Fasting Part 2, Q&A

This is part 2, find part 1 HERE.

 Last week's blog post was on intermittent and episodic fasting. It went over well, but I got lots of questions, and I kind of figured I would. That's why I asked for questions, and that's why we do the blog posts.

Today, I'm going to go over some of those questions to get them answered, a part two to last week's blog post. I'm just going to jump right in.

First question I got ... I'm grouping these. I got four main questions, but they were all phrased different ways by different people, so I think if I answer these four, it'll pretty much cover what I got. When to do intermittent versus episodic fasting. That was a pretty common question in some way, shape, or form.

I guess I gave the impression that you only need to do episodic fasting if you're having trouble with intermittent fasting, if intermittent fasting isn't working for you. It can work that way. It can certainly help you become ... Episodic fasting can certainly help you become more metabolically flexible so that intermittent fasting works better for you, but there are other advantages to doing an episode of fasting. It's not uncommon for me to have patients that are doing intermittent fasting on a fairly regular basis, but they still periodically do an episode of fasting, two, three, four, five days, up to really seven, eight. I've had patients even do 10 days, 12 days worth of fasting. It has to be managed a little bit differently at that point, but there are advantages to that.

The differences between intermittent and episodic fasting, intermittent fasting is a habit you build. It becomes part of every day. It's part of your daily schedule, so you get a little bit of the benefit of fasting every single day, every single week, month, year. There are definite advantages to that. It's just built in. It just happens once you get into the rhythm of it, and I think that's great, but it's a lighter fast. It doesn't go as deep or as long. Your ketosis levels likely aren't going to get quite so high, your ketone levels, so there are limits to what it will do for you.

If you do an episode of fasting, two, three, four days, you get to a point where your ketone levels in your blood will start to increase fairly significantly. There's a limit to where they'll go, but you'll get robustly into ketosis at that point. You can check your ketones with a breath meter. Ketonix used to be the only one on the market. Now, there are two or three others. I prefer to use a blood ketone meter. I can't remember the name of the expensive one, but the cheaper one, which actually does a really good job, is Keto-Mojo, K-E-T-O-M-O-J-O, Keto-Mojo. The test strips are cheaper. It's very accurate. You can do blood glucose and ketones on it, but it’s a good meter.

If you're checking your blood ketones while you're doing this, you'll get into a deeper ketosis with an episode of fasting most likely, and your body will go into a state of what's called autophagy or ... I don't want to say your body's in a state. Maybe that wasn't phrased very well, but you'll experience something called autophagy, autophagy, P-H-A-G-Y, literally means eating yourself up. I know that sounds weird, bad, gross, but think of it more on a cellular level. When your body doesn't get food for a while, when it gets the message that it's starving, so to speak. Not only does it tap into stored resources, like your fat storage, which we all would like to burn off, but it starts to go around the body and pick up little bits of cellular trash, mitochondria that aren't working, cell membrane components that have been broken down or damaged, and it starts to break those down and eat those up and recycle those into making new components. It causes this spring cleaning, refurbishing of the cells and the cellular components in your body. Well, cells make up tissues, tissues make up organs, organs make up systems, and systems make up people.

On a cellular level, when you do enough fasting that you're getting into this autophagy phase, you are rebuilding yourself, cell by cell, brick by brick, if you will, you're working through that process. That doesn't happen much with intermittent fasting because you're just not in that fasting mode long enough.

That might help clear up the differences between intermittent and episodic fasting. I'm going to talk about it a little bit with one of the other questions in a second. That handles the difference. That handles ketones and autophagy.

Urine test strips are not a great way to look for ketones. Initially, you'll see some ketones, but keep in mind, if the urine has ketones in it, those are ketones you're not burning, those are ketones you're peeing out. The more efficient you get at burning ketones for fuel, the lower the level of ketones coming out in urine is likely to be. Just FYI. That can be pretty variable. It's also an average of time. If you're doing a blood ketone meter, you are seeing it right then and there. If you're doing a urine ketone meter, you've been producing that urine and storing it in your bladder sometimes for several hours, and so when you take a sample of that and look at the ketones and you're seeing an average of whatever block of time there was where you were creating and storing that urine. Just not as accurate, certainly very cheap, but there's a reason why they're cheap. They're just not that accurate.

That handles ketones, autophagy, why or when you would do intermittent versus episodic fasting. I think there's absolutely a place for both. I recommend both. If you're going to be doing intermittent fasting, I recommend that you periodically, maybe once a week, once a month, once a year, that you go into an episode of fasting simply because it has different effects. It's a deeper process. I think it does more, but it doesn't happen every day. That happens in episodes.

All right. The next question I got ... That covers the first two. The next question I got was ketosis, fasting, and cancer. Big question. Got it from several patients and several listeners from other places. One of the patients made a point. It was critical for him in what he was going through, and he wanted me to share that with other people. I think that's valid, so I want to talk about it.

Any time I start talking about cancer, we get lots of questions. Some people disagree with what I say, some people agree, but let me be very clear. I'm not telling you how to treat your cancer. I'm not an oncologist. I'm' not a cancer doctor. I'm not telling you how to treat your cancer.

I am going to reference a book called Tripping Over the Truth, Tripping Over the Truth. The author's last name is Christofferson, so it's pretty easy to find on Amazon or whatever book retailer you prefer, very good book. It's one of the first books I recommend to any of my patients that come in and are cancer patients. I want them to read that book. It explains a metabolic theory of cancer. There are two main theories of cancer, genetic and metabolic. This explains the metabolic theory of cancer. I don't think ... Personally, personally, my opinion, I don't think we are squarely in one camp or the other. I think the metabolic theory and the genetic theory do have room to fit together like puzzle pieces and complete the picture of how cancer develops, but a whole different video.

Cancer and ketosis, where does it fit in? In the book, they talk about not necessarily sugar causing cancer, but sugar being rocket fuel for cancer. If there's cancer growing in you a little bit, you feed that sugar, and you're asking for this explosion. You're fertilizing the cancer at that point.

People that disagree with me, I've had arguments with oncologists in the past about this. "Oh, sugar's get nothing to do with cancer." Understand how a PET scan works. P-E-T. PET scan. You'll understand why we clearly say with confidence that sugar feeds cancer. If you were to get a PET scan to find out where cancer is in your body, they start an IV and they put in radioactively tagged glucose, sugar. They put it in your veins, and then they let you lay very still for 15 or 20 minutes, so you're not using muscles and doing all of that. You lay very still. Then, they do this, basically a CAT scan on you, and all of the places where that radioactive sugar has congregated, those light up like little light bulbs in your body because they're much more metabolically active than the rest of your tissue. They're taking up that sugar at a much higher rate than the rest of the tissue in your body, and those are the tumors.

If a PET scan works because the tumor's take up the radioactively tagged sugar more rapidly than any other tissue in your body to the point where they light up on the CAT scan like little light bulbs, then cancer likes sugar. It's not rocket science.

That being said, if you picture these tumors in your body, let's say I got a tumor here, picture that tumor sucking up sugar. It's changed its metabolism, it's fermenting sugar for fuel, so it does a couple of things. It ferments sugar, and it reproduces itself. It's like this little primordial survival mode that it's in. Just replicate as fast as you can and suck up all the sugar you can.

One of the things you'd like to do is deny it the sugar. Let's starve that thing. If the rest of your body can live on ketones, but the tumor can't, then why not put your body in a state of ketosis.

A book like Tripping Over the Truth would recommend that when you get your diagnosis, as soon as you find out you have cancer or, really, as soon as you're fearful that it's there, when you find something that's going to send you to the doctor to be investigated, do an episode of fasting. Put yourself in ketosis. That's also partly why it's important to be metabolically flexible. That way, any time you choose to, you can put yourself in ketosis, but why not do an episode of fasting, get rid of all the carbohydrates, let your body burn ketones. If you have enough body fat, fine. If you're a competitive athlete at 12% body fat, you're not going to be able to do comfortably three or four days of fasting. Then you're going to have to add more fat to your diet as fuel for you to live on, but just leave the carbohydrates out.

You go into a state of ketosis. You're starting to starve the cancer. At that point, if you go in for a cancer treatment, chemo, radiation, surgery, whatever, the cancer's already in a weakened state, so if you take a weakened cancer and apply something that's supposed to kill it, that's what we call a press pulse approach.

Press pulse is terminology that's been used in, I guess, environmental science, evolutionary science, where a certain species is put under pressure, that's the press, by changes in environment. Their food supply is dwindling, or they're being hunted by more predators than they used to be, something like that. That's the press. Then, there's a pulse. Then, there's a volcano eruption, or there's some major shift in the environment. Winter comes. That would be a pulse, and that's what knocks them out, and they go into extinction. There's this press pulse approach with cancer in this way, that if you flush your body with ketones and you're not providing the sugars that the cancer wants, that's the press. That puts pressure on the cancer cells. They're not as healthy as they used to be. They're starving. They're wandering what's going on.

Then there's the pulse, whether that's chemo or radiation, or whether that's an alternative treatment, like hyperbarics or ozone or [inaudible 00:12:28], whatever. I'm not recommending or denying that any of these have any impact. I'm just saying these are some of the things that my patients have done over the years. Regardless of whatever treatment you're doing, let that be the pulse, but let the press be denying the cancer the sugar.

Any of you that have spent time in a chemo room know that they feed you sugar. There are literally ... When you're in there getting your IV of chemotherapy, there are donuts and chips and crackers and Ensure and Boost. It's like they're throwing sugar at you when you walk in the door. Stupid, stupid.

Anyway, all right. I won't get on that soap box because we'll be here all day.

Cancer and ketosis, cancer and episodic fasting, if you can't fast into ketosis, here's the next big question. What about putting yourself on a ketogenic diet, eating enough fats that you're in ketosis, like 70% of your calories from fats, keep the carbohydrates at 20 or 30 grams a day or less? That should put you into ketosis. You're not burning off your storage, but you're burning off the fats that are coming in here.

From a cancer perspective, same difference. If you're thin enough that you don't have body fat to burn off, but you want to be in ketosis, feed yourself into ketosis. There are lots of resources on how to do that.

Exogenous ketones, which are ketones that come in as a supplement, there are lots of companies out there making exogenous ketones. They definitely have their place in the market. They're great for brain function. If you are going to fast, putting in a little bit of ketone can give you a little boost of energy. It could take care of some of the hunger cravings, so not a bad idea in that sense. Most of them don't come with any carbohydrates. Watch for weird sugars. Sometimes, they have xylitol and stuff in them, which can be problematic for many people, but the research on cancer, whether flushing yourself with ketones in a supplement form has the same effect as fasting or ketogenic diet, that research is a little bit fuzzy, so just be aware, but probably better to have ketones from an outside source than not have ketones at all when you're going through a process like that.

That's cancer and ketosis. I don't want to get too far into it. I guess I can do a whole nother video on it if you guys really want, but, again, I'm not telling you how to treat your cancer. I'm not telling you that ketones get rid of cancer. I am just presenting information that was in the book, Tripping Over the Truth, and some logic and telling the chemo rooms to get rid of the sugar, kind of not debatable there.

All right. Last main question, and it's going to seem silly when I ask, but I think it's actually a really good question. What can I eat while I'm fasting? First of all, not much, but to not make a joke out of it, truly, something is going to go in your mouth while you're fasting, water, herbal teas, not sweet tea. Those of us Texas, Georgia, places like that, not sweet tea. Herbal tea, coffee, black coffee, water, not your mocha frappe-caramel something latte, whatever. Just plain black coffee. Try to make sure it's good quality. One of the most common contaminants in coffee is mold, so if you get a coffee that's tested to be mold-free, that's fantastic. Organic is a nice second choice. Doesn't guarantee there's no mold.

Anyway, coffee, tea, water, bone broth. Bone broth, my favorite brand is Kettle & Fire. If you look at the patient resources section of this page, you'll see a link to Kettle & Fire. Bone broth has fat and salt in it, some minerals in it that you'll need, electrolytes and things, but it really doesn't have any carbohydrate in it, so it's a great resource while you're fasting. Day two, three, four, you're going to need some electrolytes at that point, so make sure some of that comes in.

Those are all options while you're fasting. Can you just do a water fast? Yes, you can, but you will likely get to a point where you are significantly craving salt. If you want to put some salt in your water, Redmond's Real Salt is the brand name of what I recommend most. Himalayan pink salt would be a nice second choice, some kind of sea salt, to get you the electrolytes, but without the sugar. At that point, some people even just put salt in their water and drink it and actually crave some of that.

Fruit and vegetable juice, a lot of people want to do that because it's very nutrient-dense, and it's get some of the electrolytes in it, but be very careful of the carbohydrate content in that. It will likely take you out of ketosis, so I would avoid that while I'm fasting. A juice fast is certainly valuable. It's a whole different thing. It's not likely to put you in ketosis. While you're fasting, if you're doing it to get into ketosis, then I would avoid the juice fast, or simply do your juice at a particular time and then wait 24/48 hours before you do it again.

There are certain pills you can take. For example, in my office, SP Green Food or Cruciferous Complete that have vegetable material in them, but they really don't have much in the way of carbohydrates. Something like that could be something you could use.

If you've seen me talk about the energy bits and recovery bits, they're very low carbohydrates, so they could be used while you're going through a fast to provide some extra detoxification capacity without putting carbohydrates in.

Let's see. Some people ask about taking their supplements. Generally, supplements are going to be okay while you're doing a fast. Just be aware of how many carbohydrates there are in those supplements and whether or not they bother your stomach.

Medications on supplement ... Because if they bother your stomach, you're going to want to put food with them.

Medications on your fast, I certainly would not tell you to stop your medications. However, some medications may be problematic when you fast. Let's say you're taking a blood sugar medication, metformin or glipizide or one of those or we're taking insulin for that matter and you start to fast. You need to watch your blood sugar very carefully. You may require little to no blood sugar medication while you're fasting. You might still require some. I've had people go as far as five or six or seven days before their blood sugar even comes down into the normal range, and so they take their medication until their blood sugar gets low enough that they can't. I'm not advising them when to take their medication, but their doctors have taught them that if their blood sugar gets down below a certain level to not take their medication so they're just following those orders. I just encourage them, if they're going to be fasting, to watch their blood sugar carefully because they may run into that problem.

Blood pressure, similar issue. If you're on a blood pressure medication regularly and you fast for three or four or five days, your need for that medication may decrease or even disappear, and if you continue taking it, your blood pressure may get very low, so check your blood pressure. Just monitor yourself and make sure that your medications aren't becoming problematic when you fast.

If you ask your doctor about it, I actually think I did a whole video on this about one point about the whole ask your doctor phenomenon. Ask your prescribing doctor about it, but be aware if you ask a doctor about how fasting is going to impact your medications and that doctor has no education in fasting, you're not going to get an answer that's worth anything. They're simply going to tell you, "Don't fast. You're gonna die. Why would you do that?" Well, you're not going to die. That's not the way it works, but if you ask a doctor about exercise or fasting or ketosis or supplements or anything, and that doctor has no knowledge of it, you have not done yourself any favors. You've fulfilled the legal requirement for people like me to say, "Ask your doctor before you do this," but you haven't done yourself any favors.

Find a functional medicine doctor or find a prescribing doctor who's also familiar with some of these concepts so that they can answer your question meaningfully.

I think that handles what to eat while you're fasting or what not to eat while you're fasting.

Protein powders, sorry. Those do come up. A low carbohydrate protein powder, not a bad idea. You can do some collagen powder while you're fasting, but if you get enough of a load of protein all at once, you can turn that into blood sugar and it can raise your insulin levels. Insulin levels stop the ketosis immediately.

Steroids, if you are a chemotherapy patient and they're putting steroids in the chemo, at significant enough amounts, that can raise your blood sugar, cause an insulin response, and you're out of ketosis. I guess in that case, if you have fasted yourself into ketosis, you go through chemotherapy, you may want to have some exogenous ketones to take while you're finishing that off because once they put the steroids in, you can check your blood with the Keto-Mojo meter. If you start to come out of ketosis, just put some more ketones in, and, that way, you'll stay in through that.

Again, ask your oncologist if you're allowed to do ketones while you're taking your chemotherapy, but be aware your oncologist may know absolutely nothing about ketosis and chemotherapy, so you might do your own research or present your oncologist with the research you found so that they can have that kind of substantive discussion with you.

I don't know. I think that pretty much covers the questions that I got. I really appreciate you guys interacting with me on this and asking your questions. I know, right now, the blog post doesn't have a place for comments and questions, and I apologize for that. That's an issue in the software I'm using to handle that, that they are working on correcting, but, in the meantime, ask your questions on Facebook or Instagram, and I collect those, or you can private message me or email me at the office and ask me questions. The office email address is [email protected]. Pretty simple, but email me your questions if this video didn't finish it. Hopefully, this ends the fasting discussion, and we can move on to other stuff, but I will answer as many questions as I need to.

That's it until next time. Like I said last time, some people didn't get the joke, I always see eat for your health, train for performance, and live the life you love today. Because we're talking about fasting, I said, "Eat for your health or don't, train for performance, and life the life you love today."

Thanks for watching. Have a good one.