obtained from food only by eating sweet peppers and citrus fruits. 1 g/day requires supplementation. Vitamin C itself is safe to supplement but there may be concerns about other compounds in the pills.

      Best, Paul

      • And, also, Chris Masterjohn has recently done a few posts about oxalate (a problem that I, too, had with high dose Vit C supplementation).

        • Hi Rachel,

          My understanding is that vitamin C becomes oxalate only if other antioxidants are deficient, especially zinc, copper, and glutathione-related nutrients (selenium, taurine or cysteine, glycine).

          However, it is reasonable to get C entirely from food by eating sweet peppers and citrus fruit daily.

          Best, Paul

  22. Hi Paul,

    I tried searching your website for anything related to diarrhea after eating liver. Before I had no problem with it, but after a break and some life changes I can’t seem to tolerate it. Two times, relatively fresh and very well cooked after being soaked in lactose-free milk, only ate ~100 grams first time and 50 grams second time.

    I eat alot of omega-3s, a reaction with vitamin A? I seem to tolerate other copper foods.

    Thanks

  23. I would add Vitamin B Complex to the list of daily supplements! It really helps to keep the energy going and also supports brainwork which is important for office work

  24. Would love to see an updated supplement protocol!

  25. Hi Paul,
    My wonherful doc passed away last year from covid. He struggled with Parkinson’s for most of his adult life, so covid was a challenge. Today I had an appointment to establish care with our local clinic of medical folks. I have mixed opinions about them. This dr seemed okay but pretty standard. Told me that I should have a lipid panel done. They drew blood, but the results don’t look like a panel. All it says is that LDL is 184. I have gone back and read through old posts and comments and realize that I have not been taking iodine. I had read that taking it with ascorbic acid is not a good thing; and since I am following Doris Loh’s melatonin/AA protocol, it seems I’m forever taking AA. I’ll figure out a way to take iodine away from the AA. The notice I recieved from the doctor directed me to make a follow-up appointment and I KNOW the purpose of that will be to talk me into a statin prescription. I am more than resistent. In fact, several years ago one of their neurologists advised me, “Don’t let them talk you into a statin!” However, recently I have heard highly respected “alternative” health folks comment about benefits of statins.
    My question to you — have you heard some of these more recent comments/opinions about statins?
    Thanks so much!
    dale

    • Hi Dale,

      I am not a believer in statins for LDL. High LDL indicates something wrong that is causing the high LDL, and statins treat the symptom without removing the cause. As discussed in our LDL series blog posts, high LDL is usually due a small intestinal bacterial overgrowth that leads to excessive circulating levels of microbial cell wall components, and is secondarily often due to hypothyroidism. Often SIBO causes hypothyroidism, so usually hypothyroidism is accompanied by digestive issues.

      I am not aware that there is any problem taking iodine and vitamin C together, especially in the doses of iodine we recommend. I would reduce the C before I would stop the iodine.

      Statins may have some beneficial effects along with their adverse effects, but there are other ways to get the benefits, so I would not be enthusiastic about them.

      Best, Paul

      • How nice to hear back from you, Paul. Thank for sharing your thoughts. After many months of eczema nearly everywhere, and finding resolution by working remotely with an ND in Kansas City, I certainly hope my gut is still in better shape, although I suppose a follow-up test would be prudent. Wondering if you ever provided a suggested schedule of tests and when to do them. Standard clinics won’t order those tests, which is one reason I so valued my former doctor. I will get back to a daily iodine schedule. Busyness was my only excuse, but I am now retired so no excuses. Thank you so much, again, for your kind reply. Best to you and your people. 🙂
        Dale

  26. What do you think about PQQ (Pyrroloquinoline Quinone) as a supplement?

  27. Hi Paul,

    as it comed to boron – as a supplement – after a quick
    google research finding this pubmed study (went quickly over it a few times)
    I would be positive to calciumfructoborate but not natriumborate as it is genotoxic following the authors.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409115/

    I liked hearing your opinion!

    Best,

    Johannes

  28. Hi Paul –

    I’ve been a long-time follower of PHD – it greatly improved my health :).

    I’ve developed chronic pericarditis, cited as idiopathic, but I’ve also high LDL, bloating and acid reflux.

    I wonder if these issues are connected and am committed to treating both. Could you provide any advice on how to talk with doctors about exploring the causes of my intestinal and digestive issues?

    Hope a 10-year revision of PHD is coming :). i’m happy to help in anyway – the book changed my life.

    • Hi Alex,

      Yes, I would bet the issues are connected. The upper digestive tract infection / microbial overgrowth that generates acid reflux and bloating will also cause high LDL (which results from microbial cell wall components modifying LDL so that it can’t be taken up by the LDL receptor and instead has slower uptake by RAGE receptors on macrophages). The cause of the pericarditis is unclear but the most likely hypotheses would be (a) some pathogens from your upper digestive tract have infected the pericardium or perhaps more likely (b) you have formed IgE antibodies against some foreign thing that commonly enters your body via the upper digestive tract and they are binding mast cells on mesothelial tissues and causing a chronic mast cell degranulation, with release of histamine/cytokines/growth factors.

      You need to address the upper digestive tract issues to fix the problem, in the meantime you can try to relieve the pericarditis with antihistamines (eg Benadryl, Claritin, Allegra).

      For the upper digestive tract be sure you are getting plenty of vitamin A, D, extracellular matrix, and magnesium; and appropriate amounts of iodine, selenium, zinc, copper, calcium, vitamin C, NAC, glycine. Time-restricted feeding with food intake concentrated early in the day (eg 9 am to 3 pm) and a long overnight fast will help. Circadian rhythm entrainment.

      Let me know how it goes.

      Best, Paul

  29. Hi Paul,

    What is your take on the healthfulness of using sunscreen, as part of a daily skincare routine. A lot of people swear by it and say that it is the most crucial aspect for maintaining good skin. Does sunscreen fit into the PHD picture?

    Thank you

    • Hi Theo,

      Generally sunscreen is harmful rather than helpful, but it’s important not to be sunburned, so if you are going to be spending too much time in the sun, it’s better to use it than be burned. However, at exposure levels that would lead to tanning rather than burning, it’s better not to use it.

      Best, Paul

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