Supplements

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

Supplemental Foods

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

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

Daily Supplements

These are supplements we recommend be taken daily:

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

Weekly Supplements

These are supplements we recommend be taken once a week:

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

Prenatal Supplements

The most important prenatal supplements are:

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

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

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

Optional Supplements


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

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

Therapeutic Supplements

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

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

Miscellaneous


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

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

Thank you for supporting the blog by shopping here!

Want to search for more things? Search Amazon:


Leave a comment ?

4,429 Comments.

  1. Hey Paul,

    I am back to bug you some more:)
    My family and I take baths with magnesium chloride crystals (about a 1.5cups in a bath) every week or two… do you have any how much magnesium supplementation this would offset? is it possible to have to much magnesium? we all take baths and supplemented magnesium and I would hate to be poisoning my little boy.

    • Hi BS,

      You’ll certainly absorb some magnesium through the skin, so that calls for reducing magnesium supplements. It is possible to get too much magnesium; the kidneys will eliminate excess magnesium into urine, but this could stress the kidneys in some circumstances.

  2. it seems like there are many different types of most kinds of vitamins.. do you have any recommendations on types? I am looking at B-vitamins and there are many different types. Don’t wanna buy crap!

  3. Hey Paul,

    Use some of your vitamin recs do have recommended forms of vitamins.. but some do not, does this mean any type will do? just looking for a few brief minutes for thiamin i have found many types including: thiamine hydrochloride, thiamine disulfide, S-benzoylthiamine O-monophosphate and thiamine pyrophosphate. I feel like this is a lot for the average person to know and far too much for a guy like me to wade through in terms of understanding the science behind it all. I like most people just want to be told what to do:)

    • Hi BS,

      In most people the forms don’t matter as alternative forms will deliver the same vitamin to the body. I think for the average person it’s enough to take the common forms; they’re usually popular for a reason, whether that’s low cost or well validated effectiveness.

  4. Hi, I read PHD several years ago and just ordered the new addition. I am wondering if you recommend any probiotic supplements. I’ve been eating mostly PHD for a couple of years, as well as eating/drinking fermented products, but can’t seem to kick this case of candida. Thank you for everything!

  5. Hey Paul, would it be best to take vitamin c ,nac and tsp of sea salt iwanter on a empty stomach during the fasted morning period and the d,k2,magnesium and iodine with your first meal at lunch? Also I understand from your first book that around fructose should be kept under 12 grams, roughly 24grams of sugar, like that in 2 bananas, but when I log my food intake in it shows extra sugar coming from other food sources like natural plain yogurt (150g plain yogurt giving 7grams sugar) or 500grams White potato giving 8grams sugar. Maybe the food tracker has something wrong, or the sugars in those foods aren’t high in fructose and theirs no need to account for them?

    • Hi Jessica,

      I think that’s OK but I would tend to take the vitamin C with food also.

      We’re now saying under 25-30 g fructose per day, all from whole foods (eg beets, carrots, fruit, berries). But yogurt is OK, get plain whole milk yogurt. Don’t worry about the tiny amount of sugar in potatoes. I think fructose is low in potatoes.

      • Thanks Paul, so I’ll just take NAC and vitamin c with all the other supplements at my first meal.Sounds great, is 25-30g still okay if you have fungal overgrowth. I’m not sure but is dandruff, rashes in warm places like the inner thigh, athletes foot fungal? If so how would you go differently about it. I remember you mentioned you were going to so a series on acne, I’ll be looking forward to it! When taking the potassium iodine from now foods, if your taking 3 tablets to get 675mcg iodine daily , can you take them at once or should it be spaced, maybe some iodine on a empty stomach fasted or it needs to be with some food?

        • Hi Jessica,

          Those are all common fungal symptoms, yes.

          I think the 25-30 g from foods is fine unless perhaps you have fructose malabsorption then it might help to cut it down a bit, but a little fructose helps get glucose into the liver which may support glycemic regulation and possibly immune function.

          I would split the potassium iodide tablets across meals, and take them only with food, you don’t want too much potassium at once. If they were iodine only it would be OK to take at once. Iodine should be taken with food.

          • Sorry, could you give details on how to take it. Being in the UK I can’t get the standard process Prolamine Iodine so I can only go with taking 4 potassium iodide tablets to get 900mcg daily, unless you can recommend any other iodine supplement. So would it be fine to take 2 225mcg tablets at lunch and 2 225mcg tablets at dinner and should it be before you eat the food,during, or after? Your speedy responses are appreciated by all of us here Paul 🙂

          • Hi Jessica,

            2 during lunch and 2 during dinner is good.

            You just want the food to slow down absorption so it doesn’t go into your blood all at once.

          • Paul, what about Iodine Kelp supplements, are those still contaminated?

          • Sorry, found the answer below, thanks.

  6. Hi there, Just listened to your interview on Latest in Paleo and really enjoyed it. You’ve been on my radar for a while and I’m looking forward to getting the new edition of your book. I’ve been eating about 80% paleo (sugar is my devil) for a while now and have upgraded my food several times to include grass fed beef, pastured eggs and raw milk several times a week. However, I do desire to have the least amount of supplements possible. I take things like DIM and iodine and vitamin D to help my estrogen metabolism and hypo thyroid symptoms, but I wonder how often you should consider either lowering or stopping these type of supplements after proper levels are reached.

    For example: Can one take DIM forever even after the estrogen metabolism test comes back in range? What about Vitamin D after the level of 40 is reached? (I am at 49-54) I am particularly concerned about taking iodine of which I take 50mg per day. Will an iodine loading test tell me if I can lower the dose or is this dose ok to take indefinitely? Thanks for any help you can offer as I muddle through my personal experiment:))

    • Hi Laura,

      Well, we recommend vitamin D sufficient to produce a serum 25OHD level of 40 ng/ml at all ages.

      Iodine at 50 mg is a very large dose, sort of a pharmacological dose that might be therapeutic for some conditions but has risks. We recommend more like 1 mg. It is OK to lower the dose.

      I don’t know anything about DIM, so I’ll leave that to others to advise you about.

  7. My apologies if this has been addressed before, but I did a search and didn’t find anything specific.

    Magnesium pills gives me the runs, and my schedule doesn’t allow for daily epsom salt baths. Do you have any other advice for magnesium supplementation?

    • Hi Bess,

      If magnesium gives you diarrhea, then it may be that you aren’t absorbing it because you don’t need it. So perhaps you don’t need to supplement.

      You could try different forms, eg an amino acid chelate like magnesium glycinate, they may be less diarrhea inducing than citrate.

  8. Hi Paul,

    I can only find Zinc Picolinate, is that OK?

  9. Hi, I’m sure this is asked a lot but I couldn’t find it from searching.

    I see no mention of probiotics or prebiotics on this list, only enzymes. What do you think of them in general?

    Chris Kesser recommends Klaire Labs’ options and they’ve been suggested by a lot of other people too.

    Only useful after mangled guts left disordered after too many antibiotics or useful for the general population? I see them on a large amount of people’s desert island supplement lists, even people who are liberal with kefir and fermented dairy.

    Thanks for all your work!

    • Also, wondering what bloodwork/other diagnostic tests you’d recommend for someone with severe brain fog/mental fatigue (rather than CFS type symptoms; no problem with intense physical exertion) already following the PHD other than the Metametrix microbial ecology panel, standard hormonal panel, and a CBC. Any of the other Metametrix tests helpful?

      • Well, there are no good diagnostic tests for problems internal to the brain, such as brain infections. If you suspect that, you almost have to try treatments and see if they help.

        If the problem originates outside the brain, the usual culprit is the gut. Then stool tests, blood tests, and immunological profiles may help.

    • Hi Daniel,

      I have no objection to probiotics, but we generally recommended fermented vegetables and fermented foods as better sources of probiotic bacteria.

      We also think food is a better source of fiber than prebiotics. Resistant starch sources like potatoes and pectin sources like tomatoes are good fiber sources.

  10. Hey Paul,

    Not sure if you are aware but there is a fruit from south america called “camu” and it apparently is 10% vitamin c by weight. Do you see any issue with taking 10g of this daily to attain 1g of vitamin c?

  11. Hello,

    I recently read your book and then went on your site and purchased your supplement recommendations. I was currently taking a b-complex that had 400mcg of folic acid. I threw it out after you spoke so vehemently against folic acid in your book. However, I just received the b-complex that you recommend and it contains twice the folic acid of the supplement that I just threw out. I suppose the argument could be made that I should have looked closely at the label, but assumed that your recommendations would be safe. A bit frustrated, can you please clear this up? Thank you.

    • Hi Stacie,

      I’m sorry you threw out your B-complex, I apologize if we were over-scary about the folic acid. The issue with folic acid is dose, 400 mcg once per week is only 57 mcg per day which is not going to do you any harm. Even 800 mcg once per week is 114 mcg per day which isn’t much of an issue. Getting to 400 mcg per day is worrisome, 800 mcg per day in prenatals even more so.

      Basically, you can take a typical food dose as the standard — for folic acid this is 300-400 mcg per day — and any supplement dose that is small compared to daily food dose probably doesn’t matter. Doses equal to the daily food dose may have an effect, and doses bigger than that could be a major issue, those are “pharmacological doses”.

  12. No, thanks for the recommendation. I’ll look into it.

  13. With the selenium recommendation, 200-400mg is recommended weekly with high dose iodine, but what would high dose be, over 1gram? How much iodine is enough to rid someone of iodine deficiency and at what amounts would it detox halides like bromine and flouride? Great work your doing Paul. I can’t seem to find a amazon link for the kindle version of the new PHD for UK!

    • Hi Anonymous,

      You need good selenium status at all doses of iodine, but it becomes more important at higher doses of iodine. I would say any supplementation of iodine warrants care in regard to selenium intake. This can be as simple as eating high selenium foods — beef/lamb/seafood, seaweed, kidney, eggs — but it’s not bad to supplement once or twice a week.

      Apparently it can take quite large doses of iodine to completely detox bromine — in some people, 50 mg/day for several years. But such high doses of iodine have greater risks. For most people, 1 mg/day should do a good job over an extended period of time. If you’re young and healthy, I don’t think you need to rush.

      Sorry about the Kindle. The UK rights to the book have been sold, but the UK edition won’t come out until Fall 2013. In the meantime other-country Kindle editions can’t be sold there.

      Best, Paul

    • Hi, I live in Europe and I bought the PHD Kindle edition off of the US Amazon site, perhaps you can do that, too?

  14. I’m taking Betaine HCL for the long term to help my stomach recover from 3 years of Prilosec prescriptions. I did the “HCL challenge” recommended by Chris Kresser and got up to 10 pills with no feelings of warmth. Unfortunately my budget can only handle about 2 tablets HCL for each meal. I’ve used organic ACV in water to help my digestion too, but do you think it’s a safe for long term use? I’ve read some concerns about it promoting osteoporosis.

    Congrats on the new book! I’m almost done within, and I bought copies for my folks and sister.

    • Hi Ginger,

      I’m not sure about apple cider vinegar. It’s a pretty strong acid — it will burn your tongue if you leave it sitting there, from the 5% solutions sold in stores — of course if it’s diluted in food then it won’t burn but then you wonder if it will help digestion. I think vinegar helps mostly by promoting beneficial flora. For that purpose, modest quantities, used regularly, are probably most helpful.

  15. Hi Paul, I’ve been taking two capsules/day of a Kelp supplement with 400 mcg of Iodine. It’s made by Nature’s Way. Perhaps you’ve addressed this already, but do you have an opinion on getting iodine this way? Also, if I use salt with iodine in it does this reduce the need to take a supplement?

    • Hi Laura,

      Kelp concentrates toxic metals along with iodine, so it’s acceptable for low doses but in general I prefer purified iodine. 800 mcg / day is more than I would like from kelp.

    • Hi Laura,

      I took a couple of years ago this exact iodine supplement 400mcg a day for a couple of weeks. I got terrible red rash on my chest and thighs which desappeared in a couple of days after I stopped taking it. Im pretty sure it was due to arsenic toxicity. I have read many good reviews about this supplement and im not sure why everybody don’t seem to have bad reaction to it. But im prone to acne aswell so I think my body is just good toxicity indicator. Maybe others just don’t know about the toxicity because they see no physical signs.

      After that I’ve taken liquid ammonium iodine drops and Iodoral tablets which gave me no symptons. I would definately avoid kelp supplements at any doses.

      • Paul and Jvn, Thanks for your input. I definitely don’t want to play around with arsenic in my supplements. Yikes!

        Paul, I forgot to ask in my first comment: does using iodized salt reduce the need to supplement at all? Or do your recs take that into account?

      • I see you just mentioned 900 mcg being a good stopping point for iodine supplementation. My husband and I are about to start 675 mcg on January 1st. I have a suspicion of Hashimoto’s according to a Cyrex Array 5 test that showed an “equivocal or low suspicious positive” to thyroid pyroxidase tissue being “attacked”, so I have stayed away from eating seaweed to supplement or boost iodine levels.
        My TSH was 1.2 (in October) and when last tested for more specific thyroid levels in June, my T4 was 8.10, FTI was 2.50, and T3 U was 31.00 (I wasn’t eating meats yet in June). From what I gather, these thyroid levels look okay; no hyper or hypo suspicion, but I am not sure. In your opinion, is it optimal to continue supplementing up to your highest doses based on this information? I’m not totally clear on the best candidates for the higher doses (Prolamine and Iodoral). Hopefully I am winding down all of my questions soon. I’m a slow learner! 😉 Thank you, thank you again for all of your help.

        • Hi Dede,

          Seaweed should be OK, just stay away from kelp. The lower-iodine seaweeds should be good for you.

          Yes, your thyroid tests look good to me.

          There’s no consensus on the optimal dose of iodine. Higher doses of iodine carry more risk of negative effects but can be therapeutic for some conditions. If you have no health conditions that you are worried about, then I would suggest stopping at a moderate dose for a while and seeing how your body does.

          • Thank you so much for clearing that up! I am thrilled that seaweed (not kelp) is OK! The seaweed snacks you list on your site look so delicious and now I can try them!

            I’ll see how it goes working up to a moderate dose of iodine.

            You’re so kind and generous of your time.

            P.S. I want you to know that after sharing your information about optimal blood lipid levels, a dear friend of mine whom I just returned from visiting feels very relieved now. Her doctor put the fear of heart disease in her and was persuading her to go on a very low fat diet after her lipid panel came back with “high” numbers!! I am ordering her the book now as a surprise as she was so intrigued!

  16. Hi there!

    I was wondering 3 things:

    1) your thoughts on candida in general, how prevalent it is and how often it should be treated antivirally, and antifungal herbal treatments that are generally recommended such as oregano oil and grapefruit extract and peu d’arco and the other regular suspects for antiviral/natural antibacterial,

    2) your thoughts on parasites and how often they can be an issue and treating them toher other herbal antiviral/antiparasitic herbs (often similar to candita)

    and 3) your thoughts on whether or not a generally healthy person should take enzymes, particularly some of the proteolytic ones, and perhaps some of the ones that are suggested for anti-candida

    Thanks so much!

    • Hi Daniel,

      My memory could be at fault here but I seem to recall Candida prevalence of 20-30%. It is a fungi so it would be treated with antifungals. The natural treatments are mildly effective against digestive tract fungi, but Candida is usually a systemic pathogen, and vegetables have natural antifungals as well, so I think having a vegetable-rich diet is probably a key factor in prevention while treatment for established infections is a difficult question.

      Parasites – I am not sure how often they are an issue, but they can usually be detected and treated, so I would recommend that people with unexplained digestive problems investigate that possibility.

      I don’t think a healthy person should take enzymes routinely. It is generally best to let the body manage such things. However, in gut disorders enzymes have a chance to be beneficial.

  17. Hey Paul and Shou-Ching……. 😀

    I just got your fabulous book as a xmas pressie to self.

    I’m 9 months post Interferon/Ribavirin tx for HCV which circulated in my body for 30 years resulting in moderate damage to my liver (F4/6 Ishak scale)

    Batteries are not charging properly… I have very un-refreshing sleep and feel worse when i get up than when I bed down… and I find it very difficult to hold my concentration because I constantly re-focus on how ‘wrong’ this all seems.

    GP’s have no idea and so with great interest I read your book and about to embark on rebalancing the nutrients my body needs.

    However… I feel I might need to tweak the PHD somewhat to realise the benefits due to my liver not at 100% (keytone production depleted…???)and some concern that the synthetic poison I took to extinguish the virus may have lasting effects on my systems ability to absorb vital nutrients.

    Any advise on what to do specific for my situation or perhaps ‘someone’ else I could consult that may be of help that you could point me in the direction of please.

    Well done… the PHD should be taught in EVERY school from the right age… it’s all so blatantly obvious once you understand the science behind it.

    Many thanks

    Nick

    • Hi Nick,

      Well, first of all every disorder is unique, so you may have personal tweaks that are special to your situation.

      But in general, I think normal PHD should be good for your situation. In general it is a diet that minimizes the amount of work the liver has to do – by eating what you need, it doesn’t force the liver to transform nutrients into other things, and also is a low toxicity diet.

      So what I would do is try regular PHD, and then maybe conduct controlled personal experiments to see if making specific changes makes you feel better. You would probably need to stick to an alteration for a month or more to get a good test; if it seems to work, reverse it and then come back to it several times.

      • Thanks Paul…

        I’ve just learnt from your reply that the liver only converts certain nutrients when your diet lacks what is needed… and I’ll now summise that when the liver has suffered trauma… such as chronic HCV… if one’s diet lacks the proper nutrients then one would be asking more than the liver is capable of when it’s not functioning at 100%…. making a PHD far more ‘noticeable’ for someone in my position…???

        cheers

        • Hi Nick,

          I do think a damaged liver is going to struggle with detoxification and maybe other functions, so you want to eat a healthy diet and will have more severe consequences than others from an unhealthy diet.

          I am not sure how noticeable the differences would be, but give it a try and let us know!

          • Hey Paul…. 😀

            One quick question that has always baffled me when it comes to measurements.

            Supps are obviously easy to measure but fresh food doesn’t come in measured caloric amounts.

            Is there a chart to work out an nice exact balance for the 20/65/15 ratio….? I want to dive in and begin immediately making sure I consume the right size meals and the right ratio of carb/fat/protein

            Nick

          • Hi Nick,

            I think the easiest way is by taste — your brain is programmed to like food best when it’s in the optimal ratios.

            So choose meats that are pleasantly moist from some fat, not dry and lean or excessively greasy. If your meat is dry and lean, add some fat (sour cream or coconut milk are good). To starches, again, let taste be your guide; add the amount of butter or sour cream that optimizes the taste of your potato.

            If you do that then you’ll be very close to optimal.

          • Paul…

            I’m at the part of your book that I find difficult to really understand and wish I could but feel I need to study a whole new language to even begin to comprehend it … chapters 9 thru 15 that explain the processes of the macro-nutrients… my brain is having difficulty putting the pieces of the puzzle together and unfortunately I think this is down to my damaged liver.

            One of the very annoying things I live with even now after annihilating the virus is passing out within 20 minutes of eating. My energy levels are very low on most days and it’s a real effort to physically do anything.

            Any tips on why that may be and a way to address it would be well received

          • Hi Nick,

            I wish I could outthink your doctors on this, but I am not familiar with those symptoms or what could cause them.

            I would try to find any doctors who may have treated patients with similar symptoms, or at least other patients with similar symptoms that you can talk to.

          • Paul…

            Firstly I wish to thank you for having this open line of communication… it must be time consuming for you.

            Is there someone here in the UK that possibly runs a workshop based on the science of the PHD… Reading your book brings up so many questions due to my lack of knowledge on the subject of nutrition and having someone who could teach this stuff in depth would be fabulous… maybe a few clones of your good self distributed around the planet.. 🙄 …?

            Happy new year to you both

            Nick……. 😀

          • Hi Nick,

            There’s no one doing seminars at this time, but it’s possible that when the UK edition of our book comes out this fall I’ll visit and do a seminar or two in London.

  18. Hey Paul,
    After visiting my naturopath and talking with him about food intolerance he has told me that a large majority of people who get food intolerance testing done have issues with egg yolks(I am waiting for my test but have had 2 friends get tests who have high intolerance) should we keep eating eggs if we get high intolerance scores? I love eggs and have no problem throwing them in anything.. but dont wanna do my body more harm than good.

    • Hi BS,

      If you are intolerant I wouldn’t eat them every day, but I would try going off and on to see how I feel with them.

      Chicken liver is a good substitute.

      • Hello Paul,
        Just a short question (my value for your and ShouChing’s work is in my Amazon review): do you eat the 3 recommended egg yolks raw? Thx very much for replying!

  19. Do you have any thoughts on calcium/magnesium butyrate as a supplement in the case of gut dysbiosis? Thanks!

  20. Have you considered formulating a multivitamin that adheres to the PHD?

    • Here here! It’s nice to be able to tweak some variables as necessary, but it’s a pain to be ordering all sorts of pills, each on a different schedule…

    • Hi PaleoMD,

      Yes, and I’ve contacted a few people to start looking into it. Our cookbook is the first priority, but I think a PHD multivitamin would fill a need. Current multis give 100% of the RDA as if nobody was eating food. I want to be careful, however, to get high quality ingredients from trusted source.

      • That is so exciting! My husband and I would be loyal vitamin customers!! And, a cookbook…can’t wait for that! I’ve made your Tom Kha Shrimp, the beef roast with beets and the Caesar dressing…all YUMMY! Truly, the beets recipe is the best I have ever tasted and I eat beets all of the time!

      • I too would be a happy customer and would love to give my money to good people like you guys. I currently take Mercola multivitamins which mostly align with your recommendations but also have bonuses like lutien and antioxidants and even if it isn’t totally optiomal to take them I can’t beat the convenience.

  21. Sounds like a great idea if the product could be manufactured without unnecessary and potentially harmful binders and fillers.

  22. What is the best way to distribute the weekly vitamin doses? Should I take all on the same day (!!!) along with the dailies or take a few each day? Does it matter? also are any best taken at night rather thsn in the AM. Seems like a scheduling nightmare!

    What do you think of IP-6 & Inositol and juvenon (acetyl L-Carnitine HCI and Alpha Lipoic Acid)? I’ve been taking both for some time. Any contraindications with all of your recs?

    Thank you!

    • Hi Judy,

      I don’t think it matters how you distribute them; but I would take them with meals, probably with a mid-day meal rather than the last meal.

      I’m not personally a fan of IP-6 although it does have some anti-cancer activity. Inositol is fine but I would pair it with choline. Acetyl l-carnitine is fine but probably unnecessary if you take vitamin C and eat a high-fat diet and get some exercise. Alpha lipoic acid I’m agnostic about.

  23. Also, breaking the lithium tabs is pretty imprecise. The tabs sometimes crumble. Does it matter if my dose is not exactly the same each day? The pieces are not uniform.

  24. Thanks! What about breaking the lithium tabs?

    Should the daily vitamins be taken with breakfast? On fasting days when I don’t eat breakfast should I wait to take them with my first meal of the day?

  25. Hi, I asked for your book for Christmas and am very impressed. Information addressing the why’s and wherefore’s is just what was required-thank you.
    I am just a little confused re omega 3.
    Having had a dreadful summer here in the UK with little sun I decided to supplement with Green Pastures fermented codliver oil and buttermilk, believing I would be then getting Vit D and vit A in natural body useable proportions believing one shouldn’t be taken without the other. Also I believed the omega 3 would be beneficial for addressing inflammation in Rheumatoid Arthritis.
    Having read your chapter on PUFA’s and HUFA’s I feel you would not recommend this protocol. I have liquid vit D3 drops but am worried then that they should not be taken without sufficient Vit A and K2. Preferring not to take supplements if I can help would you suggest taking vit D3 drops and that I would be able to get sufficient A and K2 from diet without worrying.
    Thank you for your time
    Kind Regards Lynne

    • Hi Lynne,

      I think the ratio of A to D in cod liver oil is high, so I don’t think it’s a great way to improve vitamin D status. We recommend fresh fish for omega-3s (they are fragile and fermentation or long storage may damage them), and we also recommend 1/3 lb beef or lamb liver weekly, which provides a sufficiency of vitamin A along with many other important nutrients. So cod liver oil would tend to produce an excess of A, would hinder getting other nutrients from A-rich sources like ruminant liver, and might have damaged omega-3s.

      It is in many ways an excellent food on its own, but it doesn’t fit easily into our diet — there are better ways to obtain the nutrients it contains.

      My recommendation is to take the D3 drops, get K2 either from fermented foods or supplements, and get A from diet primarily liver and egg yolks.

      Best, Paul

      • Thank you Paul for your quick reply, amazing considering what demands you must have on your time. I cannot begin to explain what it means to me to get advice directly from yourself. Loving all the information in your book-your info will change lives, highly recommended.
        Kind Regards, Lynne

      • Hi Paul,

        I’m glad that I found your reply regarding the FCLO as I was just about to order some! I’ve embarked on a 30-day autoimmune protocol (vitiligo) and want to make sure I supplement the best way possible. I do try to eat fish 2x’s a week along with 1 tsp of Carlson’s fish oil, but haven’t gotten around to eating liver for Vit. A as yet. I’m trying to incorporate fermented foods into my diet, but find that they don’t settle well in my system. I recently read about cross reactive foods such as coffee, chocolate and yeast having the same effect as gluten and perhaps that is why I don’t tolerate them well? I’m not celiac, but intolerant. I’ve been paleo for two years now. Unfortunately, over the holidays, I had some foods that I shouldn’t have had and suffered with GI problems. After returning home and beginning the 30 AIP, I broke out in hives. Could this be due to releasing those toxins? My other question is what do you think about L-Glutamine for the occasional sugar craving? I was in a habit of having a glass of wine with dinner and a square of chocolate or some other paleo dessert after dinner. And instead of melatonin, because I thought it wasn’t good for autoimmune conditions, what do you think of 5-HTP? I am in my 50’s and was also using Ubiquinol since I’ve been told it depletes over time, but I noticed that it’s not in your recommendations. My only other complaint is that I have some arthritis in my hands and knees (runner), allergies and a history of asthma. I apologize for the lengthy reply, but I want to make sure that I am making the right decisions with my health! I will purchase your book today and hopefully that will clear up some of my questions! Thank you so much for your time! I think it’s amazing how you take the time to help us! We appreciate it. Happy New Year to you and your family!

        Janis

        • Hi Janis,

          I favor starch, eg potatoes, for sugar cravings. Complete protein would be a better backup choice than glutamine I think.

          I don’t support 5-HTP, it is a nutrient for bacteria, melatonin isn’t.

          • Hi Paul,

            Thank you so much for your reply. I was eating potatoes prior to my AIP, but eliminated them (nightshades) for 30 days. Do you feel that they contribute towards arthritic pain? I also eat plenty of protein at each meal, so my cravings are not that bad, just a habit I think at dinnertime! Ah, those pesky habits! Thank you so much for the information regarding the 5-HTP and melatonin. I had no idea about that. May I ask, what did you think regarding the hives issue? I suppose it could be anything. An allergic reaction or releasing toxins? Our bodies are amazing! Do you recommend CO-Q10 or ubiquinol or are these better attained through food as well. I’m also taking Quercitin and R-Alpha Lipoic Acid and maybe I shouldn’t be taking that either. I ordered your book and like I said before, I’m sure the answers to my questions will be in there! Thank you so much for your help!

            Janis

          • Hi Janis,

            Arthritis can have a variety of causes and one of them is food sensitivities or food toxins. It’s possible therefore that in some people potatoes contribute to the disease. However, I’d be surprised if that was a major or common cause.

            The trouble is that all plant foods have toxins, so if you exclude potential contributors, you can quickly get a malnourishing diet. I think it’s worthwhile removing a category for a month to see if you feel better, but if you don’t notice a difference then I would restore those foods.

            Hives I take to indicate a vicious circle of an inflammatory immune response combined with oxidative stress; white blood cells produce reactive oxygen species to destroy threats, but oxidative stress reacts with omega-6 fats in cell membranes to create inflammatory molecules that promote immune activity. So some combination of an immunogenic agent (such as an infection or food sensitivity) and an antioxidant deficiency is usually involved. You can try taking NAC, vitamin C, vitamin A, zinc, copper, selenium, and other antioxidants to help. But the key thing is to resolve whatever is underneath.

            CoQ10 is fine to supplement. In people with high oxidative stress it is probably beneficial. Not sure about quercetin and lipoic acid.

  26. What do you think about pregenolone? For Women that are estogen domient?

    • Hi Katie,

      I don’t know – hormones are complicated and it’s hard to generalize, nor am I an expert. But pregnenolone is fairly safe to do an experiment with and see if you feel better or worse.

  27. Hi Paul,
    I received your book for Christmas and really enjoy reading it. My question is regarding gall bladder issues. I’ve been doing Paleo ( with dairies) for about 2 years now and taking bile salt( cholacol from Standard Process) with every meal due to a non-functioning gallbladder. I’ve been also taking artichoke and milk thistle supplements and AF beta food ( beet extract) for the past 2 years but my gallbladder doesn’t see, to be improving much . I’m ok as long as I’m taking the bile salt but I was hoping that eating a more high fat diet would stimulate my gallbladder and eventually heal it… I’m eager to try PHD , I’m wondering if it will have Amy positive effect on the gallbladder issue.

    • Hi Gabriella,

      One aspect to investigate is why your gallbladder is dysfunctional. This can happen due to infections — do you have any signs of small intestinal infections that may have spread to the gallbladder? These may be treatable.

      You might consider one of the gallstone/gallbladder cleanses (lemon joice and oil during a fast, usually) to see if you can clear any stones.

      Vitamin C and taurine supplements can help.

      Since I don’t know what the cause of the gallbladder dysfunction is, I can’t tell you if dietary improvements will be able to fix it. I suspect infections are a common cause, and you should pursue diagnostic testing for possible small bowel infections.

      • Paul,
        Thank you for your reply! As of October of 2011 when I had my last Hidascan w/cc done they found gall bladder dysfunction , but the ultrasound showed no stones, not even sludge. The GI doctor also did an upper endoscopy, found nothing, everything looked perfect. He just said that due to to much white flour and sugar and not enough fat in a standard diet ( I’m not overweight by any means) my gallbladder just didn’t have enough stimulation, and the best is to take it out. Of course I said no:) ive been a lot more fat and following a Paleo diet for 2-3 years now(90%) of the time, but without bile salt with every meal I still have abdominal pain and nausea. I researched a bit the intestinal infection and I found that one of the signs is diarrhea which I don’t have. Do you think following PHD will eventually “cure ” my gallbladder dysfunction if there are no other infections etc?

  28. Its difficult to find suitable forms of Iodine in the UK. The doses are usually too high or made from Kelp. What do you think of the Nascent Iodine? It is 400 mcg per drop. Do you think building up to 3 drops of this a day (which would be 1200 mcg) would be ok?

  29. Hi Paul – I’ve been looking for Prolamine Iodine from both AllStar Health(preferred) and Amazon and am not finding it. I can find it at one other site online but am not interested in setting up yet another account somewhere. I’m still taking 225 mcg of Iodine so I have a few nonths before I’m ready for the Prolamine but thought I’d ask as I’m putting in my order now for other Vitamins/Minerals. It looks like others have asked you this question but it is unclear to me. If I can’t find the Prolamine can I do the following for daily consumption:
    Month 1 – 225 mcg (1 tablet) of the ‘Now Iodine’
    Month 2 – 450 mcg (2 tablets)
    Month 3 – 900 mcg (3 tablets)
    Month 4 – 1125 mcg (4 tablets)
    Month 5 – 1350 mcg (5 tablets)
    Month 6 – 1/2 Iodoral
    Month 7 – 1 Iodoral
    Thanks again for these Recs.

    • Hi Jackie,

      I’d probably stop at 1125 mcg until you find another source for iodine. Perhaps the liquid drops would be the best. It’s disappointing that it’s so hard to find the intermediate and low doses of iodine.

  30. Hello,

    I have been trying to follow your supplement recommendations, but have been a bit confused as to when to take each. Which ones should be taken on an empty stomach, how long to wait between each supplement, which can I mix, what can interfere with their absorption? etc.

    I’d really love some kind of guideline as to how to take them in order to maximize nutrition absorption.

    Thank You

  31. I have a question on the supplement timing, from reading the comments it seems you prefer all supplements being taken with food. If you are IFing and skipping breakfast should you really wait to take the D3 until afternoon? (I have read that you should take it early to avoid sleep disruption.)

    Also, I see that you sometimes recommend NAC, and the label for NAC says to take on an empty stomach. Do you disagree with that? Also, I’v read you should up C if you take NAC, but I haven’t seen if you should take the C and NAC at the same time or not.

    Any recommendations?

    • Hi Mike,

      NAC should be taken while fasting, but most others should be taken with the first meal. I don’t think C and NAC need to be taken at the same time. I would take D with the first meal.

  32. Hi,

    What parts of the PHD are most relevant to treating teenage acne? Like any widespread disease, it’s likely polycausal, so I don’t even know where to start.

    Thanks!

    • I am no expert but I can’t help but think that removing dietary irritants would be the first and probably most important step. Get rid of gluten and fructose based sugar and maybe get a food sensitivity test to see other potential issues.

      • I’ve been very low on Gluten for awhile now and completely off recently, and I’ve never really shown signs of intolerance so I doubt I’ll improve much simply from cutting out grains. I’ve been the same with sugar, only sporadically consuming ‘unhealthy’ sugar.

        In my gut (no pun intended) I feel like it must be related to inflammation and immune health, but obviously that’s entirely speculation.

        • I would for sure recommend the food intolerance testing because it may bring to light some foods with high intolerance that you are not aware of. Get rid of gluten and try going low sugar for a while, get rid of all sugar except the small amount of fruit that PHD recommends. Drink loads of water and maybe go through the gut healing process PHD recommends.

    • Hi R,

      I don’t know but we’re planning an acne series in February so watch for that.

      • Understood. I’ll definitely be watching for those articles then.

        What about just in terms of supplements – are there any I should avoid or make sure I’m getting specific to my situation? For example, I think I recall reading that Iodine worsens acne, at least in the short term.

        • Hi R.,

          Yes, iodine generally worsens acne in the short term but it can improve it in the long run by helping the body excrete toxins like bromine.

          I’d rather withhold comments since a blog series will be coming soon and I’ll do more research as part of that.

  33. Hi, Paul –

    I just ordered a full set of daily and weekly supplements using the Amazon links on your Supplements page. I don’t know if there’s a way to get the prices to update automatically, but I did notice that some of the prices for the supplements you list have changed (sometime of them substantially) from the link on your page. Overall it’s a small price to pay for the improved health — but it’s certainly great incentive to find the necessary micronutrients naturally and eliminate the need for supplements!

    Jim

    • Hi Jim,

      Hmmm. The prices on the page come from Amazon, so I would think that if you refresh the page the prices would update.

      • Paul –

        My mistake…it was the “Best Price” versus “Buy New”. When you click on the “Buy From Amazon” link, it adds the “Buy New” item to your cart. In some cases, there are other options to buy from other sources. So it looks like things are functioning correctly when it comes to showing the prices.

        I don’t know if you get the same rebates if someone selects one of the other sources…or if you still get credit for selecting the item THEN adding it to your cart (and not using the Buy From Amazon button). I went with the safer option, in the hopes that you’ll get your share!

        Jim

  34. Hi Paul, sorry to ask another question,I do appreciate your time. During reading your book, I keep referring to your website and I came across the R.Arthritis protocol. I have a deep resistance to taking prescribed antibiotics feeling overuse and bad diet will have contributed to my developing RA in the first place. Please can you give me your take on the use of Oregano Oil to replace prescribed antibiotics in the treatment of RA.
    I use Oregano oil in the kitchen instead of disenfectants, I breathe in from the bottle if I feel that I have been in contact with anyone who is coughing or sneezing, take drops if I feel a sore throat starting and use with coconut oil to keep gums healthy. I have a good handle on the diet, maybe I will need to tweek a little, my carb and protein and up coconut oil consumption but cannot face the thought of taking prescription antibiotics again. I have a lifetime history of bladder infection/thrush cycle but have now cured with ocasional use of D Mannose. Is there any hope that I could address RA with the PH diet and oregano oil.
    Kind Regards
    Lynne

    • Hi Lynne,

      I would certainly wouldn’t recommend taking antibiotics until you’ve tried optimizing diet for a while and that has proved insufficient.

      Also do the circadian rhythm therapies. Since those depend on sunlight, you may need the summer to give them a good trial.

      Oregano oil acts locally in the upper digestive tract so it is not a systemic antimicrobial. However, it might do you some good.

      Best, Paul

  35. Hi Paul, Your reply has given me hope
    “I certainly wouldn’t recommend taking antibiotics until you’ve tried optimizing diet for a while and that has proved insufficient.”
    I infer from that, perhaps diet may be enough.
    I have eaten Paleo for well over 18mnths now but as I am sure that you know, your diet evolves as you learn more.
    The information in your book has given me a clearer understanding and a perspective from a more scientific basis of ideal nourishment.My takeaway – now focusing on my fructose (large bowl blueberries with cherry juice and camu berry powder may be over doing it in one sitting) and omega 3/6 intake (daily brazil nuts, chia seeds and avocadoes if also eating chicken) So now tweeking but otherwise would say have the PHD but what I have to tweek could definitely make an impact on my inflammation levels and so affect my RA fingers crossed. Thank you so much for your book.
    Re Oregano oil, I developed my own oregano and coconut oil to brush into my gum line (to replace toothpaste) but stopped using as I became worried that the twice daily use of oregano oil may kill off any healthy gut bacteria. Considering your comments, in your opinion may it be even beneficial for me to use the oregano oil in such a way and so often?
    I do eat saurkraut and have my daily bone broth(from pastured water buffalo) and the rest of the PHD with no grains, seed oils or sugar and since reading your book feel happy to eat sweet potato/white potato.
    Kindest Regards
    Lynne

    • Hi Lynne,

      Blueberries are a pretty good food, but you might want to leave off the cherry juice.

      I am not sure whether the oregano oil toothpaste is good or not. I don’t think it’s going to kill all healthy bacteria.

      Best, Paul

    • Thanks Paul, If once optimum PHD well established, the RA advice was to take antibiotics. My thoughts were that taking and using oregano oil may have a similar effect of eventually lowering pathogen activity/infestation and so using oregano oil may be beneficial for me as RA sufferer. Suppliers say that oregano does not have a negative effect on good bacterial populations, something I was skeptical about as having very little knowledge and could not find an explanation as to why that would be. Reading the RA article it was stated that some antibiotics have differing effects on probiotics. Is this possible?
      Sorry for being a pain – just need to understand
      Thanks, Lynne

  36. Hi Paul. I bought the Super K life extension brand from Amazon. Should that be taken daily or once a week, since it is a moderately high dose? I remember reading somewhere that weekly was enough.

    Thanks!

    Judy

  37. Hi paul,

    Hope you had a good christmas and new years. Iv been on 225mcg of now food iodine and i increased to 450mcg ( 2 tabs ) after about 3-4 weeks. Since starting 450mcg a few days ago iv started experiencing lower back pain that doesnt go away and i havent changed anything else with my workout routine, sleep and activity. Should i lower the dose back to 225mcg for another week or so, or increase salt consumption maybe, I’m already taking about 2.5grams of C. Any advice would be appreciated 🙂

    Jessica

    • Hi Jessica,

      I would definitely reduce iodine back down, you need to see if the back pain is connected to the iodine.

      It could be some kind of adrenal fatigue — do you have any hypothyroid or hyperthyroid symptoms that could aggravate that?

      Increasing salt is probably helpful for kidney function, also be sure to get sufficient fluids, so that may be a good idea if intake was low.

      If it really is the iodine then you’d like to try to figure out why the iodine affects you.

      • Great, i’ll try experiment with extra salt and going back to the 225mcg dosage. I think i had low thyroid symptoms before as I had hair loss, and cold hands and feet a lot, their still their somewhat but much less than before. I think maybe I wasn’t on 225mcg long enough for the thyroid to adjust to that intake as I increased after only about 3 weeks. I’ll update you on how it goes though Paul.

        Thanks

        • Forgot to ask, what do you mean by adrenal fatigue?

          • If you’ve had hypothyroidism for a long time, it will have stressed the adrenal glands — they have to do more work to compensate for maladjusted hormones. So it’s common for people with longstanding hypothyroidism, as seems to be your case, to have adrenal dysfunction at the same time, often called “fatigue”. Try to improve thyroid function, maybe get replacement thyroid hormone from your doctor (certainly get tested and discuss it with him/her), and don’t stress yourself much (ie you may want to eat breakfast rather than do intermittent fasting) and your lower back may feel better.

          • okay i’ll try stopping intermittent fasting for a while. I hope i can still manage my weight loss goals though as I have some stubborn fat! mMybe a low carb breakfast of 3 eggs followed by exercise, and leaving carbs for post workout lunch and dinner will suffice!

          • It might be best to focus on health/thyroid/adrenals for a bit and worry about losing the weight when your health is better. The body needs time to heal. It’s not always best to attack every symptom at the same time.

          • So true, because every time I tried IF I seem to get either acne, or dandruff or jock itch. I’m gonna stop it and just eat breakfast. I’m stopping all iodine for three days to rest the kidneys maybe from detoxing too much bromide i think because I have some red spots out of no where on my back too, because of the iodine, and try starting low again and increasing much slower. Would it be fine to have 225mcg mon-fri, with breaks on weekends to rest, thats equivalent to 160mcg a day for the week, then after a month, take no breaks on weekends so you get 225mcg daily, then next month, have two tabs for 450mcg with break on weekends, giving 321mcg daily. Is this approach viable?

          • I checked adrenal fatigue symptoms and looks like I definitely have it, disturbed sleep, low back pain along with knee and weaker muscles and salt cravings. I woke up at 4 or 5 am not being able to sleep maybe from too much cortisol. What would your suggestions be if if any Paul, for adrenal fatigue. Plenty of rest, salt, standard phd with more carbs and lowered iodine dose. Sorry for asking so many questions. Jessica

          • Hi Anonymous,

            Yes, it’s good to go slowly, that’s fine. I wouldn’t increase faster than one doubling per month, and if you have bromine symptoms like acne, stay there until they go away.

            Hi Jessica,

            I am not a clinical practitioner so I would rather not advise on treatment. I think thyroid treatment, circadian rhythm enhancement, and a healthy nourishing diet are keys. An endocrinologist or naturopathic doctor may have additional suggestions.

    • Okay,great. I know fasting is ment to help the thyroid and enhance circadian rhythms but I guess I should skip it because of adrenal fatigue, probably from increasing iodine too quickly causing a reactive thyroid as I’v read in one of your posts. I’v got tight chest pain and lower back so I know it must be adrenal fatigue.

      Can circadian rhythms still be enhanced with a overnight 12hour fast and eating breakfast consistently at 7am daily, along with daytime exercise and sunlight exposure, although missing the smaller eating window?
      And could maybe a 14 hour fast still be beneficial while not to stressful. I find this way I can wake up do some exercise and eat within 2 hours of waking making it a 14hour fast and it’s very convenient if you can’t workout later.

      • Hi Jessica,

        Just listen to your body and find a program that works for you. You should be able to detect the level of stress in your lower back, hunger, and other indicators.

      • Hi Jessica,
        Having had both you should if Paul allows this post read more
        At stopthethyroidmadness.com for indepth thyroid info and adrenal fatigue, then return to Perfecthealthdiet. Once you get your conditioned better diagnosed then you will know how to treat it with food and supplements. You need certain bloodtests, and you can get a saliva test for adrenals. Perfect Health Diet worlds well with these conditions but from personal experience you don’t want to add fasting to stress a stressed body. You want to build it back up with good foods, diet and rest. Rest not excercise if your adrenals are really shot.

  38. Hi Paul,
    Another Thursday and PHD continues to rock my world! My current question, what would you recommend as an optimal daily multivitamin for young women under the age of 30?

    • Hi Sana,

      Well, you know we no longer recommend a multivitamin, as we think food only or food only plus individual supplements would be better.

      You can see our current recommendations on this page. The full rationale is given in the new edition of our book.

  39. Paul,

    Can 5000 mcg of biotin be taken daily? It’s cheap enough….

    Also, might miss a day or two of iodine as i orderd late (my fault), would 2-3 days miss of my daily 900 mcg of iodine be “bad”? If not, would it make sense to “trick” the body every so often and have these misses? If not bad? Do i play catch up?

    tx

    • Hi Evan,

      It can, but it’s not necessary. Once a week is just as healthy. If you take it daily most will be urinated away.

      No, I don’t think missing 2-3 days is bad, but I wouldn’t increase dose soon after this.

  40. What about Osteopenia in women… What’s your take on the bone building drugs? Now I know that taking calcium isn’t helpful, other than your supplements, what can I do? I know I should be drinking bone broth, but its the one thing I haven’t tried yet…

    Judy

    • Hi Judy,

      I think diet and supplements are sufficient to cure osteopenia.

      You should be getting the proper amount of calcium. Bone broth is the best way to achieve that.

      • Whats the ‘proper’ amount? And if I don’t drink the broth regularly, should I go back to calcium supplements?

        • 3-5 bowls per week, or equivalent mixed in food.

          Alternatives are dairy and green leafy vegetables; or supplementation of 200-300 mg/day. Don’t supplement more than 300 mg/day on average.

  41. Hi Paul,

    I don’t have access to decent fish where I live in Brooklyn, so I have to go the way of supplements for Omega 3. What do you suggest? You said salmon capsules are most likely deteriorated?

    Also as I have not been eating fish but taking one capsule of salmon oil and two tablespoons of coconut oil…is this lopsided?

    Thoughts on gelatin?

    Lastly do you know what leg cramps at night are from? This is recent? Is this from not enough potassium?

    • Hi Missbb,

      I would go for frozen fish such as you can get at Trader Joe’s, but failing that the liquid refrigerated oils might be your best bet.

    • My understanding is that leg cramps are from potassium deficiency, but you can best solve that problem by taking magnesium. It worked for me. Magnesium is one of the most important supplements in the Perfect Health Diet, so you should take it regardless of whether you have muscle cramps.

    • I am not sure that Costco would have the same selection in Brooklyn as it would in Alberta Canada, but we buy our salmon from costco. It is wild alaskan salmon and comes in a bag of 8-10 150-200g serving portions for $30 canadian. It’s super high quality and very tasty. Worth checking to see if it’s available.

    • on the leg cramp thing, would you happen to be taking a PPI?

      I ask because i just did 28 days on Nexium, & started getting cramping in my calves during the night after a week or so on Nexium (especially the right calve!).
      Anyway, i stopped the Nexium today, so will see what happens.

      & as Nathan mentioned, may be an electrolytic deficiency or imbalance.

      a ref on PPI’s,
      “Prilosec, Nexium, Other PPIs Can Cause Low Magnesium Levels: FDA”
      http://www.aboutlawsuits.com/ppi-magnesium-warning-16624/

    • Sorry, forgot about the leg cramps. Usually it is electrolyte deficiencies. Salt, potassium (tomatoes, potatoes), magnesium, calcium (bone broth) are things to add. All but magnesium should be obtained from food.

      Being too low carb makes cramps more likely, as it increases excretion of electrolytes.

  42. Hi Paul. I have Osteopenia at 60 years of age. I’ve been taking Calcium with added K and D3 for the last two years, but my bone density has not improved. I understand after reading your book that I should stop the Calcium. I’m now taking your recommended does of K and D3. My doc wants me to go on one of the bone building meds but I’m determined not to do that after reading of side effects. What is your feeling about these medications? Should my dosage of K and D3 be different than what you recommend on your site? Is there anything else I should add to build bone density?

    Thanks!
    Judy

    • Hi Judy,

      I would stay off the drugs and fix it with diet. In general, it is easy to be low in calcium with food, but also easy to get optimal calcium from food, eating bone broth is the best way, this has other bone compounds too (including phosphorus, collagen, and trace minerals). The old principle is eat the part you are trying to fix, so bone broth.

      Vitamin D should be suppplemented to reach a serum 25OHD of 40 ng/ml. It’s worth doing some blood tests to gauge how you’re doing.

      Vitamin K2 is important, as is magnesium and omega-6 / omega-3 balance. Minimize omega-6 and get some omega-3 bearing foods weekly.

      Vitamin C and collagen can also be important, supplement C and include joint material, hooves/feet, or knuckle bones in your bone broth soups.

      Vitamin A is important so eat some liver and egg yolks.

      There are some helpful supplements, eg boron. Make sure your thyroid status is good. Get exercise and do the other circadian rhythm therapies discussed in the book.

      If liver function is impaired then NAC may help. Be sure also to get appropriate electrolytes, mainly salt and potassium via tomatoes and potatoes.

      I agree with you about staying off the bone drugs. This can be fixed naturally and that’s by far the best way to do it.

  43. I read with interest this article

    http://www.diabeteshealth.com/read/1999/09/01/1630/high-doses-of-vitamin-c-supplement-increase-blood-glucose-levels/

    which discusses a case in which moderately high doses of vitamin C — 4.5g/day — caused a dramatic increase in fasting and postprandial blood sugar levels. This was reversed by eliminating or reducing the supplemental C.

    Any guess as to the mechanism behind this?

    • Hi MM,

      I’ve seen these attributed to competition of vitamin C with glucose for receptors in pancreatic beta cells. Other possibilities are interactions with thyroid hormone and fat transport / metabolic regulation via carnitine. I don’t think the mechanism is known with any certainty, or in how many people the phenomenon occurs.

      Many people take similar doses of C without effect on their blood sugars, and vitamin C often relieves hyperglycemia in animal models, so it is hard to determine the cause of this phenomenon.

  44. Gelatin? Don’t have time to make bone broths right now, purchased Great Lakes brand gelatin and make a quick drink of gelatin, coconut oil and apple juice…I know apple juice isn’t the greatest but it masks the coconut oil flavor which sometimes gets to me!

    Leg cramps solved! Orange juice and carrot juice, apple cider vinegar! it! It was low potassium I believe.

  45. Hi Paul,

    I’m breezing my way through the book and i had a few quick questions:

    You mentioned a safe nitrogen balance point & probably lack of deficiency for protein to be 0.8 grams/kg.

    Also it seems you arrived at 120-160 grams of glucose for a person based on the 8 micromoles/kg/minute consumed by a fasting person’s needs. Taking that to moles->grams per minute->hour, it seems that conversion would be: 2.075 grams/kg/day of glucose.

    For those that want to be more optimal, would 2.075 grams/kg/day of glucose be a more precise estimate of what would be a goal glucose+fructose (of course still limiting fructose to 100 cals at most) to reach per day from food?

    • Hi erich,

      If you’re going to scale carb needs by body weight, that is a good formula.

      For the most part macronutrient needs scale like body weight to the 0.6 to 0.75 power. So it’s not a bad approximation to scale by body weight to the first power. We chose specific numbers because that is even simpler. You have to compromise between simplicity and precision sometimes.

      • interesting paul. what was the simple formula that you used to derive the glucose fasting person’s need for typical adult? I am wondering where the .6 to .75 power came from. I used the 8 micromoles/kg/minute that was cited in the book.

        erich

  46. Hello
    I just finished reading your book and have started following the PHD plan! I had a question regarding the vitamin K. I had been diagnosed with a lupus anticoagulant antibody/antiphospholipid syndrome and was told that I was at risk for blood clotting. I have been taking an 81 mg aspirin daily. If I become pregnant again, I will be taking daily shots of Lovenox. Should I still supplement with the K2? Thank you!

    • Hi Jax,

      Well, you should consult with your doctor, but my personal inclination if I were in your shoes would be to supplement with K2 in the MK-7 form but refrain from supplementing K1.

  47. Are cashews okay to eat? What about ground flaxseed or chia seeds?

Leave a Comment


NOTE - You can use these HTML tags and attributes:
<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

This site uses Akismet to reduce spam. Learn how your comment data is processed.