High Blood Pressure Caused by 5:2?

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  • I am sad to discover that I must stop doing 5:2 intermittent fasting because it appears to have caused my blood pressure to become uncontrollably high. I had lost 10 pounds (4.5 kg) over the course of 12 weeks, which I was very happy about. I found the program to be very easy, and the hunger pangs not that difficult to endure, and was enjoying the results of the program so much that I did not want to believe that my steadily rising blood pressure could be caused by 5:2. I am a 53 year old female who has been controlling my tendency toward high blood pressure through weight loss, diet, and exercise. My BMI was on the upper half of the healthy range when I started the fast diet, but I wanted to start training to run a 5k, and thought it would be helpful to first lose some unnecessary weight I was carrying. My goal was to lose 15 pounds (6.8 kg)…still keeping my BMI within the healthy range. I was, fortunately, keeping an eye on my BP with my home blood pressure monitor, had I not been monitoring it, I would not have known it had reached over 180/100! For the first time in my life I had to go on blood pressure medication! Even then, the medication still was not keeping it under control. My husband pointed out that the only change I had made was the 5:2 diet, so I reluctantly stopped, and after about a week my blood pressure returned to normal, and is still normal now, after two weeks. I am very relieved, as it was quite scary to have it so out of control, but at the same time I am disappointed because the Fast Diet had been such an easy way for me to lose weight. I still have 5(2.3 kg) pounds to go, and at least want maintain the weight I have lost, so I need to figure out a plan that doesn’t involve fasting. I don’t know for certain why 5:2 was apparently raising my BP, but it vaguely felt as if the level of stress hormones in my body kept rising over time the longer I was on the diet, my pulse had also been higher than normal. I am wondering if anyone else has experienced this problem?

    Hi, JeiCR. I am a doctor, and that really does sound strange! Do you think extra sodium could have been sneaking into your diet, such as in soups? Or a lot of extra caffeine? Were you taking a decongestant medication, by any chance, or any weight loss supplements that could contain stimulants? Are your ankles swelling a lot, in which case you would need to get your kidneys checked? (I know you said nothing else had changed, but just checking.)

    What is your current BMI? Could it be that you are stressing your body by trying to force it too low (although I don’t think I have ever heard of such a thing)?

    If your BMI is well within the normal range, maybe you could maintain your loss just by training for the 5K, or by fasting only 6:1.

    I don’t have a medical opinion.
    Im wondering about wether you were close to your TDEE on non fasting days. Also curious as to the foods on fasting days and feeding days.

    The only thing I can think of is your protein intake may need to be spread out. 
    Again not advice  I understand having 25g 25g 25g of protein  on feed days has an effect on the vascular system. Is the new standard. 
    This points to the type of protein intake I use on fasting days.  I use non flavored whey protein  as it is said in general to  metabolize quicker for the the body to use. On fasting days I aim for  10g 10g 10g when planning  my menu. 

    On another note if what’s happening to you was happening to me. I would make sure to get a Flu shot. Reason is typically having the flu increases inflammation.  There is a greater percentage of heart attacks occurring when having the flu. Avoiding 30 flu strains over ten years lowers to exposer to  the inflamation caused by flu.  Your 50% less likely over ten years  to have heart attack. So wether it’s 5:2 or losing weight in any other way cholesterol lvl may raise when fat is released for energy. So there could be a combination of conditions to keep watch over.  Inflamatory foods, flu inflammation, elevated blood pressure.   So If it were me I would be more sedentary on fasting days, but eating anti inflammatory foods  on feed day especially.

    Here’s a link to a list of the most anti inflammatory foods and their nutrition data.

    Again I can’t be more clear about the fact that I can’t give any medical advice whatsoever. I’m not qualified at all. I do however have an opion that what is on my fork is just as important to consider as medication. Especially when were prone to health issues.
    I’ll make a huge guess and wild assumption. If I eat a fry up , of greasy greasy greasy ,bacon,sausage,burger,BBQ. Just as poor fat as possible, and flood my blood with fat. I may also influence the level of fat in my blood by eating lower fat protein such as whey protein.
    I go as far to boil my chicken breast in water and skim off the fat before I put it in my chicken soup when I have the flu. 😉

    The biggest change I’ve made since watching The Truth About Exercise. Is to do better on my N.E.A.T, trying to also become healthy enough to accomplish H.I .T.T. So I can do it regularly. My experience trying this has made me more conscious about my meals , how to enjoy what’s good for me even more that what’s bad.
    Best wishes hope to see you around for five more decades.

    I appreciate your reply char6. My blood pressure is sensitive to sodium/potassium ratio, caffeine, and many over the counter medications, so I am very careful to limit sodium and increase potassium in my diet, limit caffeine to two cups of coffee a day, and other than that I drink caffeine free coffee or tea, club soda with a twist, and moderate amounts of wine. I never touch sweetened soft drinks or energy drinks. I avoid all over the counter medications, except in extreme situations, so I have not taken any in months. My ankles have not been swelling. I was prescribed hydrochlorothiazide, a diuretic, but it did nothing to control my blood pressure.

    My BMI is currently 21, and was formerly 22.6, both middle of the road numbers for someone my age and height (the range being 18.5 – 24.9), if I can drop the 5 additional pounds I’d like to, I’ll be at 20.2. I can’t imagine why this would be a huge stress to my body. I think I will probably take your advice and start training for the 5k, I can walk it at quick pace, no problem, but I’ve never been a runner, and would really like to be able to run the whole thing. I may try 6:1 also. I am thinking I should have a full physical exam first, with all the usual blood tests, it’s been over a year since my last one. Maybe something unusual will pop up that will explain things.

    I appreciate your reply also SAMM. I am a fan of whey protein too. I have it in a smoothie for breakfast most mornings, along with almonds, flax seed, berries, banana, greens, a dab of yogurt and coconut oil. I try to eat plenty of anti inflammatory foods and healthy fats. Food and exercise have been my medicine, until this weird blood pressure situation totally turned it all upside down. I do need to learn more about high intensity interval training and NEAT. I will have to watch The Truth about Exercise. Thanks for the tips! Oh, and you mentioned flu shots, I did not get one this year and came down with the flu at the end of December, luckily I was not super ill, but I doubt the inflammation, as you mentioned, did me any wonders. Best wishes to you, and cheers to five more decades each!

    That certainly sounds like a healthy regimen, JeiCR. I think the physical with labs sounds like a good idea. A BMI of 21 is nice and slender. I would be so thrilled to be back there again!

    JelCR, getting a complete checkup does sound like a good idea just to rule anything else out, as I haven’t heard of this before even though quite a number of people have been in research studies involving alternate-day fasting.

    However, it is possible, since fasting can raise levels of epinephrine and norepinephrine. Most peoples’ systems adjust, but maybe yours is extra-sensitive.

    Is your pressure back to normal off of 5:2 and off medication, or do you need to stay on medication to keep it down? If you have to stay on medication to keep it down, I would suspect a cause other than fasting; the rise in epi/norepi goes away quickly when you stop fasting. However, most high blood pressure is “essential”, meaning they are not able to figure out what the cause of it is.

    A relatively rare cause of very high blood pressure is narrowing of the arteries in the kidneys. This can be caused by high cholesterol OR by other things, like a condition called fibromuscular dysplasia that causes smooth muscle cells in the arterial walls to over-proliferate. If the arteries to the kidneys are partially blocked, they think the whole body is in shock and pump out a bunch of hormones to raise the blood pressure to compensate. I had to have an angioplasty of my renal arteries at age 43 because of this, and my blood pressure is still quite sensitive to sodium intake. However, if this is the problem, eventually medication will not control the high blood pressure, and then there are tests that can be done to see if this is what the problem is.

    char6, I do have a slender look in the right clothes, but I am small boned, so I really do belong on the lower end of my BMI range, and I still have too much abdominal fat, believe it or not. This has been a particular problem since menopause began. Thankfully, I am looking much less like an olive on a tooth pick these days, since losing that 10 pounds. : )

    franfit, thank you for your informative comments, which set me off doing some more research on epinephrine and norepinephrine, which seem to me to be likely culprits. I had forgotten to mention that while on the Fast Diet I was also experiencing severe hot flashes during the nights after fast days to the point where I thought I might end up as one of those unfortunate victims of spontaneous human combustion! It had been a year and a half or so since I stopped having hot flashes from menopause, so these came as an unwelcome surprise. I thought they might have been caused by losing metabolically active abdominal fat, I have read that this fat produces estrogen, and losing the fat would make me lose estrogen…I suppose this could still have something to do with the hot flashes, but I did read that epinephrine and norepinephrine can also cause hot flashes, and if fasting raises these hormones, then this all makes sense. Perplexing that these hormones seemed to stay elevated for a couple of days after a fast day, and did not go away quickly, as you mentioned they should. Another reason I think these hormones are involved is that during all three of my pregnancies I was given terbutaline for premature labor, which is derived from epinepherine, and I often had the same feeling while on the Fast Diet that I remembered feeling while on this med.

    Yes, my blood pressure is now back to normal now that I am off of 5:2, and I am in the process of slowing weaning myself off the diuretic, since it never lowered my blood pressure while on 5:2. I read that stopping it suddenly can cause raised blood pressure, hence my caution. I had received the prescription from an immediate care physician’s assistant, and I think I’ll be better off with advice from an internist who has done a more thorough exam, once I’ve had my check up. Thank you for telling me about your renal artery issue franfit, this could end up being an issue for me or someone I know too, so it is useful having this information. I hope that the angioplasty was very successful and has led to complete blood pressure control for you! : )

    So, I started the 5:2 diet when the program was first broadcast in the UK, and managed to get my weight back to normal. For clarity, I’m 53, I exercised a lot, this was that final 12 pounds around the waist that refused to shift.
    Anyway, at the time I started I had a full medical and my BP was normal.

    I’ve kept the 5:2 going, twice a week when required and once as my weight leveled off, and I can say that I’ve really felt healthier over that time frame

    16 months later, I’m training for a run and they offer a BP test. I’m sky high!
    So now I’m on BP tablets and trying to get this under control.

    I can’t point the finger at 5:2, but it’s the only thing that has changed over those 2 years and my blood result show every other factor as fine.

    Now it might be age related……but I’m no doctor!

    Weird! I was over the moon 2 months in to 5:2 to discover my BP was ‘normal’ – I could have kissed the doctor when he said it. My BP has ALWAYS been on the very high end of normal and I’ve had a lecture every time I’ve ever had it taken, until 5:2. A year and a half later I had it taken again when I joined my new gym and again I got a ‘perfect’ BP.

    I’m so sorry to hear that some are having bad BP reactions to the lifestyle and I hope you manage to find the cause but I think it must be more complex than just 5:2?? I’m in my mid 30s BTW and like I say, I’ve been right at the top end of the ‘normal’ range for as long as I can remember (along with every other female member of my family).

    wressle, same as you, I was using 5:2 to get rid of those last stubborn pounds around the waist. I have managed to stay off BP meds through detective work and lifestyle changes every time I’ve had high BP issues. I am motivated to stay off medications because my mother, who struggles with high BP, has never found really good control with them, and has had to suffer from their side effects. I did not want to go down that road if I could help it. When I realized my BP was getting high again I started checking it throughout the day with my home BP monitor and kept a journal of my BP and pulse numbers, and what was going on that day, noting any unusual activities, etc. After the first week it was becoming quite clear that fasting days where causing very high spikes in my BP, and that my BP in general was way more touchy and prone to spiking on most of my non fasting days than it was before. I monitored it for one more week, just to be sure, because I really did not want to stop doing 5:2, but decided to stop my last fast day once I hit 170/95. Now that I have stopped 5:2 completely my BP has normalized. I am no longer taking that diuretic either.

    TracyJ, actually now that I have stopped 5:2 the effect of my 10 pound weight loss thanks to 5:2 is showing up positively in my BP numbers, and I am now seeing lower numbers than I have seen in many years. My best BP numbers before 5:2 were 115/75, now they are 105/70! I hate having to stop 5:2, it made weight loss and maintenance so darn easy, and I hope to ultimately be able to continue with it in some modified way. I am sure my BP reaction to the fasting is not the norm, and I encourage people to give intermittent fasting a try, but I would also recommend frequent blood pressure checks, just in case.

    I have been on the 5:2 diet for 3 years and 3 months now. I lost 6kg over the first 6months and been a stable 56kg since then. I am female, 167cm tall and am now 50 years of age. I feel energised on my fast days and feel no hunger pangs anymore. However, my BP has increased to 157/85. Also, I had a mammogram 3 years ago which was clear. This year I had another and have been told I have cancer and precancer sites in both breasts. I am booked in for a double mastectomy. Could it have been brought on by this diet? I believe it is a strong possibility as the hormones are radically changed and there is a link between hormones and breast cancer. Ladies BEWARE.

    I must also report that sadly this diet caused my blood pressure to become high (150/95) – within two weeks of stopping the diet it returned to a normal (113/75). I was on the 5:2 for just over two months and successfully managed to loose 5 pounds (I do not have much weight to loose).

    I found the diet easy to follow and ate healthy options for my 500 calories on fast days – I did not increase my salt intake as someone previously suggested in this topic. I started to feel a bit fuzzy headed and a bizarre feeling as though I could feel my blood being pumped around my body. A routine doctor’s appointment picked up by elevated blood pressure which had previously always been normal. It was also checked several times over different times and days. The only change in my routine had been the start and continuation of this diet which I promptly stopped at the recommendation of the doctor. As mentioned, two weeks later blood pressure back to normal.

    A lot more scientific research needs to be done to further test and analyse this diet – be very cautious people and check your blood pressure if you are on this diet.

    I’m having a similar sudden high blood pressure problem, I hope you don’t mind if I ask you a question:

    As a preamble, it must be noted that the ‘flavor’ of Intermittent Fasting [IF] I’ve been doing is not 5:1 but fasting for 16 hours, then having an 8 hour feeding window and that I will not continue with this regimen, regardless of your answer.

    Is it possible that it may be caused by a sudden concentration of sodium as a result of total sodium intake remaining constant while the time in which it’s consumed is diminished? Here’s what I mean: (you could stop reading here if my question made sense)

    Say I used to consume 1500mg of sodium before [IF], those 1500mg would be spread over 3 meals and those meals would be spread, say, evenly over 16 waking hours. To give it a simple number, say the Sodium/Time = 1500mg/16h = 93.75mg/h. Now one starts [IF] and reduces those 16 hours to 8 hours, reduced by a factor of 2 thus augmenting the Sodium/Time quantity by the same factor of 2 as follows:

    [IF]_Sodium/Time = 1500mg/8h = 187.5mg/h
    = 2 * (93.75mg/h)

    Which would be equivalent to doubling your regular intake, that is to say, it would give you the same concentration as if you consumed 3000mg per day. Since 3000mg/16h = 1500mg/8h = 187.5mg/h

    is this rationalization accurate to any degree?

    I had my old pressure checked yesterday at 2 pm after fasting. It was considerably higher than usual, but not a bad thing for me as it was always too low. And I had a ton of energy.

    Also had an audience telling all the ladies at the des office about IF. Spreading the word!

    I’m finding this thread very interesting. I am a female aged 63 with around 10lbs to lose. I have another 3lbs to go but am having high blood pressure issues – the worst was a spike to 190/104 at the end of a fast day. A few days later my pressure is back down to normal level. I am monitoring it now for another week or so to see if there is a pattern.

    I have been on the diet for about 2 years. I went to the doctor today and for the first time in my life I have high blood pressure. It has always been low. As the only thing I have done differently is the diet, I am very concerned. Like some of the other posters I have a healthy lifestyle and the diet is the only change.

    Reply to andThenISaid:

    I was very happy to see your post because I am doing exactly what you are doing: I have been implementing it by a complete fast all day, everyday, with eating only in the evenings. My BP has shot up markedly from borderline-too-low to borderline-needing-meds, except that I am already on them. But just a couple of weeks ago, my doc had wanted to back them off. If he saw my BP now, he’d change his mind in a hurry!

    I did have the feeling that perhaps I was being overly generous with the salt because my inspiration for this major variant on Mosley’s regime was the history of a relative who had been definitely on the heavy side as a young woman but dramatically changed herself into a very trim and energetic person, living healthily for decades eating only in the evenings. BUT, she ate whatever she wanted. And what I have wanted in the evenings has definitely not been a low-salt regime.

    Guess I am just going to have to experiment and closely monitor the results.

    This is very interesting reading. Thank you all for posting.

    I have always had borderline high BP readings. From the age of 50 I have been on BP meds. Slowly I gained weight and my BP meds needed to be increased. 18 months ago I began on 5:2 where I gave up wheat, and all other starches and sugars while losing 17 kg (37 lb) over six months.

    I have maintained this weight loss for 12 months, with one serious fast a week, plus a lighter eating day. And I keep an eye on my sugar intake.

    My BP meds were reduced by one third as the weight came off. However, one year later my BP went borderline high again. My doctor wanted to increase my meds, as I would wake up with high BP.

    Instead I began taking my BP meds at night. This means I sleep better, and wake up in the normal range of BP. I stress that this is an experiment of one. And I am not a medico. And I do not give advice to others. Just recording what I am doing. I love my serious fast day, usually a Monday as it resets my calorie intake levels, and gives me a feeling of clean energy.

    If after a while this method of taking BP meds stops being effective, I will need to think how to handle my BP from here on. In the meantime I think it helps to read of others experience and compare.

    Cheers, Bay 🙂

    Thanks for sharing your experience Bay. Mine was very similar. I was able to get off bp meds after 18 months of fasting, but 6 months later, despite maintaining my healthy goal weight, it started to rise a bit again. I now take less meds than initially (and without the diuretic) and at night on Bay’s advice. Taking the meds at night seems to steady it. I have good bp now, even after fast days. I will test and record over the next fortnight and see if it does vary much when fasting. Always interesting to read other’s experiences. PVE

    Two weeks is up and … surprise, surprise…after monitoring my bp very carefully, at least 3 times a day, I can see that my bp is elevated most of the time. Back to the doctor to include diuretics in my meds again.

    Looking at the data, there is no obvious connection, over two weeks, between fasting and elevated blood pressure. Nor is there a connection with exercise or alcohol consumed. Time of day is the most obvious variable.

    I will continue to fast and will adjust the medications. Hypertension needs to be taken seriously …. it is the “silent killer”….but fasting has so many life benefits for me, and I cannot find a link between the two.

    Anyone else tried this experiment? PVE

    I have had a similar experience. I’ve been on the 5-2 diet for about a year now and have lost a few kilos. I went to the doctor a month ago and was very surprised to find that for the first time in my life my blood pressure is elevated. Last week it was checked again and had not improved. I am 51 years old and have always been ‘normal’. I am not finding the diet difficult so am disappointed about this new development.

    I decided to stop the diet after seeing the rise in my blood pressure. The 5×2 was the only change and I exercise and eat very healthily. Ironically my cholesterol had dropped after 2 years of the diet. Now I am wondering if fasting for just one day would still raise the blood pressure.

    It’s about 3 weeks since I stopped 5/2 diet. Had my blood pressure measured today. It’s gone back down to 121/87. It’s a relief to have it be back in the normal range however I am sad about having to stop the diet. I would love to know why this would be and if there is anyway I can get back on the 5/2 again- as it was a lifestyle that was working for me ( or so I thought).
    Question for me is why would the fasting affect someone’s blood pressure??

    Hi all,

    I have been doing intermittent fasting for over 10 years now long before Michael Mosley made it fashionable and it is one of those things that I will do for a few months and then gradually life gets in the way and then I forget about it for little while but always to return at a later date. I’ve noticed that my body seems to have a sweet spot above 12 stone whereby I will generally feel worse and get symptoms of inflammation such as arthritis in my fingers etc. Just lately after not going up the gym for a while And putting on a little bit of weight taking the above the 12 stone mark.I decided to start doing intermittent fasting again. And straight away I noticed that my blood pressure started shooting up.I have noticed this before to a lesser extent And I hadn’t tied it to the fact that I was intermittent fasting. I can normally keep it below 120/80 but for the last few weeks it has been hovering around 140/90. I have a couple of home blood pressure testers so I am able to frequently check. This was concerning me since the whole point of doing intermittent fasting is to improve my health. I think I must have gone to bed sleeping about this because the couple of days ago I woke up and thought maybe when I intermittently fast I am not getting enough liquid. I know that when you are in ketosis your body needs a lot more liquid than when you are not in ketosis. I decided to drink an extra four or 5 pints of water per day. And what a difference this has made. I have just tested my blood pressure and it is 115/71 and that is after finishing a 48 hour fast yesterday evening. I would be interested in feedback from other people to see if increasing your fluid intake (not tea or coffee) has the same positive effect that it has done for me.

    Hi Andy,

    Thanks for the ‘more liquid’ tip. I am going to try this as my blood pressure is scarily high and I would hate to have give up the 5:2 diet.

    I haven’t had time to look at any studies (because I’m in the pub) but I just saw a snippet in the paper that says research suggests that vitamin D supplements can reduce blood pressure and stress hormones.

    I’ve been reading the above comments with interest. I’m not a doctor but a nurse. I do find it surprising that the 5:2 would cause hypertension. I would have thought it did the opposite. I also suffer from high blood pressure and have been on medication for some years. My blood pressure has actually come down since I starte the 5:2. I wonder if Micheal has has a read of this site. I’d be interested in his comments.

    Whoops! Just reading, didn’t mean to post 🙂

    I recently had some tests and my Sodium is very low so this cannot be a factor in blood pressure increase for me. I posed the question on the facebook page but did not receive a reply. On the positive side, my cholesterol had reduced. It would be useful if we could have some feedback on this issue.

    Hi there

    I said I would post again after some time of taking BP meds at night. I can report that I am still on the reduced BP meds and I am still taking them at night. No diuretic. This is working for me. My BP is in healthy range. I have to drink a minimum of 2 litres of water each fast day. I have been doing 5:2 for 21 months and have maintained the 15 kg weight loss. Dehydration definitely affects BP.

    Cheers, Bay 🙂

    Hi again bayleafoz I’d say you are defiantly on the right track. Since first reading this thread I’ve been monitoring my BP daily. I take my antihypertension meds in the morning though and it includes a diuretic. My BP is very good for my age. This was not the case ten months ago when I started the 5:2. I’ve lost 10 kilos and and very happy. I’m going to continue with the 5:2 as a weight maintance strategy. I agree that one needs to drink lots of water.

    I am intrigued by the point about fasting and high BP.

    My background: I didn’t normally have a high BP, except it spiked sometimes for no reason that I or the doctor could fathom. A very long time ago, I was put on BP lowering drugs, but then my BP dropped so much that I was taken off, and I kept an eye on it over the years.

    I previously lost weight on the 5:2 – I didn’t monitor my BP because it wasn’t relevant. I lapsed and put weight back on – overweight, but not obese.

    Last spring, I was in hospital with a diagnosed kidney stone. When I was vomiting and in pain from it, my BP soared. I understand that, and I must have been dehydrated. But then the stone stopped moving and I was given pain relief, no more pain and my BP dropped. Then I was on a drip but nil by mouth for a procedure – still no pain – but it soared again.

    This happened again two months later when I went back to have the stone removed. My BP wasn’t too bad when I was checked pre-op, but when I was nil by mouth but on a drip for a full 24 hours, my BP soared again. I never understood this, I wasn’t particularly anxious, rather drowsy.

    Is nil by mouth on a drip a bit like a starvation day but hydrated? Could my BP have gone up because of the lack of food?

    I do have type 2 diabetes, normally under control with Metformin. Curiously my blood sugar level also went up when I was nil by mouth. Now I am back on the 5:2. I will have to check whether the high BP coincides with fast days, even though I stay hydrated. I too don’t want to have to abandon this method of losing weight.


    Here is an interesting clinical study on fasting and high blood pressure. Fasting seems to help: http://www.scribd.com/doc/32727377/Medically-Supervised-Water-only-Fasting-in-the-Treatment-of-Hypertension#scribd

    Hi Try,

    It may be no coincidence that your blood sugar was elevated. I’m no expert, but there appears to be a link between insulin resistance and hypertension, e.g.


    Hi Happy, hi simcoeluv,

    Thanks for the interesting links. (albeit jargon-laden! – is there doctor in the house?!) I think I understand it – it’s the metabolic syndrome – high cholesterol, hypertension, and insulin resistance. But what if anything is causal and in which direction is the question.

    In my specific hospital “fasting” experience, my blood sugar was elevated by my standards – higher than my usual HbA1c. You expect a higher blood sugar after a meal, not in a fast, but the reverse was true. Also my BP was very high for me – the highest it’s ever been to my knowledge. Apart from when I was in severe pain, I cannot understand this.

    Hence I wonder whether in this case, the impact of fasting was a higher BP, even though I was hydrated.

    I have wondered about this for a long time. My BP first showed spikes long before I had diabetes. I was thin and I thought fit. Then even after I had diabetes my BP was USUALLY normal-ish – ranging from 110/70 to 135/85 apart from spikes. My cholesterol is raised, but I believe that is familial, and had anybody tested it, was always raised, even when I was thin and “fit”.

    Now I wonder whether the culprit is visceral fat, and whether I had this problem even when I was thin with a 21″ waist (omg those were the days). Was I a Tofi? – Thin on the outside, fat on the inside.

    Medical opinion on these issues has evolved. When I was first diagnosed with Diabetes 2, the advice was carbs (not sugar) with every meal, never skip a meal, etc. Who is to say we have it right now? I leave you with a link, and a rather scary quote from that article:


    <Constant dieting may interfere with the way the body lays down fat, and there is evidence that this will increase visceral fat.>

    Could it be that some overweight people with subcutaneous fat are healthy as they are, and should not yo-yo in and out of dieting? I’m not thinking about seriously overweight, or “apples”. I just think it’s much more complicated than reducing your BMI.

    I have just checked my BP and it is a ‘Fast’ day for me, the first one in a while. It’s disappointingly high at 160/100 and this is unusual on a day when I have run. I ran 7 miles this morning and on an ‘average’day (non-fasting) my BP is down to 120/80 without my meds after an hour’s running in the morning.

    Something definitely upsets my BP on Fast days, so we are not imagining it.

    My BP is what is known as ‘labile’. (it goes up and down easily).It can shoot up to 220/115 with white coat syndrome, which is bizarre as I am a nurse myself and really like my GP of 20 years. I wonder whether others with labile BP are affected by fasting more than other hypertensive sufferers?

    There are multiple reasons for a raised BP. Another area where we need more research.

    I am new to the 5/2 fasting diet. I have been doing it for just over two weeks only. ( 5 fast days) I am on BP medication to stabilise my blood pressure . I was surprised to find today my blood pressure was down to 112/64. Never been that low! Anyone else experienced this?


    I logged on to ask a question about 5:2 and BP, as mine has increased lately. I also realised that at the end of the 2 days I felt like my BP was going high and it was. I love the diet.

    I’m wondering if it is an adrenal/insulin reaction? If it is maybe small amounts of protein through the day may help. But I also used caffeine in the form of diet coke to help me – I’d have 2 a day on diet days so wonder if this is a factor too.

    I’m off it now as it did feel an unhealthy reaction but I’m disappointed as I felt it suited me ie I could actually do it!

    I lost 10lb – my weight is 127 lbs but I’d like to get down a little lower

    New to forum and fascinated by this thread. I`m on Lisinopril, an ace inhibitor and will certainly be taking on board the advice to “dilute” the elevation in ketones by drinking plenty of water on fast days. This seems logical to me and definitely easy to do. thanks andy, and glad cimmie, I hope I get such a good result

    Hi proberts,

    Yes mine is definitely labile. I’m going to try small amounts of protein through the day and give up the diet coke and see what happens.

    Thanks for all the info on the site.

    Saw the TV programme, bought the book and thought it was time to loose some weight and adopt a lifestyle that would see me setting a longevity record! 2 weeks in and I’ve lost 7 pounds yippee!
    Checked my BP today and it is the highest I have ever seen it!! (Have a home monitor which I use weekly). I’m at 150/91! This has terrified me. The only thing I can think of is that I probably do less than the recommended 600 calories on fast days (bowl of oats and skimmed milk for breakfast then skimmed milk in my tea/coffee throughout the rest of the day but I would have expected to see an ever lower BP from that not a significant jump! I’m not sure setting a longevity record is possible when it looks like a massive stroke is just around the corner!
    Given how many people are flagging this up I wonder whether it is an area not properly considered by the authors? (I note Micheal Mosley did not include BP in his before and after testing – or maybe he did and thought the book might not sell quite so well if he included it?).
    I really would like to know whether any of the research included pre and post BP testing? I can’t believe it wouldn’t have.

    Yes I think that the stress of missing a meal can increase blood pressure. My partner recently had raised blood pressure diagnosed following a very stressful six months at work. However, by careful monitoring, a vegetable based diet – especially the leafy green ones, avoiding meat, wine, coffee, chocolate, gentle exercise and not missing meals, his blood pressure is back in the normal range.

    I think you have to be healthy to withstand a 5:2 diet – It is probably best for young otherwise fit people. For us older citizens, a more gentle and holistic approach is needed with a focus on health, healthy eating and gentle exercise coming before weight loss. Losing weight quickly means your body has been starved, and although occasional starving is not as bad as people might have thought, too much may well cause problems.

    Losing weight is a stressful activity, because however you dress it up, it is starvation! and that is stressful for a body more used to a dinner and two couches lifestyle. Stress,both physical and mental stress increase blood pressure, short term and long term. This does not mean we should avoid stress, rather that we need to be healthy enough to cope with it.

    This is not the answer for me as previously I have always had good blood pressure readings. I eat a very healthy diet. No meat, home grown organic vegetables and a couple of glasses of wine/coffee a week. Some chocolate..definitely 🙂 I am not overweight and was on the diet (for at least 2 years) to keep my weight stable and for the health benefits.

    I dance and live on a horse property so I am doing physical activity on a daily basis.
    I have stopped the diet for now but have purchased a blood pressure monitor and will try again but if my blood pressure goes up again I will have to give it a miss.

    Unlike Kazza 61 I was probably having slightly more calories sometimes. I wish Michael Mosely would comment on this matter.

    Apologies for the delay in replying – email problems (don’t ask 😉

    i agree – i think that everyone’s physiology is an individual affair and that different things are good for different people
    There are a number of simple physiological processes that people can check themselves that are relevant to blood pressure
    – first of all, blood pressure varies from moment to moment and hour to hour – and managing it is an individual process – for example, stress in a relationship or work or other area can cause a rise in blood pressure and only by close monitoring can anyone have a hope of working out what personal triggers are
    – secondly there are a number of physiological measures that we should be all be familiar with, and which interact with blood pressure, these are blood sugar – blood sugar monitors can be bought on amazon for not a lot of money. A rising blood sugar, or increasing insulin sensitivity can be associated with rising blood pressure. Also, cortisol levels – there are companies offering salivary cortisol (biolabs – are probably best value) can provide a sensitive measure of physiological stress – too much cortisol will almost certainly lead to a rise in blood pressure. In your case where there is no obvious answer with respect of health, measuring blood sugars, and cortisol would provide some useful information in relation to your blood pressure would be helpful if your wanted to look at what was causing your rise in blood pressure.

    You might also want to look at your urine pH to see whether you are in acid – base balance. Too much acid, means your body needs more green veggies to balance your pH

    Also keeping an eye on percentage body fat rather than weight gives a more accurate estimate of the extent to which someone might need to diet.

    Finally, in an otherwise healthy person carrying a little extra fat, is not necessarily that bad, especially if it is on the limbs rather than round the waist may not be too bad in terms of health

    I think your approach of closely monitoring your bp and seeing what happens to your bp is fascinating – keep us posted!

    Yes – I agree it would be useful to have Michael Moseley comment would be helpful – however he is doctor journalist as much as a doctor practitioner – maybe there are some other GPs out there who would like to comment on their experience of patients who have used this approach

    Finally – one size doesn’t fit all – we have to work with our own physiology for what works best for us -congrats on what sounds like an overall healthy lifestyle. To be honest, as doctors we know too little about healthy physiology on a day to day basis – and this is where research money might perhaps be more usefully spent because they are aspects of life that affect us all

    I love this diet and found it one of the easiest way to lose weight, BUT i too began developing high blood pressure on the day and day after my fast.. This last time i even started taking bp meds to stay on it to loose, but my bp is increasing too much even with the meds… I’m 58, eat very healthy, exercise, 23 bmi, but have struggled with border line high bp, so always watch sodium and stay off grains (especially wheat).. Really wish there was a way to use this diet, since it’s about the only one that seems to really work for me. Let me know if anyone ever figures it out??

    Interesting. Most of the research out there correlates fasting with reduced BP.

    Hi, Your BMI at 23 is good – do you need to fast?
    I think the answer to whether fasting increases BP or not, depends on where you start from. That your BP began to rise on the day of the fast and the following day may be related to increased levels of cortisol/ adrenaline related to the stress of going without food.
    Also there is likely to be a difference between a one off fast, with plenty of glycogen stores and a regular fast intended to lead to weight loss.

    I think that cortisol levels would be interesting in these circumstances as they would indicate the level of physiological stress

    I don’t pretend to know the answer! however basic science predicts that fasting is physiologically stressful and that physiological stresses, with the release of cortisol are likely to lead to raised blood pressure through a number of mechanisms. As far as I know there are no studies that take into account all of the multiple variables that interact in this situation. Equally blood sugars would be useful

    A truly healthy person’s blood sugar is unlikely to fall below 4 regardless of their food intake because they will be able to make sufficient sugar in their liver in order to keep their blood sugar stable. (Gluconeogenesis – for the geeks amongst us ) whereas those with slightly unstable blood sugars, it may fall below 4 and this is likely to be sufficiently stressful that it stimulates cortisol

    I am looking to getting a group together over the summer to study these changes in detail and hopefully come up with some answers. A Sunday/Citizen Scientist approach.

    dd22 – I would suggest monitoring your blood sugar and making sure that it doesn’t go below 4. If it does have something with a low (? – i always get this the wrong way round 😉 glycaemic index – long acting carbohydrate, such as beans or sprouts and see if that helps


    You can get blood sugar monitors either from your local chemist or online, the test strips tend to be a lot cheaper on line – I use once called True which has the cheapest strips

    Thanks for the replies Dr. Liz.. Your info makes sense.. i’ve thot that my cortisol/adrenaline levels may be off in the past, but never really knew how to check them.. For whatever reason, i don’t handle regular stresses as well on the days that i’m fasting.. Will check the blood sugar level too if i go back on the diet..(it’s normal when i’m not fasting) For now have stopped the fasting until my bp stabilizes.. Not sure i’ll go back on without clear answers.. Thanks again. would love to know what research trials reveal..

    Adrenaline is difficult to measure because it doesn’t stay long in the blood – less than a minute I think
    Cortisol levels are now widely available – Biolabs do them from saliva and recommend a profile over the day – personally I think that you need a profile from more than one day, coupled a diary records, blood sugars and blood pressures to get the most useful info – because everything interacts (no surprises there!) it might for example be interesting to do a profile on a fasting day, a non fasting day and the day after fasting

    I am hoping to start the group in the summer – based in Fulham and will post here if I may with contact details to see if anyone is interested in joining the group – self financed with results on the website –

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