Chronic Pain, Depressed, and Desperate? Consider Medical Supervised Fasting

Article in press summaries findings that medically supervised modified fasting (200–500 kcal nutritional intake/day) with periods from 7 to 20 days “is associated with mood enhancement and substantial pain relief.”

Prolonged Fasting as a Method of Mood Enhancement in Chronic Pain Syndromes: A Review of Clinical Evidence and Mechanisms Andreas Michalsen
Curr Pain Headache Rep in press 2010 abstract here

  • Initiates “strong neuroendocrine responses” associated with improved mood, increased alertness, and decreased pain.
  • moods improved after 5 days but are not correlated with weight loss
  • Also seems to act as a “reset” for lifestyle modifications that can then take hold
  • endorphin levels are elevated by fasting
  • improvements sleep, less restless legs, less arousals

Contraindications:

  • eating disorders
  • body mass index of less than 20 kg/m2 or greater than 40 kg/m2
  • liver disease
  • heart failure
  • renal failure
  • gastric ulcer
  • cancer
  • immunosuppressive drugs (except corticosteroids)
  • warfarin
  • alcoholism
  • psychosis
  • pregnancy & lactation
  • unexplained weight loss
  • on diuretics (water pills)

Initially, can get 24 h of headache from caffeine withdrawal

Plan:

  • 2 days prefast with 800 kcal/day “monodiet of fruit, rice, or potatoes according to patients’ choice. “
  • Start fast with ingestion of mild laxative – milk of magnesia 30 ml might do. they used 30 mg “Natriumsulfate”
  • “2 to 3 liters of fluids each day (mineral water, small quantities of juice <=200 mls., and herbal teas)." No real tea...
  • Looks like one starts with vegetarian meals 200 – 500 kcal/day – often a light vegetable soup

Took 11 days for significant improvement of depression from control group:

Comment – I used to do this approach but we called it an elimination diet. – very restricted food wise – headaches would improve and foods were added to see which ones caused trouble. People’s mood would improve some and this explains it. Bacterial overgrowth might improve with dietary restriction as well according to one study. Might be a useful technique for patients with chronic pain, headaches, and depression – would have to be an MSG free soup though… Would think it wise to take vitamins while fasting but if checking allergies might have to be yeast free… nike air max bw nike air max bw

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