Will intermittent fasting help my autoimmune?Dec 27, 2022
This is a HOT topic in the health and wellness industry. Advocates for intermittent fasting are PASSIONATE about the science and “proven” results for lowered inflammation and associated weight loss. Yet, those with autoimmune have mixed results when it comes to intermittent fasting and there are reasons for that.
Let’s dive in.
What is intermittent fasting?
In a nutshell, intermittent fasting is just that: fasting intermittently.
You limit calorie intake during certain hours/day or days/week so it’s more of an eating pattern than “a diet.” This means, you limit when to eat, and not so much what to eat. This appeals to people who don’t want to count calories, cut out certain inflammatory foods or use their food log to track everything.
Many also claim this is a more natural way to eat because we lived life for centuries without eating every hour on the hour. There are lots of variations for intermittent fasting so people can choose what works for them, including:
- 16/8 which is a 16 hour “fast” and eating only within an 8-hour time span (a popular recommended window is 1pm – 9pm).
- 5:2 days of fasting, where you eat regularly for five days of the week, then take in just 500-600 calories/day for the other two (non-consecutive) days.
- Stop-eat-stop, where you fast for 24 hours once or twice a week, taking in only water.
Is intermittent fasting effective for lowering inflammation or weight loss when you have autoimmune?
In the health and wellness world, intermittent fasting is like the magic bullet of weight loss and "health." For this reason, many with autoimmune jump on the bandwagon because everywhere you turn, a health coach or professional is talking about its benefits beyond weight loss, including reducing inflammation, improving insulin sensitivity, reducing cholesterol, improving brain health, protective mechanisms against cancer, and even anti-aging benefits.
There is also a lot of convincing science backing the process. However, it’s not specific to autoimmune. Or women. And when you consider that 75% of autoimmune diagnoses are women, this matters. And in some cases, intermittent fasting can actually contribute to inflammation and discomfort.
I’ll talk about that later on, but first, let's look at some studies.
How does intermittent fasting work for inflammation and weight loss?
When you are fasting ... at the cellular level ... your body produces the right type of hormones to help break down stored fat as an energy source. In a fasting state, the body produces more glucagon and human growth hormone, insulin sensitivity can decrease, cellular repair occurs, removing old or damaged proteins (autophagy) AND there are changes in genetic expression that promote longevity (aka anti-aging).
According to one review study, intermittent fasting helped people to lose 3-8% of their weight over 3-24 weeks. In this study, people also lost 4-7% of their waist circumference (i.e., belly fat). Another study of 100 people with obesity showed that after a year, the people who fasted on alternate days lost more weight than people who didn’t change their eating pattern.
BUT … and here’s where it’s interesting …
They didn’t lose any more weight than those on a calorie restricted diet, AND out of the people who were following the intermittent fasting protocol, 38% of them dropped out because they couldn’t successfully maintain the program. This means, they found it stressful or not sustainable for their lifestyles.
Next, another study of 90,000 people who skipped breakfast (how the majority of people approach intermittent fasting) showed that those who were already overweight tended to have high blood glucose levels and inflammation markers later in the day. This matters when you have autoimmune for a couple of reasons.
First, you’re trying to lower inflammation - this is why you’re working with your doctor on medication and trying your best to learn how to eat for your body and condition. Next, elevated blood glucose is a side-effect of inflammation for many with autoimmune, especially when you have a rheumatic condition. Imbalanced blood sugar and elevated glucose also causes more inflammation in the body, fuelling brain fog, food cravings and fatigue
Yet, there is a promising study on the positive effects of IF for rheumatoid arthritis.
The results not only showed improvement in clinical symptoms, but also lab values of ESR and CRP, which are a marker of inflammation in the system and are correlated with disease severity of rheumatoid arthritis. The researchers suspect that the positive results were due to improvement in gut flora, improved metabolism and decrease in intestinal permeability (leaky gut).
However, intermittent fasting alone was proven to be effective only temporarily, with the symptoms returning or even flaring up when the food was introduced again. Sustainable success depended on what they were eating and lifestyle factors in managing inflammation, NOT intermittent fasting.
Is intermittent fasting right for you?
Intermittent fasting is not for everyone - especially if you're a woman with autoimmune - but it doesn't mean it's not possible. Here's what I consider in my practice.
First, when you have autoimmune or an inflammatory condition, you have different nutrient needs than someone who does not have autoimmune. Research shows nutritional imbalances or deficiencies in B12, iron, Omega 3s, vitamin D, selenium, zinc, magnesium and antioxidants are associated with autoimmune diagnosis.
This needs to be addressed first because a body that is lacking core ingredients can not rebalance itself. Removing more doesn't serve your body ... Results won't stick. This is why identifying and addressing nutritional imbalances is always priority number one with my private clients and members inside The Integrative Autoimmune Network. From there, we slowly stretch fasting times in a way that makes sense for a person’s lifestyle and condition. This is a much safer and more health-focused approach.
There are some contraindications for intermittent fasting of which many are not aware:
- If a person has insulin resistance or poor blood sugar regulation, skipping a meal can increase the stress response, which can make inflammation worse. You are better served to rebalance your blood sugar first (addressing nutritional imbalances), and then experiment with intermittent fasting.
- There are some medical or underlying conditions that are contraindicated with intermittent fasting including diabetes, low blood pressure or amenorrhea. People taking blood pressure medications can also be prone to side effects with intermittent fasting.
- People who are underweight or have eating disorders shouldn’t fast. Neither should women who are pregnant, trying to get pregnant, or are breastfeeding.
I have also seen intermittent fasting contribute to weight gain and inflammation in my private practice.
This is particularly true if you have a thyroid issue, high stress in your life, undiagnosed food sensitivities and are eating foods that aren't ideal for your body or condition, if you have digestive imbalances, if you drink a lot of coffee during the “fast’ period, binge eat when you come off your fast, if you struggle with anxiety or nervous system dysregulation, have fatigue or are not getting enough sleep.
For some women, intermittent fasting can WORSEN blood sugar control and undermine thyroid health, the master gland of metabolism.
Another reason people have a hard time following an intermittent fasting eating pattern is that it’s hard to stick with the fasting part. They eat more than the recommended (low-level) calories on their fasting days, and when they finish fasting, they want to eat everything and anything due to the reaction of the appetite hormones and hunger drive. And rightfully so ... they are HUNGRY. They have a body that is working overtime, trying to quell their autoimmune inflammation.
I see all of the above in my private practice with clients who have tried intermittent fasting and felt worse or experienced lackluster results. Even though they initially resist eating an autoimmune-supportive (and nutrient dense) breakfast, they feel so much better very quickly. Motivation and mood also improves when they feel unexpected health benefits like more energy and focus for later in the day to exercise and be more productive at home and work. This keeps up the momentum and helps them establish a nourishing mindset. This is why breakfast is the very first thing I ask clients to work on … it works every time.
With a nutrient-dense nutrition plan specific for autoimmune and your body, Intermittent fasting may be part of the solution, but you should approach it strategically - both physically and emotionally.
Intermittent fasting is a weight loss trend that works for some people, mostly men who do not have autoimmune. It can help to improve weight and reduce belly fat, and there are lots of health benefits. You can't argue the science.
But, it isn't safe for everyone and results are negligible for autoimmune, especially when you factor in thyroid, adrenals, busy modern lifestyles, stress and the fact that people are already struggling to address nutritional imbalances that fuel inflammation and weight gain to begin with.
Intermittent fasting can also be difficult to stick with. On low calorie days, it can be hard to stick within the 500-600 calorie recommendation, nor does restricting calories serve an autoimmune body that is already struggling with fatigue, and lacking in core nutrition for a balanced immune response.
On some days, frankly, you just need to eat a little earlier in the day or a little bit more, depending on your level of activity, sleep, hormonal cycle and other lifestyle factors. You need a good understanding on how to adjust intermittent fasting guidelines without throwing it all out the window.
For the best chance of reducing inflammation and reaching a healthy weight for your body, I recommend you spend the time working on a nutrient-dense plan that will help you lower inflammation first … an approach you can stick with for the long term … and from there, you can introduced time eating in a way that is customized to your lifestyle. It is helpful to work with a trained nutritional professional to assess whether or not intermittent fasting is the right approach for you or how it fits into your overall plan (and when).
What about you? Have you or someone you know tried intermittent fasting? What were the results? Let me know in the comments below.
Confused about what food, supplement or diet is best for your body & condition? Book an introductory call with Vanessa to discover how working with a nutritional professional with a decade of experience will help you improve your weight, energy, pain and digestion.