3 Day Fast Experiment

In a previous post, Starving Yourself Awake, I wrote on the eating = asleep phenomenon (i.e. postprandial somnolence) experienced by many people, including those with narcolepsy.

In conducting research for the article, I discovered several key links between orexin activity (orexin expression and orexin receptor expression) and fasting.  A few of the important connections are summarized below:

1) Orexins stimulate arousal and wakefulness.

2) Orexins are found in the hypothalamus as well as the gut, and are up regulated during starvation/fasting, and inhibited during feeding (particularly in response to glucose).

3) Women with anorexia have been demonstrated to have higher levels of circulating orexin, while narcoleptics (with cataplexy) have little to no orexin in their CSF.

In addition to the specific effects of fasting on orexin and orexin receptor expression in the brain, fasting has been demonstrated to be effective in management of other autoimmune diseases, including MS, rheumatoid arthritis, and lupus (SLE). To my knowledge, no one has yet scientifically demonstrated this effect in narcoleptic patients. 

In light of these findings, I am conducting a 3 day fast to determine it’s effects on wakefulness and energy levels. The last time I ate was 9:00 PM 6/17/2012, and I slept 7 hours last night with no memorable sleep disturbances or hypnogogic hallucinations. I will post daily with reports on energy levels and wakefulness, and hope to provide anecdotal evidence to support (or refute) the use of fasting in narcolepsy.
——–UPDATE – 38 hours———

I have now been fasting for 38 hours. So far so good.

I do not have any remarkable changes in mood or energy level, as of yet. Last night I was less sleepy than I normally am upon laying down, but I didn’t have any trouble falling asleep. Only have had 2 short (less than 5 minute) periods of hunger (complete with tummy grumblings), but otherwise have not felt hungry.

I am hoping to see changes in energy levels and beginning about the 48/60 hour mark. My goal is to do a complete 3 day (72 hour) fast, but would be happy to make it to 48 hours. More updates tomorrow!

—–Update 48 hours——

Because I didn’t see any remarkable changes in energy level or alertness, I broke my fast at 48 hours.

I promptly went to sleep, and have been sleepy since breaking my fast.

That said, becomming sleepy after eating doesn’t really account for the fact that I didn’t feel dramatically more awake on the fast, as I had expected. Now, I did have coffee during the fast – maybe that was what kept me from feeling any better than I did?

Most people who fast for autoimmune therapies do a water only fast, and also may fast for up to two weeks! Especially because I was so dramatically tired after breaking my fast, I would like to reattempt the fast, this time for longer and to do a complete water fast.

I also think that a ketogenic diet (i.e. a diet from only fat and protein) may be more beneficial to narcolepsy than by fasting alone. 

In the first place, the benefits of fasting arise from your body’s ability to use fat and protein stores for fuel; carbohydrate metabolism (other than those arising from gluconeogeneis) are not utilized. Secondly, it was recently demonstrated that a diet of amino acids activates orexin producing neurons, and that the excitatory effect of dietary amino acids outweighed the inhibitory effect of glucose.

The best dietary “prescription” to be then would seem to be a gluten-free (benefits covered in other posts), low-carbohydrate ketogenic diet, coupled with bouts of intermittent fasting.

Anyone out there with fasting experience and narcolepsy? Or other low-carbers? What about for the treatment of other autoimmune diseases?

 

5 thoughts on “3 Day Fast Experiment

  1. To treat narcolepsy I went low carb and gluten free last July. In the first 3 months of changing my diet I was religious about carbs and kept to 20g per day. I was absolutely euphoric that 3 months…being awake was like a drug.

    At the 4 month mark I slowly increased to 50g per day and that was the beginning of my true struggle with carbs. They are like cocaine, even in small amounts. When I’m strict and hit ketosis I am awake and full of energy. Too many carbs over 20g and I’m still awake but my energy level tanks and my motivation takes a big hit.

    That being said, I noticed that I always got tired at the same times each day…10am, 2pm, 8pm…almost exactly an hour after eating a meal (as opposed to eating a snack). Didn’t matter if it was too many carbs or right on the mark. Too many carbs would make me sleepier than just the right amount of carbs would.

    Your post has me intrigued. I’m back on the 20g per day plan and want to stabilize this for a month or so. After stabilizing I’m going to give intermittent fasting a try. I’ll let you know how it goes.

  2. Madcap,

    Glad to know there are others with this out there.. and I am exactly the same way. Had a similar experience, too. When I first went GF/low carb I was super-strict and felt like a different person. The longer I go, the harder it is. Narco hasn’t come back, but ultra-low carb is difficult for me to maintain for really extended periods of time.

    My boyfriend can eat anywhere under 100 carbs/day and stay in pretty decent ketosis, though he doesn’t notice the wakefulness – promoting effects like I do. My limit also seems to be 20 carbs/day and no more. My sleepy-times are almost the same as yours too.. I am usually okay in the morning, but at 3 pm and 7 pm I’m almost dead if not in ketosis. I can handle more carbs (>50/day) if I run, but it is difficult to run so long every day while in grad school. I’m okay the day that I skip the run, but after the 2nd or 3rd day of no running and about 50-70 carbs/day, I am struggling again. I also find that the more carbs I eat, the more I want to eat, and medium-carb is more difficult to maintain than ultra-low carb for me.

    I’m going to be making a post soon, but one thing that I have recently started doing (for about the past 3 weeks) that has really dramatically improved my daytime sleepiness is L-tyrosine. I have been taking 5 grams per day (it’s about 9-12 pills of the OTC stuff). From what I can tell, the effect eventually wears off, but it hasn’t so far. The result has been actually quite incredible. I’m up until 11pm at night and up at 6am with no problems whatsoever. I’m not euphoric like I am when I’m doing <20 carbs/day, but I am stably awake with no energy swings.

    Definitely keep me updated on the intermittent fasting when you get there. Low carb is kind of easy by now, but the fasting is tough to get through on the first day. Mostly because I'm accustomed to eating more than hungry.

  3. The book “Lights Out: Sleep, Sugar, and Survival” points out a host of conditions brought on by too little sleep- type 2 diabetes, high blood pressure, depression, breast cancer. The author says we evolved to have lots of carbs in summer when the days are long and less carbs for the rest of the year. When you eat too many carbs, and don’t get enough sleep and vitamin D, the results can be disastrous. Interesting to note a ketogenic diet can benefit many cancers such as brain cancer. So by eating fewer carbs, we protecting ourselves from cancer. Nice.

  4. Christina, I love your blog and I hope you’re making good progress towards your degree!

    I started having narcolepsy symptoms when I was 17. Later that same year I developed an eating disorder (anorexia). It was a horrible time, but even though I was too exhausted to walk up the stairs, I was more awake than before–allowing me to study like a madwoman and do well my first semester of college.

    I made progress with the eating disorder and resumed my consumption of pizza, doughnuts, cookies, and so forth–not pigging out, just eating like a normal person. I also started getting tired and sleeping all day again. I chalked it up to my body trying to recover from months of starvation. But it didn’t go away after a year… or two… or graduate school. I fell asleep in classes and conferences (and was chastised multiple times). I fell asleep for ten minutes after lunch break during one of my standardized exams (oops). I fell asleep during the presentation while interviewing for a job (after eating the muffins they served us for breakfast).

    Now, I’ve had some mild relapses with the eating disorder over the years. Every time it happened, I felt better mentally–smarter, faster, more alert, no more sleep attacks. In fact, I think my narcolepsy was the trigger for the eating disorder (more than body image, control, social pressure, blah blah blah). An innocent, harmless diet led to increased alertness and encouraged me to starve myself further, and on and on until I wasn’t eating enough to stay healthy.

    I thought I would have to choose between being sleepy or being sick from starvation until I went gluten free. Some people in my family have tried a gluten-free diet for gastrointestinal symptoms and recommended that I do the same for health reasons. My initial reaction was basically: whatever, this is just another fad. But I did it anyway, and guess what? I work up to 80 hours a week these days. I’m okay. Yeah, I’m tired because I work 80 hours a week, but I’m not exhausted. Sure, I have to do accounting on my hours of sleep and I can’t go bar hopping with my coworkers on a work night, but I’m not spending all day in bed anymore. It’s incredible. 🙂

  5. Hello Kristina! It was a pleasure meeting over the weekend at AHS. I recently began experimenting with intermittent fasting for my autoimmune disorder, Ankylosing Spondylitis.

    I have always noticed a strong relationship between fasting and my symptoms, as well as that between my blood sugar and my symptoms. I’ve been ketogenic paleo for a couple years now and I have gotten great results, but not the remission I seek. Intermittent fasting is the next frontier.

    My current meal plan has be on the Warrior Diet, so I allow myself a daily eating window between 4pm and 8pm. So far so good after two days. I feel reduced symptoms in the morning and they continue to reduce until I eat at 4pm.

    I’m curious, would you have any thoughts on how to best go about a longer term fast, such as for 2-3 weeks? This seems most intriguing given the anecdotal evidence regarding remission.

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