***This is not medical advice, as I am not a medical practitioner, and this is the internet:) Please consult with trained medical professionals that know your medical history and do your own research!***
Autophagy
Ever heard of autophagy? It's pretty amazing, really. It's a state where your body can clean up damaged or dysfunctional cells and basically recycle them. It creates newer, healthier cells. It's supposed to be great for healing and anti-aging, pretty amazing. Best of all, it's free.
How does autophagy occur? You have to be in a fasted state, with no calories consumed for 18+ hours. Which means a fast where you only consume water, black coffee or herbal teas. No bone broth, no juice, no calories, period. At least that's the general consensus...I've been listening to some one who claims otherwise, but the research I've read says it's usually a minimum of 18 hours.
How fast you enter autophagy varies depending on whether your body is accustomed to fueling itself off of fat and ketones or glucose (sugar). If you have regularly practiced being in ketosis for some time and are metabolically flexible, which means your body has learned how to easily switch back and forth between fueling off of glucose or ketones, you can enter into autophagy closer to the 18-24 hour mark after starting to fast.
If you aren't metabolically flexible it can take up to 3-5 days of water fast to enter autophagy. It takes me close to 60 hours for my ketones to jump and glucose levels to fall, and my GKI to fall below 3, which are the best indicators that we have at home of gauging whether we are in autophagy, or not.
Fasting for longer periods of time is so much easier if you are practicing intermittent fasting and eating a low carb diet regularly. If you start fasting already in ketosis it is really pretty easy, because you aren't really hungry and you don't have the side effects, like headache and fatigue that you often experience when trying to fast when not eating low carb.
I have played with fasting for years and never been able to do a water fast for more than about 36 hours, I just did 64 hours and it wasn't bad!
Why is autophagy important? Because when damaged cells build up, disease ensues. Autophagy slows the older we get so we become more susceptible to the damaged cells causing disease and in general the aging process.
How do cells get damaged? Stress, environmental toxins, food toxins, trauma(emotional/mental/physical), metal toxins, you know, the Standard American Life (SAL). We are seeing increasing autoimmune diseases, cancer and diabetes spread like wildfire. We are destroying our bodies with our food, our cosmetics, our hectic, stressful lifestyles, pollutants, etc.
Intermittent Fasting
Fasting is extremely beneficial, even without reaching autophagy. There is a study, click here to read, in women with breast cancer that shows that recurrence is reduced by 36% by practicing intermittent fasting nightly for at least 13 hours! That is a huge number, most definitely statistically significant!
They found that HbA1c and C-reactive protein levels were reduced significantly and sleep improved in those fasting for greater than 13 hours each night. HbA1c is the best way to monitor what your blood glucose is doing because it is an average over the past 3 months. C-reactive protein is one of the inflammatory markers in the body.
Inflammation and disease go hand in hand, where there is inflammation, there is disease.
When HbA1c goes up, disease ensues, I've seen it time and time again with my patients. They come in every 6 months for dental cleanings and all the sudden there gums are inflamed and bleeding. When I see this, the first thing I tell them to do is go get bloodwork done and have a checkup and see what their A1c is. As A1c creeps up near 6, I often see changes in the mouth, some people can be above that and not show and signs of oral problems, but the more prevalent trend is that things digress, specifically with periodontal health.
If my patients are known to be pre-diabetic or diabetic I ask them every time they come in what their last A1c was, because 75% of the time I'll know what I'm getting into before I even look in their mouth based off of what it was 3 months prior vs their latest measurement.
If it is that good of an indicator for the oral cavity, makes sense that it would apply to the rest of the body, right?
Personally, my A1c usually ran 5.4-5.5 historically, since I have switched to keto and fasting my last reading was 4.9!!!
My Recent Protocol
My integrative oncologist and nutritionist are the ones guiding my fasting protocol. Things change based off my current treatment, bloodwork and weight.
Initially I started off just doing intermittent fasting 13 hours a night and trying to be done eating 3 hours before bed. Around chemo days I was shooting for 72 hours, but never made that. My nutritionist helped me through, tweaking things as we went and with her help I was able to do about 50 hours around chemo day. And that was enough to make a HUGE difference! The side effects from chemo became so much more manageable (and I have a rough time with chemo). I tried fasting the first time with carboplatin and paclitaxol on round 3 of 6, that round was rough, and my oncologist freaked out that I had lost a bunch of weight. I didn't tell him I was fasting, because I knew what he would say. I regained the weight as soon as I refed, so I just went with it. My nutritionist encouraged me to try fasting again the next round, she assured me that she had never had anyone have worse symptoms from fasting and she thought it was a fluke. She tweaked how I was going to fast and when to start for round 4 and it it was, by far, the easiest round I'd had up to that point. And, every round got easier from there! My last round was WAY easier than my first round, which is a freaking miracle.
When I did Folfox, for colon cancer, the year prior it was horrendous. I attempted fasting on my own and never made it more than 24 hours. I had atrocious vomiting and nausea for the first 4 months and then they found a drug that helped make things for tolerable the last 2 months. I wonder what it would have been like if I had found my nutritionist then...??? I definitely think it's best to attempt fasting around chemo with the guidance of a professional, I think you are much more likely to be successful and not cause harm. And, it can be sooooo very beneficial!
Continuing with fasting around chemo they recommended to start adding 16 hour fasts 2-3x/wk. Which was fairly easy after a month of intermittent fasting, my body was starting to adjust. The hardest part was I had not grown accustomed to drinking my coffee black at that point. Now that I've adjusted to that it's pretty easy to do.
After finishing chemo I am now supposed to be doing a 48 hour fast weekly, my integrative oncologist doesn't want me going longer than that because I don't have enough weight on me.
When I first transitioned to keto I dropped 6 pounds right away and I've stayed right at 131 pounds except for when I'm fasting, but as soon as I refeed I go right back to 131.
Recently, I've been able to start working a few days a week again and that can make things hard to fast if I don't have food already made up. Preparation is key!
If you are new to the idea of fasting I would encourage you to start listening to some people well versed in the area as there are different types of fast to achieve different outcomes.
Click on their name to go check out their website and learn more about fasting:
Ben Azadi -great podcast guests
Dr. Nasha Winters - coauthor of Metabolic Approach to Cancer
Jess Higgins Kelley -co-author of Metabolic Approach to Cancer and owner of Remission Nutrition, I work with one of her nutritionists trained in nutrigenetics and cancer. Highly recommend!
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