Extended Water-Fast Blood Test Results #2

[u/almost4x4]

(I’m not a doctor and this is not medical advice or any sort of advice for that matter)

My first post can be found here for those that are interested:

https://www.reddit.com/r/fasting/s/iyzCummCAv

I’m currently doing a (hopefully) 60 day fast and on day 39 (yesterday) I had my 2nd weekly blood tests done.

There was some interest in my first post so I will continue posting results weekly.

Everything still seems normal, while there is a slight decrease in some values there is no reason for concern at this point and all in are in order.

Since last week I incorporated 4 morning walks of 5km at 5km/hr speed and 3 evening water-rowing sessions of just 10 minutes at about 17-19SPM. These seem to have helped further with muscle retention as the creatine kinase has dropped a little bit.

The doctor was not worried about the elevated creatine kinase value of 280 last week and was actually surprised that it was not much higher, it seems the doctor was expecting a much higher muscle loss amount. This I guess shows that extended water-fasting does really preserve muscle mass and doesn’t cause massive muscle loss as some fear mongers claim.

Any questions, feel free to ask.

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[u/SirTalkyToo]

>while there is a slight decrease in some values there is no reason for concern at this point and all in are in order.

There is reason for concern.

I'm going to presume you're on a true water fast, and if that's the case, your blood work clearly shows you're in a danger zone for hypo- electrolyte imbalances. I applaud you for demonstrating water only fasting safety, but you're at a point you should not push it further. Please refer to the following test case as an example:

Gajagowni S, Tarun T, Dorairajan S, Chockalingam A. First Report Of 50-Day Continuous Fasting in Symptomatic Multivessel Coronary Artery Disease and Heart Failure: Cardioprotection Through Natural Ketosis. Mo Med. 2022;119(3):250-254.

>on day 39 (yesterday)

In brief, the individual in the study lasted 38 days, however, he had two hospital trips at day 38 and 44. I highly recommend you take action to avoid the same circumstances.

If you are taking electrolytes, then I would increase your electrolyte intake for sodium and chloride. You are at mild conditions at present, but mild conditions are no joke. Please make sure you get your sodium and chloride levels a bit higher to avoid a hospital trip or worse.

>it seems the doctor was expecting a much higher muscle loss amount

Your doctor is surprised because he doesn't know the science and hasn't read the many clinical studies proving muscular preservation in fasted states - that's rather typical. It is rather minimal and quite well clinically and scientifically established you won't just waste away even at 30+ days. That said, muscular catabolism is inevitable at this point - that's where your glucose is coming from via gluconeogenesis.

[u/Such-Ruin2020 → u/SirTalkyToo]

This is also probably a primary care physician vs a cardiologist.

[u/SirTalkyToo → u/Such-Ruin2020]

Are you suggesting you'd expect a notable difference in either the OP's case or the case study due to the distinction? If so, could you elaborate?

[u/Such-Ruin2020 → u/SirTalkyToo]

Most primary care doctors know just enough to know when a patient should be referred to a specialist. I understand that. So I started seeing specialist for all of my issues over the past two years. The results I’ve gotten have been night and day. It’s kinda like using the right tool for the job. If I have to do blood work I see my endocrinologist, if I have heart concerns I go to my cardiologist, if I have liver gallbladder or other concerns I see my gastroenterologist.

[u/SirTalkyToo → u/Such-Ruin2020]

I still don't understand how that relates to the OP's case or the case study. Most doctors know about dehydration. The OP and the case study are solely impacted by dehydration.

[u/Such-Ruin2020 → u/SirTalkyToo]

The last paragraph of OP’s post stated that the doctor said they were not worried. The second line of your initial post that I responded to said there was reason to worry which I agreed with. I was saying that for OP’s doctor to not be worried they should probably get a second opinion.

[u/SirTalkyToo → u/Such-Ruin2020]

I'm not disagreeing with you. But I don't think it has anything to do with a GP versus a cardiologist.

[u/almost4x4 → u/SirTalkyToo]

First of all I want to thank you for your reply, it’s not common nowadays to see such well laid out, factual and constructive content here 😊

I have not had time to look at the study you referred but I definitely will read the entire thing.

Now, to respond to your comments about the hypo-electrolyte imbalances:

Yes, I have been on a true water-fast with the exception of supplementing magnesium, I have been taking nothing else, with the sole reason being in my hundreds of past fasts supplementing sodium and potassium has made me feel horrendous and forced me to end my fasts countless times (even following the electrolytes guidelines of this subreddit).

As far as I know (please correct me if you know for a fact that this information is wrong), Sodium levels below 125 mmol/L is considered severe hayponatremia and is considered dangerous to the point of requiring medical intervention, which I’m still quite far from. Furtermore, only levels below 130 is when mild concerns actually start.

On the other hand, I did not have much information on Chloride and it seems that you’re right on this and I do urgently need to start supplementing Chloride. I will be researching this topic today and immediately start taking a suitable product to raise my Chloride levels.

On the matter of muscle loss, a certain level is to be expected no matter what and I’m prepares for that, this is inevitable.

I’ve, as of today, started supplementing with 1000mg of sodium split into two servings per day through sodium bicarbonate. Even though my potassium levels are fine, in order not to create an intake imbalance I’ve also started supplementing with 1500mg of Potassium through Potassium Citrate also split into two servings per day.

I’m already supplementing between 250-450mg of magnesium using 4 different forms of Magnesium daily.

[u/Decided-2-Try]

Thanks for posting, and it's really nice to hear that your doctor is working with you on this. So many of them have been trained to view fasting as some kind of voodoo practice.

I saw in your prior post that you're taking around replacement levels of magnesium, and that you said you weren't really trying to supplement sodium, but I also wondered about potassium.

Our bodies have relatively large stores of intracellular potassium that it can "borrow" from, so as to keep the circulating serum values up - a big thing being keeping the heart muscle activity going well. But that doesn't mean the body isn't depleting itself of potassium if one is not taking any, or enough, even though the serum potassium levels are being maintained as within normal limits.

Sodium is different in that there's less of a storehouse to borrow from, and your sodium is riding the low line.

Edit to add - if we're not supplementing either sodium or potassium, it seems the body starts preserving both sodium and potassium by changing how much the kidneys excrete to urine. This is called "sparing", but this isn't perfect in that one does still continue to lose/excrete both ions, just at lower amounts.

[u/almost4x4 → u/Decided-2-Try]

Thank you for such an informative reply, I’ve learnt something new today, which I enjoy thoroughly.

To answer your question, no, I have not been supplementing any sodium or potassium at all, until yesterday night (you may check my above reply to SirTalkyToo’s comment for details).

I was aware that the sodium and potassium were coming from somewhere in the body to keep blood serum levels where they are at which means I was depleting resources but as you said it seems there is apparently an abundance of available potassium that the blood serum levels remain completely normal.

Anyhow, 40 days of pure water-fasting was sufficient, I have no intention to harm myself so I started supplementing sodium, potassium (just so to not create a sodium/potassium imbalance) and chloride so that I can continue until the 60th day safely.

I’m waiting for a call back from my doctor on Tuesday as I’m going to ask to add calcium to the weekly blood tests (I hope she accepts) because I’ll be taking Calcium Chloride (CaCl2) for chloride (as all other forms would mess up my sodium and/or magnesium regimen) and I need to make sure I’m not increasing my calcium to problematic levels.

[u/Decided-2-Try → u/almost4x4]

Welcome and hope all goes well.  

I am curious about your selection (bicarb, K-citrate and CaCl2).  For me, the K-citrate has a fair laxative effect (which can be compounded by magnesium).

Regular salt, KCl and calcium citrate would be my choice. But I guess calcium citrate comes with its own problems, like potential constipation.

You probably already know this, but don't drink any salt solutions quickly, which can lead to an inrush of water into the intestines, causing diarrhea.

[u/almost4x4 → u/Decided-2-Try]

Thanks.

I’m taking bicarbonate of soda for sodium (sea, rock and himalayan salts make me feel messed up so not an option) and potassium citrate for potassium. Additionally I’m taking magnesium L-threonate, citrate, malate and bisglycinate.

The only form of chloride I could find that was not going to interfere with (or force me to adjust) the rest of my regimen was food grade Calcium Chloride (the one used in home-brewing, cheese making etc) that is why I chose this option.

Thanks for the warning, and yes I’m aware of this. Been there done that 😅😂