Online Klinika - FAQ

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DISEASES WHY US ABOUT US TESTIMONIALS English
PKD diet rules

What are the 3 major rules of the PKD?
1. Eat four-legged animals

2. Eat a meat:fat ratio of 100g and 35g fat and eat the right amount of food
3. Eat organ meats on a regular basis
What are the 3 major rules of the PKD in a more detailed way?
1st rule
You should eat meat, organs and fat from four-legged animals (beef, pork, veal, sheep, lamb). Do
not eat poultry, fish and seafood. There are two reasons for recommending four-legged animals
over poultry, fish and seafood. One is that four-legged animals are containing higher amounts of
nutrients and are also more complete in nutrients. The second reason is that four-legged animals
are generally much less contaminated than poultry, fish and seafood. Ideally, you should eat meat
from organic, grass-fed sources. If you live in the US, you should keep in mind that pork is generally
of low quality and is better to avoid. This may be the case in many other countries in the world, so
it is suggested that you double-check whether the quality of pork is good or not if you decide to
consume it.
2nd rule
There are two subpoints here: ”A” and ”B”.

”A” is that you have to eat according to a 100:35 meat:fat ratio.
This means that for every 100g of lean meat/organ, you should add 35g of fat. Remember that this
is the weight of the meat raw, before cooking it, on a kitchen scale and not the amount of protein.
We advise against calculating protein or energy percentage as such calculations may not be
accurate or may result in miscalculations. Keep it very simple, only deal with meat and fat because
this is what you have on your plate. Initially, use a kitchen scale for measuring everything you eat.
To keep it very simple: everything on your plate that is red is regarded as meat, and has to be
complemented with fat. If you have meat that contains white visible fat, you should take this into
account when adding extra fat. If 1/3 of the meat is visible fat, you do not need to add any extra fat.
If less than 1/3, you should add accordingly.
”B” is that you have to eat an amount of food that matches your physiological needs. You should
not eat beyond your needs. The PKD is a diet very high in energy. If you are coming from another
diet and you start eating a similar amount of food on PKD, you will most likely be overeating. Keep
in mind that overeating has negative consequences. For most people, the ideal food amount is
much less than they eat on a Western diet, vegetarian diet, GAPS diet, carnivore diet or any other
diet. During the 2-week program we will help you fine-tuning the amount that is right for your
body.
3rd rule
In order to have enough nutrients from your food it is absolutely necessary to eat organ meats.
Organ meats should come from four-legged animals and specifically should include liver and bone
marrow or brain. You have to eat at least 400g of liver a week and at least 200g of either brain or
bone marrow a week. Brain and bone marrow are interchangeable.
QUESTIONS RELATED TO FOOD ITEMS
Should I eat grass-fed meat?

×
https://archive.is/2022.09.12-223530/https://onlineklinika.hu/en/personal/faq 1/18
Yes, if possible, eat grass-fed, grass-finished beef. Depending on the country where you live, the
quality of the meat may be very different, so if possible, go for the best available quality you can
source.
Should pork be grass-fed?
Pork is an omnivore animal. Thus, obviously, the ”grass-fed” category does not apply to the pork.
Can I eat pork?

If you live in the US, the general suggestion would be to avoid pork. In the US most pork is fed with
soy which is the major concern. Any pork that was fed with soy should be avoided. Yet, there may
be other quality issues with the pork in the US. The problem may also apply to other countries,
typically in Western-Europe. It is important that if you eat pork, you double-check that it is coming
from an ecological farm, and the animals were not fed with soy. Grain and corn fed pork is not a
major problem since pork, as an omnivore animal, may process these foods. If you cannot
ascertain the origin and the quality of the pork, it is best to avoid it.
Can I skip liver?

No, it is absolutely necessary to eat liver. Without liver you will not have enough vitamin D, folate,
vitamin C and you may miss other nutrients too.
Can I eat chicken liver?

No, you have to eat liver from four-legged animals. Chicken liver (or liver from any other poultry
animal) is much less nutritious and may be chemically contaminated too.
Brain is not available where I live, what can I do?
You can eat bone marrow instead. Brain and bone marrow can be interchanged.
Can I eat fish or seafood?

No, do not eat fish or seafood, as fish and seafood is less complete in nutrients and at the same
time often polluted.
Can I eat chicken or other poultry?
No, do not eat poultry, as poultry is less complete in nutrients and at the same time often
contaminated.
Can I eat eggs?

After going through your medical history, you will be given an individual suggestion as to whether
avoid eggs or not. If you are allowed to eat eggs then make sure that you only eat organic, soy-free
eggs.
How many eggs can I eat?
Even if eggs are allowed for you, do not eat more than 4-5 eggs a week. Remember, eggs are not as
nutritious as red meat and organs. If you eat more eggs than suggested, they will take place away
for meat and organs that are more nutritious. If you eat eggs, make sure they’re coming from an
ecological farm and the chickens are not fed with soy.
Can I eat duck eggs?
If you are allowed to eat eggs, and duck eggs are coming from an ecological farm and the ducks are
not fed with soy, then yes.
Can I eat pork crackling?
If you prepare the cracklings at home, yes you can eat them. Do not buy cracklings from a store, as
they often contain milk, additives or they are fried in vegetable oils (even if the seller claims the
opposite). If you live in Europe you can still eat crackling or crackling paté from Eskimokitchen
(http://eskimokitchen.eu/) as they are prepared in a PKD-compatible way.
Can I eat pork rinds (beef rinds)?
No. There are two reasons against eating pork rinds:
1. They are either prepared with additives or vegetable oils

2. They most likely contain chemicals that are used during the process of removing the animal’s
hair.
Is there an upper limit for eating liver?
You can eat up to 800 grams of liver a week. There is no risk associated with eating more liver than
this amount, but if you eat more, you will take space away for the red meat which is also
fundamental to eat.
Is there an upper limit for eating brain?
The maximum amount of brain you can eat is 400 gram/week. There is no risk associated with
eating more brain than this amount, but if you eat more, you will take space away for the red meat
which is also fundamental to eat.
Is there an upper limit for bone marrow?

The bone marrow is almost pure fat. You can eat as much as you want so far you do not exceed the
fat amount you should eat.
Can I eat other organ meats?
Yes, you can eat tongue, lung, heart, spleen, stomach, kidney, adrenals, sweetbread (thymus).
Is there an upper limit for eating organ meats in total?

Organ meats should not exceed 40% of the total amount of food you consume weekly. In simple
terms, always eat more muscle meat than organ meats. There is no risk involved with eating more
organ meat than this 40%, but too much organ meat, will take space away for muscle meat which is
also important to eat.
Is there any organ I should not eat?
Do not eat udder because it may contain milk. The gall bladder is an organ that is not edible.
Why is it important to avoid overeating?
The PKD is very high in calories, so it is easy to overeat, especially if you are coming from another
diet. Finding out the right amount of food to eat may be tricky in the beginning, because this may
be influenced by several psychological factors. Eating more than needed can prevent you from
having the expected blood glucose and ketone levels, can result in certain symptoms, can hinder
your recovery, and in the long run may result in losing certain nutrients.
Do I have to eat bones?

No, there is no need to eat bones. You can easily obtain calcium and magnesium from meat and
organs. You can give the bones to your dog.
Can I eat egg shell?
No, do not eat egg shell. It is not beneficial and it may put you at an infection risk. You can easily
obtain calcium and magnesium from meat and organs.
MEAT AND FAT

How much should I eat?
The first thing to make sure is that you eat the right amount of fat with the meat. It is suggested
that you use a kitchen scale to make sure you eat according to the suggested meat:fat ratio. At the
beginning, eat according to your hunger. Eat when hungry. Do not eat when not hungry and do not
eat beyond your hunger. In order to do so you have to recognize your “real” hunger. This can take
time, self-reflection, and learning. During the 2 weeks we will help you to fine-tune the amount of
food, if it is needed.
How should I measure food?
Use a kitchen scale to make sure that you do the right meat:fat ratio. Once you’ve learned this,
there is no more need to measure your food on a daily basis.
Why is it important to measure food?
Knowing the amount of food that you eat is an important piece of information for us and it is part
of your learning process. Later on, once you have learned the relationship between your hunger
signals, eaten food amounts, and the resulting glucose and ketone numbers, you can stop
measuring food, and can follow your hunger.
Do I have to combine meat and fat for every meal?
Yes, for each meal you have to follow the 100:35 rule.
Should I add fat to my organ meats?
For most organ meats, yes. For detailed information about this topic, see the ”Adding fat” section.
I cook big batches of meat for the whole week. How can I measure my cooked meat?
During the cooking process, the meat looses its water and fat content and every cut is so different
from the other that is impossible to say how much you will lose. So, the only way you can measure
the meat is when it is still raw and you consider this raw weight until the end. Here is an example:
you have 800gr of raw beef to roast. After roasting, its weight is down to 600gr. Once the meat is
cooked, you cut 6 equal slices of 100gr each (cooked weight). If you consider the raw weight, which
was 800gr, you actually have 6 slices of 133gr each and that is the amount of meat you have to
consider. To that meat, if it is lean, you need to add the according fat (fat can be measured after
cooking).
HOW TO PREPARE MEAT AND FAT
Can I eat raw?

If you prefer it raw, you can, but it is not necesssary.
What are the benefits of eating raw?
Raw meat, fat and organs may contain somewhat more nutrients, although the difference between
raw and cooked is small. Most patients enjoy the full benefits of the PKD by eating cooked foods.
Is it ok to include some raw food?

×
Yes. In addition to cooked food it is beneficial to include some raw meat and fat. You may eat meat,
liver, fat or bone marrow all raw, also keep in mind that traditionally smoked meats are considered
to be raw as well.
What kind of cooking techniques can I use?

You can use any kind of cooking technique including frying, braising, grilling, slow-cooking, sous-
vide. Make sure, you never over-cook, char-grill (burn) the meat. Ideally, do not cook everything
you eat at a high temperature. Always remain on the side of less cooking (or cooking at lower
temperatures).
DRINKING
How much should I drink?
You should drink according to your thirst. Drink when thrirsty and do not drink when not thirsty. On
average people on the PKD do not drink more than 1 liter of water a day, but this also depends on
the air temperature, physical activity and on how much you sweat.
What should I drink?
Drink water. If the tap water quality where you live is good, drink it. Otherwise, you may drink
carbon-filtered water, oligomineralwater (waters low in minerals) or spring water.
Should I filter the tap water?
The major problem with the tap water is the chlorine. In order to remove the chlorine you may use
the following techniques:
1. Use a carbon filter

2. Boil the water
3. Fill a pot with water and wait a few hours so that the chlorine dissipates
Do not use water filters other then carbon filter. More advanced filters, softener, purifiers (like the
reverse osmosis filter or other resin-based filters) not only remove impurities but may also
introduce unwanted material into the water.
Can I drink mineral water?
Mineral waters are overmineralized and that may have negative consequences. Thus, do not drink
mineral water on a regular basis.
What can I drink instead of mineral water?
Drink waters that are called oligomineral waters meaning that are containing only small amounts
of minerals. The tapwater is usually low in minerals. Spring water also contains low amounts of
minerals.
What kind of spring water can I drink?
There are springs almost everywhere in the world. Thus you may want to find a locally sourced and
bottled spring water. Spring waters are low in minerals. You may also want to make sure (check the
label) that the spring water is not containing iron, fluoride, sulphur, boron, bromide and nitrate.
Can I drink sparkling water?

Yes, you can. Although, if you have bloating, drinking sparkling water can worsen this symptom.
Also, keep in mind that drinking sparkling water may result in drinking more water than you need.
Can I drink medicinal water?
No, do not drink medicinal waters. Despite their names, they do not have a healing effect. They
may contain ingredients like iron, sulphur, fluorine, iodine, bromide which may have negative
effects. You may need these ingredients but not coming from medicinal waters sources.
×
Can I drink water with added salt?
No, do not drink water with added salt. It has no benefits and makes no sense. Drinking salty water
can worsen your symptoms.
Can I drink coffee?

In most cases, coffee is not allowed. At the start of the program you will be given a suggestion as
regards you are allowed to drink coffee or not. Even if you are allowed to drink coffee, do not drink
more than one coffee a day. Keep in mind that even if you are allowed to drink coffee, it may have
negative effects on you.
You said I am allowed to drink coffee. What kind of coffee can I drink?
Choose dark-roasted coffee, and more widely-known brands. Coffees may widely differ in their
composition of biologically active substances. In our experience small brands may have more
pronounced negative effects. Avoid coffees that taste sour or too bitter. Avoid ”bullettproof”
coffee.
Can I drink bone broth?
Yes you can. As a general advice, do not drink more than 200ml bone broth a day.
Do I have to drink bone broth?
No, you do not have to. Your PKD will be of full value without any bone broth too.
Can I drink tea?
No, tea is not allowed.
Can I drink alcohol?
No, alcoholic drinks are definitely not allowed.
I understand that alcohol is not allowed and I understand the possible negative consequences
of drinking alcohol. Still, can you let me know which one is the least harmful?
There are differences in how bad alcoholic drinks are. Based on the extent of their negative effects
here is a list you can keep in mind (with number 1 being the worst and 3 being the least harmful):
1. Beer
2. Wine and spirits including whisky, gin, vodka, etc.
3. Distilled fruit spirits like grappa, brandy, cognac and pálinka
https://en.wikipedia.org/wiki/Pálinka which are traditionally prepared without sugar or any
other additives.
SALT
Can I use salt?
Yes, you can. You should add salt to your food.
How much salt should I use?
Use salt to taste. Your taste is the best feedback. On this diet you will crave for less salt.
What kind of salt should I use? ×
Only use white or grey rock salt or sea salt without additives. Ideal salts include locally mined salts
(rock salts), the maldom salt and the celtic salt. Do not use pink Himalayan salt or any salt with a
red or reddish colour (like the Redmond salt). You shouldn’t use any salt with iodine as an additive
or anti-caking agents. Also, do not use smoked salts.
CHEMICAL CONTAMINATION
Which food items may be chemically contaminated?
Animal tissues are usually containing less contaminants as compared to plants. Among animal-
based food items, eggs and pork meat are the most often contaminated. Organ meats are also
more prone than muscle meat to accumulate contaminants. If you are concerned of a possible
contamination, eggs and pork should be avoided, and the source of the organ meats should be
changed.
What other sources contamination may be coming from?
Below you can read the most frequent sources of contamination:
- medicines, dietary supplements
- coffee, tea
- contamination from flour, milk, additives (for example because of sharing a kitchen with a non-
PKD family member)
- toothpaste, mouthwash
- skin creams
- chewing gum, tic-tac, menthol, candies
- deodorants, skin care products
- air fresheners (even inhaled)
- cleaning agents in the household (even inhaled)
- disinfectants/sanitizers used at public places for COVID (also even inhaled)
- hair dye (or for dying the beard in men)
- certain indoor flowers or plants that have an intense odor (for example jasmine or hyacinth)
- essential oils (used for aromatherapy or on the skin)
TRANSITION TOWARDS THE PKD

I am new to the PKD. Should I expect any side-effects when starting the PKD?
Even though the PKD is a healthy diet itself, you may experience side-effects when starting the PKD.
The few side-effects that you may experience include headache, nausea, muscle weakness, low
mood and tiredness.
How long these side-effects last?
The side-effects are transitory. On average they do not last longer than 3-4 days. In a few cases, it
may last as long as 7 days.
QUESTIONS ABOUT SIDE-EFFECTS?

What are the side-effects of the PKD?
There are no side-effects of the PKD (other than the transitory side-affects at the beginning of the
diet). Any side-effect you might have read or heard of are side-effects of the classical ketogenic diet
and not of the PKD.
I am doing PKD but still experiencing symptoms. Why?
These symptoms may be caused by the following: ×
- an error in your PKD
- the medications and/or supplements that you are still taking
- not following the suggestions as regards tapering medications
- side-effects of diet transition
- an environmental effect (for example chemical contamination)
- residual symptoms stemming from your pre-existing condition
- psychological, emotional factors
Please be aware that in any of the above cases, introducing a non-PKD food item (as a ”remedy”)
would only hinder your recovery. Eating something that is not suggested on PKD, may help a
psychological factor (for example food cravings) in the short-term and you may feel psychologically
better, but it will cost you more in the long run.
Even though the PKD is a healthy diet itself, you may experience side-effects when starting the
PKD.
QUESTIONS RELATED TO BODY WEIGHT

What can I do aginst losing weight?
For most people, losing weight is part of the process. With the PKD you will be able to reach your
ideal weight. Once you start deepening ketosis, you will be going to lose retained water. Later on,
you will be losing excess body fat. During the 2 weeks we will keep an eye on how your weight
changes.
I am losing muscles. What can I do?
First, losing weight is not equal to losing muscles. If you properly follow PKD you will be losing
water and fat, but not your muscles. If there is muscle loss after all, it is because of a decrease in
exercise rather than because of the PKD. With time, it is very likely that you will be able to
reintroduce exercise and thereby increase your muscle mass, if you wish.
It is for sure that you will not lose muscles due to the PKD. You may be losing muscle for other
reasons though (while doing the PKD). This may include overdoing endurance sports or stopping
weight training. Whatever you do (in terms of overdoing endurance sports or stopping weight
training) the PKD provide the most efficient way to preserve muscles.
Is there a minimum amount of meat I have to eat to prevent muscle loss?
Yes, eating 200 grams of meat per day is enough to prevent muscle loss in an average weight
person.
I look like a skeleton. Is this normal?
In our modern age, there is a false perception about ideal body weight and body composition.
If you properly follow the PKD your BMI (body mass index) may go as low as 17 which is still in the
acceptable range. If you start following PKD and you start seeing your ”bones”, it is an indication
that previously there was too much fat under your skin or your tissues were swollen and retaining
water. It was not the muscles that prevented you from seeing your ”bones” earlier!
I am over 50. On the PKD I started to see more wrinkles on my face, what can I do about it?
What you perceive as having more wrinkles can actually indicate that your face is no more as puffy
as before. Don’t worry too much about the wrinkles. As time goes on, the quality of the skin will
improve as you will nourish it from within.
OK, I understand that it is fat and retained water what I lose, but still I don’t like how I look
now.
If you have a disease, you have to prioritize your health over what you think you should or want to
look like. We are here to help you regain your health, and cannot give you a suggestion that would
please you in the short run but would put you at a health risk in the future. This is why we cannot
recommend you eating more, or aiming for a heavier body weight, if this is not what you need for
your good recovery and health.
I am underweight. Can I gain weight?
If you are underweight as a result of a previous condition (for example malnutrition, Crohn’s
disease, type 1 diabetes) you will be gaining weight on the PKD. However this will take time.
Usually this means several months. Be patient. As a general rule it can be said that normalization of
your vitamin stores, normalization of the intestinal permeability, and normalization of
inflammation comes first. Then there is a possibility to slowly regain weight. This will never happen
in a reverse order. There is no way to speed up your weight gain in a healthy way. Eating more will
not help you gaining weight in a healty way. Eating more will only result in a setback in your
symptoms.
I am underweight. Can I use pharmaceutical keto-formulas to gain weight?
No, do not use these preparations, as they are typically containing milk protein, plant oils, and
many other unhealthy components.
Can I use exogenous ketones?
No, do not use them, they are useless, and containing harmful additives. When thinking about
ketones, be aware of the fact that in the state of ketosis the body is predominantly using free fatty
acids for energy while ketones are used only to a smaller extent. The ketone level is ”only” a marker
of the ketogenic state. Elevated ketone level is not everything, it is just one end-point of eating this
diet. Supplementing with exogenous ketones would definitely result in elevated ketones, but doing
so you would bypass all the other benefits related to eating a meat:fat based diet. The general
phylosophy also applies here ”Do not try to outsmart nature!”
EXERCISE
Can I exercise?
The general suggestion is to do not do major exercise. If you will be able to exercise, we will let you
know at the beginning of the program. You will only be allowed to do major exercise if you are
completely healthy. If you have an already existing disease, exercise will not speed up your
recovery. On the contrary, especially during the first phase, excess physical activity will hinder the
effectivity of the PKD and will also hinder your recovery.
I do not like inactivity. What activities am I still allowed to do?
You can do light yoga, streching, household-related activities, social activities. You can do a 30 min
walk a day. Keep in mind that being engaged in intellectual activities is a form of activity too.
Since I am following this diet I gained a lot of free time. What can I do instead of workout?
Remember remaining active is not all about sports. Being a human has more to do with intellectual
activity or socializing, than with ”pure” physical performance. You can engage in many kinds of
intellectual activities like playing games (for example table games) with family or friends. You can
start some kind of self-learning, practicing an old or new hobby, learing a foreign language, a new
instrument. Keeping your mind busy is an integral part of remaining mentally healthy.
Will I be able to exercise in the future?
Yes. Once you reach your baseline health condition, meaning a good blood work, normalization of
your symptoms, being free of medicines, you will be able to workout again. There is no general
timeline for this. When you will be able to exercise again, depends on your disease, previous
medication, and your improvement pace.
SUPPLEMENTS
Where do I get vitamins from on the PKD?
The PKD is a nutritionally complete diet. This means that if you follow all the rules of the PKD you
will have all the nutrients you need. Organs are specifically important sources for vitamins.
Remember, your diet cannot be complete without organs. Vitamin D is primarily coming from the
liver while vitamin C is coming from the brain/bone marrow. Liver is the best source for iron,
magnesium, vitamin K and many other vitamins. You do not need to eat any plant food to have all
the nutrients you need. Also, ingesting any plant food may hinder the absorption of the nutrients.
More information on vitamin C:
https://www.paleomedicina.com/en/vitamin_c_and_disease_insights_from_the_evolutionary_perspective
More information on vitamin D:
https://www.paleomedicina.com/en/vitamin_D_sunshine_vitamin_cause_of_vitamin_d_deficiency
Why do you advise against supplements?
Supplements may be doing more harm than good. Supplements are not innocent at all. They can
result in undesired side-effects and can prevent the normalization of the intestinal permeability.
Supplements with a potentially harmful effect may include artificial vitamins, minerals, peptides
and amino acids, proteins, plant extracts and many more. It may be the inappropriate form of an
element (for example in the case of magnesium salts) or the filling or coating material that is
responsible for the negative effects. It may also be that excess minerals, salts, electrolites mess up
the fine-tuned physiological electrolite balance of the body. It may also be the case that the
supplement with an alleged beneficial effect, is not only not beneficial but is actually harmful. See
an example for curcumin: https://pubs.acs.org/doi/pdf/10.1021/acs.jmedchem.6b00975
I cannot stop taking magnesium supplement because if I do I will have leg cramps
If you now have leg cramps it is because of an erroneous aspect of your previous diet. With proper
PKD adherence you will not have leg cramps. Instead of covering a symptom with a magnesium
supplement, you have to remove the cause of the symptom. A more detailed article on the relation
between magnesium and the PKD:
https://www.paleomedicina.com/en/paleolithic_ketogenic_diet_magnesium
In case you have leg cramps you may drink homemade bone broth.
Can I use ancestral supplements (dried organ powder or capsules)?
No, you cannot. You just have to eat organ meats in the form of food. There is a loss in nutrients
when organs are dried out. Therefore relying on dried organs to get all necesssary vitamins is not a
good idea as they will not do so.
MEDICINES
What is the problem with taking medicines?
You need to know that medicines are associated with side-effects, and can also hinder your
recovery. In addition, going on with your previous medicine regime while starting the PKD can
predispose you to problems that you did not have before. If you start following PKD, there is an
absolute need to review your medicines and adjust if it is needed.
Is it possible to taper down medicines?
If you are taking preexisting medicines, during the 2 weeks you will receive a suggestion on how to
adjust or taper medicines. There are medicines that can be stopped immediately, there are others
that have to be tapered gradually, and others that may not be tapered. Do not change your
medicines alone without having being advised to do so. One of the aims of the 2 week program is
to guide you through adjusting/tapering your medicines in a safe way.
Is it safe to taper down medicines?
In most cases, it is possible to taper down medicines in a safe way. In order to safely taper down
medicines, we need to ascertain that you are strictly adhering to the PKD. Therefore, please,
remember to send us the daily feedback which allows us to continuously monitor your condition.
How to adjust/taper down medicines?
During the program we will be giving you step-by-step suggestions on how to taper down your
medications. Medical recommendation as regard medicines will be guided by the feedback that we
receive from you on a daily basis. Without receiving the daily feedback from you, we will not be
able to guide you as regards your medicines.
Can you give an example why medicines should be adjusted/tapered?

×
If you start following the PKD your blood pressure will drop. If you, for example, have been taking
blood pressure lowering medication and you go on with the same dose of it, your blood pressure
may drop too low and you may faint. Keep in mind that adjusting/tapering medicines on the PKD is
not just an option but an absolute need.
TOOTHPASTE
Can I use toothpaste?
No, do not use toothpaste. Toothpastes are packed with chemicals, artificial sugars, fluoride and
plant oils. These compounds may be absorbed from the mucosa in the mouth or involuntarely
ingested while brushing your teeth. These compounds are regarded as contaminants which can
give you symptoms or hinder normalization of the intestinal permeability. The same applies for
toothpastes that are labeled as ”natural”. Only use dental floss (unflavored), toothbrush and warm
water. If you follow PKD, you only need a mechanical cleaning of your teeth and no chemical
cleaning.
Can I use salt or baking soda for brushing my teeth?

No, not needed and not suggested either. Only use your toothbrush and warm water.
Can I use mouthwash?
No, do not use mouthwash. What is described for toothpaste also applies for mouthwash.
Can I use shampoo or soap?
Yes. You can use toiletries that you wash off of your skin. Although, even in this case use them
sparingly, and choose the ones that contain the least additives.
Can I use make up or deodorant?
Occasionally yes, but use them sparingly.
What can I do about bad breath?
There is no bad breath if you follow PKD. Bad breath is resulting from carbohydrates. You can still
have a bad breath if you eat too much meat. What you have read or heared about the connection
between classical ketogenic diet (or the carnivore diet) and bad breath does not apply to the PKD.
I can smell the ketones. What can I do?
You cannot smell ketones. Ketones are odorless. If you smell ”something” double check if you are
following all rules of the PKD properly. If you smell vinegar-like odor it is not ketones either. It is
acetic acid and comes from vegetables, alcohol, or sugars.
QUESTIONS RELATED TO SKIN
My skin is dry. What can I do about it?
Your skin will improve once you start eating animal fat and organs. Eating too much meat can also
cause dryness of the skin. That’s also why it is important to eat according to the suggested meat:fat
ratio. Do not use skin creams, lotions, face creams or sunblock,
these may be containing chemicals which may absorb from your skin. You can put tallow on your
skin. Also, you may want to avoid hot water bath, or washing hands too often if you feel that your
hands are too dry.
QUESTIONS RELATED TO BOWEL MOVEMENTS
I have no bowel movements. What can I do?
After staring the PKD the bowel movement frequency will change. It is normal to have much less
frequent bowel movements compared to when on other diets. This is not constipation. On average,
people on the PKD have only one bowel movement every four days. When you start the PKD,
periods without bowel movement can be even longer than this. Be patient. So far you do not have
major abdominal pain, there is no concern about not having bowel movements. Bowel movements
will become more regular with time. Do not use plant-based or medicine-based laxatives. Also, do
not drink coffee to ”help” bowel movements.
I have diarrhea. What can I do?
This may happen in the first few days after starting the PKD. If you still have diarrhea later on, make
sure that you adhere to all the PKD rules. Make sure that you follow the right meat:fat ratio, do not
eat too much meat, and do not eat altogether too much, do not eat plant food items, do not eat
dairy, and do not take supplements. Even if there is another reason for the diarrhea, the above-
mentioned factors need to be excluded first.
”WHY” QUESTIONS
Why I am not allowed to eat the ”forbidden” food items?
Because these food items increase intestinal permeability and therefore going against the major
aim of your diet which is normalizing intestinal permeability.
Why do you recommend against supplements?
Supplements contain additives which can increase intestinal permeability and thereby worsen
your condition. Supplements, in addition, can cause unwanted side effects. Vitamins and minerals,
in the form they are found in supplements, are very often not bioavailable and thus are not useful.
Why do you suggest against exercise?
In the first phase of your health journey, exercise may hinder your recovery. Exercise can elevate
blood glucose level, can make you overeat, and thereby can work against your diet. Exercise can
deplete your nutrients, including vitamin D. Exercise may introduce additional variables which can
make your follow-up more difficult.
Why do I have infrequent bowel movements?
This is because the PKD is a high energy-dense diet. It contains a high amount of energy in a small
volume of food. Also, you make use of almost everything you eat: proteins, fats, water and vitamins
are all absorbed. This means that in the end, there is almost no waste. This is very different from
eating any other diet. Diets containing plant fibres result in a more frequent and bigger amount of
stool.
Why shouldn’t I drink more than needed?
Drinking more than needed can result in gastrointestinal symptoms, can also worsen the effectivity
of your digestion, and can also lead to loss of minerals.
ADAPTATION TO KETOSIS
How long does it take to develop ketosis?
If you are coming from a carbohydrate-based diet, developing ketosis (reaching a ketone level of at
least 2 mmol/l) will take 2-3 days. ×
Does being in ketosis equals to being adapted to ketosis?
No, after developing ketosis it can take more time to get fully adapted to ketosis.
How long time does keto-adaptation takes?
Primary adaptation occurs in 4-5 days. This means that in 4-5 days you will be over the transition
side-effects, and you will start feeling the benefits of ketosis. A full adaptation can take as long as
several weeks or months. This means that you may continue experiencing a gradual improvement
across the first weeks and months. With certain diseases (like type 1 diabetes and hypothyroidism),
this metabolic adaptation can last even longer.
QUESTIONS AS REGARDS ”AFTER THE 2 WEEK

FOLLOW-UP PROGRAM”
How long do I have to eat like this?
The PKD is a healthy diet itself. This is the diet that best suits your metabolism. If you deviate from
it, you may experience negative effects or experience a setback. So far you want to remain healthy
or in remission with a disease, you have to eat like this.
Will there be any allowance later on?
Depending on your disease and your progress, there may be some allowances later on.
How long do I have to wait before having dietary allowances?
This depends on your disease, your condition and the speed of your recovery. As a rule of thumb,
you should follow the initial suggestions (most strict version of the PKD) at least until the following
three goals are reached:
1. the first control blood work

2. the first blood work showing perfect adherence to the PKD, and that reflects the important
blood work parameters as expected
3. until your condition and symptoms stabilize
There are certain instances (very advanced diseases) where allowances cannot be done at all in the
foreseeable future.
What is the next step after the conclusion of the 2WFU?
As a next step, it is suggested that you do the blood work according to the parameter list that you
can find at this platforn at the ”Laboratory parameters” part. The blood work will provide detailed
and objective information about all the important body functions and reveal if anything else has to
be rectified in your diet. Once you have the blood work result, it is suggested that you do a control
consultation: https://c.nutriintervention.com/order
Why do I need to do a control blood work?
The blood work provides all the necessary feedback that we need to further advise you. The blood
work may show whether the meat:fat ratio is correct or not, whether ion, mineral and vitamin
levels are as expected, whether there is a chemical contamination and will answer many questions
beyond. If you are recovering from certain diseases or your medication is being tapered down then
the only safe way to go on is to do regular blood works for your own safety. Without a blood work
we cannot do the control consultation, because we cannot provide you with the necessary
feedback.
When do I need to do the control blood work?
The control blood work is suggested to be done at 3-4 weeks from starting the follow-up program
(if not advised otherwise).
×
Do I need all parameters of the blood work list?
Yes, in order to provide you with a proper feedback we need all the parameters on the list.
Do I need a blood work even if I was 100% perfect with the diet?
Even if you think you were 100% perfect there may be things out of your view. In order to be
entirely sure that you are doing all elements of the PKD perfectly, and there is nothing that may be
hindering your recovery without realizing it, you need to have a blood work done. Otherwise you
may carry on with the same mistakes for week or months.
I HAVE HEARED IN A FACEBOOK GROUP, FROM MY

NATUROPATHIC DOCTOR THAT…
What about ”keto flu”?
The term ”keto flu” has been used for describing the side-effects of transitioning towards the
ketogenic diet. Remember, the PKD differs from the popular/classical ketogenic diet, and thus
some of the so-called keto-flu side-effects never appear while transitioning to the PKD. For
example, you will not experience flu-like symptoms or a skin rash as a transition symptom. The
side-effects of the transition to PKD are described in the ”Transition to PKD” section. If you still
experience other symptoms, it is suggested that you double-check if all rules of the PKD and our
suggestions are followed properly.
Do I have to worry about histamine intolerance?
The concept of histamine intolerance is not fully backed by science. It is more fiction than a real
issue. It is one of the many bogus diagnoses that are circulating on the internet and may be
diverting your attention from real issues and real solutions. If you think you have histamine
intolerance, it is very likely that it is something else that is causing your symptoms. But most
importantly, whatever you think of histamine intolerance, these symptoms will resolve if you
perfectly follow PKD, and/or once you are without medicines and supplements.
Can I eat smoked meats if I was said to have histamine intolerance?
For histamine intolerance see the answers above. Smoked meats, if they are of PKD-compatible
quality, cause no problems. If you think that you experience ”histamine intolerance” symptoms
when eating smoked meats, it may be that your smoked meat contains nitrites/nitrates or other
additives (and not histamine intolerance).
What do I have if not histamine intolerance?
If you feel that you are ”reacting” to certain foods it is very likely because you have a high intestinal
permeability. It is only the PKD that can normalize elevated intestinal permeability. Elevated
intestinal permeability is the common cause of many symptom and diseases.
Why do you think histamine intolerance is bogus?
First, there is no exact medical test to diagnose histamine intolerance. Second, the alleged
symptoms of histamine intolerance are too vague and overlap with symptoms of too many other
conditions.
I heared that I should avoid PUFA (polyunsaturated fats) because they are inflammatory. Is
this true?
From a nutritional and human physiological point of view, the ratio between saturated,
unsaturated or polyunsaturated fats is completely irrelevant. Our body is able to process both
saturated and unsaturated fatty acids. From the health point of view, it is only the origin of the fat
that matters. Plant-derived fats are inflammatory because of plant-based biologically active
substances they contain. Animal-derived fats do not contain anything like that. So, in short: plan-
derived fats are inflammatory while animal-derived fats are not inflammatory.
×
I have heared that keto causes or aggravates hypothyroidism. Is this true?
What you have heard applies to the popular/classical ketogenic diet only. The popular/classical
ketogenic diet contains unhealthy vegetable oils and dairy. Remember, PKD is very different from
the popular/classical ketogenic diet. The PKD does not predispose to hypothyroidism. On the
contrary, PKD, if correctly applied, is able to cure hypothyroidism.
QUESTIONS ABOUT DIET ALLOWANCES
Is there any diet allowance for me?
Whether or not there is an allowence for you, we will let you know at the beginning of the program.
This may depend on your condition and will be individually suggested. But as a general rule, it is
suggested to start doing the PKD in its strictest form, also in order to have a base for later
comparison.
Can I eat honey?

At the beginning of the program, you will be given an individual suggestion about it. Remember,
honey is an allowance and not a recommendation. In case you are allowed to eat honey, you
should not eat more than 2 teaspoons a day. If you are not allowed to eat honey now, there is still a
possibility that in the future you will be able to eat it.
Honey has a high glycemic index. Why do you think that it is acceptable?
There are many more aspects beyond the glycemic index. Actually, the aspects that honey and
other sweeteners differ are more important than the glycemic index itself. In order to have a full
picture on honey we suggest this article:
https://www.paleomedicina.com/en/honey_only_healthy_sweetener
Why honey is regarded as an allowence while other sugars and sweeteners are discouraged?
We suggest reading this article on the topic:

https://www.paleomedicina.com/en/honey_only_healthy_sweetener
What are the benefits of eating honey?
No, there are no benefit of eating honey. Honey is only an allowence and a treat for those who have
a sweet taste and can consume it.
What kind of honey can I eat?
If you are allowed to eat honey, get a real, raw honey. Prioritize local and trused bee-keepers. The
best is to choose honey from common plants/flowers in the area where you live, and bee-keepers
have experience with, rather than honey from exotic plants. Some of the exotic kinds of honey may
contain ingredients with less well known or even harmful physiologic effects.
Can I eat vegetables and fruits?
In most cases all vegetables and fruits are discouraged at the start of the program. When starting
the program you receive information about whether you are allowed to eat vegetables and fruits or
not.
What are the food items I definitely have to avoid?
1. Milk and dairy (remember butter, ghee, kefir, yogurt and cheese are dairy too)
2. Cereals and grains and any food containing any of those (bread, pasta, pizza, nachos,
tortillas, baked goods, etc.)
3. Nightshades (tomato, eggplant, potato, bellpepper, paprika)
4. Legumes (lentils, beans, peas, soybeans, peanuts)×
5. Oilseeds (nuts, almond, macadamia) and plan oils (coconut oil, olive oil, sunflower oil etc.)
6. Sugar, artificial sweeteners (stevia, erythritol, xylitol, monk fruit, etc.)
I understand that I should not eat fruits and vegetables now. You said I will be able to eat
some vegetables and fruits in the future. How much should I eat?
It should not be more than what would keep you out of a stable ketosis. As regards the amount the
following rules apply:
1. Do not eat more vegetables and fruits that prevents you from achieving at least 1.6 mmol/l
ketone level.
2. Do not eat vegetables and fruits that exceed 30% in volume of your meals.
3. Remember, to still avoid certain food items (nightshades, legumes, oilseeds and vegetable
oils, and exotic vegetables).
You said I am allowed to eat some vegetables. Which ones can I eat and how much?
Vegetables have to be organic, local and in season. Consume traditional vegetables like carrots,
turnip, cabbage, kale, celery, brussel sprouts, broccoli, cauliflower, cucumber, mushroom, lettuce,
radish, parsnip. Do not eat nightshades and legumes. Do not eat exotic vegetables like avocado,
sweet potato, tapioca, yam, ginger. As a rule of thumb, do not eat any vegetable that your
grandmother did not know. Only eat garlic, onion if you are completely healthy.
You said I am allowed to eat some fruits. Which ones can I eat and how much?
There is no forbidden fruits list like for vegetables. But if you eat fruits, they should be organic, local
and in season. Always pick the ones that are low in sugars, otherwise you will quickly be out of
ketosis.
Can I expect symptoms after eating vegetables or fruits?
Yes, you can. Even if you pick a vegetable from the relatively ”benign” vegetable list, you may
encounter symptoms like tiredness, sleepyness, gut pain, bloating, diarrhea, constipation and
more. Especially, if you haven’t been eating vegetables and fruits for a long time. Remember,
vegetables and fruits are potential allowences only, they are not part of an ultimate healthy diet.
Can I eat erythrithol, xylitol, or stevia
No, we advise against eating the above sweeteners. Sugar alcohols (erythritol and xilitol) may
impair liver function, and cause gut issues, or problems with eyesight. Other artificial sweeteners
may be causing the same or additional problems. The stevia is derived from a plant, and as such
may be associated with undesired side-effects.
OTHER FAQ
Is this diet safe for those with APOE4?
Yes. It is not the APOE4 (Apolipoprotein E4) that is causing the disease, but a bad diet. You can still
follow the PKD with APOE4 gene.
What about metabolic flexibility on the PKD?
Prioritizing metabolic flexibility is a bad direction in nutritional science. You need to strive for a
healthy diet rather than striving for flexibility between a healthy and an unhealthy diet.
Nevertheless, if you are keto-adapted you will still be able to run your body on glucose (although
eating carbohydrates would be associated with negative effects). This is not the case for the
opposite, as developing keto-adaptation needs time. It is easier if you forget about the idea of
metabolic flexibility.
Can I drink anti-inflammatory tea to deal with inflammation?
No, any tea, including herbal teas or those with an alleged effect of lowering inflammation, would
just worsen inflammation. The PKD itself will be able to control inflammation.
I have endometriosis / insulin resistance / histamine intolerance / cancer etc. Can you tell me
a specific diet that target these conditions?
There are no specific diets for specific diseases. It is the PKD itself which is able to tackle all
conditions. This is because the PKD is targeting the common root causes of these conditions. The
two major root causes of diseases are overconsumption of carbohydrates and the increased
intestinal permeability. Both factors are normalized by the PKD.
I CANNOT…
I cannot eat this way
It is more likely that you do not want to eat in this way. Nobody should put pressure on you and
your diet choices. We will not put any pressure either. It is your decision whether you are willing to
follow this diet or not.
I cannot eat in this way, I need time
Depending on your disease, you may or may not have time to waste waiting before you start the
diet. During the initial consultation, you may be advised as regards you waiting or going through a
transition phase before starting the diet.
I cannot digest fat
Everyone can digest fat. If you had problems with eating fat before, this is likely due to eating too
much fat or fat that was not of good quality.
I cannot eat liver
The PKD is not of full nutritional value without liver. You can get away with some time without liver
but after a few weeks the negative effects of not eating liver will prevail. Liver is not only about
vitamin D. Without liver you may also miss other vitamins including vitamin C, vitamin K and other
vitamins and minerals too.
I cannot eat bone marrow
No problem, you can eat brain instead.
I cannot eat brain
No problem, you can eat bone marrow instead.
I can neither eat brain nor bone marrow
You have to eat at least one of the two. Otherwise, you will be missing a set of vitamins.
All rights reserved: ICMNI-International Center for Medical Nutritional Intervention (Paleomedicina Hungary) 2013-2021 GDPR Impressum

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DISEASES WHY US ABOUT US TESTIMONIALS English

PKD diet rules

1. Eat four-legged animals

There are two subpoints here: ”A” and ”B”.

QUESTIONS RELATED TO FOOD ITEMS

Should I eat grass-fed meat?

Should pork be grass-fed?

Can I eat pork?

Can I skip liver?

Can I eat chicken liver?

Brain is not available where I live, what can I do?

Can I eat fish or seafood?

Can I eat chicken or other poultry?

Can I eat eggs?

How many eggs can I eat?

Can I eat duck eggs?

Can I eat pork rinds (beef rinds)?

No. There are two reasons against eating pork rinds:

1. They are either prepared with additives or vegetable oils

Is there an upper limit for eating liver?

Is there an upper limit for eating brain?

Is there an upper limit for bone marrow?

Can I eat other organ meats?

Is there an upper limit for eating organ meats in total?

Is there any organ I should not eat?

Why is it important to avoid overeating?

Do I have to eat bones?

Can I eat egg shell?

MEAT AND FAT

How should I measure food?

Why is it important to measure food?

Do I have to combine meat and fat for every meal?

Should I add fat to my organ meats?

HOW TO PREPARE MEAT AND FAT

Can I eat raw?

What are the benefits of eating raw?

Is it ok to include some raw food?

What kind of cooking techniques can I use?

What should I drink?

Should I filter the tap water?

1. Use a carbon filter

Can I drink mineral water?

What can I drink instead of mineral water?

What kind of spring water can I drink?

Can I drink sparkling water?

Can I drink medicinal water?

Can I drink water with added salt?

Can I drink coffee?

Can I drink bone broth?

Do I have to drink bone broth?

Can I drink tea?

No, tea is not allowed.

Can I drink alcohol?

No, alcoholic drinks are definitely not allowed.

How much salt should I use?

What kind of salt should I use? ×