Fasting and Metabolic Damage

During fasting thyroid function becomes severely dysfunctional.
Not only does free T3 drop but reverse T3 rises. This is the worst case scenario. Reverse T3 (rT3) is not even looked at by most doctors so you may have normal TSH/T3 but still present as hypothyroid. You can still be having all the negative symptoms like difficulty losing weight and extreme fatigue yet the doctor will tell you it is all in your head. 
Reverse T3 is a disposal form of the active thyroid hormone. When fasting or calorie restricting, it builds up and blocks receptor sites so that any active T3 cannot get into the cells. This essentially disables thyroid function and shuts metabolism down to Just enough to keep you alive but slow enough not to have any weight loss. This is how people can fast and lose little to no weight. Those that do lose some weight often see it come back as soon as they eat again. This is because all they lost is mostly water weight. 
This is a life preservation system. If this didn’t happen you would die of starvation very rapidly when food is not available. Your metabolism would keep running on high and you would quickly consume all your muscle and then your organs. If metabolism stayed high you would continue to use glucose for the cells that need it at a high rate and this requires either glucose coming in or it will use your protein (muscle and other tissue) to fuel gluconeogensis to make glucose. Your body shuts down metabolism to a bare minimum to keep you alive as long as possible in order to survive through the starvation period. It does this to save you and there is a cost. It saves your life but it does damage to your thyroid and metabolism. Doing it enough will do permanent damage and this is why so many women are having to take thyroid medication now and so may more are suffering the symptoms but are yet to be diagnosed. Once doctors start testing and understanding the role of rT3 I think we will see the number of diagnosed cases rise dramatically. 
If you look at the most prolific promotors of fasting in the keto community they are:
Jason Fung: Has admitted publicly, though Megan Ramos (Director of IDM), that they do not fast people more than 24-36 hours except in extreme cases and only under strict supervision. They ensure it is safe by check their blood work constantly to ensure safety. He himself does not do extended fasts on a normal basis . This is a video where Megan Ramos (Director of the IDM clinic) admits that they rarely do any fasts beyond 36 hours. She changed her presentation based on a presentation against fasting given by Stephen Phinney which I speak about later. 
Listen to this talk. This is how fasting can be done safely. In clinic. With supervision. She discusses the very key aspects of doing this safely and that includes diagnosing issues that may be problematic like former eating disorders, obsessive behavior and bullying from weight issues. All of these can lead to obsessive fasting which can be extremely dangerous. I still don’t think it is necessary but if you really want to do it, do it in a clinical setting where you can be led safely through it. This is not something that anyone should ever do on their own.
Jimmy Moore: Jimmy wrote the book “The Complete Guide to Fasting” which recommends fasts as long as 21 days and more. People doing this level of fasting on their own is something that Dr. Fung would never recommend. It is not only stupid but dangerous. Blood should be checked regularly in order to assure there is no danger of any nutrient deficiency. Dr. Fung does this in clinic but all those at home doing this as recommended by Jimmy do not. This is unethical .Jimmy has gained back massive amounts of weight and despite his continued dedication to fasting he can no longer lose weight. He blames this on “Metabolic damage” and he is right. This is caused by his continued fasting and nothing else. He successfully lost 170lbs around the exact same time I did using Atkins just like I did. I believe he started Atkins in 2004 and I started in 2005. We both followed the 20g per day initial phase of the program fro the whole time we were losing weight and didn’t cut calories. We both lost massive weight. If his reason for not losing weight is metabolic damage from when he was obese the first time why was he so easily able to lose it then but now he can’t? The reason is because he has caused his current metabolic damage by continuing with these extended fasts. 

Like Jimmy, I was insulin resistant, I was poor, I was sick and I was obese. I was metabolically damaged yet I am still able to maintain my weight loss and continue to lose weight year over year. Why? I don’t fast and I don’t calorie restrict. That is it. Other than that we had the exact same experience. 

Lets look at what fasting has done for Jimmy:

It has gotten worse. If fasting was beneficial should he not be getting leaner with all the many multiple day fasts he is always doing? He appears to be getting more metabolically damaged not less. Why can’t he see it?

I read Jimmy’s book. Primarily because I thought it was written by Dr. Fung. It turns out it was written by Jimmy and made to look like it was written by Fung. Fung was only a contributor. When I read the book I implemented the recommendations.

I started the year at 214lbs. I did extensive fasting periods. Way too much from what I now understand. I likley spent 3/4 of an entire year in a fasted state with alternate day fasting and numerous extended fasts ranging from 3-5 days. I ended that year at 215lbs. Really beneficial right?

The only time I had this type of results when I was doing paleo and eating 1500 cals a day. Complete stall. This past year I have not missed a single meal. I have also spent 42 days eating 5,000 calories when my normal intake is approximately 2500 calories. I started this year at 215lbs and I am currently sitting at 195lbs consistently. My lowest weight in 6-7 years and I also have the most amount of muscle mass I’ve ever had. With no fasting.

Carl Franklin (Two Keto Dudes): Carl often talks about the latest extended fast he is doing. From 7-14 days is what he refers to mostly. He is also still obese and can no longer lose any weight. Despite his constant fasting. How can a person not eat for 14 days and not lose weight? Extreme metabolic damage. How does one cause this? By shutting down their thyroid with fasting. He has now gotten himself to a point just like Jimmy where he can no longer lose weight no matter what he does.

Luckily Carl has not gained any weight back but he clearly is not having any success in losing anything with his continued fasting. Why continue to starve yourself if there is no measurable effect? Yes he lost alot of weight but at 297lbs he is still obese and is now stuck and cannot seem to lose anymore. From what I understand he didn’t start fasting until late into his weight loss.

The one common factor in every person I work with that is having a hard time losing is thyroid function and that they have a long history of calorie restriction and fasting.
It is a clear fact that low calorie drops metabolic rate. What is the most extreme version of calorie restriction? Fasting.
Here are some articles I wrote with links to studies showing the fact that caloric restricting and fasting lowers thyroid function:
Here is a video by Dr. Stephen Phinney Discussing why he disagrees with fasting. I don’t agree with his estimates on lean mass loss and there are lots of reasons I don’t think it is accurate but mainly because the physiology dictates that lean mass preservation is taken as priority. What he is using as an extrapolation is what very active people see when fasting and only in the short term. The act of the body shutting down thyroid decreases the amount of lean mass losses. You will still lose lean mass though. There will always be a need for some glucose so if you are fasting you will need to get that from somewhere. Some of it will come from autophagy (breaking down of unnecessary/defective tissue) which is why it is said that fasting is good for autophagy, but some will still come from lean mass. For me that part that is bad is the thyroid shutdown and the more fasting you do the more damage you do.
Lastly I want to discuss something that someone brought up in the facebook group.
“But I know people that do long fasts and they feel great. They are full of energy and don’t feel cold. How can it be true that thyroid function drops?”
Lets look at what happens in fasting:
1. Caloric intake stops. Insulin and blood sugar drops.
2. The body continues to use glucose to fuel the tissues that need it.
3. Thyroid starts to down regulate metabolism to preserve lean mass
4. After a full day all possible glycogen stores are gone and blood sugar starts to get very low.
5. This causes an increase in cortisol in order to trigger gluconeogenesis to keep blood glucose stable and prevent hypoglycaemia.
6. Epinephrine and adrenaline are also released as a result of the low blood glucose. These are the reason people get surges of energy and clarity when fasting. Especially in later stages like day 2 and 3. This is for one reason and one reason only. To give you the energy and mental clarity to HUNT AND GET FOOD!!!
This whole process is one of survival and not one of some magical fountain of youth or magic healing process. It is survival of the fittest and nothing more. It is the body doing everything to keep you alive long enough to eat again. No animal in nature is foolish enough to purposely go without food. Except humans.
Our ability to use science to dig into the mechanisms of how the body reacts to eating or not eating is amazing but it is also our greatest enemy. It led us to “fat is bad” and “eat less and move more”. Two of the greatest mistakes of our time and now it has led us the next great mistake. “Fasting is good for you and will help you lose weight!”
Don’t let this next big mistake ruin your thyroid and your ability to get healthy and maintain that health. Just eat the right foods and enough of it to keep your body functioning properly and the weight you lose will stay off rather than creeping back like it has for so many others.
Keto ON,
Coach Jack

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Dementia Tsunami

This is a response I wrote to an article that was on the front page of our local paper last year. Several people have been sharing it from my personal feed lately so I thought it would be good to repost here.
I have never written to any news publication but today I had to.
This article was in the local paper today. It seemed fitting as I have been ranting like a lunatic about this very issue for months or more. The article was in regards to the growing elderly population and the increasing number of cases of dementia and Alzheimers cases. Having a grandfather and uncle suffer from these diseases I am very familiar with the struggles. All they did was talk about how we need to prepare care programs for them and how we need to find out what causes it.
We already know and there have been hundreds of studies showing why. This is my letter to the editor.
“Good afternoon,
I have never even considered writing to an editor before regarding an article in any publication but after reading todays front page I felt I had to address this.
Having a grandfather that suffered his last months with this disease as well as my uncle currently battling a severe case of Alzheimers I am all to familiar with the struggles the many affected families face.
While I absolutely love the fact that this was addressed in the article, what I find deplorable is that in this day we are still talking about what to do to better handle people suffering and that we still need research to determine the cause. I have been researching what causes this disease heavily for almost a year and it has become very evident to me there are some very simple factors that are contributing to this and while age makes us more susceptible to these disorders, it is not the major factor.
My grandfather was 94 years old before he finally went into a home. This was mostly due to the passing of his wife. Until she passed he was taking care of her and the household just fine. One day in particular I remember speaking to him and he was complaining about his back. I asked if this was normal and he replied “No, I was playing around on the 4 wheeler and went over a little jump and landed too hard.” He was 92 years old. No signs of dementia at all. After his wife passed he felt it was too difficult to manage on his own. It was very shortly after his entry to the facility that we started to notice a quick decline in his faculties. It progressed so rapidly that it was kind of shocking. We just assumed it was nature taking its course. Soon he didn’t even know who we were. He passed away not knowing he faces that were there with him in his final days.
Only recently, since completing my certification is sports nutrition and researching the science behind diet and its effect on disease, did I start to see the big picture. Then after spending a week in the hospital with my wife and seeing what they would bring her to eat at every meal did it start to become more clear. In the months that followed I would dig deeper into the causes of dementia and Alzheimers. I stumbled on a book called The Alzheimer’s Antidote. It was absolutely mind blowing. It connected all the dots.
These diseases are not a disease of age but of diet. The whole problem with the people that are affected by these terrible afflictions is that they cannot properly utilize glucose in the brain. Alzheimer’s is actually being referred to now by many experts as “Type 3 Diabetes” because it is a problem of metabolizing glucose for fuel in the receptors of the brain causing them to be malnourished. This causes them to shrink and when the synapses shrink they cannot properly send signals across them. Think of a spark plug in a cars engine. If the gap is just right the spark is hot and the engine runs well but if the gap becomes too large the electricity cannot properly jump the gap and the engine sputters. It is the same with the synapses of the brain. These disorders are simply an electrical misfire of the brain.
When I looked at the food that was being served in the homes and hospitals it was very apparent to me why our elderly are declining so quickly. The foods served are almost exclusively carbohydrate and severely lack in healthy fats. Our body requires fat to absorb vital minerals and vitamins. Our brains are comprised mostly of fat and even our sex hormones are derived from fats. If the issue with these disorders is a problem of metabolizing glucose, then why on earth would we be feeding people a diet that is primarily carbohydrate. Carbohydrate is converted directly to glucose in the body and the brain will try and fuel with this preferentially but if an affected persons brain cannot metabolize it, what will it use for fuel? Nothing. It will starve and the cells start to shrink and die. Thus the onset of dementia and Alzheimers.
In addition, I think about the poor woman in the story. My first and probably a safe guess is that she is either pre-diabetic or already a type 2 diabetic. My next guess is that she is on statin drug for controlling cholesterol. First, diabetes is a disease of glucose metabolism and insulin sensitivity. This is a precursor to dementia and Alzheimers for the most part. Again this comes down to a problem with diet and not age specifically. All very controllable and reversible. On to statins. They have been shown to increase risk of type 2 diabetes, Alzheimers, Parkinsons, and a host of other issues. They are being given to people far too easily without ever being really needed. Especially in the elderly. Having higher cholesterol in your later life has been shown n study after studu to be protective of brain function and shows a decreased risk of all cause mortality. There is virtually dozens of studies showing they do absolutely nothing for preventative care and very little for post cardiac event care either. I am 39 years old and a 6 year crossfit athlete and because my LDL cholesterol was slightly elevated I was offered a statin with no other risk factors. I won’t continue down this path for now as I could write 10 pages on this subject alone and am currently working on a study with a prominent researcher in the Cholesterol field that may go a long way towards changing the way statins are prescribed. I’ll just get back to the issue at hand.
So in summary;
1. These disorders are due to poor metabolism of glucose for fuel in the brain.
2. We continue to feed these people the fuel that they cannot use to fuel their brains
3. We are perplexed when the cells shrink and die even though we are starving them for fuel.
4. We exacerbate the issue with the carbohydrate laden foods we serve them in care facilities.
5. We give them drugs to lower an arbitrary number that has no causal relationship to cardiac issues but actually pushes them closer to dementia and Alzheimers.
6. We look at ways to care for them after they have it rather than ways to stop it from happening even though it is right in front of us already.
So am I just ranting or do I have a hypothesis on how to correct it? I do have such a thing.
There is an alternate fuel to glucose that the brain is very happy to use. It is called ketones. They are produced by the body in the absence of substantial carbohydrate. It is a natural state that infants are born in and continue to be in while breast feeding. It was the way our ancestors survived for thousands of years when they got their food from being hunter gatherers rather than going to grocery store for bread and pasta.
The state in which I speak of is called ketosis and has been used to treat neurological disorders like epilepsy for over a hundred years. It can also be used to treat and reverse Type 2 Diabetes, Alzheimers, dementia and a host of other metabolic disorders. All it requires is a dietary change that includes eating real food like meat, eggs, fish, cheese, nuts, seeds and non starchy veggies. How hard does this sound? Not at all!
I now this sounds ideological but it isn’t. I suggest anyone suffering with this disease read the book “The Alzheimer’s Antidote” by Amy Berger. It may change yours or your loved ones life forever. Please note that I do not have any affiliation with the author but the book is too important to not speak about. I hope this letter does more than make it to your inbox and deleted as it has such an important message that so many have heard and used already to save themselves from this terrible plight.
Jack McAnespy Pn1, CF-L1″