liver Cirrhosis and Fasting!!

[Hope1011]

Hi all, I wonder if anyone has any thoughts / experiences on fasting while having cirrhosis. Thanks

[AyrshireK]

I would say seek the opinion of a liver specialist dietician if you can, when you have cirrhosis your liver can't store and release energy the same as a healthy liver and generally the advice is to eat little and often to avoid entering a state of deficit.

Fasting is probably not a great idea, a healthy and balanced diet is probably more appropriate. People with cirrhosis are usually advised even to have a carb rich supper because the 'fast' as you sleep overnight can actually cause you to start burning your own muscles as a cirrhotic liver will do this before it'll burn fat.

Get proper dietician advice before doing anything drastic.

Katie

[Hope1011 in reply to AyrshireK]

Thank Katie for your reply. As a muslim we fast in the month of Ramadan. I didn't fast last year because i was a bit anxious about not being able to eat or drink for at least 13/14 hours would be difficult. This year however, I haven't consulted with my doctor (didn't think about it). I thought I will give it a go. Its my 6th day of fasting and so far so good. Haven't felt any side effects. I just wanted to know if anyone else had any experience of fasting. Thanks

[AyrshireK in reply to Hope1011]

There appear to be a number of medical studies on line about the safety or otherwise of Ramadan fasting in people with different degrees of liver disease. Having now learned of the circumstances you mention I have just done a quick interent search 'Liver Cirrhosis and Ramadan Fasting' and there is differing guidance for the different stages of cirrhosis and what other symptoms you have i.e. presence of varices, diabetes etc.

I know that some people are excused the fast on medical grounds but also understand how important it is to your faith. Perhaps have a look at some of the studies and where your level of cirrhosis lands.

"Ramadan Mubarak"

Katie

[Hope1011 in reply to AyrshireK]

Thank again Katie and appreciate your greetings. You are right we are exempt to fast on medical grounds. I was trying to test it out to see if I can manage. However, i always read about benefits of fasting not that i am fasting with that intention.

Luckily for me I am at stage 'child A'. I am not dietetic and also don't suffer varices However, i do have couple of other autoimmune diseases and heart disease.

I will look at the website you mentioned.

Thanks

Hope

[DaveQ67]

Hi,

I have been asking the same/ similar questions to so many people, departments, GP etc and have been passed around pillar to post.

I’ve read online looking for answers and the only consistency is inconsistency regarding answers on diet for cirrhosis, including any type of fasting.

I assume like everyone else I was told Mediterranean diet, little and often etc.

for me this is a very common sense diet to suggest, getting in low fat, healthy whole food, little and often I find is difficult to do and not very practical, especially healthily.

I was seeking info if I could take a protein supplement to help train and seemed sensible in order to get more protein in.

I could not get a straight answer from anyone, I spent weeks trying too.

I was eventually told to contact my liver specialist who said it was fine.

I’ve read so so so much in how to eat. I’ve read how fasting forces your liver to get rid of bad cells? Might be a good thing you would think? I actually went through extremely low carb, eating lean meat, eggs, veg. Never felt as energetic and clear minded being sharp mentally in my life and yet I have cirrhosis !!! Plus I lost some belly fat and it was easy to prep, manage and was never hungry.

My short experience so far has taught me one main thing, I don’t think anyone can really %100 say what’s the best route.

You hear stories about people’s improvement which I understood to be impossible.

I would say be sensible, listen to your body, obviously no alcohol and try it. All I found was most people won’t commit to an answer. If you feel the worse for it stop.

All the best

[Hope1011 in reply to DaveQ67]

Thank you!

[DK421]

Hi there. I can only relay what was told to me by my liver specialist (consultant hepatologist) and my specialist liver dietician. It probably depended on where I was with my individual circumstances which was diagnosed with cirrhosis, no symptoms other than tiredness (including no varices, edema, ascites, jaundice etc). Just sharing for info, not trying to say this is the way for everyone

I was told I had to keep my liver steadily busy as it would go into fasting mode a lot quicker than healthy livers, but not to overload it. If I didn’t do this with small frequent meals my liver would rapidly go into fasting mode and start to take material from muscle mass and store that as fat within the liver, which in time could obviously turn into more scarring. So although it may not be noticeable for a while, it would be doing damage (just like the development of cirrhosis in general).

With regards to food composition, I was told I needed a lot of protein to help with the cellular regeneration of my liver and to build muscle mass, at 1.5g per kg of my weight. At the same time I had to eat a good deal of carbs - this was so my body (and liver) had energy to use for regular day to day metabolic function. If I didn’t have carbs then the body would use the protein I was consuming, which meant my liver wouldn’t have the materials it needed for regeneration purposes.

As part of my faith I fasted last year during days of lent. This year I didn’t. Maybe at some point in the future I will.

Maybe also worth saying that I’m aware all those carbs and protein create calories. But I’ve managed to balance it with exercise and in the space of 6 months I’ve lost almost 5 stone in weight, taking my BMI from 43 to 33. If I deviate from that eating plan (like when I went on holiday recently) the weight immediately piles back on. (Edit: even without exercise I’d still be losing weight as I’m managing to keep daily calorie intake below my basic metabolic rate - there are weeks when I don’t exercise and still manage to shift a little bit)

Hopefully things will get a bit looser in future, but for now I’m being told that losing weight whilst regenerating cells in my liver and keeping the liver busy is job one.

As I say this advice was given to me and I’m not posting it to tell others that’s what they should do. I’m just relaying it on. Your liver doctor will always be the best person for advice.

Good luck!

[Hope1011 in reply to DK421]

I appreciate your through response. The technical info you provided is enlightening. Honestly, even prior to fasting I never paid much attention to the intricacies of food, I simply ate whatever was convenient. My docs also didn't emphasis the importance of dietary consideration. I will look into this and strive to achieve a balanced my food intake. Hope

[DK421 in reply to Hope1011]

Best of luck! Happy to clarify anything above if I can.

[ProteinPower in reply to DK421]

hi glad that you’re doing well.I was diagnosed in late last year with cirrhosis A (on the Child score) and went from 104 kg in November to 88 kg now.I’ve tried the med.diet plant diet etc etc but my meals are still unstructured.The more info I read about food the more I realise that’s there is lots of stuff like oxalates and other things in plants as well as problems with meat and everything else.I’m trying to find a liver dietician here in the Northern part of NSW in Australia for specific meal plans as so far the ones I’ve dealt with are pretty vague.The Dr’s and specialist ask how I lost the weight etc and I tell them the truth which is that I’m winging it.Keep up the good work.

[DK421 in reply to ProteinPower]

That’s great mate! I wonder if you could get a specialist dietitian to work with over Zoom if you’re finding it challenging to get someone local? I seen mine twice in person but to be honest it could have easily been over Zoom.

[ProteinPower in reply to DK421]

Thanks for that mate that’s something worth trying that I hadn’t thought about and also means I can look further afield than where I’m living.Cheers

[Pie-eater]

I lost 3 stone in the year leading up to my transplant despite my appetite being normal so for me, I think fasting would have been a disaster. I’ve put a bit back on since but I’m really struggling to build muscle despite taking protein supplements.

[Hope1011 in reply to Pie-eater]

Hope you are doing well. I take steroids and have gained a lot of weight. I always been 8st and now I am 10st can't take it off

[Hope1011]

Thank you! that's very reassuring. I think the key factor is to be aware of your body and symptoms. I kind of given up on seeking knowledge to keep myself informed and that is not good. Reading the replies to my post has definitely made me think about my lack of knowledge in this area. Hope

[BritishLiverTrust11 Moderator in reply to Hope1011]

Hello

Here is a link to a section on our website for Diet and cirrhosis which you may find helpful:

britishlivertrust.org.uk/in...

Best wishes

British Liver Trust

[Pie-eater]

Yes thanks, I’m doing fine now, the first 6 months after transplant were a bit rough but I’m ok now. My weight is stable, I can get it to go up or down with minor adjustments to my diet, though I’d like to regain a bit of muscle. I’m also on steroids but it’s being reduced by 1ml every month. Hope all goes well with your fasting.

[Liversheep]

Six years of very low glycemic nutrition, with various types of fasting restored my health. Everything I consume is Whole Foods, not processed. Blood markers across the board are ideal. I focus on healthy fats, high protein and non starchy vegetables, fermented foods. It all works for me. Zero food cravings, very rock solid low glucose monitoring continuously, low insulin, my liver produces all the glucose I need. Fasting has helped me. Dropping 200 pounds in six years, added muscle with resistance training. Liver is still compensated. High glycemic nutrition & liquid HFCS was what damaged my liver in first place, I reject it.

[ProteinPower in reply to Liversheep]

Hi glad you are doing so well.Can you tell me what type of vegies you eat,what fats and type of protein ie chicken fish etc you consume.Cheers

[Liversheep in reply to ProteinPower]

Above ground non starchy vegetables. Fermented vegetables. All animal products including high fat dairy. All seafood. No sugar no starch nothing processed. Occasional nuts seeds.

[ProteinPower in reply to Liversheep]

Great thanks for that it’s really helpful and appreciated.Cheers