Precautions and Contraindications For Therapeutic Fasting
Medical fasting has many empirically documented beneficial effects, but there are contraindications and precautions to take.
Therapeutic fasting is, according to Buchinger (1878-1966), a medically supervised fast that can be used for prevention (healthy people) or as a treatment. It is based on daily consumption of vegetable broth, fruit or vegetable juice, honey and liquid (2 liters to 2.5 liters of water or herbal tea per day). You can eat 250 to 500 calories (kcal) a day.
Therapeutic fasting is proposed, based on studies often non-randomized (low level of evidence), obesity, diabetes, osteoarthritis, hypertension, migraine, functional and inflammatory digestive disorders, certain psychological disorders. Data on rheumatoid arthritis are stronger.
However, not everyone can follow such fasting, or under medical supervision.
This fast is not recommended in the following situations:
- Anorexia and eating disorders
- Uncontrolled hyperthyroidism
- Advanced cerebrovascular insufficiency or dementia
- Severe hepatic and renal insufficiency
- Pregnancy and breast feeding
Indications that present a risk and must be supervised by a doctor
- Diabetes type 1
- Psychotic disorders
- Unstable or severe coronary heart disease
- Retinal detachment
- Duodenal or ventricular ulcer
Treatments that must be adjusted during a therapeutic fasting
- Non-steroidal anti-inflammatory drugs
- Systemic corticosteroids
- Antihypertensives (especially beta-blockers and diuretics)
- Anti coagulants
- Psychotropic (especially neuroleptic and lithium)
- When to stop a therapeutic fast
- Non-observation of fasting by the patient
- Severe cardiac arrhythmias
- Reflux and gastric disorders
- Severe electrolyte disorders (potassium <3.0 mmol / L, sodium <125 mmol / L, or chlorine <90 mmol / L)
- Cardiac decompensation
Wilhelmi de Toledo F, Buchinger A, Burggrabe H, Hölz G, Kuhn C, Lischka E, Lischka N, Lützner H, May W, Ritzmann-Widderich M, Stange R, Wessel A, Boschmann M, Peper E, Michalsen A; Medical Association for Fasting and Nutrition (Ärztegesellschaft für Heilfasten und Ernährung, ÄGHE. Fasting therapy – an expert panel update of the 2002 consensus guidelines. Forsch Komplementmed. 2013;20(6):434-43.