Curious... some of my symptoms have improved a lot since a 3 day water fast last weekend. And, my ESR dropped "back to normal" (doc)

[SoulNature]

My history: I was diagnosed with PMR at the end of May. I'd developed stiffnesss and pain in my pelvic girdle overnight during Xmas week gone, 2018. Then beginning of May or so I woke with two 'frozen' shoulders which developed a lot of pain and I couldn't turn in bed. I was diagnosed at the end of May with PMR. My ESR went from 15 to 30 to 60 within a week. I was feeling malaise and slight nausea, poor appetite, fever and bouts of daily fatigue, along with pain in my arms including niggley travelling pains in my arms, elbows and hands at times. My pelvic griddle pain and stiffness had improved weirdly though since May. I’m not on any medication, haven't started prednsone as of yet. I have no other conditions that I know of and currently all my blood lab values are what are considered the normal range. My ESR dropped to 20 last week.

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I've been interested in fasting for a couple of years now so I felt very motivated to try. So, Friday, Saturday and Sunday of this weekend gone and the previous weekend (I was very motivated!) I've fasted, consuming only water each of those days. However, I did also take all my supplements including my Magnesium. I drank anti-inflammatory nettle tea (organic tea bags variety) the first weekend too. And I felt to take a little pinch of salt in my water once a day. I felt weak at times and a little nauseous - though I'd already been feeling that the week before anyway.

The results... since the first fast I've not had any malaise, nausea or fatigue or fever at all. I've been sleeping far better. I got my ESR checked on the Monday (mid-afternoon after eating a lunch and a breakfast before that), and my doctor texted my to say my ESR came back as 20, "almost back to normal". I feel better again today after this weekend of water fasting. This time I had more energy and though wanted to rest a lot of the time, still met with friends, got some work done, went for walks and even went shopping for food! It was very hot and my tummy was a little upset today - I think I needed some salt yesterday.

I have been hearing since of research to say that fasting (18 hours, intermittent (16:8 hours) and longer fasts can stimulate autophagy, that is cleaning up the body such as clearing away autoimmune cells and resetting the immune system. Also, improving gut flora and helping the immune system that way too.

I wanted to share my experience. I will continue with some kind of fasting practice and will let you all know how I get on. Fasting isn’t appropriate for a lot of people, depending on what meds are being taken (see edit below).

I’ve also been supplementing with the enzyme Bromelain (found in pineapples), it’s anti-inflammatory if taken on an empty stomach accruing to the website Healthline (they do advertise but they reference the articles from evidence based research). I’ve also being taking alpha lipoic acid supplement on an empty stomach. I’m finding ginger in smoothies and food really settles my tummy and seems to be helping with the inflammation. My shoulders are still sore but I can lie on them better.

EDIT. I myself am not on any medication, nor do I have any other condition that I know of, and my blood lab results are are all within what is considered 'normal' ranges. I took all that into consideration for myself when decdng to try the fast. I can't recommend fasting for anyone else.

EDIT. Some important advice from Blearyeyed's comment below on reading my post: “I would just be concerned about anybody on steroids considering a full fast as not taking your Pred with a small amount of yoghurt or food is bad for your stomach lining and can cause excessive gastric reflux , nausea and can cause gastric bleeding that has led some people to the Emergency Room.

So , although choosing an option of fasting days may help with certain issues like weight loss , retention issues and certain types of bloating or bowel issues , it is not sensible to do it with no food intake at all for someone on medications that can damage the stomach lining…

…Nobody should , however, do any of these sorts of diets without taking medical advice if they are on any form of drug regime as many drugs do not work efficiently , or can cause nasty side effects, while fasting. And obviously , if there was anyone reading this with other issues apart from PMR like Type 2 Diabetes and kidney or blood pressure issues fasting regimes are inappropriate . Just thought it was worth mentioning in case anyone was considering doing the same.”

[Blearyeyed]

Are you also taking Pred / Steroid and other medication?

I would just be concerned about anybody on steroids considering a full fast as not taking your Pred with a small amount of yoghurt or food is bad for your stomach lining and can cause excessive gastric reflux , nausea and can cause gastric bleeding that has led some people to the Emergency Room.

So , although choosing an option of fasting days may help with certain issues like weight loss , retention issues and certain types of bloating or bowel issues , it is not sensible to do it with no food intake at all for someone on medications that can damage the stomach lining.

You will feel a rebound of energy 48 hours into a fast after a day of initial tiredness ( and often increased Fatigue or headaches) because your body is not expelling energy in digestion which for some people can be quite draining and cause sleepiness , especially if the diet they use contains alot of sugar , complex fats , dairy or gluten . This rebound of energy may not , therefore , mean that you are systematically improving just that you are not taxing your system by doing two types of bodily functions at once.

Just interested to know had you started eating again before you had your blood taken for ESR or were you still fasting?

This might have made a difference to the results.

Have you had any side effects from returning to eating food after your fast?

Many people do , with rebound headaches and inflammation and some stomach bloating , cramping and food intolerance so you might want to be careful about what you eat the day after and keep an eye out of any increase in pain on a normal dietary regime .

I'm glad you felt some benefit by doing this fast , but my advice would be don't be tempted to do it for more than 24 hours at a time , and not too often , when living with a Chronic Condition. The long term use of fasting on a body with Chronic issues can be negative in ways it isn't for healthy individuals with no underlying health issues , or daily drug regimes.

I'm glad to hear you are finding benefits from Pineapple and Ginger which can have good antiinflammatory effects and can help with liver health as long as their use is appropriate for your health conditions and other drugs you use.

Finding self care techniques in terms of diet , lifestyle and exercise that are comfortable for you as an individual is always beneficial to a quicker , smoother recovery .Nobody should , however, do any of these sorts of diets without taking medical advice if they are on any form of drug regime as many drugs do not work efficiently , or can cause nasty side effects, while fasting. And obviously , if there was anyone reading this with other issues apart from PMR like Type 2 Diabetes and kidney or blood pressure issues fasting regimes are inappropriate . Just thought it was worth mentioning in case anyone was considering doing the same .

[SoulNature in reply to Blearyeyed]

Thanks for your response Blearyeyed., For many people fasting is not recommended as you say. People with type 1 diabetes being one obvious example. I realise it's important those dangers are assessed. I tried to say that but you said it much better than me! I will edit my original post and paste in your cautions. I understand it's important to inform pope of dangers. I'm not promoting or suggesting fasting to anyone. I just wanted to share my experience because I thought it would be of interest for any number of reasons. I know this journey is long and this benefit I've experienced may not stay with me. To answer your question I'm not taking steroids, not yet anyway. I am still considering prednisone as a treatment. I'm reading a lot of the advice on this forum for one thing. I won't undertake prednisone without careful planning. And, on starting a course I would give that my 100%. I found doing the fasting challenging to do and I didn't and wouldn't undertake it without careful planning, I am transitioning to an autoimmune protocol diet from a relatively 'healthy' diet anyway so I'm avoiding foods that are thought to cause the most reported issues. I didn't experience any bloating or any ill effects after starting eating. I am not on any medication, nor do I have any other condition that I know of, my blood lab results are are all within what is considered 'normal' ranges. I took all that into consideration for myself. I couldn't recommend fasting for anyone else. Where did you read about fasting being dangerous? I'd like to see that. The 3 day water fasting has brought me great relief, I can feel my inflammation has come right down. The ESR test was taken later afternoon, I'd had breakfast and lunch before that. I don't know when I'll next get to do a fast. I had the past two weekends free so I chose to do these 3 day ones. I am looking into shorter fasting too.

[Blearyeyed in reply to SoulNature]

Glad it worked for you but thankful you are going to include the fact that you are not currently taking steroid medication for your PMR yet , and that fasting is not right for anyone with conditions like Diabetes or on strong medications in your post.

I know , it may seem like checking with your doctor or being aware that it is not a good diet regime for people with different medical conditions may seem like an obvious thing , but some people do read posts and do forget these things so it's always good to cover the bases so we all keep happy and safe in our choices.

The fact that fasting regimes can be harmful with certain types of illnesses ( not just Type 1 , but also Type 2 Diabetes , Diabetes Mellitus , which is often experienced by people with PMR/ GCA ) and medications will usually be voiced on any responsible diet site , and warnings against certain types of diet plan are usually available with recommendations for lifestyle choices on websites to do with the disease you may have or medication you take.

As you haven't chosen to start Pred yet , and haven't got any other underlying chronic health issues it's not surprising that you wouldn't know that this information is available , you thankfully haven't needed it up to now.

It was good to hear about your experience , I hope that your natural route to health works for you , but I'm also glad that if you do begin to suffer worse inflammation and pain caused by your PMR you will be willing to try medicinal help too.

Good luck

[SoulNature in reply to Blearyeyed]

I'm open to whatever is going to bring healing, for sure, yes. I wasn't and still am not recommending fasting to anyone. I'm really clear about that. I posted about my own experience only out of possible interest to others. I understand the importance of people taking medications to know the dangers fasting could have for them. I did say fasting would not be possible for people on certain medications n my original post. I can't and wouldn't give medical advice to anyone of any kind as I'm not a doctor. I can only share my experience with others. Or links to scholarly articles at best. So that's where I'm coming from. I'll continue to share my experience if it seems to have any possible value to someone. I know I am appreciating all manner of posts I'm reading on this forum that are helping me learn more about what I'm dealing with. I'm grateful for everyone's time and energy. Thanks for yours and best wishes to you.

[Yellowbluebell]

As a moderator of the forum I have to reiterate Blearyeyed's response to this post that it isnt appropriate for people to just start fasting under the impression this will help their pmr.

If you feel this might be something you would like to do then I urge you to speak to your gp or rheumatologist before starting any fast. YBB

[TooSore]

I too have read about fasting and try to make sure I eat dinner on time or early, not snack after so that there's 12 hours before breakfast. I have also been trying to get a protein in my breakfast - too easy to eat carbs! My biggest challenge is that if I exercise after work, it pushes dinner later. I do think that while we can't blame "gut health" for everything, it makes sense that the healthier we eat/sleep/live, the better equipped our bodies can be to function/heal.

With such a quick response to fasting - have the doctors considered a food allergy/intolerance? Even something like a celiacs?

[SoulNature in reply to TooSore]

Hi TooSore,

I'm exploring diet right now and I also find it tricky to tweak. There is so much information about diet, especially on the internet, a lot of it seemingly contradictory.

Somehow, it hadn't occurred to me that I could get checked by my GP for specific food intolerances. Thank you for that suggestion.

[Suet3942]

Last year I was quite ill for 2 days with a horrible tummy bug. Nothing would stay down and I was really worried about my 10mg pred not staying in as I was being sick constantly. To my amazement I had no pain whatsoever for the next couple of days. I mentioned this to my rheumatologist and she suggested I Google the Clint Paddison anti inflammatory way of eating. Juices loads of veg every day. It does seem to make sense but is too difficult to stick to.

[PMRpro Ambassador in reply to Suet3942]

Why juicing the veg? Whole fruit and veg are much better for us in so many ways.

[Suet3942 in reply to PMRpro]

I think it's because he uses skin and peel as well.

[PMRpro Ambassador in reply to Suet3942]

Fair enough - but it still releases the sugars into the blood fast because the cell walls are broken down.

[SoulNature in reply to PMRpro]

Someone I know who juices a lot explained the idea behind it to me recently when I asked her. She said that for people with compromised health who may not be absorbing nutrients, the juicing process already does some of the work of our digestion system, and so helps with bioavailability. Juicing vegetables, like celery, rather than fruits high in sugars would be preferable and avoid spikes in blood sugar. I think myself diet is a huge subject and best when tailored to the individual and their own special needs.

[sennetta]

I firmly believe you are are onto something here SoulNature, would like debate this with you and share my experience. But I haven't time to do loads of internet stuff just now owing to catering for my daughter's wedding which is happening next week. And then I am going away for a week or so to look after grandchildren. Maybe we could "connect" again after about three weeks or so when life is a little less frantic. I'll pm you just now so that I can find you more easily.

[SoulNature in reply to sennetta]

Hi sennetta. I'm guessing I'll be updating the public forum here from time to time to share my experiences. It'd be good to hear yours too. I hear how busy life is for you. Thankfully this forum is not going anywhere so there's no pressure. I think there is a 'follow' button (top of your screen somewhere?) you can press to follow certain posts or people so that way you won't miss a thing. I don't expect my posts to be all that interesting necessarily though!

Wishing you well.