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-
Should we be concerned about choline made from GMO corn and condiments like gluten free soy sauce made from GMO soy?
Hi John,
The corn choline might be a concern; corn oil is highly toxic (Rose Corn Oil study) and similar toxicity from peanut oil was traced to peanut phospholipids. So it could be that corn phospholipids are dangerous.
So that would raise the issue: is the choline purified or still in its native phospholipids?
Regardless, egg yolks and liver are excellent sources of choline and are safe, so I would recommend eating more egg yolks rather than supplementing.
I think gluten free soy sauce is OK, we use it ourselves.
Hi Paul! I hope you and Shou-Ching had a great thanksgiving. My husband and I will run out of our K2 supplement later this week. Should I re-purchase the lowest dose you recommend, or move to a higher dose? I am unclear if we should stay on 100 mcg (Jarrow MK-7), or not. Thank you!
Hi Dede,
Well, I take a higher dose, but you should follow your own judgment. The 100 mcg will deliver most of the benefits. Expense is probably more of a concern than safety with vitamin K.
Okay, thank you. I’d like to try a higher dose. I’ll order the next level on your rec supp site. 🙂
Paul,
General question on supplements.
How do we as consumers know if what we are buying really contains what is advertised on the bottles?
tx
Evan
Hi Evan,
There’s no way to know for sure. You have to find a reputable manufacturer. I believe Consumer Reports tested supplements and found they are generally close to the label. You might want to look up their study.
Consumer Reports reviewed nutrients but never pharmaceuticals and yet the back page of many of their publications had full page ads of drugs. Hmmmm! Unbiased?
hey paul, you have helped with a lot of confusion iv had with my health problems. I was doing low carb and ran into some problems which i managed to fix following the information in your book. I had cold hands and feet and acne which seem to have improved adding in safe starches, liver kidney, soup,and yogurt but i still seem to have trouble with acne and my wounds heal slow. The supplements im taking at the moment are vitamin d3/k2, magnesium 200mg, iodine 225mcg and vitamin c 1-3grams to help aid iodine detoxing. Iv started using charcoal which has helped a bit. Im not taking the other supplements such as the b vitamins and zinc because when i tried zinc before i broke out and i try avoid intermittent fasting worrying that maybe ketones generated will feed fungal growth and produce acne. Do you think fasting would be okay as long as i have sufficient carbs and do i need the b vitamins/zinc and more than 1gram of vitamin c.
Great work am looking forward to your new book.
Greetings from London 🙂
Hi Abu,
Yes, I think fasting will be good for you. A short (16-hour) daily fast won’t generate many ketones.
If you reacted badly to zinc, you may be low in copper or selenium.
You probably don’t need the B vitamins, but they aren’t likely to hurt either if you take them occasionally.
Best, Paul
Hi, Paul! I’m sorry to bother you, but I just realized the copper supplement I purchased is 2.5mg instead of 2.0 This seems insignificant; however, I’m unsure. As a non-liver-eater, would this amount be acceptable? Thanks!
Hi Laura,
It’s fine. Just take it 5 days a week instead of 7.
Thanks so much, Paul.
Hi Paul! Congrats on the new book edition – I’m looking forward to it.
FYI – The Amazon search boxes at the top, and all of the product links lower down on the updated supplements page show up only in Internet Explorer and Safari, but not in Chrome or Firefox.
Hi Matt,
Probably you have an ad blocker on in Chrome and Firefox.
I’ll see if I can change to a different way of presenting it that doesn’t run afoul of ad blockers, but it’s a low priority.
Ah, of course that’s it. No worries, a little fiddling of settings and now all is well. Thanks for the tip!
Hi Paul,
I am currently supplementing with HCL for meals (3x 650mg with pepsin = 1950 mg). What are your thoughts on supplementing HCL along with BCAA as well to maximize digestion of BCAA?
Secondly, what are your thoughts of pressure cooked bone broth vs slow cooked bone broth? Our bone broth made from short ribs is not at all gelatinous after being refrigerated. We think it may be using pressure cooker or is it because of short ribs?
Erich
Hi Erich,
I don’t think you need to digest BCAAs, I think they’re pre-digested.
Yes, the higher temperatures in a pressure cooker may well degrade the protein. It’s probably still similarly nutritious but the texture isn’t the same.
The short ribs may have less collagen too.
ahh that makes sense on the bcaa.
1) what are your thoughts on lysine supplementation for muscle building? or do you think leucine+valine+isoleucine is good enough?
2) is the only sacrifice with pressure cooking most likely the texture and not nutritional value?
3) Do you think another possibility for the lack of gelatin may be the ACV quantity?
4) How necessary is the collagen in your overall whole foods supplementation scheme? Is denatured collagen still as nutritious?
Erich
Hi Erich – I have some ideas about your broth. I LOVE my pressure cooker, it is my Favorite Appliance and I boil bones in it all the time. When I get the joint end bones I get a very gelatinous broth, even if I cook it at pressure all day. When I have middle (marrow) bone sections or leftovers from meat cooked on the bone, it is much more liquidy. I would suggest you find some joint ends if you want gelatinous broth.
hi laura!
what are joint end bones? do short ribs classify? what about shank? we are using leftover bones from meat cooked from short ribs or shanks. do you know if you get it from US Wellness?
Also what is the minimum time you have cooked in pressure cooker to get the gelatin? Does cooking it longer make it more gelatinous?
Lastly, what are your thoughts on ACV (apple cider vinegar) for getting gelatin?
erich: joint bones are joints of animals, also called knuckle bones or gelatinous bones. where the animal has a lot of cartilage. you can also get feet, hooves, tails, and tendons to make very gelly broth.
it is easiest to just get s acheap electric crock pot and cover the gel bones with water. don’t add anything except a splash of something acidic – you want neutral gel that can be eaten with anything. if after 8 hours you use some tongs to pick up a knuckle and there is still shiny cartilage on it then cook it for a few more hours until all those bones are devoid of tissue. usually knuckle bones will be stripped of muscle meat, but some have both meat and muscle and so must be put through a strainer while hot.
do not make this more complicated than it needs to be.
Hi again Erich. I sometimes boil my bones all day, but I have found that I can just use 2-3 cycles of high pressure (my cooker goes up to 99 minutes on a cycle) make a nice gelatinous broth if I have the right kind of bones. That means I can strain it, then add more water and boil it again (sometimes with a few extra bones thrown in for good measure) and get two batches of broth in one day. That lets me get about four batches in a weekend, which comes to 8-10 quarts of broth, enough to last me a few weeks.
I usually get my bones at BJ’s (my local wholesale club – not top quality, but meets the budget) and I can buy a whole tray of chunks of joint-ends like knees, they have a lot of that waxy white cartilage on them. I start the first batch with just the joint bones, then each time I strain it I throw in a few steak/porkchop/chicken bones leftover from dinners for the next batch. I get a variety of different consistencies from the different boilings and it makes a nice change because I have some every day.
I used to use a splash of vinegar but I no longer do this and my broth is always great. When I am portioning it out into jars for my daily lunches, I just add a pinch of salt, then throw it in the microwave at lunch time and it’s perfect. I hope this is helpful!
ohhhh no wonder… I was wondering why the supplement recs page had empty squares. I disabled adblocker and it shows the links. Thanks for providing amazon links Paul!
Question about these supplements… what factors did you consider when choosing these brands? Quality or price?
Also, is MK-4 sufficient? Or MK-7 is needed as well? Which one activates Vitamin A and D?
Hi Monnyica,
We considered dose and form of the supplement first of all, price third — we don’t have a good ability to judge quality so we sort of have to take that on faith. If other factors are critical for you then you may want to do your own search.
MK-4 is sufficient, so is MK-7 since they can fulfill one another’s functions for the most part; ideally one would get a mix of both. They both activate vitamin K-dependent proteins and are synergistic with vitamins A and D.
Hi Paul – I have a question about copper. I have a copper IUD in, and I have recently read that it may cause some women to have problems with excess copper. I would value your thoughts on copper-zinc balance for women using copper IUD’s. I think I am going to try supplementing with zinc. Thanks, and I am looking forward to the new book!
Hi Laura,
I have also heard that IUDs can raise copper levels, but I have no idea by how much. It might be worth asking your doctor to test copper levels to get an idea.
A little zinc is good, but be careful not to overdo it.
Thanks so much for your recommendation! I will try just a little zinc and see how I feel.
Hi Paul-
Is saw palmetto a worthwhile supplement for BPH?
Paul,
Besides scrambled, over easy, hardboiled etc. do you have some good suggestions for intake of the 3 egg yolks a day – to cut the boredom down.
Hi Evan,
I mix them in to soup or leftovers, and microwave the combination.
Come on all you PHD folk, give us your 3 egg yolk formulas. While you are at it, tell us how you include the red palm oil once a week.
I LOVE egg yolk over freshly prepared white rice; it barely cooks it when the rice is still hot! YUM!
Done this the past 5 days. AWESOME!
thanks!
red palm oil goes very nicely over green beans with salt and a splash of lemon juice.
I also like with any lean fresh and roasted fish..
Eggs yolks stirred into any meal containing rice or tapioca.
Similarly I stir red palm oil into a bowl of rice, meat and vegetables just before serving.
Back when I was very strictly excluding dairy I developed a recipe for potato gratin using coconut milk and red palm oil. Served it to company and everybody thought I had used cream.
Boil potato slices 10 min in 2 cups stock
drain reserve stock and place in casserole that has been rubbed with garlic and intersperse
With thinly sliced onions or shallots, and minced garlic
Dot with red palm oil
Add coconut milk to stock. You want half stock half coconut milk. Enough to just cover potatoes
Bake about an hour till slightly moist and top is golden
Reheats well.
I typically vary eggs for breakfast between poached, boiled, scrambled, basted, and raw yolks. Scrambled eggs are good for stir fried rice type foods. Sometimes use raw yolk like a fat/oil and add to starch/potatoes. Top salads with hard-boiled eggs (think Cobb-style) – could top other foods with hard-boiled eggs, too.
Ideas that I don’t personally do could be mix raw yolks in yogurt with fruit (smoothie type idea) … I hesitate to put yolks in a high-speed blender myself in case that’s harmful to PUFA/cholesterol, but maybe that’s irrational and I have no scientific basis. Mix eggs yolks into a hot “Cream of Rice” cereal.
I really like red palm oil in eggs or potatoes. I tend to favor more salty-spicy flavors over sweet and I actually like licking the extra red palm oil off the spoon after adding to my food. 😎
hmmm, I wonder what coffee with egg yolk stirred in would be like …
A couple Hawaiian favorites …
Loco Moco – rice, meat, egg, substitute coconut milk or other sauce/fat for flour-based gravy.
Musubi – seaweed/nori wrapped around sticky rice, egg, choice of meat/seafood or more egg.
bibimbap i guess too
Yep, one of Paul’s standbys … I had bibimbap at a restaurant recently and it came with a cooked egg on top.
3 egg yolks in a coffee cup with 1 tbls olive oil,2 tsp. lemon juice,and a pinch of sea salt.swirl and drink.
i get my cococnut oil fix with a heaping tablespoon into a hot cup of green tea….got to be a bit careful with the first few sips as the scolding hot oil can scorch the throat
twice a day, once in the afternoon, and once in the evening
Careful with hot beverages in general: http://www.webmd.com/cancer/news/20090326/hot-tea-may-raise-esophageal-cancer-risk
Hi Paul,
Do you have an iron supplement you recommend? I was recently tested and my iron is very low after nursing my baby well into toddlerhood. The supplement my doc gave me has 400 MCG of each Folic Acid and B12 as well as a tiny bit of Vit C. I don’t know if those nutrients are a problem for daily use and you recommend something better.
Thank you!
Hi Kristen,
I don’t have a specific recommendation. Heme iron as found in animal meats might be the most beneficial form. Vitamin C improves iron absorption so you might take extra vitamin C. But any of the commercial iron supplements should work.
I can not tolerate egg yolk since I’ve developed gut infections, maybe I am leaky (?).
Do you recommend supplementing with choline?
Thanks,
Alex R
Goodness. I didn’t see that this question is addressed above.
Hi Paul,
I recently came upon this article: http://www.thehealthyhomeeconomist.com/should-vegetable-cooking-water-be-saved/ .
She mentions two things
1) Discarding the water used to steam vegetables
2) Not reheating leftover vegetables
What are your thoughts on these? I currently use bone broth to steam my vegetable and then drink that bone broth (infused with vegetable juices from steaming).
Also I bring lunch to work and microwave the vegetables.
Hi Erich,
That sounds like a good strategy, as long as you don’t overdo the bone broth.
The pesticide residues even on non-organic vegetables are minimal, especially if you rinse them before cooking, so I personally wouldn’t worry about that. And I don’t believe there’s any problem with reheating vegetables, as long as it’s done gently, as in a microwave.
Paul,
I love your book and read it a year ago–my first Kindle purchase! I was following Primal/Paleo WoE for a year prior and thought your book provided an even more sensible framework for choosing how to eat. This topic fascinates me and makes me want to go back into Biochemistry/Physiology or Medicine (if I didn’t have a great job already…).
I do have one question that I cannot seem to answer on my own: Is there a place on this site (or was there in the book) where you have recommendations for lab work to order and optimal ranges for results? It has been nearly two years since my last bloodwork and I am quite curious to see how my diet has been doing for me.
Thanks and looking forward to the next edition.
Hi Sarah,
I’m gradually trying to build up a knowledge base about lab tests — eg see our category “biomarkers” which has posts about LDL/HDL cholesterol at the moment. We also have discussions of optimal TSH in thyroid posts. But I don’t have any other specific recommendations at this time.
Last time I asked for both the VAP profile and the NMR profile, but only was given script for VAP.
VAP gives you more info like how much Pattern A (big and fluffy) and how much Pattern B (small and dense). However, as my doc said the NMR would be an even more informative test as it actually gives you a particle count – which I plan to have done in a few weeks. I would suggest you get at least one of these, as low carb does raise LDL (and HDL) and to ease everyone’s fears, its good to know the quality of the LDL.
Paul,
Sorry last comment for the day, but I was wondering on a PHD which is a form of LC, althought not VLC, how much sodium and potassium should be targeted from food sources a day. I quickly inventoried today’s intake of food and noticed i was about 1640 mg of sodium and 1240 mg of potassium. But then had a large cup of beef bouillion (one cube +790 mg), so now at 2430 mg of sodium and 1240 mg potassium….however, when i add the potassium iodide tabs (400 mcg I comes with 99 mcg times 2 of K), i pressume that is 99×2 more of K, so 1438 mg. Is that a good ratio?
Hi Evan,
That’s low in both. Add some salt to get to 3.7 g sodium per day, and eat tomatoes / potatoes / bananas / vegetables to increase potassium.
To be clear, 0.5 grams of salt is 200 mg of sodium. So to get to 3.7 from my 2400mg so far I need to add 6 small packages to my chopped meat tonight or add a teaspoons of salt? Wow. Happy to read articles you wrote on sodium but had difficulty finding links. Can u post links?
Less than a teaspoon of salt should do it, along with the sodium in food. It’s discussed in the book.
Dear Paul:
What is your take on the Flu shot for children, elderly, and pregenat women? Should these people rely on a healthy lifestyle and dietary habits to prevent the flu? If so, would you recommend high doses of Vitamin D if the flu is contracted as recommended by Dr. Mercola and Dr. John Cannell:
1. Stock your home’s pharmacy with several fresh bottles of 50,000 IU capsules of Vitamin D3 (a medicine at this dosage, not a supplement) and if you get this flu, take 2,000 IU per kg of body weight per day for a week. As I weigh 220 pounds, I would take 200,000 IU per day for seven days if I thought I had an infection with a 1918-like influenza virus.
http://www.vitamindcouncil.org/news-archive/2009/h1n1-flu-and-vitamin-d/
Will 50-80 ng/ml vitmain D3 serum levels protect my children (3 & 6) from deadly flu? And is it safe to get the flu and then recover from it thus, achieving natural immunity which supposedly far superior to artificial immunity to that of a seasonal flu shot? I followed Dr Cannell’s suggestion once with my then 5 year old son one time for only one day. Do you think calcium went into his soft tissues? He is not on calcium supplements.
Last, my children get very little vitamin K. Yes, they eat eggs, butter, and cheese all pasterized and the cheese and butter from grass-fed cows but the amount of K2 MK4 and MK7 are probably insufficient. None of my children nor me or my wife are on Warfarin or Coumadin or any medications. Should I give my children a vitmain MK7 supplement of around30-40 mcg?
And me and my wife consume veggie shakes with plenty of collard greens, kale etc. We drink our veggies from a shake we make. We consume about 4 16oz servings per day. I know a little is converted from K1 to MK7 in the digestive tract but again it’s maybe insufficient? None of us have digestive disorders and we are all healthy. Would you recommend I take say, 100mcg of vitamin K2 MK7? What about a supplement that would give me a mix of MK7 and MK4? Does that exist and if so, should me and my wife take that?
I seem to be a bit confused and in search for answers.
Hopefully you will be kind enough to lend me a helping hand with your thoughts.
Hi Paul,
My girlfriend works at a hospital and they are doing mandatory “whooping cough” vaccinations. what are your thoughts on the safety of this? is it necessasry?
erich
Good afternoon, I have a question regarding iodine.
I have built up to a quarter of Iodoral tablet (approx 3.1mg) per day over the past 9 months. I see you are now only advising 1mg per day. Should I start gradually reducing back down to 1 or 1.5mg – would that be safer? I could perhaps change to Prolamine which would be easier to cut into halves. I have no health issues that I know of. (I take 3 brazils a day and Super Selenium Complex once a week). Thank you.
Hi Liz,
I think 3 mg/day is fine too. If you’re comfortable at that dose then you could just continue with it.
Hi Paul, January 1st, I will go up to 900 mcg of Iodine. I bought the Now Brand with potassium from your site and am taking 2 per day, i at lunch, and the 2nd at dinner because of your recommendation of spacing them due to the potassium. Since I will jump to 4 tablets next month, how should I take them? Or, do you suggest trying to quarter the Prolamine?
Thank you for your guidance.
Hi Dede,
You can do it either way, but I think the Prolamine is hard to cut into quarters. You could take two at a time as long as they are with meals. You might go to 3 of the 225 mcg tablets per day first, follow that for a month, and then try 4. Gradual is best.
Hi Paul,
What are your thoughts on Lugol’s 2% solution as an iodine source?
Thanks.
It’s fine.
I will do more gradually, and I appreciate as always your help!
I really enjoyed the Underground Wellness show!
Counting the days until I receive the book next week!
Paul,
Almost done with first bottle, 60 count of MK-7. Saw the 180 count High Dose you list as a good value play, $42 for 180 vs $12 for 60 at a much lower dose.
Question, what is the downside with taking this higher dose? Based on short vit K half-life, wouldn’t a higher dose be better??
Hi Evan,
I don’t think there is a downside. Some people worry that there might be an unknown problem because the higher dose supplement is synthetic in origin and has both left and right chirality (only one of which is biologically natural). But these have been tested in clinical trials and shown positive results.
I searched your site and supplement recommendations for whey protein powder because I am curious about whey protein isolate versus whey protein concentrate. Also, I’m looking for a reputable grass-fed brand and am wondering if you’ve come across a recommendation. Thanks for your time.
Hello Jeffie:
The differences are subtle and similar. They both contain key amino acids to help retain muscle. Either way, try to restrict protein intake. Good and reputable brands include, Jay Robbs and Dr Mercola.
Based on this information:
http://suppversity.blogspot.com/2012/12/chromium-picolinate-worsens-insulin.html?spref=fb
Do you still recommend chromium? Seems like chromium may actually be harmful for non-diabetic, non-obese individuals.
Hi Jason,
We’ve reduced our recommendation from daily to once a week. So our recommended dose is about 1/20 the amount tested in that study.
It should be noted that (as far as i can tell) most of the studies on Chromium are using Chromium Picolinate.
So a chelated chromium form may or may not act in the same way?
Here a few related comments from other sites;
http://www.acu-cell.com/crcu.html
“…Chromium Picolinate (chromium + picolinic acid) does not increase lean muscle tissue and decrease body fat, as advertised by other sources. In fact, in contrast to the control groups, some of the participants in the chromium picolinate group actually gained weight (one of my patients took part in that research), and one published medical report stresses the implications of analogues of picolinic acid being able to cause significant behavioral changes in those with an increased susceptibility for mood disorders.Chromium picolinate is clearly the least desirable form to be used for supplementation (see below for more adverse effects).”
http://www.acu-cell.com/dis-pro.html
“…While supplementing zinc alone would theoretically help left-sided sciatica, this does not always normalize a low zinc / high potassium ratio since increased zinc levels may boost potassium levels also,so instead, one needs to supplement Chelated Chromium (not Picolinate or GTF)…”
http://lpi.oregonstate.edu/infocenter/minerals/chromium/
“Most of the concerns regarding the long-term safety of chromium (III) supplementation arise from several studies in cell culture, suggesting chromium (III), especially in the form of chromium picolinate, may increase DNA damage (29-31). Presently, there is no evidence that chromium (III) increases DNA damage in living organisms (1), and a study in ten women taking 400 mcg/day of chromium as chromium picolinate found no evidence of increased oxidative damage to DNA as measured by antibodies to an oxidized DNA base (32).
Several studies have demonstrated the safety of daily doses of up to 1,000 mcg of chromium for several months (23, 33). However, there have been a few isolated reports of serious adverse reactions to chromium picolinate. Kidney failure was reported five months after a six-week course of 600 mcg of chromium/day in the form of chromium picolinate (34), while kidney failure and impaired liver function were reported after the use of 1,200-2,400 mcg/day of chromium in the form of chromium picolinate over a period of four to five months (35). Additionally, a 24-year old healthy male reportedly developed reversible, acute renal failure after taking chromium picolinate-containing supplements for two weeks (36). Individuals with pre-existing kidney or liver disease may be at increased risk of adverse effects and should limit supplemental chromium intake (1).”
Dear Paul:
I bought and read The Perfect Health Diet many times. With nutrient-dense food, vitamins, and a healthy lifestyle, what is your OPINION on the Flu shot? Are these good enough strategies to avoid the flu shot? Do you recommend a high doses of Vitamin D to maintain serum levels around 60-70 ng/ml? What are your thoughts on safe tanning beds that use electronic ballasts and high UVB and very little UVA?
Your book mentions to keep 25OHD levels around 40-50 ng/ml. Other credible sources mention keeping 25OHD levels around 60-70 ng/ml year round for Vitamin D to help protect against flu, cold, and other viruses. Question: How can you prevent the flu when 25OHD levels are only at 40-50? What is the relationship of Vitamin D in terms of protection from contracting the flu and some of the negative side effects like reduced bone density as mentioned in your book?
According to the Vitamin D Council—a source you used in your book—when you contract the flu, one should Stock your home’s pharmacy with several fresh bottles of 50,000 IU capsules of Vitamin D3 (a medicine at this dosage, not a supplement) and if you get this flu, take 2,000 IU per kg of body weight per day for a week. As I weigh 220 pounds, I would take 200,000 IU per day for seven days if I thought I had an infection with a 1918-like influenza virus (http://www.vitamindcouncil.org/news-archive/2009/h1n1-flu-and-vitamin-d/).
What are your thoughts on mega-dosing when a child or adult contracts the flu?
Last question: My children get very little vitamin K. Yes, they eat eggs, butter, and cheese but the amount of K2 (MK4 and MK7) are probably insufficient. According to the National Academy of Sciences in 2000, they recommend children 1-3 consume 30 mcg/day, 4-8 consume 55mcg/day, 9-13 consume 90 mcg/day. Should one supplement a little less than these recommendations since eggs, butter, and cheese are consumed throughout the week with some veggies?
I seem to be a bit confused and in search for answers. Please lend my family and I a helping hand with your thoughts.
Sincerely,
Eddie Pena
Hi Eddie,
I would rather not advise on flu shots as it is not an area of expertise for me.
I do believe 40 ng/ml is healthier than 60-70 ng/ml.
It may be beneficial to overdose on D while one has the flu, but 200,000 IU is much too much. Do not do that. Maybe 10,000 IU/day for a week at most.
Vitamin K2 is not toxic so it’s OK to give children extra. They can take 90 mcg/day supplements along with aged cheese and fermented foods.
Dear Paul,one more question:
In your book, you mention under the Finally DO section, supplement a daily multivitamin. Most multivitamins contain supplements which you suggest to only consume weekly. The suggestions seem to be contradicting. How can daily multivitamin consumption containing nutrients we should consume weekly be possible? Or do we just skip the multivitamin and buy each of the weekly supplements separately? Last, do you recommend whole food supplements over synthetic supplements? There seems to be bioavailability and toxic concerns with synthetic vitamins? Thank you for providing a privilege and charity to all of us.
Sincerely,
Eddie Pena
Hi Eddie,
Look above at this page, we’ve changed our recommendations and no longer recommend a multivitamin. Skip the multivitamin.
For most nutrients the whole food and synthetic supplements should be equally good. There are some where food matters, but most of those we recommend getting from food.
Thank you, Paul. You are truely a blessing to us all! With the supplement recommendations, is there anyway you can come up with dosing for toddlers, children, and teens (either in your book or in this site)? Such information would be tremendously helpful for those like myself who have children.
Hi Eddie,
Dosing for children is a good topic for a blog post, or series. I’ll work on that when I get time.
Hey Paul congrats on the book launch. I heard the podcasts and I think you mentioned that eating half a pound of fatty fish to a pound offers enough omega 3. A pound supplies about 10grams which is what the first edition recommends, but in the podcast you says half a pound a week is okay which gives only about 5 grams omega 3 a week? Just wanted to clarify that and also would eating a pound of fish in one day be okay if it’s tough to space it due to travel giving 10g omega 3 in a day or should it be spaced over maybe two days. Thanks in advance
Hi Abu,
No need to space it, you can eat a pound of salmon in one meal if you want.
Free range vs conventional raised eggs. Is the recommended daily amount different for each?
Hey Paul,
If I don’t eat egg yolks daily because I am very sensitive to them. How much choline should I take per day? Thanks!
Hi Katie,
500 mg is a good amount. It’s very safe.
Hey Paul, I started iodine two weeks ago at 225mcg and make sure to eat the supplemental foods, for selenium, along with d,k2,200mg magnesium, 1gram vitamin c. Since taking the iodine I have a very sore throat which hasn’t gone away yet,it’s been 3 days. And am getting acne on my face, and a bit on shoulders and one or two red spots on my neck. At the same time I started dandelion tea so I’m not sure if that could be a cause. Should I try taking more vitamin c maybe 3 grams daily. I use now foods c-1000 with rutin and bioflavanoids. Help!
Hi Jessica,
That sounds like bromine toxicity. Take extra vitamin C, salt, and water. It can take a long time to expunge the bromine but it is good to get it out of your body. You can google this to see if symptoms match.
I might avoid the dandelion tea, rutin, and bioflavonoids for a bit, look for some pure C. Also get thyroid levels checked after 3-4 weeks to make sure thyroid status isn’t impaired. Don’t raise the iodine dose further until thyroid status is normal.
I was reading the post from jessica about the iodine. I have been taking about 3mg of iodine a day. I feel like detox also. I am hypo thyroid, and take ndt. Isnt the iodine good for the thyroid? What do you mean check the thyroid after the iodine? Thanks!
One last thing about iodine, can it cause constipation 🙁
Hi Katie,
Hypothyroidism can cause constipation.
Iodine can be good or bad for the thyroid, depending on the situation. This is why you want to increase dose gradually and watch for effects. Be careful to maintain good selenium status.
Thanks Paul, So would the following vitamin c be acceptable http://www.jgsupplements.com/products/vitamin-c-powder-227g-8oz.html Would a quarter teaspoon of salt be in addition to the salt in food be sufficient, and does it have to be unrefined sea salt or is regular fine? Yeah Katie, i think if you take too much at once it can cause a reactive thyroid so you need to start low and build up gradually, Paul has a post on it 🙂
Hi Jessica,
Yes, that’s good.
Unrefined salt is better but regular salt is acceptable. I’m not sure a quarter teaspoon is enough. I would recommend a teaspoon a day probably.
Hi Paul,
Do you see Sodium Ascorbate as an okay form of Vitamin C?
Especially for those who have no problems with sodium.
1,000 mg of sodium ascorbate contains 889 mg of ascorbic acid and 111 mg of sodium (source wiki).
& for those with sodium affected hypertension…may be best to avoid as a Vit C source?
…i get the impression (see link below) that when Vitamin C is administered intravenously, it is the sodium ascorbate form that is used.
I could easily be wrong on this though (google research).
http://www.orthomed.com/titrate.htm
“Vitamin C, Titrating to Tolerance”
Hi darrin,
Yes, I do.
The amount of sodium is so small in relation to daily needs, it’s not a concern. We need sodium.
Do you think maybe stopping iodine for a while would help because the sore throat hasn’t gone yet. Maybe having 225mcg on weekdays and stopping on weekends, which is 160mcg a day? I’m not sure if I’m getting enough selenium, I eat quarter pound of liver and about half a pound of kidney, egg yolks daily and the rest is meat fish and chicken, but no brazil nuts or seafood. Also Paul, in your book it says 40mg is the upper limit for zinc, any more and it can induce copper deficiency and feed pathogens. I only seem to be getting 20mg with food and supplementing 50mg once a week, but was thinking of trying more to help with acne, is it plausible do you think?
Hi Jessica,
I do think it makes sense to cut down on the iodine to make sure that is behind the sore throat — that it comes and goes with the iodine.
The zinc is worth an experiment also, to see if it affects the acne. It would be good to know if the acne is due to bromine driven out by the iodine, or some other cause like zinc deficiency.
Do you have any information about beeturia. Is it an indicator of poor health-iron overload or some kind of malabsorption? I was told it was normal, but a google search freaked me out.
Thanks.
Hi Tami,
I’d say it’s primarily an indicator of gut flora, secondarily of iron status. It tends to indicate low iron, not high iron. It primarily indicates high oxalate levels in the gut, possibly also a deficiency of bacteria in the gut able to digest betalain. Oxalate is generated by fungi, so it could indicate a fungal overgrowth in the gut.
It could indicate oxidative stress also, since vitamin C can be oxidized to oxalate.
So I think it has diagnostic value. I wouldn’t be overly concerned about it, I would continue to eat beets, but I’d try to get more bacteria into the gut and fewer fungi, and maybe work on glutathione status.
Thanks, Paul. Any advice on how to have fewer fungi? I drink home made raw milk kefir almost daily. And I noticed the beeturia when eating a cultured veggie from a company called Zuke’ made of beets, Dulse, and kale. I phd diet exclusively except for the very occasional restaurant meal. Any other ways to increase good bacteria and work on glutathione status would be appreciated.
Hi Tami,
Well the kefir has yeast so that could be part of it. You could switch to bacterial ferments, eg yogurt or our fermented mixed vegetables.
Glutathione – vitamin C, NAC.
Okay. I will add NAC I am already taking C. I love my kefir so that will be a tough one. I have regularly been under 100 g of carbs. Maybe I should up that before letting go of the kefir? I was under the impression that the yeasts on kefir were beneficial.
Thank you
Hi Tam,
Well, if your only symptom is beeturia, there’s no real reason to think they’ve been doing you harm.
Hi Paul,
I have noticed you do not list Source Natural Minerals anymore. I take these at 1 tablet, 5 times per week. I think everything comes out within range of your recommendations with this dosage. Is it because of calcium there you do not recommend it? Also I am not sure about Manganese, that comes out about 10mg per week, is that ok?
http://www.iherb.com/Source-Naturals-Life-Minerals-No-Iron-120-Tablets/1258
Hi Steven,
It’s a good formulation, I like that one. Manganese would be the only significant concern for us in that one.
Thanks Paul, So what is the maximum Manganese dosage per week?
I think food provides plenty.
Hey Paul,
I take a multivitamin that is 8 pills daily and aligns pretty closely with all of your supplement recommendations. Plus take a K2 and eat liver for other requirements/eat a very well balanced PHD diet … is there any reason I should go to all the work to get a bunch of different supplements when my multi seems to cover all the bases?
Hi BS,
Well, if you read the micronutrient section of the new edition you’ll see our thinking. We have concerns about an excess of various micronutrients, notably manganese.
I have ordered the new version of the book.. can you give me a super short version of the concern? how much is too much manganese?
Any supplemental manganese may be too much, as the amounts in food seem to overlap with the toxic range.
Hi, Can I take lithium with prozac?
Hi imran,
They do have interactions (http://www.drugs.com/drug-interactions/lithium-with-prozac-1477-0-1115-648.html) so I would consult your doctor. The dose we suggest of lithium is low, but you should work with your doctor.
Hi Paul,
I have ordered 3 copies of the new edition of your book, one for myself and two for gifts. I am very excited to read it.
Some of my friends (we are all “women of a certain age”) take Strontium for osteoporosis. What is your opinion on Strontium?
Hi Donna,
It is sort of a calcium substitute. It’s not clear to me that it’s better than calcium. It is heavier so it increases bone mineral density, but without necessarily increasing bone health! My other problem is that the doses of the available supplements are too high. I’ve seen strontium tablets of 750 mg. We should get 750 mg of calcium per day. So this dose is of the same order as the total dose of calcium we should get — effectively this would create an overdose of calcium+strontium if you took it every day.
I don’t think there’s enough data to really judge if it is beneficial or harmful. I sort of prefer just getting the right dose of calcium by eating bone broth soups occasionally, and optimizing D/K2/C/collagen/magnesium.
Thanks for your quick and careful reply!
I am already taking D/K2/C/magnesium per your recommendations and making/eating 3 bowls of bone broth weekly as you suggest. Hopefully, my year following the PHD will show up as an improvement in my bone density when I am retested in a few months. I have already noticed improvements in digestion and rosacea.
Hi Donna,
Good to hear about the digestion and rosacea. Let me know how your bone mineral density comes out.
Hi Paul,
Quick question about B12. My doctor recently included a B12 panel in my yearly blood test. It turns out I am pretty high in B12. The high end is 900pg/ml and I tested at 1245. She didn’t seemed concerned because my other blood counts looked normal. However, I have read that it is very uncommon for people to have high levels without some sort of problem. I eat a substantial amount of red meat, dairy, eggs, etc. Also, recently I noticed that a B-complex I was occasionally taking had way more B12 than I thought. Do you think this is enough alone to cause the high levels? I was under the impression that B12 being water soluble meant that the body disposes of that which is doesn’t need. Any thoughts?
Thanks much!
Hi Lindsay,
It is common to have high levels of B12 during infections or some gut dysbioses. I’m not sure why that is or what it means.
In your case it might be because of the B12 supplementation. The B12 half life in the body is about 6 days, so levels might still be elevated a week after your most recent supplementation. We recommend supplementing once a week in the new supplement recommendations.
Hey Paul,
Ordered 2 copies of the new book and will be getting them on monday:) Maybe you have gone over it in the new book or in this mammoth comment section, but do you have any specific recommendations for when and how to take certain doses or vitamins? I feel like if your taking something only once a week you would want to optimize it;s absorption. Best to take them in the morn or at night? after eating fats or not? with certain foods or without? as always I appreciate your feedback.
Hi BS,
Generally speaking, supplements should be taken with food, preferably with the largest meal of the day, but not too late in the day.
Hi Paul,
I take your recommended supplements and follow the diet to a T except for the bone broth soups. I’m having trouble finding bones. However I still have a slight haziness once and awhile and am not fully able to focus sometimes. I’m on full alert if I drink anything with caffeine, but I would rather not rely on something like that (I never have caffeine). I also heal somewhat slow and get infections very easily. Otherwise I feel great, I no longer feel lethargic as I once did. To note though, about a year and a half ago I got a really bad infection on my foot and had to go to the hospital and was on a 6 week regimen of 3 different types of antibiotics so no doubt that messed me up, but is it possible I haven’t fully recovered even though I’m over a year removed?
Hi Erich,
It can take quite a while for the gut flora to recover from a course of antibiotics — several years, which you can possibly accelerate by eating fermented foods. You might want to get a stool test to see if you can detect anything treatable there.
It can also take years to recover from chronic infections. Many people live with chronic infections their whole lives, so it becomes a matter of managing/minimizing them rather than eradicating them.
It is hard to diagnose these chronic conditions until they become so severe that the infection at fault dominates everything else. So, if you can’t get a diagnosis, the best thing is to eat and live well and give your immune system its best chance to win the war.
This might be a stupid question.. but with all the topic of oxidization I can’t help but wonder if most supplements should be kept in the fridge? or are they all stable enough for cupboard storage?
Hi BS,
It’s not a stupid question but I think the label advice to store in a cool, dry place is best. The trouble with the refrigerator is that when you open a bottle stored in the fridge there will be condensation and the water is much more dangerous than air or room temperature. The exceptions would be oils like fish oil or probiotics.
Hi Paul, I am reading the new addition of your book and it is excellent! Thank you so much for all the hard work you and Sou-Ching have done. I do have another question-concern-what about the arsenic in white rice? You may have discussed this elsewhere, but I was unable to locate the information. Thanks, Vicky
This would be a good one to add to a FAQ page on the site:
http://perfecthealthdiet.com/2012/12/launch-day/comment-page-1/#comment-104668
Hi Paul, I just finished up the chapter on the fat soluble micro-nutrients. I first purchased from your link, the lowest dose recommendation of 100 mcg of K2 and took one per day. When I ran out, I purchased from your link, the moderately high dose (Life Extension Super K). After reading this chapter, it says once a week supplementation of K2 when it is 1 mg of mixed MK-4 and 7. Does this mean I should be taking the Life Extension once per week? I have been taking it daily. Your clarification is much appreciated. Thanks a million!
Hi Dede,
I take it daily but once a week is probably sufficient, so you could save some money doing it that way.