By Marika Sboros
Fasting really is as old as the hills of ancient Greece. It’s a bedrock of traditional healing systems across the globe to boost and protect health.
Yet many doctors and dietitians dismiss fasting as “dangerous”. They call it “trendy” and a “fad”, including in its “intermittent fasting” (IF) incarnation. Growing numbers of doctors, dietitians and researchers disagree. However, they acknowledge that fasts may cause unwanted, short-term side effects.
Canadian clinical nutrition researcher Megan Ramos says it’s easy enough to resolve these side effects. Ramos is a specialist in therapeutic fasting and co-founder of the Intensive Dietary Management (IDM) program with nephrologist Dr Jason Fung.
Fung is author of, among others, The Complete Guide to Fasting. Ramos has worked alongside him since 2003. They co-founded IDM in 2012 after doctors diagnosed her with type 2 diabetes. She was the program’s first guinea pig.
Ramos says that fasting has benefits ranging from weight loss to reduction in medications required for type 2 diabetes and hypertension (high blood pressure). Some short-term side effects are “unwanted consequences of fasting, due to the body transitioning from sugar-burning to fat-burning mode”.
In a blog on the IDM website (scroll down for a link to the full version), Ramos explains these consequences and how best to get rid of them:
By Megan Ramos
I always tell patients to think about their body having two different factories: the sugar-fuelling factory and the fat-fuelling factory. Many of us have been using our sugar-fuelling factory to keep our bodies running for years and maybe even decades. During that time our fat-fuelling factory remains closed.
Now suddenly you switch from eating all the time to forcing your body to fuel on fat stores. This means you must wake up the fat burning factory and slow down the usage of the sugar-burning factory.
Now, imagine how many struggles it must take to slow down usage of the factory you’ve primarily used for years and starting up the fat factory that has been sitting there collecting dust. It isn’t going to be a perfectly smooth transition.
There will be some inevitable barriers you’ll have to push through to get the factory up and running efficiently.
For some people, this transition is flawless and they won’t experience any side effects. Others aren’t as lucky. But if you fall into the category that experiences one of the undesired side effects below, don’t fret! Most side effects go away completely within two to four weeks on sticking to the same routine.
The more consistent you are with your regimen, the sooner you’ll adapt and the side effect will go away.
You are most likely to experience side effects of fasting if:
- You’re new to fasting (less common in people who start fasting on a low carb or ketogenic diet);
- After consuming more carbs and processed foods during a vacation or holiday.
You are least likely to experience side effects if you:
- Are on a low-carb or ketogenic diet prior to fasting (your body is already fuelling on dietary fat);
- Don’t deviate from your diet, i.e. eat lots of junk foods on the weekends;
- Stick with your fasting consistently
Here are the major side effects:
Headache, Dizziness, Mental Fog and Lethargy
This group of side effects is usually due to low sodium levels. Our insulin levels begin to drop significantly when we start fasting. This drop-in insulin sends a signal to our kidneys to release excess water since insulin causes water retention. Most people find they urinate quite a lot when they’re new to fasting for this reason.
As our bodies rid themselves of excess water, we also lose electrolytes through our urine. We’re also not eating as much food and have a dramatic decline in electrolyte consumption. Our bodies tightly regulate our electrolyte levels and this sudden change can throw off our body’s homeostasis.
- Add a pinch of natural salt (Himalayan or Celtic salt are two favourites) under your tongue or in a glass of water a few times throughout the day;
- Drink some bone broth or non-starchy vegetable broth;
- Drink some pickle juice (no sugar).
Expert Tip: If your sodium levels become too low, you may have to end your fast even if you try to take some broth later. We often call this “the point of no return.” To avoid this, take a pinch of salt, broth or pickle juice every three hours even if you feel okay. This will prevent you from feeling unwell in the first place.
My favourite electrolyte supplement: Fasting Drops
This is one of the most common side effects that people who are new to fasting experience, especially if they’re entering the fast after eating lots of carbs. It is also caused by the dramatic drop in insulin levels, which signals to the kidneys to excrete excess water. That can result in watery and unwanted bowel movements.
- Take 1 tablespoon of psyllium husk, stir into 1 cup of water, let it sit for 5-10 minutes before drinking it first thing in the morning;
- Repeat with a second tablespoon if necessary later in the day.
Expert Tip: Our bodies can lose electrolytes through bowel movements just as through urination. People who experience diarrhea or watery stools often start to feel symptomatic of low sodium levels. Make sure you drink an extra cup of broth or pickle juice on days you experience this unwanted side effect. You can also take an extra pinch or two of salt in your water.
If you’re not eating, should you really expect to have a poop in the first place? Most of us are used to having one or more bowel movements a day. And sometimes, it just feels “weird” or “wrong” not to have one. If you’re not feeling uncomfortable, then don’t worry. If you are feeling uncomfortable, then try to troubleshoot the constipation.
Some people have digestive tracts that move a lot slower than others and eating constantly helps things stay moving. When we start fasting, we’re not consuming anything to help move the previous meals through your system. After a few days, you may start to experience some discomfort.
- Drink water if you’re thirsty;
- Take magnesium citrate to help hydrate your colon and get things moving;
- Exercise more.
Expert Tip: If all else fails, add some coconut oil or MCT oil to your tea or coffee in the morning. It’s not a perfect fast but it’ll get things moving and grooving again.
Insomnia and Feeling Anxious
These side effects are due to the production of the counter-regulatory hormone, adrenaline, that is produced when we start fasting. Usually, it’s a good thing. It boosts our metabolic rate and helps us feel energized.
But it can make us feel energetic at certain times when we’d rather be sleeping. It can also make us feel jittery.
People who suffer from anxiety start to worry that fasting makes it worse – it doesn’t. It’s just your body producing more adrenaline that is making the jitters worse than usual.
Humans are a highly adaptable species. That is one of the many reasons why we’ve been so successful. And our bodies will adapt to having these higher adrenaline levels as we continue to fast consistently.
- Practice proper bedtime etiquette by turning off electronics 90-minutes before bed and wearing blue-light glasses in the evening;
- Take Epsom salt baths to help your body relax;
- Lather yourself in magnesium oil or gel in the evening;
- Take magnesium bis-glycinate or malate 4-6 hours before bed;
- Scale back on the fasting, i.e. if you’re doing a 36-hour fast, then maybe do a 24-hour fast and work your way up to doing a 36-hour fast after a few weeks of successful fasting.
Expert Tip: Even pro fasters can experience these side effects if they try to mix in a prolonged period of fasting into their regimen. If you’re looking to dramatically increase the duration of your fast, pick a slower time in your life (i.e. career, family, social functions, etc) where you can afford to be tired for a few days.
- Acid Reflux
We aren’t exactly sure why people experience acid reflux when they start fasting. From my many years of clinical experience, this side effect only tends to occur in people with a long-standing history of reflux. Rarely does someone experience reflux for the first time when they’re new to fasting.
There is some good news! If you do suffer from reflux, it will likely improve dramatically or even disappear once your body has adapted to fasting. That’s especially if you’re following a low-carb diet in conjunction with the fasting. Just like so many things in life, it goes from bad to worse to better!
People with a history of reflux should take some preventive measures to prevent it from occurring or becoming worse.
- Add 1-3 tablespoons of lemon juice to your water throughout the day;
- You can add 1-3 tablespoons of raw, unfiltered apple cider vinegar to your water;
- Avoid broth and pickle juice.
Expert Tip: Avoid spearmint or peppermint teas as they may worsen your symptoms. Instead opt for licorice tea, which may help prevent reflux.
Like acid reflux, we’re not quite sure why people develop gout while fasting. Also, people rarely develop gout from fasting if they don’t have a history of gout attacks. I’ve had less than three cases in nearly a decade where an individual with no history of gout developed gout from a fast, especially intermittent fasting.
- Stick to intermittent fasting when you start, i.e. 24, 36 or 42 hours, three times a week;
- Add 1-3 tablespoons of lime juice to your water;
- Take cherry root extract – this won’t disrupt your fast.
Expert Tip: It’s best for people with a history of gout to start off slowly with fasting. Go from three meals a day to two meals to one over the course of one to two months. If you start to experience gout pains, then scale back. The remedies listed above are best used together as opposed to using one or the other.
One of the consequences of losing weight is bad breath. We often call this “keto breath”. When we’re experiencing keto breath, our tongues become white and we have the taste of acetone in our mouth because acetone is a byproduct of fatty acid metabolism.
Many people immediately freak out about their white tongues and assume they have some sort of horrendous nutrient deficiency. Others have spouses that refuse to kiss them and even make them sleep in the guest room because their morning breath is so unbearable.
Don’t worry! You’re just burning fat and it’s a good thing. As fat loss starts to slow down, your breath will improve. Your tongue will go back to being pink and you’ll be welcome back in your bedroom.
- Oil pull with coconut oil two to three times a week;
- Brush your teeth more frequently throughout the day;
- Use a tongue scraper;
- Drink more water.
Expert Tip: You may want to scale back a little bit on your protein intake during the first month of fasting. If you’re looking to lose weight and maintain muscle mass, then you should be consuming 0.6 g of protein per kilogram of total body weight.
- This article first appeared on the Intensive Dietary Management Program website.
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I have had acid reflux problems for over a decade. I am in my late 60’s. Acid reflux is caused by not having enough acid in your stomach, not by having too much acid. Your acid levels go down as you age, not up. Did you ever get acid reflux in your teens, 20’s or 30’s? Most likely not and at those ages you had a lot more acid than at age 50-80. The medical community can never tell you why you have acid reflux. They assume it is from too much acid but they can never explain the cause. They are wrong. The acid blockers they give everyone are design to be used for only a few weeks. It states that on the labels. Yet, they have people using acid blockers for years and years. I got rid of much of my problem by not eating after 6-7 PM and changing some of my eating habits. Just like most doctors think fasting is some kind of voodoo, their false determinations about the causes of acid reflux are likewise. I have started an 18 hour fast daily and do not eat after 6-6:30 PM until noon the next day or later the next day. There has been little change in acid reflux activity. If I have a problem, a glass of water with fresh lemon juice cures it at night.