“The best of all medicines is resting and fasting.”
15-28th May 2017
Following months of insignificant improvements with regards to my arthritic autoimmune symptoms, I decided it was time to take another drastic measure and fast longer than I had ever done before. The pain in my right ankle and metatarsal joints and tendons had now progressed so badly (again) that I was limping with every step and I just felt I couldn’t live like this forever. The modern medicine my Rheumatologist was giving me (Methotrexate and Prednisolone) did not seem to help stop this progression. Furthermore, they interfered with my normal bodily processes (i.e. hormone production).
In contrast, after the previous 3-Day Juice Fast, my tendon pains and swelling disappeared. This was more improvement than any conventional synthetic pill had done recently, in such a short period of time. Unfortunately, my joint pains persisted and insidiously got worse by the weeks. Eventually the tendon pains came back again. I was convinced those 3 days weren’t enough although it was more successful than the previous 7-Day fast.
A little bit on fasting
Fasting is probably one of the oldest forms of natural treatment that may predate the existence of ancient medicine. It is an instinctive behavior that all animals engage in during times of illness or stress to allow the body to rest and conserve energy for recovery. In nature, animals such as a dog or cat will refuse food when they are sick and rest until the crisis is over and their internal healing is accomplished. Their appetites then return naturally of their own accord.
The healing mechanism of fasting works by conserving the energy required by our digestive organs in ordinary daily digestion and redirecting that towards cellular detoxification and healing. Fasting also reduces the amount of inflammation in one’s system, reduces immune system ‘over-reactivity’, increases stem cell proliferation, improves mitochondrial function, increases baseline metabolism (yes, your metabolism actually goes up by 10% after day 4 when you switch to burning fats solely for fuel), upregulates lipolysis (burning of fats) and autophagy (cellular cleanup of less than healthy cells). Thus it can help reset your immune system, lose unnecessary weight, purge cancerous cells, improve metabolic and mitochondrial health and much more. [1, 2] Additionally, past case studies show that prolonged water-fasting has been shown to induce remission of various autoimmune disorders from Rheumatoid Arthritis to Lupus and Fibromyalgia. 
The benefits of fasting were clearly recognised and promoted by early philosophers, thinkers and healers such as Hippocrates, Plato, Seneca and Paracelsus. Almost every religion and culture practiced fasting for various reasons ranging from physical to spiritual ones. That said, there are still certain groups of people where fasting is contraindicated like children, pregnant women, the malnourished and the underweight.
It is important to differentiate ‘starvation’ from fasting. Starvation is an involuntary situation that results in nutritional deficiency and eventually death. Fasting is voluntary and the individual is in full control of how long and when to start or stop the fast. Fasting is also usually accompanied by a period of refeeding to ensure the body returns to a state of homeostasis.
“Everyone has a physician inside him or her; we just have to help it in its work. The natural healing force within each one of us is the greatest force in getting well. Our food should be our medicine. Our medicine should be our food. But to eat when you are sick is to feed your sickness.” – Hippocrates
Clearly, this fast I am doing is for therapeutic reasons and this time I decided to utilize the help of modern advances in nutritional supplements as well as draw on my previous fasting experiences to fine-tune and make the most of my fast. I am pretty confident in the healing ability of fasting from my research and experience. All I needed is more time, and patience.
The aim of this fast was therapeutic and I wanted to mitigate the stress and adverse effects from fasting as much as possible. Hence there were certain strategies I used which might have helped, listed below.
1. No solid foods whatsoever – this is kinda obvious right… However it is important to note I did not do a pure water fast. Juices were permitted for the first 7 days and these were just plain vegetable juices (no fruits) so with little to no fiber, sugar or protein. Sugar, from carbohydrates, and proteins cause an insulin spike which puts one out of the fasted state. Fiber will tax the digestive system and not let it rest. I needed to spare my digestion and preserve energy for healing and detoxification. In fact, people detoxify and heal more quickly with a water fast than with a juice fast because the organs and digestive tract are given complete rest allowing for energy to be directed to cleansing and healing. Consuming juices requires energy to digest and absorb the nutrients thereby not allowing the body to fully concentrate on recovery. 
I drank upwards of 3 litres of water a day. This volume included tea and various mixtures of water with raw apple cider vinegar, lemon water or pink himalayan sea salt.
2. BCAAs to prevent muscle loss – I lost a significant amount of muscle and strength from the previous 7-day fast and it took me many weeks to gain that back. This time I decided to follow Tim Ferriss and Dom D’Agostino’s advice on taking BCAAs during a fast. This is detailed in Tools of Titans (pg. 25). Tim takes 1.5g of BCAAs upon waking and 3g intra-workout. This allowed him to not lose a single pound of lean muscle mass during a 10-day fast as opposed to losing 12lbs on a 7-day water fast only.
For this fast I consumed this brand of BCAAs and followed the 1.5g upon waking. Sometimes I found having to consume BCAAs intra-workout a little inconvenient thus I split it 1.5g before and after my workouts.
On Day 11 I started taking Fish Sauce, a few drops at a time throughout the day to get some natural forms of essential amino acids, B vitamins, minerals and good bacteria into my system. I stopped this from Day 12 as I learnt that this intermittent consumption also meant intermittent increases in insulin throughout the day. Not good for the fast.
However, later on during my research, I found that the BCAAs altogether may not be necessary after all. This is detailed in the Discussion section below.
3. Continue supplements prescribed by my Naturopathic Doctor – These are detailed below (with dosages and links) but in short they are: Homeopathic Colchicine, Wobenzym N, Vitamin-D drops, Fish Oil, Tart Cherry extract, a GI Repair formula, Boswella, Curcumax Pro and Theracurmin. The reason for continuing these supplements was I wanted to give my body some extra recovery boost through the use of the supplements. Much like how the BCAAs prevented my body from catabolizing my muscles. Additionally, I stopped all synthetic medications like the methotrexate and prednisolone I was taking.
Again, later on while continuing my research on Day 12, I realized I might have been better off without taking any supplements and just doing a pure water or broth fast. Details in the Discussion section below.
4. Ease into the fast – I started the first day with one avocado and coconut milk and for the next 7 days, drank a greens juice that did not contain fruits or sugar. Initially I drank up to 3 cups of juices a day, with 3 tablespoons of coconut oil in each. From Day 4, I drank one cup a day without the coconut oil. After Day 8, no more juices. It was just water with lemon juice, Apple Cider Vinegar or Pu-erh Tea. I found hunger was virtually non-existent after the 4th day. More details below.
5. Exercise – For the 1st week I continued my usual of 3:1 day exercise-to-rest routine consisting of gymnastics rings training, swim intervals and calisthenic exercises. However I toned things down on the second week with more rest days and less intensive training for reasons outline below.
6. Other daily practices – Thankfully I did this fast during the period after my last semester so I did not have any work or school commitments. That said, I still tried to stick to my usual daily routines. Waking up at 5am, blogging/researching, going down to get some sunlight, meditate and exercise in the morning and once again in the late afternoon, taking a nap in the afternoon and sleeping as early as possible, no later than 10pm.
After the fast though, I stopped setting the usual morning 5am alarm and allowed my body to sleep more until I woke up naturally. I figured, my main goal is to heal so why force myself to wake up so early when clearly my body wanted to sleep more. I sleep on average 9.5hrs each night now and may even take an hour’s nap in the day.
7. Breaking the fast – I had a lot of time to think about this topic and conduct my own research on this. Going straight into binging on all the comfort foods I’ve missed would be a surefire way to certain health problems. It is wise to start with small, easily digested and absorbed meals.
Besides replenishment, another aim of mine was to heal the intestinal lining of my gut while re-populating it with healthy bacteria. Hence I started with just bowls of nutrient dense fish bone broth and chicken bone broth together with their accompanying veggies and meat which were already very soft and tender from the many hours of simmering in the pot. Porridge was a good complement to the broths. I made sure to eat some fermented foods with each meal such as Fasskraut, fish sauce and chinese pickled cabbage (xian cai). I ate small amounts of fruits like watermelon, blue berries and avocado. Lastly, I started to introduce milk kefir and kombucha into my diet. I feel these have really made a beneficial impact and will write a separate post on this soon.
Regarding fibrous foods, I took a few days to gradually increase my intake of vegetables, starting from cooked ones to raw ones. Lastly, I was no longer as used to consuming coconut products as before and had to cut back and really ease into it to avoid digestive issues.
Results, Observations and Discussion
Looking at the big picture, this fast was able to achieve most of its objective which was to relieve my autoimmune symptoms as much as possible and hopefully achieve remission. I would say 85-90% of the symptoms have improved and my system feels more ‘clean’ from the detox and overall less inflamed. I guess I was being overly optimistic to hope for remission. That shall be a future goal.
1. Pain and swelling – Like the previous 3-Day juice fast, the tendon pains in both feet were the first to subside. By Day 3 the only pain left was in the joints of my right foot at the lateral topside of the ankle, including the metatarsal joints. It was also swollen and red. This area had a much slower rate of recovery and up to Day 7, I only experienced very minor improvements with each day.
However after starting on Wobenzym N. on Day 7, I experienced RAPID improvements with regards to pain and swelling. Within one day the pain had gone down several degrees and by 3 days there was hardly any swelling! However after the swelling went down, I started to feel pain in the tendons and joints beneath it. I think due to the long term nature of the injury and inflammation involved, the area had started to degenerate as do most arthritic joints that go untreated. The pain got worse on Day 10 even though the swelling was down. I then started on some warm epsom salt foot baths.
Presently, 6 days after breaking fast, the pain and swelling has gradually been decreasing with each day and I am slowly but surely regaining function and mobility. I attribute this to lots of rest (using crutches to relieve my bodyweight), plenty of healing foods like broths, kefir and kombucha and some traditional chinese red hibiscus ointment that I’ve been applying consistently several times a day.
2. Hunger and Energy
Day 2 and 3 was the worse. After that it got better with each day. I almost forgot what it felt like to be hungry and as long as I did not exert myself too hard for a workout, energy levels were stable.
Tip for hunger: hunger comes in waves. It doesn’t last forever. So when it comes, it helps to keep your mind busy until it passes. Drinking lots of water helps too – flavored with lemon or cucumber/citrus slices is ok.
I consumed quite a bit (up to 6 tbsp) of coconut oil during the first days of the fast as I thought the Medium Chain Triglycerides (MCT) would help with the hunger & energy. After Day 6, I felt that the coconut oil was giving me some gastric distress and discomfort. I removed it and all was well. By this point I could not take anymore coconut products (milk or oil) for the same reasons. It seems my gut could not tolerate it anymore.
3. Weight and Muscle
Despite my efforts, I still lost 3.5kg by the end of the 14 days. Barring a proper body composition analysis, I cannot claim this for certain but I suspect this is in the form of fat tissues rather than muscles. This is because I still felt strong and could hit my usual ring muscle-up repetitions at the end of the fast. I’d say I retained at least 90% of my strength. Besides, if a pound of fats is around 3,500 calories , it makes sense that I utilized (and would lose) a few kilograms of fats over 14 days for energy.
However, upon further research, I realized that your body does not want to burn muscles when you fast. Instead, it downregulates the level of protein metabolism to preserve muscle mass as muscle is a functional tissue that the body does not want to lose. Besides, there is a huge surplus of fat tissues in our bodies which are stored for the very purpose of releasing energy during times of fasting/starvation. Much like how a grizzly bear puts on fats over the summer to burn off during the winter hibernation, it doesn’t make sense for mother nature to design the bear to burn muscle during hibernation. The same muscles it needs upon coming out of hibernation to hunt and gather food.
If this were the case, during the previous 7-Day fast where I became so skinny and scrawny, why did I lose such a significant amount of muscle mass and strength? The answer lies in the SAID principle – Specific Adaptations to Imposed Demands. This is a concept almost all sports science students are very familiar with. I was too incapacitated from pain in various joints of my body that I had to forgo all forms of resistance exercise for more than a month. In this same period I spent most of my time lying in bed, sleeping and walked around with a crutch. Naturally I would lose muscle and bone mass simply because my body adapted to the lack of resistance or pressure on my muscles, bones and joints. This was muscular atrophy related to de-training, not fasting.
Moving forward, the aim of future fasts would still be to maintain/preserve muscle mass and strength. I will probably experiment with not having to rely on BCAAs and maybe take bone broths for extended fasts instead since it also contains essential amino acids as well as key nutrients for healing (although it wouldn’t be a true fast then). Also, when it comes to exercise I guess I should just keep up a ‘maintenance’ workout instead of going balls to the walls trying to damage my muscle fibres to grow new ones. That would be counter-intuitive to the goals of the fast which is to let the body heal and reset, not stress it more. This is a perfect segue to …
4. Exercise – The first couple of days I was still feeling strong and had the usual energy and eagerness to work out. However after a week I guess I had depleted my glycogen stores and the body was in full fat burning mode. I started noticing significant drops in my ability to perform anaerobically such as the times for my sprint intervals. Additionally, I would ache badly from a hard calisthenics workout for days. This was when I became weary of pushing too hard when in a fasted state, especially when it came to resistance or strength training. I reasoned that there was no point exercising and breaking down too much muscle and stressing my body to direct its resources to healing those muscles when my goal was to recover from my autoimmune symptoms.
Thus for the 2nd week, I settled on an easier routine that consisted of more rest and less intense exercise. I just couldn’t push myself to sprint for the swim intervals so I did 20 minutes continuous swimming instead. For the gymnastics/calisthenics exercises, I broke the training up into multiple sets throughout my day. This meant I did one set of exercises every time I took a break from writing or researching, about once every hour.
I felt this was much less stressful for my fasting body and should be the way to go for future fasts. Ideally, low intensity aerobic exercise is best.
5. Acne/pimple outbreak – From Day 3 I started to notice new pimples surfacing which only got worse as the days passed. Probably a sign of detox as I don’t get outbreaks anymore. The same thing also started happening by a few days into the previous 7-Day fast. This gradually got worse with each day until I stopped the juices on Day 7. By Day 9, I could distinctly feel a reduction in acne activity but new ones were still coming out albeit at a slower rate. This continued until I broke the fast. Its been a week since then and the acne has started to clear at a remarkable rate.
I believe the acne outbreaks are my body’s characteristic method of detoxification. It seems to be a repeated reaction to extended fasts so I can continue to expect this in the future. The skin is one crucial way our body clears toxins. I guess the only other ways are through our bodily excretions.
Thinking back, during my teenage years from 17 to 21, I used to have terrible cystic acne that manifested as boils all over my face and even my neck and back. I guess back then I was already filled with toxins and that could have contributed to this autoimmune problem I now suffer from.
In the days immediately after breaking the fast, I attribute my remarkable skin recovery to plenty of rest, bone broth, fermented vegetables and beverages (kefir and kombucha) and applying coconut oil directly on the pimples.
6. Most effective supplement for arthritic/rheumatoid/gout pain – Of all the supplements I took, it’s hard to tell which worked and which didn’t. One in particular stood out from the rest and induced significant improvements from the day I started it (day 7). This was Wobenzym N. It’s a blend of enzymes coated in a vegetarian tablet thats engineered to relieve pain from rheumatoid and gout pain. I had taken this in the past before but it did not work then. This was very effective for reducing the swelling surrounding my ankle joint in the first 2 days.
However, on the 3rd day after stopping the greens juices, the pain in my right foot skyrocketed! Wobenzym didn’t really do much thereafter. I guess it’s because my body transitioned into a deeper fasted state similar to a water fast. This causes an increase in uric acid levels which may increase pain. I continued taking Wobenzym but progress was slow and steady from there.
I then did more research and realized that taking the supplements while fasting would only cause my body to excrete enzymes to digest the supplements. Thus I would not be resting my digestive system as much as I wanted to. Since the supplements hardly made a difference, I will omit these in future fasts.
7. After breaking fast – The feeling of hunger has strangely not returned. I now skip breakfast and practice time restricted eating with my first meal usually after noon (and after a workout). This gives my body a longer fasting window each day for cellular detox.
My 1st meal is normally a huge bowl of bone broth with veggies, some protein and lots of healthy fats like ghee or coconut milk. The second would be dinner where my mother will whip up our traditional rice/porridge and some dishes (usually a steamed fish and lots of veggies). In between I continue to drink various teas, kefir, kombucha and water mixed with raw apple cider vinegar or lemon juice.
This is my 6th time fasting and 3rd extended fast. It seems the more you exercise the fasting muscle, the easier it becomes. I am starting to feel and realize the benefits of fasting other than that of relieving pain and autoimmune symptoms.
Besides the overall systemic cleansing, there is also a feeling of clarity and emotional release when fasting. I was very patient, had a better temperament and emotionally stable throughout the fast. I really began to appreciate all the little things I’ve been taking for granted such as the smell of my mother’s cooking which is multiplied several folds better when you fast.
With regards to hunger, I am no longer really bothered or too concerned with it since I’m now more confident the body can go for much longer periods. In fact, I’ve been noticing that most of the time we eat because of habit or greed and not really because of innate, instinctive hunger.
Moving forward, I am definitely going to incorporate fasting more in my life. Maybe the last 3 days of each month and a 5-day one each quarter. In fact, I’m already looking forward to the next one!
“The most important message, I suppose, is that health is really yours to take back, to take back from all the drug pushers and the people who just want you to take medications and who tell you that you can’t do it…” – Dr. Jason Fung, author of The Complete Guide to Fasting
Further readings and resources on fasting:
- The Complete Guide to Fasting: A special interview with Dr. Jason Fung
- Fasting: Molecular Mechanisms and Clinical Applications
- Brief case reports of medically supervised water-only fasting associated with remission of autoimmune disease
- Fasting and Muscle Mass
- Greek Medicine: Fasting and Purification
- Guidelines for Breaking a Fast
- Past posts:
Supplements and what I consumed:
- BCAAs – MRM, BCAA+G, Lemonade (Amazon, iHerb)
- Independent testing for this supplement showed that its safe from heavy metals
- Green Juice recipe (without the green apples to avoid sugar)
- Wobenzym N. (Amazon, iHerb)
- Red Boat Fish Sauce for BCAAs, good bacteria and B vitamins
- Coconut Oil (Amazon, iHerb)
- Raw organic Apple Cider Vinegar with the ‘mother’ – this is rich in malic acid which gives ACV its anti-viral, anti-bacterial and antifungal properties. I presumed this is good for cleansing the gut of bad bacteria or parasites which have been associated as one of the causes of autoimmune disease.
- Pink Himalayan Sea Salt (Amazon.com, iHerb.com)
- Epsom salts for footbath (amazon.com, iHerb.com)
- Kefir & Kombucha
- Supplements from the Naturopathic Doctor
- GI Repair
- Theracurmin HP
- Curcumax Pro
- liquid form of Vitamin D
- Fish oil, after finishing existing supply, am currently taking this brand
- Magnesium after finishing existing supply, am currently taking this brand (1 tbsp before bed)
- Homeopathic Colchicine to prevent build up of uric acid levels that may lead to joint pains related to arthritis or gout. (Chew 5 tab away from food x 3/day)
- Tart Cherry Juice (amazon.com, iHerb.com) to reduce uric acid in blood
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