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
  • Use chelate (e.g. glycinate) or citrate
  • Daily dose 200 mg
  • 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
  • For those who don’t take a B-50 complex
  • We recommend 50 mg to 100 mg per week
  • We recommend 5 mg once per week
  • We recommend 500 mcg to 1 mg once per week
  • Sublingual methylcobalamin is preferred
  • We recommend about 50 mg per week
  • Be sure to follow our copper recommendations as copper-zinc balance is crucial
  • 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.

  • 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
  • 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)
  • 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.
  • 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
  • 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
  • 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
  • We recommend 150 mcg to 1 mg per week
  • 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.

  • Precursor to glutathione
  • Recommended dose is 500 mg
  • Can take more in cases of severe chronic infection
  • 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
  • Supports muscle growth and preservation; especially valuable for the elderly
  • Up to 1 teaspoon (5 g) per day
  • 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.


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 ?


  1. you mention curcumin therapy in your Vit D article, yet it is not one of your supplements. Can you give me some more information please or point me in the right direction for this therapy.

    Many thanks

    • Turmeric is one of our most favored spices. In general, if you can get something from food, we recommend getting it from food. I suppose we could list it among therapeutic supplements.

      • Add a bit of pepper too. As I understand it the piperine in pepper slows the liver down from getting rid of the curcumin, thus making it more bioavailable.

      • Oh yes, turmeric is delicious; I hope your cookbook will have many recipes with it.

        The fresh root is hard to come by here, and unfortunately I’ve often found the powdered version to be bitter. But recently a had a bit of an epiphany in the matter:

        Frying the powder in a small amount of hot oil for 1/2 minute or so completely removes the bitterness.

        Literally not even a trace of bitterness remains. You can add teaspoons of powder to a single serving of rice and the taste is completely agreeable. The color you end up with is also spectacular. (The roasting, when done right, seems to intensify the deep orange.)

        Other spices, besides turmeric, that seem to get a lot of press for potential health-benefits are garlic and ginger. Are there any besides those that you think are especially worth noting?

        Or perhaps herbal teas?

        There is no doubt plenty written about this subject on the Internet but usually of too suspect authenticity for me to make sense of it.

      • I am allergic to molds. Can I find the b vitamins you suggested that are mold free or not created from mold?

  2. Hi Paul,

    Besides lithium and vitamin D in the morning, are there any other supplements that are preferable to take at specific times of the day for sake of circadian rhythm?

    (In particular, I thought I read somewhere that magnesium was best taken in the evening… but I’m not sure I’m remembering correctly, and I cannot seem to find the source for this claim.)


  3. are any of these brand recommendations based on consumerlab testing or just your preferred brands (with dosages you recommend)?

    • Hi Tami,

      They are not brand recommendations, but these are forms of the nutrient we recommend, in dosages we recommend, from generally reputable brands. We do not make independent evaluations of brands so if you got the same nutrient in the same dose from another respected brand, that would have our endorsement as well.

  4. Hi Paul, how are you doing?
    Thanks for all the advise you give to people.
    I’ve read on Amazon reviews a lot of people complaining about vitamin k2 Mark 7. About increasing blood clotting, I am not taking it now. But can you give a little of insight on it please?

  5. What do you think of Vit K2 MK& supplements for children. I’ve recently noticed my children have poor enamel on teeth despite PHD. It might be lack of calcium since we don’t do much dairy, but do have broth daily. They didn’t have this problem when they consumed dairy daily. So I will up raw dairy but still wondering about Vit K. Thank you

    • I think vitamin K is one of the most desirable supplements for children, especially if they don’t eat fermented foods and green leafy vegetables daily.

      • Good to know. What dose is good for children for Vit K2 MK7? They are picky about the leafy green veg they like, but do eat a bit of butter or ghee daily and some fermented foods too.

        • 90-100 mcg per day is good. If you want to give less, just give the capsules every other day instead of daily.

          • Thank you. So that is almost/the same as the adult dose you suggest. Even for a 2 year old? In that case, do you think adults could easily take more Vit K2 supplements? I’ve been taking 100mcg daily.

          • Hi Bernadette,

            No, the need for vitamin K2 is elevated in children due to their growing bones. Adults don’t need any more than children do.

          • Thank you. I’ll start supplementing to make sure they get enough. Would be very useful if perhaps you could do a post about PHD for children and supplements for them. I would really appreciate that information, as I’m sure many other parents would too.

          • Oh yes, as a prospective parent myself I’d be interested in this too.

          • My children have been taking the Vit K2 since you said but I was shocked to notice a hole in my 7 year olds tooth. Probably been there a while but I only just spotted it. This is a first in all of my children. I am so suprised as we eat better than ever. Perhaps it would have happened anyway but I am now really wondering if it is lack of calcium since they haven’t had much dairy these last 6 months. Perhaps my broth just doesn’t supply enough. We mainly drink chicken broth made from the carcasses.
            And also I only very rarely have been giving them cod liver oil like I used to. They do eat a small liver meal weekly though.
            Is there perhaps anything you could recommend. I’m thinking perhaps I need to add the dairy and cod liver oil back in?

          • Hi Bernadette,

            It could be a number of things, calcium, magnesium, vitamin D, sulfur (taurine is a good source), silicon, boron, and avoiding excessively acidic foods (or neutralizing the acid with bicarbonate) may help.

          • Thanks Paul. I’ll try more sulfur, silicon and boron. I hadn’t thought of those. Never tested my children for Vit D as I didn’t think they would appreciate the needle prick. Perhaps I should…

            Apart from Vit K, regarding supplement dosages would you say a 7 year old could have half the adult PHD dose in general or perhaps a quarter dose? I worry about overdosing on supplements.

            We have started rinsing the mouth with bicarbonate of soda after meals now.

  6. Hi Paul,
    I tried to search for the reason why you have reduced the recommendation for iodine supplementation from 1mg to 225mcg but could not find it.
    Currently I am following the dosage of 4 tablets of 225 mcg potassium iodide, should I gradually reduce it to 225mcg. Is there any risk if I continue with the original supplementation of 4 tablets? Many thanks.

  7. Paul, if supplementing with Choline + Inositol, what dose do you recommend?

  8. Do you think someone who has a copper wrapped IUD should still take a copper supplement? I’ve been reading about copper toxicity and poor copper absorption from the IUD (amongst other side effects) on the internet, but I can’t tell if this is something to take seriously.

    Would you have too much copper if you have a copper IUD and eat liver?

    Hi Paul,
    I tried to search for the reason why you have reduced the recommendation for iodine supplementation from 1mg to 225mcg but could not find it.
    Currently I am following the dosage of 4 tablets of 225 mcg potassium iodide, should I gradually reduce it to 225mcg. Is there any risk if I continue with the original supplementation of 4 tablets? Many thanks.

  10. For taking with pure choline supplements, would Inositol Hexaphosphate be suitable? I found this as a seperate supplement. Would it be OK instead of the Choline/inositol combination supplements you suggest?
    Thank you.

    • Hi Bernadette,

      No, that’s not a form that provides inositol to the body. Rather it’s a metals chelator used to clear iron and other minerals. It can induce mineral deficiencies.

      • Thanks! I’ll stay away then. I did hear someone say it could be good to use topically for the teeth as a reminerelising powder though…

  11. I repeatedly have a negative reaction to magnesium citrate (Natural Calm, 200mg). Within 15 minutes of drinking it with water, especially at night, I have lower back pain/tension, leg and foot pain, jaw tension, and sometimes trouble breathing, like I’m hyperventilating. It also makes me feel ‘wired’ and unable to sleep through the night.

    Do you know of any possible negative side effects of magnesium supplementation? Does this mean that my body has ‘enough’ magnesium already?

    • Most likely you are deficient in calcium, there has to be magnesium-calcium balance. Possibly you are low in other electrolytes or fluids too, hindering kidney excretion of excess magnesium.

      • Is there a good way to test for calcium levels? I heard that serum calcium is not accurate.
        Or testing for electrolytes in general? When I was unwell this past year I suspected electrolyte imbalance/lack. There were times I had dry mouth, excessive thirst, tight chest sensations, ‘air hunger’. I could never figure out what caused it. I have had air hunger (where I can’t seem to take a deep enough breath) on and off since childhood. It is unpleasant but I can’t work out what is causing it.

        • Testing for Calcium in RBC (red blood cells) can sometimes give you a much more accurate idea of what’s going on.

      • Thanks so much, Paul. Maybe I’ll try Natural Calm with Calcium. I know you say not to supplement calcium, but I almost never eat cheese, so perhaps I am deficient. Do you have an ‘electrolyte’ supplement you recommend?

  12. Hi Paul!

    What’s your take on diet and lifestyle for adrenal fatigue and severe dysbiosis/SIBO. Would you still advice intermittent fasting and safe starches?

  13. Paul,
    Is supplementing K2 a good idea for people with afib or stroke risks where you want to minimize clotting?

  14. Feel totally overwhelmed by all the many individual pills recommended. Isn’t there a multivitamin that adequately covers most of these?? Or is it necessary to avoid other vitamins that may be contained in a multi? Or are there no multis that have the recommended levels? Just the thought of spending so much money and swallowing so many pills is making me want to give up.

  15. Don’t, Cynthia! Follow the food re ommendation first and foremost. Then introduce one or two of the daily supplements which are essential, say the vit D3 and K2 first. Then when you feel you’re getting a handle on it all add,any, VitC and magnesium, and so on. You’re right, the multis have vits. that Paul doesn’t recommend daily and there isn’t a multi out there which has Paul’s approval. Take it a step at a time – the dietary guidelines are the basis of this protocol; get them established and then you can addin the vit/ min recommendations. It actually isn’t so costly when you’re up and running- just the initial purchases – so do it a little at a time. Best wishes.

  16. would someone remind me how much copper is suggested weekly/daily? I don’t eat liver. I know I should, I just can’t get it to cross my lips.

    • never mind, i just read the copper section properly.

      • Well, I do have a question about copper. Perhaps you’ve come across this study before:

        The way I interpreted it at first is that supplementing 2 mg/day of copper would likely supply more copper than eating liver (containing 14 mg) once per week, because the percent absorbed appears to drop at high doses.

        Although it may also just be that the adaptation to absorb less copper only occurs after a few days of sustained high intakes…

        What do you think?

        (The data seemed well presented but accurately assessing studies on nutrition is slightly beyond my comfort zone!)

  17. Have seen this article Paul?

    • Yes, not impressed with it.

      • Would love to see a critique if you have time.

        • I read that and I thought it had some rather convoluted logic. Let’s take one example.

          He uses milk consumption as an analogy for wheat. The claim is that because some people are lactose persistent now (after only 11,000 years), adaptation can happen rather quickly.

          But the problem with that logic is that just because some people are lactose persistent doesn’t mean everyone has adapted. I know because I am severely lactose intolerant.

          I suspect the same thing is true of wheat. Some people have adapted and can process and others can’t. And this is what the author’s analogy should conclude. Instead, the author’s implication is because some people are lactose persistent, everyone should just get over it and eat some wheat (unless of course you are celiac and then you are excused).

          And for the record, I am actually experimenting with sprouted wheat and some whole grains on myself so I am not anti-wheat. But this article is rather cringe worthy and certainly would not be the reason why I would avoid wheat. Great article for grabbing headlines and soundbites. Not so great as a serious piece of analysis.

          • Typo. I meant to say the article would not be the reason I would eat wheat.

          • I didn’t think lactose was a good example because its presumably easier for humans to extend a capability from childhood that they already have than it is to form a new one.

            But the Finnish/Russian story is compelling.

  18. The finnish russian example indicates there are strong interactive effects between wheat and other factors. It suggest that reactions to wheat will be conditional on a host of unknown factors which are largely speculative at this point.

    A fair point but too speculative to draw any solid conclusions from the point of view of an individual trying to decide whether to avoid wheat or not. It certainly does not let wheat off the hook as a very strong trigger nobody how hard the author tries to.

    • Agreed, but it does make me wonder if I’m barking up the wrong tree thinking my eczema or psoriasis and hay fever is gluten/diet related.

      It reminds me of Jasper Lawrence who went to Cameroon (since he couldn’t find a single lab that would sell them to him) to infect himself with hookworm, which immediately cured his horrendous allergies. He then formed a company called AutoImmune Therapies that sells sterilized hookworms so that people can infect themselves.

  19. Dear Mr. Paul Jaminet,
    In this article you recommend Lithium supplementation and according to my research Lithium has some very nice beneficial properties. However, I also read that Lithium does what it does by inhibiting Magnesium pathways and possibly absorption. Given that Magnesium is a very important mineral isn’t that a drawback?
    Also if one is supplementing with both magnesium and lithium, aren’t they cancelling each other or worse? 😕
    Thanks in advance.

  20. Hello Paul,

    Regarding silicon supplements, I was just looking through at what’s available, and I’m curious if you have any thoughts on “Choline-Stabilized Orthosilicic Acid” as a source of silicon (or choline, for that matter):

    Also same question for silicon dioxide, like found here:

    Thank you

  21. Paul:

    What do you think of Fiji water for silica??
    I hear it’s high in that mineral.

  22. Hi Paul, based on this, would you change your Vitamin E and C recommendations?

    • Hi Spor, No. We don’t recommend vitamin E to begin with, although a low dose would benefit some people. C is likely to be beneficial for most people. It has many effects and the response to exercise is only one of them, not necessarily the most important. There is no clinical evidence that maximizing response to exercise = maximizing health.

      There is also the question of how to measure response to exercise. I think strength and respiratory fitness is the best measure. By that measure the C and E supplementers did as well as the placebo group. Their 1RM max improved just as much.

      I think it’s clear that muscle that can produce more strength from less mass and size is healthier muscle. Symptoms of vitamin C and E deficiency include damage to muscle and cardiomegaly, overgrowth of the heart. The muscle fibers become damaged and unable to exert as much force, and the heart overgrows creating more fibers to keep up its ability to pump. That could be happening here in the leg muscles of the low C/E group. I think it’s quite possible that this study is evidence in favor of C and E supplementation.

    • That study is obviously confounded: combining fat-soluble and water-soluble antioxidants means they changed at least two variables to produce an outcome. Vitamin E likely has a long half-life ( but Vitamin C does not. I’m personally not going to slight Vitamin C until a study like this is done without such a blatant design flaw. Also, frankly, the statistical significance of these effects are not very impressive. The “antioxidant” group had plenty of members that improved their strength, and strength improvements matter more than muscle size increases.

    • Don’t take antioxidant supplements on workout days. It hinders recovery. Muscles need to be damaged and send out inflammatory distress signals to be rebuilt up better for the next time.

      Also it seems evident to me the elderly were overtraining so that’s another confounding variable. But, overtraining is pretty typical of the mainstream/research approach to exercise (I mean true exercise that specifically builds up muscle not feel good entertainment), i.e. more is better.

      • MachineGhost,
        I have been wondering about how to go about this myself. On the one hand DNA testing reveals an increased need for exogenous anti-oxidant support ( among other things I feel amazing when taking liposomal glutathione but worry about long-term consequences), on the other hand I don’t want to suppress the body’s own supportive reactions and decreased the hermetic effect of exercise. As my fruit and vegetable intake is lower than ideal due to SIBO I have arrived at what you suggest; I take most antioxidants only on non-workout days.

        Do you have any references, further thoughts or ideas for further reading on the topic? I feel that this is an important piece for me.

        • I am also interested in this topic. Liposomal glutathione and vitamin C does wonders for me when I am limited in the type of fruits and vegetables that I can eat.

  23. I want to start the perfect health diet because I suffer from migraine attacks frequently, i do a lot of walking and sometimes cardio exercise . What would you reccomend I add to my diet for energy ( I can’t have fruit) thanks

    • Hi Julia,

      You should add whatever you are missing nutritionally in your current diet. The best diet is balanced, neither too much nor too little of anything. PHD aims for that balance so I’d recommend just eating PHD, with our standard supplements. If fruit is a problem, focus on starches and vegetables for carbs; and also gut healing nutrients like vinegar, liver, extracellular matrix in soups and stews, sunshine, intermittent fasting, circadian rhythm entrainment, green leafy vegetables, egg yolks. Additional supplements that could help include taurine, glycine, and vitamin C.

      Intermittent fasting will be very helpful to you but be sure to eat enough food, especially carbs, during your feeding window.

      Best, Paul

  24. Paul, What are your thoughts on Calcium d-glucarate as a liver support and a benefit to reducing high LDL?

  25. Hi again!

    I can’t see if you answered my question already, so I ask again. What would you advice for adrenal fatigue and severe dysbiosis/SIBO? Would you still recommend intermittent fasting and safe starches?

    • Hi Markus,

      Yes to both. We have a long list of advice for those conditions, if you browse the comments you’ll find them. For adrenal fatigue just manage symptoms during the fast by providing electrolytes, e.g. salted tomato, and appropriate water. For SIBO our regular advice and some therapeutic supplements are appropriate.

      • Could you please point me in the right direction? I’ve been suffering from this for a long time and it has taken a hard toll on my body.

        Since I don’t have access to a integrative medicine practitioner, I have to manage my condition on my own.

        I am currently following your general recommendations, although I do eat breakfast but don’t tolerate eggs. What would you add for additional therapeutic support?

        I am very grateful for any advice from your part!

        • Hi Markus,

          Vitamin A (liver), vitamin D (sunshine), vitamin C, vinegar, taurine, glycine, intermittent fasting, circadian rhythm entrainment, fermented vegetables, egg yolks (try duck eggs, or cooking the yolks and discarding whites), PHD generally.

  26. In the book it says to take Pantothenic Acid (B5) once a week (pg. 324), but here you say to take it daily. Which do you suggest?

  27. I have a question for Paul, and any others who may care to comment, if you are willing to do so?

    I have the paperback edition of the PHD from 2013. I’ve implemented it once for only 3 months and then fallen off the wagon, and am now doing it again for the last month, and this time bringing my family along with me.

    I have chronic sinusitis, which despite four operations to open the sinuses, continues to plague me at a low-grade level and flares to become quite acute and debilitating whenever I am under some stress in life. I have had sinusitis since my early 20s, now 45, and the last 10-15 years have been a constant struggle with infection, low energy and facial pain on one side which was diagnosed as atypical facial neuralgia (which may/may not be related to the sinus).

    Whenever I take antibiotics, or immune stimulating herbs such as Echinacea, astragalus or golden seal, the pain and infection seems to resolve down to one side and one point but never completely goes away. X-rays and endoscopy seem to be unable to find a point where the infection is persisting. My ENT believes I have biofilms of bacteria that jump into action when my immune system is down or when antibiotics are not present. My ENT now wants to put me on Keflex (cephalexin, Panixine) for 6 months to try to give my system a chance. I am scared about the long-term consequences of antibiotics for that long, but also equally scared about the long term consequences of the infection being unchecked.

    One dentist feels that I may have cavitations in my jawbone from wisdom teeth extractions, but a second and third opinion seem to disagree with the first dentist, and nothing is obvious on X-ray or cone beam X-ray of the area.

    I did have several amalgam fillings that I had removed at age 21. I didn’t detoxify with supplements at the time. Since about 2005 I have tried to follow the Andy Cutler protocol for low dose mercury chelation using Alpha Lipoic Acid (ALA) and then later DMPS. However I seem to have trouble and react negatively to many of the vitamin and mineral supplements he recommends while chelating, and ALA seemed to flare up some of my sinus symptoms and requires you to dose at 2-3 hour intervals around the clock (yes at night too!) for at least three days, which would leave me exhausted and then facing another week at work really struggling energetically.

    So I’m here to try to “harden up” my terrain. I’m unsure what to do to supplement the PHD to minimise, reduce and ultimately be infection free. I am taking iodine but only at the 225mcg/day level. I know Paul has revised the recommended amount downwards from several milligrams per day to the 225 mcg due to toxicity concerns. However what happens in the case of infection? Is it wise during infection to increase the dose as high as I can, possibly into the mgs/day range?

    Also using Vitamin C to bowel tolerance. I have tried it in the past and got to around 50-60 grams before loose stools occurred. I seem to have trouble with the acidity of it however, and I do worry about taking that much acid and how the body can cope? I do take good brand Vitamin C Foundation Quali C powder, which as far as I can tell is pure vitamin C, so I don’t think it is additives or impurities causing the issues.

    My Vitamin D levels were checked and were 42ng/ml, which is OK. Is there anything else I can supplement with, or do to make my body more infection resistant?

    • Hi Andrew,

      Make sure your vitamin A intake is good … about 10,000 IU per day of animal form from liver and maybe supplements would be good. Control iron levels through blood donation. Glutathione & bile support with glycine, N-acetylcysteine, taurine, and vitamin C may be helpful. Intermittent fasting and circadian rhythm entrainment. You could go a bit higher in iodine but don’t exceed 1 mg. Possibly apply probiotics to your sinuses.

      • ‘apply probiotics to your sinuses’
        You have peaked my interest with this Paul…
        Could you give more details or links,
        as to how to do this exactly, how often & which bacteria/s etc


        • Me too. I’ve had a sinus problem for 25 years and nothing has helped.

        • Hi PAul
          What are your thoughts on using colloidal silver for sinus infections? I’ve heard that a product called Argentyn 23 nasal spray is good.

          • I’m not a fan but also not an expert.

          • Hi Jane,
            if you give the colloidal silver nasal spray a go.
            pls post back with the results, i would be interested to hear.

            I may try myself, if i do, i’ll post back with my findings.

          • Hi Darrin, yes I’ll let you know if my nose turns blue or not. 😉

          • The colloidal silver nose spray sold at will not turn your nose blue! Xlear is also a great nose spray (xylitol in it – recommended by Dr. David Williams of the Alternatives newsletter). Also ask your ENT if a one day over the counter antigfungal product (Difucan-150mg – one pill $25) might be worth a try.

      • Thanks Paul. I really appreciate the advice! I’ll try the suggestions.

  28. Diass » Eat Right and Exercise Regularly - pingback on July 18, 2015 at 9:01 pm
  29. Paul, what do you think of Jack Kruse’s leptin optimization recommendations and leptin protocol? I don’t really seem to get the reasoning behind it.

    • His individual recommendations are often sound, he borrows them and some of his sources are good, but the stories he tells to make them sound unique are wild and usually incoherent. If you got the reasoning behind them, that would be the time to worry.

  30. I’m having trouble getting Potassium plus Iodine on Is Potassium Iodide the same? Thanks for any help.

  31. What do you think about green powders ? waste of money or not ? (type vitamineral green , grenn vibrance …)

  32. Hi Paul!

    First of all, thank you kindly for responding to all the questions!

    I have a few questions I’d like to ask.

    There are more and more research indicating that rice is generally high in aflatoxin and arsenic. What’s your stance on this since you seem to be favoring rice as a safe starch?

    Also, what do you think about the high carb low fat plant-based vegan diets such as 801010 and John McDougall’s Starch Solution that are becoming more and more popular? From my perspective they seem to be very imbalanced but a lot of people are singing their praise of these diets.

  33. Has there been a recent review and recommendation of ubiquinol? The last one I see was in 2010, and I know things can change in that amount of time. Any modifications to recommendations for older adults?

  34. hi Paul,

    Under Therapeutic Supplements, you list N-acetylcysteine (NAC or N-A-C).

    I was just looking into NAC a bit…& it would seem there are pros & cons depending on the person. & i do note that you are not recommending it for everyone (therapeutic use only).

    I would be interested to hear your educated views on two points in regards to taking NAC;
    1. N-Acetyl Cysteine should be avoided if you have amalgam fillings (mercury).
    2. N-Acetyl Cysteine inhibits or blocks DAO (Diamine Oxidase).

    very keen to hear your opinions (or even better facts with refs) on this Paul.

    Much Appreciated.

    • Hi Darrin,

      As far as I can tell the evidence runs the other way on both counts.
      1. This paper,, states that “The ability of N-acetyl cysteine to enhance mercury excretion and its wide availability in clinical use indicate that it may be an ideal therapeutic agent against methylmercury poisoning.”
      2. According to this paper,, NAC raised DAO in the small intestine and lowered it in serum, which is what you want.

      Best, Paul

      • Good find on number 2 Paul.

        I’ll have to get back to with some more context on number 1. I’ve think i’ve seen that same ref cited as a reason to avoid NAC if you have amalgam fillings.
        The sort of articles/posts i’m thinking of, talk about using NAC only After amalgams have been removed.

        past my bed time now, will dig up some more tomorrow my time.
        i know i should not be on the laptop, but it is running f.lux, there are no lights on & i am wearing my orange safety glasses 🙂

    • ok i found a bit more info on the NAC & amalgams subject Paul,

      it would seem to based on the possibility that NAC may cross the blood brain barrier.
      i found a couple of studies that mention NAC & the BBB;
      & perhaps it’s an individual thing, some peoples bbb is more permeable (or ‘leaky’) than others. or the bbb is more permeable in the young. etc.

      Anyway, if we presume that NAC is a chelator that can cross the BBB, the theory is, that NAC will move mercury from an area of high concentration to an area of low concentration, which could be the brain.

      Alpha lipoic acid (ALA) is a chelator that apparently can cross the bbb, and is also not recommended if you have amalgam fillings.

      Safer chelators that are mentioned are DMPS or DMSA, which apparantley cannot cross the bbb.

      So i guess the precautionary stance would be to presume that NAC does cross the BBB. Even if it may not (in everyone). & that it could move mercury & deposit it in the brain.

  35. 👿

    This can’t be too “perfect” of a lifestyle if you have to take 20 supplements/day plus eat all of this food.

    Personally, I can’t take this many pills per day. I’m lucky to get down 1 Levothyroxine. Surely, there is a multivitamin that will give you everything “required” with this “perfect” plan?

    • Did you read the book?
      Some others have posted ways they minimize the supplementation- getting plenty of sunshine (Vitamin D) eating seaweed (iodine), citrus fruits (Vitamin C), etc. Perhaps someone else can provide more specifics.

      • No, David .. I haven’t read the book. I’m a “find out everything you can” type person before I waste money on a book that will sit in my home collecting dust.

        That’s not to say the book is worthless. My personality is such that I research everything before spending money.

    • Hi Emmes, look more closely – it’s not 20 supplements a day. More like 5. Multivitamins have much more stuff. Perhaps we should formulate a multivitamin to make it easier for you.

      • It’s probably a lot of work, but I’d love to be able to take one pill too. 😎

      • @Emmes, It is worth buying a copy. I got it from the library first, then bought a copy for reference. You can always get it for your Kindle, so it does not collect dust somewhere.
        I mention the book b/c Paul gives some good background on the supplement recommendations.

        • Recent comments indicate the backers have run several other that have never delivered anything, so since I can’t edit my post, consider it null, void and a scam.

      • A comprehensive multivitamin would be fantastic.

        The company Seeking Health produces some high-quality supplements as another commented pointed out.

        I was perusing what they have on offer and they do have a combination Trace Mineral product that looks almost serviceable:

        The forms of the minerals are certainly good. But based on your recommendations, and having looked into the average daily intake people get of minerals, some of the amounts could be varied around a bit. (e.g. manganese could probably be done away with, and the boron would be insignificant even as a daily dose while the vanadium is sky-high.)

        They write ‘physician formulated’ but I think with your input they could do better.

    • There are two problems with multis. One is timing and the other is quantities. Multi vitamins and minerals always have too much of something you don’t need and too little of something you need more of. It would be impossible to make a multi that suited your needs all the time, let alone everyone’s needs.

      With regard to timing, some things are best taken daily, some weekly, some three times a week, some two times a day. Again, that’s something single multi pill just can’t deal with.

  36. I’ll check it out. Thanks, David.

  37. I agree about multis, but was hoping there would be 1-2 that would cover the basics or enough to where I could find other supplements in gummy form. Gummies aren’t a problem to take every day .. I just have a problem with eating in a manner that requires multiple supplements daily.

    To me, that means I’m not eating balanced in the first place.

    Thanks for the input. I’ll have to see if I can adjust this plan to suit my needs or if I will have to pass.

    • There are some supplements I’ve come across that come in liquid, chewable or dissolvable powder form.
      Dr Lynch of Seeking Health brand has a range of non capsule/tablet vitamins:

      e.g. he has Vit D drops and Vit B12 lozenges etc…

      However the diet is the priority to start with rather than the supplements.

    • I have never come across a properly formulated multi-vitamin and mineral. Either its a junky ingredient form, insufficient ingredient quantity and/or there is an ingredient omission. So the only way to go is to use separate, concentrated supplements to create your own proprietary multi-vitamin and mineral.

      Paul complicates it even further with his ultra-conservative recommendations where you only take certain ingredients once or twice a week instead of daily, but that is within the holy grail of a perfect diet. It’s important not to overlook that subtle context. If you cannot eat exactly perfectly and get at least the RDA of all nutrients (nevermind acquiring optimal quantities of them which is a whole different ballgame) then supplementing is necessary. There’s nothing wrong with that. We have a very limited tolerance to eating the same foods over and over each and every day just to acquire at least the RDA.

  38. hi Paul,

    Back to the NAC therapeutic supplement (N-acetylcysteine)…
    I see you mention ‘severe chronic infection’, are you able to go in to more detail what it is good for.
    & better still, relate that to my ‘issues’ below;

    The reason i was looking at NAC, was because i saw mention that it may help with chronic sinus issues.
    I cannot recall the details, but i think it related to reducing mucus.

    My own issue, as per CT & MRI scans, is i have mild “mucosal thickening” of most of my sinuses.
    Specific areas mentioned with mucosal thickening were: sphenoid sinuses (both sides), inferior maxillary sinuses (both sides), left frontal sinus, ethmoid sinuses largely clear.

    I suspect i have had this all my adult life (& could have even started in childhood). This is Not an acute thing for me…so i presume that it is not allergy related.
    I believe (not sure) the condition is more generally referred to as chronic rhinosinusitis (CRS).

    Another ‘wide bow’ on the use of NAC was that it may help with tinnitus, which i also have. On a TCM tinnitus site, it mentioned NAC is useful for ‘liver health and dries up mucus congestion’.

    (ps. i have amalgam fillings, which prompted my earlier NAC related queries).

    Much Appreciated.

  39. (repost of comment, so it sits under my last comment)

    ok i found a bit more info on the NAC & amalgams subject Paul,
    it would seem to based on the possibility that NAC may cross the blood brain barrier.
    i found a couple of studies that mention NAC & the BBB;
    & perhaps it’s an individual thing, some peoples bbb is more permeable (or ‘leaky’) than others. or the bbb is more permeable in the young. etc.
    Anyway, if we presume that NAC is a chelator that can cross the BBB, the theory is, that NAC will move mercury from an area of high concentration to an area of low concentration, which could be the brain.
    Alpha lipoic acid (ALA) is a chelator that apparently can cross the bbb, and is also not recommended if you have amalgam fillings.
    Safer chelators that are mentioned are DMPS or DMSA, which apparantley cannot cross the bbb.
    So i guess the precautionary stance would be to presume that NAC does cross the BBB. Even if it may not (in everyone). & that it could move mercury & deposit it in the brain.

  40. Hi Paul,

    Do you have any supplement recommendations for recovering from post partum HYPER thyroid. I had this with my first pregnancy in 2011, and went from hyper to normal function around one year. I am now 8 mos post partum from my second pregnancy (both were healthy pregnancies and babies) and my thyroid is hyperthyroid. My thyroid labs started changing toward hyper just weeks after delivery. I am told that post partum hyperthyroid can become hypothyroid in the long run.

    My hyperthyroid symptoms have been manageable and I am not taking anything for it, but I would like to promote recovery.

    I have followed your diet since I learned of it in 2012. and have removed dairy to a dairy intolerance.

    A recent genova lab showed that I am low on selenium and zinc, so I am taking 200mcg/day selenium as selenomethionine, and zinc 16mg/zince-carnosine pepsin GI brand a 75mg day.

    Do you have any supplement recommendations besides those on your site?

    I would also love a practitioner recommendation. I have not been able to find a naturopath with specific experience treating post partum HYPERthyroid.

    Thanks so much for your help.

    • Hi Sara,

      The main thing is extracellular matrix (bones, joints, tendons, chicken feet), vitamin C, taurine to promote wound healing; vitamin A/vitamin D for immunity; circadian rhythm entrainment, intermittent fasting. It might be good to avoid red meats if you have Hashimoto’s antibodies. Take selenium 200 mcg/week (not per day) just to make sure you are not deficient. Avoid iodine at first but try introducing one nori sheet per day, then 2, then 3, then 4, then try a low dose (225 mcg) iodine supplement as the hyperthyroidism fades. I think you are taking too much zinc also. Measure iron and make sure it is normal (ferritin 50 to 150 is good).

  41. Today was the first day I took the daily supplement

    I took the following pills 30 minutes following my first meal of the day.

    -1x 200 mg Magnesium Citrate
    -1x 1000 mg Vitamin C
    -1x Potassium Iodide
    -1x 2 mg Copper
    -1x 100 mcg MK-7 Vitamin K-2
    -1x 500 mg Pantothenic Acid
    -1x 1000 IU Vitamin D-3 (Will adjust the supplementation based on my sun/food intake.)

    Roughly 30-40 minutes after having taken the pills I felt very nauseous and could have easily puked. It definitely wasn’t a reaction to anything I ate.

    So what am I doing wrong? Should I space the pills throughout the day instead of taking them all at once?

    Advice appreciated.

    • I usually take my pills with meals; that is either before or just after I’ve eaten. Also, like you’re suggesting, I space the supplements throughout the day rather than take everything all at once. So for instance, I take vitamin C, D, K and iodine with my first meal and then take copper, magnesium and pantothenic acid with my last meal.

    • Try that and see if it helps. Otherwise it might just have to do with you not being used to taking a lot of pills/supplements and the feeling of nausea will go away with time as you adjust.

    • I also take Vitamin C/D/K and iodine in the morning, and then magnesium in the evening. I always take them with a meal.

    • Try taking them one at a time until you find the culprit. 1000mgs of vit. C gives me bad gas and diarrhea. I can only take 500/day of ester C with bioflavinoids. Also, you didn’t say how much iodine you were taking. Should be 225 mcg.

    • Copper is very hard on the stomach and has to be taken with a large meal, and yes it gives me that problem.

      I also take it away from Vitamin C though I don’t remember the quote why.

  42. Hi Paul,

    I have handed out several copies of your book as eating the PHD way has affected me most positively. However, you do not recommend alpha lipoic acid (ALA). May I ask why as I have been taking Juvenon for several years without any ill effects; plus, I do admire the work of Dr. Bruce Ames. Your answer will be greatly appreciated.

  43. I think I may have an allergy to one or more of the daily supplements.
    I took the daily pills again and spaced them out over a period of 7+ hours (after eating).

    I didn’t feel nauseous at all this time around, but I did notice what appears to be four different rashes on my shoulders. They look like large mosquito bites, but they aren’t. They could be pimples, but that isn’t a typical occurrence for me. My skin is usually blemish free. So coming down with 4 on my body at the same time seems highly suspect.

    A quick google search indicates that Vitamin D and Vitamin C supplements can cause skin irritations. Also, the B Vitamin weekly supplements–which I haven’t taken yet–can cause irritation as well.

    So, not sure what to do. I’ll probably see a doctor for advice and discontinue use for now. I guess the only other thing I could do is to take 1 pill per day and monitor myself to see if there’s any continued reaction.

    Sigh, this did not go as well as I had hoped.

    • Iodine can cause a rash, something about bromines detoxing through the skin. At 225mcg, this is unlikely, but if the dosage is too high, like mg instead of mcg…

      • My Potassium iodide is 225 mcg per pill. I only take 1 of them.

        I was very careful to only order and consume the recommended dosages.

      • Lower doses of iodine like 225 mcg can also cause an acne rash. If that’s it, keep taking the iodine and the rash will go away, usually in 3-6 months.

    • Try tapering up the supplements. Start off with 1/4 – 1/2 of the capsule or tablet for 3-4 days, then increase the dose. It can be quite normal to experience changes when you take supplements as you are kicking your metabolism into a higher gear in some ways, and this can cause small “healing crises”.

  44. Are you perhaps becoming allergic to eggs? If you’re following PHD closely and having 3 eggs per day, make sure it only the yolks.

    • I know a few years ago when I had allergy testing done it showed that I had a mild sensitivity to egg whites, so I stopped eating eggs in general for over a year.

      Within the past 5 or so months I started eating them again and I never noticed any issue. I think it’s a bit odd to have all that time pass without noticing anything unusual and only just now. It seems more likely that it has something to do with the supplements. But perhaps I should consider eating only the egg yolks for now.

  45. Hi Paul!

    Are there any known risks of taking high amounts of B12 daily? The reason I’m asking is because I’m currently taking a B-complex every day containing 100 mcg of methylcobalamin due to recommendations related to adrenal fatigue.

    Also, would it be better to take biotin in amounts of 1000 mcg daily rather than taking 5 mg once per week?

    • Hi Markus,

      There are potential risks to B12, but they are not well understood. Could affect gut microbiome, aging. 100 mcg per day should be fine.

      In general, with B vitamins once a week is better than daily.


  46. I love your book – thank you!!
    and I already feel better cutting back on fructose 🙂

    so I want to use dextrose, but I don’t find a non-GMO source..
    and rice syrup is always from brown rice, which has arsenic 🙁

    .. ideas? sources?
    thanks so much!!!!

  47. Hi Evelyn these foods are excluded for toxins. It says so in the book. I remember reading Paul that peas are allowed though.
    I would love Paul designed a multivitamin it would be awesome.

    • I know, Rodrigo, but lentils are not always categorized under legumes (or treated different some times). Black rice and wild rice are special, too..therefore I asked.. – I agree, the book and Paul’s help is outstanding!

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