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?


Hashimoto’s disease, lichen planus, and lupus

While many autoimmune diseases are known to be associated with one another (take celiac disease and type I diabetes, for example), few reports exist in the literature documenting what is termed “Multiple Autoimmune Syndrome,” whereby an individual patient manifests three or more autoimmune diseases at the same time.  In fact, it is commonly asserted, though not conclusively shown (in my humble opinion), that multiple autoimmune syndrome is rare. 

I do not believe that this is accurate. In my limited experience, it seems to me that multiple autoimmunity is actually quite common, particularly in individuals with documented food sensitivities, such as celiac disease/gluten intolerance. When gluten, and other food, sensitivities exist, the gut becomes leaky and allows foodstuffs, bacteria, and other pathogens to pass the intestinal barrier, where they can be detected by the immune system.  While everyone likely harbors “self-reactive” immune cells, not everyone mounts an autoreactive immune response, like people with autoimmune disease do.  Pathogen (food, bacteria, or otherwise) encounter by the immune system in the gut delivers inflammatory signals, that may then lead to the activation and response of autoreactive immune cells.  In fact, current data suggests that all autoimmune diseases may begin in the gut.

Because of the supposed rarity of multiple autoimmune syndrome, my favorite articles are case studies of individuals with multiple autoimmunity. In the case reported here, a 24-year-old female presents with lichen planus (a suspected autoimmune disease), lupus (a known autoimmune disease), and hashimoto’s thyroiditis (also called autoimmune hypothyroidism), and to date, it is the first association of it’s kind.