Monday, November 9, 2009

Paleo Diet Q & A - 11.9.09

Dear Readers,

We hope you're finding our Q&A posts from the Paleo Diet community to be useful and informative. We've received several new questions and comments on previous Q&A posts, and encourage you submit yours.

We receive a great amount of feedback, and we are not able to always answer personally. We do read all questions, and are very interested in hearing your thoughts and learning about your experiences with the Paleo Diet.

Q: Dr. Cordain, I was interested in your Sept. 25th issue because of long standing problems (since the early 1980's) with Chronic Fatigue Syndrome and also various bowel problems. I have been doing quite well for the last seven or so years (thought I am 70 now) thanks to the Paleo Diet, but am not fully recovered. With regard to your list of foods to avoid, I do avoid, completely, all those foods except pepper with capsaisin. Over the course of a week, I consume 2 teaspoons of cayenne pepper. I do this specifically to help with widespread inflammation as capsaisin in known for healing inflammation. I am alarmed now that something I am eating is actually working against my recovery and healing, but I can't understand why a product that reduces the inflammation connected with CFS and bowel disease would be contributing to those diseases. Perhaps you made this obvious in your report, and I simply didn't understand it. But if you could make it more clear to me, in layman's language, I would be very grateful.

Thank you.

A: Yes, capsaicin has anti-inflammatory properties. However, in case of irritable bowel syndrome, capsaicin is able to increase intestinal permeability and this condition can increase the activity of the immune system lining the gut, which means low grade chronic inflammation, despite capsaicin's anti-inflammatory properties. In other words, increased intestinal permeability (and hence inflammation) exceeds the anti-inflammatory capacity of capsaicin. If you didn't have irritable bowel syndrome capsaicin would be an anti-inflammatory nutrient. As you may know, increased intestinal permeability allows increased passage of gut bacteria and nutrient antigens into circulation, and this is associated to CFS (see reference list of the last newsletter).

On the other hand, in the case of intestinal irritability, we recommend the use of several supplements such as Probiotics (6-9 billions/day), Prebiotics (2-4 grams/day, L-glutamine (0,2grs/kg/day), Zinc (25mg/day), vitamin D3 (test your blood levels and be sure to be in the 50-70ng/ml range) and omega-3 fatty acids (4 grams a day at the beginning).

We hope this helps.

Q: I am a personal coach working with some clients on health issues. At a table discussion last week a colleague mentioned that amaranth and quinoa are exceptions in the general GRAIN category and therefore acceptable in the Paleo Diet. I think not, but would like your opinion.

A: You are correct. Quinoa and amaranth are grain-like crops with potential harmful substances namely saponins. Saponins have been demonstrated to increase intestinal permeability which is one of the factors contributing to many autoimmune diseases, as well as irritable bowel syndrome. So, we recommend to avoid quinoa and amaranth, specially if you suffer from an autoimmune disease.

Q: I am not a fan of the taste of shellfish or seafood. Can I still obtain the same benefits of this diet if I only eat the meat and not any of the suggested fish or seafood?

A: There are a lot of crucial substances for optimal health in fish and seafood such as omega-3 fatty acids, zinc, selenium, vitamin E, etc. So, if you can't eat it we suggest you to take some supplements, such as:
  • Omega-3 fatty acids: EPA+DHA 3-4 grams a day
  • Zinc 25mg a day
  • Multivitamin/multimineral supplement
Eat lean meat to ensure an adequate protein balance.


  1. I have been doing the paleo diet for a few months now, prior to this I followed the Zone diet for 12 years.
    I have a mild autoimmune condition (lupus) ANA positive 1:64 speckled pattern. I used to get swollen knees, and a sore neck, but not any more using paleo foods combined with zone balance and added Omega 3 and vitamin D.

    Other problems that are completely resolved are PMS (breast pain, but no more now) Severe menstrual pain (virtually none now with paleo, exercise and omega 3)
    Constipation (none now with paleo)

    A couple of months ago I had blood tests and found a few problems. Thyroid: TSH slightly high 5.1, T4 okay.
    Also borderline low B12 and folic acid. Both of which I get plenty of in food and a supplement.
    I also have Raynauds (not very severe though)

    Dr thinks they are all related to the auto immune problems.
    I would like to resolve the B12 and thyroid problem.
    I was using a little soy milk, but I've cut that out 6 weeks ago. I've started taking iodine tabs (Kelp) and had to have a vitamin B12 injection.
    I would like to know what factors might be causing me not to absorb B12 and folic acid. Also how can I improve thyroid function.

    No other health problems, I'm at my ideal weight, do CrossFit for exercise. I'm 50.


  2. I read your recommendation that it might not be a good idea to include fruit with full meals because of the way they are digested in combination with fat and protein, thus making them a better choice for snacks. Do you recommend eating ONLY fruit in said snack? I thought it was a good idea to include lean protein with every meal/snack.


  3. Julianne,

    You might think that a TSH @ 5.1 is just slightly high, but most with hypothyroid would call that figure very high. I don't know how Paleo Diet folks feel about dessicated thyroid preparations, instead of T3 or T4 solo preparations, but you might want to look into that with your trusted family physician or endocrinologist.


The Paleo Diet Team invites you to leave comments or post questions to our blog. We receive a great amount of feedback, but we are not able to always answer personally. We read all comments, and we are very interested in hearing your thoughts, learning about your experiences, and understanding what questions you have. Note that we review all comments before publishing them on the blog. Comments posted that do not contain questions or comments related to paleo nutrition, or those that point to web sites that do not provide content that would be deemed helpful to our readers, will be rejected.

Thank you.
The Paleo Diet Team