Intermittent Fasting and Autoimmune Diseases: A Science-Backed Guide

Living with an autoimmune disease can be draining, to say the least. The feeling that you are always in a fight, spending a lot of time waiting for a good day to come, and when it does, you spend your time dreading the next flare up. Patients with autoimmune disease do not rely only on medications, because with many autoimmune diseases, a drug that works well will lose its effectiveness over time, requiring an increase in dose or a shift to a new drug altogether. Traditional remedies, traditional medicine, and changes in lifestyle (especially the last one) are part of every patient with autoimmune disease who is seeking some relief. 

Intermittent fasting is something you might have heard of as a way to lose weight. It has gained wide popularity as a diet. Recently, however, there has been some research into the effects of intermittent fasting on autoimmune disease. Can intermittent fasting help with autoimmune diseases? We will use science and studies to answer this question. 

Autoimmune Diseases

Autoimmune disorder is when your immune system, which is designed to fight against foreign bodies such as bacteria and viruses, takes a part of your body as a foreign entity and starts attacking it. We do not know yet why this happens.

Treatment for autoimmune disease focuses on two aspects: weakening the immune system (necessary as it is, it leaves the patient susceptible to infections). The other aspect is relieving the symptoms that accompany the autoimmune disease. 

Symptoms of autoimmune diseases vary from one condition to another; they include:

• Pain

• Fatigue

• Headache 

• Nausea 

• Rashes

The autoimmune diseases known to us today are over 100 diseases. Most commonly are:

• Rheumatoid Arthritis 

• Lupus Erythematosus 

• Crohn's disease 

  
  

• Celiac disease 

• Grave’s disease

• Hashimoto's thyroid

• Type 1 diabetes mellitus 

Autoimmune diseases inflict women more than they do men, and they can run in the family (1).

Intermittent Fasting

Intermittent fasting is an eating pattern that involves alternating fasting and eating periods. Throughout history, intermittent fasting has been practiced religiously by many religions, most famously by Muslims, who fast for 30 days every year during the month of Ramadan. 

Nowadays, intermittent fasting has become a popular method for weight loss and as a method of promoting health.

There are two types of intermittent fasting:

• Wet fasting: is most commonly practiced. The person practicing this type fasts from food only.

• Dry fasting: in this type, the person practices it fast from both food and water. Muslims practice dry fasting, while other religions mostly practice wet fasting. In fact, most of the studies done on intermittent fasting are done this month.

During intermittent fasting, you do not count calories or restrict your diet to certain types of food. You can eat regularly (2). 

Intermittent Fasting and Autoimmune Diseases 

Now that you know more about autoimmune diseases and intermittent fasting, it is about time that we explore the relationship between the two.

Research on the effects of intermittent fasting on health and metabolism started in the middle of the last century. However, the relationship between intermittent fasting and autoimmune disease has only recently started coming to light as more research is done in this area. Below are the things we know so far:

1. Intermittent Fasting Might Alleviate Cognitive Decline Associated With Type 1 Diabetes Mellitus 

Patients with type 1 diabetes mellitus experience higher rates of cognitive decline compared to those in people who do not have it. Scientists suggest that this happens because of the altered metabolism of glucose in the brain, and the cardiovascular diseases related to type 1 diabetes. This leads to a decline in the quality of life of the patient (3).

In a 2023 study done on mice, it has been noted that intermittent fasting has led to an increase in memory function. Intermittent fasting might lead to improvement in type 1 diabetes related cognitive decline by reducing oxidative stress and apoptotic signals (signals that induce brain cell death). This means that intermittent fasting can be used as a way to reduce the cognitive decline associated with type 1 diabetes (4). 

WARNING

You should NOT try intermittent fasting without the supervision of your doctor, as it can put you at great risk if it is not adjusted to your case. It might lead to a dangerous decrease or increase in blood sugar levels.

2. Intermittent Fasting Might Be an Effective Way to Treat Multiple- Sclerosis 

In this study, the focus was not on intermittent fasting but rather on the Fast Mimicking Diet. This diet is designed to mimic the effects of fasting without having to fast and eat in cycles. It is low in calories, usually around 700 kcal per day. Although it is not exactly intermittent fasting, this study suggests that intermittent fasting might have similar effects.

In this study, researchers concluded that a fast-mimicking diet can suppress autoimmunity through inducing lymphocytes (a type of white blood cells) apoptosis. Not only that, FMD also helped with nerve repair. They suggest that this diet and a long-term ketogenic diet can be a potentially effective treatment for patients with relapsing-remitting multiple sclerosis (5).

If that's not enough for you, another study on intermittent fasting and multiple sclerosis came to the result that intermittent fasting can reduce the number of memory T cells associated with the symptoms of MS. And an increase in naïve T cells. This suggests that indeed intermittent fasting might be an effective treatment for MS (6). 

3. Intermittent Fasting and Rheumatoid Arthritis 

In 2022, a group of researchers studied the effects of fasting Ramadan on patients with intermittent fasting. What they found was astonishing. The results of an entire month of fasting were a rapid improvement of RA activity. These positive effects can last up to three months, so the recommended period between fasting might be three months (7). 

According to a meta-analysis on Mediterr J Rheumatol, committing to a short period of fasting followed by a modified diet leads to favorable results in patients with rheumatoid arthritis (8). 

4. Other Autoimmune Diseases That Are Affected By Intermittent Fasting

One study conducted on Muslims during Ramadan showed that fasting had a beneficial effect on psoriasis 8.

Intermittent fasting has also shown some good results in patients with psoriatic arthritis 8.

Intermittent fasting might reduce the inflammatory response in patients with ulcerative colitis 9.

Takeaway

Intermittent fasting represents a promising approach to the treatment and control of autoimmune diseases, as a good number of studies showed favorable results. However, more research and clinical trials are needed. Also, the effect of intermittent fasting needs to be studied in more autoimmune diseases, as the focus of the existing studies is rheumatoid arthritis and multiple sclerosis. 

WARNING

This blog is informative and does not recommend intermittent fasting to patients with autoimmune diseases. If you are considering intermittent fasting as a treatment approach, then you must consult your doctor first. 

FAQ: Intermittent Fasting and Autoimmune Diseases

1. What is intermittent fasting?

Intermittent fasting is an eating pattern that alternates between periods of fasting and eating. It does not restrict specific types of foods but focuses on when to eat.

2. Can intermittent fasting help with autoimmune diseases?

Some studies suggest that intermittent fasting may alleviate symptoms and improve outcomes in certain autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis. However, more research is needed to fully understand its effects.

3. What are the types of intermittent fasting?

The two most common types are:

• Wet fasting: only abstaining from food, while still allowing water intake.

• Dry fasting: abstaining from both food and water.

4. Is intermittent fasting safe for people with autoimmune diseases?

Intermittent fasting may not be suitable for everyone with an autoimmune condition. It's crucial to consult a healthcare professional before starting any fasting regimen, as it may affect blood sugar levels and overall health.

5. What autoimmune diseases have shown potential improvement with intermittent fasting?

Research indicates potential benefits for several conditions, including:

• Rheumatoid arthritis

• Multiple sclerosis

• Psoriasis

• Psoriatic arthritis

• Ulcerative colitis

6. Are there any risks associated with intermittent fasting for autoimmune patients?

Yes, fasting can pose risks such as significant fluctuations in blood sugar levels, particularly for those with diabetes. Always seek medical advice before trying intermittent fasting.

7. How long should one fast for optimal benefits?

The duration and frequency of fasting can vary. Some studies suggest a month of fasting during Ramadan can improve rheumatoid arthritis symptoms, but individual results may vary.

8. What should I do if I want to try intermittent fasting?

If you're considering intermittent fasting, consult your healthcare provider to ensure it aligns with your health needs and to determine the safest approach for you.

References and Citations

1. https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases

2. https://www.healthline.com/nutrition/intermittent-fasting-guide#effects

3. Anna Shalimova, Beata Graff, Dariusz Gąsecki, Jacek Wolf, Agnieszka Sabisz, Edyta Szurowska, Krzysztof Jodzio, Krzysztof Narkiewicz, Cognitive Dysfunction in Type 1 Diabetes Mellitus, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 6, June 2019, Pages 2239–2249, https://doi.org/10.1210/jc.2018-01315

4. Choi, I. Y., Piccio, L., Childress, P., Bollman, B., Ghosh, A., Brandhorst, S., Suarez, J., Michalsen, A., Cross, A. H., Morgan, T. E., Wei, M., Paul, F., Bock, M., & Longo, V. D. (2016). A diet mimicking fasting promotes regeneration and reduces autoimmunity and multiple sclerosis symptoms. Cell Reports, 15 (10), 2136-2146. https://doi.org/10.1016/j.celrep.2016.05.009

5. Choi, I. Y., Piccio, L., Childress, P., Bollman, B., Ghosh, A., Brandhorst, S., Suarez, J., Michalsen, A., Cross, A. H., Morgan, T. E., Wei, M., Paul, F., Bock, M., & Longo, V. D. (2016). A diet mimicking fasting promotes regeneration and reduces autoimmunity and multiple sclerosis symptoms. Cell Reports, 15 (10), 2136-2146. https://doi.org/10.1016/j.celrep.2016.05.009

6. Fitzgerald, K. C., Bhargava, P., Smith, M. D., Vizthum, D., Henry-Barron, B., Kornberg, M. D., Cassard, S. D., Kapogiannis, D., Sullivan, P., Baer, D. J., Calabresi, P. A., & Mowry, E. M. (2022). Intermittent calorie restriction alters T cell subsets and metabolic markers in people with multiple sclerosis. eBioMedicine, 82, 104124. https://doi.org/10.1016/j.ebiom.2022.104124

7. Ben Nessib, D., Maatallah, K., Ferjani, H., Triki, W., Kaffel, D., & Hamdi, W. (2022). Sustainable positive effects of Ramadan intermittent fasting in rheumatoid arthritis. Clinical rheumatology, 41(2), 399–403. https://doi.org/10.1007/s10067-021-05892-4

8. Venetsanopoulou, A. I., Voulgari, P. V., & Drosos, A. A. (2020). Fasting mimicking diets: A literature review of their impact on inflammatory arthritis. Mediterranean journal of rheumatology, 30(4), 201–206. https://doi.org/10.31138/mjr.30.4.201