Sourdough Goes Gluten-Free!

Updated: October 13, 2022

Sourdough Goes Gluten-Free

After I developed great gluten-free recipes for bread, scone, cake, pie crust, muffin, crackers and even pizza dough for my son, Galen, giving up wheat was easy, with just one exception: sourdough bread.  

If you love the tangy flavor of sourdough (and the health benefits of fermented foods) as much as I do, I have great news for you: it’s easy, although a bit time-consuming just at first, to make wonderful gluten-free (GF) sourdough bread.

I’ve done the research and have combined the information in several excellent books on GF bread-baking* to make the process easy, fun, and most importantly, the result, consistently delicious, for you. Follow my directions below for a reliable, hearty GF sourdough starter and two foolproof loaves of GF sourdough bread—one lighter, one heartier.

Before you start, you need to create a sourdough starter. Here’s how to get yours off to a robust start, followed by two surefire recipes for GF sourdough bread you – your family, friends, and your bones — will love.   

Sliced Gluten-Free Sourdough Bread For Bone Health

Make Your Own Sourdough Starter

After spending several weeks experimenting with the best (least costly–both financially and time-wise—and easiest) way to create a robust sourdough starter, mine has become a family pet. I’ve named her “Gertrude.”

Currently, Gertrude’s sleeping in my refrigerator, but when put in a warm place and awakened (by stirring in a ½ cup of water and a ½ cup of GF flour), she has quite the bubbly personality. And she’s a very low maintenance pet. All she needs is to be taken out of the refrigerator, put somewhere warm (~70 degrees) and fed ½ cup of water and a ½ cup of GF flour. Then she usually perks right up and, in 4 hours, is ready to create a loaf of a wonderful loaf of sourdough bread. If she’s still getting her act together, a second feeding (another ½ cup flour and just enough let it mix in well – so somewhere between ¼ and 1/3rd cup), will do the trick.

Sourdough Goes Gluten-Free

Gertrude (Sourdough Starter)

Least costly(both financially and time-wise) and easiest way to create a robust sourdough starter!
No ratings yet
Prep Time 4 days
Cook Time 4 days
Total Time 8 days
Course Breakfast
Cuisine American
Servings 1 starter
Calories 932 kcal

Ingredients
  

  • 1 tbsp dry yeast active (1 packet= 1 tbsp)
  • 1 cup coconut milk organic (not canned), room temperature (if you tolerate dairy, cow’s milk can be substituted)
  • 1/2 cup sorghum flour (oat or quinoa flour can be substituted)
  • 1/2 cup millet flour oat, teff or quinoa flour can be substituted)
  • 1 tsp maple syrup or honey

Instructions
 

  • In a glass 1 or 2 quart-jar, or in a glass bowl that will hold 4 to 8 cups, add the yeast to the room temperature milk and stir with a wooden spoon to dissolve the yeast. The spoon must be wood, not metal; yeasts do not like metal – it really stresses them out.
  • Add your flours and maple syrup and stir to mix well.
  • Cover the jar loosely with a thin, breathable dish towel (that old, worn out, but clean, favorite dish-towel you haven’t been able to bring yourself to consign to the pile of rags in the garage) or a piece of cheesecloth. If you use cheesecloth, it won’t be long enough to drape fully over the top of the jar, so keep it in place with a rubber band).
  • Let the jar sit in a warm place (around 70-75 degrees) away from drafts for 2-3 hours. Now that Fall’s cool weather is here, I create a warm place for my starter by putting it next to the corner wall of my kitchen counter and placing our slow cooker, which I leave on its “warm” setting, in front of it. You could set your starter on top of the refrigerator or on your stove top, which will warm up if you turn on the oven at its lowest temperature.
  • After 3-4 hours, your starter should start to bubble and will appear pockmarked on the surface. If it hasn’t already, in another hour or so, it will develop a thin layer of clear liquid on top. This thin liquid layer is called “hooch,” and is a good sign that your yeast has fed and produced acetic acid, the byproduct of yeasts’ fermentation that gives sourdough its tangy flavor. Just stir to incorporate the hooch back into the mixture, cover the jar (or bowl) again loosely, feed your starter with another ¼ cup of flour (and another ¼ cup of water if adding ¼ cup of flour makes the starter too thick to stir well), and let it sit out overnight. Remember to keep your starter warm (70-75 degrees).
  • For the next 2 days, repeat this procedure. Once in the morning, once in the evening, stir the hooch back in, mix in ¼ cup of flour and if needed, ¼ cup of water, cover the starter loosely and leave it on the counter in a place where it will be kept warm (~70 degrees).
  • The morning of Day 3, if you’re not going to bake a loaf of sourdough bread that day, just transfer your starter to the refrigerator. It will go into hibernation mode until it is removed from the refrigerator and fed. And then it will need about 4 hours to become bubbly and active again.

Notes

I use Bob's Red Mill gluten-free flours, which are available in most grocery stores and online.

Nutrition

Calories: 932kcalCarbohydrates: 103gProtein: 20gFat: 53gSaturated Fat: 43gSodium: 49mgPotassium: 932mgFiber: 9gSugar: 3gVitamin C: 2.2mgCalcium: 41mgIron: 11.9mg
Keyword bread, gluten-free, sourdough
Tried this recipe?Let us know how it was!

Feeding Your Sourdough Starter

    • At least 4 hours before you will want to use your starter, take it out of the refrigerator, uncover it and stir with a wooden spoon until the hooch is fully incorporated, and the starter is smooth.
    • Remove 1 cup of the starter and discard it. This sounds wasteful, but what you are trying to do is concentrate the yeast, so you have a very potent starter. (And you can always give this cup of starter to a friend, who can use it to create another starter.)
    • Add 1 cup of slightly warm water (just test on your wrist, about 100 degrees is what you want and will feel just slightly warm) and 1 cup of flour (you can use a cup of any of the flours listed above or a half cup each of two of them). Stir with your wooden spoon to combine until smooth. Cover loosely and let the starter sit out in a comfy spot (around 70 degrees, no drafts) for at least 4 hours, or overnight. Once it’s bubbling and thick, it’s fed and ready for baking. If it’s not already bubbling in the morning, feed it again with ½ cup flour and ¼ cup water and give it 3-4 more hours to become active.
  • Take out the amount of starter your recipe calls for (typically 1 cup), feed the remaining “mother” starter with ½ cup warm water and 1 cup flour, stir with a wooden spoon to combine, cover loosely and put back in the refrigerator. If the result is too thick, just add ¼ cup more water.

OK, from now on, all you’ll need to do is feed your starter about once a week 4 hours before you want to use it. And you’ve got your 1 cup of active starter, so you are ready to bake wonderful GF sourdough bread!


Good for Your Bones:

Sourdough Goes Gluten-Free

Light and Lofty Sourdough Bread

Deliciously light and vegan sourdough bread! Discover how to use chia seeds in place of eggs as a natural vegan binder.
No ratings yet
Prep Time 15 minutes
Cook Time 15 hours
Total Time 15 hours 15 minutes
Course Breakfast
Cuisine American
Calories 3097 kcal

Ingredients
  

  • butter pastured or vegan to coat
  • 2 tsp chia seeds

Wet ingredients

  • 1 cup sourdough starter
  • 1- ½ cup coconut milk organic (the kind in cartons in the refrigerator section of your grocery store, not canned)
  • 2 tbsp maple syrup organic, Grade B if available
  • 3 tbsp olive oil extra virgin organic

Dry ingredients

  • 1 cup millet flour
  • 1/2 cup sorghum flour
  • 1/2 cup arrowroot
  • 1/2 cup tapioca
  • 1/2 cup potato starch
  • 1/4 cup flax seed meal
  • 2 tsp xanthan gum
  • 2 tsp salt

Instructions
 

  • Prepare your loaf pan by generously coating it with pastured butter or a vegan butter replacement. I use a Pyrex loaf pan, which measures 9×5 inches.
  • In a glass measuring cup, mix your 2 teaspoons of chia seeds into a ¼ cup of room temperature water.
  • Let sit for 5-10 minutes while you assemble the rest of your ingredients. The chia seed/water mixture will thicken and form a gelatinous goop that will help bind the flours together and add healthy fiber to your bread.
  • In a large glass or crockery bowl, add your wet ingredients and combine, using your mixer on its lowest level.
  • In a medium-sized bowl, add your dry ingredients and stir to combine.
  • Add the chia seed mixture to the wet ingredients mixture.
  • Then add the dry ingredients to the wet mixture, adding a ½-1 cup at a time into the wet ingredients. Use your mixer on medium speed to combine everything thoroughly – for 4-5 minutes. A fairly thick, sticky dough will form.
  • Using a spatula, scoop the dough into your prepared loaf pan and spread it out evenly. Cover loosely with a thin cotton dishtowel or cheesecloth. Now let the dough ferment and rise for at least 8 hours. This is the minimum time to develop any sourdough flavor. The longer the starter’s yeast works on the flours in the dough, the richer the sourdough flavor, so, after all your effort to create outstanding sourdough bread, don’t bake it until the dough has fermented at least 10-12 hours or overnight.  
  • Remove the loose covering and bake the loaf at 400 degrees for 50 minutes to 1 hour. Check at 50 minutes. It’s done when the crust is a golden brown and a knife or wooden skewer inserted into the loaf comes out clean.
  • Remove the loaf from the oven, turn it out onto a cooling rack (because you buttered the loaf pan, your bread will fall right out), and let cool fully – for about 1 hour – before slicing. Letting it cool properly is important; the bread will contain excess moisture that will evaporate while it’s cooling. Skip this step, and you will have soggy bread.

Notes

Nutrient-density per slice (2 ounces):
  • Calories: 147
  • Complex Carbs: 24g
  • Protein: 2g
  • Fiber: 3g
  • Fats: 5g (2.24g monounsaturated, 0.65g omega-3, omega-6 0.27g, saturated 1g)
  • Calcium: 18.45 mg
  • Magnesium: 4.24 mg
  • Potassium: 13.79 mg
  • Iron: 0.72 mg
  • Vitamin B12: 27 mcg
  • Vitamin D: 11.34 IU
  • Vitamin A: 69.69 IU
  • Vitamin K: 1.62 mcg
  • Vitamin E: 37 mg
  • Folate: 2.46 mcg
  • Choline: 2.49 mg

Nutrition

Calories: 3097kcalCarbohydrates: 428gProtein: 45gFat: 141gSaturated Fat: 72gSodium: 4942mgPotassium: 2417mgFiber: 35gSugar: 33gVitamin C: 6.4mgCalcium: 367mgIron: 23.4mg
Keyword bread, sourdough
Tried this recipe?Let us know how it was!

I definitely learned all of the above the hard way. Now, the morning prior to baking, I take my starter out of the refrigerator and feed it, then feed it again in the afternoon, and prepare my dough in the evening after dinner. I let the dough ferment and rise overnight, then bake my bread first thing the following morning.

If you’re up by 7:30 AM, your bread will be done and ready to leave out to cool by 8:30 AM.  You can slice it by 9:30 AM or just wait until you get home.


Good for Your Bones:

Sourdough Goes Gluten-Free

Hearty and Dark Sourdough Bread

Nutrient-dense sourdough to the rescue! Feed your bones and your gut with a bread you'll constantly crave!
No ratings yet
Prep Time 15 minutes
Cook Time 15 hours
Total Time 15 hours 15 minutes
Course Breakfast
Cuisine American
Calories 2763 kcal

Ingredients
  

  • butter pastured or vegan to coat
  • 2 tsp chia seeds

Wet Ingredients

  • 3 eggs free range organic
  • 1/2 cup coconut milk organic(in a carton, not canned, or full fat cow’s milk, if tolerated)
  • 1 cup sourdough starter
  • 1/4 cup water & chia seeds (the mixture you prepared below)
  • 1 tbsp maple syrup

Dry Ingredients

  • 1 cup millet flour (mix in ½ cup at a time)
  • 1/2 cup sorghum flour
  • 1/2 cup teff flour
  • 1/2 cup flax seed meal
  • 1/2 cup potato starch or tapioca flour
  • 1/2 cup arrowroot

Instructions
 

  • Prepare your loaf pan by generously coating it with pastured butter or a vegan butter replacement.
  • In a glass measuring cup, mix 2 teaspoons of chia seeds into a ¼ cup of room temperature water.
  • Let sit for 5-10 minutes while you assemble the rest of your ingredients. The chia seed/water mixture will thicken and form a gelatinous goop that will help bind the flours together and add healthy fiber to your bread.
  • In a large glass or crockery mixing bowl, use your hand-held mixer to combine the wet ingredients.
  • Mix in your dry ingredients, a little at a time, to thoroughly combine (this takes about 4-5 minutes).
  • The thickness of your dough will vary depending upon where you live and current climate conditions. If the dough isn’t quite thick enough (you want a consistency a bit heavier than cake or quick bread batter), mix in an additional ¼ cup of either sorghum flour or – for a delicious nutty flavor – hazelnut meal. I haven’t tried chestnut flour, but expect it would work beautifully as well.
  • Using a spatula, scoop the dough into your prepared “buttered” loaf pan and spread it out evenly. Cover loosely (I use an old, thinned out, cotton dish towel), and let ferment and rise overnight.
  • The next morning, remove the covering, transfer the bread to your oven and bake at 400 degrees for 50 minutes to 1 hour.
  • Check at 50 minutes. It’s done when the crust is a golden brown and a knife or wooden skewer inserted into the loaf comes out clean.
  • Remove the loaf from the oven, turn it out onto a cooling rack (because you buttered the loaf pan, your bread will fall right out), and let cool fully – for 1 hour – before slicing. This is important; the bread will still contain excess moisture, which will evaporate while it’s cooling. Skip this step, and you will have soggy bread.

Notes

Nutrient-density per slice (2 ounces):
  • Calories: 166
  • Complex Carbs: 26g
  • Protein: 6g
  • Fiber: 5g
  • Fats: 5g (0.8g monounsaturated,2g omega-3, omega-6 >0.01g, saturated 0.32g)
  • Calcium: 32 mg
  • Magnesium: 1.5 mg
  • Potassium: 5.28 mg
  • Iron: 2 mg
  • Vitamin B12: 0.09 mcg
  • Vitamin D: 3.65 IU
  • Vitamin A: 88 IU
  • Vitamin K: 0.01 mcg
  • Vitamin E: 1.10 mg
  • Folate: 0.73 mcg
  • Choline: 0.1 mg

Nutrition

Calories: 2763kcalCarbohydrates: 409gProtein: 79gFat: 95gSaturated Fat: 31gCholesterol: 491mgSodium: 301mgPotassium: 2555mgFiber: 63gSugar: 19gVitamin A: 715IUVitamin C: 4.2mgCalcium: 829mgIron: 26.9mg
Keyword bread, sourdough
Tried this recipe?Let us know how it was!

It’s okay to leave your bread out for several hours after baking. Sourdough bread keeps very well and will be fine for several days if not refrigerated. If refrigerated, sourdough will keep for at least a week to 10 days.

Gluten-free Sourdough For Healthy Bones

You Can Feel Good About Eating These GF Sourdough Breads

Not only are they loaded with many nutrients your bones require, (as the nutrient lists show), but the fermentation process that creates sourdough also:

    • Pre-digests the grains, which makes the minerals they contain much more bioavailable.
    • Produces gut-friendly lactobacillus bacteria, which not only crowd out unfriendly bacteria that wreak havoc in the digestive tract, but themselves produce B12 and other B vitamins, improve immune function and lessen inflammation.
  • Produces acetic acid, which in addition to being responsible for the unique flavor of sourdough, is a natural preservative that inhibits the growth of mold, so your sourdough will stay fresh longer — in the unlikely event any is still around after a couple of days.

Sorghum, a Grain with Unique Bone-protective Benefits

Sorghum has special health-protective properties superior to those of other staple grains – insights just confirmed in a meta-analysis of 19 studies published in the September 2016 issue of Nutrition Reviews.

The results of current studies indicate that sorghum helps maintain healthy blood sugar and insulin levels and decreases oxidative stress. When sorghum is consumed, the increase in blood sugar that typically occurs after a meal is up to 26% less compared to the increases in blood sugar seen after consuming wheat, corn or rice.

Not surprisingly, since blood sugar rises so much less, the amount of insulin produced to usher that sugar inside our cells is also significantly lower – a full 55% lower when sorghum is consumed compared to wheat, maize or rice!

In addition, after sorghum is eaten, levels of beneficial polyphenols are higher, while those of markers of oxidative stress (free radical damage) are much lower:

    • Two hours after eating pasta containing 30% red sorghum, a 24% increase in blood levels of protective polyphenols was seen. In contrast, the consumption of wheat pasta caused a 1% decrease in polyphenols over the same 2-hour time period.
    • In addition, a 34% increase in the activity of a powerful antioxidant our bodies produce called superoxide dismutase (SOD) was recorded after consumption of red sorghum pasta, while consumption of wheat pasta produced a puny increase in SOD of just 0.7%.
  • Lastly, protein carbonyl, a marker of oxidative stress/free radical damage to proteins in the body, decreased by 26% after red sorghum consumption but increased by 8% after wheat pasta consumption.

Why is This Important for the Health of Your Bones?

High blood sugar and high insulin levels promote oxidative stress, and all three (high blood sugar, high insulin levels, oxidative stress) promote inflammation. When the foods we consume at every meal trigger large increases in blood sugar and insulin, and cause oxidative stress, we are constantly in a state of low-grade inflammation. And when chronic, inflammation, even low-grade inflammation, activates osteoclasts, causing bone loss. 

*If you’re looking for more info, I highly recommend:

  • Nicole Hunn’s Gluten-Free on a Shoestring Bakes Bread, Da Capo Lifelong, 2013.
  • Jennifer Katzinger’s Gluten-Free and Vegan Bread: Artisanal Recipes to Make at Home, Sasquatch Books, 2012.
  • Sharon Kane’s The Art of Gluten-Free Sourdough Baking, Cultures for Health.com

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  1. Lynn

    May 31, 2018 , 7:32 am

    Sounds so interesting. Had thought to try heirloom wheat as sourdough (going thru hours of rising) but trying other grains or seeds might work also. Had got so used to SCD for healing digestion that bread actually look like a dried up old thing. Had read something last week about sprouted sorghum to be careful with, think for thyroid health. Healthy bone studies sound encouraging. Have read that sulfites are sometimes added to potato or tapioca starch so contacting company in case allergic to it (or get organic or make it yourself) . Thank you for the recipe

  2. Gloria Armstrong

    January 4, 2020 , 2:54 pm

    I couldn’t download the free ebook

  3. Megan AlgaeCal

    January 7, 2020 , 3:46 pm

    Hi Gloria, thanks for letting us know.

    It seems like the button isn’t working properly – we’ll get our team to take a look into this. In the meantime, there’s actually another way to download the ebook! You should see a green button at the top right of the page with the words “FREE Bone Recipes.” Click on this button and follow the steps to get your ebook!

    If by any chance this doesn’t work either, please do let us know! We hope you enjoy our bone-healthy recipes 😀

    -Megan @ AlgaeCal

  4. Gina

    April 28, 2020 , 8:00 am

    Is it possible to substitute coconut milk with oatmilk? Nut allergy

  5. Lara Pizzorno

    April 28, 2020 , 9:11 am

    Absolutely, any type of “milk” will work beautifully.

  6. Krista

    April 29, 2021 , 7:54 am

    Could you use water for the first step of the starter vs coconut or any other type of milk? Or is there a science purpose for starting with something other than water? Thank you!

  7. Megan AlgaeCal

    April 30, 2021 , 9:38 am

    Hi Krista, good question!

    We haven’t tried this particular recipe with water, but it should work just fine as a substitute for the liquid here. Enjoy 😀

    -Megan @ AlgaeCal

  8. Lauren

    November 26, 2022 , 2:47 am

    I tried this recipe but it turned out really dry. What can I do to the next batch to make it more moist.

  9. Chelsea Dugas

    November 29, 2022 , 7:59 am

    Great question, Lauren! For your next batch, you could try adding a little bit more liquid, but not too much as it could make your dough too sticky, a thinner crust and denser bread. You can try experimenting a little, perhaps a tablespoon at a time. Bread-making is an art, after all – it takes a bit of trial and error. Hope this helps and enjoy the process! 🙂

    – Chelsea @ AlgaeCal

  10. Sharlena

    December 29, 2022 , 2:45 pm

    What would you recommend using as a replacement for the potato starch? Everyone in our house is allergic to gluten and potatoes and half are allergic to eggs too. I’ve been failing at every bread recipe I have tried because I have to adapt it too much and it doesn’t rise, falls apart, tastes terrible, etc. This recipe is sooo close to something we could actually eat! Would almond or coconut flour be a good replacement? Or more arrowroot and xanthan gum?

  11. Brianne AlgaeCal

    January 3, 2023 , 8:47 am

    Hi Sharlena,

    Thank you so much for commenting! We’re so sorry to hear of all of the allergies your household is facing, and we hope that this recipe might be a good fit for you! You can try using tapioca flour as a replacement for potato starch. That said, you may have to experiment a little and use slightly more tapioca than what the recipe calls for with potato starch to get the desired consistency. HERE is another bread recipe from our blog you might enjoy! 🙂

    I hope this helps!

    – Brianne @ AlgaeCal

  12. Kathy Wright

    February 19, 2023 , 1:41 pm

    I would like to try the recipe – but need it to be lectin free. Can the chia seeds be omitted or substituted?
    Thanks

  13. Manja

    February 22, 2023 , 11:02 am

    Hi Kathy! Absolutely! You can either omit the chia seeds or substitute them with flaxseed. While flaxseed is slightly larger in size, they contain about the same amount of protein and fiber as chia, and they are lectin-free. Please note: if you decide to omit them, you may wish to slightly reduce the amount of liquid used.

    – Manja @ AlgaeCal

  14. Ali

    February 25, 2023 , 8:52 pm

    Thank you for proving this! I’ve been looking for a GF starter recipe. Do you know of any subs for flaxseed? I’m allergic and was hoping something else would work?

    Thanks!

  15. Chelsea Dugas

    February 28, 2023 , 7:03 am

    Happy to hear you’re going to try our GF sourdough recipe, Ali! If you’re looking for a substitute for flaxseed, you can also try chia seeds, psyllium husk, or hemp seeds. Hope this helps and let us know how it turns out! 🙂

    – Chelsea @ AlgaeCal

  16. Crystal

    April 7, 2023 , 6:16 pm

    Hello!
    Does the maple syrup have to be real sugar? Or can o do sugar free?

  17. Chelsea Dugas

    April 10, 2023 , 11:35 am

    Hi, Crystal!

    The small amount of maple syrup is needed as food for the yeast, which will simply gobble it up and convert it to CO2. Hope this helps to clarify! 🙂

    – Chelsea @ AlgaeCal

  18. Brandi

    October 1, 2023 , 3:57 pm

    When you take it out of the refrigerator you feed it twice, in the morning and evening? How much?

    Also, do you always throw out a cup of the starter before preparing the bread or is that just once

  19. Shelby AlgaeCal

    October 2, 2023 , 3:24 pm

    Great questions, Brandi! The instructions for “feeding” the starter in step 6 are merely the first steps of getting it started! For the first few days, “once in the morning, once in the evening, stir the hooch back in, mix in ¼ cup of flour and if needed, ¼ cup of water, cover the starter loosely and leave it on the counter in a place where it will be kept warm (~70 degrees).” Beyond this, after you take it out of the fridge, you always remove 1 cup and then feed it with 1 cup water and 1 cup of flour. If you feel like it’s not super bubbly yet after 1 feeding, then feed it again with 1/2 cup flour and 1/4 cup water and give it another 3-4 hours.

    The last step is to take out the amount of starter your recipe calls for (typically 1 cup), feed the remaining “mother” starter with ½ cup warm water and 1 cup flour, stir with a wooden spoon to combine, cover loosely and put back in the refrigerator. If the result is too thick, just add ¼ cup more water. After this, you can take it out of the fridge, let it sit for 4 hours, and bake it when you’re ready! Hope you enjoy. 🙂
    – Shelby

This article features advice based on cutting-edge research from our industry experts to give you the best possible information to support your bone-building journey.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Emma Gasinski
PT, DPT, RYT - Physical therapist and certified yoga teacher with a Doctorate in Physical Therapy from Rocky Mountain University of Health Professionals,
Dr. Lawrence (Larry) A. May
MD, FACP, Harvard Medical School Graduate, Physician, Author, Public Speaker - Doctor of Internal Medicine at Providence Cedars-Sinai Tarzana Medical Center and author of several articles and books, including the widely utilized and best selling medical textbook Primary Care Medicine,