High Blood Pressure Caused by 5:2?

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  • As JeiCR says, in the long term the weight loss does benefit BP, however the problem is that once BP goes up, it is difficult to get it to come down again. And I endorse what she says about the meds. Unless the cause is sorted, the tendency is to need more and more meds as time goes by

    Hello everyone. I am interested in these posts as I am on HB meds and have been for some years. I am 65 and have been on the 5/2 since the end of Jan this year with good results. I also love the regime and feel I could maintain for sometime. I want to measure my blood pressure regularly as a bit concerned to read all the comments about a possible link to this fasting diet. One of my reading since starting the diet has resulted in low bp. My doctor was okay with this. But am not monitoring it regularly. Can someone recommend a good BP monitor that I can get from Boots. Don’t really want to spend a great deal. Was thinking of getting the HoMedics upper arm Pressure monitor. £30 Any advice would be helpful. Thanks.

    Although I posted earlier in this thread that my BP has sky-rocketed, within a couple of weeks it had reduced to lower than it had been previously. It is now steady around 120/75 which at 55 I’m pretty pleased with. My only worry with the 5:2 diet now is that whilst I lost 12lbs very quickly, it seems fasting on 2 days only maintains my weight. But that will be an issue for another thread…

    I think the Homedics is what I have. The one thing you need to note when buying a home machine is the size of the cuff. Some of for smaller arms, some for larger — and you will get an incorrect reading if using the wrong size.

    I have slightly elevated BP and take Diovan (Valsartan). I also take Magnesium at night, which tends to lower BP as well. I have not monitored since starting this way of eating. I should do so!

    Hi Liz:

    If you are interested in fasting and blood pressure, this clinical study may be of interest: http://www.scribd.com/doc/32727377/Medically-Supervised-Water-only-Fasting-in-the-Treatment-of-Hypertension

    After getting away from 5:2 for a few years, I decided to start in again. I’m 62, with BMI=32. I have hypertension that’s more or less controlled with 25 mg of HCTZ daily. I check every few days and my typical readings lately have been 134/84. Not ideal, but passable.

    This morning, after my first full fast (no food for about 36 hours), my BP was 166/94! I also have sleep apnea (for about ten years), pretty well controlled with a CPAP.

    I’m uncertain about whether to continue with 5:2 or try something else. My doctor isn’t a fan of fasting to begin with, so you know what his advice is. I only had about 50 calories, in the form of some bone broth. I found in the past that the 500-600 calorie “fasting meals” tended to make me hungrier than eating nothing.

    There is research out there that shows fasting lowers BP so I’m wondering if the first fast is somewhat stressful and you’re dealing with an adrenaline reaction to that? I know others have noted the BP issue – but i don’t know if it works itself out over time.

    @k-lo, That’s what I’m trying to understand. Some of the people posting in this thread have elevated BP after weeks or months on the 5:2 plan, which seems to go against the idea that fasting should lower insulin, and with it BP. I guess it’s possible that, being 62 and fat, it was too much of a shock to my system. Maybe I should’ve at least had the 500 calories. But I’m just guessing, and a little hesitant to do it again.

    ubizmo, perhaps you could try a day at 50% of your TDEE and see how that goes?

    I may give that a try, perhaps alternating days, and monitor BP daily to see how I respond.

    Very interested in this topic. I started 25 mg HCTZ last month. I am 64 female about 40 pounds overweight. I did 5:2 about 2 years ago but stopped after about 4 months when I started having serious panic attacks and insomnia and very rapid weight loss. Not sure if it was related to the diet. The actual fasting days felt great to me. Now that I gained all the 40 pounds back and am more stable emotionally (I don’t know what happened, but I did brain retraining and some other work to manage emotions), I am dealing with High Blood Pressure, & FAT, so my MD suggested I try 5:2 again. However, I just sent her a link to this thread. Dr. Liz Miller, I also just ordered your book. I love your explanations here, and would am so confused over all this cortisol, adrenal, fat, blood pressure, insulin, leptin, whatever connection. Thanks every for weighing in on this connection between 5:2 and BP. Good luck and good health to us all.

    Update: I ate normally yesterday, but even in the late afternoon my BP was still very high.

    This morning, I measured again: 161/91 the first time. I waited two minutes and did it again, same arm: 137/84.

    To put this in context, I almost always check my BP two or three times, because the first measurement is usually high, then the next two are lower and similar to each other. The same thing happens in the doctor’s office. The nurse takes a reading and it’s high. A few minutes later, the doctor repeats it, and it’s lower. I suspect the very act of checking my BP scares me, at least at first. But yesterday even the second and third readings were high, so it was the real deal.

    Anyway, I did call the doctor’s office yesterday about my BP. I got to speak to the nurse, who wasn’t very helpful. “We don’t recommend fasting” was her comment. Okay. She asked if I’d had anything salty during my fast. Well, yes, I had some boullion–maybe that was a mistake. She scolded me about the sodium. I explained about my practice of checking my BP. “We don’t recommend that,” she said, because usually repeat measurements cause it to go up. I pointed out that mine ALWAYS go down, from first to second check, even in their office.

    So…I’m not sure where I’ll go from here. I first want to see if my BP stabilizes back where it normally is; then I’ll think about trying to fast again, or do .5 TDEE or something.

    Interesting forum. I did not know there were others like me. I cannot eat better exercise more and yet my blood pressure is uncontrollable. I went on a 4 hour bike ride the other day. when I returned my blood pressure was 125/69. I have had readings without medication of 106/65. Two days later i went to a blood test which required fasting. I was gooding to be gone all day so i took my blood pressure medicine (25 Losartan). I did not eat. I ate later but all day my bp increased by that evening it was 185/95. It took two days to come down.
    I am searching for the answer. I was in Law enforcement for 30 years, so the cortisol information makes sense. How do I lower cortisol?

    Hi BuffaloSoildier, I am hoping someone replies. I am trying a insulinogenic diet on the recommendation of my MD. I just started so I can’t weigh in yet but I hope others have suggestions for lowering cortisol. It all is complicated at my age. Things were simpler when I was 30-50 pounds lighter and 40 years younger!

    I should say, I am 55 years old 6′ 4″ 210 pounds and very muscular. I have a flat stomach and have no problem with any fitness issues. I have 12% body fat and a low BMI. This is why High blood pressure make no sense for me.

    mamaglee I will look into insulinogenic diets. Thanks for your comment.

    I found that a nap/sleep, black tea, meditation, music, and chewing gum lower cortisol,

    Yes, lack of sleep raises my BP. A few days ago I meditated, had a nap, used tuning forks that produce Nitric Oxide to reduce BP, sat on the deck in the warm sun, and mine raised, even though all you say above should work. I didn’t know about gum chewing. Do you know what that works?

    mamaglee, tuning forks?

    Tuning Forks for the body. There is a certain frequency of sound that stimulates the release of Nitric Oxide. One tuning fork in particular is the OTTO 128 by Biosonics, and also using the C/G tuning forks can help to normalise blood pressure. For those musical, the C/G is the Perfect Fifth. They have a scientific study .pdf for free download about how this works. My MD suggested it.

    Nitric Oxide, NO, has the ability to regulate blood pressure by dilating arteries.

    I am reaching for every trick in the book. Losing weight, which used to be easy for me, is not working. So if I could get some pounds off, I think other things might fall into place. I have tried Paleo, restricting grains, restricting sugars. My functional medicine MD thinks that my weight and BP have something to do with insulin resistance.

    If you have health issues, the application of tuning forks to pressure points stimulates the release of nitric oxide. Nitric oxide is made inside the vascular, nerve and immune cells and is rhythmically released into the surrounding tissues as a gas. It participates in the healthy functioning of all main organ systems and acts as a signaling molecule and attacking molecule neutralizing viruses, bacteria, and other free radicals. We’ve even tested it in laboratory experiments demonstrating the healing power of sound.

    It’s been a couple of weeks since I posted in this thread. Concerning BP, I take hydrochlorothiazide, and it’s pretty well controlled. I do have sleep apnea, but that’s also well controlled with CPAP. I monitor my BP several times a week, if not daily.

    After my BP came back down from the last fasting experiment (it took two days), I waited a week or so and decided to try a more limited fast. I did a 24-hour fast, of the “Eat, Stop, Eat” sort: No food from dinner one day until dinner the next day, instead of the 5:2 fast, which typically lasts 36 hours. My BP didn’t rise. I tried it again, and there was no increase in BP (beyond the usual daily fluctuation).

    I’m not sure what’s going on here, but using this form of fasting, there’s no calendar day without food, and maybe that avoids the extreme cortisol response. That’s just conjecture, but I play to continue the experiment. I think the benefits of the two forms of fasting should be similar, and I still hope that over the long run doing this will benefit my BP and other health markers.

    Part of the theory of fasting is the hormesis phenomenon, involving limited disruptions of equilibrium that trigger reparative mechanisms. Possibly, at my age (62), 36 hours was simply too large a disruption. We’ll see how it goes.

    mamaglee, this is new to me. Very interesting.

    My grandma told me once, that if you have a high blood pressure spike but no medication close by, put your hands in sink with hot water. It will temporarily reduce blood pressure and give more time for doctors to arrive. I don’t know if it true or not, since I have low blood pressure. But I still remember the advice.

    @coldpizza — The version I’ve heard is to soak the feet in warm water.

    @mamaglee — The tuning forks are a new one for me too, but I keep an open mind about such things. There’s much about hypertension that still isn’t well understood. It’s certain, though, that nitric oxide is a vasodilator, and if tuning forks can somehow stimulate the release of NO, well it’s worth a try.

    Looks like I’m also one of the unlucky one’s trying to add 5:2 & experiencing BP spikes .Normally it stays in the 128’s /75’s . Yesterday was my first day , by 4 pm mine jumped to 147/85 was almost time for my BP med so I took it early. By 10 pm it shot up to 161/91 only had decaf coffee, water & a sprinkle of salt on what food I ate. While having high BP for a few years I found two things that helped when it got high. Deep breaths & hold to count of 10 ( exhale) do this for a min. Second one is 1/4 tsp. cinnamon in hot water ( make a tea )sip slowly. My BP was fairly under control since I dropped 40 pounds doing LCHF. Even lowered my meds from 300mg to 100mg a day eating this way. Wanted to do 5:2 to stay at goal/ maintain . For I bounce between 5-10 pounds (gain) wanting to reg. weight more. Seeing high BP runs in my family my Dr. told me I may always need to be on meds for it (bad genes) . Not sure if 5:2 diet will work for me , don’t want to go up on meds again. All my Blood work results last month came back good. I’m going to do more research …..

    I’ve done two more 24-hour “dinner-to-dinner” fasts since last posting, and checked BP the following day. Results have been encouraging. BP has actually gone down a bit. And I’ve lost a pound or two.

    I’m going to continue with this mode of fasting for a while. It seems to be less of a stressor and, from what I’ve read, should be about as effective as Dr. Mosely’s 36-hours with 600 calories mode.

    Hello Ubizmo, I’m from Brazil and I write with Google Translate.
    I adapted well to this form because I find it difficult to eat in a normal day and then back to fast. Before I was 16: 8 but in my work changed my lunch break at 11:00, I did not adapt to eat at this time there to 23: 1 was easy.

    so I like because I have difficulty sleeping and few calories insomnia comes easier, and if there’s a commitment I have to eat lunch do not get worried.

    last month eliminated more than 3 kg (7lb)

    @ubizmo I also do 24 hour fasted state. I’m doing ADF(Alternate Day Fasting) and 36 hours is really hard on me. 24 hours seems to work well. Losing weight and inches steadily and sleeping better.

    While I am not on the 5:2 plan I have been doing an “intermittent” fast. Water, nuts and yogurt in the morning and full low/no carb diet for dinner every day. I became quite dizzy and light headed this morning. My blood pressure was 188/53. (I don’t know what the metric numbers would be). I ate some probiotic yogurt and some macadamia nuts. Did a morning swim and still felt dizzy and light headed. Decided to have a full meal for breakfast (low carb) and took a potassium pill.
    My blood pressure has come down, 134/88.
    I am going to begin to eat more and continue with the potassium. Thank you all for your willingness to share on this topic. Very Helpful!
    I don’t know who Michael is but he should definitely weigh in on this topic.

    Dr Michael Mosely is the author of a about the 5:2 intermittent fasting plan. I agree it would be desirable to have his opinion about the blood pressure issue.

    I am got one great reading the other day then a moderate one today. Both were in the fasted state. I was dehydrated when I took it and knew I was but did not think it would affect my BP! Now that I have read this thread I will try to monitor more and stay well hydrated. Over the years I have consistently been in the 120-140 systolic range. About a week ago I got a great reading and thought it might be from the fasting, I was not dehydrated that day. Then today I felt parched, so much so that I was thinking about it all morning and I couldn’t be bothered to drink water because I was going to a function where I didn’t want to use the restroom! Anyway it was back to my “normal” and that upset me, but now I think it might be attributed to my level of hydration. That is what my gut is telling me that it is in my circumstance. But I think that for some people, it might be different things, maybe age and fasting or sodium intake, etc. We definitely need more data. But for now all we can do is be our own labs!

    I’m chiming in again here, with disappointing news. I’ve continued doing the 24 hour fast I’ve noticed my BP going back up, after about 20 hours. I’ve been struggling with hypertension long enough that I can feel when it’s elevated. So during the tail end of the last few fasts I put on the cuff to check and, sure enough, it was up around 170/100–not good.

    Until I get some medical illumination on this subject, I’m just not going to keep doing the fasting. Maybe something like “Fast-five”, which is a daily 19 hour fast, will work for me. Or maybe it won’t.

    I agree with your choice ubizmo. You have tried enough variations and high blood pressure is no joke. I’m hoping we can get some more science on this as i also have hypertension. I don’t want to lose the benefits I’ve been seeing with ADF, (Weight Loss, Sleeping Better, General Mood) but I have enough family history with bad outcomes due to hypertension to know I can’t mess around with it. I’m going to try hydrating more and not going the full 24 hours for the fast period to see if that helps.

    ubizmo, have you considered trying to contact Jason Fung? His specialty is nephrology. Maybe he has some thoughts. Of course, you should be guided by your own physician but maybe he has seen this before.

    Hi ubizmo:

    I don’t know what a 24 hour fast is, but I assume you are not doing 5:2 (36 hour fast) and are doing something like 2pm to 2pm, which is an everyday reduced calorie diet. In any event, I am aware of only one study that tangentially addresses blood pressure and IF. It was a study on 20:4 ‘eating windows’ (one hour different from ‘Fast- five’) using healthy, normal weight people eating to their TDEEs every day (no calorie restriction). In it, every one following the eating window way of eating demonstrated higher blood pressure readings. Here is the quotation on the subject from the study:

    “Although within normal values, both systolic and diastolic blood pressures were higher than baseline during consumption of the 1 meal/d diet. Experimental data for normal-weight men and women on the effects of consumption of 1 meal/d rather than 3 meals/d on blood pressure have not previously been reported. Overweight men and women showed that consumption of 1 meal/d, with caloric restriction, improved blood pressure and heart rate after exercise (22). In animal models, intermittent fasting without caloric restriction has been shown to decrease blood pressure and heart rate (15). The observed increase in blood pressure in our subject population consuming 1 meal/d may be due to a circadian rhythm in blood pressure (23). Diurnal changes may have occurred, because blood pressure measurements were obtained in the late afternoon in the 1 meal/d diet versus early morning in the 3 meals/d.” http://ajcn.nutrition.org/content/85/4/981.long#T3

    Blood pressure can be tricky and I believe you should go with your ‘gut’ and physician’s advice.

    Good Luck!

    I out doing the 5:2 fasts but resulted in very high BP, so I switched to 24-hour fasts–but still only twice a week–as a “compromise.” At first it seemed to work, but after a few such fasts my BP shot back up at about the20th hour, as described above.

    I don’t know if there is s some other underlying condition that’s being unmasked–perhaps non-alcoholic fatty liver.

    I wrote a question on Jason Fung’s blog today. I hope he sees it.

    ubizmo, I will be interested to see his response…and if other readers offer their experience.

    ubizmo, i also like what Jason Fung has to say. I think fasting is very stressful on the body and should only be done under the careful eye of a knowledgeable physician. If you examine Dr. Fung’s Long Distance program you will find that it requires ongoing blood work, monitoring medications, working with your local physician, and on and on. Physicians of patients who are participating in the Long Distance Program must agree to closely monitor anti hyperglycemic meds. I live in Atlanta and I am going to look for a Nephrologist who agrees with this kind of plan. We’ll see.

    make sure you are hydrated, especially on fast day. The general rule of thumb is 1/2 your body weight in lbs in oz of liquid water. For example, 65oz (~half a gallon) of water for a 130-lbs person.

    Apparently dehybration can cause HP according to:


    it’s plain water, not tea, not juice, not coffee, just simple clean water.

    good luck

    i forgot to also mention about water fasting:


    this article was fun reading, but got me started looking into fasting:



    Im so deeply sorry to express that my BP has gone up since starting ADF two months ago.
    I thought had nothing to be with the fasting and since I’m on medications for my gut I am still fasting and it doesn’t seems to get better, my BP has been up for 3 weeks and that has never been my case. I’ve lost 10 pounds so far so I was pretty excited! I will keep posting to see if resuming my food intake would make my BP levels normal again. (I’m 35 and 1.60cms and 70 kgs)

    As an update I am posting my progress: I took another BP reading yesterday, late in the day and on a non-fast day. It was normal and better than the past. As an average, my BP is going down. Maybe the fasting is causing spikes, best to find out why that is happening. I will continue with the diet as I see a downward trend in BP.

    Hi from the US! I really appreciate finding this thread. I just participated in a guided juice fast for over two days. I started with tachycardia in the middle of the night, and my BP is elevated as never before. The person guiding our fast claims that I am the only one, in many years of experience fasting people, exhibiting these issues. Your forum has been very validating. I am hoping for my BP to return to normal. So far, I have been out of the fast slowly for almost one week… not resolved yet. I wish everyone the best. Thanks!

    Well now I really don’t know what to do, I was about to give 5:2 another try as I have about 2 stone to lose. Problem is I already have high blood pressure which I am on medication for. I’m not sure I can risk it going even higher as I have already been referred to a cardiologist to be assessed. It really is catch 22 situation I need to lose weight to lower the blood pressure but the diet might put it up! Help!

    If you have a BP cuff of your own, you can try fasting and check your BP frequently as you go. Fluctuations in the course of a day are to be expected anyway, but if it goes up and stays up you probably don’t want to continue.

    A few months ago, my doctor switched my BP medication to Valsartan 80mg+12.5mg HCTZ. This is actually controlling my BP in general better than what I had been on previously. I’ve started experimenting with fasting again, and so far, so good. I’m hoping that in the long run I’ll lose weight and improve insulin sensitivity to the point where I won’t need the medication, but until then the new med seems to be working well enough. But on fasting days I do check my BP multiple times, to make sure it’s not spiking. Sometimes I can tell by the way I feel, but not always.

    Took my blood pressure again today and it was 117/74. Again showing that my blood pressure on average about 10-15 points lower than any time (besides pregnancy) in the last 10 years. It’s not a fasting day though so I will take it on the morning after a full day fast.

    Today I’m fasting and I checked my blood pressure today at regular intervals. The highest was first thing in the morning, really before I would have eaten anything even on a NFD. Anyway at that time it registered 126/74 with a resting heart rate of 72. Lowest was at 5 pm when it was 123/74 and heart rate of 71.

    I started 5:2 (sometimes 4:3) six weeks ago. I’m 59 and went to one of those stalls where they were doing on the spot health checks. Had BP done, it was 130/82; was slightly overweight so went on the diet. Love the energy and have lost half a stone, which puts me now in the okay range of BMI. But this afternoon (hadn’t eaten anything at all) had BP checked and it was 150/100! Very scary indeed. I’ve never had high BP before and decided to check out this site to see if anyone else had experienced the same – clearly they have.
    Going to check it again tomorrow and Monday and see what happens.

    There’s some emerging literature showing that one unintended effect of low carb diets might be to increase blood pressure in some people. The mechanism seems to be via the body using cortisol and possibly other hormones to generate glucose from protein (gluconeogenesis). Normally glucose is derived from carbs but with low carb diets the body has to look elsewhere for glucose energy. Protein is an obvious source but the conversion of protein to glucose requires cortisol as well as other hormones. A side effect of this process might be that the increased cortisol circulating in the blood stream has the effect of increasing blood pressure.

    In theory I see no reason why this wouldn’t apply for fasting periods in the way it does for low carb diets (i.e. periods that supply the body with less than normal/required carbohydrates).

    As a previous poster noted, cortisol levels can be tested. However reducing cortisol is more problematic, though there is some evidence that exercise and relaxation techniques do seem to have some positive effect.

    I should have added of course that even if you don’t eat protein on your fast days you will still synthesize and degrade the protein held within the body’s muscles etc. This happens naturally on a continuous basis (apparently around 200g per day for an adult).

    So even if you don’t eat protein your body will still produce increased cortisol to achieve gluconeogenesis.

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