Dear Mark: Glutathione, Workout Nutrition, Cartilage Regeneration, Pam, and the Best of the Worst

It’s another round of rapid-fire Q&A with reader questions this week. Ever wonder about olive oil in a spray can, or which meat to choose when dining out? Do you have joint issues, or questions about workout nutrition? These readers do.

Read on to learn my answers to these and other questions. And if you have your own pressing nutrition and fitness quandaries shoot me a line and I’ll try to answer them in a future “Dear Mark” post.

What do you know about Glutathione and what is your opinion of it?


I have a high opinion of glutathione (though I’m not sure what it thinks of me), which the body synthesizes from the amino acids L-cysteine, glycine, and L-glutamic acid. It’s a potent endogenous antioxidant – your body’s favorite, perhaps, if it were forced to choose – that neutralizes free radicals and reactive oxygen compounds, regulates the nitric oxide cycle (important for control of blood pressure and inflammation), helps the liver process toxins, and plays a role in DNA synthesis. Simply put, it’s the master antioxidant in the human body, and we need it to stave off assaults on our health.

I don’t, however, have a very good opinion of glutathione supplementation. The problem is that orally supplementing with glutathione does little to affect levels in our body. Maybe it’s neutralized by the digestive process, but the point is that we already make our own glutathione, and eating the stuff straight is essentially useless, unless you really, really like the taste. If you want to boost your glutathione with supplements, take glutathione precursors, like N-acetyl-cysteine (NAC), whey, or alpha-lipoic acid (which helps recycle glutathione), all of which have been shown to increase cellular levels of glutathione. Get a regular, moderate dose of a wide variety of polyphenol-rich foods and spices, like chocolate, coffee, berries, red wine, tea, cinnamon, and turmeric; polyphenols often up-regulate the body’s natural antioxidants, among which glutathione features prominently. Also, make sure you’re replete in selenium (found in fish, brazil nuts, and organ meats), a crucial regulatory agent for the antioxidant activity of glutathione, because many people are not. There’s some talk that glutathione given as an anal suppository or via IV works, but how tenable is that for the average guy or gal that simply wants to fortify their generally solid health?

Hi Mark,

Quick question related to fueling my intense anaerobic workouts. I understand that I should keep workouts below an hour on the Primal Blueprint diet, or my body will crave carbs/sugar to replace the glycogen. Correct? My main question: when should I eat the most carbs. I am reading that post-work out is ideal but I am feeling enervated during workouts (heavy lifting/crossfit/sprinting). I remember one day recently I had a big hero sandwich (all the bread included) for lunch and I felt like superman for my evening crossfit workout.

Sincere thanks for your insight.



If you perform better having eaten before a workout, eat before your workouts! Don’t listen to dogma and Pubmed abstracts that contradict your experience. You’ll find that different types of workouts require different fueling strategies. While the longer Crossfit WOD, for example, might require some appreciable preworkout nutrition, you might feel and perform fantastically lifting heavy or hiking on an empty stomach.

If you train hard on consecutive days (a strategy that is NOT part of the PB Fitness plan, by the way) you will want to be sure to top off glycogen stores after each hard workout to prep for the next. That does mean upping your carbs from fruit or starchy tubers a bit over the next few hours (and, yes, that means taking advantage of the 45 minute “window of opportunity” just post workout).

If I were you I’d play around with all the various feeding strategy/workout permutations. Then, go with what works. Different things might work for different days, and that’s fine. Crossfit WODs in particular are heavily glycolytic, regardless of how long you spend doing them, simply because of the crazy intensity. In fact, that’s the point of many of them – to cram as much work into as little time as possible. If you’re regularly engaging in Crossfit WODs while adhering to the main-site 3 on, 1 off schedule, go into your workouts sufficiently fueled up (although I would recommend against the hero sub).

Hello Mark,

I think what your doing is awesome and really appreciate your daily articles. To start off I’m 16 years old and a couple of years ago I got Lyme’s disease. One day I went to the doctor when my knee blew up and he told me that I must have got bit by a tick a couple of months ago, which would explain why my knee was extremely swollen. I had taken many pills and injections which failed but finally a couple of months of infusions cleared it. A month later I collided with another kid playing baseball tearing my meniscus. So I had surgery a month later just to repair a simple meniscus. Well the 45 minute surgery ended up being 3 hrs in which the doctor drilled several holes into my kneecap to try and draw blood to the surface of the knee in hope to repair any cartilage I had left. The doctor said it had a 20 percent chance of working, of course it didn’t. So after a year at Columbia Hospital my parents decided to take me to a specialist at Hospital Special Surgery in NYC. After a long hi-def MRI my doctor told me that all of my knee cartilage was gone and my meniscus was torn again. He performed an osteotomy to realign my leg because it was collapsing inwards. A year goes by with multiple large screws in my leg and my doctor tells me that my knee is finally aligned and my bones look great. Well that’s awesome but now he has to take the hardware out and put cartilage in my knee. So after 6 months of waiting for donor cartilage I had my third surgery on January 12, 2011. The surgery was 6 hrs, he took half of the screws out and tore my acl to get to the cartilage. So long story short, I now sit at home with a home tutor everyday patiently waiting to walk again and for my pain to be over with. I go to the doctor in a couple of months for an MRI to see if the cartilage was not rejected and it was properly healed. To be honest I have doubt that it will work but I’m hoping that there is something I can do besides eat Primal and drink bone broth that can help. My question for you Mark is there any Primal trick that Grok would have done to help heal cartilage? Thanks!


The regeneration of cartilage is not settled science. Most orthopedic surgeons will probably tell you that once it’s gone, it’s gone, and that the regrowth of severely damaged cartilage will never reach its original capacity. They may be right, but I’ve seen people with dire prognoses for the state of their cartilage regain what appears to be full mobility and activity levels.

Eating Primal and drinking (homemade) bone broth is a great start, maybe with some chicken feet for added connective tissue. It also can’t hurt to focus on maximizing the nutritional content of the food you eat, so be sure to eat your liver and other organs, bone marrow, leafy greens, and get plenty of vitamin D via sunlight or through supplementation. Avoid inflammation by ditching excess omega-6 fats and taking time to relax and de-stress. Get plenty of quality sleep, since that’s when the healing occurs. And be sure to avoid all grains and legumes, as the dietary lectins may trigger autoimmune attacks on your connective tissue (researchers are beginning to think that wear-and-tear osteoarthritis may also have an autoimmune component, similar to rheumatoid arthritis). You must also use your knee as much as possible, taking care to follow your physical therapist’s instructions and guidelines. Don’t be afraid to test your knee if you feel ready because, ultimately, the resumption of weight bearing activities (which could be anything from body weight squats to weighted squats to simply walking) will send the necessary signals to your joints to begin regrowing the cartilage – if it’s going to happen. The old adage “use it or lose it” applies here.

Basically, I’m not asking you to do anything different than what I’d tell someone looking to get healthy and stay fit. Just do it as if your ability to enjoy life to the fullest extent possible depends on it, because it might. Good luck!

Hey Mark

Your post on olive oil based mayo made me think about if using olive oil-based Pam is actually good for us. I use this whenever making anything in a pan, to spray on a chicken or turkey I am baking, or on my George Foreman grill so meat does not stick.

Is it ok to use or are there better substitutes to get the same or better results?

Thanks for your time and advice 🙂


The fact that I was unable to find the exact ingredients of Pam online makes me think that ingesting it is not the best idea. Also, Pam? Really? Just use some real fat!

I can name dozens of superior alternatives: butter, lard, tallow, coconut oil, olive oil, palm oil, bacon grease, red palm oil, macadamia oil, duck fat, palm shortening, intramuscular hind quarter clover-fed mutton fat… If it’s the convenience attracting you, keep some olive oil in a pressurized spray bottle.


I was wondering if you could do a post on how to choose the best worst option:

i.e. my girlfriend and I are always debating when we go out to a crappy old normal dinner is it “better” to get the beef or the chicken or the shrimp curry. Chickens have high omega 6’s and are fed crap, but they have no antibiotics.  Beefs (if they are lean) do have antibiotics but most of the bad stuff is in the fat, and what about farmed fish/shell fish?

I would be interested in knowing when faced with “less than ideal” options how you would rate their relative merits.



p.s. (I usually go beef and she goes chicken)

If this is an irregular occurrence, I’d suggest simply getting whatever you want. But for the sake of the question, I think you’re right, Jeff, and here’s why:

Remember though, the most important thing to consider is how the food is cooked. The aforementioned answers assume that everything else about the meal is equal except the protein source. If you’re choosing between grilled chicken breast or country fried steak, you’re obviously going to go for the chicken.

Thanks for reading, and be sure to keep sending in questions! I’ll do my best to answer. And as always, feel free to chime in on the comment section and expound on the answers.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

If you'd like to add an avatar to all of your comments click here!

81 thoughts on “Dear Mark: Glutathione, Workout Nutrition, Cartilage Regeneration, Pam, and the Best of the Worst”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. I have been wondering about the last question you answered for MONTHS! I guess I should have asked you at Primal Con. I just never thought about it because the food at Primal Con was as good as it could possibly get!

    I never get fish unless I am certain it is wild caught. I had been thinking that something like Shrimp wouldn’t be so bad because all the toxins are stored in fat. Shrimp doesn’t have much fat.

    But, I have been going with steak most of the time. Then, my second choice is chicken breast.

    Thanks for answering this question. Good to know I have been making the right choice!

  2. A shame. I’m surprised you don’t know about Dr Demopoulos’ Ultrathione. A GSH supplement that passed FDA Stage I testing years ago. Dr deVany has been taking it for decades. I’ve been taking it myself for several years.

    Dr D makes a modification to the GSH molecule – it involves adding a sulfur – that allows it to be absorbed into the bloodstream.

      1. As Mark writes, its the body’s master antioxidant. It has responsibilities far beyond what is mentioned here too. For example, GSH is a precursor in T-cell production. If you are an AIDS patient, you definitely want as much GSH as possible. Those that have live longer.

    1. I used to work in the supplement field and always steered people away from the glutathione and over to the NAC, Vit. C and turmeric instead. Regular oral glutathione isn’t very efficient.

      But, then there’s transdermal glutathione cream, mainly used in autoimmune management protocols, which is a good and effective delivery system. I’d say that if you just want more glutathinone, take the precursors and help your body make more.
      If you have a very inflammatory/autoimmune condition, than the cream is very helpful. I use the Apex Oxicell kind (one jar lasts me months with 3x/day application).

      1. Erin, could you help me find how much GSH is in that Oxicell? The Apex website doesn’t seem to have the info. And they make you pay for a lot of other stuff in the cream too. Still, if I can get the same amount of GSH for less $ I’m all ears.

        Dr D’s website is His formulation is in testing as a treatment for a couple of different maladies. The FDA Stage I phase is to prove a dosage/response relationship, and Ultrathione handled it just fine. 75-80% absorbed in 1-2 hours. Time a pair of doses a couple hours apart and blood GSH levels can elevate for 20 hours.

      2. Would L-cysteine raise glutathione levels as well as the NAC form?

    2. DeVany has never provided solid clinical evidence to support his claims for Demopoulos’s glutathione preparation. Instead, he supports its use by the fact that he (i.e., DeVany) never gets sick. Ok. That’s good, but doesn’t help to work through the relevant biochemistry. The preponderance of the literature supports Mark’s claim that oral supplementation of glutathione is inefficacious.

      1. DeVany shouldn’t have to provide the clinical evidence, since it isn’t his research. You can call Dr D up yourself. Or you can look up the FDA info yourself. Check IND 45012.

        And Dr D’s formulation is NOT simply pure glutathione. No one says that works. Dr D’s GSH adds a sulfur atom that enables absorption.

        The ignorance seems almost willful.

        1. Cromulent, chill out and please don’t accuse others of “ignorance” based on a couple of lines in a web comment. Very bad form.

        2. Brilliant, Will. I call you on this and you respond with the vapors over the mildest invective.

          I’m sure the vast majority of readers here – and apparently Mark too – don’t know Dr D, and that’s fine. If you know enough to be familiar with Demopoulos’ name and work, yet still claim that his formulation isn’t absorbed despite a raft of evidence then willful ignorance is something you might reasonably be accused of.

          And if you look at IND #45012 you’ll see its actually a compressed Phase I&II study. And there is a patent too.

      2. Immunotec makes a product called Immunocal that raises the bodies level of glutathione via bonded cysteine, a glutathione precursor.

        Listed in the U.S. Physicians’ Desk Reference (PDR) and the Pharmacist’s Red Book. Immunocal also holds a Health Canada Natural Product Number.

  3. where does pork chops or something like that fit into that scale of beef chicken fish shrimp?

    1. One pork chop is a very solid choice! Pork is known to have more omega 6 fatty acids – comparable to chicken. This is why I don’t eat bacon everyday like some cavemen…

      But, pork chops are lean.

      A single pork chop comes in with only .7 grams of omega 6 according to Nutrition Data. That ain’t bad at all! 34 grams of protein to boot.

      Eat 2 with some buttered veggies – yum!

  4. Side note about Pam Olive Oil. It contains soy. Says so right on the can. Which really just pissed me off. Sneaky bastards. 🙂

    Pam, Cooking Spray Organic Olive Oil
    INGREDIENTS: Organic Extra Virgin Olive Oil, Organic Grain Alcohol (Added for Clarity), Lecithin from Soybeans (Prevents Sticking), and Propellant.

    1. A lot of dark chocolates contain Soy Lecithin.

      I am not sure myself. So I am asking an “expert.” Are minor amounts of soy lecithin something to worry about? Say the amount in dark chocolate and PAM olive oil.

      I don’t use PAM myself but am curious.

      1. Soy Lecithin is another word for hydrogenated soybean oil…I’ve looked it up and researched it 9 months ago.
        They love to use that word in europe to ‘confuse’ everyone.
        In Europe they also like to call it hardened plant oil….people think it’s some healthy substance since the word ‘plant’ or ‘vegetable’ is in it…/sigh

  5. For anyone who might be wondering — that Misto pressurized spray can Mark links to above at “pressurized spray bottle” is great!

  6. For those of us with soy allergy, Chocolove 73% Organic chocolate bar has no soy lecithin and is a very delicious dark chocolate treat. It is not bitter at all and 1/2 serving (3 squares-just the right amount!) is 7 carbs. Yes, it does have sugar, but for the 80/20 rule and a sensible vice, this chocolate bar fits right in.

    1. I just can’t give up my dark chocolate … yet 🙂 Here I can get Dagoba dark chocolate chips (73%) and Lindt 85% and 90% chocolate bars. They are all soy-free.

  7. Why stress over eating out? It’s one meal out of 1000s you’ll have in your whole life, it’s effect will be quite minimal on your health as a whole. In other words, why not eat whatever protein you enjoy the most?

    1. Well said, it’s not one meal that will forever damage one’s health but the successive choices that build up over a lifetime.

  8. To Matthew:

    Cartilage does regrow. I’ve had rheumatoid arthritis in ALL of my joints. Xrays revealed damaged cartilage on top of inflammation.
    Guess what, all that damage is repaired, I have 0 inflammation and have 0 pain in any of my joints. The worst pain was in my ankles, feet and wrist…I now lift heavy weights regularly without triggering any attack. It’s like I’ve never had it. Bone Broth, cartilage off chicken, bone marrow (raw), i peel every bit of cartilage off whatever cooked animal lays in front of me and eat it. I also take Cod Liver Oil and High Vitamin Butter Oil as stated on Weston A. Price site. And I take Azomite, red clay minerals 1/2 teaspoon a day. Saturated fat chelates the clay minerals and makes them bioavailable. I also drink raw goat’s milk.

    To Jeff:
    All Poultry in the usa is fed arsenic to promote early age growth (facts on On top they’re fed soy and once slaughtered the carcass is soaked in chlorine chemical solution for min. of 45 minutes to kill things that otherwise kill us because of the conditions of the facilities, both for animal and slaughter facility…yuck.
    Some fish overseas (esp. China)are fed dead PETS from the USA, like your own dog or cat…made into pellets and sold as fish feed to other countries. The ships leave the coast of California.
    Forever Rover? Bon Appetit…yuck.

    1. I’m not sure that you can accurately say that all poultry in the US is fed arsenic and soy and soaked in a chlorine solution after slaughter – I think that most accurately refers to the factory farmed chickens. We grow chickens on pasture, their food contains no soy and no corn, and I’m pretty sure doesn’t have any arsenic – I’ll check with the man who mills it for us. As for the chlorine, we bleach our tools, knives, hands, tables (if they get contaminated), but never our birds. If a bird gets contaminated, we toss it – expensive, sure, but we are committed to a clean healthy operation.
      A good idea, as we saw in a MDA recent post, is to know and support your local farmer.

      1. He referred in his post about chicken bought in the grocery store though…those would be factory farmed, yes. So, you’re correct about that.

        Check out facts about all poultry in the U.S.
        Europe has banned the import of ALL poultry coming from the U.S.
        Google arsenic in poultry and see for yourself. They’ve been doing it since the 1960’s…mmmyummm…

    2. I would like to hear more about how you conquered your RA. I was diagnosed 2 1/2 years ago. I took myself off my medication with my last dosage on Jan. 21, 2011. Went primal, more or less,(dairy is still in my diet). Just this week I have experienced some flares. One day it has been my knees.Then it leaves but the next it was my left hand and it is gradually leaving. I eat fresh turmeric, fish oil and a whole lot of other supplements. I do lift weights, golf and spin. I don’t think I am out of the woods yet. Any information you can pass along would be most helpful.
      Marybeth Sullivan

      1. Hi Marybeth,

        I have lupus (diagnosed when I was 21 – 14 years ago), major symptoms are RA, kidney involvement if really bad. Going paleo has been a godsend for me. I have been in a flare for the past 3 years and since starting this WOE seven weeks ago, I’m pretty much symptom free. Are you taking vitamin D? I am taking 10,000IU daily and I feel that it helps so much. I too, get a stiff, sore hand or a knee or a finger here and there and I notice it’s after I eat out or at a friends. Inflammatory substances are everywhere. Even though, I’m careful about what I order, I think in most instances vegetable oils are used. I think I’m fairly sensitive to vegetable oils and believe the omega 6’s to be the culprits (which I totally control and don’t eat at home). Gluten is an entirely different story, I suspected it played a role in my inflammation and RA but put it to the test this past weekend. I had some pasta over the easter weekend after totally eliminating it for 7 weeks (stupid I know) and I became violently ill. I now realize how incredibly gluten intolerant I am and am even more diligent about what I’m putting in my mouth. Gluten can be lurking in the most unsuspecting places.

        Are you keeping a food journal? This is important as you will be able to analyze the foods that you eat prior to symptoms and and figure out what you may be sensitive to.

  9. Hmm.. Reading all your comments is very interesting. I would like to see a post on what you think Mark on the whole dining out and which protein to choose issue, as well as the whole soy lecithin problem. I consider myself very well informed in the soy lecithin area but some commenters were speaking of things I’d never ever heard of and I listen/research valid sources. Thanks everyone and Mark!

  10. I am trying to avoid soy whenever possible, I still eat soy sauce (organic light) and sometimes drink soy milk (organic). I eat alot of dark chocolote, always choose organic and a minimum of 80% cocoa (Green and Blacks 85% is my favorite)…. it doesn’t say it has soy lethicin but could it be hiding elsewhere?

    1. Have you tried liquid aminos instead of soy sauce? Tastes almost exactly the same and is good for you. Bragg’s brand is popular and can be found in any health food store. Yes, there is soy in all sorts of packaged foods including cans of tuna etc.. usually says in small letters “contains soy” due to allergies.

  11. Mark’s blog post was excellent but so many of the comments remind me of why I don’t often read MDA anymore.

    Lecithin is not hydrogenated soy oil but rather an extract of soy. That’s my understanding fwiw:

    re: Glutathiane production. It may be worth eating more bone marrow, bone broth and organ meat to increase substrate for glutathione production rather than supplement it. For a few isolated conditions, NAC supplemention is worth it but the ‘crunchy collagen’ effect (HT Emily Deans) is a serious downside to consider. I’d take it only if it dealing with serious affect disorders that are otherwise treatment resistant.

    re: lecithin in food. Pam is worth avoiding. The amount of lecithin in good chocolate is minimal and not likely at all problematic.

    1. *The amount of lecithin in good chocolate is minimal and not likely at all problematic.*

      That stuff accumulates in the arteries and rest of the body, heart, too. It takes 2 years minimum to get rid of a tiny fraction of this stuff…surely people will eat chocolate again within a 2 year period.

      I used to eat chocolate a lot when I first started out primal, the cravings for carbs made me insane. In order to not cheat on my primal diet I allowed myself the dark chocolate.
      Problem with it is, chocolate cravings come due to a iron deficiency caused by a (previously) grain diet. Other problem, cocoa (the chocolate) is HIGH in phytates which bind with the iron that is in the chocolate…leaving very little iron available. Next, there is usually BAD sugar in chocolate which causes glandular damage and cause tooth and bone demineralization. And last soy lecithin is just another word for hydrogenated soybean oil…it is what it is. It’s emulsified soybean oil…emulsified means hardened. Hardened is another word for Hydrogenated. The amount is tiny, but still accumulates.

      You’re better off taking a teaspoon of mineral clay which has all minerals in the correct ratio.
      I have 0 desire for chocolate (and I was a chocoholic my entire life), even around menstruation. My “mineral bank” is completely topped off.

      1. Where do you get edible mineral clay? (I live in the UK, not sure how it’s available here.) Also, is this in addition to vitamin supplements etc.?

        1. For Europe:

          Behn Meyer Europe GMBH
          Mr. Matthias Wetzel
          Ballindamm I, D-20095 Hamburg
          Postfach 10 44 20, D-20030 Hamburg


          Phone: +49 (0) 4030 299-301
          Fax: +49 (0) 4030 299-300

          Email: [email protected]

          This is straight off the website…they also offer an additional Contact e-mail and have Facebook and Twitter contacts.
          There are many other so called ‘healing clays’ available on the market, I just don’t know anything about them. Azomite is not processed in any other way then ground down into fine powder.

        2. I’m sorry I forgot to answer your question. Yes, take it on top of your vitamin supplement. Vitamin supplements are usually low in everything, for example, there are 12 known vitamin D’s…yet a vitamin supplement only supplies you with 1 kind of vitamin D. The correct vitamin A for humans is retinol, although a healthy person can make the diffictul conversion of beta-carotene into retinol, much of it is lost during digestion. Fish eyes are extremely high in retinol.

          In addition to mineral clay I suggest Cod Liver Oil and High Vitamin Butter Oil ( ). More info on this at Weston A. Price Foundation web site. WAPF also explains the pro’s and con’s about commercial vitamin supplements and has an article about Azomite mineral clay. Hope this helps 🙂

    2. “Mark’s blog post was excellent but so many of the comments remind me of why I don’t often read MDA anymore.”

      Thanks, Katherine!

      Been a lurker for a real long time–though an avid one. But honestly, good folks, your dogmatism can sometimes get distressing. (Mark had a VERY good post about dogmatism a while back.) While I understand that proselytes to a new way of life (i.e., the Primal lifestyle) often feel compelled to throw themselves into it with unreserved zeal, perhaps to “prove” that it’s the (only?) RIGHT way to live…sometimes you might just wanna lay off and take a chill pill. Perhaps the most important bit of Primal wisdom is that not only is the human body a magnificent machine, but it is also a marvelously mysterious one. And you don’t know it all. So stop spazzing out at the merest mention of 0.9g (or a whopping 900mg!) of soy lecithin et al. like they be the Devil incarnate, slash looking at those who partake of a few soy products like they are wretched souls that need to be saved by weaning them off this OMFGPOISONNNN.

      I’ll be noble-minded (or naive?) enough not to expect some “if you don’t like it here, STFU and go away” replies, but if there are any–well, I’ll just say that I was never active here in the first place, and if you wish to snipe fellow readers into forage for insightful material elsewhere, that they might very well do.


  12. On glutathione:
    Yes, oral glutathione is neutralized by digestion. Useless to take it.
    However, there are some products out there with the precursors in proportions that have been clinically shown to raise glutathione levels by 292%. Also, there’s a compound formulated by Dr Herb Nagasawa who is a very big wig in medicinal chemistry that uses ribose to encapsulate a cysteine molecule for on demand release to support glutathione – first published peer reviewed article on this substance was in 1987 and there have been 16 more since then. The “energy shot” containing it is both effective and much healthier than anything else out there.
    I’ve been taking these things for 3 years now and have not had a single day when I was sore after a workout. I also have not been sick, defying a life long track record of winter illness. Yay!
    All studies are online to be perused at and on my website

    1. This is wrong. Dr Demopoulos’ GSH formulation is 75-80% absorbed within 2 hours. Proven by FDA Stage I study. You can look it up.

  13. Mark,

    You state: The fact that I was unable to find the exact ingredients of Pam online makes me think that ingesting it is not the best idea. Also, Pam? Really? Just use some real fat!

    Good common sense, I am in a household with a non-primal spouse. The third ingrediant in Pam (Soybean Oil) is Wheat Flour.

    Thank you for your wisdom

  14. OK wait a second…the comments section and Mark’s articles are two separate entities and because you don’t care for some commenters does not equate with not actively reading MDA…I must admit I rarely read the comments as Mark is the person whose opinions/ideas/comments matter here, not yours or mine. While all opinions are welcome no one is forced to read beyond the article Mark posts.

  15. Donnersberg wrote: “That stuff accumulates in the arteries and rest of the body, heart, too. It takes 2 years minimum to get rid of a tiny fraction of this stuff…surely people will eat chocolate again within a 2 year period.”

    I’m interested in reading more. References would be greatly appreciated!


      The soy lecithin you’re thinking about does little harm if you consume it rarely. Most people make it a daily little nash and that’s where things turn different. I’m sorry if I can’t sound any smarter or don’t have all the fancy words, my first language isn’t English.

      In Germany, soy lecithin is garbage, it’s a known wasteproduct that makes you ill.

    2. Also, I can’t find the article again that stated that soy lecithin is just another name for hydrogenated soybean oil.
      That is what freaked me out about it in the first place. I’m sorry if I misinform people…if it isn’t true, then that’s wonderful good news. For the past year though, ever since stumbling upon that 1 article, it’s been freaking me out and I stopped eating chocolate all together except the one coming from Tropical Traditions, which is fermented chocolate without soy lecithin. They use the chocolates own ‘liquor’ to glue the chocolate into a bar.

  16. Soy lecithin is most certainly not hydrogenated soy bean oil, nor does lecithin accumulate in the body. Seriously, where do people come up with htis nonsense?

  17. I did a bit of research on lethicin awhile back, because I like almond milk and most brands have some kind of lethicin (soy, sunflower, egg yolk)… lethicin is a fatty substance that is part of many of the foods we eat, like meat, eggs, dairy, grains and beans. Apparently it is found in the highest concentrations in beef liver, sheep brains and eggs.

    It is used to keep food products from separating, which makes sense since eggs are often used to hold things together.

    Our bodies do need it, but we generally get enough if we eat eggs or other natural forms.

    I don’t know how it clogs your arteries, couldn’t find that info, if anyone else has read that I would like to know more.

  18. I just recently noticed the variation in ingredients on dark chocolate and wanted to know, too, more about soy lecithin!! For now I am going to avoid it!!

  19. A lie can travel halfway round the world while the truth is putting on its shoes. –Charles Haddon Spurgeon

    And so it goes with lecithin. Did you all know that bone marrow has lecithin in it?

    Anyway, let’s cover some science. Thankfully, we need not bring out the biochem textbooks as wikipedia does a nice job with lecithin:
    “Lecithin is a generic term to designate any group of yellow-brownish fatty substances occurring in animal and plant tissues, and in egg yolk, composed of phosphoric acid, choline, fatty acids, glycerol, glycolipids, triglycerides, and phospholipids (e.g., phosphatidylcholine, phosphatidylethanolamine, and phosphatidylinositol).

    The word lecithin was originally coined in 1847 by French chemist and pharmacist Theodore Gobley to designate pure phosphatidylcholine”

    The part of eggs that holds things together is the whites. The yolks offer a little lecithin but not as much as bone marrow and brain (all ruminants and probably all animal brains, not just sheep).

  20. Donnersberg won’t be able to supply solid sources because there aren’t any.

    Lecithin does accumulate in our bodies, but not in a bad way. In a very necessary, helpful way as it is a major phospholipid component of cell membranes.

    It’s necessary. Healthful. Helpful. Beneficial. Almost certainly, lecithin from brains and marrow are better choices but lecithin from soy is not harmful and may indeed have beneficial effects.

    1. Sure, attack me, go ahead…meanwhile you can keep eating this waste product, while I enjoy my 100% primal life style without cravings =P

      1. My goal is the understand the information we currently have, as well as one can considering all of the limitations of knowledge due to cognitive bias.

        Please share what you’ve found, Donnersberg, If small amounts of lecithin are harmful, I, like many others here, would want to be corrected.

        For me it is not about being right, but rather about uncovering information with the help of science and critical thinking while also understanding the limitations of both.

  21. Joint healing:

    Cartilage/joint rehab is possible. It won’t get back to perfect but it will be healthier.
    Good diet is important but probably not enough. Optimizing movement patterns/coordination, joint mobility, stress reduction, energy medicine (acupuncture, shiatsu) will help.

    I would check gluten sensitivity (Cyrex Lab), antibodies, Neurotransmitter, DHEA, Cortisol (stress test).
    BtW: Painkillers ruin joints and connective tissue.

    Joint Mobility practice is very important. Coach John Siffermann explains why. … sifferman/

    Interview with Coach Sonnon. He had severe joint problems. … ng-system/

    Interesting fact I learned from smart PTs: cartilage works actually better under load than without. Yup!

    Movement is healthy? No. Only efficient, well coordinated movement is healthy. Assess and correct movement patterns.

    Physiotherapist Gray Cook:

    Coach John Siffermann: … n-perfect/

    Most people are far from optimal. Look for a Functional Movement Test (Gray Cook) or even better: Selective Functional Movement Assessment (SFMA) . I did the FMS test some month ago. It is cheap and easy to do.

    Hormone optimization is important for strong connective tissue. Cortisol overload destroys connective tissue.

    One well informed PT is Doug Kelsey, Austin, Texas. He helped a lot of athletes and fitness enthusiasts.

    Here are some good posts from his blog:

    Kelsey’s own rehab in 2010

  22. Just wanted to say that I’ve been loving the knowledge I’ve been getting from these Q & A posts. I think they are a phenomenal addition to the site. Much appreciated, thanks Mark!

  23. After all the talk about lecithin I thought I’d throw this in. FWIW, non-stick sprays like Pam are basically alcohol, lecithin, and a teeny bit of oil. There’s not much to them, good or bad.

    I’m sure it won’t kill you to use it, but other fats have actual bennies, not to mention flavor!

    1. I’ve just used (organic) Pam on my asparagus this morning and it’s surprisingly delicious. I don’t eat chicken or pork *ever*, nor fish from China, so whatever steps backwards I’m taking with the Pam if any are likely canceled out by what I’ve decided to omit from my diet. BTW anyone see the twitter thread that’s going around as of April 2019 on the bio testing of fish and sushi samples to see what kind of fish they really are and what contaminants may be on them? Good read.

  24. There are Glutathione patches put out by a company called Lifewave, they make other antioxidant patches as well. The science behind them is complicated but pretty interesting as they do not transfer the substance through the skin but cause the body to generate the antioxidant itself.

  25. A couple of comments. As a diabetic(it is improving since I went primal)I do find I need to have a small snack before working out to keep my blood sugars stable. On Pam or any cooking spray, I don’t know what is in them, but I do know I am very allergic to them. They are an instant asthma attack since childhood.

  26. I like to use a sandwich bag to grease my pans. I stick my fingers into the bottom of the bag so the inside of the bag is sticking part way out and swipe butter, coconut oil, or bacon fat with it. I wipe the fat over the surface of the pan(s) and then pull my fingers out (which are still CLEAN!) and either seal up the bag to use again or toss it in the trash.

  27. It turns out Advanced glycation end products prevent the self repair of cartilage. So any damage won’t be repaired, possibly fueling the belief in the western world that cartilage cannot repair itself. Aminoguanidine supplimentation may decrease glycation and improve cartilage renewal.

    1. Hi Jack, I have been having slight knee problems for over a year now, last week my knee totally flared up. All of a sudden fluid build up and swelling totally incapacitated me. I had an MRI which showed loose bodie floating inside. I got told i need a arthroscopy opperation. But now my knee has improved heaps and im not even limping anymore. I havn’t spoken to the surgeon yet, but i am thinking that i want to avoid the surgery as im not keen on the thought of letting a surgeon in there to scrape away at cartilage i want to keep, im worried he will over do it. I believe this issue has stemmed from being a vegetarian for the last 3 years and eating grain (im now paleo) and i wonder if i could heal myself with paleo/primal lifestyle and at least, not rush into surgery, as the knee seems to be improving daily. Can you please offer me your thoughts on my situation. Am i crazy to think of avoiding the surgery? 🙂

  28. Hi Nicole
    If your knee problem is showing signs of improvement, surgery should be the last thing on your mind. I’ve had arthroscopic surgery on my knee several times and IME the surgery weakened the structure of my knee. Surgeons know now that surgical intervention is very likely to cause arthritis in later life, but it does help them pay for their Lexus so they do it anyway.
    I tore some hip cartilage last year (because of a poor diet I believe) and was told I’d need surgery to “repair” the damage, repairing cartilage to a surgeon means basically to cut something out. I decided not to have surgery and now I make my own bone broths and eat them almost daily. I also adjusted my Omega 3 to Omega 6 ratio and removed most grain products from my diet. As a result my hip is back full function and mobility and now I even lift weights.
    I wouldn’t have surgery again unless it was a last resort ie. If I couldn’t walk.

  29. Hi Todd, Thanks for your reply. My initial surgeon appointment finally arrived on Thursday, and the surgeon said that i have a loose body of cartilage floating around in the back area of my knee. He said that it could have been there for a while because it could be slowly growing like a pearl. He also said without my prompt that there would be no scraping done, just removal of the 2.1cm loose body. I am walking fine but i can feel it, its in the way. I cant see how i can get away with this without removal of this loose body, I would like to avoid arthroscopy, but what else is my option? Leave it in?It moves around, i can feel it, sometimes it hurts more on the left sometimes the right, back, front, upper sometimes lower. The feeilng is mild discomfort. I would not be able to do squats with it in as that would cause damage for sure. I am totally convinced that this has happened because of grains, sugar and crappy fats, plus other bad foods that i am still paying the price for, weakened. I know it sounds like i have made up my mind on having piece removed but i am interested in your oppinion as you have ‘been there’ Hope to hear back soon, and thanks Todd 🙂

  30. Sorry to hear that Nicole. That sounds similar to the first injury I had to my meniscus. Surgery could well be the best option in a case like that. Then as you already know good nourishment will rebuild the rest of the cartilage to prevent it happening again.
    If you do decide on surgical intervention you may want to look into the role of vitamin C in wound healing and cartilage synthesis.
    Good luck I hope it all goes well for you.

  31. I have had tremendous benefit from doing the exercises recommended by Pete Egoscue, termed the Egoscue Method. My left knee had been evaluated by two different surgeons. Both recommended total knee replacement. At 52 years old, too many years of chronic cardio, the X-rays showed bone on bone and I was in terrible pain. Egoscue has changed my life. I highly recommend doing a Google search and looking into Pete’s program if you are suffering from joint pain. I am a total believer that cartilage can regenerate. Miraculous, as far as I am concerned and yet another motivation to take control of my health. Traditional medicine and the SAD will make you sick. Thank you, Mark.

  32. Good advice when it comes to pre-workout eating. Depending on the intensity, there are days when i kill it on any empty stomach, and days when it’s tough. It’s best to just experiment with what works best for your body.

  33. Wow, Mark thank you so much. I have lost cartilage in my knees and this is the first sensible, hopeful thing I’ve read on the topic!!! Thank you so much for the site and the insight into Paleo!!! I am 36 hours into the diet, and already my body is completely changing. I have a healed fissure, my kidneys are no longer aching, my belly is no longer bloated and I have energy and a clear head that’s lasting for longer than an hour at a time for the first time in way too long. Thank you so much for an amazing site, and kudos to you from someone who’s life is about to completely change . Thanks.

  34. Dear Mark, Thank you, as always, for your wonderful website…as well as your books. I am really loving the new cookbook! After years and years of chronic cardio, I was told by 2 different surgeons that I needed a total knee replacement. I saw the pictures myself of bone on bone and walking was pure pain. On the path to surgery, I discovered the Egoscue Method and Primal Eating! 2 years later, I am pain free. I haven’t been back to have my knee X-rayed, but I am thrilled with the results. I truly believe that many people could avoid painful surgeries if they were willing to try Pete Egoscue’s ecises and eat whole foods that don’t inflame their bodies. Egoscue has truly been a lifesaver for me! Hope that it will help some of your other readers as well.

  35. oh brilliant. Thanks once again Mark: I’ve been searching for a post on cartilage rebuild for a while now, so so pleased to see this one!!! THANK you so much. I’ve always fought the idea that ‘once it’s gone it’s gone’ – what a ridiculous concept!!! 😛 appreciate your insight here – I had guessed the broths, and was already craving and supplementing vit D, so this echos my own experience for certain. I believe my cartilage is about half back now, so whoopee for me!!! very good to read re use it or lose it though – I’ve been scared to start – coincidentally began about 4 days ago, so again, just a massive thank you for this. So so helpful. Very grateful. All the best, and also loving your articles on coffee at the mo!!! 🙂

  36. Anybody have thoughts about early greying (45 years old) and brown spots on hands? Is it lack of ability to detox? Is this something that increased glutathione would help? Any suggestions welcome. Family members have gone white haired prior to age 60.

    1. Julia, I believe early greying is connected to a copper deficiency.—Dr-Joel-Wallach-
      if you have age spots on your hands you have an early Selenium deficiency. That’s free-radical damage and the best way to deal with it is through optimising glutathione in the body (there is a good supplement available) as well as Selenium supplementation.
      Let me know if you want more info or directions to some references online.

  37. This thread dates back a few years I see. Since it started there has been some great breakthroughs in glutathione optimisation, particularly by biochemist Dr Herbert Nagasawa. His Riboceine technology has been tested numerous times by a number of independent labs and every time has proven to be outstanding. Worth looking into for allowing the body to optimise production of glutathione, low levels of which have been connected to 74+ major conditions.

    Dr Nagasawa first published work on riboceine in 1987. His focus was liver health and cysteine (a glutathione precursor and critical for the health of the liver) and other people were focused on the ribose side of things.

    Experiments showed that Ribose-Cysteine (Riboceine) protected the liver from a toxic dose of Acetaminophen, or ACP. An overdose of ACP, the active analgesic agent in many over the counter cold and flu medicines, produces liver and kidney damage similar to the effects of cirrhosis. Ribose-Cysteine serves as an effective delivery method of bringing L-cysteine to cells, stimulates glutathione biosynthesis and protects them from toxins. The ribose-cysteine compound also makes for an ideal dietary supplement since it’s made from endogenous elements already in our body.

    Further experiments went on to show that ribose-cysteine was even more effective than NAC in increasing glutathione content within a liver cell. A supplement available that supplies the Riboceine precursor has been shown to increase levels of glutathione by up to 300%.

    So really worth looking into.