Hello Holistica Patients and Friends!

Happy 2024! May you all start your year invigorated and ready to dive into a new chapter of your health and healing.

I cannot resist any modality that helps patients gain self-sufficiency in their healing, reduces reliance on pharmaceuticals, improves numerous areas of one’s health, and can be done by oneself (for the most part). It is a great love of mine to teach people autonomy over their health and healing.

The new year is always a great time for a reset, and often people see some sort of cleansing or fasting for a recalibration. There are more ways to fast and cleanse than can be counted: however, there is one approach that has caught my attention. Fasting can address numerous health conditions, such as autoimmune disorders, cardiovascular disease, thyroid disorders, digestive ailments, fatigue, and just about every hormonal challenge one can face. Many people have heard of or have tried intermittent fasting (IF), but I have a new proposed way to approach fasting. There are three main concepts to share:

Metabolic Fitness:

The goal of fasting is switching between metabolic states: sugar burning or fat burning to gain metabolic fitness. This is what we are trying to achieve when we intermittently fast, but doing the same fast day in and day out encourages your metabolism to become tolerant of the fast. This is called: “laziness when fasting”. Fasting the same way every day can be counterproductive for many people. You might not get into the fat-burning state ever, and you may never realize this. We benefit most from fasting by “stressing” or alternating the fasting periods so that we do not become “lazy” metabolically.

When we fast for 12 hours, we are sugar-burning, and longer fasts (>13 hours**) push us into the fat-burning states where we can heal, rejuvenate, calm inflammation, and have a clear mind and exponential energy. Consider fasting, like pushing yourself into one state or the other, like flipping a switch. You will see major health benefits.

Fasting Cyclically (for a woman menstruating on average every 28 days): 

Ideally, we are doing longer fasts of 13-72 hours (follicular phase of the cycle, days 1-10, and after ovulation for 5 days 16-20), and shorter fasts of 13-15 hours for some months (mid-cycle days 11-15) and no fasting (day 21 to menses). Men should alternate their fasts also – one suggestion is to fast 13-72 hours** for 2 -3 weeks. You can fast for 10 days in a row depending on your goals, or every other day and take one week off without fasting at all. Ideally, you are doing longer fasts like 24 or 36 hours more infrequently–1-3x per month.

When you fast in this manner, you are supporting different hormones at different times of the month. This encourages hormonal harmony, can eliminate hormonal challenges, such as PCOS and PMS, and can encourage adrenal balance and promote energy.

If you have adrenal fatigue, wearing a glucose monitor can help you understand if you can fast without putting your adrenals in further stress. If you can fast for 13 hours without seeing irregularities. If blood sugar readings are below or above the normal range of 70-120 then you are fit to fast. If your blood sugar is dysregulated, then focus on adrenal health for several months and then re-assess.

Re-feeding: 

Some people who are on intermittent fasting struggle with hunger, fatigue, irritability, and diminished brain power on their fasting schedule. This is a signal that they may not be refueling properly after the fast has ended. It is crucial to end your fast with protein and good fats. Eating carbohydrates to end a fast causes problems with estrogen metabolism, increases insulin spiking, and raises glucose dysregulation. Suggestions for re-feeding include lean protein (e.g. poultry, fish, eggs, tofu) and healthy fats (e.g. avocados, seeds, nuts, eggs, olives, olive oil). The more good fats you consume, the more successful you will be at switching to the fat-burning stage. I repeat: the more fats you eat, the more success you will have. For longer fasts (>24 hours), start re-feeding slower with bone broth, and fermented foods to re-feed your microbiome and olives. Always seek medical guidance for longer fasts…always.

Fasting with greater awareness about what is happening can be achieved by wearing a Continuous Glucose Monitor. By watching what happens when you eat, and more importantly, what happens to your blood sugar between meals, you will gain a great deal of information about your metabolic health, adrenal health, why you might have hormone challenges, how your energy might improve, and how to optimize your cognition and weight loss.

For more information, I have attached a fasting handout we share with patients at Holistica that has information to take this a step further. Fasting is an amazing tool to reset your health no matter what condition you are treating, and there are very few patients who would benefit from a fast that is by your cycle, your life, and your metabolism. Please reach out to your provider if you have additional questions!

Happy New Year and may you all have a healthy 2024!

Dr. Mary Shackelton, MPH, ND

** Please see the attached handout for more specific instructions HERE

** Please do not undergo longer fasts (>24 hours) without getting guidance from your provider

** Please read “Fast Like a Girl” by Mindy Pelz for a greater understanding of fasting and for more information on how to best proceed with your specific health needs.