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

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4,429 Comments.

  1. I like to think I am a careful label reader, but I just noticed there is calcium in that Solgar silica. My high cholesterol numbers prompted my doc to want a calcium plaque scan and my result was 206.8, which is “moderate.” Have intended to not take supplemental calcium since 2012, but here it is in my silica.

  2. Regarding vitamin k-2, it appears that most of the MK-7 form is derived from soy, and a lot of the K2 products sold are in soybean oil. Apparently the Life Extension product uses a synthetic MK-7. Do you have any opinion on whether synthetic MK-7 should be avoided?

    In terms of the research, what percentage of the studies are using MK-4 and what percentage are studying MK-7? How important is it that we get a blend of these two?

  3. It occurred to me that poultry livers should be emphasized over beef liver. For, beef liver very quickly leads to copper overdose, even when eaten in small quantities. This is especially true if one consumes chocolate and vegetables. Indeed, perhaps beef liver should not be eaten at all.

    No one minds the taste of poultry liver, and poultry liver pate is universally loved, but many people cannot stand beef liver in any form. Perhaps this too is a sign that poultry liver is healthier and safer. Any thoughts?

    • You might be on to something with the copper overdose if eating beef liver. However, and I don’t know how credible this is and if it even matters, but the IF factor is so much higher for chicken liver than for beef liver. I guess, the high Omega-6 in chicken liver is responsible for that. Omega-6 in beef liver is very low.

      • That’s a good point. But I wonder if beef liver is really safe in any dose, other than in a bite-sized amount, given its extraordinary copper content.

        A quarter pound of beef liver gives one a week’s worth of vitamin A, a high dose of B vitamins, and a week’s worth of copper (that’s a lot of copper, especially in the context of a balanced diet).

        A quarter pound of chicken livers gives one two days worth of vitamin A, a healthy dose of B vitamins, and no associated mineral overdose.

      • chicken liver does have a higher n6 compared with beef liver, but it’s still not a ‘massive’ amount…

        according to nutritiondata, 100 grams of raw chicken livers has (approx) 486 mg of omega-6 fatty acids

  4. Poultry livers, unlike beef liver, could even be eaten daily, it seems, without any toxicity. And it seems like there might be real nutritional benefits to doing so. For, one would get various B vitamins and would approximate the RDA of vitamin A.

  5. So I guess multivitamins aren’t recommended then?

  6. So far, beef liver is all that I’ve been able to find that is pastured. I make a gentle sauté recipe with spices and onions, then steam an apple and add everything to my Vitamix. Blend it up and measure it out in small jars so that I have about 0.6 ounces a day. I have wondered about the copper in my lovely dark chocolate. I am highly sensitive to omega-6 foods and if chicken livers are high in it, I cannot risk it because it gives me horrible joint pain. I am so much better than I was before PHD.

    Wonder what Paul thinks of the copper overdose potential.

    lana

  7. Re beef liver v chicken liver question. The Jaminets give their researched recommendation on page 409. Either ” 125g per week of beef or lamb liver IF chocolate is not eaten for copper OR 125 to 250 g duck, goose or pastured chicken liver if 30g per day of dark chocolate is eaten for copper”

    • Oh, very good. But I wonder if extra copper is needed at all (let alone an additional 14 mg per week!) if one eats a balanced paleo diet (with or without chocolate).

    • And I wonder what is less harmful in the long run—getting your vitamin A from small doses of fermented cod liver oil (with its fragile PUFA) or getting it from weekly servings of beef liver (and risking copper overload). — I guess I’m inclined to place my bets on fermented cod liver oil.

      It strikes me as though fermented cod liver oil would be a plausible option for anyone who eats 30 grams of chocolate and lacks access to pastured poultry livers.

      • Why not alternate from one week to the next? Eat beef liver one week as per PHD recommendations; change to poultry livers the following week. Change the copper and vitamin A supplementation as recommended to suit the weekly food choices (different sources of liver, chocolate or no chocolate).

        • I think Hillary’s suggestion is definitely along PHD’s recommendations to get nutrients from a wide variety of foods, thus minimizing the risks of toxicity and maximizing variety of nutrients.

    • I don’t see what you see on page 409, as that seems to be the index. Wondering if you mean 309? But even then, I don’t see a recommendation related to chocolate. The book does seem to imply that copper in supplements is the worry and not so with food. I am establishing the practice of preparing a pate and dividing it into amounts that contain a quarter pound of actual liver. I divide that quantity into six small jars and consume the contents of one of those over two days. Sunday is a “no liver” day. Still have not found pastured chicken livers. I usually have about 47 gr of 72% chocolate per day, even on liver days. Can you check your page number and I’ll look again. thanks 🙂

      • Ooops…I meant 3 small jars. So, a quarter pound of liver is in 3 jars — 1 jar = 2 days.

      • Hi Iana. Ah, i am in the UK and have the Scibe Publication 2013 edition – written for the UK I believe. However the liver/ copper/ choc details may be the same in your edition in the chapter entitled Meal Planning and Recipes, then find Dinners using Liver and other Organ Meats. There again, the book may be revised completely! Perhaps get the very latest edition ( the Uk one) from amazon.co.uk! But what I wrote in my original post is what they recommend. Since they have done all the research etc and their recommendations are based on this, I don’t see the point of querying/ arguing / putting forward alternative suggestions as some others have:)) I for one ‘just do it’ until there are updates to their recommendations. Hope this helps Iana. But please ask if I can help further.

        • The position that we find in “the perfect health diet podcast for men” is that “it’s best to get nutrients from food sources, when one can”. It stands to reason, then, that the PHD’s well-researched position is that anytime we can bring micro-nutrients into the plateau range from food alone, then we should forgo the option of supplementation, which if added, might even have the result of pushing the levels past the plateau range.

          According to the food calculator on the “nutritional-data” website, my diet provides an average of 200% of the RDA of every micronutrient, except for thiamine and vitamin E. Were I to eat beef liver, this would bring the % of copper quite a bit higher, but, if I recall, Jaminet only recommends about 4 mg of copper per day anyway.

          I would infer, therefore, that the advice of the PHD, as it applies to me personally, would be to not supplement anything.

          This is why I typically cut all pills in half, if I choose supplement at all, which I occasionally do.

          • The Perfect Health Diet is not Leviticus. It’s, at bottom, an abstract theory which has a great deal of flexibility depending the person’s specific situation. The theory can be summed up as follows—bring nutrients, preferably from food sources, into the plateau range.

            (This is why it probably makes sense to consult a nutritional calculator. That way you can figure out how you might most advantageously bring your nutrients into the plateau range.)

          • For the average person at least, the supplements are best regarded as “tools” that might assist one in bringing nutrients into the plateau range in the unfortunate circumstance of their not already being in that range from food alone.

          • Something else I have found helpful is Foundation Training. They have a website – but it’s all about posture and back pain. It has been very helpful for me.

          • How does one know which nutrients ones body is actually absorbing as opposed to this one canceling that one and this one helping that one to be absorbed etc. The calculator seems to be a good tool to make sure you are eating the right things. Just not sure it helps you know that it’s actually being used. Maybe I just answered my own question. I would think though that some nutrients we eat aren’t being utilized anyway b/c of some underlying other problem.

          • Euthyphro – keep in mind that the RDA values for various nutrients may be just as flawed as much of the advice we’ve been given from our government.

            For example, the same people that publish the RDAs say we should eat 1/2 pound of grains per day. If you are a believer in the PHD, what attention would you pay to the RDAs for everything else?

  8. Euthyphro,
    thanks for the reminedr about the high copper content of beef liver. Would you mind explaining why you prefer fermented cod liver oil over non-fermented?

    • No particular reason. I’ve never tried regular cod liver oil, and I like how I feel when I take (two capsules of) fermented cod liver oil. The colors of environmental objects literally look brighter to me (I don’t think I’m imagining this) and my mood is elevated. — But, ultimately, I think I’m just mesmerized, like everyone else, by the apostolic writings of Weston Price. Man is a Rational and religious animal.

  9. By the way, I thought the articles on the relation between jumping and bone density in the NY Times were interesting and possibly extremely important. Perhaps regular barefoot jumping (with an upright stance and Gokhalean anteverted pelvis, of course!) should be part of a PHD exercise plan.

    It seems as though if one were to choose a single exercise—as the only exercise one ever did—it should be the activity of jumping up and down.

    • Thanks! You made me search for that jumping article and also for Gokhale, and both results are very interesting, especially the gokhale method.
      For everyone reading this who has not heard of it, it is about using good posture (as in _real_ good posture, not average “don’t slouch”) to reduce / get rid of back pain (and other annoyances).

      • Something else I have found helpful is Foundation Training. They have a website – but it’s all about posture and back pain. It has been very helpful for me.

        • That’s really awesome!

          I’ve found that these kinds of posture exercises combined with learning to tap into the body’s natural elastic capacity for “pogo” jumping is the key to a strong spine and also the key to graceful, free and elastic barefoot running form (see, e.g. plyometric pogo jumping, Russian high jumping plyometrics training, or the Massai warriors dance jumping on you tube).

          Barefoot Ted always said that he only began to learn how to run after he learned how to jump. And I’m beginning to see why that is true.

          • Jumping doesn’t always sit well with ladies after having their sweet babies. 😉

          • Jumping after babies shouldn’t be a problem. We hold ourselves wrong these days… Katy Bowman has a good program on how to correct that. And she is great with all things alignment. The Gokhale method is supposed to be good too

          • From what I’ve read, a very large percentage of women suffer from some form of incontinence after childbirth, and especially if forceps are used. But perhaps this kind of damage to the pelvic floor is partly related to the fact that we give birth in a supine position as opposed to in some kind of upright-squatting position. I’m not an expert of this, but it seems as though anatomically sound child-birth posture might reduce damage to the muscles of the pelvic floor.

          • Similar remarks could be made regarding the risks associated with western (i.e., non-squatting) toilets.

          • Thanks for mentioning “foundation training”. It is subtly but perhaps importantly different from Gokhale’s advice.

            I think the idea of expanding the chest area by bowing the rib cage and upper back backwards, while also keeping your butt behind your center of mass is plausible as a means of getting into a position that resembles the form of hunter gatherer children who have never worn shoes.

  10. What are your thoughts on unsweetened almond milk?

    • I have the book -thank you.
      You say most people do not cook beans properly. What is the PROPER way?
      Thanks.

      • Beans should be soaked and sprouted or fermented. For example, proper methods for soy beans would to produce natto or tempeh, both of which are fermented. Also soy sauce is fermented although usually with wheat (I use gluten-free tamari for that reason). Beans can also be sprouted (as in bean sprouts! 🙂 ). These are all methods to reduce phytates but it’s still a matter of individual experience if it’s OK to consume even properly prepared beans. There is some discussion on this website of the proper methods for preparing beans, but also if you want more information there is plenty at http://www.westonaprice.org

  11. Welcome – Now read the book! ( on amazon.uk)

  12. There is a problem with getting copper from liver. Liver has a lot of highly available iron, and the more iron you have, the more copper you need.

    ‘… Iron overload can have adverse effects on copper nutriture and can produce cardiac disease in people. … High iron increased the dietary copper requirement of the animals. …’ http://www.ncbi.nlm.nih.gov/pubmed/11396784

    Whole grains and nuts have quite a lot of copper. Many people think white rice is better than brown rice because of the phytic acid. Phytic acid has actually been found to improve copper absorption.

    ‘Enhancement of Cu bioavailability in the rat by phytic acid’
    http://www.ncbi.nlm.nih.gov/pubmed/3373335

  13. I can’t find manganese on the supplement list. People eating a lot of meat may have iron overload and manganese deficiency. Iron overload can cause diabetes as well as heart disease. Recent research has shown that excess iron stops manganese from getting into mitochondria. No manganese in mitochondria = diabetes.
    http://www.ncbi.nlm.nih.gov/pubmed/23372018

  14. Jane, have you read the Jaminets’ book in its entirety? It is hugely well researched and each vitamin and mineral addressed. It is phenomenal in its detail. Hopefully Paul Jaminet will address your queries/ comments 😛

    • Hi Elsie
      No, I haven’t read their book. I believe it was published in 2012? The paper I linked on manganese wasn’t published until 2013. This paper has changed everything.

      We knew iron overload was involved in diabetes, and that most studies implicate iron from meat. We did not know how iron interacts with manganese to cause diabetes. We now know that it stops manganese from getting into mitochondria, so the critically important enzyme MnSOD has no Mn and doesn’t work.

      Meat is very high in iron and very low in manganese. Manganese is very easily excreted, and iron is hardly excreted at all. People who want to eat meat every day need to think about their manganese intake, especially if they eat a lot of saturated fat, which increases iron absorption and inhibits manganese absorption.
      http://www.ncbi.nlm.nih.gov/pubmed/11697763

  15. Does Paul recommend DHA supplements if we can’t always include everything recommended in the diet.

    I don’t eat the bad stuff, but I also don’t always eat the good stuff in the recommended quantities.

    It seems DHA would solve that problem.

    Anyone have the answer?

    • I’ve been wondering the same thing myself, for about the same reasons 😕

      • All the cooking and chopping and trying to find grass fed beef and free range chickens in this neck of the woods is more than I want to deal with.

        One (pill) and Done is my goal … that and food delivery of things I can and want to eat. 😉

  16. Hi Paul,

    In reference to the weekly supplements – B-50, Zinc, Boron, Chromium and Copper. Is there an optimal pattern to take them in or can I take them all at once?

    I just wanted to check in case any of them interact with each other and block absorption (I know this is an issue with zinc and iron).

    Thanks

    Kate

  17. Wittgenstein remarked that the epigraph he originally considered for Philosophical Investigation was the line from King Lear “I’ll teach you differences.” Now, there is an important conceptual distinction which is acknowledged but also blurred to some extent in the Perfect Health Diet, and the blurring of this distinction has the potential to produce a good deal of confusion and mischief. The distinction is between (a) a therapeutic use of a supplement versus (b) the use of a supplement as a tool to bring a nutrient into the body’s plateau range, assuming the nutrient is not already in that range from food sources.

    Jaminet has, for example, remarked that high doses of vitamin C have therapeutic benefits for certain diseases. But such doses, which push the nutrient far past the body’s plateau range, will be likely to be accompanied by some unnatural and perhaps undesirable effects, effects which would not be a good trade off for the average person, who has nothing to benefit from the high doses. Jaminet has estimated that the plateau range of vitamin C is around 400 mg. This is an amount that is difficult to obtain from food alone, but it is possible. And yet the PHD “non-therapeutic” daily recommendation of vitamin C is 500 mg to 1 gram. Now, such a recommendation either contradicts the PHD framework, which posits that we should bring all nutrients into the body’s plateau range, preferably from food sources, or, I am confused about the PHD framework, and Jaminet believes that we are all in need of something bordering on a therapeutic dose. But what reason is there to assume that the health of a normal (non-diseased) person would be improved by pushing a nutrient, such as vitamin C, more than 100% past the plateau range and on a daily basis at that?

    But if the PHD framework can in fact be summed up as the doctrine that we should bring all nutrients into the body’s plateau range, and preferably from food sources, then it is seems clear that we should place a high priority on the improvement of our understanding of the technique of obtaining micro-nutrients from food sources, a topic which has, for the most part, been inexplicably neglected.

  18. Hello Paul,

    Would you please comment on the posts made by Jane and Darrin regarding the manganese question – whether supplementation is necessary? I would value your comments on this topic. Thank you.

    • Hi Elsie,

      No, I don’t believe manganese supplementation is desirable or necessary. If you eat the 4 pounds per day of natural whole foods we recommend, you’ll get more than enough manganese, and more is likely to be toxic rather than beneficial.

        • Scientists can only get funding to study manganese if they focus on its toxicity, and because of this many people think it’s a potent neurotoxin. Certainly if you inhale manganese dust every day it can be, but the idea that low doses damage the brain has been disproved. Low doses injected directly into rats’ brains were found to PROTECT them from iron-dependent damage.
          http://www.ncbi.nlm.nih.gov/pubmed/9681949

          Manganese intoxication was widely believed to have caused the mad cow epidemic here in the UK, although the evidence actually suggested manganese deficiency. In Iceland the sheep equivalent scrapie occurs where the forage is LOW in manganese and high in iron.
          http://www.ncbi.nlm.nih.gov/pubmed/16987395

          In Canada people think manganese in drinking water damages children’s brains. The amount thought to do this is 100 times less than the amount in their food. Nobody seems to think this is odd. Once again, the real culprit may be iron, which correlated with manganese in the drinking water (Pearson correlation 0.68).
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018493/

  19. Dear Paul, I have been supplementing with Ascorbic Acid Powder for over a year now but find it extremly unpleasent to drink. Recently I have come across articles claiming that Sodium ascorbat is much better absorbed by the body. What form of Vitamin C do you recommend for supplementation?

    Thanks you in advance,
    Jana

  20. I am trying to find the copper content of 100% cacao unsweetened baking bars. Most of the ingredient labels do not list copper at all.

  21. For Zinc and Copper, wouldn’t it make more sense to take a supplement that balances these nutrients in the right proportions? For example, why not just cut this one in half, which gives 7.5mg zinc / day and 0.75 mg copper /day ? That somewhat undersupplements, but the hope is you make up the deficiency by Perfect Health Diet:

    http://www.amazon.com/gp/product/B0001VKDDM

  22. Hello,

    thanks for the wonderful information on this blog!
    I am in situation where I have to budget my diet quite tight so can’t allow all supplements you recommend. Could you tell which ones are absolutely must and which ones you can get away without?

    Thank!

  23. Hello Paul,
    It was really great from you to replay on my message about 6 months ago. I was following your advice strictly for the last 6 months, following supplements and PHD diet. The doctor says that I have IBS but never suggest anything useful to help me. I live in UK. I always been active and healthy even before I have followed the PHD. But since I have followed the PHD I have seen too many improvement in my health apart from the constant pain in my stomach. Every few days I start to suspect a new food which can be a problem. Few weeks ago I stopped eating eggs as I noticed I have pain when I eat them. I am worried that I will end up finding nothing to eat. I don’t know at the moment how to stop this pain as I can’t understand what cause it.
    I hope you can give me any idea where to go from here. Best wishes, and thank you for your kindness to replay on my messages

    • Nima – some people can eat egg yolks but have trouble digesting egg whites which are just protein. The yolk is where all the good stuff is anyway 🙂 so perhaps it would be worth it for you to try just the yolk and see how you feel?

      Another possible route is to use the 30-day protocol developed by the Hartwigs in ‘It Starts with Food’ which is designed to test your reaction to a group of common problem foods by avoiding them completely for at least 30 days and then gradually re-introducing them, one at a time, while watching for problems. The foods to avoid are grains, legumes, sugar, dairy, certain oils. For ‘special populations’ (and it sounds like you would be in this category) they recommend also avoiding nightshades, eggs, nuts and coffee. They provide full menus and recipes for meals during this period (most developed by Melissa Joulwan who has written 2 great cookbooks) which helps to get through the 30 day period.

      You can look up the book on Amazon and read through some of the 1000+ reviews – a lot of people have been helped by it. It cleared up a few questions for me but I also found I needed more time to re-introduce certain foods and some, such as wheat, I didn’t bother to test since I already knew it was a big problem for me. Much of what they truly recommend most people should be eating is PHD compliant. The authors present a path to sort through all the confusion with foods that cause sensitivities, intolerances or allergies.

      • Hi Hillary, Thank you very much for your kind replay. I have started avoiding some food 1 week ago (such as eggs and dairy). I will get that book you recommended as it seems a very good book and it would help me do it properly. thanks a lot for the advice.

  24. Hello Paul,
    It was really great from you to replay on my message. I was following your advice strictly for the last 6 months, following supplements and PHD diet. The doctor says that I have IBS but never suggest anything useful to help me. I live in UK. I always been active and healthy even before I have followed the PHD. But since I have followed the PHD I have seen too many improvement in my health apart from the constant pain in my stomach. Every few days I start to suspect a new food which can be a problem. Few weeks ago I stopped eating eggs as I noticed I have pain when I eat them. I am worried that I will end up finding nothing to eat. I don’t know at the moment how to stop this pain as I can’t understand what cause it.
    I hope you can give me any idea where to go from here. Best wishes, and thank you for your kindness to replay on my messages

  25. I started taking higher doses of B vitamins everyday and some eczema which I’ve had for about a year cleared within one week.

    Thiamine seems like a vitamin that would be especially low on the Perfect Health Diet, as it is found in legumes and whole grains. It seems as though thiamine could be regarded as a mandatory supplement and one which could be taken frequently. Thiamine is the only vitamin that comes out below RDA levels on the self nutritional-calculator, whereas everything else is closer to 200%.

    Also, for those that don’t eat liver, wouldn’t it seem prudent to supplement vitamin A in the form of retinol (derived from fish liver) at 10,000 IU about 2 per week?

    • And thiamine doesn’t seem to produce the same experiential side effects that other B vitamins can, such as a feeling of hyperactivity, excess energy and loss of appetite.

      • I am beginning to appreciate the importance of B vitamins first hand, since they appear to positively influence my skin conditions such as my chronic eczema and dandruff. B-1 seems especially important to take on the Perfect Heath Diet. I also understand that folic acid and niacin are not recommended, and I understand the reasons.

        What I don’t understand, however, is the rationale for mega-dose quantities of the “safe” B vitamins such as B-1, etc.

        Why not empty out the powder from the B vitamin capsules and take more realistic doses? Taking the mega-dose quantities makes me feel positively strange and hyper. But taking bits of the powder does not produce noticeable side effects.

        • Just curious what does and combo of B you have found useful for your chronic eczema? Would love to give it a shot myself!
          thanks

          • I took “Super-B” by NatureMade. It contains mega-doses of Thiamin and Riboflavin and then normal doses of the other B vitamins. I took it everyday, as opposed to once a week. It was taking it everyday that seemed to help.

            I could be completely wrong, but I’m guessing Thiamin and Riboflavin are the ones that may have helped. I’m currently experimenting with cutting individual Thiamin, Riboflavin, Biotin, and Pantothenic Acid capsules.

            What’s nice about the PHD supplement list is that they essentially give you every single relevant micro-nutrient in existence and then you can sort of make your own custom multivitamin.

            Although I’ve been somewhat critical of supplementation in the past, I’m not opposed to it in principle or anything; there is no getting around the fact that the body has its micronutrient requirements; my problem is that I usually experience experiential side effects from the large doses; the standard doses are just way too high for me; and so I wish there was a low-dose multi (like a kids vitamin) that contained only the safe micro-nutrients and avoided the toxic ones.

          • Mega-doses of vitamin C and also normal doses of lithium seem to actually exacerbate my dandruff problem. So, it’s very complicated and there are so many variables.

            What I can say though is that iodine, magnesium, chromium, selenium have never seemed to really reverse my dandruff or eczema problem, but large doses of B vitamins seem to help. I have no idea why.

          • It seems like another good solution would be to cut a B-100 vitamin into 7 pieces. This way one gets a good dose of all the safe stuff except for biotin. Moreover, the folic acid, once it is cut into 7 pieces, is negligible.

  26. Can someone here explain how many drops of J.Crow’s Lugol’s Solution 2% would give the Perfect Health Diet recommendation of 225 mcg of iodine? J.Crow’s labeling is horrible, and their web site is also horrible. As far as I can tell, one drop of the 2% Lugol’s Solution will give you 1.25 mg, which is about five times the PHD recommendation?

    • using your numbers above,
      1.25 mg = 1,250 mcg
      That’s nearly 7 (seven) times stronger than 200 mcg.

      And, I actually think that the 1.25 mg is wrong (too small), i think one drop of 2% Lugols is actually 2.5 mg Iodine (1 mg Iodine + 1.5 mg Iodide from 1.95 mg Potasium Iodide).

      I also found a chart here (page down to the comments) http://www.earthclinic.com/Remedies/lugols-iodine-supplements.html
      that agrees with me ie. 1 drop 2% lugols = 2.5 mg Iodine.

      2.5 mg = 2,500 mcg

      • “That’s nearly 7 (seven) times stronger than 200 mcg”…actually just over 6 (six) times stronger, but you get the point.

        Anyway, if it was me, i would assume (to be on the safe side) each drop of 2% solution was 2.5 mg Iodine. ie. 2,500 mcg Iodine or over 12 (twelve) times stronger than 200 mcg.

      • so you could feasibly, put 1 drop 2% solution in to 1.2 Litres of water & mix.
        & drink 100 ml per day, giving you 208 mcg per day (2,500/12)…

        …if you could be bothered

      • slight correction just for my own sake (i wish we had a edit option),

        …one drop of 2% Lugols is actually 2.5 mg Iodine (1 mg Iodine + 1.5 mg Iodide from 2.0 mg Potassium Iodide).

      • Has anyone taken larger doses of iodine, in the 5-12.5 mg range, and what was the outcome?

  27. Hi Paul,

    I have been searching about my Zinc intake and I just realize that with the amount of beef that I eat daily (3/4 pound) should be enough without any kind of supplementation and without the need of eating oysters.

    Am I correct or do I need more Zinc apart from the one that I get from Beef?

    Thanks!!

    • What matters, according to the PHD, is reaching the “plateau range” for zinc. Note, however, that the “plateau range”, as determined by the PHD, is higher than the RDA.

      • I agree, so if we eat 400gr of beef daily I assume this should be enough.

        Since 400gr of beef equals 23mg. This should be added to 2mg (3 daily eggs), 1.2mg (1 pound daily), plus at least 2-3mg from different vegetables or fruits. For a total of 23+2+1+3=29mg daily.
        Being Zinc’s peak health range in 15-30mg I assume we don’t need supplementation here if we are following the PHD (unless we eat around 0.5 pound or less of beef daily)

        • Yes. Keep in mind, however, that the inclusion of shellfish, such as oysters, has numerous benefits for what Aristotle called “the naturally organized living body”.

          Also, keep in mind that, in the context of a balanced diet, the ratio of zinc to copper is perhaps more important than the absolute amount of either. The best source of copper is beef liver. Chicken liver has lower amounts of copper, but is still a good source of vitamin A.

  28. Hi Paul, do you recommend cod liver oil as a supplement? I already take medications several times a day for some autoimmune conditions that I have and really try to get all my nutrients/vitamins from food so I am not taking more pills/supplements. I’ve heard many people rave about the benefits of taking cod liver oil and was wondering what you think about it. Thanks.

    • From what I can gather, the PHD does not recommend cod liver oil as a primary supplement; however, the PHD might recommend it under certain circumstances; for example, if you don’t eat liver, then you would want a source of retinol; or if you don’t eat fish, then you would a source of omega-3. However, the PHD does not consider fish oil to be an ideal source of omega-3, since it is not fresh, and omega-3 is thought to be especially fragile. The PHD is also skeptical of “fermented cod liver oil”, since they worry that the fermentation process leads to potential rancidity. If fish oil is taken, they recommend refrigeration.

      Although I assume the PHD is correct in their reasoning, I personally take small amounts of fermented cod liver oil, since it is a traditional food, and I like how it makes me feel. It also has led to improvements in the color saturation in visual perception.

    • No, we recommend animal liver and seafood as the source for vitamin A and fish oil, respectively, because they bring many other desirable nutrients as well. If you ate liver and cod liver oil you could overdose on A. But, if you don’t eat liver, cod liver oil would be a good supplement.

      • Thanks. I know a couple people that basically eat the Perfect Health Diet, but who don’t eat liver at all. (I understand that liver and seafood are considered to be almost non-negotiable supplemental foods without which the Perfect Health Diet would no longer be perfect.)

        But for such a person, would an actual vitamin A supplement, say 10,000 IU of true vitamin A, twice a week, be a reasonable supplement?

      • Hi Paul
        Would taking CLO cause someone with thyroid issues to overdose on iodine?

  29. Hello Paul,
    I have been studying my vitamin A intake and I am worry that I am eating too much. In the book you say to take around 10,000IU per day if you are healthy.

    My week diet has: 300gr of spinach (27,000IU), 300gr of kale (45,000IU), 400gr of carrots (50,000IU), beef liver (28,000IU)…
    That already is a total of +150,000IU of vitamin A per week and my intake is probably much higher than that, around 250,000IU per week.

    Is that healthy for me or could I be overdosing myself?

    Have in to account that I only take vitamin D from supplements 2,000IU and little sun and my K intake is the one recommended in the PHD too.

  30. Thanks for the answer BS,

    So you mean that in 100gr of kale we get around 300IU?

    100gr of Kale. 10,000IU. 6000 beta caroteno*0.05= 300IU of vitamin A.

    http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2461/2

    • Yes Andoni that sounds about right, give or take a bit depending on the person but 5% is probably a reasonable amount to assume.

      • Ok, thanks for the answer again. I guess is extremedely difficult to toxicate of vitamin A following the PHD then.

        Do you think that there is any way to reach levels of toxicity by eating 1 pound of green leafy vegetables every day in my smoothie? Because I have read histories of people who get sick by eating too much greens, but I don’t know how much is too much if you eat the PHD diet.

        I rotate between 4 different greens (kale, spinach, broccoli, swiss chard).

  31. I would not worry about Vitamin A toxicity from any plant foods, that being said eating to many green can cause problems with things like oxalate’s and I think a pound might be a bit green heavy.

  32. Thanks for the answer again BS. I think I would drink 1 pound of greens 4 days a week only, I guess with that and by rotating them should be enough to stop problems like oxalate’s.

    I have another question; respecting to the vitamin K2 this time.
    I am getting around 2400mcg of vitamin K daily (mostly from greens), and I would like to know how this transfers to vitamin K2.

    How much K2 is this worth? Am I near the upper limit (UL)? Do I still need to supplement 100mcg from MK-7 daily?

    Thanks!!

  33. Don’t sodium, potassium, and magnesium need to be in a particular ratio to each other in serum? If yes, does it make sense to take these together, maybe in the form of a sports salt that mixes them all together?

  34. Hi Paul,

    Can you comment on whether one of the various forms of B12 (methylcobalamin, hydroxocobalamin, cyanocobalamin, adenosylcobalamin) is preferable to the others in terms of supplementation?

    Thanks,

    Jordan

  35. Nausea After Taking Supplements: Hello. I have been taking supplements for years (PHD recommendations for the last 2.5). About 2 months ago I started feeling nauseous after taking supplements. Initially I thought it was related to zinc after increasing the dosage due to illness. But now it seems like pretty much every thing makes me feel off (tablet or capsule, magnesium, iodine etc.) regardless of when or what food I take them with. I am assuming it must be partially psychosomatic at this point but I figured I would post something here to see if anyone else has experienced this. I have stopped all supplementation for the short term and will try again in a few weeks.
    Best,
    Brennan

    • Hi Paul and Brennan –
      i too have just started to feel nausea a few hours after taking my PHD vitamins. i always take them with food and have never had problems before. the same with coconut oil bark. i haven’t stopped the supplements because they help me function so much. my appetite has disappeared as well despite the fact i’m still nursing a toddler. Any thoughts Paul?
      thanks

  36. Nausea After Taking Supplements: Hello. I have been taking supplements for years (PHD recommendations for the last 2.5). About 2 months ago I started feeling nauseous after taking supplements. Initially I thought it was related to zinc after increasing the dosage due to illness. But now it seems like pretty much every thing makes me feel off (tablet or capsule, magnesium, iodine etc.) regardless of when or what food I take them with. I am assuming it must be partially psychosomatic at this point but I figured I would post something here to see if anyone else has experienced this. I have stopped all supplementation for the short term and will try again in a few weeks

  37. So are you supposed to take the Vitamin B tablets just once per week, or every day?

  38. Hi Paul,

    My wife is 5 weeks pregnant and we’re following the PHD diet and supplement recommendations. My question is about excessive Vitamin A and birth defects.

    I’ve read a paper that defends liver consumption in pregnant women but recommends limiting it to 50 g per week as well as keeping total intake of Vitamin A below 10,000 IU per day.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1664333/?page=1

    You recommend 1/4 lb (~100 g) of beef or lamb liver plus additional poultry liver per week. The ruminant liver alone contains about 30,000 IU per the USDA Nutrient Database.

    Should we be concerned?

    • Hi Steve,

      I recommend 1/4 lb per week, the 1/2 lb is a firm upper limit due to A toxicity (if you eat duck/goose/chicken liver), the 1/4 lb is a firm limit if you are eating beef/lamb liver due to copper toxicity. So I am recommending about 30,000 IU/week, not more.

      A deficiency is just as great a concern as A excess. See for example this recent story: http://www.the-scientist.com/?articles.view/articleNo/39505/title/Vitamin-A-s-Influence-on-Immunity/

      I think the authors of the paper you read are being overcautious. I stand by our estimate of the optimal amount of A. One thing to keep in mind is that the optimal amount of A is proportional to the amount of D you get, and most people are D deficient, so if you look at the general population you will see many people who seem to do best on a relatively low A intake, but really would do better to get more A, D, and K together.

      Best, Paul

      • That makes sense. I’m less concerned since we’re getting ample sunlight and supplementing K2.

        I think we’ll try alternating weekly between the beef and chicken liver, capping it at 1/4 lb.

      • I’m in the same position. I used to take 1tsp fermented cod liver oil and 1/4 tsp high vitamin butter oil. hen I started eating liver weeky too, less than 1/4 pound though.
        So now I’m focusing on eating more liver and seafood and less cod liver oil. I hope I wasn’t overdosing Vit A before.

        I’ve now started taking 400units Vit D daily. Not sure how much Vit K to take though. In your nursing mothers notes you don’t talk about supplements but to ge it from food. I do eat liver, cheese maybe once or twice a week, sauerkraut daily (1 to 2 tbs) and kefir or yogurt almost daily. Would this be enough for Vit K or should I still supplement.

        I wonder if Vit k deficiency has something to do with losing too much blood at birth? his is a concern to me as I have had a few births and with each one the blood loss has increased.

  39. Hi Paul,

    I am supplementing with Iodine for my thyroid nodules (thyroid function is normal), i am now at 4 mg/ day from Lugol solution. I also supplement with vitamin C, magnesium and 200mcg Selenium.

    I know that you now recommend taking the Selenium from food, but in te context of high doses of Iodine I understood from pne of your other articles that Selenium is still needed.

    Which form of Selenium is best: methylselenocysteine or l-selenomethionine? I take the latter but I have recently learned about the former being more bioavailable and having better anticancer protection.

    Thanks a lot for your help.
    Mihnea

  40. I just finished reading the 2010 edition of PHD. Within the authors recommend 2 Tablespoons of coconut oil a day for the short chain fats. But here on the supplement recs page, I do not see the daily 2 Tablespoons recommendation (although coconut oil is listed under nutritious foods). Do the authors still recommend 2 TBs a day of coconut oil? Thanks!

  41. Rhonwen Seager

    Hello Paul,
    I would very much like to know what you think about fulvic minerals as a ‘natural’ way of getting a full range of trace minerals. I appreciate the importance of the ones you recommend supplementing with, but it concerns me that there are so many others that may be equally important, and here in New Zealand the soils are very deficient in many things. I wonder, though, whether you would think that taking fulvic minerals leads to overdosing and stepping into the toxic realm on some things e.g.iron? The one I have been using has no mercury but does have aluminium on the very long list of minerals it contains, presumably in microdoses but…..? Thank you, Rhonwen

  42. Hi Paul
    What would be a firm limit for a weekly intake of beef liverwurst(US Wellness Meats)?

  43. hi Paul,

    reading your comment here http://perfecthealthdiet.com/2010/07/bowel-disease-part-ii-healing-the-gut-by-eliminating-food-toxins/comment-page-3/#comment-516857

    “We don’t recommend going above 225 mcg iodine any more”

    perhaps? you need to update or clarify the bullet point above under your Daily Supplements heading that currently reads,

    ” Iodine at least 225 mcg, recommend 1 mg “

    • hi Paul, In line with Darrin’s comment, I have been supplementing Iodine for a while now, but when I had a test to check my status (iodine serum), it was low! What could possibly cause low iodine serum, in spite of supplementation?
      Thanks
      LN

  44. Paul– Doc’s Best Lithium has been discontinued. Since the only other options are 5 mg capsules, that would be difficult to split, what do you think about taking 1 capsule every other day? Or is that still too much at once?

  45. I’m concerned by the PHD statement that most inorganic sources of copper are toxic. Are there any forms of supplemental copper that are safe?

    Complicating this issue is that zinc and copper should be in balance to each other. It is both easier and safer to do this if the zinc and copper co-exist in the same supplement, thus guaranteeing a proper balance.

    I found one zinc-copper supplement by AOR Research that contains proper balance as well as multiple forms of zinc and copper to maximize absorption:

    Zinc (citrate, malate, succinate, fumarate) 15 mg
    Copper (citrate, malate) 2 mg

    Paul, can you comment on these sources of Copper and Zinc?

    • Perhaps this is a reason to eat both oysters AND beef/calves liver, especially when one craves them; furthermore, beef/calves liver has numerous benefits in addition to the copper.

      If you find liver to be unpalatable, it helps to first soak it in water. Also, calves liver is relatively mild.

      Given the side effects I’ve experienced in the past, I will never take supplemental copper again.

    • I don’t think taking copper and zink together is the best way to obtain balance, as they compete for absorption.

      E.g. http://www.ncbi.nlm.nih.gov/m/pubmed/3968585/

    • Hi Pone, I think what Euthyphro below is trying to say is that a lot of foods in nature contains both zinc and copper. Nature already has zinc and copper in the forms the supplement is trying to sell! Plus a lot of other goodies (choline, folate, iron, B12, and surely others I cannot remember) that your supplement does not have.

      Also, this may help understand copper-zinc balance a little better (or at least illuminate that it’s very complicated and why it might be best to get copper via food):

      “So, the body has a pretty elaborate system for managing and regulating the amount of trace minerals like zinc, copper, iron, manganese, and chromium in the blood, and what happens is if blood levels of any of these trace minerals are depleted, then we have a system for absorbing them from the diet, and then they are transported from the blood into cells if the cellular levels are inadequate, or they’re excreted from the body if blood and cell levels are sufficient or overloaded.”

      and more:

      “Any disturbance of homeostasis or oxidative stress will deplete zinc levels over time. So, it’s important to manage your stress if you’re dealing with copper imbalance. One of the first things I would do with patients like this is order a SpectraCell micronutrient analysis, which tests micronutrient levels within the white blood cell, and that can help determine if there are deficiencies of other micronutrients that help reduce copper buildup. So, these are things like vitamin B1, B3, B6, folate, inositol, and choline, and those are all antagonistic to copper, and then there are some minerals that are antagonistic to copper, like zinc, of course, which we’ve been talking about, manganese, iron, sulfur, and molybdenum.”

      http://chriskresser.com/rhr-could-copper-zinc-imbalance-be-making-you-sick

      Probably best to try to get copper via food. It’s quite complex to supplement it, and without knowing where you are starting, and the status of all those other minerals and vitamins, You could be creating a problem. plus, liver rules – I recommend using sage, lots of butter, and a little white wine to deglaze the pan. Cream helps as well. Good luck though!

    • Hi Pone,

      Copper and zinc should be in balance, yes, but in the overall diet, not necessarily in supplements. Our diet includes copper rich foods like beef liver, lamb liver, and chocolate, so copper deficiency is rare. In fact a little bit of beef or lamb liver has so much copper that you should need some zinc supplements (or oysters) to balance it, but no copper supplements.

      I would recommend the liver over any copper supplements. It is hard to replace all the nutrients in liver.

  46. Not being a chemist, maybe someone could explain to us how is “organic” copper different than inorganic? Are any of the copper sources in the AOR Research product organic?

  47. PHD indicates that Selenium from selenomethionine may be more toxic, yet the selenium supplements you link to appear to be this form?

    PHD indicates that Selenium from selenocysteine is far less toxic.

    The only supplement I could find that was clearly labeled as the non toxic form was Life Extension Se-Methyl L-Selenocysteine. Are there others?

  48. Hi Dr. Paul!
    I was wondering what supplement you would suggest for receding gum?
    Thanks!
    Sarah

    • There are many nutrients involved in gum health so really standard PHD recommendations, which cover everything, are best. Everything from vitamin C, to omega-3 fats, to vitamins A and D and K, to zinc and copper, to B vitamins, to protein, to iodine, to salt, can affect gum health.

    • Hi Sarah, my friend has this problem, do you buy any chance breathe with your mouth open? In addition to all the PHD recommended types of foods, if you like to eat lemon with water, or other acidic things, might want to consider bringing your mouth pH up before you go to sleep. Of course, mouth pH is really complex – affected by hormones, flow rate of saliva, minerals in your saliva, etc.

      Good luck and hope it works out.

  49. Lisa McLelland

    I’ve read that taking Chlorella supplements can help with MS. Do you hold this to be true?

    • Eating leafy green plants like seaweed and spinach helps, yes. Chlorella supplements are OK as a substitute for seaweed, spinach, etc., but we generally favor a natural whole foods approach.

  50. so i just don’t have the inclination/extra brain power/time to do all the supplements individually. does anyone have a multivitamin that they recommend, preferably one that is whole foods based. thanks

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