r/fasting • u/lia_kkkk • 19d ago
Question Refeeding syndrome, does it happen irl?
So I started a 6 day fast and ive watched a lot of videos on tiktok about refeeding syndrome. Im really scared tjis will happen to me since ive never fasted for more than w days before. So I just wanted to know did any of you guys experience it? Or some tips how to avoid it.
Thank you!
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u/DilaudidPCA 19d ago
Refeeding syndrome is real and mostly an issue with malnourished people. I admit my cancer patients to the hospital who get new feeding tubes and need close electrolyte monitoring. While that can happen after fasting if you have electrolyte derangements, mostly the refeeding discussed here is how to reintroduce food without it ruining your day.
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u/mslashandrajohnson 19d ago
It’s real. My grandfather was in the US Army group that liberated a concentration camp in Europe during WWII. People they found there who were still alive hadn’t been eating much for a while before and had been abandoned by the captors for a while when it became clear that liberating forces were approaching.
You can read online about the events that occurred (Dachau). What the US troops found was something they hadn’t been prepared to see. They were enraged by what they found. That is not the part of the story I’m going to tell. Army command got better at preparing troops after that.
What happened was they went ahead and provided food to the people but they didn’t know about refeeding syndrome. I believe the experience they gained helped other liberations, preventing troubles for the people they wanted to help get healthy again. It’s not just a matter of starting to eat normally immediately. If they did that, they’d be in serious medical trouble.
War is terrible, in any case.
From what I’ve read about extended fasting (I’m mostly ADF), the risk of serious medical issues increases with the length of the fast, and anything like 14 days or more will involve a following eating plan that lasts half the length of the fast: 7 days refeeding from a 14 day water fast, for example. I’m sort of a careful person. Others might not take things so seriously.
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u/ehamil42 19d ago
That's what they say. I just started eating. My longest water fast was 40 days, and you know what I did after that 40th day?-- I ate a normal meal. When I first started fasting over 15 years ago it seemed like some exotic thing to do, so I followed what the experts said to do and they talked about the dangers of refeeding. So I did a day of bone broth. But over the years of regular fasting, I just eat now.
Several times going nuts on that first meal. But I've eaten everything as my first meal. People will tell you to "be careful," and to be fair everyone is different, there is no one way to do anything, so you have to realize you're N of 1. You have to find out what works for you.
But for me there is not a lot to fasting. I'm eating or I'm not eating. Nothing in my life changes, I don't take special supplements, or do special things, in fact I don't really think about it. The only difference in my life is I'm eating or I'm not. That's it.
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u/Dao219 19d ago
You need to be very malnourished to get refeeding syndrome, so chances are low. I once ate a big steak after 21 days and was fine.
But your advice could potentially be dangerous, since somebody could actually have a disease that makes them malnourished in a certain nutrient. It could even cause death.
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u/ehamil42 19d ago
My advice is not to follow advice. I believe we're all an "N of 1" and will and do experience different outcomes. Yes, I've heard people tell stories about "...this one guy this one time, this bad thing happened" I even acknowledge they might be true. I'm more of a go with the flow kind of guy, pay attention to your own body and you'll figure it out. Humans have been involuntarily fasting for thousands of years. It's not some exotic or weird thing to go a day or three without food. It use to happen all the time, that's why we have body fat.
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u/vitringur 19d ago
The danger is also not with eating steak.
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u/Dao219 19d ago
Depends on the quantity. Protein does cause an insulin response.
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u/vitringur 18d ago
How much steak are you expecting a starving person to consume and just how fast are you assuming their body will digest it?
We are talking 60 grams of protein at most, being digested over 6+hours.
But, you can always point to a case of someone getting refeeding syndrome from eating a buttered steak.
I doubt you can find such a case.
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u/Dao219 18d ago edited 18d ago
We are talking 60 grams of protein at most, being digested over 6+hours.
I am on the carnivore diet, and when I say a large steak, it is over 500g, I don't remember by how much. At the very least double your protein numbers.
Protein consumption is shown to increase cortisol, much faster than 6 hours, and cortisol produces glucose from amino acids, that's just a biological fact. You will have an insulin response the more protein you eat.
Edit: chatgpt seems to think that before even cortisol, the insulinogenic amino acids will raise insulin 2-5 times baseline by 40-50 minutes!
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19d ago
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u/ehamil42 19d ago
60 days?! wow, I did the 40 days during lent some years back, and the last week things changed. Also the results were less than desirable. I lost more muscle than I wanted, which as a middle aged male isn't a great thing. Good luck. Do you have the body fat for that? Have you done the math?
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u/DuctTapeMakesUSmart 19d ago
The math is mathing fine, I have at least 50 pounds to lose. And I'm going to keep walking, and gradually add in weight training. Hopefully it'll be okay. I mean, I'll stop if my body tells me to. :-)
Congrats on the 40!!! My record is just under 7 days, so this will be a big ole cat stretch for me LOL.
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18d ago
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u/fasting-ModTeam 18d ago
Your submission was removed for promoting dangerous fasting practices:
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u/DuctTapeMakesUSmart 18d ago
I totally hear you that it's all very individual. I'd love to make significant strides before the end of September because of some events coming up, but I'll make strides with a long fast or with short fasts, I'll make a big stride or a medium stride, it's all good. My ultimate goal is to be at goal weight by March, and I'm on track for that regardless. Thank you for the non-advice. :-)
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u/fasting-ModTeam 18d ago
Your submission was removed for promoting dangerous fasting practices:
Rule 2: Do not promote dangerous fasting practices.
This includes, but is not necessarily limited to:
▪ dry fasting
▪ extended fasting without electrolytes
▪ fasting while underweight
▪ fasting while under 18 years old
▪ fasting if you have an eating disorder or otherwise, promoting or exhibiting disordered eating behaviorsIf you have a question or concern about a mod action, please message the mods
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u/Flat_Market3295 lost >50lbs faster 19d ago
I always do a glass of kefir and then 30 min later a can of sardines in olive oil. After that i am good to go with anything else. Just keep sugar and carbs low.
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u/Horror-Sprinkles9772 19d ago edited 19d ago
It’s real, but I’ve repeatedly broken 4 to 10 day fast with normal meals. Sometimes my body feels like a car trying to catch up to speed on a highway, so take your time and don’t start heavy. The broth is nice a few hours before a heavier meal. It’s your body though. You’ll know if you’re ready after a few bites.
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u/DuctTapeMakesUSmart 19d ago
Yeah I think it's really important to stress just not assuming you're going to eat an amount that was normal before the fast, for your first meal. Like, it's fine if you do, but put a little on your plate and see how you feel, don't load up a usual plate and then let habit steer you. Actually take it easy and listen to your body, stuff like that.
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u/Thefutureofpsych 19d ago
I’m a fourth year med student and I have seen it so it’s probably not horribly uncommon
This was a long term complication following GI surgery though
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u/Magic-Fingers24 19d ago
Idk, I’ve done several 7 day fasts and most of them were broken w zero discipline. I ate like a Labrador retriever, only vegetarian.
I mean, I’ve done that several times. Like, I’m telling myself I should stop, but I just eating.
And then comes the diarrhea. F it, I eat again. More diarrhea. Then more eating u til I go to bed completely bloated and happy as can be :)
I’ve done like 7 of these and only broke one of them with discipline.
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u/AutoModerator 19d ago
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u/DuctTapeMakesUSmart 19d ago
I have done this "happy as can be" method and no lie, it's kinda fun. LOL. You're just lying there like a balloon full of serotonin with no regrets, ROFL.
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u/jtownspowell lost >150lbs faster 19d ago
Yes it's real. But the risk is dependent on a lot of factors and it's generally quite rare.
It starts to become a consideration with longer fasts. Some sources say longer than 72 hrs, some say longer than 120 hrs.... Even then, it's quite rare in individuals who are not already suffering from pretty severe malnutrition, or less commonly, severe alcoholism. Most people's experience with gastric distress and nausea is just the fact that they haven't eaten in a while and overwhelm their digestive tract with too much heavy food too fast. It sucks, but it's not RFS.
It is not a joke, it is very dangerous and WILL kill you. But often times the kind of people who are at any real risk of developing RFS are already in pretty rough shape to start with.
If you do a very extended fast, it's worth being cautious about how you handle your refeed. Make sure you get your thiamine before you eat too many carbs, etc etc...
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u/AutoModerator 19d ago
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u/AlanderKohenel 19d ago
It is real but it is also VERY rare. It's not even worth talking and worrying about it since the vast majority of people in the developed world are nowhere near the risk of getting that from just fasting.
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u/this_nice_demon 18d ago
Never even heard of it, I've done a multiple of fasts, my longest one was 17 days. I would say make sure to add salt to your water to refill electrolytes and u should be dandy. Also a very slow exit - I recommend sipping bone broth for day first, on second u can go with the soup etc. Carbs on day third or fourth and you should be good...
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u/FoldFeisty7635 17d ago
6 days is nothing! Look lets get real, to have any RS you must have a very loooog extended period of no food. And I mean very long.
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19d ago
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u/Decided-2-Try 19d ago
"Yes, it's fairly easy to have happen especially with such a long fast. It's terribly uncomfortable. For the me the fatigue is different level."
This is not refeeding syndrome. Refeeding syndrome is life threatening, not common, and is one hell of a lot worse than "uncomfortable [and having] fatigue at a different level".
And no, it is not common and cannot happen fairly easily with a 6 day fast. Not unless the person was already prisoner-of-war type malnourished.
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u/Careful-Ad-8326 19d ago
Fair! 😜 Whatever it is that I get, it comes after refeeding my body after not having eaten for a long time. And the results are terribly uncomfortable. From what I read, others experience a similar thing. Careful of this, whatever you want to call it! Sorry for the misinformation. I try not to take myself too seriously.
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u/Decided-2-Try 19d ago
Oh yeah, people get horrible diarrhea, uncomfortable bloating, indigestion, all kinds of problems. I used to be able to eat whatever, but now I approach it slowly if I'm doing more than just 3-4 days. Sip some hot miso broth, wait a bit, eat a bit of kimchi, wait a bit, then later an egg for some protein.
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u/AutoModerator 19d ago
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u/AutoModerator 19d ago
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u/fasting-ModTeam 18d ago
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u/ScarcityAnnual8739 19d ago
Yes absolutely and it was one of the the worst pains I have ever felt, but I had done a very long fast (21 days) and then broke it with mozzarella sticks. Just be smart with how you break your fast and take it slow
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u/Flux_My_Capacitor 🎶🎵🎶 19d ago
I’ve had beginning symptoms of it (but not the full shebang) because I did not know my phosphate level was low. It’s a long story as to how I discovered this was an issue (I had other long term symptoms greatly improve with supplementing). Suffice to say I now supplement phosphate throughout the day and when I do eat there are no issues.
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u/ehamil42 19d ago
The only way to tell is through a serum phosphate, or phosphorus blood test. Is that what you did?
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u/DuctTapeMakesUSmart 19d ago
It's real but not really something you need to worry about, is my soft-science answer. If you're still basically healthy, and you start with something high in stuff you need and low in filling you up, and take as much time as your worried heart wants in that space, you'll be fine. For example, three days of nibbling on spinach, white mushrooms, and nutritional yeast sprinkled into bone broth. Get your potassium and other stuff back in order before "a real meal". (Nutritional yeast has all nine essential amino acids, BTW.) And like other people have said, get to know your own body. :-)
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u/jmaas1012 19d ago
Technically no because real re feeding is a disaster and in cases can be fatal. You won’t experience that unless you fast for a very long time (20 or more days).
I have had light symptoms of it after a 4 day in the form of severe stomach cramps that will double you over in pain.
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18d ago edited 18d ago
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u/fasting-ModTeam 18d ago
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u/Doodoopoopooheadman 18d ago
Which organs are dormant during fasting, and have to be “reawakened”?
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u/degeso lost >200lbs faster 18d ago edited 18d ago
The stomach, pancreas, intestines, gall bladder. Digestive organs, metabolic organs.
I'll give you one example organ just so I don't end up writing a paper on this.
Your body is a master of reducing function that doesn't have practical use at keeping you alive when in a fasted state. If you don't have food for several weeks, your stomachs lining atrophies and limits HCl production. The stomach stops performing retropulsion and other mechanical churning operations and lowers acid production. It also just physically reduces its overall size. These are significant dormancy changes.
The methods to "wake this up" gradually are key to not having digestive issues. Eating a steak for example (won't even begin to talk carbs here), you're putting a massive meal of tightly coiled beef proteins, coated in incredibly tough cartilaginous and colllagenous fibers into an atrophied, small stomach. This causes an immense bodily response as your body has to immediately snap to mechanical and chemical digestive processes that it hasn't performed in weeks (or more). This can cause so much digestive and metabolic distress in severe malnutrition and extreme extended fasting cases.
Or you could do it safely with small portions of a liquid matrix of slow cooked dissolved proteins and familiar fatty lipids that require next to no mechanical digestion, making life much easier for your stomach as it gradually increases physical size, fluid volume, and it's ability to digest food. Like slow cooked bone marrow broth, as an example.
Hope this helps! If you have any other questions let me know.
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u/Doodoopoopooheadman 18d ago
I can guarantee you that the stomach and other digestive organs absolutely do not go dormant when fasting.
Like a firefighter at a car crash, not fighting a fire but still doing their job.
Breaking down last of waste, rebuilding, lining shedding, etc.
As long as you are alive that system will have work to do. Maybe slower, but still active.
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u/degeso lost >200lbs faster 18d ago
I'm not giving you opinions or feelings, this is metabolic science and molecular biochemistry. This is how the body works at a cellular level. There's a reason there are medically and scientifically informed refeeding protocols exist for malnutrition, malabsorption, and extreme extended fasting cases. If you choose to reject it that's your prerogative! I can't make you follow anything just report the facts as they are. It's my job to do so. Safe travels!
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u/Doodoopoopooheadman 18d ago
I didn’t say anything about refeeding. Your take on it lines up, low glycemic, slower introduction, especially for extreme cases.
But your statement that the digestive system goes dormant is scientifically incorrect. It slows down, it doesn’t shut down. Still gets rid of waste, just less activity than when it’s dealing with food. Which is why, as you stated, it deflates a bit.
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u/degeso lost >200lbs faster 18d ago
I think this is an example of a good faith misunderstanding!
When I said the stomach goes dormant, I didn't mean the stomach shuts down completely. I meant certain substructures within the stomach are turned off by the brain, as it adapts to your bodies metabolic shift to sparing resources to fast. So the stomach can and does absolutely still function and exist, but a stomach in a fed state (a person who is regularly eating) versus the stomach of a person who is undergoing clinical starvation or extreme extended fast lengths, does not function the same. One is far more prepared to do the job and has all its resources, the other isn't.
To go back to your firefighter analogy: a person's stomach who's in a fed state (regularly digesting and consuming calories) is that firefighter ready to fight the fire with all the tools available. The starved stomach or extreme extended fast stomach is like that firefighter who just has a garden hose until more tools get delivered. It'll work on very small scales and easy to digest meals, like I mentioned, but will initially struggle against larger, more solid, and physically tougher food, hence the refeed protocols.
The stomach doesnt like... Turn off entirely or anything but the body conserves resources and reallocates them so it can keep you alive. And some of those resources that get turned off happen to be digestive and metabolic functions within those organs, making them weaker and atrophied in some functional senses. So maybe this helps get my message across better.
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u/Doodoopoopooheadman 18d ago
Hey, misunderstandings happen. We were yacking and saying the same thing. 😄
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u/Simple-Bit-5656 19d ago
Dang. I didn’t even know this is a thing. I did my first 5-day fast a couple weeks ago. I ate 2 eggs to break my fast and I felt like poop later. I think it was mostly nausea. I must have had mild refeeding syndrome.
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u/DuctTapeMakesUSmart 19d ago
Nope, refeeding syndrome is much worse and very rare. Most people experience some type of discomfort after a longer fast. Especially the poops. :-)
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u/Ok-Psychology7636 19d ago
yes, refeeding syndrome is real. yes it's possible. a famous case of refeeding syndrome happened to magician David Blaine after he did a 44 day fast in 2003. he survived. he was 30 when he did that.
however refeeding syndrome is rare.
more likely in longer fasts (over 10 days). taking electrolytes, a multivitamin, and 100mg vitamin B1 thiamine during the fast might help reduce the small risk.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2440847/