Readers Summary:

  1. What are the Top Ten supplements to consider when changing to a paleo lifestyle?
  2. Why do I consider these to be the best core supplements for a paleo lifestyle?
  3. What is the most important to least supplement in a paleo lifestyle?

When a person decides to become optimal and eats a paleo/primal diet, there are many changes that occur to one’s RNA/DNA and to our epigenetic switches. Many of these bio-machinations will take months to give the full hormonal response, but there are some potential issues that can exist when a person implements a change to their life. One of the big issues to initially delineate is: What kind of paleo diet are you instituting? Many people eat a lot of grass-fed skeletal meat and avoid all offal at first. This might be a problem in a modern microwaved world.  You need more DHA and iodine than cow meat/offal can provide.  Others cut their carbs while others car-load based upon their activity levels. Some use a high-protein approach to control hunger, while others use a low protein approach if they are running a vegetarian regime. This blog will attempt to outline what someone might supplement if they are eating a standard paleo diet as outlined in a Paleo 1.0 book.  I recommend that people with disease consider altering their template to the Brain Gut 6: Epi-Paleo Rx.  Your lipid profile will thank you!  It is all about avoiding the dehydration in the change over from paleo to the Brain Gut 6: Epi-Paleo Rx.

Most people making the change to this lifestyle are coming from diet that is usually not optimal, like a SAD (Standard American Diet). Moreover, the USA food supply is so altered that most Americans are not getting the full nutritional value that they could or should get, that our counterparts in the rest of the world are getting, because of the practices in the food and agricultural industry. These practices have been allowed to occur by the USDA and federal governments inaction on many fronts. Recent decisions favoring Monsanto being able to genetically modify seeds and alfalfa are examples. They have gone after small farmers who are farming organically or farmers who produce raw dairy products. They have have also tried to make the lives of companies like Nutiva and Tropical Traditions miserable with regulations to protect genetically modified foods whose origins are usually from Monsanto. Given this legal and regulatory environment, we each have to make some adjustments to offset the losses of nutrient density in foods available in America. I think the world needs to pay attention to this, because we are major exporters of our foods globally. This is really bad news for the world.

1. DHA/EPA

The reason is simple. Most people start their lifestyle change with excessive omega 6/3 ratios in their diet and tissues. I strongly recommend everyone getting a O6/3 blood assay done prior to making the shift. I did and mine back in 2006 was 37:1. Today its 4:1. I do not believe this would have been possible without the use of supplements in the beginning of my transformation, because of how badly our food supply is loaded down with O6 and stripped of O3.  DHA has to be in the SN-2 position to get into the brain and nervous system.  Seafood provides this and grass fed meat, is relatively poor source.  Grass fed lamb is far better choice.  I created my version of the paleo diet (the Epi-Paleo Rx) based upon my labs, which was influence by the outstanding work of Dr. Stephen Cunnane and Michael Crawford.  We must consider that the O6 content in our systems may not just be from dietary sources. It could be caused by a modern mismatch in mammalian cell membrane biology that most are unaware of.  When you read about his work you begin to realize there is a lot more to the story of what is best for modern humans.  I cover his work in the Brain Gut series in Brain Gut 4: What was Homo’s Solution? and Brain Gut 5: Paradigm Drifts Paradigm Shifts: Epi-Paleo?

Even food sources naturally high in O3‘s, like fish and meat, have been stripped by feeding farmed fish and cows corn and soy pellets loaded with O6’s. The levels one should shoot for are based upon your current O6/3 level and your highly sensitive CRP. Most people will fall between 1-4 grams. The more inflammation one has, the higher dose one should consider. Increase your seafood intake could be a helpful move as well.  I think the ideal 06/3 ratio is below 6:1, and I think we should be careful before we bash 06 to the ground. I think that maybe unwise. I have a theory that may explain why modern humans concentrate O6s as a byproduct of all neolithic disease.  (Caveat: I am a much bigger fan of eating seafood in its evolutionary biologic package than I am in using Fish oil or Krill Oil).  When one begins to understand what DHA is used for in humans (brain function), we begin to understand how this PUFA is protected best in its evolutionary package (seafood) by Iodine in synapses and in many critical areas like the adrenal gland.  Other chemicals that protect the double bonds of this PUFA are made from DHA called resolvins, lipoxins, maresins, and protectins.  I cover these extensively in Brain Gut 4: What was Homo’s Solution?.  The Paleo Solution may not be Homo’s solution.  A paleo template is a great option to reclaim your health from a western diet, but there is a level above it when you have a large brain that may be riddled with inflammation.  A paleo diet may not go far enough for some of us; for example, you will find your LDL and HDLs will take 3-4 months to adapt on a Paleo diet.  These adaptations happen much quicker on an Epi-paleo Rx template because of the brain specific nutrients contained within it.

2. Minerals Iodine, Iron, and Selenium


This threesome is critical for optimal thyroid function. The paleo diet is much too low in iodine and in DHA relative to seafood.  In our modern microwave world, this is a key distinction in any disease reversal.  The most important mineral for a human with a large brain is Iodine.  I cover this later in the blog in the massively important Brain Gut 5: Paradigm Drifts Paradigm Shifts: Epi-Paleo?  The most common clinical scenario I see is thyroid disfunction, notable because because in my pathology book from the 1980s, it said thyroid disorders were quite rare.  Today, they have become ridiculously common.  Our epigenetics have been altered dramatically because most food is now manmade and processed,  our light is artificial light, (specifically blue light, and environmental toxins of all sorts have gone through the roof over the last 100 years.  When we eat man-made foods, we get neolithic diseases.  Moreover, the more carbs one eats the lower iodine levels drop in humans.  If the thyroid is not working well, free T3 levels will be low and likely unavailable to convert LDL cholesterol to the hormones the brain uses to control our 20 trillion cells. Remember that T3 and Vitamin A are cofactors in the conversion of LDL cholesterol to the steroid cascade. We covered this in the Hormones 101: Clinical thoughts revealed.  Thyroid dysfunction is epidemic in the world where a Western diet is entrenched. One in ten adult American women have been diagnosed with thyroid disorders, and some endocrinologists suggest that as many as 25{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of adult American women are afflicted with clinically detectable thyroid dysfunction.  I think this number is conservative and gets worse with every subsequent generation at the effect of epigenetics.  I have had numerous female patient eat a paleo style diet from Robb Wolf, Mark Sisson, Chris Kresser, and Paul Jaminet develop significant medical problems that required bio-hacking.

Severe iodine deficiency can cause hypothyroidism. But many physicians believe iodine deficiency is rare in the United States and other developed countries since the addition of iodine to salt. I am not so sure about this. I think it is related to water dehydration because fluorine replaces iodine in structured water in humans. Fluoridated water blocks re-hydration and cause us to lose salt. Fluoride is also a dielectric blocker causes circadian cycles to uncouple first from the cell cycle and then from metabolism.  This can lead to severe autoimmune disease, adrenal fatigue, and cancer.  We actually can see a cerebral salt-wasting syndrome in those who drink water that is highly fluoridated. This is common in the Western US. Again, just because iodine is in salt does not mean we absorb it if the water we use has a dielectric blocker in it.

The WHO (World Health Organization) estimates between 1.5 to 2 billion humans are iodine deficient.  The more red meat one eats, the more iodine deficient one can expect to become because iodine is bountiful in seafood in its primordial evolutionary package, not in red meat. Iodine is also found in sea vegetables and seaweeds.  Considering the work of Drs. Remko Kuipers, Cunnane, and Crawford about the importance of seawater in human evolution, it would make sense this is where our best supplies come from.  (Kuipers spoke at AHS 2012 @ Harvard.)

I have found women are most at risk for poor absorption of Iodine.  A classic finding is a low progesterone, low pregnenolone, and high estrogen level on their labs, with an elevated LDL cholesterol. This is a sure sign of severe dehydration due to Fluoride being a dielectric blocker to Iodine in water supplies. This affects brain cognition, especially if EMF is present, because the blood brain barrier become permeable with EMF and the fluoride can gain access to CSF and displace Iodine in the cerebral spinal fluid. After the thyroid gland needs, the distal portions of the human mammary glands are the heaviest metabolic concentrators of Iodine in the body. Iodine is readily incorporated into the tissues surrounding the mammary nipples and is essential for the maintenance of healthy functioning breast tissue.  In my opinion, the absence of Iodine plays a huge role in fibrocystic disease and the the development of breast cancers.

One clinical finding I always ask about is the presence of fibrocystic breast disease.When it is present, the woman is likely suffering from an undiagnosed Iodine deficiency. I distinctly remember in medical school seeing a woman’s fibrocystic disease cured in less than an hour by an ancient physician who taught us how to examine a woman’s breasts. A woman had volunteered to be a guinea pig for us during our medical education, and on this day, we could not examine her without making her scream and cry because her breasts were so tender to palpation. Our MD proctor was about 80 years old ,and he too was a volunteer helping us learn our craft. He stopped me from examining her breasts, asked her a few questions, and then he asked us to leave the room. He applied Lugol’s solution to her vulva and her nipples, and we were able to examine her without any pain a half hour later. It made a huge impression on me. He had asked her if she was on any thyroid meds and if she had bad energy or weight gain. A lack of iodine was the source of her painful breasts!  Her labs did not reveal any major issues, either, because she had only been screened for TSH and not a free T3 or free T4 level. I never forgot this lesson on the thyroid.

When one begins eating a Paleo diet, your nutrient density and food substrate improve; your Iodine needs go up as your mitochondria are being asked to do more. Often with a Paleo diet, you get a relative Iodine deficiency for the first 3-6 months of adaptation. I ask my patients to eat shrimp twice a week for the first six months of the Paleo diet or to supplement with a kelp vitamin every third day which will do the trick for most people. I have people take higher doses if they drink fluoridated water. We can use Lugol’s or potassium Iodide to offset it a bit. Coffee does the Iodine 200-300 mcgs every other day if you eat seafood once a week. If you eat it more frequently, you likely don’t need any supplementation.

Iron. Clinically, Iron is not important to supplement because the Paleo diet is extremely robust in iron. But many of us forget our diet is only as good as what we absorb. If gut dysbiosis is present (and it usually is to some degree) or there is a lot of fructose in the diet, Iron absorption could be a real problem. When one eats a lot of fructose in juices or in fruit (or HFCS products), one will increase absorption of Iron in the gut while also increasing serum Albumin. High Iron levels are not good. High Albumin levels can cause our free testosterone or estrogen levels to dramatically fall because the increased albumin binds them, much like SHBG does in obesity or in hypothyroidism. None of this is good for optimal.

Selenium. For the thyroid gland to produce the most active form of the thyroid hormone T3, Selenium is essential but also helps regulate the amount of hormone that is produced. Remember, T3 is a co factor in steroid cascades and also in reversing muscle leptin resistance at UCP3. We need 200 mcgs a day, and one brazil nut daily can do the trick. Most don’t get enough Selenium. If you don’t eat brazil nuts, then I recommend a supplement every other day of 200 mcgs. It’s dirt cheap and easy to find. Selenium is critical in many stress-related processes, and is active in prevention of oxidative stress. by working with a group of nutrients that includes vitamin E, vitamin C, glutathione, and vitamin B3 to prevent oxidative stress. I wrote about selenium here in more detail. Se is one brazil nut a day or 200 mcgs a day. Fe is 325 mgs a day, and take it with a vitamin C to increase its absorption and help to lessen nausea.

3. Vitamin D3

Vitamin D3 is a pro hormone and is vital to immunity and to other physiologic functions. Vitamin D3 is an important neuro-steroid hormone responsible for many elements in brain development and behavior. Vitamin D3 increases brain levels of glutathione, a powerful natural antioxidant that is the body’s most important tool for detoxifying and excreting heavy metals, and one that is rapidly consumed during oxidant stress from toxins and other sources. Vitamin D3 is made from LDL cholesterol in the steroid chain. Most vitamin D3 in the American food chain is added and is D2, not D3. This is especially true for dairy products. The active form of vitamin D is D3 and is made in our skin by sunlight. The best dietary source of D3 is fatty fish like salmon or other animal products. Few people have good dietary sources of vitamin D3. Vitamin D3 can also be made from sun exposure, but the dermatologists have done a masterful job of convincing many they will succumb to skin cancer if this is their major source of Vitamin D, so conventional wisdom in America guides people away from getting vitamin D3 this way, creating an epidemic of patients with low vitamin D levels. Most Americans fail to even get the too-low RDA of 400 IU from all sources. I would suggest you read my Vitamin D post here. I suggest a basal dose of 5000IU of D3 for most patients. For those who are suboptimal, I push this big time. And I am no fan of 50K of Vitamin D2 a week….its suboptimal dosing with a suboptimal form of Vitamin D for humans.

4. Vitamin K2


In my practice, I see a lot of osteoporosis as a spine surgeon. This vitamin is one I test for quite often, and in my estimation, there is a bigger epidemic in low vitamin K2 levels than low Vitamin D3. The American diet is virtually depleted of K2. K2 is found best in raw dairy products, but raw dairy is hardly available anywhere in the US. Our pasteurized dairy is devoid of K2 because pasteurization virtually eliminates any K2 from the dairy. Vitamin K is also found in organic green leafy veggies like kale and spinach, but its levels in non-organic versions are dramatically altered.

What does Vitamin K do to make it so important? Vitamin K is the cofactor for the enzyme γ-glutamyl carboxylase, which converts specific glutamic acid residues in a number of substrate proteins to γ-carboxyglutamic acid (Gla) residues, which then serve to form calcium-binding groups in these proteins and are essential for their biologic activity. Carboxylation thus activates this family of Gla-proteins, which are involved in a number of the body’s essential activities, including blood coagulation, bone metabolism, vascular repair, prevention of vascular calcification, regulation of cell proliferation, and signal transduction.  K2 is also part of the protocol I use to re-engineer a gut flora.

While osteoporosis is its own epidemic due to leptin resistance, heart disease is the number one killer of men and women in the USA. A clinical study from Rotterdam, Holland revealed a correlation between long term adequate Vitamin K2 intake and a lower incidence of calcification of the wall of the aorta. Arteries with no plaque have been shown to have a massive increase in Vitamin K2 concentration in their walls and plaques when compared to arteries with arterial plaques. Vitamin K2 depletion is critical in developing heart disease, as seen in many longer term studies, like Framingham and the Nurse’s Study. There is a link of Vitamin K depletion in CVD, AD, and in liver cancer from viral hepatitis. Vitamin K is also recycled in the gut and uses the gallbladder as a conduit along with the enzyme VKOR. So in people without a gallbladder, there is a very real risk of Vitamin K depletion. Most patients I have checked with a history of cholecystectomy also tend to have very low HDL levels and leaky gut. This is a big clinical pearl I look for. The lowered HDL level allows for poor endotoxin clearance in the portal circulation, and this increases the plasma’s ability to oxidize sdLDL cholesterol also a factor in development of heart disease as well. The daily dose needed by humans is only 45mcgs per day. Even with this low requirement, we see a major epidemic in depleted vitamin K levels. Most vitamin K2 is made from the gut bacteria provided there is not dysbiosis. If there is, the clinical situation is worse. The best clinical measure of this is arterial calcification in the face of frank osteoporosis, with a low HDL and elevated LDL. Most patents show a high sdLDL on VAP testing as well. There are three isoforms of K, but my favorite for bone and heart health are K2 MK-4 subfraction. I think a mix of all isoforms is good for most people (K2 in mcgs doses are fine for regular patients) but for my bone and heart patients with calcified vessels, I put them on high dose K2 with MK-4 subfraction. Dosing can range 5-45mgs for these people. Vitamin K2 appears to be evolutionary related closely to Co Enzyme Q10 and may have evolved from Q10 after the appearance of molecular oxygen after the Cambrian Explosion.

5. PQQ

Many Paleo folks may not even know what this is. I call it the long-sought-after “exercise in pill form.” PQQ is pyrroloquinoline quinone, and is probably the most important B vitamin when one is transitioning from a sugar burning metabolism (which is what the Standard American Diet creates) to a fat burning furnace (Paleo/Primal diet). When I first began to blog, I started with a deep mitochondrial series. I think many questioned why I did so: your change to a Paleo diet it is really not maximized unless your mitochondria are optimal first. This was shown in the leptin series, as well at the muscle level (Oprah post). In my practice, helping my patients become leptin sensitive is one of the first clinical moves I make to light the pilot light of the mitochondria.

PQQ has two major effects that make it critical: it’s stimulatory to mitochondrial biogenesis. If you read my mitochondrial series from June of 2011, you will see why this is critical to reengineer a human to optimal. Since I have written extensively about leptin, energy efficiency is critical to optimization. If one is energy deficient due to leptin resistance (hormone cascade disruption) or due to poor mitochondrial function (inability to make energy well), there is little chance of getting someone to optimal quickly. My Leptin Rx solves the steroid cascade problem. PQQ is the tuneup that the furnace needs. Remember, our mitochondria are the engines that drive our metabolisms. If one is devoid of energy, we call that person a cadaver. If one is lacking energy, they are either leptin resistant or the owner of a bunch of bad mitochondria. Most people on a the Standard American Diet have a Nissan Sentra engine in their Ferrari body. There is a huge energy mismatch of what their bodies want to do and what they can do. This obviously affects basic functions and the ability to exercise, too.

The second major effect of PQQ is glycation control from AGEs and ALEs. One of the under-appreciated benefits of going Paleo is the huge change in dietary carnosine intake. What is carnosine? Carnosine is a multifunctional dipeptide that interferes directly with the glycation process. Carnosine has been shown to inhibit glycation early on, thus helping protect us against further damage as we age. Carnosine is found in large amounts in red meat and seafoods. When one makes the change to Paleo, the substrate for electrons in our food is red, grass-fed meat/seafood loaded with carnosine. A person eating a Standard American Diet is filled with mitochondria not optimally equipped to handle an acute change to massive carnosine. Some other little known facts in our Paleo community about carnosine is that its levels fall off rather dramatically in humans as we age. It has also been shown in research that high levels of carnosine are also seen clinically in humans with long telomere lengths. Long telomere lengths indicate longevity.

Longer telomeres are directly tied to mitochondrial health and optimal functioning. This biology was worked out by Nobel Prize winner Elizabeth Blackburn’s lab at UCSF in 2009. Having great mitochondria is critical if you are going to make the superior substrate jump in a Paleo lifestyle. It makes no sense biologically to eat great if your body’s engine cannot harness that power to transform your health. I recommend a higher dose of PQQ for all Paleo patients: 20mgs a day. If I eat a lot of meat and coconut oil because I worked out hard, I will dose even higher.

6. Co-Enzyme Q10

This one should be obvious, given what I just told you about PQQ. CoQ10 is a co factor in mitochondrial electron transfer, and in many stress reactions biochemically in the body. The higher our Q10 levels  in the plasma, the higher our zeta potential. This correlates to how well particles in suspension flow in a biologic system. The lower Q10 levels are, the more sticky things like LDL, platelets, RBCs, and HDL become. It means that LDL stays in the plasma too long because the LDL receptor in the liver is not as effective at grabbing it up from the plasma and it gets subjected to higher levels of oxidative damage because the lowered Q10 cannot buffer it from the oxidation. It then becomes oxidized and is deposited in arterial walls.

The ten in Q10 is for the side chains that scavenger free electrons to prevent free radical damage. They are what keep Q10’s zeta potential so high biologically to scavenger them. Having this fat soluble vitamin in excess is needed when providing better nutrient density to the mitochondria to make more energy so we can increase our exercise ability in any stressor we face. Honestly, I think within 10 years, we may find low Q10 levels are our single most important tracking mechanism for inflammation. CoQ10 is a critical supplement for those who eat a high meat and low seafood diet. Vegans and vegetarians measure the lowest zeta potentials. If they also happen to be endurance athletes, the data is even worse. Excessive endurance exercise increases our plasma oxidation from ATP loss and the stress hormone response. Most often, exercise is hormetic when things are in balance. When there is a CoQ10 depletion by neolithic diseases, statins, or by being generally out-of-shape, we need to increase dietary supplementation to optimize an Epi-paleo diet.

CoQ10 comes in two formulations: Ubiquinone and Ubiquinol, an oxidized form and a reduced form, respectively. Ubiquinol (the form I recommend) is three times more costly but is readily absorbed by the gut, while the oxidized version is not. Moreover, it is more difficult to manufacture Ubiquino, the reduced chemical form. It contains two hydroxyl (OH) groups instead of just one. This advantage allows it to bond with water molecules, and makes it more readily absorbable by our mitochondria in our cells for energy production. Ubiquinol is the biologically superior form of CoQ10 because it’s an electron donor, which makes it a very effective neutralizer of free radicals and the only form of CoQ10 that scavenges lipid peroxyl radicals that can damage the polyunsaturated fatty acids of your cell membranes. In my view, this is a massive benefit when you’re eating Paleo. You need far less when you are eating Paleo. The more bacon you eat, the more Q10 you will need. Depletion of cellular CoQ10 will not even support basic cellular function. A Paleo diet and higher activity level require optimal mitochondrial and cellular function because of the stressors put on mitochondrial energy supply and substrates. We will cover this later in my Mitochondrial Rx.

Remember, the heart muscle is critical to the increased activity levels some want in a Paleo lifestyle. Heart disease is a major killer in our country, primarily because of our diet. Findings at the 5th Annual International CoQ10 Symposium held in Kobe, Japan demonstrated the superiority of ubiquinol in a group of seriously ill patients with advanced-stage cardiac disorders. If this can help people close to death with severe heart failure, it is clearly critical to any human looking to optimize their life through their diet. This study revealed that clinically ill patients who suffered from severe heart failure readily absorbed ubiquinol CoQ10 into their bloodstreams (acutely and chronically by blood assays) and showed improvements in all health parameters. Another key point: those with autoimmune disease or Hashimoto’s really need to use only ubiquinol because they can’t convert from ubiquinone to ubiquinol well due to low B6 and B12 levels. They often need higher dosing.  This can be assayed in a lab test.  Now, we prove that CoEnQ10 is the first new drug to improve heart failure.

7. Magnesium

Remember from the mitochondrial series or the Gnoll’s post that Magnesium is a co factor in making every last bit of ATP in the mitochondria. So if you don’t have optimal magnesium, you are not going to be energy positive or optimal. T2D have the lowest levels of Mg I have ever seen. When people begin to eat Paleo, they usually are depleted of magnesium. They complain of poor sleep and develop constipation and muscle aches within the first few weeks of adopting a paleo diet. Magnesium will not work if the patient is also dehydrated because Magnesium is a hydrophillic cation.  You can best assess this with your BUN/creat ratio.  With my patients, I offset this with a pretty hefty supplemented dose of Magnesium Malate, usually two hours prior to bed. If they need more, I’ll add a morning dose. This should never be taken with AM Vitamin D3 because they compete with one another for absorption. I am also a big believer in the use of Epsom salts topically in those with big depletion risks.

There is another big benefit that comes with topical epsom salt use and that is increasing the sulfur intake topically as well. Those neolithic diseases that could benefit include T2D, sleep apnea sufferers, restless leg syndrome, and those with fibromyalgia. Sulfur intake is notoriously poor in vegetarian diets and helps explain why vegetarians suffer from so many skin and connective tissue disorders (psoriasis, eczema, dandruff, folliculitis [infected hair follicles], warts, and pityriasis versicolor; vitalize are some). Sulfur is an important component of our body’s proteins. It is present in our hair, skin, nails and tendons, and plays a critical role in maintaining the integrity and elasticity of connective tissues. After adopting a Paleo diet, if the patient still complains of persistent skin issues, I usually suspect a sulphur deficiency and recommend Epsom salt baths. Sulfur is an element that is part of four amino acids called methionine, cysteine, cystine and taurine. Sulfur is found in many animal meats and eggs, so longer term, it may not need to be supplemented on a Paleo diet. This is very common in Vegetarian-to-Paleo conversions, because vegetarians are so deficient and tend not to become ravenous carnivores right off the bat. Epsom salts are a nice way to get some sulfur into your body to get optimal. If you need more, you can consider a sulfur supplement like dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM). I like Magnesium Malate, 800 mgs two hours prior to bed. If you need more, add 400 mgs in the AM or eat dark chocolate daily.  For those with inflammatory brain diseases like obesity, multiple schlerosis, alzheimer’s disease, PD, and most any autoimmune disease, I use a special version of mag called Magnesium Threonate because it penetrates the CSF of the central nervous system, while no other formulation can.

8. Multivitamin

A multivitamin is critical, because of the various nutrient depletions in our food supply. Few people and their doctors are aware of how deficient we are in essential nutrients. We are down to the fundamental fact that the vast majority of Americans fail to obtain even the tiny amount of nutrients in their diets that the medical establishment says are needed. A Paleo diet provides a far better mix than the SAD, but when one makes the change from SAD to Paleo, one is starting with a deficit, as evidenced by bad body composition, poor energy levels, and altered hormones. In the January 23, 2008 edition of the Journal of the American Medical Association, the findings from a study that measured vitamin E levels in people 65 years and older showed that those with the lowest blood levels of vitamin E were 60{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} more likely to suffer physical decline over the three-year follow-up period. The same has been found for Vitamin D, Magnesium, Selenium and Iodine levels in various studies. Vitamin A is critical, because optimal levels are needed to convert LDL cholesterol to the steroid cascade with T3.

9. B Vitamin Complex with Vitamin C added

They sell this really cheap in Sam’s Warehouse Club. If you want a better source look for a B complex that includes S-adenosylmethionine (SAMe) too! If you do SAMe is usually in a B complex formulation because SAMe should be taken with cofactors vitamin B12 and folic acid. Our body requires methionine and vitamin B-12 to synthesize SAMe (also a Sulfur containing protein), a substance that is involved with the production of DNA. DNA is hereditary material in humans and animals found in the nucleus and mitochondria of nearly every cell in our body. The only people I do not recommend taking SAMe are those with bipolar disease. Published research shows that methylation defects create a variety of DNA/RNA age-related problems, including neuronal and hepatic dysfunction. When we go Paleo, we are trying to optimize the liver and brain so this co factor is vital. Optimal methylation is critical for health and also a major factor in neolithic diseases like cancer and heart disease. In my view, you can not take enough B vitamins. They are critical. Always get your B12 level checked and your homocysteine level. Always try to make sure B12 is around 1000 on your testing. This is critical for optimal thyroid functioning and optimal methylation.

10. DHEA/MELATONIN

Most patients I see have sleep disturbances prior to becoming Paleo. I have written a special blog on DHEA that explains why people have sleep issues:  a bad diet causes spikes in inflammatory cytokines. Sleep is critical to become optimal. This is when all cellular repair is done by our body, governed by a cellular process called autophagy. Poor sleep is consistently seen with high levels of IL-6 in sleep research studies. DHEA levels tend to fall in both sexes dramatically after the age of 27 and directly correlate with poor sleep. DHEA decreases IL-6 in a dose-dependent fashion, but its use must be done through consultation with a physician. Many people use melatonin on their own for sleep without understanding the complex neural wiring between the brain, gut and pineal gland that must be taken into account before adding this to your routine. I find these two supplements very useful in the first six months of a making a change to a Paleo lifestyle. I use blood and salivary testing for tough cases to make a decision on care. I can not over-emphasize how critical reestablishing optimal sleep is to this lifestyle. Melatonin you can start with low dose at 2-3mgs two hours before bed and titrate for effect. Highest I have taken myself was 20 mgs when I had serious jet lag. DHEA for guys: I base it on labs, but most can take 50-100 mgs safely. The ladies could consider using the 7 keto version of DHEA and I would keep it below 50mgs a day without testing.  When a person has a diurnal pattern of cortisol that is abnormal in the AM or late night, you can bet the melatonin axis is off badly.   Read the EPCOTx protocol for re engineering gut flora and gut health to you will see how important melatonin really is. Prior to leptin’s ascension in the mammalian brain, I believe melatonin was the most important hormone all life followed because it signals when we are most chemically reduced and able to replenish all our ATP stores and recycle all our worn-out proteins from life’s daily grind.


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