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Fasting with Medical Conditions

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Fasting and gallstones
19 Oct 2014, 12:19
Hi, I fasted very successfully last year and lost about 17 kilos combining 5:2 and eating lowish carb on feast days. I have a LOT to lose. But, as these things happen, I have put most of it back on this year. :( I also found out I have gallstones . They dont seem to cause me any problems - but I have a lot of them.
Reading about gallstones, fasting is not recommended because it causes the gall to sit in the gallbladder which is not prompted to empty by eating. So the gall can become supersaturated and stones may then form.
So, is this fab diet out of bounds for those of us with gallstones. I wonder if there is any research with 5:2 + gallstones?
I suppose that the 500 cals could be spread out into 2 or 3 meals during the day. But for me, that loses the best thing about fasting - that not eating doesn't start your appetite up. For me, not eating is easy but eating very little and often is almost impossible.
My stomach says 'I've started so I'll finish!'
Thanks for any ideas. Does fasting cause gallstones?
Re: Fasting and gallstones
19 Oct 2014, 12:56
Hi @bleubell and welcome

Being overweight is associated with a higher chance of gallstones. I am not sure about how long a fast is enough to make problems with gallstones, but will try to find out for you. Watch this space!

Maybe @peebles knows?
Re: Fasting and gallstones
19 Oct 2014, 13:25
I've got gallstones and I found out I had them long before I started fasting. They're very common, especially in overweight middle aged women. I would hazard a guess that they're absolutely nothing to do with your fasting last year. They will be more to do with the diet you had which led to you being overweight.

My gallbladder is full of stones apparently and it was a hospital admission due to a stone moving and blocking the bile duct which caused me to adopt this WOE in an effort to get the weight off. Prior to that, I was getting repeated bouts of cholecystitis which was misery to be honest with you. I've not had even a glimmer of trouble since I began this WOE 6 weeks ago which is no doubt due to the healthy eating I've now adopted with as little fat as possible.

When I go back to see the consultant for a follow-up, I should hopefully be going on the waiting list to have my gallbladder removed. I will be glad to see the back of it!! I've had a miserable year because of it.

Re: Fasting and gallstones
19 Oct 2014, 13:28
Thanks carorees :) Yes there are so many variables around gallstones. I found my gallstones by accident from a CT scan when I was being investigated for a kidney stone.
I stupidly probably caused that kidney stone because I didn't drink enough when fasting last year. It was so easy to just not eat or drink at all during a fast day! I now drink LOTS of water over 2 litres daily to avoid, if I can, new kidney stones.
My GP said the stones were probably growing slowly for years. Yes I am fair fat and - well 50+!
I feel a bit caught in Catch 22 becsause I need to lose a lot of weight and 5:2 is so good and I have never felt better than when fasting! So I want to use 5:2 but then not exacerbate the gall stones. I know that's probably impossible as weightloss also causes gall stones. I lose at about 1 kilo per week. More than that is also not advised.
I wanted to try the medical treatment available to dissolve gallstones but it seems gs not causing problems are not treated - although in some countries that medicine is gived when people have gastric band surgery as gallstones are a very common side effect of fast weightloss.
If you can find out anything that would be great. GS sites mostly say 'Dont fast too long' They mean I suspect eat breakfast / 3 meals a day. But whether that is based on any real research or that it just sounds like good, common sense advice I'm not sure.
Re: Fasting and gallstones
19 Oct 2014, 13:34
Thanks Cheekychicken, I'm sorry you have had such trouble, I know it is horrible as my mother also had it (another family risk I have).
Can I ask you what fasting routine you followed? How many hours did you fast?
Another thing I didn't understand is that the advice is always to eat little fat but surely that causes the gb not to contract so increasing the saturation of the gall and so increase the size or number of galllstones?
May I also ask why you are haing the gb out if it is not longer causing problems? Or is fasting / eating little fat just a way to keep it under control rather than actually solving anything?
Thanks very much. I hope you get it sorted soon. x
Re: Fasting and gallstones
19 Oct 2014, 14:00
It's a bit of a Catch 22 really.

You're told to avoid fatty food because this then makes the gallbladder contract and it's the contraction onto the stones that causes the pain of cholecystitis. Believe me, it's misery.

Your gallstones may not as yet have caused you any problems, but the chances are at some stage they will. Lots of people have them for a long time and don't realise it because they take a long time to build up. I intended trying to control mine with diet (cutting down on fat) as I absolutely didn't want surgery but in the end it seemed that anything set it off and even something like a small piece of cheese gave me a night of agony.

I'm doing ADF so my fasts are long. Maybe fasting will increase the size of the stones, but if I reverted to having my previous unhealthy diet then that would also be worsening the stones plus it would be making me feel ill much of the time.

After having several months of being ill I am more than happy to undergo surgery now and to get rid of the gallbladder and the stones once and for all. I have spent far too much time in pain. My consultant told me when I was admitted that as it had caused me complications (I was jaundiced) then they would want to remove the gallbladder otherwise there was a very high chance it would happen again.

I appreciate that your situation is different though and I can fast in the knowledge that my gallbladder will be removed whereas you are trying to avoid making them worse.

Re: Fasting and gallstones
19 Oct 2014, 14:22
Hi Cheekychicken, thank you. YOu have had a very painful time also with the jaundice. I really hope it get solved soon for you.
I'm fairly certain that I won't be able to avoid having my gb out at some point but I am frightened of the anaesthetic because of my weight. I know that makes an operation riskier.
You know those films where to escape the hero has to run then roll underneath a garage roll door that is slowly closing? I feel like that! I have to lose a lot of weight to get anywhere near a better weight for the anaesthetic for when, I'm sure, I will have to have my gb out. I think it is already starting to play up. I'm not sure if it's that though but I suspect it to be. I need to get to a better weight before the gs flare up!
So I want to close my eyes, run for the door and do 5:2 as I did last year with 0 calories on fast days (lots of water though!) and drop 25 kilos to get to a reasonable weight for the operation.
Because of my weight, I couldn't have the usual non-invasive treatment for my kidney stone but had to have two operations via my urethra. My nice urologist disn't say I was too fat but too short!
For me personally, bread, which I love, now causes a lot of discomfort. Course it might also be what I put on the bread! Complicated beings we humans! Best wishes,xx
Re: Fasting and gallstones
19 Oct 2014, 15:47
Bleubell wrote: I'm fairly certain that I won't be able to avoid having my gb out at some point but I am frightened of the anaesthetic because of my weight. I know that makes an operation riskier.

Exactly. The priority has to be losing the weight for all manner of reasons. My number one priority at the moment is shifting this weight. The gallstones are not my focus right now and luckily this WOE is keeping them quiet so that's another plus point.

You've got the stones anyway and the chances are that at some point they will become symptomatic regardless of whether or not you've been fasting. Concentrate on getting your weight down so that if or when the day comes that they begin to cause you problems, you'll be at a healthier weight to deal with the treatment.

Re: Fasting and gallstones
19 Oct 2014, 16:37
Thanks Cheekychicken, though I know it, but it's so useful to talk it through and hear you say it because when I think about it all myself I can lose that focus and start to concentrate on the gs just in case when the literal elephant in the room is weight! Lol :)
Re: Fasting and gallstones
23 Oct 2014, 10:55
Sorry it has taken a while to come back to you on advice re fasting and gallstones.

As you can imagine there is not a lot of information available. From what I can tell there is some evidence that longer fasting times can increase the risk of problems and so I would suggest that you might be best modifying the fast so that your fast days are split into three fasting periods of 12 hours. (i.e., fast from dinner the night before at say 7pm to breakfast on your fast day at 7 am then fast through to dinner on your fast day at 7pm and then again through to breakfast the next day at 7 am). At the same time, I would consider doing 4:3 rather than 5:2 but have a larger calorie allowance on your three fast days, say 750 cals. At the same time try to avoid high carb foods like bread, potatoes, rice, pasta on fast days.

The paper I found that looked at fasting periods and gallstones found the increased risk was with 14 hours or more of fasting. Here's the link if you're interested:
Re: Fasting and gallstones
23 Oct 2014, 13:33
Thanks so much for researching this Carorees. :)
I hadn't found that paper. It's not what I wanted to hear, but it's good advice. I've also adopted the strategy of having a cup of milky coffee in the morning as I've read coffee is 'good for gallstones' and also eat raddishes having read the same about them! Not related but I found out recently that beetroots are rich in nitrates so to be avoided if you get kidney stones!
Such a shame because I found 24-36 hours not eating to be so simple and felt really good and energized!
If I ever find myself not having a gb I'd fast longer again! I suspect then it would be reversed and the resulting lack ofproduction of gal is probably (probably!) idea with no gb. But that's a whole new area to look at if and when!
Thanks again for your help. x
Re: Fasting and gallstones
21 Dec 2014, 22:57
Hello again after quite a long time. End of the year seems to be a time to look back and reassess.
This time last year I was at a high point having lost 16 kilos with fasting and exercise.
Then came winter blues and eating then found I had kidney stones in Feb, Saw I also had a gallbladder full of stones in a ct scan.
Being too fat to have the usual outpatient blasting treatment I had to have a general anaesthetic and up through my bladder to grab the stone. Really, really scared! Unfortunately because they didn't have the right equipment available on the day in the theatre, I had to have the operation twice. Found it really scary because of all the warnings the anesthetist gave because of my weight.
But it went ok. But you know what? I didn't go on fasting. I got scared that fasting was increasing/causing my gallstones therefore I'd need more surgery (worry worry worry, you know how it goes). So I comfort ate and got back to where I started before I lost weight last year. Illogical I know, but that's how we humans are sometimes.
Feeling ill now because of the weight - and yes probably a little gallbladder discomfort, I'm still scared to start fasting again - regardless of the helpful replies from Carorees and Cheekychicken above.

Then today, circumstances led me to unwittingly to have fasted - apart from lemon water ( great if you are trying to avoid more kidney stones) and white coffee. And do you know what? I felt great again!!! I love fasting!
You'd think I must love eating to have become obese wouldn't you? But really, it's not so. It's just something I do; habit? Maybe? I don't know.
So, this is the story of someone who has failed at diets before and has failed at fasting - except I know fasting works so I'm staying with it rather than moving on to yet another new diet. But losing weight is not just a rational process. It's an emotional, and complex thing. Whatever WOE you are following.
A very kind doctor who spoke to me when I was in hospital said the most important thing I could do for my health was just lose weight. So here I go again. Fasting but a little more gently than my previous 36 hour easy fasts last time.
According to the research Carorees found suggests that maybe 14 hours should be the maximum length of fast so that the gall in your gallbladder doesn't get too thick and form stones. Unfortunate because not eating at all for 36 hours is SO easy and the weight fell off! But silly me I also drank much, much less and that was probably the cause of my kidney stones.
So of I go again, modified fasts, lowish carbs and exercise. Wish me luck! xx
Re: Fasting and gallstones
03 Jul 2015, 14:14
I was interested to find this topic here and the research paper @carorees

I recently had an episode of intense central abdominal pain which caused me to faint. I felt a lot better the next morning, but then it started to come on again, so I popped in to see my doctor, who did an ultrasound and blood tests. He could see that my gall bladder was enlarged and it looked as though the common bile duct was or had been obstructed. He could also see stones or sludge in my gall bladder.

Since starting 5:2 in Jan 2013 I have had a few similar episodes, starting always after a meal, on a fast day, or in one instance, after prolonged fast that I did before a medical procedure.

After doing some reading, I concluded that my usual 24 hour fasts could be a bad idea for me, and that it would be advisable to eat more regularly, keeping the gall bladder more active, so there would be less opportunity for it to develop sludge and then eject it with force when a meal starts to move to the small intestine. I have not experienced any particular problems with fatty foods at all, in fact, I had thought that it was beans in particular that were causing my problems, as there has been an uncanny connection in most cases, or beans + cabbage family.

Luckily I quickly recovered from that episode and the doc agreed that I could go off on my planned holiday the following day, but the blood test results are not very encouraging, so I think I may need to have my gall bladder removed. I am off to see a specialist next week.

I wonder whether we should be making more of an emphasis about this potential risk of undertaking longer fasts?

We seem to have quite a few reports of people who, like myself, have had pains that they have attributed to trapped wind. Now I am beginning to be concerned that longer fasts may have aggravated a natural tendency.

Re: Fasting and gallstones
03 Jul 2015, 16:12
Belinda, I'm sure that 24 hour fasting, as I did, will have caused or contributed to my and others' gall stones. The difficulty is that we cant tell how long they have been brewing and whether or not, had we never heard of fasting, we would have had exactly the same problem. Most asymptomatic stones dont ever cause problems - but a minority will of course. Also many people have silent stones so it would be quite hard to do the research.
Reduced fat diets do help most people with pain I know but it seems illogical in the long term. Low/no fat stops the gb contracting and flushing itself out so no pain but the gall gets more concentrated.
I also got a kidney stone probably because on my 24 hour fasts, I forgot to drink as well then your urine gets too concentrated and can cause kidney stones.
For myself I have a breakfast cocktail on fast days of the juice of a lemon with water at breakfast - kidney stones don't like lemon juice! And a tablespoon of linseed oil to make my gb contract. And the same later on in the day. I believe that to be about 60 cals per time and 6 carbs.
I'm only not certain how much fat you need to take in to get the gb to empty. I'm hoping what I'm eating is enough.
But I do feel it is something that the traditional fair, fat and over 40 gall bladder candidates should be aware of when undertaking long fasts - longer than the 12-14 hours mentioned in the research Caro found.
Re: Fasting and gallstones
03 Jul 2015, 17:26
Thanks for your thoughts. Agree @bleubell, I may well have been headed towards having them anyway, there is no way to tell. But the question is now, if I change my fasting patterns, will things remain quiet, or is the damage already done? I think the lemon and water is a great idea, I find it really refreshing. Yes keeping a reasonably regular intake of fat seems sensible, but I did do 24 hours of no fat immediately following the painful episode to help relieve the stress. Trying to understand how these complex systems work isn't easy! I'm hopeful that now we have a lot of folk who have been following this way of eating for 2 to 3 years, that we may have a better understanding of how common a problem it may be. I certainly will change my advice, as I like so many others, found it no more difficult to skip breakfast on a fast day and save all my calories for an evening meal - thinking that a longer fast would be better. Well, maybe not for everyone.
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