Water fasting is a topic becoming increasingly popular amongst circles of health conscious individuals, facebook support groups, bloggers and health professionals. 
People are joining facebook groups focused on supporting one another to do extended fasts up to 40 days. While fasting is an exceptional medical treatment it is also not without its risks. 
Fasting at home can be done safely as long as certain requirements are met. Below are some things to think about when deciding when, where and how long to water fast. 
​

1. People taking pharmaceutical medications

​
During water fasting the digestive tract slows down. It stops secreting digestive enzymes required to breakdown food and medications. People taking 1 or more prescriptions are at a risk of taking too much of their medication while water fasting since less is needed. 

Also, some medications require food for proper absorption and activation. When we eat, the digestive process begins in the mouth with salivary amylase - the enzyme that breaks down sugars. It continues with hydrochloric acid in the stomach which kills bacteria and breaks down food. The food mass (known as chyme) that proceeds to the small intestine  is acidic. Chyme activates the enzymes released from the pancreas into the small intestine. Without this acidity the enzymes are not activated to break the molecular bonds in foods and medications. 

Consider adding a dense and compact pill into a gut without acidic chyme and activated enzymes. Luckily some medications are small and dissolve easily which allows for absorption but not all.  People on pharmaceuticals need to consult with, and be monitored by, a medical professional when water fasting to ensure proper dosage and a safe fasting experience. 

2. People with kidney disease (and other organ issues)

​
The kidneys regulate electrolyte balance in our bodies primarily sodium, potassium, calcium, chloride, magnesium and water. Electrolyte balance is very important for each one of our cells which use ions like these for: cell to cell communication, action potentials, movement of nutrients in and waste out of the cell. In tissue electrolytes can determine whether a muscle contracts or not. When that muscle is the heart, electrolyte balance is vital. Not being able to regulate ion concentration due to kidney disease is a total contraindication to water fasting because, among other things, it can cause cardiac arrest - heart failure. 

The liver and other organs each play a role in the body's homeostasis. Liver disease or chronic alcohol or drug use, could be a total contraindication to water fasting because this is where toxins (from metabolism, environment and fat storage) are processed for release through our bile and into our digestive system. Impaired liver function could mean a build up of toxins in the liver, muscles or organs which could cause a serious adverse event. Most of the environmental toxins we are exposed to are fat soluble, meaning they bind and are stored in our fat tissues. During a fast fat is broken down to be used as fuel. The toxins within the fats are then mobilized into circulation. If there is a lot of fat, or a high degree of toxin exposure due to industrial or job site exposure, living near sprayed crops, eating non-organic food, drug or alcohol use, history of poly pharmacy, then there is a lot of toxins for our body to process and all our organs need to be in top working order.

​If you are wondering how your organs are functioning, visit your doctor who can run blood tests and perform a physical exam for assessment. 

3. People with a current diagnosis or history of eating disorders

​
The main eating disorders today are: anorexia nervosa, bulimia, a mix of both, orthorexia and disordered eating syndromes. These eating disorders are often present in combination with obsessive compulsive disorder, another absolute contraindication to water fasting. Orthorexia is a newer phenomenon defined as an extreme obsession with being healthy. People with orthorexia have cut out so many things from their diet, in an effort to achieve maximum health, that it is actually unhealthy. This illness is also associated with extreme lifestyles such as:

• Compulsive checking of ingredient lists and nutritional labels
• An increase in concern about the health of ingredients
• Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
• An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
• Unusual interest in the health of what others are eating
• Spending hours per day thinking about what food might be served at upcoming events
• Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
• Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram
• Body image concerns may or may not be present

People with eating disorders may already have calorie, nutrient and electrolyte imbalances and possible organ compromise depending on the severity and duration of the illness. Water fasting is completely contraindicated due to this physical state of depletion and the weight loss associated with water fasting.

The state of starvation is when the body is depleted of the necessary nutrients and calories required to sustain life. In this state the body's organs are compromised, sometimes permanently. When a body enters a state of starvation, medical intervention is necessary and life saving. Someone with a current presentation or history of an eating disorder is at a higher risk of starvation, nutrient and electrolyte imbalance. 
​
In other cases, the illness may not be in total remission, or the fast could trigger a return of symptoms. 

​
4. People with an adrenal fatigue diagnosis 

​
Adrenal fatigue is a diagnosis made when people have experienced prolonged states of stress which has resulted in altered cortisol production causing fatigue, sleeplessness, anxiety, low immune function, abdominal weight gain, low blood pressure and cold intolerance. People with stage 2 adrenal fatigue may also be experiencing hair loss, menstrual cycle irregularities, PMS and depression. 

In this state it is necessary to eat regular, frequent meals to regenerate the adrenal system. Water fasting is a stress to the system that someone with adrenal fatigue can not support. 

5. Fear of fasting 


Another contraindication to fasting is having a fear of fasting because of the physiological effects it has on the body. Fear creates anxiety which can cause gut symptoms, increase blood pressure and metabolism. Fear of fasting can precipitate a negative outcome for the fast, whether it is the side effects mentioned above during the fast or difficulty with reintroduction. It is important to be informed about the process of fasting before embarking on a fasting journey and to be clear about your boundaries, health state and fasting plan.


6. Fasting for weight loss

​
This is a poplar topic on fasting groups online. People talking about how much weight they have lost, asking about how much weight you can lose, how much weight others have lost and complaining that they haven't lost enough. There is a theme. During a water fast people lose between 1-2 lbs per day. I have noticed when people are inflamed to begin with, they can lose more at the onset followed by a tapering and levelling out after 1-4 days. 

Water fasting is not a stand alone treatment for weight loss because it doesn't address all of the causes of weight gain. There are many, and compounded, reasons why people overeat or have a high weight, some of which can include: 

• ​lack of education around nutrition, portion size, lifestyle & exercise
• emotional trauma 
• coping mechanism for stress
• ​endocrine issues: diabetes & PCOS, leptin desensitization 
• food addiction
• history of eating disorder (starvation can lead to weight gain)
• side effect of medications
• genetics 

It is important to identify the combination of reasons why someone is overweight and address them all. A water fast may be partially indicated. 

During food reintroduction there is a weight gain as the body reacts to calories and nutrients coming back into the system. If a food addiction or endocrine imbalance is not addressed, someone could regain the weight they lost during the fast and more. 

Water fasting is not a stand alone tool for weight loss.

And even in this case it is important to follow the following guidelines: 


1. Fast for a reasonable amount of time


Consider the following age and duration recommendations when thinking about water fasting at home:

Age:
0 - 15 years - Absolute contraindication to water fasting
16 -20 years - Contraindicated unless physician monitored
20 - 49 years - 1 - 7 days
In a residential/In-patient setting, fasting over 7 days necessitates blood work and supervision to make sure your body is responding well to the fast and that you are safe to continue fasting. It is not recommended to fast beyond 7 days without physician supervision. 
50+ - Consider getting a workup done by a physician including blood work and physical exam to determine current state of health prior to the fast (see blood work recommendations below). Your current health status will determine the length of a water fast that is safe for you. 

Consider trying a 24 hour fast for your first one and make sure to follow my guidelines about How to Prepare for a Water Fast. Once you have experienced a 24 hour fast, you can continue to 48 or 72 hours on your next fast. 

Remember to plan an appropriate amount of time for reintroduction which is a time that you have to be mindful of the food you are eating, prepare your food in advance, and consider that you might not be in top performance. 


2. Make sure you have time off


Depending on your history of food choices, how much you weigh (toxin load carried in fat) and other forms of toxicity you may have quite an intense detox reaction. This can involve migraines, headaches, body pain, nausea and vomiting, lethargy, weakness and fainting. You do not want the added stress of being at work, or taking care of anyone else when you are water fasting. 

The benefits of a water fast go beyond avoiding food. It is a time of increased clarity and connection both with your higher self and the Divine. Take this time to become centred in your body and make room for the downloads and information that will come during the fast. If we are distracted by job tasks, kids or other obligations, this part of the fast can be lost, however the physical benefits remain the same. 


3. Have a support network you can connect with


When you begin a fast it is important that someone in your immediate circle is aware  and can check in on you for safety and support. Support can also come from someone else committed to doing the fast at the same time. 

On facebook, there are water fasting support groups which can be good to find someone going through the same process. However, beware of the medical advice offered on these groups, it can be not only false but dangerous. If you have any medical questions make sure to speak with a professional who can properly assess your symptoms. 


4. Fast safely

• Get blood work done within 1 month of beginning your fast
  • CBC with differential - this shows your red and white blood cells
  • Chemistry panel - to determine your electrolyte balance
  • ALT, AST, GGT - measurements of liver function
  • Creatinine, GFR - measurements of kidney function
  • Lipids - as a treatment marker. Do they improve after the fast?
  • Any other parameters that are relevant to your case.
• Drink enough water - 2L per day 
• Do not add anything to your water - some people think you should add salt, electrolytes or vitamins into your water. This not necessary for a fast under 7 days (if at all) and can cause dangerous electrolyte shifts and imbalances. Just water is all you need - carbonated or straight. 
• Move slowly - remember your blood pressure drops so you want to move to sitting and then standing slowly. If you are feeling faint, sit down or lay down where you are and wait until it passes. 
• Do a proper water fasting preparation. 
• Reintroduce your foods properly depending on the number of days you have fasted. 
• Have a contact who you will communicate with each day who can help you if anything comes up - this is a real life person who can come to your house if need be.

​

My next post will be about "Extended Water Fasting"




If there is a particular question you have about water fasting, please leave it in the comments and I can make sure to answer it in a following post. 



​

Many people have questions about water fasting: the benefits, the risks and how to do one properly. 
I have written about some of the benefits of water fasting in my other blog posts. In this post I will supply a guide for how to safely prepare for a water fast to prevent extreme detoxification reactions. 
​
​

Water fasting is an intensive detoxification process. That means, if you have never detoxed before, or if you are dealing with a signifcant toxic burden (post- chemo, heavy metal exposure, obesity, poor diet), a water fast can have severe reactions. 
During the intensive detox phase of a water fast (the first 1-3 days) people can have any number of reactions: dizziness, diarrhea, nausea, vomiting, headaches or migraines, 10/10 body pains. It is hard to predict exactly how someone will react. 
To reduce the likelihood of an intensive detoxification reaction there are a few things you can consider during the preparatory phase. Depending on how toxic you are will depend on the length of time that you should spend preparing for your fast. Longer amounts of time are beneficial for more toxic states.

​Here are the options I recommend:
​

A juice cleanse can be a great first step towards doing a water fast. It is a gentler detox with fewer detoxification reactions than a water fast. Because sugar is consumed in the form of fructose, the body does not go into ketosis which is the major driving force of detoxification and healing in a water fast. A juice cleanse is a break from digesting and metabolizing which uses about 30% of our energy. Without fiber the vitamins and minerals in the juice are rapidly absorbed for increased nutrition and health. Fresh live juices contain active enzymes which help to break down scar tissue and reduce inflammation. Juices keep us hydrated and help to flush out toxins through the kidneys. 

My juice recommendation for a juice cleanse would be:

• Green Juice - this is the staple of the Gerson Therapy for cancer and it is a good alkaline juice option. These juices need to be drunk fresh because they oxidize quickly and shouldn't  be stored. Consider making them yourself, or having a juice company prepare (and perhaps deliver) them directly to you. Here is the recipe. 
• Carrot apple - this is the other juice recommended in the Gerson Therapy. It is 3-4 large carrots to 1 green apple. This juice can be stored in an airless container for 24 hours. 

Avoiding juices that are highly acidic, or with too much spice and essential oil (ginger) is important because you don't want to damage your digest tract at all. 
Dosage for juices is about 8 -10 oz. 3 - 4 times per day. Juices are very filling and you might not be able to tolerate much more than this. Remember you can drink water between your juices. The number of days you choose to do the juice fast can range from 1 -7 days. 

1 day - this is a great first step in detoxifying. If you would like to go slowly and see if not eating for 1 day is even possible, take o the challenge by doing a 24 hour juice cleanse. Drink 6-8 oz. of juice 4-5x per day and see the results!

3 days - this is a beginner juice cleanse and can be done by most people. It will reduce inflammation and help to heal the gut. 

4-5 days - this is more intensive and can be done by people who are ready to experience some minor detoxification reactions, gut healing and a decrease in inflammation. 

6+ - this is an intensive juice cleanse that will produce results. Some autoimmune diseases can go into remission between 7-10 days of just juices, the gut will show signs of healing and inflammation will go down. You might notice your skin healing (reduced acne) or an aggravation of acne and rashes if there are a lot of toxins to be released.  

Note: if you have pre-existing medical conditions and you are not sure if a juice fast is safe for you, make an appointment with a local naturopathic doctor or other medical professional educated in juice cleansing to help you decide. 
​

Combine a juice cleanse and vegetarian or vegan meal each day. 
Doing juices (6- 8 oz. 1-3x per day) and having 1 healthy meal is another good way to cleanse the body. Consider a meal that is high is fresh, raw greens and vegetables like a hearty salad, buddha bowl or dahl or soup. 
Raw crackers accompany a vegan meal well - this is my recipe. 
A healthy grain like quinoa can be added for extra density and protein. 
​Avoiding gluten and dairy in this meal is an important part of this regime as well as the other suggestions above for dietary and lifestyle changes. 

Naturopathic doctors can do a provocation test for heavy metals which show the tip of the iceberg for the quantity of heavy metals stored in your tissues. They can be removed from the body using oral or intravenous chelation. 

Preparing to do a water fast before you do one can decrease the severity of detoxification reactions which make a water fast safer and more enjoyable. 

​

How to safely do a water fast at home and when to seek out medical guidance. 

- Dr. Ariel Jones