Supplements

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)	<br />	<br />	<br />
Vitamin K2 Recommended dose: 100 mcg MK-7 Pharmacological, possibly therapeutic doses: 1000 mcg to 5 mg MK-4	<br />	<br />	<br />
Magnesium Use chelate (e.g. glycinate) or citrate Daily dose 200 mg	<br />	<br />	<br />
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	<br />
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	<br />	<br />	<br />
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	<br />	<br />	<br />

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	<br />	<br />	<br />
B2 (riboflavin) 100 mg per week	<br />	<br />	<br />
B6 For those who don’t take a B-50 complex We recommend 50 mg to 100 mg per week	<br />	<br />	<br />
Biotin We recommend 5 mg once per week	<br />	<br />	<br />
B12 We recommend 500 mcg to 1 mg once per week Sublingual methylcobalamin is preferred	<br />	<br />	<br />
Zinc We recommend about 50 mg per week Be sure to follow our copper recommendations as copper-zinc balance is crucial	<br />	<br />	<br />
Boron The 3 mg dose can be taken one to three times per week	<br />	<br />	<br />

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	<br />	<br />	<br />
More Probiotics Bifidobacterium spp can help with leanness and weight loss. Lactobacillus spp can help with small intestinal issues	<br />	<br />	<br />
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.	<br />	<br />
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	<br />	<br />	<br />
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		<br />	<br />
Silicon Up to 25 mg per day Most people would benefit from more silicon Seaweed is a good food source	<br />	<br />	<br />
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	<br />	<br />
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	<br />	<br />
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	<br />	<br />
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	<br />	<br />	<br />
Molybdenum We recommend 150 mcg to 1 mg per week	<br />	<br />	<br />
Taurine We recommend 500 to 1000 mg weekly for healthy persons Supports production of bile salts	<br />	<br />	<br />
Vitamin E Red palm oil is a good food source If supplementing, take mixed tocopherols and tocotrienols	<br />	<br />	<br />

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	<br />	<br />	<br />
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	<br />	<br />	<br />
Creatine Supports muscle growth and preservation; especially valuable for the elderly Up to 1 teaspoon (5 g) per day	<br />	<br />	<br />
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	<br />	<br />	<br />
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.	<br />	<br />	<br />

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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4,387 Comments.

Milton Safonidas November 18, 2022 at 3:55 am

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

Reply
- Vanessa November 24, 2022 at 3:34 pm
  
  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.
  
  Reply
Micael Leão Michaelsen November 24, 2022 at 12:23 pm

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.

Reply
- Paul Jaminet November 25, 2022 at 2:06 pm
  
  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
  
  Reply
Gianluca December 10, 2022 at 12:00 am

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

Can anyone help?

Reply
Nick December 10, 2022 at 12:58 pm

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

Reply
- Gianluca December 10, 2022 at 11:04 pm
  
  You are right, I can see the link to amazon now. thanks Nick
  
  Reply
Angela January 7, 2023 at 11:16 am

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.

Reply
- Paul Jaminet January 7, 2023 at 11:22 am
  
  Hi Angela,
  
  Yes, vitamin D3 is the bioidentical human compound and will be safe regardless of her allergies.
  
  Best, Paul
  
  Reply
renata February 6, 2023 at 9:32 pm

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

Reply
- Paul Jaminet February 12, 2023 at 7:01 pm
  
  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
  
  Reply
  - W February 22, 2023 at 11:22 am
    
    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?
    
    Reply
Kendall S. February 7, 2023 at 4:46 am

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.

Reply
- Paul Jaminet February 12, 2023 at 7:02 pm
  
  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
  
  Reply
jose barao February 19, 2023 at 5:21 am

Dear Paul

Is there any way to reduce arterial calcification?

Thanks

José

Reply
jose barao February 19, 2023 at 5:25 am

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

Reply
Singh February 23, 2023 at 9:32 pm

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.

Reply
W April 10, 2023 at 3:49 pm

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?

Reply
- Paul Jaminet April 10, 2023 at 4:56 pm
  
  Hi W,
  
  Nausea is a known side effect of excess vitamin A. See https://www.mayoclinic.org/drugs-supplements-vitamin-a/art-20365945. So one thing to consider is whether your diet already has enough.
  
  If you do supplement A, be sure to mix the supplement into a meal / take it with a meal. You don’t want supplements by themselves.
  
  There are also nutrient interactions. Deficiencies of vitamin E, selenium, zinc, copper can make nausea more likely. Excess intake of omega-3 fats can also generate negative effects from vitamin A, see my blog posts about this, eg https://perfecthealthdiet.com/2011/04/omega-3-fats-angiogenesis-and-cancer-part-i/ and https://perfecthealthdiet.com/2011/04/omega-3s-angiogenesis-and-cancer-part-ii/. Therefore, do not take cod liver oil, and try to minimize omega-3 fats to see if that helps.
  
  You can also try to get vitamin A precursor carotenoids from various foods and let your body make vitamin A, rather than taking pre-formed A. See if that helps.
  
  Best, Paul
  
  Reply
  - W May 17, 2023 at 4:18 pm
    
    Thanks very much Paul, I will experiment with your suggestions.
    
    Reply
Holly May 9, 2023 at 2:47 pm

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

Reply
Johannes Baur May 11, 2023 at 12:08 pm

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

Reply