Answering the Top 20 FAQ's on Extended Fasting

Who should fast? Can I jump right in? How do I break a long fast? What if I have diabetes? What can I drink? How does refeeding work? What about supplements? Do I need salt? How much water do I need?

1. Who should do an extended fast?

• Those with spike protein disease, either from the COVID vaccine or long COVID. I explain how to get tested for high levels of antibodies here (continued high antibodies mean high spike protein), and explain symptoms and who might want to get tested here.

• Those who want to reverse insulin resistance and break through a weight loss plateau. I cover insulin resistance and weight loss resistance in this post: Understanding Insulin is the Key to Fasting Success

• Those who need gut rest, want to heal an autoimmune disease, reduce inflammation, reset the immune system, promote autophagy which slows aging, heal fatty liver disease, and reverse type 2 diabetes. In this video, I cover the scientific evidence showing that extended fasts accomplish all those things.

2. Can I jump right into extended fasting or do I need to work up to it?

I recommend practicing at least one month of intermittent fasting (IF) before attempting a fast longer than 24 hours. If you need to know how to get started with IF, read this post: The Three Week Challenge

I also recommend that you eat a diet with moderate to lower carb intake. It’s best to eat high protein, high fat, and minimal ultra-processed foods (chips, cereal, crackers, fast food, etc). You do not need to be on an official keto or Atkins diet. But if you are addicted to large amounts of carbs and sugar, you will find fasting very difficult.

This is especially important for the last meal right before your fast. The lower that meal is in carbs, the better you’ll feel during the fast.

3. How do you define extended fasting?

People define extended fasting differently. For the purposes of this Substack, I’m going to define it as any fast longer than 24 hours.

4. How do you break an extended fast?

The short answer is very slowly, by sipping or nibbling tiny bits of food over a period of a half hour to two hours, depending on how long the fast was. The details of how to do this are covered in this post: How to Break a Fast.

5. Do longer fasts have a cumulative effect, meaning, does one 72-hour accomplish more than two separate 36-hour fasts?

The one 72-hour fast will absolutely accomplish more autophagy and cellular healing than two 36-hour fasts spread out. Furthermore, you will get an immune system reset from stem cells and other stem cell production from the 72-hour fast that you will not get from two 36-hour fasts. That said, you will definitely get some autophagy and health benefits from even the 36-hour fast.

6. Do you recommend I fast longer than 72 hours?

Once you get beyond 72 hours, your body will begin to slow down your metabolic rate a little. Up until the 72-hour mark, your body raises its metabolic rate. However, there are certain instances where the benefits of a longer fast will outweigh the slight metabolic slow down which should recover.

These cases apply to severe type 2 diabetes, cancer, or other severe health problems not responding to other treatments such as severe gut problems. If you are considering this, I highly recommend you book an appointment with me so we can discuss this. You need support to do a longer fast. You can also work with Dr. Jason Fung’s TheFastingMethod.com if you prefer. Their coaches have a lot of experience.

7. Can someone fast who has type 2 diabetes?

Regular fasting can cure people of diabetes in months and sometimes weeks. I often have people message me that their blood sugar numbers came within a normal range after fasting for only 2 weeks after being high for years. Read the success stories in this post: Reversing Diabetes Success Stories.

However, there is one very big caveat. If you are an insulin-dependent type 2 diabetic, you need to work very closely with your doctor to fast safely. The body knows exactly how to handle fasting on its own but when you are injecting it with insulin, this can be a dangerous situation because your blood sugar can get too low from combining injected insulin with fasting.

Many diabetics come off of all insulin within days/weeks of intermittent fasting. Taking too much insulin while fasting could cause you to pass out. Work with a doctor who is familiar with fasting so he can help you taper appropriately. The safest plan is to take no insulin at all while fasting, but stop only with a doctor’s approval.

8. Does it matter what you eat when you break the fast?

Yes! This is your opportunity to retrain your taste buds because the first food you eat will taste amazing. Therefore, eat the most nutritious foods first. Some ideas: beef liver, oysters, egg yolks, red meat, salad, veggies, bone broth.

One of the most beneficial things you can do is train your taste buds to appreciate savory and umami flavors. This is one of the many reasons I find that zero-calorie sweeteners such as Stevia hinder people’s weight loss progress. Since those sweeteners are so much stronger than sugar, they over-stimulate the sweet taste receptors on the tongue and cause the brain to release insulin, your fat-storing hormone. For a full discussion, see How Zero Calorie Sweeteners Can Sabotage Your Success

9. Is it important that extended fasts be clean fasts defined as water, black coffee, and black tea only?

Absolutely. However, you can also have sparkling water if it’s unflavored. Clean fasting keeps you deep into fat-burning mode. See Why Should I Clean Fast? for a full discussion.

10. Is there a limit on how often one should do extended fasts?

The general rule I use with most clients is three 36-hour fasts per week and one 72-hour fast per month. However, in cases of very high spike proteins, Dr. Pierre Kory recommends up to two 72-hour fasts per month.

Dr. Fung also uses a two 48-hour fast per week protocol, and I have found that some people enjoy this although I’ve not tried it myself on a regular basis.

11. How does refeeding work?