Welcome to The Fast Diet › The official Fast forums › Body › Medical conditions and fasting › what blood tests should I do before starting my IF journey ?
This topic contains 21 replies, has 5 voices, and was last updated by cornish-jane 10 months, 2 weeks ago.
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8 May 18
Hello, this is my first posting. Before starting intermittent fasting I would like to know if there is a list of what blood tests I should do and when should I do the second blood test to monitor my progress ?
Hi casel and welcome:
Most don’t do any tests. I guess you can if you want and are curious. Some that have existing tests when they start find that their cholesterol and triglycerides improve, which generally happens whenever there is significant weight loss. None to date that I am aware of show any material improvement in IGF-1 levels – they are basically controlled by protein intake – the less protein intake, the lower the IGF-1 levels.
Most that stick with 5:2 are just happy with their weight losses. Here are some tips: https://thefastdiet.co.uk/forums/topic/the-basics-for-newbies-your-questions-answered/
9 May 18
Look up Ken Sikaris on youtube. He’s a lipid expert and I actually met him last night at a “workshop” on low carb eating. Depending on whats available try and get a full lipid profile done. You want to have no sdLDL3 sdLDL4, sdLDL5 fractions in your blood, these are the bad ones. It is an oversimplification to say HDL is good and LDL is bad. Also have your CRP levels taken. C-Reactive Protein is an inflammation marker, the lower the better, less than 1mg/L is what you should aim for. Also HbA1c measures long term glycated blood. Lower the better. Then you could just buy a cheap glucose monitor like diabetics use and monitor your fasting blood glucose levels. Try and aim for between 3.9 to 5.9mmol/L.
I tweak my diet and change one (major) thing and then get my bloods taken after 6 months to see if its had a long term impact. Good luck.
Wow sim the person asked about blood tests and I gave them what I thought might be good markers to look at. I don’t think 5:2 is crap? When have I said 5:2 is crap? I used to do 5:2 and now I do 6:1 as I don’t want to lose any more weight. Have been going it for 3 and a half years now. What I consistently say is that if you continue to eat the same “poor food choices” and do 5:2 then you will struggle to be successful. Its possible but its going to be hard. If you just want to do 5:2 to lose weight then that’s fine. If you want to lose weight and be healthier as well then you have to look at what you eat more closely. There almost seems to be this time capsule bubble here with respect to what Michael Mosley said all those years ago. Even MM has moved on and is advocating healthy food choices and not just simply eating 500/600 cal 2 days per week.
@simcoeluv, you are the one always pushing CICO. It really isn’t that simple. That is just one factor. Yes you can overeat and gain weight although that isn’t a sure thing and likewise most people will lose weight if they restrict calories at least for a while. For some it works wonders but for most it doesn’t work long term.
Your message seems very confused. You talk about the wonders of fasting and then you often say it is just CICO. It isn’t but calories are a factor. The standard calorie math is nonsense and in fact people can’t even closely determine how many calories they consume. Even processed food manufactures are often off by 25% or more when there food is tested and they have amazing tools for measuring and tracking food components. TDEE is just a wild estimate and human energy expenditure isn’t constant and have large variations based on many factors. It is unlikely a calorie deficit of 3500 calories results in 1 lb of fat loss for most people, that is another estimate based on multiple estimates. So just cramming 5:2 down the CICO hole is basically a very narrow viewpoint of it.
You typically claim that 5:2 is eating 500/600 calories on a fast day. It isn’t, that was only a concession made early to make the diet easier for some people. That limited eating does push things towards calorie restriction, but it also a very narrow definition of 5:2. In the end 5:2 is just a general concept. I do two 36+ hour water fasts a week. You can’t claim that isn’t a valid form of 5:2.
I don’t really agree with the low carb approach that bigbooty pushes either, but I haven’t see him call 5:2 “crap”. There is room for many different viewpoints, even your CICO agenda which I strongly disagree with. (CICO implies it doesn’t matter what a person eats, just the energy in it matters and that is just pure fiction.)
@casel898 I only do blood lipids one or two times a year because frankly it is isn’t that meaningful. High levels imply an increase risk of CVD but it doesn’t really make that much difference. The links between LDL levels and heart disease aren’t a solid as one would hope. Also many factors can temporary impact LDL levels, notably stress. Anyway, all adults should be getting blood lipid panels at least once a year.
Years ago I was border line high blood lipids and now after cutting most added sugar out of my life my numbers are in the vegan range and I’m not vegan. Frankly I’m concerned my implied cholesterol might be a little too low. My HDL is nearly as high as my LDL (60 vs 71) … interesting but not really useful. However I’m changing my diet all the time.
What I’ve found more useful is measuring blood glucose. That way I can understand how different things impact me. This can be done by yourself. So I know for a fact that eating 4 or 5 pieces of fruit doesn’t raise my glucose that much, but I can get some increase in blood glucose just from short intense exercise.
I saw a youtube video of where a person with T2D eat 4 pieces of fruit and their blood glucose when to 199mg/dl. I tried the same thing and mine went to 115mg/dl. It could be the drugs taken for his T2D too. Anyway the point is when it comes to things like blood glucose we are all different and high blood glucose is a very strong indicator of disease risk. Also while fasting it can be useful to understand what is going on, for example if feel light headed maybe your blood glucose took a dip.
Interesting question @casel898. You got a heated response! I wish i had done more tests when i started 5:2. I suggest you do as many as your doc will agree to and then see what happens to them over time! I fast with my husband and he has seen big changes to blood pressure, resting pulse and cholesterol. He maintains healthy blood sugars. His c-reactive protein (inflammation marker) is so low it can’t be measured. Similar results for me but i’m less sure of my starting point!
If you are in the UK and over 40 you can get a free nhs health check – its a bit simplistic but ask for more tests and they may do them. Private testing is not that expensive and they will do an insulin test, which may tell you more than a blood sugar test regarding your diabetes risk.
Most people fasting are trying to lose weight and prevent lifestyle diseases like metabolic disease. Maybe ask yourself why you want to fast and that will guide you on what you want to measure. And take some ‘before’ photos if you are looking for weight loss! I was camera shy and do not have many.
Most of the comments you made I have made previously. There is no reason for you to know that as I have been posting here for many years and there is no reason for you to have reviewed my hundreds, if not over a thousand, posts.
My focus on this site has always been on newbies. They often come here wanting to lose weight but having a history of being unable to do it. It is proven that 5:2 works for many people that other diet plans have not. But, just like most other diet plans, 5:2 fails for most that try it.
But there are many on this site that are quite happy with 5:2. Its flexibility helps many that are unable to long follow a strict dietary plan. And the number of people that return after having some success with 5:2 and leaving and regaining weight shows that it has some benefit even for those that fail initially.
From a scientific point of view, it has never been proven that CICO is a fraud. Please show me clinical studies that prove that a person can consistently eat over their TDEE and lose weight, or consistently eat under their TDEE for any length of time and gain weight. There are none. The body needs a certain amount of energy, measured in calories, to function each day. If it gets too many calories, it stores them and if it gets too few, it uses those it has stored. Every body is different, so the amounts for each individual are different, but the formula always works. You can long discuss how some foods spike blood sugar, cause insulin to spike and all of the various ramifications of that process over time, but that has nothing to do with calories. It has to do with the chemical make up of the foods being eaten and their interaction with how the body processes those foods. The fact is, a person can eat nothing but pure sugar, and if the sugar calories eaten are lower than that person’s TDEE they will lose weight and if they are higher than the TDEE, they will gain weight. They will hardly be ‘healthy’ over time, but that is a different discussion.
And that is the problem. People confuse calories with how the body processes various foods. They say a ‘calorie is not a calorie’ when they really mean that certain foods cause the body to react in one way while other foods cause it to react another. A calorie in gasoline is identical to a calorie in lettuce. But gasoline and lettuce will have drastically different results on a body when ingested!
Even a few years observation on this site shows that if a person does 5:2 as outlined they will lose weight. They will also, over time, change their diets from whatever diet has made them fat to a diet that will allow them (often with the help of continuing 5:2 or a variant) to maintain their weight loss. Raining upon newbies the necessity of immediately changing their diet, measuring their IGF-1 or blood sugar levels or whatever, and timing when they must eat simply makes a newbie more likely to give up and try something else. As it is my goal to get them to stick with 5:2 long enough for them to recognize and enjoy the benefits that can come from following it for awhile, I sometimes challenge people that are telling newbies they must do . . . or fail.
As for my support of fasting, you confuse fasting for weight loss and fasting for ‘other health benefits’. 5:2 has little to do with fasting – you eat seven days a week. The 5:2 book hints at ‘other health benefits’ that may come from following 5:2 that have never been proven and are unlikely to ever be proven, as many of my previous posts have explained. But research is now showing that real fasting (measured in several days of water fasting) can have real ‘other health benefits’. I have posted many times that I believe 5:2 can help those that may be interested to enter the world of real fasting and perhaps gain some of the benefits fasting can provide. But that is a personal decision that many have no interest in or find too difficult to pursue.
But the bottom line is that if a person follows 5:2 they will lose weight. And that is why most end up on this site. So I simply am here to help people get past the many challenges they initially face so they can lose some weight and then decide for themselves if they want to continue or take some other path. And I am bothered by people that scare them away, and make a very simple (but not easy) process much more difficult than it needs to be.
Losing weight is not rocket science, and most people instinctively know that.
The less you eat, the more you lose.
@simcoeluv – You are the only one I’ve seen claiming that 5:2 has little to do with fasting. It is fine that you are trying to help newbies, but that is just misinformation. The whole point of fast days is to get as much time in fasting as possible. Even the fast day meals lean more towards a ketogenic type of diet, not that dissimilar from Victor Longo’s FMD. Well it is only a 36 hour period in 5:2, the power comes from longer periods of fasting rather than the typical 8 to 10 hours many people do. Over time many people work in more and more fasting because it of the merits it has.
For the record CICO has never been proven to work long term, in fact almost every diet is based on it and almost all diets fail. There are plenty of short-term studies that do effectively use CICO and achieve some initial weight loss. That really doesn’t mean much because we all know it is easy to lose some weight. The problem is not gaining it back. Sure there are examples of people that achieve long term success, but for every one of those there are probably 20 that fail. CICO simply isn’t sustainable and it is based on concepts that can’t be accurately followed. I also know that long term the there is adaptive thermogenesis that can occur and I experience it first hand several years ago. The body can simply fight against reduced energy consumption. Fortunately, even modest amounts of fasting appears to be a cure for that, at least for me.
Your example about sugar is completely wrong. In fact you can probably eat double or triple your TDEE in sugar and lose weight, because there is no nutrition in sugar. Your body will starve and be forced to consume itself. There is a British series call “Super Fat vs Super Skinny” and in that there are plenty of super skinny people that are consuming more than enough calories but it is mostly sugar. It simply doesn’t work, food isn’t just about energy.
You say you are bothered by people that scare people away. Well that is exactly how I felt about your posts when I first started seeing them. A problem with CICO that it is commonly used as a weapon. “You aren’t doing it right” or “you are just lazy” or “you are just a glutton”. It is just too simplistic.
Granted how much you eat is important but so is what you eat and when you eat. The human body is a lot more than just a gas tank.
I gave 5:2 a try because of the BBC documentary about it. It was totally about fasting. You are taking a very narrow version of 5:2 and saying that is all it is. I simply don’t agree with that. You are welcome to have your views and even share them, but that goes for others too including bigbooty and myself. I don’t even agree with a low carb approach as I find it extremely restrictive, but it sure worked for bigbooty.
PS. I see your posts were removed. I assume you were able to do that. Hmmmm … kind of makes it look like I was jumping on you for no reason.
Interestingly not all calories in foods are available to be used by the body.
Eg Our bodies only use approx 80% of the calories from raw nuts but vitually all the calories from highly processed foods. That 20% difference in calories could make the difference between being healthy weight or being over weight. Irrespective of the other effects on our health.
I’d like to see more publicly funded science on these issues to help contradict the ‘healthy food’ labels put on many highly processed foods. And help inform lay people like us – as where are we to get our unbiased information?
10 May 18
There have been many studies looking at the impacts of eating fruit on health and weight. https://www.youtube.com/watch?v=nU_RkeA88DY The impacts on weight and fruit consumption are often out of sync. The NutritionalFacts.org has a whole series of video about what happens to the missing calories in nuts. Most people simply don’t gain the expected weight and often even lose weight when nuts are added to the diet. However competing interests claim those studies are funded by the nut industry. I don’t like how the videos are broken up though, it makes it a little hard to follow.
Fasting also changes how the body works as it can take less than 24 hours to run the liver out of glycogen forcing the body to access more fat reserves. Over time this can help reduce visceral fat which is metabolically active. Over time, that can change a person’s response to the food they eat. There is large amounts of information written about the fasting, diet and studies at https://idmprogram.com/blog/. However Dr. Fung actually refers to CICO as CRaP (Calorie Reduction as Primary), he his isn’t a fan an CICO. Still the studies illuminate what type of blood work has been done.
Getting back to the question of the thread. I think any lipid panel may show changes over time. It seems like the particle density measurement that bigbooty referred too are becoming more common but one as never been offered to me. IGF1 (Insulin like Growth Factor) type of tests are difficult to obtain but are more influenced by the amount of protein in a diet. It might be possible to get a blood test that measures fasting insulin which would hopefully go down with fasting. Getting an H1C blood sugar test might be useful too. However the impacts are going to vary based on how much one changes their diet too.
Since I started fasting my blood lipids have been low except my HDL. In fact my doctor called my results low. I’m not so sure that is a good thing, but vegans sure point to those kinds of levels as being low risk. However vegans aren’t immune from heart disease either. https://www.youtube.com/watch?v=q7KeRwdIH04 (Very long video … summary is that if you are vegan you better eat flaxseed and take vitamin B12)
wow I hope casel hasn’t been scared off. The original question was about having bloods taken to establish a base line and then I can only assume they wanted to measure that with time to see what sort of progress was being made.
With regards to all the other tangent topics that have developed I suppose that’s all good and healthy to have a diversity of opinions. Do I believe in the simple CICO concept? No. The concept of a calorie is quite simple. You burn the item under test in a controlled environment. 1 cal is the energy needed to raise 1 gram of water by 1 degree. How does that physics concept translate to a biochemical process in a human? It sort of loosely translate but its not that good a fit. The foods we eat actually have an impact on the amount of energy we consume. C-jane makes a very valid point and I’ll use this as an example. Eating almonds results in 30% of the energy “disappearing”. Im not talking about the simple energy requirements needed for actually processing that food. That accounts for a small portion of the missing energy. The food itself alters our metabolic rate. Do all foods alter our metabolic rates? I don’t have proof of that but to me its not a far fetched concept. So CICO is too simple a concept as the foods we eat as our CI alters the CO.
If you eat the “right foods” and I wont say what they are for fear of starting another war, just to say that each person will have a “right food combination” then for the most part your body will self regulate. Im excluding of course situations where there is a well known medical reason for this not to be true. I don’t count calories, my body tells me when to stop eating. I do not crave more food once I am satiated. This was not always the situation. Ive found what food combos work for me, and Im happy to tell others what works for me if they ask. Everyone needs to figure out what works for them. If what youre doing currently isn’t working then change it. Doing more of the same just means you’ll get the same results.
PS Dykask. You disagree with me??? Im sorry but Im going to have to flame you in another reply. ha ha.
Bigbooty I agree everyone needs to find what works for them. I think we also agree on how bad added refined sugar is … past that we diverge a bit.
My main concern are how restrictive I find LCHF and while I’ve been in ketosis a number of times, I don’t find it a preferred state. It is more of an acceptably functional state. The only thing I have found to be better in ketosis is distance running. I have concerns about the long term impacts of so much fat and amount of protein that must be consumed (mainly due to limited food choices). My average protein consumption is well less than 100g / day.
I don’t think much about blood lipid levels because I’m already low, maybe too low. But blood glucose I’ve been in the pre-diabetic levels before and I tend to run on the very high side of normal except when fasting. I would be interested in various hormone levels and the levels of micro-nutrients in my blood though. Lately I’ve been measuring fat loss by the increasing vascularity. Multiple times a month I’m finding new veins on my arms and legs and even my upper body.
My last lipid panel was higher then before and in mg/dL (US units) It was total cholesterol: 148, Triglycerides: 87, LDL 71, HDL 60. I don’t have any idea of the density breakdown nor am I sure it matters in the low range. The time before that my doctor told me I was low, this time he just said it was in normal ranges.
I might get a physical in Japan this year and I might ask for my vitamin/mineral levels to be measured. In Japan they seem to love diagnostic tests and typically a physical takes a full day at a clinic with plenty of modern diagnostic equipment. Not all of it is as pleasant as a blood drawing. For example they typically stick a camera down the throat and into the stomach checking for cancer. Let your mind wonder from there.
Oh that brings up a point … blood tests for liver function are likely more accessible and might be useful.
Yep sugar in any form as far as Im concerned is crap. I place refined grains in the same basket. In fact they may even be worse than sugar. They are converted into glucose before they even leave the stomach. To add insult to injury grain based “flour” (wheat rye barley etc) contain amylase/trypsin that promotes an inflammatory response in the small intestine. This leads to leaky gut and all the associated problems. You do not need to suffer from celiac disease for this to be a problem, although of course for these people it is severe. I severely limit all grains.
I look at all these diets, Atkins, Paleo, LCHF etc. and none of them appear to be what I eat. What I eat is not LCHF. Its none of the above as I depart from them in one way or another. I went to the LCHF downunder workshop because I primarily wanted to meet Ken Sikaris who specialises in lipids. Anyways LCHF diet does not allow fruit and legumes as part of their diet. I love legumes and eat fruit in moderation. However during my weight loss phase I didn’t eat fruit. Now I do. The reason for that is that it only takes me about 20 hours to flip into ketosis during my water fasting day. This was not the case originally and it was taking me about 60 hours. From this Ive come to the conclusion that my glycogen stores (in muscle and liver) are now never fully topped up. Thus when I eat fruit the glucose/fructose/sucrose is able to be stored as glycogen as Ive got room for it. If however these stores are full then your liver has no option other than to convert everything into fat and to store it in your adipocyte cells.
Anyways as I keep banging on, if what youre doing isn’t working then doing more of the same isn’t going to change the results. I eat almonds like other people are addicted to chocolate. It has no detrimental affect on me. No need to count calories. Id hate to think what would happen if I went back to eating bread like I now eat almonds. Find foods that work for you and stick to them. For me I have to avoid processed sugars (that’s a no brainer) and all grain based foods.
Well I agree that experimenting and figuring out what works for yourself is extremely important.
@dykask – I thought the liver could only store about 1000cals of glycogen and therefore up to about 12 hours worth of energy? And thats why getting 12 hours of no eating overnight is generally a good thing for human health. But I can’t remember where I read this, so can’t check the references. Maybe this varies a lot on the person and the size of your liver?!
You’ve sent me off down a rabbit hole now as I use this generalisation to moderate how and when I eat, and I may be oversimplified things a bit!
And yes, I think casey has been scared off and not surprised either!
The amount of glycogen stored in a liver is highly individualized. Basically, the heavier (maybe fatter is a better term, to distinguish from those body builder/athlete types) a person is, the more glycogen you might find in the liver.
As for depleting the liver glycogen, many forget that the first sugar used by the body comes from the last meal. This can mean that the body does not begin to use liver glycogen for six or more hours after eating, depending on the make-up and size of the last meal.
The basic research shows that, for normal people that are not impacting glycogen stores or use by consuming a low carb diet or exercise, it takes about 24 to 48 hours of water fasting after the last meal to run through typical glycogen stores in the liver.
Some people also believe that when they do run through the glycogen stores in the liver they immediately start getting all of their energy needs from burning body fat. However, research shows that is not the case. Some forget that a state of ketosis can be attained and continued by the body while also burning protein. Ketosis can be defined as when the body is getting a majority of its energy from fat (either body fat or dietary fat), but a majority is 51%. Initially, the rest of the energy comes from protein (muscle burning). Research shows that while a body usually can get into a state of ketosis within two or three days, it takes a body up to two weeks of water fasting to get a large majority of its energy from fat. Even then, the body will continue to burn a small amount of muscle because it needs the nutrients in protein to survive.
In a fully fasted body (two weeks of water fasting and more), 90% or more of its energy will come from fat, and 10% or less will come from protein. The body can survive quite nicely without any dietary carbs. Not surprisingly, research currently shows that the healthiest diet for humans is very low protein, with the rest of the dietary energy coming from ‘good’ fats and complex carbs.
Obviously, the above is a gross simplification of a very complex process. And any or all of this information may change with the latest research publication, so stay tuned. It is an exciting time in the world of nutritional research!
11 May 18
It is true that when glycogen stores are exhausted varies from person to person but it isn’t true to claim there isn’t any fat burning going on until the glycogen stores are depleted. In the body there is almost always some processes going on all the time. Ketone detection is a delayed indicator of fat burning because ketones are a byproduct of fatty acid metabolism. Ketones only start to build up when the fatty acid metabolism is at higher levels than normal. For example people doing long bouts of cardio exercise will be using mostly fat for fuel after about 20 minutes of the activity but that rarely results in measurable ketone levels. Much of the acetone (a ketone) from fatty acid metabolism is either metabolized or lost from the breath during cardio exercise. It takes hours for ketones to build up to easily detectable levels in the blood or even more for the kidneys to be filtering out ketones.
For me I typical have a large drop in blood glucose levels about 20 to 22 hours into a fast. Most likely that is related to liver glycogen being depleted. The glucose levels recover to the normal range over a couple of hours. The timing can very by what was eaten in the last meal but it is reasonably consistent. That implies my liver is storing 12 to 14 hours worth of glycogen. Hard exercise can extend the period sometimes by a bit or at least temporary increase blood glucose levels. That happens because muscles hold on to glycogen for their own use. When muscles consume the glycogen, lactic acid is produced and that can be converted back into glucose by the liver. (CORI cycle)
Probably most people that practice fasting enter into a fully fasted state within 24 hours. Initially lipolysis (breaking down of fat) will be occurring but typically that falls a bit short of supplying enough fuel and the body will use some of the amino acids (from protein) to provide the glucose, this is gluconeogenesis. This is completely normal and it doesn’t imply a loss of lean body mass. Our bodies are recycling protein all the time and while fasting our intestines even shed cells from the lining that are recycled. As more of the lipolysis continues, ketone concentrations build up and are also used for fuel by many cells in the body. Gluconeogenesis then typically goes below normal levels and the body actually become protective of lean body mass. Hormone levels become favorable for building lean body mass. This is one reason why many bodybuilders practice intermitted fasting as it can help with building muscles.
So 12+ hours is a good rule of thumb for how long it takes for glycogen to be depleted but that glycogen use typically only starts happening after the last meal has been digested, which typically takes at least 8 hours. Here is an blog entry by Dr. Fung that talks about glycogen depletion: https://idmprogram.com/fasting-and-exercise-fasting-23/ (Note that graph early in the post that shows the spike in protein consumption and then dropping lower than when feed, also note there a good about of calories coming from fat even while feed.)
Note the above all implies a healthy liver. If you have metabolic problems the timing of how this work could be different.
This article has a better chart and explains the stages of fasting better:
From the text the stages of fasting:
1. Feeding – During meals, insulin levels are raised. This allows uptake of glucose into tissues such as the muscle or brain to be used directly for energy. Excess glucose is stored as glycogen in the liver.
2. The post-absorptive phase – 6-24 hours after beginning fasting. Insulin levels start to fall. Breakdown of glycogen releases glucose for energy. Glycogen stores last for roughly 24 hours.
3. Gluconeogenesis – 24 hours to 2 days – The liver manufactures new glucose from amino acids in a process called “gluconeogenesis”. Literally, this is translated as “making new glucose”. In non-diabetic persons, glucose levels fall but stay within the normal range.
4. Ketosis – 2-3 days after beginning fasting – The low levels of insulin reached during fasting stimulate lipolysis, the breakdown of fat for energy. The storage form of fat, known as triglycerides, is broken into the glycerol backbone and three fatty acid chains. Glycerol is used for gluconeogenesis. Fatty acids may be used for directly for energy by many tissues in the body, but not the brain. Ketone bodies, capable of crossing the blood-brain barrier, are produced from fatty acids for use by the brain. After four days of fasting, approximately 75% of the energy used by the brain is provided by ketones. The two major types of ketones produced are beta hydroxybutyrate and acetoacetate, which can increase over 70 fold during fasting.
5. Protein conservation phase – >5 days – High levels of growth hormone maintain muscle mass and lean tissues. The energy for maintenance of basal metabolism is almost entirely met by the use of free fatty acids and ketones. Increased norepinephrine (adrenalin) levels prevent the decrease in metabolic rate.
A typical 70kg adult stores 100g to 120g of glycogen. That is less than 500 calories worth of energy.
Thanks @dykask and @simcoeluv for the info!
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