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
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Vitamin K2
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Magnesium
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Iodine
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Vitamin C
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Vitamin B-5 (pantothenic acid or pantethine)
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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)
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B2 (riboflavin)
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B6
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Biotin
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B12
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Zinc
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Boron
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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
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Inositol plus Choline
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Iron (optional)
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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
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More Probiotics
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More Probiotics
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Chromium
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Lithium
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Silicon
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Copper (Only If Liver Is Not Eaten)
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Vitamin A (Only If Liver Is Not Eaten)
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Calcium (If No Mineral Water or Bone Stock)
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B-50 complex
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Molybdenum
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Taurine
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Vitamin E
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Therapeutic Supplements
These supplements are unnecessary for healthy people but may be helpful in various disease conditions.
N-acetylcysteine
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Glycine
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Creatine
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Melatonin
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Detoxification Aids
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Miscellaneous
These items may be helpful in implementing Perfect Health Diet and Lifestyle advice.
Pill boxes
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Pill cutter
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Hi Paul, I ordered zinc and copper separately and am awaiting my order. When I run out of copper and zinc, is the Opti-Zinc from Source Naturals that has copper in the ingredients (300 mcg) something I can order to supplement both zinc and copper? I don’t always eat beef liver weekly, maybe once per month.
Thank you.
Hi Dede,
That’s not enough copper to be an adequate source of copper, but it’s fine as a source of zinc taken once or at most twice a week.
Be sure to get some copper elsewhere, preferably from beef or lamb liver, otherwise from copper supplements.
Thank you so much!
Hi Paul,
I found duck liver pate at Whole Foods. Duck liver’s pretty high in copper at 1.7mg per oz. (versus 2.7mg per oz. w/beef liver). Will report back if I can find any nutritional data on the product itself. I’m sure it’s delicious.
Apologies if this has already been asked, but what is the purpose of Vanadium in the body? I have never noticed it in a multi and a few quick Google searches give me mixed information.
Thanks!
Hi Lindsay,
Here’s a discussion: http://www.ncbi.nlm.nih.gov/pubmed/15093669
It seems to be beneficial against diabetes and cancer, and supports thyroid function as well as glucose and lipid metabolism.
I don’t think we need or want much, but it seems prudent to avoid an overt deficiency. 25 mcg weekly is 3.6 mcg per day which is less than some multivitamins contain, eg Centrum Silver has 10 mcg. Older people may benefit more based on high rates of diabetes in the elderly and lower food intakes.
Maybe I should have made it optional. If you eat a lot of vegetables you probably get enough from food.
Hi Paul,
Do you have any particular Betaine HCL & Digestive Enzymes supplements that you prefer/recommend.
Should the betaine HCL supplement include Pepsin.
& if so, any particular ratio pepsin to hcl.
thank you
sorry to bug you Paul, just a note to say,
I would like to give the betaine HCL & digestive enzymes a try. & I was planning on buying today.
But i will hold off until i hear from you Paul.
As i would appreciate your opinion first.
Plus i do not want to waste money buying the wrong products.
greatly appreciated
Hi Darrin,
I don’t think it’s necessary to get one with pepsin. However, if you show signs of lots of undigested protein (eg very smelly stool/gas), then it might be worth a try. I wouldn’t know what amount would be best.
Digestive enzymes — I mainly recommend ones that have a diversity of enzymes including carbohydrate digesting enzymes such as hemicellulase, cellulase, amylase; natural food enzymes such as bromelain and papain; and mixed proteases. These are more likely to help against microbial biofilms. We suggest a brand in the supplement recs but I don’t have a strong brand preference.
thanks Paul
Hi Paul,
I still have 2 bottles of Now Foods Zinc Picolinate 50 mg. Do you find think this form is less effective? I do not mind tossing these out to get the ones you recommend. Or do you think I should finish these off and then pick up your recommendation for Zinc?
Erich
Any problems supplementing very low levels of Iodine whilst on natural thyroid medication Paul?
Thanks
It may take ~3-4 weeks to adapt to higher iodine intake, but I think it’s beneficial to take some iodine. It helps heal thyroiditis, reduces antibody levels in autoimmune disease, and over time it usually reduces the amount of thyroid hormone you need to take.
Hi Paul,
I have to take Levothyroxine to suppress thyroid function, because I had Papillary Thyroid cancer 18 years ago and they only removed half of my thyroid back then. (55 now) My TSH is kept below 0.1. I am taking all your supplement suggestions, except Iodine.
Will it be safe for me to take a low dose of Iodine?
Will it change my TSH levels?
My Endocrinologist thinks I don’t need it, but because of all the benefits I am thinking of trying it. (I also have gut issues and waiting for Metametrix results.) The remaining part of my thyroid has shrunk over the years and I don’t have antibodies. Shrimp and seaweed isn’t part of my diet, but I have started with the rest of the food on the PHD.
Thank you so much for your time and insight!
Hi Erica,
I’m afraid I’m not familiar with that situation, so I don’t feel able to advise you. But if your endocrinologist says it is safe, I would think it is worth a try.
You might start by adding seafood to your diet.
Thank you Paul, I will start adding seafood and talk to my endocrinologist.
Hey Paul,
I just bought your recommended supplements. My wife is worried that the Potassium in the potassium iodide can dangerously affect heart function. Is this a concern?
Thanks,
Tim
Hi Tim,
Potassium supplements are limited to 99 mg for that reason. But you normally eat 4,000 mg per day. Just take the tablet with food and the 99 mg will be a drop in the bucket.
If it’s a drop in the bucket, why bother with it?
It’s recommended for the iodine, not the potassium. The iodine is significant.
I have a question about having dark chocolate daily. Does it need to be every day or what is the mininum grams per day. I have been having around 35g a day of 70% but I wondered if less would be ok or not having it at all. I am just worried about having sugar as I have had been addicted to sugar before. Maybe there is a way of having dark chocolate without sugar. thank you.
Hi Bret,
No, it doesn’t need to be every day. In fact you don’t need chocolate at all if you don’t want it – we recommend supplementing magnesium and zinc for instance so there’s no real need for its nutrients.
But there might be a benefit to having some chocolate every day. It has opioid peptides (exorphins) which may support daytime circadian rhythms. So eating chocolate during the daytime (not at night) might support health.
But the sugar is bad, so you should get dark chocolate. 70% is OK, 85% would be even better. I think 35 g is a healthy amount.
Can’t the issue of sugar simply be bypassed by using cocoa powder instead, or is there some specific benefit (apart from the taste) to ingesting cocoa in the form of chocolate?
Hi Lilian,
Well, the cocoa butter portion is also healthful. Nothing wrong with cocoa powder, but nothing wrong with chocolate either. A small amount of sugar won’t do much harm.
Another idea I found is having a handful of Organic Cacao Nibs a day, which is pure Cacao and no added sugar.
Also check out World Market (née Cost Plus). They are the only reliable — i.e., local / affordable — source of 99% dark chocolate. It’s pretty great.
I get 100% Ghirardelli chocolate from the baking section of the supermarket. It’s a little hard without the soy lecithin.
What are your thoughts on the brand Emergen-c in the packets for Vit C supplement?
I don’t think brand matters when it comes to vitamin C.
Emergen-C is basically a multivitamin. It has zinc, B vitamins, manganese, etc.
Buying it solely because of the Vitamin C content makes it incredibly overpriced (about 10 times as much as the typical Vitamin C supplement, according to my pricing spreadsheet).
Hi Paul,
Thank you so much for the work you do. It is very much appreciated.
It seems like there are A LOT of supplements to take. Even if we forego the optional ones. Are there any concerns regarding the effectiveness of these supplements? Most of them are pretty cheap, which is nice, however, how much do we know about what’s actually IN them and the quality of it? How much confidence do you have that these super cheaply made products are actually benefiting our health?
I value your opinion greatly and would love to hear your thoughts on this.
Thanks Again,
Eric
Hi Eric,
Although there are a lot of pills, there’s not a lot of the active compounds. If you compare them to a multivitamin, the daily dose of most is lower, and many things in a multi are missing.
So quality and fillers/binders would be the concern.
As far as I know, all the linked supplements are made by reputable firms and have what they promise.
I’ve heard concerns raised about a few binders, like magnesium stearate, but have not seen strong evidence against them.
So I guess my answer is, yes, it’s not a perfect situation; it would be better to make our own multi which has everything in one or two pills with minimal binders. But until we find the time to delve into the supplement industry and understand it, this is the best we can do. Overall, I think getting the right amount of the various nutrients is more important than avoiding binders/fillers.
Hi Paul-
Is Lucine alone just as good as BCAA,or maybe even better because of the concentration?
Hi John,
Leucine alone is good. Most of the BCAA mixes are about 2:1:1 leucine:isoleucine:valine, but optimal might be 4:1:1 or 8:1:1. Leucine alone is probably at least as good as the 2:1:1 mix. This is for supporting a ketogenic diet / ketosis.
Hi Paul, why not just take a multi-vitamin that has all of these things? True, it may have higher amounts and other nutrients than what you suggest, but wouldn’t you just pee out the excess anyways?
Hi Alex,
Issues are discussed in the book. No, you don’t just pee out the excess (that’s only true of water-soluble vitamins, and even that takes time).
I apologize in advance if this question has been answered (either here or in your book), but how come you recommend taking B-Vitamins weekly rather than in smaller daily doses? Why don’t you recommend Folate (B9)? And lastly, why do you recommend such a large amount of B1 (thiamin)?
Thank you very much for your time.
Hi Paul,
Just wanted to double check: I still have 2 bottles of Now Foods Zinc Picolinate 50 mg. Do you find think this form is less effective? I do not mind tossing these out to get the ones you recommend. Or do you think I should finish these off and then pick up your recommendation for Zinc?
Erich
Yes, zinc picolinate is fine. 2 bottles will last quite a while at 1 pill a week.
🙁 i need some input so will try to be as brief as possible. February 2012 severe Rt3 issue.
Reversed with T3 only treatment. Iron is perfect, B12, D, etc all within excellent limits for hashimotos person. Adrenal saliva diurnal testing showed low normal morning low midday, low normal evening and hgh night cortisol. I did the Circadian dosing with T3 and immediately felt better this past summer. Started Nature Throid in August (2 grains twice a day was starting dose), and iodine 1mg per month. Am now up to 3mg. I also do selenium 200mg 5x a week and ALL b companion nutrients, Vitamin C, K2 etc. Basically everything on the Perfect health supplement page pertaining to these items..I take. I eat gluten free, low fruit safe starches and NO sugars of any kind except red wine. I am taking 1/2 grain nature throid 3 x a day now bc I felt my adrenals crashing out at the topping dose of 4mg I was on about two weeks ago. I have HIGH morning temps (98.75 and 99.0), high to normal mid morning temps 98.9 and 98.48, and mid day temps settle around 98.48 each day around 3pm. Here’s the problem: I feel like crap. I have fat around my middle that won’t budge, I can’t exercise for long at all (I personal train and by mid morning I an ZAPPED), and sex hormones are low: testosterone is low normal, progesterone low (estrogen dominant) and on low dose of Emerita and testosterone. my SHBG is HIGH 9in the 200’s) even though I am hypothyroid. NO one can figure that out for me…and no one can help me. Why is my temp high with hyper feelings and heart POUNDING after dosing with nature throid yet I feel hypo? My BP is typically 110/70 BPM 69 but 90/54 yesterday. doctor attributes it to how physically active I am. I am clueless and out of ideas. MY last Rt3 was 18.7 (RATIO should be under 20) and my frees were middle low. With adrenals and thyroid and sex hormones all having so many of the same symptoms I have NO idea what to do. The iodine has caused Bromide purging (I am deficient in iodine by 20% with a high bromide percentage) so taking Iodine has done something to me….I also take 2mg of LDN each night. what should I do? stop nature throid and support adrenals? If so with what? Way too many adaptogens are out there and conflict with hashimotos…I have most of them on hand. thanks ahead of time for reading and responding…I am out of ideas and my doctor isn’t going to be able to help much in this dept. 🙁 More testing tomorrow on alll thyroid labs to keep up with everything. I should also mention I am 5’6 1/2″ and weight 131. I am 6 pounds from my idea weight. I also follow circadian sleeping and lifestyle with plenty of exercise and outside time etc regardless of how I feel. I am going broke trying to figure this out. p.s. the Paleo style NO carb diet is what I believe threw me into RT3 last fall….I felt like death.
Hi Carmen,
I sympathize with your plight. Unfortunately it’s hard for me to tell what you should do. I think your diet and supplements sound good now; I’m assuming you’re no longer too low carb. It’s hard for me to tell from your reported symptoms whether the hormones you are taking are helping or hurting.
One thing to consider is that hyperthyroid symptoms can resemble hypothyroid symptoms, and that some people are not clearly one or the other, but can be both: thyroid hormones do not follow normal rhythms and can be too high sometimes and too low other times. So perhaps the lab tests are misleading, or were measured at the wrong time of day to flag a problem.
I would try to take minimal hormones – just enough to keep you from feeling lousy – not necessarily the amount the doctor prescribed. Often you can cut pills with a razor blade to test lower doses. The goal is to avoid interfering with the body’s natural processes as much as possible.
I’d also continue to give yourself time to heal. The circadian rhythm strategies are important. Also it’s OK to be a bit overweight while your thyroid and adrenals are messed up. That’s natural and you shouldn’t fight it – rather try to heal and then your weight will come down.
Finally, I’d try supplementing NAC just in case there is an infectious component to this. NAC is good against many chronic infections.
that was NOT brief. sorry 😯
Thank you Paul…I certainly don’t expect you to tell me what to do..the way I phrased that was out of desperation….I just wanted your expert input on some next steps. I don’t think the hormones are doing much to be honest….three months on progesterone and libido is still MIA. 😕 I am off all meds today for testing and have been off iron for three days so I hope to get an accurate updated picture of this mess. The joint pain is the worst…snapping and cracking noises (no arthritis…been that route several times) and then shots of pain when it happens. I am reading and re-reading all of the Mario posts (I can’t retain much info at one time so I contstantly repeat). I really appreciate your time.
Hi Carmen,
I had some similarly confusing hormonal readings and felt like crap, despite being fairly PHD compliant. I’ll spare you those details.
I persisted in trying to diagnose infections, and after months of testing and doctor visits have discovered an acute epstein-barr infection, and worse, lyme disease. I probably have other infections too.
So for now I’m working on infections and not worrying so much about hormonal and other general health metrics. Liberated probably is too positive a word here. But I am at least willing to postpone worrying about say my cholesterol or thyroid readings while these infections are active.
Perhaps you’ve already pursued this angle, just my two cents. Also, as a former overexerciser myself, maybe it’d be better not to push yourself until you get your health back.
Thanks Shawn….I have been tested for EBV and Lyme. Sadly…I gave up intense exercise quite some time ago and literally only walk my dogs and do some minor core work right now as endurance is crud. 🙁 I am glad you at least got some direction…I feel lost.
Hoping you find answers soon. And I sure do miss intense exercise, four years since I’ve been able to do it.
Hi Carmen,
You know, my wife had snapping and cracking noises and discomfort in her joints, especially hand joints, until she start supplementing vitamin K2 (and D), then they went away. It may have been some kind of calcification of soft tissue in the joints. I would be very careful about nutrition. If you optimize diet and lifestyle, it should improve, and then you can have more confidence that remaining problems are infectious and can search for specific treatable causes.
Hi Paul,
in a generally healthy person, how much N-acetylcysteine (NAC) should we try to get (from food/supplements) per day on average.
thanks
🙂
hi Paul, i think you just sort of answered this query under the q&a section.
btw, the smiley face was my lame attempt at a gentle ‘bump’
Hi Paul,
I read on a website that “food state” supplements are better absorbed than “non-food state”. Is this true?
Also what brand of Sea Salt do you use? What do you think about the “anti-caking agent” added to Salts? Do you know any brand of Iodized Sea Salt that does not use anti-caking agent?
Hi Monnyica,
It can be true, but in most cases if you take the supplements with a meal that contains a diversity of foods including some fats, then they’ll be well absorbed. Conversely the “food state” supplements may not have enough “food” in the pill to enable good absorption if taken apart from a meal. So I think taking them with a meal is most important.
If I am taking 25mg of iodine daily (2 Iodoral tabs) do I need to be taking more than 400mcg of selenium per week?
Hi Laurel,
I think if you eating mainly beef/lamb/seafood as your meats, bone broth, eggs, and low-caloric-density plants as your plant foods, then you should be fine with 400 mcg selenium per week.
If you eat more calorie dense plants/grains and meats from animals not on a grass-or-algae based food chain, then more selenium might make sense.
Hey Paul,
When it comes to supplementing with Iodine, are there any other supplements which should not be taken along side iodine?
I am going to start supplementing with Iodine when I break my 16 hour fast at around midday. I’m going to take the magnesium and vitamin C at the same time too. Is this safe and would not effect the potency of the Iodine?
I’ll make sure I get enough good salt too.
Thanks
Paully
Hi Paully,
It’s safe.
Thank you Paul…I take the K2 you recommended. As of today I feel less joint pain (could be because I took my nature throid down due to hyper feelings…had an ekg yesterday bc of heart pounding (my doctor insisted even though I have Mitral Valve Prolapse and it can cause irregularities). EKG came back abnormal. I feel better on less medicine (could be the iodine raise I did is doing more work so will stay the course with your recommended supplements and diet. You’ve been a tremendous help.
Hi Paul,
I haven’t found anything on sulfur/sulfate in your list of recommended supplements. Do you still recommend one teaspoon of Epsom salt daily dissolved in a cup of water in order to fix a sulfur deficiency?
Hi Erik,
Well, I’ve sort of backed away from that as a routine thing, out of concern that too much sulfur in the digestive tract might support an excess of sulfur-metabolizing bacteria. Epsom salt baths would be safer, or sulfur-rich foods.
It’s hard to know who is sulfur deficient. Some of the most important sulfur is in protein (cysteine, methionine).
Hi Paul,
How about MSM as a supplement? I’ve had what seem a bit like allergy symptoms, e.g., eyes more inflamed w/windows open overnight, and am thinking it might help.
Yes, MSM is fine. Not sure how useful it is, but it is safe.
Thanks
Hi Paul,
After reading this post and watching your AHS safe starches panel (kudos on both), I am curious about the following:
Background:
I do none of that Crossfit/Metabolic conditioning/interval training(heart pumping) work and only pure strength dedicated work through gymnastics/movement with the goal of gaining more relative bodyweight strength (not necessarily more hypertrophy as in body building; muscle gain is fine so long as the focus is on maximizing relative bodyweight strength a la gymnasts).
For the intake of macronutrients, should they be based on “ideal” Lean body mass that we wish to achieve or is it more of a blanket recommendation?
What would you suggest my intake for these elements (should the prescription be general (ie: 600 calories for any person) or as some ratio using your “ideal” lean body mass that you wish to achieve? ie: 1 gram/kg of ideal LBM)
1) carb
2) whole protein
3) BCAA supplemenation
4) leucine supplementation
Thank you for any input you can provide here!
Hi erich,
I answered this here: http://perfecthealthdiet.com/2011/03/protein-for-athletes/comment-page-2/#comment-98512. Sorry for the delay.
Thanks for the response Paul!
So if my 1 g/kg leads me to 65 grams of protein, and i take in 600 carb calories, that puts me to 860 carb+protein calories, 340 calories short of your recommended 1200.
1) Since BCAA and leucine supplementation saves me money off from whole protein, can I make up for this deficiency with 85 grams of BCAA and leucine (that sounds like a lot)? Or should I add in whole protein and carb to get to 1200 calories?
2) what would be a good split for BCAA and leucine.
Erich
Hi Erich,
I’m a bit confused. It’s not necessary to eat 1200 carb+protein calories, although for athletes that may be beneficial. For most people 860 is sufficient, and the 600 carb / 1 g/kg protein is intended for ordinary people.
85 g BCAA/leucine is too much. 10 g would be plenty for one day. Protein is very cheap — eggs are cheap, you can get grassfed organ meats for $3-4 per pound.
A good mix might be 4 leucine : 1 isoleucine : 1 valine.
Thanks for the quick response Paul!
two Final questions:
1) would eating too many egg yolks be a PUFA concern? I avoid egg whites because of avidin, as I heard that it is still a small concern even when cooked from a masterjohn article.
2) So 600 carb calories, 1 g/kg (65 g protein – ~1/2 lb meat + 3 egg yolks + liverwurst from time to time) and 10 g BCAA should be sufficient and near optimal for someone looking to gain strength?
Erich
Hi erich,
I think 3-6 egg yolks a day is acceptable. I also avoid egg whites.
It’s sufficient on average, not necessarily optimal. Optimal is to have intense workouts and rest days, and to overeat after a workout (~25% extra calories, including at least 25% extra carb+protein, maybe more of an emphasis on carb and protein) and undereat on a rest day. The overfeeding / calorie excess is important for strength gains and getting the most out of workouts.
thank you paul!
Paul,
Prior to LC, I was low fat.
Major changes when cutting carbs was:
HDL from 40 to 72. Doc was amazed, asked how did it. Was it from exercise? Looked stunned when I said I actually exercise less. That I cut all sugars and refined carbs – was amazed I don’t eat dessert etc. I went into my usual Taubes, PHD, Protein Power rant and asked if I sounded like a nut. Again, Doc was cool and open minded.
Also, dropped weight by 3% (without even keeping track of calories).
As you know I added carbs (1.5 cups of rice a day, which is 65 carbs that i didn’t have before, and been a tad more loose on veggie carbs etc). Also, been strict on 3 eggs a day and the rec supplements (not the optional ones). Maybe close to 100 grams of net carbs a day now (up from 20-30 and a SPIKE in LDL.)
Question 1: Will this level of carbs lower my HDL? So far, weight is steady (a plus).
Question 2: Why no egg whites – saw it on some Q&A on the site? Is it just that they can start an allergy? Or to make sure not too much protein is consumed.
Question 3: Is brown rice not as optimal as white? Why am i thinking the fiber/husk is good, but there is a toxin??
Question 4: Do i need to read the first book or does book 2 have that all covered?
Like I said, primary care physician was very open minded on diet, being low carb etc. Even said my A pattern (LDL) was good news, I had a zero quantity of the second of the two B patterns. Even agreed to get me NMR lipid bloodwork profile – to count LDL particles. I agreed to see a cardioligist.
Question 5: Anything specific i need to ask the cardiologist or should have tested there? I like to be prepared.
Question 6: Do you enjoy answering questions? If not, I promise to cut them down to a bare minimum in the future!!
Oh, i brought some paperwork to doc to back up my “claims” and Doc asked for me to leave it so she can read it over.
specifically:
Crestor, Jupitor, CRP and Heart Attack by Jeffrey Dach MD
http://jeffreydach.com/2008/11/14/crestor-jupitor-crp-and-heart-attack–by-jefffrey-dach-md.aspx
and
http://www.ahjonline.com/article/S0002-8703%2808%2900717-5/abstract
which shows that HIGH LDL is far far far less correlated to CHV events than LOW HDL. 50% hospitalized with LDL 100 or lower! While high HDL cut risk by 8 fold for low ldl and 4 fold for high ldl. All about the HDL!!!
thanks!
Evan
Hi Evan,
Q1. It shouldn’t have a big impact on HDL. We did a post on how to raise HDL: http://perfecthealthdiet.com/2011/04/how-to-raise-hdl/ if you’d like ideas.
Q2. It’s fine to eat egg whites, but they provide only protein, and I personally prefer meat or fish as a source of protein. Egg whites are more immunogenic than meat or fish.
Q3. Yes. Most rice toxins are in the bran so white rice is safer.
Q4. Book 2 is better. Wait for that.
Q5. Apart from diet, thyroid status is the biggest determinant of cardiovascular disease risk and lipid profiles. So you might want to be aware of your thyroid status.
Q6. Yes.
HOLY KRAP! YOU ANSWERED ALREADY!
Oh yeah, i mentioned to Doc i think lack of iodine (crucifers, and sea salt etc) got me hypo. Then Doc pointed to my “normal” T3. I replied, but that didn’t measure reverse T3, which would be more telling.
thanks for making me a more educated patient!
BTW, got another person to order your book today. So kudos for you Paul!
Note that egg whites have 40% of an eggs selenium. 3 egg whites have 20 mcg selenium, or 140 mcg weekly if eaten daily. 4 oz kidney has 160 mcg selenium. So, egg whites could be one option for supplemental selenium … some weeks kidney, some weeks egg whites, some weeks supplement …
Or being sure to swap the egg whites for selenium containing meat/fish to maintain selenium, which of course will be more nutrient dense overall.
Also note that 3 egg whites are only 50 calories. That’s about 1 oz of meat/fish.
Hi Paul,
My girlfriend currently eats about 200 protein calories and 250 carb calories a day. The rest are fat, probably averaging 1700 total calories. I want to incorporate more carb calories into her diet per your new suggestion, but she has trouble eating 600 carb calories in the 8 hour window that we eat food. She also feels extremely full after eating any increased carb load past 250 carbs and we noticed slight weight gain with that. Since she is relatively thin and small, and also she does not do any high intensity workouts/crossfit type, just strength/resistance work that is not metabolic conditioning, is her current diet okay? I’m worried about the glucose deprivation dangers (which she has not expressed any symptoms – dry mouth, etc) and the expensive pathways associated with using other fuel substrates.
Thanks,
Erich
Hi Erich,
I would expect that if she added another 250 carb calories she could cut 400 fat calories without hunger and without weight gain. But a petite woman could probably survive on what she is eating. It seems a bit of a starvation diet though, in terms of carb+protein. She would find it easier to improve her strength and fitness if she ate a bit more carbs.
Thanks Paul!
Our compromise was for her to have a 100 calorie carb + 10 grams BCAA Post workout shake on days that she works out to support strength gains through overfeeding
Best,
Erich
Hello, I am following the PHD. I have been on statins for two years after my heart attack because my cardiologist won’t treat me if I go off them(tried that). What supplements besides CoQ10 can I take to protect myself from the side effects of the statins?
Hi Paula,
I’m disturbed that your cardiologist will refuse you care if you don’t cede control of your health to him.
May I ask: How will he know if you reduce the dose of your statins (or go off them)? If you would have abnormally high LDL/TC without them, then you should look at the nutritional or thyroid issues that would cause that, and fix them. Your GP/PCP can help with thyroid testing and treatment. If it is that your cardiologist wants to suppress LDL/TC to unnaturally low levels, then I think you should seek a second opinion.
For things that you might be deficient in as a result of statins, see the figure on the right in this article: http://en.wikipedia.org/wiki/Mevalonate_pathway. They include: cholesterol, ubiquinones (like CoQ10), Heme A, Sterols, and other things. You could eat a lot of red meat and butter and egg yolks and liver, or even take sterol supplements like pregnenolone, but really there is no way to fully counteract the effects of the statins, other than to stop them or reduce the dose.
Hi Paul,
About to up idoine from 225 mg (potassium iodide) to 450, as it has been 4 weeks. In 4 more weeks plan to go to 900 mg.
My question is, should I take this as four 225 mg tabs? All at once or 2 in morning and 2 at night?
Also, having 4, won’t that be 4×99 mg of potassium by supplements? Too much?
tx
Evan
Hi Evan,
Yes, 4 225 mcg tablets is good. You could also go to liquid iodine drops if you prefer.
The potassium is fine as long as you take the pills separately and with food.
Evan, you mean mcg right? (not mg).
oops, yes MCG. Perhaps my PCP thinks i am a not now from what i told her.
Paul, what do you mean take the pills separately and with food?
you mean if i take 4, space them out and have food?
As of tomorrow as i start two 225 MCG, i shouldn’t take them at the same time with food due to the potassium?
Hi Evan,
Yes, take one with lunch, one with dinner, one with a snack. Maybe two with dinner, but spaced apart. You don’t want too much potassium at once.
Which form of lithium aspartate or oroatate???!!
Was getting to reorder as I ordered 5 mg capsules instead of tablets
Hi MissBB,
Sorry, I removed the aspartate capsules because I decided 5 mg is too much for most people, and you can’t cut the capsules.
We only have the 5 mg orotate tablets listed now. Those can be cut in half easily, they tend to crumble when cut in quarters.
We really need someone to offer a 1 mg or 2 mg tablet.
I did get orotate tabs but they don’t cut in half very well at all!
There were a few articles mentions that the aspartame long term was damaging, versus other form. Yes a tiny tablet would be perfect!
I noticed the same thing when I tried to cut a pill, so now I just take 1 whole pill on Mon, Wed, Fri. Hopefully that’s okay.
Be careful, 5 mg might be too much. Pay attention to how you feel those days.
The tablets do crumble but that might be OK.
Hi Paul, just now noticed that there is no more link for the probiotic. I always go through your link when I purchase my supplements and am running out of probiotics and noticed it’s gone from your list above. Any news am not aware of about probiotics? I haven’t been been able to check out your blog regularly as I should. Waiting for the delivery of the new book and excited to read it. 🙂 Again, thanks for all the work you and Sou-Ching has done so far. Great job!
Hi Els,
I just decided that we’d rather recommend eating fermented mixed vegetables than taking a probiotic, so I deleted the probiotics.
However, you can still use the Amazon search box to find a probiotic you like and we’ll get the same income.
Thanks for reading us Els!
Hey Paul,
A few supplement/product recommendation questions:
1) What are your thoughts on Coconut Oil . It’s a coconut oil with NO guar gum. Doesn’t mention GMO or organic though… Is that a concern here? Would you still prefer your recommendations over this?
2) Also are there any detriments to eating coconut butter/ coconut manna (sometimes in excess) besides the small amount of sugar it contains?
3) Are there any detriments to coconut flour?
4) what are your thoughts on vanilla extract? Any negatives?
5) I noticed that you had “brown rice” syrup as well as “brown rice” noodles Isn’t brown rice supposed to be more toxic than white rice?
Looking forward to December 11 !
Thanks,
Erich
1. Sounds good.
2. Not that I’m aware of.
3. It’s possible to get too much fiber.
4. I’m not aware of any (as a flavoring agent).
5. Yes. If they would make white rice syrup and noodles, I would recommend those instead. Hard to find those however.
Paul,
Which form of lithium and does it matter?
Hi Paul,
I had a quick question on the timing of food, supplements, saurkraut and bone broth.
I have read that in general it is best to drink liquids apart from meals so that the acidity of the stomach is not diluted.
I have read that taking supplements in the beginning of your meal is best so that they can be better absorbed by increased acidity of stomach as well as the fat soluble vitamins that require fat.
I have read that saurkraut is best eaten apart from food so that they can empty out of the stomach as fast as possible without much exposure to the acidity of the stomach.
Would a routine of:
1) Drinking bone broth in the morning and eating saurkraut as well as adequately hydrating yourself for the day, and having meals throughout the day without liquids be the best idea?
2) Or is it not sub-optimal to have bone broth with meals?
3) Is it sub-optimal to hydrate yourself while eating saurkraut?
4) Is it true that I should take supplements at the beginning of the meal after the first few bites of food? I usually take HCL, and begin to eat immediately. After a few bites, I take my supplements.
Thanks,
Erich
To clarify my very first question, I intend to do this routine.
Drinking 1 cup of water + 1 cup of bone broth + 2-3 teaspoons of saurkraut upon awakening
Wait 30 min
Have my breakfast
Then have the rest of my meals throughout the day. I’ll try to drink water at least half an hour before the meal or 2 hours after a meal.
Let me know if the other 3 questions are unclear. 🙂
Hi erich,
I’m doubtful about the need to limit water at meals. Soups and stews are central elements of many cuisines, and probably very healthy.
I think supplements should be taken with meals but the precise timing doesn’t matter.
It’s true that stomach acid will kill some of the bacteria in sauerkraut. So if you want the highest dose of probiotics, then eating it as an appetizer or snack may be best. However, it’s not clear that most people would really benefit from a larger dose of bacteria. The key thing is to get some into the gut, then they can multiply themselves if they’re filling a niche.
Thank you so much for the lightning fast response Paul!
I guess I have 3 quick questions around that:
1) Does bone broth yield an increase in stomach acid? ie: To optimize sauerkraut timing, is it sub-optimal to take it with bone broth?
2) Is it sub-optimal to take sauerkraut with water?
3) Would bone broth nutrients be maximized alongside a meal, as in it may be sub-optimal to have bone broth on an empty stomach?
4) We mainly use bone broth from short ribs. Do those have enough gelatin/collagen or would you reocmmend that we use shank or even oxtail?
Erich
Hi Erich,
Bone broth has a bit of protein and salt which will promote stomach acid a bit, but not enough to worry about.
I don’t think it’s a problem to take these in any combination.
Short ribs are good. You might get some bones with white joint material attached from time to time.
Hi Paul and Erich,
I cook with my broth rather than drink it. For example, the broths are my liquid for rice cooking. Paul, do you think it is important to drink it for better absorption? I never thought it mattered, but reading these posts, I thought I’d ask your opinion. Also, before I read some negative things about prolonged cooking times with meaty bones, my broths would be very gelatinous after cooking it between 2 days for 20 hours or so. Now, I cook my meat broth for about 3-4 hours and the bone broths, I am still cooking for 12 or so hours. Too long since they are not very meaty? Also, I definitely get meat or bone broth daily rather than your recommended few times per week. Do you think daily is too much?
Thank you!
Hi Dede,
Cooking with the broth is great. No, you don’t need to drink it too. In fact you could easily get too much if you do both those things.
We cook our bone broths for only a few hours, and re-use the bones several times. The flavor is still pretty good for us.
I would say 3 to 7 bowls per week is ideal. So every day is fine, if it’s about a bowl a day.
Thank you Paul. I am just removing my last long cook time bone broth from the stove now. After we finish this one, going forward, I will use your method of a few hours only, whether it is a meat or bone broth. I am sure our gas bill will be lower now! Ha-ha!
I hope you and your wife have a wonderful holiday!
I don’t have any exciting questions. Just wanted to tell you how useful it is to have all this on one page! I’ll definitely reference this again, thanks!
Paul-
I’m not clear as to what you meant about too much bone broth.Would it be too much glycine?
Hi John,
Too much calcium and phosphorus is the main concern, those are the two primary minerals in bone.
What about too much bone marrow?
Boiled big chunks of beef bones, with massive chunks of marrow in them, with some bullion cubes, water, onion and a carrot for several hours.
Ok to eat all the marrow? and drink a half gallon of the broth?
Hi Evan,
Eat as much marrow as you like. A half gallon of broth is a week’s dose of calcium, more or less.
Hi Paul,
I noticed you had written this comment about Magnesium Citrate a while ago “Thank you, KKC, very interesting. I guess we should stick to the chelates. Too bad, since citrate is so much cheaper!” because KKC noticed his magnesium level was not rising until he switched to chelated forms. Do you still recommend citrate? It is a lot cheaper. Also, my friend mentioned that he gets diarrhea much more frequently with citrate. What are your thoughts?
Erich
Hi Erich,
Chelates are better absorbed and less likely to cause diarrhea, but citrates are cheaper, especially the liquid in the pharmacy sold as a laxative, so you decide. For us, we’d rather not recommend something that may have unpleasant side effects.
personally i think mag citrate is “evil”… 👿
but that’s because the first time i tried it, i did not read the label first.
I bought mag citrate in powder form, & on the label it reads “this product must be diluted into a liquid before digestion.”
I am so use to just dropping powder supps in to my mouth, and i did the same with mag citrate 🙁
A very bad rooky mistake, this stuff seriously burns, & sticks to the inside of your mouth. I got it out as quickly as possible, with some burns to tongue and roof of mouth.
That one experience put me off using it at all, even dissolved.
I’ve since read that some people recommend dissolving fully in hot water.
It also made me wonder what mag citrate in capsule form might be doing in the stomach.
I currently use Magnesium Malate.
I started taking Magnesium Citrate a while ago to help with constipation and was please with the results. However, when my magnesium levels were measured I was surprised to find that they were low. I increased the dosage to 800 mg a day but the retest was still low. I now realize that I should try another form, or maybe switch the afternoon dose to see if it helps.
Darrin’s comment concerned me. During the time I’ve been taking Mag Citrate my food sensitivies have increased exponentially and I have been unable to reintroduce foods without side effects. I wonder if the Citrate is adversely my gut health? Is it possible that Mag Citrate is a gut irritant and that’s why it helps with constipation?
Hi Elyse,
It definitely sounds like it might have disturbed your gut. There are several mechanisms by which magnesium citrate could do that. I think it’s a good move to change forms.
Hi Paul, quick question to clarify in supplement recs in regards to selenium. My Cyrex Array 5 Multiple Autoimmune Reactivity Screen) finally came back and reveals an “equivocol” which is between negative and suspicious low. The ELISA Index reference is 0.1-1.3. My value was 1.15 and my ND says I have Hashimoto’s. I take upir lowest recommended dose of iodine and will increase monthly. My question is your selenium rec says 200-400 mg and mcg; so I want to know if I should be taking 200 – 400 mg or mcg per week?
Thanks a million!
Hi Dede,
Yes, that’s per week. Try 400 mcg per week.
I lost the email you sent with how to list ourselves as physicians working with PHD and wholistic testing. May I have the link again?
I’ve informed Van Merkl DC, who teaches nutrition by lab analysis to hundreds of DCs about your work.
http://www.sciencebasednutrition.com
Hi Cyrus,
Just email me at pauljaminet at perfecthealthdiet dot com.
Hi Paul,
This is my first time ordering supplements. I’d like to start with Vitamin D/K. Have you heard any negative reviews/Do you recommend: Thorne Research Vitamin D3/K2 (MK-4)? Are there better brands you’d recommend?
http://www.amazon.com/Thorne-Research-Vitamin-Liquid-1oz/dp/B0038NF8MG/ref=sr_1_1?ie=UTF8&qid=1353467141&sr=8-1
Hi Monnyica,
That’s fine.
I’ve seen Chris Kresser recommend that one.
I sometimes find the combo vitamins a little trickier, because say if more is taken in the winter for the vitamin D, then you get more K2 … maybe that’s good to keep them in a proper ratio, I cannot recall PHD guidance there …
Considering “10 drops contain 5,000 IU vitamin D3 and 1 mg vitamin K2” – that would be a high dose of K2 wrt to the PHD recommendations …
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
Vitamin K2
•Low dose: 100 mcg MK-7
•Moderately high dose: 1000 mcg MK-4, 100 mcg MK-7
•High dose: 5 mg MK-4
Paul,
Re: K2
Vitamin K2
•Low dose: 100 mcg MK-7
•Moderately high dose: 1000 mcg MK-4, 100 mcg MK-7
•High dose: 5 mg MK-4
How do you decide where you should be on this dosage? Better not to have calcium in the arteries, so is more better considering not too many foods in the US have much K2??
looks like LEF have changed there Super Selenium Complex.
it was,
Selenium (L-selenomethionine) 50 mcg
Selenium (sodium selenite) 50 mcg
Selenium (selenodiglutathione) 25 mcg
Selenium (Se-Methyl L-Selenocysteine) 75 mcg
new one,
Selenium (L-selenomethionine) 50 mcg
Selenium (sodium selenite) 50 mcg
Selenium (Se-Methyl L-Selenocysteine) 100 mcg
http://www.lef.org/Vitamins-Supplements/Item01778/Super-Selenium-Complex.html
Paul, does this make any difference, does it still look like a good one?
Hi Darrin,
I think it’s OK. I don’t like the selenite, but I guess 50 mcg is livable. I might go for a selenomethionine tablet and eat beef or lamb kidney for other forms.
Hi Paul,
For the magnesium citrate you recommend (Solgar), I noticed that the 400 mg tablets are a measure of magnesium citrate, not elemental magensium. Should I take two of those near bedtime then to get 200 mg of elemental magnesium?
Erich
or rather should I take 3 pills at dinnertime before bed? as it seems 500 citrate is 80 mg elemental?
erich,
because the solgar ingredient is labelled,
Magnesium (as magnesium citrate) 400 mg per serving.
This should indicate that each serving contains 400 mg of elemental magnesium.
btw, the serving size for this solgar product is Two tablets, therefore a single table will contain 200 mg elemental magnesium.
For absolute confirmation, you should contact Solgar directly
http://www.solgar.com/ContactUs.htm
Thanks Darrin. I have contacted Solgar, but the doctor’s best says Magnesium (elemental), while the solgar says magnesium (as magnesium citrate). Also internet sources say “Magnesium citrate contains 80 mg of elemental magnesium per 500 mg tablet.”
Paul, do you have any thoughts here?
thx for the update erich, let everyone know what Solgar say.
i guess you would also be able to tell by assessing the size/weight of the tablets,
If the tablet weighs approx 500 mg then its approx 80 mg elemental mag.
If the tablet weighs approx 1250 mg then its approx 200 mg elemental mag.
…just had a look at a photo of the Solgar bottle, the tablets look pretty big,
my guess would be that they are around the 1250 mg size (weight)
http://www.solgar.com/SolgarProducts/Magnesium-Citrate-Tablets.htm
Hi Darrin,
They do weigh 1.5 g per tablet according to our kitchen scale. But they include other ingredients per tablet, cellulose is the first ingredient.
Erich, since the label says magnesium 200 mg (as magnesium citrate), I believe they have 200 mg elemental magnesium.
Just noting that Doctor’s Best has additional info on the next line of the nutrition lable showing weight amount of the magnesium salt. Glycinate is 10% elemental vs. Citrate 16%, so it’s all making sense. Doctor’s Best is just a little better with the details on the label.
Magnesium (elemental) 200 mg 50%
– (from 2,000 mg magnesium glycinate/lysinate chelate*)
Paul,
Since adding back rice I have now returned to Japanese restaurants, and boy have i missed sushi and rolls. Look at the pluses, rice (safe non toxic, fish (lean or fatty), and seaweed. However, i am leary of soy sauce.
So i went and bought a bottle of Braggs Amino Acids (gluten free).
What are you thoughts on this products.
Thanks much,
Evan
Hi Evan,
I also like getting sushi sometimes. I was told at one restaurant that traditionally Japanese would not add soy sauce, ginger, wasabi … just plain seafood and rice.
Besides the obvious risks of eating raw seafood, there’s also the mercury to consider:
http://www.nrdc.org/health/effects/mercury/sushi.pdf
Mark,
Check out this chart from the Washington Post.
http://www.washingtonpost.com/national/health-science/2012/04/03/gIQABd16sS_graphic.html
It is my go-to table for fish “healthiness”. Been seeking out bluefish lately.
-Evan
Hi Evan,
I think it’s healthy, it’s just a matter of taste whether you like it.
Paul,
I do. But I was leary of soy. Perhaps the HCL neutralizes the negative properties? Hence why I asked if you would “approve” it on PHD.
One thing that got me curious is K2. Isn’t more better? Why limit to only 100 mg a day?
Also, I am devouring all your prior articles, and was astounded by your experience with low C and scurvy. I used to take 4 MG of C a day regularly, but reduced to 1 MG as per your guidelines – and I think I recall some negative interaction with Cu, is that true. Or can go back up to 3-4 MG a day in C?
As you know I have fine tuned supplements and carbs to attack a rising LDL issue.
Thank you in advance and I wish you and your family a happy and healthy holiday season.
kr,
Evan
Hi Evan,
We use Kikkoman’s gluten-free soy sauce. I think given the small amount of soy protein, and the fact that it’s fermented, it should be safe.
Yes, more K2 is better, but 100 mcg should be adequate for good health and there may be reasons to limit pills or save money not to go higher.
4 g/day C is OK if you prefer that and your digestive tract tolerates it.
Hi, I take a wholefood multivitamin and wonder if you could check it for me. Does it contain enough for me not to have to purchase additional supplements?
http://www.powerbody.co.uk/product-natures-way_alive-once-daily-mens-50-plus-60-tablets-,3286.html
Thank you in advance.
Hi Gary,
It looks to me like it gives excessive amounts of vitamin A, niacin, folic acid, zinc, selenium, copper, and manganese.
Not sure what the herbs are doing.
We no longer recommend a multivitamin in the new edition of our book.
– Starting this as a new thread –
Hi Paul,
For the magnesium citrate you recommend (Solgar), I noticed that the 200 mg tablets are a measure of magnesium citrate, not elemental magnesium. Internet sources says “Magnesium citrate contains 80 mg of elemental magnesium per 500 mg tablet.” Does this mean I should take approx 6 200 mg solgar tablets before I go to bed?
As another datapoint my magnesium glycinate from doctor’s best actually says elemental magnesium at 200 mg.
Could this be why KKC (from an earlier comment) noted that he did not see magensium levels rising as he might have been taking too few?
Erich
Hi Erich,
We have a bottle of the Solgar magnesium citrate at home and the label says “Magnesium 200 mg (as magnesium citrate)” which I assume means it has 200 mg magnesium per tablet.
I wouldn’t recommend taking 6 of the tablets.