Water-Only Fasting: Reversing Chronic Disease & Cutting Meds

Physicians often tell patients that once they start taking certain medications for chronic conditions, they will be on them for life. However, Dr. Alan Goldhamer, founder of TrueNorth Health Center, offers a different perspective. He is a pioneer in plant-based nutrition and medically supervised water-only fasting, a method he believes can help people reverse chronic diseases and eliminate the need for medication.

The Power of Water-Only Fasting

Dr. Goldhamer's approach involves the complete abstinence from all substances except water, in an environment of complete rest. This therapeutic, medically supervised water-only fasting can last up to 40 days. He highlights the stark reality of global health: three billion people worldwide suffer from chronic diseases, and in the US, over 70% of adults are overweight, with 40% being obese.

He attributes this widespread health crisis to the "pleasure trap," where hyper-concentrated food byproducts like salt, oil, and sugar (SOS) are added to food, fooling the brain's satiety mechanisms. These additives are not food themselves but are designed to make food taste better, leading to overconsumption and weight gain. Dr. Goldhamer advocates for a whole plant food, SOS-free diet, eaten to satisfaction, as a way to maintain optimal weight and health.

Fasting: A Spectrum of Approaches

While various forms of fasting, such as intermittent fasting, time-restricted eating, and fasting-mimicking diets, have gained popularity, Dr. Goldhamer emphasizes the unique benefits of prolonged water-only fasting. These other methods, while potentially beneficial for weight loss and behavioral changes, do not require the same level of medical supervision or carry the same risk profile as prolonged water-only fasting. Consequently, they may not achieve the same profound disease reversal seen with extended water-only fasting.

Dr. Goldhamer views prolonged water-only fasting as a superior protocol for addressing acute or chronic lifestyle diseases, particularly when other methods have failed. Patients often come to TrueNorth after exhausting other options, seeking a more intense intervention.

Determining Fasting Duration

The duration of a water-only fast at TrueNorth typically ranges from 5 to 40 days, followed by a recovery period of half the fast's length in a supervised setting. The length of the fast is determined on a case-by-case basis, with the goal of resolving specific complaints such as high blood pressure, type 2 diabetes, autoimmune diseases, or certain cancers.

For instance, patients with high blood pressure fast until their blood pressure normalizes. For type 2 diabetics, factors like hemoglobin A1c and visceral fat levels guide the duration. The aim is to bring individuals as close as possible to their optimal weight, as excess visceral fat is a major contributor to inflammation and chronic diseases.

The Role of Visceral Fat

Visceral fat, which accumulates around the abdomen and organs, has hypermetabolic effects, producing inflammatory products linked to heart disease, diabetes, autoimmune diseases, and some cancers. Dr. Goldhamer likens visceral fat to a tumor, emphasizing the body's preferential mobilization of this fat during fasting. Studies using DEXA scans have shown that while a person might lose 10% of their total body weight during a fast, they could lose as much as 55% of their visceral fat. This preferential mobilization is a significant benefit of fasting.

Even individuals who are not overtly obese can have high stores of visceral fat. While DEXA scans can identify this, Dr. Goldhamer stresses that adopting a health-promoting diet and lifestyle, including exercise and adequate sleep, will naturally lead to optimal weight and the conversion of fat to muscle. Fasting can accelerate this process.

Why Water Only?

The strict water-only protocol is chosen because it allows the body to enter a full fasting state, rather than a fasting-mimicking state, which is believed to be more effective for deep-seated healing and the mobilization of visceral fat and other materials. While other fasting programs with supplements have benefits, Dr. Goldhamer's experience and research focus on the efficacy of water-only fasting.

The use of distilled water is also part of the protocol, with the understanding that the body's natural mechanisms are sufficient to maintain electrolyte balance during a supervised fast.

Managing Medications During Fasting

Many patients arriving at TrueNorth are on multiple medications. Dr. Goldhamer challenges the conventional medical advice that these drugs are for life. He asserts that by addressing the root causes of conditions like high blood pressure and diabetes through aggressive diet, lifestyle changes, and fasting, patients can safely come off their medications.

A study at TrueNorth involving 29 patients with high blood pressure demonstrated that 28 were able to eliminate their medication, and one reduced their dosage by half. A year later, 75% of those who could be followed up had maintained their weight loss and drug-free normal blood pressure. Adherence to diet and lifestyle changes was the key differentiator for long-term success.

Research and Safety of Fasting

TrueNorth has published 19 papers in peer-reviewed journals, including case reports in the British Medical Journal, demonstrating the efficacy and safety of prolonged water-only fasting. One notable case involved a woman with stage three follicular lymphoma who resolved her cancer after 21 days of fasting and remained cancer-free for over 10 years. Similar successes have been observed in other lymphoma patients, including those with stage four disease.

A safety study published in BioMed Central, the first long-term fasting safety study, showed that when done according to TrueNorth's protocol, fasting can be safely conducted. While minor adverse events like nausea, headaches, and dizziness are common, serious complications are rare. Most "medically significant" events were related to hypertensive crises, which occurred as blood pressure normalized during the fast.

Autophagy and Physiological Changes

Fasting profoundly increases autophagy, a process where the body clears out damaged cells and tissues. This explains the temporary drop in white blood cell counts during fasting, as non-functional cells are cleared, rather than indicating a weakened immune system.

The physiological changes during fasting often parallel those seen with vigorous exercise, including increased brain-derived neurotrophic factor (BDNF), which protects the brain. Both activities help undo the consequences of dietary excess and mobilize fat, particularly visceral fat. These beneficial biochemical changes can persist even after the fasting period ends.

Fasting for Healthy Individuals

While TrueNorth primarily treats individuals with chronic ailments, Dr. Goldhamer believes healthy people can also benefit from fasting. A study on metabolically healthy women showed that the magnitude of beneficial changes was even higher in them than in sick individuals. He suggests that fasting can be a powerful preventive tool, slowing the aging process and promoting healthy longevity.

The Pleasure Trap and SOS-Free Diet

Dr. Goldhamer attributes the global health crisis to the "pleasure trap," where salt, oil, and sugar (SOS) are added to foods, making them hyper-palatable and leading to overconsumption. He argues that these are not foods but hyper-concentrated byproducts that artificially stimulate dopamine in the brain, driving people to eat more than their bodies need.

He advocates for a whole plant food, SOS-free diet, which includes grains, legumes, fresh fruits, and vegetables, while excluding animal products, oil, salt, and sugar. This approach aims to eliminate the artificial stimulation that leads to overeating and chronic disease.

Navigating Social Challenges

Adopting an SOS-free diet can present social challenges, as food is deeply intertwined with social interactions and emotions. Dr. Goldhamer advises patients to communicate their dietary choices without judgment and to focus on their own health. He suggests strategies like bringing their own food to gatherings or calling restaurants ahead of time to ensure suitable options.

He draws parallels to addiction recovery, noting that individuals who have overcome addictions often find it easier to adhere to strict dietary guidelines because they understand the power of abstinence over moderation.

The Future of Fasting in Healthcare

Dr. Goldhamer believes that the medical establishment is slowly beginning to accept the role of fasting. TrueNorth is collaborating with a major HMO on a randomized controlled trial for high blood pressure, with plans to extend this research to lymphoma treatment. The goal is to integrate fasting into mainstream healthcare protocols, making it more accessible and accepted.

Despite the small sample sizes in some studies, the significant effect sizes observed in TrueNorth's research provide strong evidence for the efficacy of water-only fasting. Dr. Goldhamer envisions a future where fasting is recognized as a powerful tool for preventing and reversing chronic diseases, contributing to a healthier and longer lifespan for many.

TrueNorth Health Center aims to integrate fasting into mainstream medical practice, starting with specific conditions. The center is collaborating with a major medical group to establish fasting as a standard protocol for certain conditions.

Addressing Criticisms of Small Sample Sizes

A common criticism of fasting studies is their small sample sizes. However, the effect sizes observed in these studies are often so large that extensive sample sizes are not required to achieve statistical significance and clinical validity. TrueNorth's studies, despite being relatively small-scale due to facility limitations (79 beds, processing 1,200 people annually), have met these criteria and have not faced criticism regarding sample size.

Challenges in Replicating the TrueNorth Model

Despite TrueNorth's 40 years of success, the model has not been widely replicated. This is partly due to the economics of the healthcare system. TrueNorth operates as a 501(c)(3) nonprofit, offering services at modest fees (a couple of hundred dollars per day) compared to hospital costs (thousands per day). The extended stay required for patients (three to six weeks) makes it a costly process if charged at market rates.

The center's non-profit status means it avoids many typical business expenses like advertising and promotion, allowing it to operate with modest facilities. For the model to become more widespread, it likely needs integration into conventional healthcare systems, where insurance or Medicare covers most costs. This is why TrueNorth is working with HMOs to make fasting an accepted part of mainstream care.

An entrepreneurial, for-profit model, akin to high-end spas, might cater to wealthy individuals seeking supervised fasting. However, such facilities often prioritize comfort and client desires over the rigorous, sometimes uncomfortable, nature of prolonged water-only fasting. TrueNorth functions more like a "human subjects laboratory that looks like a clinic," with research funded by participants. This is not a typical lucrative business model.

Success Stories Beyond Metabolic Dysregulation

While TrueNorth has significant success with metabolic dysregulation, diabetes, and obesity, fasting has also shown remarkable results for other conditions:

• Hashimoto's Thyroiditis: A 2023 case report published in Integrative and Complementary Therapies detailed the successful management of Hashimoto's thyroiditis through prolonged water-only fasting. A 61-year-old patient experienced significant improvements in symptoms like weight gain, edema, joint pain, constipation, cold sensitivity, and brain fog after a 21-day fast and 10 days of refeeding. Her TSH levels dropped from 61 to 6.8, and CRP (a marker of inflammation) decreased from 13 to 1.2. This condition, where the immune system attacks the thyroid, is theorized to be linked to gluten sensitivity in individuals with the HLQ gene.
• Polypharmacy and Dementia-like Symptoms: An 82-year-old gentleman with atrial fibrillation, hypertension, and dementia-like symptoms was placed on a diet-only regimen. He was safely weaned off multiple cardiac medications, leading to normalized blood pressure and cardiac rhythm. His "dementia" was revealed to be polypharmacy, a negative reaction to his numerous medications.
• Keratotic Growths and Psoriasis: Keratotic lesions often fall off during fasting, and plaque psoriasis, a disfiguring autoimmune condition, has shown dramatic resolution. Photos from a study demonstrated changes within 10 days of fasting and sustained resolution with a health-promoting diet. Many doctors believe diet has little to do with psoriasis, but TrueNorth's experience suggests otherwise.
• Autoimmune Conditions and Gut Leakage: Many "itis" conditions (Hashimoto's thyroiditis, vasculitis, rheumatoid arthritis, asthma, eczema, plaque psoriasis) are autoimmune and often associated with gut leakage. Fasting allows the inflamed gut to heal, and a whole-plant-food, SOS-free (salt, oil, sugar-free) diet reduces oxidative damage from processed and animal foods. While fasting and diet can manage these conditions, symptoms may recur if patients revert to conventional diets.
• Bowel Disorders: Ulcerative colitis, irritable bowel syndrome, and chronic constipation are conditions where TrueNorth has extensive experience. These often respond well to fasting and dietary control, particularly avoiding gluten, wheat, and sugar, and maintaining a whole-plant-food diet. Chronic stress can also aggravate these conditions, sometimes requiring lifestyle changes beyond diet.

Fasting as a Facilitator, Not a Magic Pill

Fasting is seen as a powerful facilitator for health, dramatically changing diet and lifestyle. It's not a "magic pill" but a tool that accelerates the healing process. Sustained results depend on maintaining a healthy diet and lifestyle post-fasting.

Remote Fasting and Accessibility

TrueNorth has expanded its services to include remote fasting through telemedicine, making it accessible to those who cannot travel to California. This requires:

• Working with a local doctor for lab monitoring and medical oversight.
• Adherence to TrueNorth's protocol for history, exam, lab monitoring, rest, and proper refeeding.
• Careful refeeding to prevent refeeding syndrome, which can be serious or fatal.

The book, Can Fasting Save Your Life, provides detailed protocols for patients and their doctors, covering testing, monitoring, side effects, and adverse events. TrueNorth also offers telemedicine coaches to provide personalized support.

Remote fasting is not suitable for everyone. It's generally limited to three weeks, not for individuals unstable on medications, or those who are poor candidates for fasting. TrueNorth also provides free daily lectures via live streaming and a Roku channel to offer educational resources.

Finding Supportive Doctors

Finding a supportive doctor for fasting can be challenging. However, TrueNorth has trained doctors through residency programs, and many doctors in the College of Lifestyle Medicine and integrative medicine are supportive. Walter Longo's ProLon program also has 10,000 offices, many of which may be open to fasting. Success with one patient often leads doctors to refer more.

TrueNorth offers free consultations to assess if individuals are candidates for fasting, home fasting, or if they need to adopt dietary changes first.

Who is Not a Good Candidate for Fasting?

Individuals who are not good candidates for fasting include:

• Those on medications that cannot be safely withdrawn (e.g., anticoagulants for pulmonary embolism or atrial fibrillation). Fasting on these medications can potentiate their effects and lead to serious complications.
• Individuals with recent serious medical events (e.g., pulmonary embolism, cardiac arrest).
• Those unwilling to commit to a healthful diet after fasting.
• People who cannot rest adequately during the fast.

The book Can Fasting Save Your Life details who is and isn't a candidate and how to manage medications. The goal is to ensure patients are stable off medications and have conditions likely to respond to fasting.

Personal Fasting Practice

Dr. Alan Goldhamer, the founder of TrueNorth, practices daily intermittent fasting (16 hours) and a one-week water-only fast annually. He emphasizes that fasting requires rest and can be challenging, but he finds it highly beneficial. His personal health, including blood work and blood pressure, is excellent, which he attributes to a lifelong commitment to a healthy lifestyle (vegetarian since age 16, no smoking, no alcohol, no drugs).

The "Radical" Approach to Health

The term "radical" means "root" or "cause." TrueNorth's approach is radical because it addresses the root causes of disease, which are often dietary and lifestyle choices. While society focuses on treating the leading causes of death (heart disease, cancer, stroke, diabetes), the actual causes are often smoking, drinking, and consuming animal foods and highly processed carbohydrates.

Given the pervasive nature of highly palatable, ultra-processed foods, Dr. Goldhamer focuses on influencing the 1-2% of the population eager for information and willing to make changes. He hopes these individuals will set an example, leading to a "hundredth monkey effect" that benefits future generations.

A Prescription for Health

For individuals seeking better health, Dr. Goldhamer's message is:

• Health results from healthful living. This requires paying the "price" of living healthfully.
• Diet: A whole-plant-food, SOS-free diet is recommended.
• Exercise: Regular exercise within one's capacity.
• Sleep: Abundant sleep, achieved by creating a cool, dark, and quiet sleep environment and maintaining good sleep hygiene.
• Fasting: Daily intermittent fasting (12-16 hours) and occasional longer fasts as appropriate.
• Stress Management: Develop strategies to minimize stress, focusing on controllable aspects and letting go of uncontrollable ones.

The book Can Fasting Save Your Life is recommended for those interested in learning more. TrueNorth Health Center's website (truenorthhealth.com) offers registration forms for a no-cost screening call to help individuals review their options.