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What a 36 Hour Fast Looks Like for Me as a Dysautonomia/POTS Patient

haleysnipes
Mar 26, 20236 min read


Last week I wrote an article about how I finally started losing weight as a Dysautonomia patient (which I will link at the end of this post) and it got quite a lot of reads. Because of this, I decided to follow up with showing you what a 36 hour fast looks like for me. In this post, I will talk a little bit about alternate day fasting (ADF), what I consume on my fast days, how I balance my activity, and how fasting and weight loss have impacted me as a Dysautonomia patient.


(There is a list of helpful links at the end of the post for anyone who wants more information about ADF or intermittent fasting)


Alternate Day Fasting (ADF)

Alternate day fasting is a method of intermittent fasting in which you eat one day, fast for 36 hours, and then eat for 12-16 hours before going into your next fast. The fast is 36 hours instead of 24 because you are fasting one entire day, plus a second night. During your fast you can consume only water, black coffee, and plain tea; on your feeding days, you may eat freely. A typical alternate day fasting pattern would look something like this:


(Disclaimer: Alternate day fasting is generally considered safe, but you should always check with your healthcare team before starting any new diets. Certain medical conditions and/or medications may not be suitable for fasting. You should research carefully before deciding if alternate day fasting is right for you. I am not a medical professional.)


What Fast Days Look Like for Me

A typical fast day for me will start the night before. The evening before my fast (the evening of my feeding day) I try to eat a good dinner. Because dinner is my last meal before my fast, I try to make sure that it is sizable and nutritious. I cook Mediterranean style when I can and aim to eat until I am full, but not uncomfortable.


The morning of my fasting day, I will start out with a cup of black coffee and some water. At breakfast (I do not eat, but I sit with my spouse while he has breakfast) I will drink another glass of water and take my morning medications along with some electrolytes. It is important that I start off my morning with electrolytes to keep my blood pressure and electrolyte levels balanced throughout the morning. Because I have POTS, it is extremely important that I consume enough salt and electrolytes on my fasting days.


Throughout the morning, I will drink water and sometimes a cup of plain tea if I am cold. At lunchtime I will take more electrolytes if I feel that I need to, otherwise I will just drink water and continue with my fast. I stay hydrated throughout the rest of the afternoon and evening and then take my multivitamins, sleep supplements, and medications right before bed.


I break my fast with creamer in my coffee first thing the next morning and at breakfast I usually eat eggs on toast with yogurt. It is important to break your fast with a balanced meal (preferably more protein and fat than carbohydrates) so that you do not spike your insulin too high. Between breakfast and dinner, I enjoy eating a variety of foods and do not portion/track them.


How I Balance Activity On Fasting Days

Because I have Dysautonomia, I have to be mindful of my medical issues and symptoms while I am fasting. Some of the symptoms that I must be mindful of are difficulty regulating body temperature, fatigue, low blood pressure, orthostatic intolerance, headaches, and lightheadedness.


In general, my symptoms do not bother me any more than usual on my fasting days, but I do try to make sure that I do not do anything to aggravate them. My first two or three fasts were challenging because my body had to adjust to fasting, so I struggled a little more to manage my symptoms then, but once I was into the second week of ADF most of them had subsided.


Most of the symptoms that I listed above are managed by taking electrolytes, so the only symptoms I typically have to worry about now are difficulty regulating my body temperature and fatigue. There are a few reasons why these symptoms are more bothersome on fasting days:

  • While fasting does not necessarily require more energy than eating normally since your body is simply using fat stores instead of food for energy, it does take away the ability to eat food to get an energy boost or “sugar rush” which can make fatigue more pronounced.

  • If you are like me and do not particularly like black coffee or tea, you may find that you consume less caffeine on your fasting days, which worsens fatigue.

  • Fatigue may seem more pronounced if you are bored. (The process of eating can take anywhere from 2-6 hours a day for cooking, eating, and cleaning, so if you are not eating you may find that you have a lot more time on your hands).

  • You may become more fatigued if you are struggling to stay warm, because your body is having to work harder to maintain your internal temperature.

  • If you are fatigued, you may not be moving around as much, which can cause you to get cold.

  • Because you are not eating, your body is not digesting food (which produces heat), so you have less things going on internally to keep you warm.

  • Once again, if you do not like black coffee or tea, you may not be drinking hot fluids as much to keep you warm.


Regardless of why certain symptoms are worse on fasting days, they still need to be managed, so a few things I do to balance my activity and manage my symptoms on fasting days are:

  • Take electrolytes (very important for general symptom management, even if you do not have POTS, because fasting can cause headaches and fatigue if your electrolytes are imbalanced).

  • Dress in layers (because it is harder to manage my body temperature, I wear layers and warm socks).

  • Do not exercise intensely (light house work and walking are good options for fasting days, but I would not recommend anything intensive unless you are confident you can handle it).

  • Allow time to rest (I usually have to lay down and rest after lunch regardless of if I am fasting or not, but it is even more important on my fasting days).

  • Try not to do anything especially physically or mentally stressful (because I am usually a little more fatigued on my fasting days, I try not to do stressful activities if it can be helped).

  • Stay hydrated (dehydration can make many symptoms worse even if you do not have Dysautonomia).


How Fasting and Weight Loss Have Impacted Me as a Dysautonomia Patient

Fasting and weight loss have had an overall helpful impact on me for symptom management and weight loss. Because fasting helps to reduce inflammation, facilitate autophagy, provide quality sleep, and detoxify the body, it has helped with symptom management, but it can be challenging at times.


The increase in fatigue on my fasting days has meant that I shift more of my computer work onto my feeding days, but that is not necessarily a bad thing. I use fasting days to catch up on housework and more mundane computer work that I typically like to procrastinate on. Furthermore, the fact that I do not eat for 3-4 days a week can be challenging socially because I like eating meals with my spouse, but I am still able to sit at the table and be present at meal times even if I am not actively eating. Overall, I would say that fasting has been worth it, but it does require an element of dedication and mental discipline to be successful.


Conclusion

ADF is a method of intermittent fasting that involves fasting for 36 hours, eating for 12-16 hours, and then starting another 36 hour fast. My fasting days mainly consist of making sure that I stay properly hydrated and taking electrolytes, while my feeding days are geared around refueling my body and eating freely. Fasting can make some symptoms worse, so those have to be accounted for and managed, but with some preparation and planning they should not be overly bothersome. Although fasting can be challenging at times, it has been helpful for me overall.


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