When to call it for extended fast?

(Bean) #1

We are at 96 hours. I’d like to at least another 24.

I’m exhausted and weirdly, still hungry. Hubby doing great. We are doing this for autoimmune/ gastro reasons.

My glucose is 57, but I’ve read it’s common to go lower. I was so tired at work I could have slept anytime I sat. I didn’t have my meter, so I don’t know if that was low glucose or electrolytes. I hit the electrolytes pretty hard this afternoon and feel slightly better. Other than exhaustion, I don’t have any other hypo symptoms. Neither of us are diabetic, but I have long standing reactive hypoglycemia related to my autoimmune problems.

Thoughts? How do you know if it’s okay to push through?

(Doug) #2

Have you fasted for 3 or more days in the past? The body gets better at using ketones and fasting in general, usually, the more it does it.

57 is ‘pretty low’ but some people feel fine even below that - the body running mostly on ketones and only needing 25% or so of the blood sugar it would use if eating high-carb.

I’ve fasted 3 to 12 days, at least 40 fasts in there. How do you know? Hard to say… :smile: I could have always gone on, another hour, another day, another week, really - but sometimes I “just wasn’t feeling it”… Two or three times, I wanted to go at least 6 days, but quit at 3 or 4. There’s always time in the future, there will be more fasts.

Stopping at 4 days, versus 5 - I see no shame at all in that. I love numbers and really, really, like to stick to the program and achieve the ‘target,’ no matter how arbitrary, but there are times that it’s like, “well, not today…” Life goes on.

(Bacon is a many-splendoured thing) #3

Or not enough fat, which is the alternative energy source to glucose.

Fasting is not required, you know. As Professor Bikman continually points out, the state of nutritional ketosis strongly resembles the state of fasting, from a metabolic point of view, except for the absence of hunger. The problem with fasting is that, with no protein coming in, the body has to take amino acids from tissue in order to produce glucose as an alternative energy source to the missing fat. It also needs a certain amount of nitrogen every day, and this nitrogen can come only in the form of amino acids.

This is why there is always a certain amount of lean muscle tissue lost when we fast. As we get older, it becomes harder and harder to create new muscle mass.


It’s easy for me. When I stop enjoying it, the end is very near :slight_smile: But I never needed it for some specific reason, that could have made a big difference.
But if my body tells me it’s enough (I get annoyingly hungry, weak or disoriented), I always stop. I dislike ignore the signs of my body, it knows WAY better what it needs (it just have a not so right idea about it sometimes, it is like a spoiled kids a bit but it has the power to make me miserable so I better don’t say no to it. sometimes I do).

Not everyone handles EF well even when the time is right (as I had no problem one time and couldn’t do it another time). I suspect that even my fat body with plenty or reserves can’t handle a longer one but I don’t want longer ones anyway. 48-72 hours would be lovely and enough. My longest was 5 days, just water (and probably tea. my coffee times came later). I had no idea about electrolytes at that time, it was funny… I continued when I got weirdly dizzy as it wasn’t unpleasant. I continued when I started to think about food in some obsessed way (but I had no urge to eat. it was all mental). I have stopped when I got hungry (but only could eat a few bites, normal feeding came the next day). So I only did it when it was easy (in my determined, curious, stubborn, not tempted state, that made it trivial) and I felt well enough. I don’t even try to break through something serious, I know it wears me out in no time anyway and I don’t do suffering. Maybe for some very sure health benefits but I would feel unlucky to have that situation. I don’t think fasting is strictly needed for me but it still have some benefits and anyway, I could fast easily (but I didn’t choose the time usually, it just happened) on high-carb, I could do it (with difficulties) on keto, I won’t accept carnivore made it impossible for me for ever. But I am against forcing myself. As I wrote, it can be different for others due to a different personality/attitude or different, very good and important reasons for a fast.

But 96 hours is pretty long, I don’t think stopping is a bad idea at this point. I would already worry about my muscles, I simply can’t imagine our not very tiny protein need can be met without food at this point. Of course, the muscles can be rebuilt and in some cases, the benefits may overpower the loss but I still don’t want to lose them in the first place or just in very minimal amounts. So I do the shortest EF when I do any.

Thankfully the already built but lost ones are easier to rebuild than going further than ever… IDK if it is affected by aging too though (sure, if we lost some that is beyond what is possible at a later point, we can’t get that back but otherwise, when one is far from the upper limit? not like the limits are necessarily fixed but I am out of my depth here).

(Bean) #5

Thank you all. I went to bed and slept okay for the first time since we started so I feel a little better this morning. My glucose is 52 this morning.

I’ve done some teaspoons of fat here and there in this fast, but I’ll up it to tablespoons today and add some collagen. This is my longest fast, but mostly because I have Hubby on board, which might be a one time thing. He’s got his groove and could probably do our original 7 days. I think I’ll end it tonight for dinner at 5. Our lives are crazy and it seems that we have some sort of food event with adult kids or parents or something every week, so this window to do a longer fast will be hard to find again.

I’m a long running carnivore who never, ever seems to get into ketosis, even when I up my fat. I also cannot lose weight even on a 19:5 IM (which I do have 15-20 pounds to lose). I am fairly muscular. I want ketosis for autoimmune arthritis and I am losing a little while fasted. I didn’t really get into ketosis until the beginning of day 3.

I’m going to try to come out of the fast with therapeutic ketosis macros, keep my 19:5 and try a weekly 48 hour fast, which was the easiest part for me.


Oh yes, that was my idea sometimes but I never realized: if I can’t continue a fast, I still could add only some fat or maybe a full-blown fat fast meal… That has many of the benefits still.

Oh, it seems helpful! My SO coming home is usually the end of my IF, there are other circumstances tied to that time too so I don’t wait even if I otherwise could. He never does EF but if he did, I surely would join, enjoying the extra help.

Good luck with your goals!

(Bob M) #7

Usually, the second day is the hardest. The third, you begin to cruise, and the fourth is even better. But that’s not always the way it is.

If you want higher ketones, you could try MCT oils (unless you don’t want any plants). Those should increase your ketones. Warning: they can cause some stomach/digestion issues. At least for me, they do.

I also have low ketones, and pretty much am only in ketosis at night or fasting multiple days (if “ketosis” is > 0.5 mmol/l BHB).

(Bean) #8

Thanks Bob,
I know- it’s weird. Day 4 should not be harder than day 2. The only plants I do are olive oil, refined avocado, and refined coconut oil, mostly because eggs and dairy are also off the table for now.

I react to coconuts and avocados, but the oils are okay and the only way I can keep my fats high enough for what I want.

Since I’ve had good luck with refined coconut, I will try mct again.

I feel okay right now. I do also have a little less inflammation. I’m right at my plateau/ stall weight (unchanged from yesterday), so if I can break through that, I feel like I’ll be setting myself up for a successful transition for going forward. I’ve been stuck both health and weight wise for 6ish months.

(Bob M) #9

It’s tough because I know MCTs help with ketones, but what I don’t know is whether MCTs could help or exacerbate autoimmune arthritis.

You might take a look at these articles:

For the last one, I did try all three supplements. Unfortunately (or fortunately, depending on how you look at it), I don’t know if I have an auto-immune disease. So, I can’t gauge feedback. I took all 3 supplements for a while, over 2 months. The good news: they didn’t cause side effects. The bad news: I don’t know how much benefit, if any, I got from them.

(Bean) #10

Sadly, I have strong reactions to turmeric and cumin. I do take fish oil weekly but not daily. I know some people choose to be carnivore, but plants and I do not get along. At all. I’m not sure if it’s LTPS, sulphites, salicylates, or (most likely) some combination of those.

My RA factor is extremely high (along with other autoimmune antibodies). I am very lucky to have as little pain as I do. I would like to keep it that way.



100% Absolutely. I stopped all of my extended fasting and IF. I discovered (via DEXA scan) over a 12 month period that I had lost some muscle mass. As we get old, even over 50 it can become very hard to gain muscle. I recently came across a study that showed two senior groups each doing strength training three times per week for six months. The first group gained zero lean muscle; the second group took a protein supplement via a protein shake and gained about 3 pounds of lean mass on average.This would suggest it was the extra protein that made the difference. It remains unclear whether protein supplementation helps to improve muscle strength as well as muscle mass. Missing your daily protein requirments is not good.


Does this happen with all foods, including protein and fat? Have you had an OGTT where they also measure insulin responses every 30 minutes over a period of time (2–5 hours)? This test was also called the Kraft test. It tests for both glucose and insulin responses.

Show me the science. I would be researching how to recolonize your gut biome. What does your immunologist or your rheumatologist suggest?

(Bean) #13

Just carbs. I was tested 19 years ago, so while I know I had spaced blood draws (and an alarmed tech who came out to make sure I was upright), I don’t remember details other than them stopping the test at two hours because I was dropping so fast. I managed it for the first 16-17 years with a moderately low carb diet. It really started to ramp up again so I went carnivore. That seems to be managing it.

(Bean) #14

Yep- been working on the gut health. (ETA- celiac is autoimmune #2) Rheum says to “keep doing what you’re doing”. She’s one of the best in our area and is happy to consider all avenues to improve patient outcomes.

(Bean) #15

Kind of dense, but useful since it’s a literature review and covers different studies and opinions:


ETA- Hashi’s is #3. It’s still unclear if I have a fourth, but Type 1 diabetes and Sjorgen’s is in my family. Oh and Stiff Person.

(Bean) #16

Also, broke the fast this evening at 120 hours with chicken thighs and chicken fat. I really want a steak, but that’s dinner tomorrow. :grin:


I’m confused by this. I’m particularly interested in a few of the benefits of autophagy, and fasting puts us in that state. It helps to get rid of the flabby wrinkly skin often left behind after significant weight loss, and it has age reversing benefits too - so of course at 58 I would be very interested in fasting to benefit from autophagy.


. Extended fasting also has risks. It is impossible to meet your daily protein requirements. Loss of lean muscle mass should be a big concern, especially after the age of 50. It can be very difficult to gain muscle mass and strength as you get older. As Paul and I have mentioned many times, it is not required when doing keto. The scientific literature on fasting is still relatively weak, notwithstanding the many popular books that have been written about fasting in its various forms. I think it may be useful for people who have severe metabolic dysfunction, but having read most of the main studies, I am less persuaded that it is the panacea that some believe it to be.

(Bacon is a many-splendoured thing) #19

Apparently, so does keto. The point is that fasting and a low-insulin diet are both catabolic states, since insulin is low. Autophagy, of course, is happening all the time, but when the metabolism is in a primarily catabolic state, the breakdown of tissue (which is what catabolism is) is increased. To get the best explanation, watch one of the interviews and lectures given by Professor Ben Bikman, who studies metabolism as his primary area of investigation.

(Nicci) #20

When we’re born, if our mother was good enough to breast-feed us; she passes on to us two (actually, three) important ingredients. The first of course, is water. About 75% of breast milk is water. About 7% is carbs-BUT- they are in the form of polysaccharides. (remainder is protein)
Humans cannot use these polysaccharides as a food source. So scientists were wondering-what is their purpose in breast milk?

They discovered that the polysaccharides are used to help set up the babies’ gut, benefitting the child with a symbiotic relationship with two forms of gut bacteria that eat the polysaccharides. These two species help set up a major part of our immune system.

I mention this because Original Poster spoke of their immune system. So, enrich your diet with polysaccharides. In a Carnivore diet, try Lion’s Mane mushroom extract. There are other mushroom extracts that contain a high number of them as well.

Me being Keto, I have found Astragalus extract works well. (a plant for those who don’t know) There is a brand I get over at Amazon that contains 70% polysaccharides. Since I started taking them, I have noticed a much better gut stability. And-I never get sick. Is this a part of the reason? I don’t know, but I’ll try whatever I can to help. :slight_smile:

Anyway, I wish you well on your journey. I have a hard time fasting too, but have found the MCT helps me hang in there, as some have mentioned. Maybe I should quit fasting, as some of you have also mentioned muscle-loss over 50. I am, and didn’t know this. Thanks.