Supplements

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

Supplemental Foods

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

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

Daily Supplements

These are supplements we recommend be taken daily:

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

Weekly Supplements

These are supplements we recommend be taken once a week:

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

Prenatal Supplements

The most important prenatal supplements are:

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

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

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

Optional Supplements


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

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

Therapeutic Supplements

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

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

Miscellaneous


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

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

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Leave a comment ?

4,438 Comments.

  1. Cindy June 11, 2013 at 1:51 am

    Please explain why you don’t like fish oil supplements and a good substitute – cod liver oil? Any brands to recommend?

    Reply
  2. Lilian June 11, 2013 at 7:42 am

    Hi Paul,
    In the past you’ve recommended against Potassium supplementation and the use of Potassium salt. What is the exact reason for this, , and how do you recommend a person with poor tolerance of fruits and vegetables reach optimal potassium levels?
    Thanks in advance!

    Reply
  3. Olivia June 11, 2013 at 3:58 pm

    Since becoming aware of folic acid scary news and being in the midst of a breastfeeding/multiple pregnancies lifestyle and exposed to high folic acid prenatals, I’ve switched to occasionally taking a generic B and otherwise taking methylfolate (per Chris Kresser’s recommendation) and methylcobalamin and dessicated liver for iron…the dessicated liver tablets have made a huge difference in my energy levels. Of course other things, organic pastured ghee, sardines, some cod liver oil too.

    Reply
  4. gill June 18, 2013 at 4:02 pm

    I’m intrigued as to why the iodine recommendations have changed? Do you still think doses up to 1mg are a good idea or should we all stick to 250 mcg?

    There is so much conflicting information on the web about iodine supplementation with huge doses suggested by some… Do you think boron is also important?

    Many thanks

    Reply
    • Paul Jaminet June 18, 2013 at 5:30 pm

      Hi gill,

      I think 1 mg is good, but we recommend eating a lot of seafood so you will probably average close to 1 mg/day from food if you eat seafood 2-3 days per week and seaweed regularly. In this case the 225 mg/day supplements are just to even out iodine intake so the thyroid sees a reasonably steady level.

      Reply
      • gill June 19, 2013 at 4:27 pm

        Thanks for your prompt reply!

        Just a thought – to support your blog we should buy through Amazon. However, in the UK, we can only buy through Amazon UK. If you get many more UK followers maybe you could put links to Amazon UK instead so you continue to receive the benefit.

        Thanks again

        Reply
        • gill June 19, 2013 at 4:30 pm

          Sorry – typo – I meant “as well” and not “instead” in the last line!

          Reply
        • Paul Jaminet June 19, 2013 at 5:26 pm

          Hi gill,

          Yes, thank you! I have a search box for Amazon.co.uk, just not the individual supplements listed. Perhaps I should add a UK page.

          Reply
        • MattK June 26, 2013 at 12:20 am

          Hi Paul,

          Just wanted to add a data point about iodine. I’m about 75% on your diet for a couple years now (intending to finally go all-in this summer) and have been following the supplement recs, although I just now finished my multivitamins and will be switching to the new recs this week. I started low-dose iodine supplementation as you suggest about a year ago, and have worked my way up to potassium iodide caplets from GNC which IIRC contain about 3mg of iodine. However, since starting to take those, I experience occasional sinus-focused allergic reactions. It is only recently that I’ve pinpointed the iodine as the culprit – I don’t take it every day anymore, and I only have reactions the evening or next morning after I have taken one. Symptoms are a *very* rapid swelling of mucous membranes (from the time I feel first hints of onset to full-blown reaction generally about 15 min) in sinuses on one side of my head to the point where it is impossible to breath through that nostril and painful on that side of my throat when I swallow. Increased mucus production in sinuses and bronchial tubes. General feeling of misery.

          I pop a generic OTC Claritin the moment I feel onset, and that generally ameliorates most of the symptoms within about 20-30 min.

          We were moving and taking a bunch of our stuff out of storage in a nasty moldy attic when this started happening, so I thought at first that it was some new allergy to mold/dust/pet dander brought on by that mold exposure, but we’re long past the move and I’ve tracked carefully for a few months and realized it only ever happens just after taking the KI. I suspect that it is brought on by some small-particle insult to the mucous membranes in the sinuses, but I think it may be an overactive immune response when I’m on the high dose of iodine. Have you heard of anyone else having similar issues with medium to high dose iodine supplementation?

          Reply
          • Paul Jaminet June 26, 2013 at 8:35 pm

            Hi Matt,

            Thanks for the update. You probably noticed that we no longer recommend high doses of iodine except in certain therapeutic situations (eg bromine toxicity). 225 mcg/day is our normal recommendation.

            It is possible for there to be issues on higher doses of iodine. I haven’t heard reports that sound just like yours, however.

  5. erich June 23, 2013 at 8:23 am

    Hi Paul,

    Should we be peeling our vegetables in general to get rid of toxins?

    If so, should we be doing this for fermented vegetables as well? Or should we leave the fermented vegetables unpeeled for the surface bacteria?

    Erich

    Reply
    • Paul Jaminet June 23, 2013 at 11:39 am

      Hi Erich,

      I don’t think so. Rinsing in water is pretty good at removing pesticides, and you want to keep the natural bacteria that live on the skin — especially in fermentation.

      Reply
  6. Frank June 23, 2013 at 4:15 pm

    Hello Paul
    i dont know my iodine status but i want to try eating seaweed.I read that eating to much of it isnt healthy.What kind of seaweed do you eat and how much of it?
    Frank

    Reply
  7. Kim June 24, 2013 at 1:06 am

    Hi Paul! I have just ordered some grass-fed beef gelatine powder to boost intake and help to heal my gut. What do you think is an appropriate dose?
    I have also come across a farm in Australia selling dehydrated bone broth which is great for when you run out of time to make your own. I think it’s worth a try. They are also looking at producing and selling beef tallow. Cheers! 🙂

    Reply
    • Donna June 24, 2013 at 11:23 am

      Hi Kim. Could you tell me where you ordered these 2 products? grass fed beef gelatin powder, and dehydrated bone broth? Thanks, Donna

      Reply
      • kim June 24, 2013 at 5:45 pm

        Donna, the dehydrated bone broth is from Broth of Life. Go to their facebook page and contact them through that (they are just starting out and this is the only way to order at the moment). The gelatin is from GPA Wholefoods – they have a web page so you can google that. Both of these are in Australia by the way. 🙂

        Reply
  9. Andy June 24, 2013 at 11:29 am

    Hi Paul! I’ve been studying your work recently and have begun to implement many of your suggestions… transitioning from Dave Asprey’s “bulletproof” ideas. My experience with cyclic keto was terrible. I gained a ton of weight and my sleep was ruined. I suspect pretty extensive adrenal fatigue.

    What I’ve been doing is eating adequate carbs and lower protein/fat. My macros are in line with PHD recommendations as are my supplements mostly. The exception is magnesium (I take 360mg at night) and vitamin A (10,000IU/day). I am intrigued about why you suggest a relatively low dose of magnesium, considering that most people are deficient. Also I think vitamin A is important if cod liver oil or liver is not eaten.

    Lastly, are the B vitamins an essential part of the PHD supplement regime. Or can I get away without them. I currently have thorne B-complex #5. Should I start by taking this weekly or is it very much inferior to your B vitamin stack?

    Reply
  10. Donna June 24, 2013 at 12:04 pm

    Hi Paul (or anyone); Anyone know of a dextrose supplement that is made from non GMO corn?

    Reply
  11. erich June 24, 2013 at 4:53 pm

    Hi Paul,

    I noticed in your fermented vegetables post that you added only fresh seasonings.

    What are your thoughts on dry spices, such as curry, tumeric, italian seasoning, cayenne pepper, paprika that come in “powder” form?

    Erich

    Reply
  12. merle June 24, 2013 at 6:22 pm

    My husband and I are TTC. The RE recommended L-Carnitine, Acetyl-L-Carnitine, Co-Enzyme Q10, Vitamin E and Selenium for my husband.

    1. What are your thoughts on this list?
    2. Any thoughts on brands?

    Reply
  13. Judy June 24, 2013 at 7:26 pm

    Hi! For those of you looking for bone broth sources… I get mine at Wise Choice Markets in Canada. They have a website full of wonderful organic products. They ship me bone broth which is frozen in 24 ounce containers and packed in dry ice – delivered to my door. It’s delicious, convenient, and reasonably priced. Hope you’ll check them out!

    Judy

    Reply
  14. Judy June 24, 2013 at 7:31 pm

    Paul, what do you think of the sweetener xylitol? Also curious about chia and ground flaxseeds? Although you prefer real food, I do enjoy adding these to my whey or pea protein shake every morning along with coconut milk, MCT oil and raw egg yolks.

    Judy

    Reply
  16. Darrin June 28, 2013 at 8:59 pm

    Hi Paul,
    Do you know much about the effect of supplemental NAC (N-Acetyl Cysteine) on Diamine Oxidase (DAO) enzymes.

    I was reading a couple of things,
    1. ‘DAO breaks down ingested histamine helping to lower overall histamine levels’.
    2. ‘NAC may block Intestinal DAO’.

    So in people who have (or suspect) they have too much (too high) histamine, should NAC be avoided. As NAC may reduce the normal breakdown of histamine via an effect on DAO.

    The ‘low histamine’ diets on the web suggest avoiding ‘Drugs/Substances that may block intestinal DAO’ & list some examples, N-Acetyl Cysteine (NAC), Cimetidine, Amino guanidine, Isoniazid, Alcohol,

    Reply
  17. Donna June 28, 2013 at 9:13 pm

    Dr. Mercola also doesn’t recommend regular NAC supplementation if one has almalgam (mercury containing) fillings. Sth about decreasing the bodies ability to deal with the mercury? Comments on that too, Paul?

    Reply
  18. Daniel June 30, 2013 at 11:05 am

    Hi Paul,
    What do you advise regarding taking supplements on fast days as all, or most of the supplements, recommend taking them with a meal?
    Thanks,
    Dan

    Reply
  19. kevin June 30, 2013 at 12:22 pm

    Is powdered gelatin/collagen a good sub for bone broth? I believe it used to be one of your supplement recs.

    Reply
  20. Charles June 30, 2013 at 7:55 pm

    I suffer with Gout and I understand liver has high purine content. Is the Perfect Health Diet great for Gout?

    Reply
  21. Rory July 1, 2013 at 3:30 pm

    Hi Paul,

    What are your thoughts on duck eggs? I’ve been getting them from my local farmers market and eating 2 per day, which I assume meets the egg yolk requirements of the PHD, but since I’m an already lean-ish woman looking to lose 5-10 lbs, it would be great if I can get the requisite nutrition from 1 duck egg per day. What do you think?

    Thanks!

    Rory

    Reply
  22. Donna July 2, 2013 at 12:14 am

    Equivalent in weight? grams of protein? calories? nutrients? choline?

    Reply
  23. Rory July 2, 2013 at 9:57 am

    Thanks, Paul! A separate question: Are there any supplements you can recommend for women with PCOS and Insulin Resistance? My BMI is 21 so I’m not overweight, but I still have the “lean” version of PCOS and have tested positive for insulin resistance. I originally went paleo looking for a nutrition-based solution, but feel much better now that I’ve added in safe starches. At the same time, I am worried about IR getting worse (I can feel the blood sugar effect of carbs unless I take some vinegar before my meal), and causing fertility troubles down the line. I am already taking your recommended daily supplements and Chromium GTF. Anything else you can suggest?

    Reply
    • Alex Gatsis July 2, 2013 at 10:04 am

      Rory,

      Have you considered candida. Low carbs did make my candida worse. I am following PHD, and we finish eating at 3:00 everyday to kick in autophagy. Also going to take udecylenic acid for 8 weeks per Dr Jeff McComb’s recommendation followed by kefir to help replenish gut good gut population. He doesn’t think it’s worth taking probiotics while addressing candida because he thinks biofilm keeps them from taking hold.

      Reply
    • Alex Gatsis July 2, 2013 at 10:04 am

      Rory,

      Have you considered candida. Low carbs did make my candida worse. I am following PHD, and we finish eating at 3:00 everyday to kick in autophagy. Also going to take udecylenic acid (thorne SF722) for 8 weeks per Dr Jeff McComb’s recommendation followed by kefir to help replenish gut good gut population. He doesn’t think it’s worth taking probiotics while addressing candida because he thinks biofilm keeps them from taking hold.

      Reply
      • Rory July 2, 2013 at 11:07 am

        Hi Alex,

        No I haven’t really considered candida, although I’m not sure what that would have to do with PCOS? I was diagnosed based on elevated androgen levels (and its ill effects) and ultrasounds.

        Reply
        • Alex Gatsis July 2, 2013 at 11:19 am

          Hi Rory

          The fungal form of candida can raise estrogen levels. One of the toxins it releases is an estrogen mimetic. Also, Candida creates inflammation which result in a wide variety if symptoms depending on your body. In causing inflammation, you’ll run higher blood sugars which can result in insulin resistance. The link below explores the connection between candida and PCOS.

          Here’s a link

          http://www.pcosdiva.com/2013/01/pcos-the-candida-connection/

          It miight be worth exploring as so many people do have the fungal form of candida. It’s crazy how many different symptoms it can produce.

          Reply
  24. Rory July 2, 2013 at 11:28 am

    Thanks for the info, Alex, but my estrogen levels have always been normal and I’ve never even had a yeast infection, so I doubt that’s it. Thanks anyway!

    Reply
  25. Webraven July 2, 2013 at 11:43 pm

    What to do about an intolerance of fermented foods and probiotics (significant bloating/distention) that doesn’t seem to improve no matter how slowly the probiotics/fermented foods are incorporated? How can the microbiota be improved if this ways of adding new strains doesn’t work?

    Reply
    • Kim July 3, 2013 at 3:00 am

      Webraven, I have the same question. I am wondering if SIBO is involved as I have read that having a bacterial overgrowth in the small intestine means that the bacteria are not where they belong and dumping even more of them into the small intestine via probiotics causes symptoms to get worse. Paul’s thoughts would be appreciated 🙂

      Reply
  27. Dan July 3, 2013 at 2:41 pm

    Paul, what’s your opinion on potato starch that you find at Asian markets? Usually, there’s no way to tell whether or not it’s unmodified.

    Reply
  28. Erich July 7, 2013 at 6:42 pm

    Hey Paul,

    I’m still confused when it comes to iodine. Dr. Brownstein talks about how different tissues take up iodide as opposed to iodine and that you need both. Particularly the thyroid takes up iodide as opposed to iodine according to him. Right now I am taking Eidon minerals liquid ionic iodine concentrate and have worked my way up just about 1.2mg. I can’t remember if I read it in your book or not but I read somewhere that iodide was generally less toxic than iodine.

    So my question is am I getting too much iodine since I’m taking straight iodine w/ no iodide?

    What is the threshold of toxicity for iodide as opposed to iodine? Or is there a difference?

    And if I’m ok on my iodine intake should I be taking iodide as well?

    Reply
  29. Catherine Saylor July 7, 2013 at 10:55 pm

    I’ve just finished reading your book at Jennifer Fulwiler’s recommendation and am excited to get started on the diet. I have several questions. Do you recommend a multivitamin? In your book, it sounded like not, but I’ve seen several posts on here (weight loss version, for one) where you do. I’m a breastfeeding mother of a 10 month old, and also want to know if your supplement recs apply to breastfeeding moms too.

    Also, do you have any specific recommendations for children following the PHD? Or supplements for them? Thank you so much!

    Reply
    • Paul Jaminet July 8, 2013 at 7:20 am

      Hi Catherine,

      No, we don’t recommend a multivitamin, but we used to, that is why old posts mention it. Current recommendations can be found in the current edition of the book and on the Supplement Recommendations page.

      Yes, the supplement recs apply to breastfeeding moms. There is a prenatal section on the supplement recommendations page, but these should not be necessary when breastfeeding.

      Children should eat a slightly higher carb variation of PHD, and generally should not supplement. They should be outdoors two hours per day if possible.

      Reply
  30. MachineGhost July 8, 2013 at 8:11 am

    Paul, what is your opinion on gliadin or piperine extracts used in supplements to increase absorption of low bioavailability bioagents? They appear to work by causing increased gut permeability???

    Reply
  31. Dead Can Dance July 9, 2013 at 7:38 am

    Hi Paul,

    Can you use dulse powder, instead of taking an Iodine supplement ?

    Reply
  32. Eric July 10, 2013 at 7:35 am

    Hi Paul,
    I’ve been following the PHD for over a year now. In the beginning I took all the recommended supplements, including 200mg magnesium citrate a day from NOW foods, and had no problems. After that I stopped taking the magnesium for a few months, for no real reason, and when I restarted taking the exact same 200mg magnesium supplement it gave me diarrhea the next day. I retested it many times, also with a different kind (glycinate), but it still gives me diarrea the next day. Do you have any idea as to why this happens? From what I’ve read 200mg shouldn’t cause any problems. Thanks in advance

    Reply
    • Paul Jaminet July 10, 2013 at 10:38 am

      Hi Eric,

      I don’t know but I imagine it indicates a change in gut flora. Magnesium supports microbial metabolism and is a component of biofilms, and bacteria can affect bile salt metabolism in ways that produce diarrhea — this is common in IBS. I would take it as evidence that you are fairly replete in magnesium so a significant amount is not being absorbed and is reaching the colon where it is affecting the gut microbiome. You should probably reduce magnesium supplementation — maybe take it once or a few times per week.

      Reply
      • SteveRN July 12, 2013 at 2:12 am

        It might be worth trying the magnesium made by Jigsaw Health. It is slow release, so you can take bigger doses, no diarrhea. Unless of course it is r/t a microbial problem. Might be worth posting a ? to Morley Robbins over on magnesiumman.com.

        Reply
        • Eric July 12, 2013 at 2:57 am

          Thank you for your suggestions, Paul and SteveRN. If it means that I’m replete in magnesium, then that would be good news. However, I wouldn’t be surprised if it’s a microbial problem, since my gut has always been troublesome. For now I’ll quit the magnesium, work on gut health and retry the magnesium later on to see if that changes anything. I’ll let you know if I notice anything interesting. Thanks again!

          Reply
          • SteveRN July 12, 2013 at 4:04 am

            Just another thought (or two!), again, from what I have read from Morley Robbins. http://magnesiumman.com/
            First, if you really want to know your magnesium status, go get a Mg RBC blood test. On the serum blood test, you can ofter register as normal, when you are really short. Most Mg is stored inside the cells of the body. If you are low, the body will release the Mg from inside the cell, to stabilize serum levels. But in turn this will leave your tissue deficient.Morley suggests a Mg RBC of greater than 6.5, a bit higher than the minimum limit listed on the test. You can go to requestatest.com and get one for about $49.
            If you can not take oral, another good way to get Mg is by taking daily Epsom salt baths, 2 cups Epsom salt, one cup baking soda, for about 30 minutes, and/or applying Mg oil to your skin for about 30 minutes daily. The oil can make your skin tingle a bit, especially if you are low. The more I read, the more important I think Mg is, and everyone should be on it, or at least be tested. Of course, take into consideration, most of my understanding is gained from reading blogs like this one, not from reading the actual research like Paul and others who write the blogs do, so…..Paul, please feel free to correct anything I have said you may feel is even a little incorrect. Please!

  33. Sara July 10, 2013 at 6:03 pm

    Great response. I’m in the same boat so this helps me too. I gave up on the magnesium but I’ll try taking it less often. Does this mean that we should take the enzymes you recommended to get rid of biofilms?

    Reply
  34. Val-David July 11, 2013 at 11:32 pm

    I’m very interested in trying your diet/supplement suggestions. However, I take warfarin and I’m concerned about supplementing the usual no-no’s like vitamin K and E, etc. I tried twice in the last 10 years to get off warfarin only to end up with severe DVT rebound in my left leg both times. My doctor told me I’m on it now for life. I also have neuropathy in feet and legs and ‘enjoy’ other annoying and tedious poor health problems. I’m 57.
    Can you recommend a way for me to start using your program?

    Reply
  35. Peter Silcverman July 12, 2013 at 6:36 am

    Hi, I’ve been following your recommendations since your first edition of the book. I have an extremely high level of calcification in my heart arteries. (1188 on CT scan) though never had symptoms including on my 10 mile a day bike ride. Any suggestions how I might lower my score?

    Reply
    • Paul Jaminet July 12, 2013 at 6:48 am

      Hi Peter,

      Sorry to hear that. Vitamin K2 and vitamin D optimization are priorities 1 and 2. Thyroid status is next – hypothyroidism is a major cause. Tend to gut health, oral health, and infectious disease since inflammation and infections are factors. Circadian rhythms.

      How do your thyroid and cholesterol numbers look?

      Reply
  36. Linda Seidman July 15, 2013 at 1:11 am

    Can’t something be done about these bogus email messages…..

    Reply
  37. Joseph Downey July 15, 2013 at 7:18 pm

    Hi Paul,

    I see that red palm oil is listed as a weekly supplement. Any harm in taking a tablespoon a day? My wife and I are fasting 16/8, and she can’t eat coconut oil, so I switched from coconut oil to red palm oil daily. When I saw that it’s only recommended weekly, I cut back, but had a flare-up of seborrheic dermatitis, which had gone away along with the ring worm problems I had pre-PHD. Started taking 1 Tbs./day again and the seborrheic dermatitis went away.

    I’m also still a bit confused about the iodine recommendation. The book says to double each month until you get to 1mg. on 3rd month, but now you’re recommending staying at 225mcg.? Following the recommended oily fish and shellfish but not much kelp.

    Thanks!

    Reply
    • Paul Jaminet July 16, 2013 at 9:11 am

      Hi Joseph,

      If it’s therapeutic for you then take it. You might also want to consider supplementing mixed tocopherols and tocotrienols for vitamin E.

      Yes, my recommendations for most people are to stay at 225 mcg/day. If you want to take a higher dose in hopes it will be therapeutic for some health condition, such as bromine poisoning, then increase dose slowly.

      Reply
    • MachineGhost July 16, 2013 at 10:24 am

      FWIW, Chris Masterjohn pointed out that when switching to an ancestral diet, the goitrogen content goes up due to the increased vegetable consumption (which interferes with iodine uptake) and that 1mg of iodine per day should be enough to compensate.

      Japanese intake is 1mg to 3mg a day: http://www.thyroidresearchjournal.com/content/4/1/14

      Reply
  38. I’m a Mutant! | Shieldmaid - pingback on July 16, 2013 at 5:56 pm
  39. Mary Wilkinson July 16, 2013 at 7:45 pm

    Hi Paul, I am still trying to get some advice on TMJ which I developed suddenly at the age of 64. I was eating vegan from summer of 12 until May 1. I got back blood work and was shocked to see my triglycerides had shot up, HDL down, LDL up. Started the PHD immediately but after about 6 weeks this TMJ came on.. I have read it might be a manganese deficiency. I noticed you developed it also – What supplements should I try or omit from your book’s recommendations- How did you get over yours? I am taking the big 4 you recommended: C, D3, Magnesium, and MK-7. Should I stay on these- Will 50 of manganese be alright with those? Thanks for any other ideas- Mary

    Reply
    • Paul Jaminet July 16, 2013 at 10:23 pm

      Hi Mary,

      In my case the TMJ was apparently infectious and it went away after antibiotics and adopting PHD. I don’t know the precise timetable because I was wearing a night guard and one day I realized I didn’t need it any more.

      Magnesium deficiency is a common cause of spasms/cramps/clenching so I would try that. I doubt you have a manganese deficiency. You might try 225 mcg/day iodine, and vitamin C.

      Paul

      Reply
  40. Judy July 17, 2013 at 10:12 am

    Paul, I’ve been reading about The China Study. How do you refute the evidence that the author presents regarding the benefits of a very low fat plant based diet? No added oil, no animal products….appears to result in fewer cancers and reverses cardiac disease. His new book, Whole, continues to push me to believe I should eliminate these things from my diet. I’m confused by two opposing ‘truths’. Why does this debate exist?

    Thank you,
    Judy

    Reply
      • Judy July 17, 2013 at 11:09 am

        Thanks Kenny. I’ll read it, but what about current evidence in clinics now using this diet? Looking at the author, Campbell who used to be a dairy farmer, and others like Esselstyn, Fuhrman, McDougall…they all present programs for eating that seem to demonstrate among patients and believers what the China study attempted to prove… Less cancer and heart disease. Look, I’m a big proponent of PHD, my numbers are great, my BMI is 21, my thyroid is now working better, and my bone density is on the way up. However, the more reading I do, the more confused I become 🙁

        Thanks again for sending the link.

        Judy

        Reply
        • Kenny July 17, 2013 at 11:27 am

          I don’t doubt people would get better (at least initially for a while) going to a vegan diet if they were coming from a SAD diet. I don’t think the question is whether you can get better, it’s whether it’s sustainable and optimum.

          Reply
  42. Kelly July 20, 2013 at 9:02 pm

    Hi Paul,

    I’m hoping you can offer some explanation why I can’t seem to tolerate increasing my saturated fat levels without discomfort — usually in the form of ‘restless leg syndrome’ (seems to related to circulation issues) but also it seems when it comes to overall circulation.

    Eggs for example — cannot tolerate egg yolks. And I noticed they’re listed as ‘strongly inflammatory’ on the nutriondata website:

    http://nutritiondata.self.com/facts/dairy-and-egg-products/113/2

    I’ve asked this question to several doctors, also Masterjohn and Kresser, and no one seems to be able to explain it.

    Note: I was eating small amounts of ‘whole sugar’ and brown rice (and brown rice flour), but just discovered those are also highly inflammatory as well, so perhaps that’s the problem?

    I know low-fat is not healthy though, but feel like I’m stuck.

    Any suggestions would be most greatly appreciated!

    Kelly

    Reply
  43. Alex Gatsis July 20, 2013 at 9:22 pm

    MIT researcher Stephanie Seneff has noted that the prevalence of food allergies might be related to vaccine use. It seems that many people have developed allergies to ingredients used in vaccines, like eggs and peanuts. I used to get migraines after eating eggs. I recently completed NAET, an allergy elimination technique, and I’m now able to have eggs and a ton of other things without an inflammatory response.

    Reply
  44. Darrin July 21, 2013 at 9:55 pm

    Hi Paul et al.

    is phosphatidyl choline (phosphatidylcholine) the same thing as choline.

    &/or would a phosphatidylcholine supplement achieve/give the same benefits (do the same job?) as a choline supplement.

    thx

    Reply
    • Paul Jaminet July 22, 2013 at 12:52 pm

      Hi Darrin,

      Choline is an organic molecule. Phosphatidylcholine is a compound that combines choline with two fatty acids via a glycerol backbone and phosphate group. It is a component of cell membranes because the choline is water soluble and the fatty acids like to bond with other fatty acids, so phospholipids facing each other back-to-back make a stable lipid membrane.

      Both are nourishing, so ideally one might supplement a mix. You can also get CDP choline which is an intermediate form useful for phosphatidylcholine synthesis.

      Reply
  45. Linda Seidman July 22, 2013 at 1:49 pm

    Paul:
    I never saw a reply from you to the question about a vegan diet.
    I know you devote at least a chapter to the perils of such a diet.
    You and Loren Cordain and others find such a diet very unhealthful
    for a host of reasons, not the least of which are the attendant toxins in
    many vegan foods. In addition, isn’t it a loss of vital nutrients not to be
    eating meat, fowl, and fish??? Could you sum up your thoughts on these issues. They are of great concern to me because a Chinese MD
    told me to eat a strictly vegan diet in order to reduce my very high
    lipid numbers.
    Thank you, Paul,
    Linda

    Reply
  46. The Perfect Health Diet | Catholic Mom Apologia - pingback on July 22, 2013 at 4:46 pm
  47. phd-er July 23, 2013 at 3:13 am

    Hello Paul and Shou-Ching,

    I began following the PHD and taking your recommended supplements 2 months ago after reading your book. I just came across this article elsewhere on line:

    http://www.theatlantic.com/health/archive/2013/07/the-vitamin-myth-why-we-think-we-need-supplements/277947/

    Makes it sound like supplements are dangerous! Does this affect your views?

    Reply
  48. Linda July 23, 2013 at 9:20 pm

    Dear Wout:
    Thanks for your reply.
    My total cholesterol was 290.
    LDL was 200 and HDL was 64.
    Triglycerides were normal. I am confused
    about diet because of Chinese MD telling me
    to eat strictly vegan. Chris Kresser and Paul
    et al advocate a very different approach, as
    you know. What to do is the question???
    Your thoughts, Wout????
    Thanks,
    Linda

    Reply
    • Wout July 26, 2013 at 10:19 am

      Hi Linda,

      LDL is high-ish but doesn’t seem outrageous. Your HDL is nice. Have you read http://perfecthealthdiet.com/2011/09/high-ldl-on-paleo-revisited-low-carb-the-thyroid/ ?

      Anecdotally, I would believe that going vegan lowers your cholesterol, but not in a good way IMHO.

      Please read the cholesterol explanations at chriskresser.com that I linked to in my previous answer and you’ll hopefully get a feeling for the health risks, if any, in your case.

      There are tons of MDs out there saying things, and some of them will recommend that you go vegan and others will tell you to take statins. Should you listen to them? That’s your decision to make 🙂

      Reply
  49. sabrina July 26, 2013 at 1:39 am

    Hello Paul and Shou-Ching,
    I have been following the diet and feeling great – I would really like to start the supplements but am having difficulty in purchasing MK7 – Amazon.com does not ship to Australia (I am in Western Australia)and I am not sure about some of the other sites I have found. Can you or anyone recommend a trustworthy site? Thanks, Sabrina

    Reply
    • Paul Jaminet July 27, 2013 at 1:48 pm

      Hi Sabrina,

      I’m not familiar with Australian vendors but if you can’t find it, try eating fermented mixed vegetables (make them at home per our recipe) and aged cheese. That should give you good vitamin K2 status.

      Best, Paul

      Reply
  50. Kats July 26, 2013 at 5:38 am

    Iherbs.com ship for a small fee overseas. Found them very reliable.

    Reply
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