Pain in back hips and butt at day 4 of extendedfast

(Susie) #1

Hi all
Complete newbie here.

About 6 to 7 weeks ago I decided I needed to change. Menopause meant I just kept putting weight on, mostly round my middle, rest of me is skinny. Bought a blood glucose monitor and my BS was def higher than the norm
Started with one day fast. Did a 3 day fast a couple of weeks later and have just finished 5 day water only fast. Now looking towards more of a kerogeic lifestyle.

My question is around the intense pain I had in my lower back hips and butt. Started at about the 4.5 day mark. So bad that I quit the fast 3hrs short of the 5th 24 hr period. Feel fine now

Having trouble with EF? Discomfort etc...? Try the EF golden rule of using a laxative pre fasting
Day 8 on Keto Low Back Pain!

I’ll be watching these responses as I had the exact same experience fasting and in the very early days of keto. Seems to hit the biggest muscles, and worst at night trying to sleep. I’m assuming it is caused by low electrolytes but would be keen to find out details


Electrolytes. Take Sodium, Magnesium Citrate, and Calcium Citrate to relieve those aches and pains. Also stay well hydrated. Tons of threads on here about supplementing so the electrolytes stay good. @Brenda has posted her ketoaid recipe on many threads, search for it.

(IDM Educator) #4

Mid-Back Pain During EF

I’ve gotten the exact same pains during longer fasts, it usually hits me around day 3-4. I researched and found it’s actually quite common but there was no verdict on the actual cause. I don’t know how much I buy into the “toxins” thing but one theory I heard was that toxins are released from deep within the muscles and the colon causing aches in the legs, lower back, and hips. The aches were so bad during one of my fasts I cut it short because I couldn’t stand it. The reason I’m inclined to believe it has something to do with detoxification is because it has been less and less noticeable in subsequent fasts.

I got one of those bags you heat in the microwave and put on aches and pains, that seemed to help. Icy hot also helped some, as did taking hot baths. Good luck.

(Mark Rhodes) #6

This has been interesting! My wife began to complain of back pain last night and a great deal this morning. We are in hour 84. I told her to try and eat. She said no she wanted to see how 108 hrs feels. I did not make any correlation between the fast and back pain. I immediately texted her and she said she wants to make a Dr appointment tomorrow. I said I woulld in the meantime try a ketoade. If that didn’t work, try some butter. If that didn’t work to use my old TENS unit. Finally before actually going to the Dr that she should eat tonight. If she feels better then we know. I will update as we learn things.

(VLC.MD) #7

You told a woman what to do ?


Is that even legal ?

(Suzanne Leigh) #8

I’m having the exact same problem. A deep aching in my lower back/glutes/hips that reverberates down my legs all the way to the ankles. It’s non-existent during the day when I’m up and about, but at night in bed it’s terrible. I’ve been drinking keto-aide throughout my fast, and supplementing with lots of additional salt, so I doubt low electrolytes is my issue.

I broke the fast 2 days ago, after 96 hours, in part, because of the low-back/leg pain. I broke with 1200 calories (85% fat) and had another 300 calories yesterday morning (85% fat). I felt better throughout the the day, but by last night my legs/back ached worse than before. I took tons of melatonin–no help in getting to sleep. At 4am I ate 300 calories of macadamia nuts, hoping for relief, and it didn’t help.

Until I read this post I wondered if my body couldn’t handle the low GKI (ketones 6.1, glucose 2.4-3.2), but Rian’s post makes me re-consider:

I’ve had constipation for the last couple of years, so the comment about the colon interests me. Rian, how did you manage to push through the pain on the fasts you stuck with? I haven’t taken anything to mitigate but wonder if it would be advisable.

I’ve also heard Dom D’Agostino say that he doesn’t think ketones above 5 are particularly health because they put a stressor on the system. Anyone else correlate their pain to high ketones and/or low blood glucose?



Well, I’m stubborn so I didn’t let the pain stop me. Actually I did but I pushed through from days 5-9 with fairly significant hip and lower back pain before finally throwing in the towel. For me, sitting around was the worst. So I went for a lot of walks and paced around the house a lot. I used that microwavable heat pack I mentioned earlier, I took several hot baths, I tried icy-hot, and I did finally break down and take some Tylenol which helped immensely (but I was reluctant due to my desire to stick with “water only”).

The times where I had the worst pain (evenings after day 3 or 4) do correlate with the times where blood ketone readings were at their highest levels. This could certainly be a factor but I would have no clue what that mechanism looks like. I’ll be paying close attention the next time I fast to see if these symptoms recur, as it seems they have gotten less severe each time. The decreased severity over time is the reason I actually bought into the toxins idea but I’d really love to see some definitive science on this.

(Douglas James Meyer) #10

Given the length of fasting, this likely put you into ketosis, trying or not. In addition, you likely expelled all your minerals, so I would recommend putting hymalian salt in your water as this has lotta of mineral, over 100. As noted by others, you should also get a supplement of potassium, magnesium , and calcium for your next fast.

(David John O'donnell) #11

In order to try something in addition to what others have suggested, trying doing child pose and half pigeon. There are some great videos out there, better than I can describe.

Losing weight can mean that it takes your body time to adjust, especially your muscles. I have suffered from this at different times and feel sometimes like I am chasing different muscles in different parts of my body.

Around your hips, you have your glutes and a lot of big muscles coming into play.

This may not be the root cause but it can help relieve the pain.

(Suzanne Leigh) #12

Thanks Rian, Storytellertn and David_John_O_Donnell for your replies.

Rian I would be curious if the others who’ve experienced this severe pain have also had commensurately higher ketone readings during that time. I also wonder if the pain spikes cortisol as a stress response, and if that inhibits fat burning (and perhaps contributes to the massive insomnia). Or maybe that’s just my mind playing tricks on me, telling me 'fasting spikes your cortisol so you should eat" LOL.

Storytellertn, yes my ketones were 6.1 this morning. Highest reading ever. I am drinking keto-aid constantly and eating himalayan salt.

DAvid, I will try the yoga poses. Thanks for that suggestion!


I know the first few times I fasted I had some moments when I would almost panic like “what am I doing? What if my blood sugar drops too low?” etc. That is the mental aspect so many people talk about. For me the mental part is much harder than the physical part. But the pain doesn’t help as far as second guessing goes. It’s natural to think “If this is so good for me why does it hurt so much?”. I think places like this forum helped me realize what I was doing was right and that sometimes things have to get worse before they get better. The reality is fasting isn’t all that hard when you set your mind to it, and while fasts over a week are rather long in my opinion the idea that most people think it’s impossible is troubling to me. I’ve never been one to say I could never do something without trying. It troubles me that so many people are willing to give up before they even get started.

Have you ever read The Fasting Cure by Upton Sinclair (published in 1911)? I thought it was a great book, it has a lot of testimonials where people took leaps of faith and fasted based on very little science and virtually no outside support. Back then people had 1/1000th the information we have now and yet in many ways we are more ignorant now than they were. People are fatter and sicker than ever and yet skipping meals is taboo? Are you fukking kidding me?

(Suzanne Leigh) #14

Yes I read some, but not all, of Upton Sinclair’s book and it helped prepare me mentally for the fast. I now wish I’d persevered with the fast for at least a few more days because now that I’m out of the mode, I’m having trouble getting started again. Yes, I’ve been fasting 23 hours a day (except for today) but that doesn’t have the same healing effects as a long term fast. Every day I think “I’ll start fasting again tomorrow” and every day I decide to have a meal instead LOL.

I appreciate all of your info. Your posts have been incredibly helpful to me.

One more odd thing that happened today, a good 4 days after I broke the fast for good: I noticed bumps on my thighs that have never been there before and when I squeezed one a hard, light yellow, seed-like thing came out. Its size, shape and consistency was similar to a decent size grain of sea salt. I poked around at the other bumps, about 10 on each leg, and only water came out, but all the bumps were hard, like they had a seed inside. I’ve read about rashes before, though I wouldn’t call this a rash, per se. It did make me think of the detox issue you and I discussed with the low back/leg pain. Maybe I’m popping out little baby toxins. haha…

Thanks again for your help thus far!!


I’m on day 4 right now and the hip and lower back pain is creeping in. It’s not as severe as the last few times but it’s getting uncomfortable. My plan was to break my fast today anyway so I’ll be fine but it is a mystery. I’d love to know the answer. My ketones are around 5.0 mmol so I wonder if that’s a factor or if it’s strictly coincidence. The pain starts around day 3 or 4, the same time ketones get around 5.0 or higher.

I am by no means going to say this is credible source but I did find this also:

“We have often encountered this lower back/hip pain in the first few days of a fast. In all honesty, although I can put forward a few theories, I have seldom been able to fully explain it. In some cases it is due to the rapid tone-up of the abdominal wall which straightens the lower back and thus put tension on the posterior ligaments.”

Visceral fat disappearing at a rapid rate and abdominal muscles moving around and pulling on stuff? I’ve heard crazier ideas. I’m a big golfer so I’m thinking about hitting up the driving range today before I break my fast. If this lower back pain is muscle related I’ll know it really quickly. Nothing twists and turns the lower back like hitting a few hundred golf balls. I’m thinking it’ll feel really good actually.

(Suzanne Leigh) #16

Thanks, Rian. I read that explanation when I was researching, and it might hold true, but in my case the pain vanished within 24 hours of eating. Given that, the ‘fast abdominal fat-loss’ issue doesn’t make sense. My fat loss held, within 24 hours of breaking the fast, but the pain evaporated.

I read in Valter Longo’s book, in a discussion about the pros and cons of Prolon, his fasting mimetic, that one con could be ‘lower back pain’. I messaged his FB page asking what would cause such pain but didn’t get an answer.

I’m thinking of going to True North I’m March to do a true extended fast. It’s clear to me now that without extreme circumstance (straight jacket, desert island, ‘fasting facility) I’m not likely to fast for a long period. And while the short fast helped my inexplicable belly distention, it didn’t fix my constipation, which is my #1 reason for fasting.

True North aligns with the vegan religion, so could be bumpy on the refeed. But then again, my high fat/low carb lifestyle was in full swing when my health went whacko, so 3 days of fruit and veg refeed might be a good change of pace. I wonder how I’ll look at fruit after a long fast? Probably love it versus my current DANGER view :blush:

Let me know how your back did with the golf swing and breaking the fast. Thanks again for sharing your info.


I figured I’d report back on my progress the last few weeks. I have been fasting for 90-hours the past three weeks. Doing water, salt and black coffee only from 8pm Sunday thru 2pm Thursday. This has proven to be a good thing all around: I feel great, I have shed a few inches around my midsection, and my mental clarity has greatly improved. Most notable the hip pain has all but disappeared. The first week (around the time of my last post) was a tad rough but in the 2 fasts since there has been almost no pain. So the reason for the pain remains a mystery but I’m content just knowing it goes away over time.

Someday as fasting gains more traction maybe I’ll find out the real reasons but for now all I can do is wonder. Anyways, just figured I’d check back in. Hope all is well on your end.

(Suzanne Leigh) #18

Thanks for touching base!! I’m glad to hear your low back pain is gone, and that you’ve found a good weekly fasting system that makes you feel great. I’ve not fasted since my last posts about it (January 16-January 22) but I’m planning to do a supervised extended fast next month at True North.

I know, I know, it seems crazy to pay for fasting help when it’s free at home, but because I 1) felt like death with fatigue and 2) had such terrible back and leg pain, I’m skeptical of my ability to do an extended fast without support. I’ve booked 19 days starting March 3. They require a re-feed onsite, so I’m hoping to fast for 12-14 days. Of course they’re of the vegan religion, so my re-feed will be a challenge :joy:

Despite all the health benefits of nutritional ketosis, it hasn’t reduced my appetite as it does for so many. Fasting, on the other hand, helped me unhook from food in a way I never imagined. PLUS, I’m using a nifty little device that, just in the last few days, has dramatically reduced my appetite–I’m truly amazed. It’s called Modius. It’s a headset that electrically stimulates the vestibular system, and the hypothalamus, and for many people reduces both appetite and body fat. I was pretty skeptical but it had a money back guarantee so I went for it. I’ve used it 15 of the last 17 days, and just 2 days ago I noticed a HUGE difference. Now super easy to eat OMAD, or eat a small snack and one big meal, then fast for 18+ hours daily.

I’ll post a new thread from True North. Take good care!!


Good luck!

Since you’ll be there for 19 days I hope you take the time to pick their brains about every little fasting question you’ve ever had. If and when you do, make sure to report back. They have over 3 decades of experience so it’ll be interesting to see their perspective on things.

I’ve never heard of a Modius, I’m going to look into it today and see what it’s all about.


Im not fasting, unless you consider skipping breakfast after an early dinner to be fasting, but I have the most excrutiating lower back pain. Its worse when I walk around, making my legs buckle at one point like they were literally giving in. Have had my electrolytes for the day and that helped but I don’t know if its safe to have more.