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Ketosis as alternative source of energy

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07 Oct 2007 20:17 #163 by david
david created the topic: Ketosis as alternative source of energy
Ketosis is an alternative fuel for the brain using the body's fat stores for energy rather than simple and complex carbohydrates, which is believed to have some advantages over deriving energy through carbohdrates. Without going into all the details of why ketosis might be a more favorable source of fuel, is it possible to achieve ketosis while not on a water fast?

By this I mean by possibly following a very low carbohydrate diet which remains below the pancreas' 'detectable' threshold.

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21 Oct 2007 19:36 #180 by TheFastDoctor
TheFastDoctor replied the topic: Re:Ketosis as alternative source of energy
To some extent ketones are actually used all the time.. you don't need a \"very low carbohydrate diet\". Whenever you burn up your available carbohydrates (blood sugar and liver glycogen) your body \"looks\" for alternatives. The most logical alternative is protein (such as organs or muscles) so we need to protect these. To this end I recommend a low protein diet (so the body does not \"consider\" protein an energy source, but a structural material) and load a bit of fat before every fast.

If you burn off your blood sugar with some exercise, you do indeed start burning fat also, particularly if your (Physical) activity \"signals\" to the body that the muscles has uses other than being fuel. (This is why physical activity is important during a fast.)

Most (active) people probably burn ketones for up to a few hours some days, even when not fasting: Whenever the blood sugar is \"used up\" and not immediately replaced, one can convert to fats. No marathon athlete can complete a run without digging into these reserves, so they all eventually go ketotic. Regular fasting ensures that the mechanism for breaking down fat into ketones remains active (\"on standby\") all the time and ketosis can \"kick in\" on short notice, so the \"switch over\" is much easier and happens smoothly.

André

All my posts are "generic", based on my opinions and experiences only and are not intended to replace the advice of your own licensed medical practitioner.
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26 Oct 2007 15:17 #206 by wiseaerial
wiseaerial replied the topic: Re:Ketosis as alternative source of energy
Hello,
I like the expression \"the switch over happens smoothly\" because I noticed that \"feeling\" many times. After fasting, the body knows how to go to the \"fat\" phase much easier than after eating and even exercising. It is very smooth, and there is no feeling of cravings or pain.

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27 Oct 2007 01:12 #209 by Andrew
Andrew replied the topic: Re:Ketosis as alternative source of energy
I have only just started studying the actual chemical changes produced in fasting. One thing that has occurred to me is that ketones in a pregnant woman's urine is seen as a sign of their health being in danger. I wonder if the opposite could be true, and if the body is always trying to feed the growing baby from our stores, possibly at times when vital organs are being grown etc. I am reminded of an article I read recently describing how some lizards when growing their tails back will fast until it is done. Also tadpoles will devour their tails while fasting in the process of transformation, and of course caterpillars can eat nothing new while they are transforming into butterflies. There is also the matter of repairing tissues efficiently while fasting, which in nature is the norm. Wouldn't creating a new life be the ultimate in the transformation of our flesh using ketones?

Maybe the diet pre-pregnancy is of far more importance than the doctors who have you test for ketones would suspect. And that it is just as important for a pregnant woman to draw on their own body stores to create the new life inside them as it is for them to eat well during their pregnancy. Maybe more important even, maybe they shouldn't be increasing their intake of food by much at all, rather allowing the actual baby to be created mostly from stores built up in the seasons before the pregnancy. In this way the body may have more control over the quality of nutrients and going to the baby rather than relying on having perfect nutrition during the pregnancy- which in nature may not always be possible. Animals will respond to an abundant season with more offspring, obviously consuming more and building stores in their bodies. They cannot obviously see to the future and predict a good harvest with which to feed their pregnant bodies or newborns. I doubt many pregnant animals would be taking the trouble to double their iron intake.

If this was meant to be the case then in a pregnant mother at least ketones and glucose could well be working together or alternating regularly a lot quicker than we would see under the usual fasting rules.

Andrew.

\\"Truth is often painful, but ignorance is never bliss.\\"

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09 Nov 2007 02:56 #237 by TheFastDoctor
TheFastDoctor replied the topic: Re:Ketosis as alternative source of energy
You are SO right, Andrew.. should we \"build babies\" from dead animals (meat), cooked vegetables, or.. real human tissues?

Ketones has a \"bad\" name amongst my colleagues because they have often just \"heard the bell ring\" that when the cells does not receive enough sugar, you will form ketones.. and they tend to forget this is perfectly normal and natural, UNLESS you have HIGH blood sugar at the SAME time (Then the blood becomes hyper-osmolar).

Congratulations on a very well composed post Andrew!

André

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24 Nov 2007 22:04 #285 by david
david replied the topic: Re:Ketosis as alternative source of energy
Thank you Dr Kruger and Andrew for your stimulating posts!

I trust someone will be able to shed some light on a point which I feel is crucial in understanding the \"ketone as alternative fuel\" debate.

I though I had a reasonable grasp on what ketones where until reading an article from Diabetes UK

\"In the short term, consistent high blood glucose levels can lead to a condition called diabetic ketoacidosis (DKA). This happens because of a lack of glucose entering the cells where it can be used as energy. The body begins to use stores of fat as an alternative source of energy, and this in turn produces an acidic by-product known as ketones.\"

One could easily assume from the previous posts in this topic, that ketones and one's body's supply of fat were one and the same thing, however the above quote suggests that ketones are in fact a by-product of the body breaking down bodily fats for fuel. Is there a double meaning to the word Ketosis namely a) breaking down of fat and b) acidic by-product of breaking down fat? or more than likely there is a wide gap in my knowledge of physiology and need this topic 'dumbed down', or have I simply not read the posts correctly?

Very grateful for all your efforts.

David

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28 Nov 2007 05:49 #299 by TheFastDoctor
TheFastDoctor replied the topic: Re:Ketosis as alternative source of energy
This quote from Diabetes UK is an eye-opener. It seems as if even at this esteemed institution there are no one understanding basic energy metabolism. When fat (triglycerides) breaks down to be used as energy, it forms 4 baic molecules:

1. Glycerol (3 carbons in a row) and
2. the 3 major ketones.

The glycerol can\"come together\" in pairs to form glucose (blood sugar) but more than 80% of the energy from fat takes the form of ketones. So to call it a by-product is a real stretch of the imagination.

Yes ketones are weak organic acids in their own way, but these are buffered by the blood proteins (also made up of acids: Amino acids). If the pH of the blood falls from 7.4 to 7.3 we do get worried; I have succesfully resuscitated only one patient whose pH fell below 7.0; this was 6.9. So acidosis can be dangerous.

BUT a well body forms only enough ketones to supply the needs of energy in the cells. Fasting on its own will therefore NOT cause dangerous keto-acidosis.

Where the diabetologists' concern comes from, is the fact that their patients forms ketones while there's still a lot of glucose in the blood. This is because the glucose can't reach the inside of the cells, either due to lack of insulin (type 1) or insulin receptors (type 2). The cells therefore gets a false message that there's not enough sugar, and sends signals \"ordering\" ketones. When these arrive, the mixture of high sugar plus ketones then \"sucks\" water from the cells which is the big danger.

This will not happen in non-diabetics. With good supervision this need not happen in diabetics either.

So there's mis-information based on inappropriately/incorrectly interpreted information even in high circles..

André

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01 Jan 2009 21:59 #1682 by ReginaNoel
ReginaNoel replied the topic: Re:Ketosis as alternative source of energy
Interesting discussion - the concept of creating new life off of energy reserves. I am four months pregnant. And I have fasted off and on over the last 11 years. And I will say - I feel like I need one now! In the first trimester, I found I didn't eat much. I was more tired than anything. Now in the second trimester - I am eating everything. Interestingly enough, I'm not hungry - ever. My stomach is so squished by the growing baby, and I really feel uncomfortable. Your bowels slow down, too (supposidely to allow time for the baby to utilize nutrients). So I'm eating - but it's not "cravings" like you hear women get. I think it's more emotional (nerves, stress from work, finances, etc., baby). And probably a bit of "I have no control over my body any more - so what's the point". I have wanted to fast - but everything I read says it is not good for pregnant women. I'm rather well educated, and really listen to my body. So I am inclined to believe that if I went on a "liquid diet" (while still taking my supplements) as opposed to a full-on fast, I'd be fine. And get the rest my body needs!! Intuitively, I feel like this is what I should do - because eating is not helping me feel good! I wouldn't go nuts - 3 to 5 days max. I need to bring some balance back - physically and emotionally. Any thoughts, advice most welcome...

P.S. I had a docotor's visit week 13. They did find ketones in my urine. It was a 3pm appointment, and I hadn't eaten since the previous day. I actually felt pretty good.

Regina

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01 Jan 2009 22:35 #1683 by TheFastDoctor
TheFastDoctor replied the topic: Re:Ketosis as alternative source of energy
Regina, listening to your body is always good advice. But now you have 2 bodies, and the little one inside might not have full on communication with your mind. So be careful.

But think of this: Do you want to "build your baby" from only the best "materials"? Then what's better than parts of yourself? This is ultimately what happens. You only build a few grams of baby per day, and there's thousands of grams of you. As long as your blood protein levels are reasonable, there's more than enough materials to assemble the new human. So forcing yourself to eat serves no function.

I dislike "supplements" and see them in exactly the same light as other drugs like antibiotics and antidepressants.. only good for sick people. In the middle of the worst famines we see normal babies born. There's a theoretical risk of folic acid deficiency in the Western world due to the processing of food.. but you can have your blood levels measured, and eating a bit of leafy foods is often adequate.

The notorious "hyperemesis gravidarum" (Nausea of pregnancy) is likely the body informing you that it is doing some critical building work and wants nothing from outside..

Short fasts (less than 3-5 days) are VERY unlikely to cause a problem, provided you are well hydrated and feel good. And a "liquid diet" can be more than adequate: Bear in mind many good "solid" foods are liquids by the time they reach your stomach..

Ketones simply means you are burning fat.. which is no problem unless you have high blood sugar at the same time. Most pregnant girls end up with more fat at the end of a pregnancy anyway.

Don't force yourself either way. If you decide to fast for a while, check your pulse rate (and if you can, your baby's) for unexplained increases. Look at food (even fruit juice is a food) regularly, asking yourself if you really need it and if the answer is yes, don't resist just to make a point. But don't force it on yourself just to make a point either.

How about a whole new topic to follow your pregnancy on this site?

André

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17 Apr 2013 12:29 #16171 by moises
moises replied the topic: Re:Ketosis as alternative source of energy

David wrote: I though I had a reasonable grasp on what ketones where until reading an article from Diabetes UK

\"In the short term, consistent high blood glucose levels can lead to a condition called diabetic ketoacidosis (DKA). This happens because of a lack of glucose entering the cells where it can be used as energy. The body begins to use stores of fat as an alternative source of energy, and this in turn produces an acidic by-product known as ketones.\"


We really need to distinguish three things:

1. making ketones
2. being in ketosis
3. having ketoacidosis

We need to distinguish them, because they are distinct.

1. We all make ketones to a greater or lesser extent. Urine ketostix are notoriously inaccurate. A more accurate way to monitor ketone production is with a ketone meter, available without a prescription. This measures beta-hydroxybutyrate (BOHB) levels in the blood.

2. If blood BOHB levels are 0.5 mM or above, one is said to be in ketosis. With levels below 0.5 mM, one can still be making ketones. But ketones are not a significant energy source for most of the body's cells, particularly, for the brain. Instead, glucose is the primary fuel.

People who are fasting or who severely restrict carbohydrates (and moderately restrict protein), and have BOHB in the 0.5 to 5.0 mM range can be in a healthy state of ketosis. They are using ketones as an energy source to a much greater extent than someone with BOHB less than 0.5 mM.

Ketones are acid compounds. But when blood BOHB is 0.5 - 5.0 mM, the body easily maintains a healthy pH balance.

3. When serum BOHB reaches the 15-25 mM range, one has the pathological condition called ketoacidosis. In the absence of insulin, the body keeps pumping out ketones to such an extent that the body becomes dangerously acidic. Since almost everyone, except for the most severe diabetics, produces some small amount of insulin, ketone production will never reach these extremely high levels.

Over time, once the body adapts to being in ketosis, it tends to conserve ketones and does not spill them into the urine. So, one can be in ketosis and yet not show any ketones on the urinary ketostix.

Since severe diabetics could die if they have very high serum ketones, there are monitors available to measure serum ketones. The monitors typically cost about $20. The strips that the monitors use, however, tend to be quite expensive. The best prices that I have been able to find for the strips are about $2 each, available from online Canadian pharmacies. If someone knows of a better source, please let me know.

In summary, we need to distinguish being out of ketosis, being in healthy ketosis, and being in unhealthy ketoacidosis.

People tend to be out of ketosis when they consume more than 50 grams carbohydrate per day. People tend to be in healthy ketosis when they consume less than 50 grams carbohydrate today, and moderately restrict consumed protein. Obviously, if one is water fasting, one is consuming no exogenous carb or protein. People tend to be in pathological ketoacidosis when their pancreas is "burned out" and can secrete virtually no insulin.
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17 Apr 2013 13:07 - 17 Apr 2013 13:15 #16172 by Ockeghem
Ockeghem replied the topic: Re:Ketosis as alternative source of energy
Moises,

Thank you for a very informative post.

I have been trying to gather empirical evidence with regard to the effectiveness of keytones as an alternative fuel once glucose and glycogen are depleted. I have never measured or monitored my keytone production. However, I have fasted and continued to exercise rather rigorously while in ketosis. (My assumption is that I am in some degree of ketosis during the second, third, and fourth weeks of a fast.)

I have run ten miles (approximately 1.5 hours) a couple of times during the second week of a fast, and have run eight miles a few times during the second and third weeks of a fast. Although I was fatigued in the early stages of my mileage, I found that around the seventh or eighth mile I had more energy. Fatigue was felt for the most part in my lower legs, something I rarely feel after a twenty or more mile run when I am not fasting. I have not run more than ten miles at any one time after the fifth day of a fast. I am gradually building up to the point where I will extend my running to twelve or (hopefully) fifteen miles at one time while in the second or third week of a fast in order to determine how my body reacts to longer running while in ketosis.

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17 Apr 2013 14:19 #16173 by moises
moises replied the topic: Re:Ketosis as alternative source of energy
First, in the last paragraph of my post #16171, it should read:

People tend to be in healthy ketosis when they consume less than 50 grams carbohydrate per day, and moderately restrict consumed protein.


Second, in reply to Ockeghem,

Your endogenous glucose and glycogen are rapidly depleted on a fast, as I am sure you are well aware. By the process of gluconeogenesis you can break down your own muscle protein to create glucose. Most people would agree that this is not desirable.

There is a growing body of evidence that suggests that it takes about two weeks for an exercising person whose main fuel source is glucose to switch over to burning fat. The process of switching from burning glucose to burning fat is sometimes called "ketoadaptation."

This suggests to me one possible strategy that you might want to test. Since the first two weeks of ketoadaptation could be uncomfortable, why not limit the runs? Then, on day 15 of the fast, when, in theory, you are using almost all ketones, start doing the longer 12-15 mile runs.

You might want to keep a journal to compare how you feel on a ketotic 12-mile run versus a standard 12-mile run. I don't know how quickly you feel that you decondition. I know that more than 2 decades ago I ran my one (and only) marathon. The week before the marathon I "tapered" and only did short, easy runs. When I ran the race, I ran the entire race at a much faster pace than I was able to train at, even when I was training much shorter distances. So, if you took it easy for the first two weeks of a fast, maybe you could consider it a kind of recovery period.
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17 Apr 2013 15:41 - 17 Apr 2013 15:43 #16174 by Ockeghem
Ockeghem replied the topic: Re:Ketosis as alternative source of energy
"This suggests to me one possible strategy that you might want to test. Since the first two weeks of ketoadaptation could be uncomfortable, why not limit the runs? Then, on day 15 of the fast, when, in theory, you are using almost all ketones, start doing the longer 12-15 mile runs."

Moises,

This looks like an interesting suggestion, and one that I will probably try. Although not by design, I seem to be moving in this direction somewhat. My twenty-mile runs are almost always done at the very beginning of my next fast. I have wondered if cutting back in the early stages would help.

"You might want to keep a journal to compare how you feel on a ketotic 12-mile run versus a standard 12-mile run. I don't know how quickly you feel that you decondition. I know that more than 2 decades ago I ran my one (and only) marathon. The week before the marathon I "tapered" and only did short, easy runs. When I ran the race, I ran the entire race at a much faster pace than I was able to train at, even when I was training much shorter distances. So, if you took it easy for the first two weeks of a fast, maybe you could consider it a kind of recovery period."

Thanks. I have kept a running journal yearly which dates all of the way back to 1978, the year I first started running. That journal eventually morphed into a running / fasting journal as of about three or four years ago. Once I do longer runs in the latter stages of a fast, such a comparison (ketotic vs. standard) could prove to be very useful. Much appreciated. :)

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18 Apr 2013 12:03 - 15 Oct 2013 04:30 #16181 by TheFastDoctor
TheFastDoctor replied the topic: Re:Ketosis as alternative source of energy
Thank you, Moises, for your invaluable input. It is much appreciated.

Indeed it can take up to 3 days for a "normal" person to produce adequate ketones to protect the muscles from the process of gluconeogensis. But in people who fast regularly (eg. weekly), and assure ketosis each time, this transformation is much more rapid, even almost instantaneous, when the blood sugar drops. The timing of events is very much dependent on your activity levels and in our experience also on the "detox" activities. This is one reason I very seldom advise patients to go on the traditional "passive fast".

And dear Ockeghem, we men always like measurables. Thus if you could measure the effects of a fast on resilience (for example the time, distance and effect on heart rate during eating and during a fast) that would give us some figures to compare..

André

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14 Oct 2013 19:07 #18529 by ginakjar74live
ginakjar74live replied the topic: Re:Ketosis as alternative source of energy
Dear Dr. Kruger,
I am looking for someone in my area to supervise my fast, but having absolutely no luck. It seems that the Mid-Western Dr.'s here are stuck in a closed minded vacuum. That said, I have educated myself to the best of my ability, and have begun my own fast, unsupervised. I am undertaking this fast because I am changing my life for the better. I have had high blood pressure and hypertension for 1 year now brought on in late term of pregnancy. It has responded some to diet and exercise along with medication and a water pill. I have been water fasting for 8 days now, but have still been taking the blood pressure med. and water pill. I am having extreme thirst. I am probably drinking almost a quart of water per waking hour, maybe more. I am trying to sip only when thirsty.
I have cut my water pill in half, and am planning to do the same with the nifidepine 30mg tablet this evening. My hope is to wean myself from them completely within another week, as my blood pressure is responding beautifully to the fast.
I am concerned about my water intake though. It seems very High. I would gladly pay you for your services if you would consider supervising my fast online.

Blessings to you,
Gina K.

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14 Oct 2013 23:12 #18530 by danielle
danielle replied the topic: Re:Ketosis as alternative source of energy
Gina,

I commend you on 8 days of fasting! It's always so inspiring to hear people's successes.

My thoughts on your thirst are this...the medication is perhaps making you thirsty? I don't know for sure, but when I take some meds, I get dry mouth. I also know, personally, that when I stop drinking water and get most of the food out of my gut, I no longer feel thirst.

The doctor will answer your question and is more knowledgable. Just wanted to say Hi and offer some input. I wish you much success. Hope I make it 8 days too!

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14 Oct 2013 23:19 #18531 by Elizabeth C
Elizabeth C replied the topic: Ketosis as alternative source of energy
Hello!
Congrats on 8 days of fasting.
Are you taking your blood pressure? You may also be depleting important minerals which can be dangerous. I would be very careful with continuing those meds. Get checked - even a walk in clinic can help you.

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15 Oct 2013 04:36 #18533 by TheFastDoctor
TheFastDoctor replied the topic: Re:Ketosis as alternative source of energy
Dear Gina, I do share your concerns re the high volume of water intake. This can lead to dilutional hyponatraemia which is indeed dangerous. Depending on the kind of "water pill", this medication can sometimes be protective. Yet it makes no sense to me that you take a pill to get rid of water, and then add a lot of water to the equation again. Nifedipine is generally safe in these circumstances though.

Please see if you can find a lab that will at least test your electrolytes: Na, K, Cl, HCO3, plus perhaps the minerals Ca, Mg, PO4. Without some hard facts it will be rather difficult to give advice.

André

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01 Nov 2013 15:33 #18615 by Jonathan
Jonathan replied the topic: Ketosis as alternative source of energy
Hello everyone
,
this is my first post on this forum and I must say how pleased I am to be here. Before I mention my interest in the subject heading, I hope you won’t mind me saying a bit about myself by way of introduction. I have been visiting your site for a while and reading posts and the responses to them with great interest .I have been really impressed by the spirit of selfless service displayed to all by the Dr and others of the experienced fasters on this site...you are blessed here indeed.

I am quite excited at having the opportunity to post about my progress to people who might share my interests as this sharing is rarely possible to the same degree amongst those in my immediate environment. It’s always good to read about the experience of others not only because we can learn more ourselves but we may even be able to help others by our contributions.

I am indebted to Dr Kruger, Okeghem , Moises and others for their invaluable information on Ketosis. It all makes such sense and resonates with me. Thank you.
At the time of writing I am a healthy 52 year old Afro - Caribbean male living in the United Kingdom. Part of my motivation for adopting the fasting regime is that I experience pain in my left hip that I suspect is arthritic although I have not had it diagnosed as such. In the past my short intermittent fasts have always resulted in a dramatic reduction in pain and I’m hopeful that with regularity and frequency I will be able to clear this completely.

I regard my diet as a healthy one, easy for me to maintain physically and emotionally, established over a good number of years of experimentation, and perhaps most importantly - well suited to my lifestyle and temperament. With the exceptions of bee pollen and vitamin D3, I am a raw-food vegan. I have lots of energy and feel great. There is always however room for improvement.

I don’t have the goal of eliminating carbohydrates since I love my fruit too much however my particular version of a raw food diet excludes grains. potatoes and bread etc so it is already lower in carbohydrates.

My interests at present include regular Intermittent water and dry fasting and how I might incorporate both of these into a long term lifestyle. I am particularly interested in becoming “ketone – adapted” and am currently adopting a pattern of eating and fasting that I hope will help me achieve this. So far, results have been very encouraging with my first “ Ketostix” ketone reading measuring 16 mmol/L or “Strong” taken today at the end of my second 42 hour dry fast.(I read that ketone - sticks are not the most reliable of indicators for some conditions but I only need them to be a general indicator and not a fine measurement. )

The pattern with which I am experimenting at present is as follows

Day 1– 42hr water fast
Day 2 – 6hr eating window
Day 3 – 42hr dry fast
Day4 – 6hr eating window
... to be repeated in similar fashion.

Today is day 8 and I’ve just broken my dry fast with a mixed juice of coconut water, beetroot and black grape – delicious! At present I want to see how long I can maintain this and to what extent I feel different over time. I have experienced some weakness in the latter stages of the fast days but that has already been different second time around. I’m treating this as my ketone adaptation period.

I welcome interaction on any aspect of this whether it be comment, questions or advice and hope that I have something to contribute that will be of value to others.

Thank you

Jonathan
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01 Nov 2013 16:23 #18616 by TheFastDoctor
TheFastDoctor replied the topic: Ketosis as alternative source of energy
An admirable undertaking, dear Jonathan! I cannot see it not working very well.. provided you do elimination cycles also.

Whilst I do dry fasts myself I don't recommend ever suppressing the thirst sensation though. There's a lot of water in the body and any you take in simply assimilate with what is already inside. The safety of dry fasting will of course vary depending on the climate (sweat loss) and since I do insist on elimination activities, which causes water loss, I suggest you always remain open to heeding your body's message regarding fluid.

André

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