Dry fasting: The ultimate in autophagy
Dry fasting represents what I believe to be the ultimate method of cleansing the body of toxins, cancers, viruses, and bacteria and should be practised routinely with wet fasting only serving as a stepping stone to this more therapeutic practice. It will decrease the risk of cancer and quell all types of inflammatory processes. It essentially is the cure for anyone with diabetes, obesity, hypertension, and gut dysbiosis. In addition, a regular dry fasting practice will reduce your speed of aging, helping you look and feel younger for longer.
What happens at the cellular level is cell death of inefficient cells that cannot tolerate the loss of both nutrients and water, and the survival of only those with efficient organelles. Decrepit cells are replaced with newer ones from your stem cell population. In addition, since water is scarce, infections, both bacterial and viral are inhibited (if I ever catch COVID, I am immediately doing a dry fast). Only the amount of water necessary for survival is produced de novo from your fat stores, which allows you to burn fat to a much greater degree than wet fasts. In those experienced with dry fasting, a 7-day dry fast is said to be comparable to 21-day water fast in terms of weight loss, with greater preservation of muscle tissue. The conversion of fat to water also prevents the feeling of thirst and makes dry fasting surprisingly tolerable. However, care should be taken not to cause excess loss of moisture from mouth breathing, speaking or sweating.
Dry fasting also allows you to resorb pathologic tissue and heal from old wounds. Cellular activity slows down, and heart rate and metabolism decrease. Regular dry fasting is, in my opinion, far superior to taking rapamycin for its purported longevity benefits. While rapamycin and dry fasting both down-regulate mTOR and increase autophagy, fasting activates rather than inhibits the immune system, which is your protective shield against cancer.
A dry fasting protocol that has been scientifically tested has not been developed for longevity. The ideal frequency, length, and depth are not known. The following protocol is one that I’ve adapted from Sergey Filonov’s book “20 Questions and Answers about dry fasting” and August Dunning's “The Phoenix Protocol”, with my own perspective and personal experience having done monthly dry fasts for 6 months. The protocol is largely based on the authors of these books but will be refined over time as I become more experienced and listen to the accounts of my patients, and of course, as the science catches up.
A personal anecdote on dry fasting and the reason why I think it is more powerful than doing wet fasts. I measure my blood sugar levels continuously in order to prevent blood sugar spikes. However, I measured it this one time during a dry fast and the results shocked me. I have done multi-day wet fasts, where my blood sugar levels were always low but within normal range. See Figure 1.
Figure 1. A 24-hour wet fast with a Dexcom continuous blood glucose monitor. Personal data. Nov 7, 2020.
However, a single day of dry fasting kept my blood sugars below 4.0 mmol/L without symptoms of hypoglycemia because I was already in ketosis! As you can see in Figure 2, starting at around 6 pm and throughout the night, I was in the red zone (hypoglycemic) but felt completely fine due to the body converting fat into ketones. Ketones are a secondary fuel source our body can use as energy, however, cancers cannot. With the combination of immune activation, autophagy and a lack of sugar to survive (see Warburg effect), pre-malignant cells are removed from the body. A weekly dry fasting routine, will not only slow down your speed of aging, but should in theory cause pre-malignant cells to die off even after a single day of dry fasting. Thus, starting a dry fasting practice as early as possible will lead to compounding gains, significantly delaying the onset of cancer.
Figure 2. Continuous glucose monitoring during a 24-hour dry fast, breaking my fast at 11 am. Personal data. June 25, 2023.
Schedule
Sergey Filonov suggests doing a 1-day dry fast a week, 3-day dry fasts a month, and 7-day dry fasts a year to maintain optimal health. The limitation of fasting depends on your nutrient stores, fat stores and stem cell population. Overdoing dry fasts could deplete your body’s resources of these critical components.
A 1-day dry fast would be eating your last meal Friday at noon, and resuming eating Sunday morning (starting with half your usual amount of food).
A 3-day dry fast would be having your last meal on Thursday, skipping Friday, Saturday and Sunday, and eating again on Monday (starting with a quarter of the usual amount of food and doubling each day until back to maintenance).
A 7-day dry fast would be having your last meal on Sunday and eating again on Monday (starting with 1/8 th of the usual amount of food and doubling each day until back to maintenance).
Always eat one meal a day (i.e. a 2 to 4-hour eating window) at the same time to keep your circadian rhythm consistent.
Preparation before a dry fast
One should be comfortable doing prolonged 3 – 5 day wet fasts and practice daily time-restricted feeding with at most a 4-hour feeding window, before attempting to dry fast.
Nasal breathing is an absolute must during a dry fast, as breathing through your mouth will make dry fasting too uncomfortable. You should be prepared to be silent most of the time during a dry fast. If you are a mouth breather while you sleep, mouth taping will be essential.
Sergey Filonov suggests doing a liver and colon cleanse prior to dry fasting. What I suggest, is a week before attempting a dry fast, support your liver detoxification pathways with vitamin B complex, NAC and glycine, to avoid experiencing negative side effects of toxins being released from adipose tissue. Milk thistle and activated charcoal for a week to further promote detoxification. You should also determine whether you have normal kidney and liver function before attempting a dry fast (ask your doctor for lab tests), in order to assure adequate toxin removal as they are released from fat stores.
Avoid being constipated or bloated when entering a dry fast. Clear out the colon first with magnesium citrate and psyllium husk with your meals, and begin dry fasting with an empty digestive tract. You do not want to exacerbate constipation and bloatedness further through dehydration. If you still have constipation, an enema may be required.
Clear out caffeine gradually from your system at least a week before the dry fast, as caffeine is a diuretic and can cause you to lose excess electrolytes and fluids. You also don’t want withdrawal symptoms from not having caffeinated drinks during this period.
Having a shower head with a water filter is especially important to avoid increased exposure to heavy metals and pollutants, as water is absorbed through the skin to a greater degree when dry fasted.
Things to do during a dry fast
In the mornings, I continue doing a red light sauna session, however, I stop if I feel I am about to sweat. I shorten my sauna session to 20 min instead of 30 min. I continue this practice as red light exposure produces melatonin, which is an antioxidant and protects against DNA damage. I also take activated charcoal on an empty stomach before my sauna session, to help remove additional toxins.
Exercise as tolerated in all forms: aerobic, strength, stretches, balancing, and walks in nature. Exercise is necessary to help maintain muscle mass. Though doing HIIT is probably too excessive, you don’t want to stress your body that much.
Meditate
Breathing exercises: I do Wim Hof breath work which will increase the production of red blood cells as the body experiences temporary hypoxia, helping to rejuvenate the body more quickly as stem cells are released from the bone marrow.
Supplements: Supplements should be taken sparingly, as you are not losing much through the urine. For short 1 to 3-day fasts, you can skip your supplements. However, for a 7-day dry fast, it might be a good idea to have the following supplements taken on day 3 or 4:
vitamin B complex, NMN
vitamin C, NAC + glycine, magnesium threonate, and zinc (though zinc can be difficult for some people to take on an empty stomach)
vitamin D, omega 3, CoQ10, astaxanthin
I basically swallow 5–6 pills at a time with a very small mouthful of water and some olive oil (to help absorb the fat-soluble vitamins).
IMPORTANT
Avoid getting up too quickly, as you will be slightly dehydrated and may lose balance. If at any point during your fast, you feel dizzy, light-headed, spaced-out, or weak, temporarily break the fast with some water and electrolytes (1L of water + 2 teaspoons of potassium citrate + 1/2 teaspoon of Himalayan salt), until symptoms resolve.
Dr. Filanov advises one to NOT brush teeth during a dry fast as you are slightly acidotic due to the ketone bodies being produced, which can soften enamel.
How to exit a prolonged 3-5 day dry fast
Food
After a 3 – 5 day dry fast, gradually return to your normal one meal-a-day diet over the course of 3 – 5 days. For the first day, start off with a very small bowl (appetizer-sized amount) of kimchi or other fermented fibre (sauerkraut, fermented beets, carrots for example), 1/4 cup of soaked nuts, and psyllium husk. All these foods are easily digestible and will reduce the chance of constipation. You don’t want to overwhelm the digestive enzymes, which need to be revamped by the pancreas and liver, otherwise, you may experience diarrhea or constipation. In addition, you don’t want to cause an insulin spike which could trigger refeeding syndrome. Add back more of what you normally eat, by doubling your serving on the 2nd day, and then double that amount again on the 3rd day so that you are eating the equivalent of 4 small bowls of food. If there is no bloating or constipation, gradually increase your intake as tolerated.
For the first few days, it is critical that you avoid simple or complex starchy foods such as sweet potatoes or fruits as you will only be able to convert fat to energy at this point. Slowly reintegrate carbs over the course of 4 – 5 days. Use a continuous glucose monitor to ensure you are not experiencing elevated blood sugar levels.
Fluids
Fluids should also follow a similar pattern, with a gradual return to baseline. I just dissolve 2 teaspoons of potassium citrate with 1/2 teaspoon of Himalayan salt in 1L of water or tea (try to avoid caffeine still at this point), and sipped gradually over the course of the day as tolerated. Do not drink too much at once, as this may lead to electrolyte imbalances.
Contra-indications to dry fasting
Those who have an increased risk of kidney stones or who have renal failure eGFR < 70.
Those with liver failure or a heart condition
Body fat % of <8% for men, <14 % for women
Eating disorders
Metabolic conditions (e.g. fatty acid oxidation defects, mitochondrial disease)
Thyroid disease (e.g. hypothyroidism)
Bleeding disorders (e.g. sickle cell anemia)
Individuals with hypotension, autonomic dysfunction
During pregnancy or lactation
Elderly or young
A side note
The arguments against fasting and caloric restriction for longevity, that people like Dr. Peter Attia have promulgated, run counter to what biology has shown. He is looking at it from the perspective of epidemiological data, where people with lower muscle mass are at increased risk of falling and fracturing (those orthopods! lol). While that may be true, maintaining large amounts of muscle by consuming protein will activate mTOR and accelerate aging (intuitively you don’t expect someone like Arnold Schwarzenegger to live past 100). There is an optimal amount of muscle tissue that one should have for longevity, and I look to the Blue Zone populations to see what kind of physique that should be. Here in Japan, for example, almost everyone around me has a slender build and eats meat sparingly, yet the Japanese have one of the longest lifespans.
With that said, before committing to a fasting routine, one should also take steps to avoid sarcopenia and frailty. Thus, it is important to also practice strength training AND balancing/stability exercises. Bone health is also essential and thus exercises that put stress on the bones, such as running, martial arts etc., will mitigate bone loss. Nutrients to support bone density include collagen, hyaluronic acid, glucosamine, vitamin K2, vitamin D, magnesium, and antioxidants. In Japan, Karate/Judo masters have some of the highest bone densities, while remaining fairly lean. Therefore, one should not train to build as much muscle as possible (which accelerates aging), rather one should train to increase bone density and stability while inhibiting mTOR through fasting.
Resources
Join the dry fast discord group to meet other like-minded individuals who are just starting a dry fast and those with more experience to ask any questions!
https://discord.com/invite/yHUhW2Wjc7