Clinical trial results
Altogether, the 10-week regimen of a no-sugar diet, time-restricted eating (TRE) and Fasting decreased the average Long Covid Score by 51.8% (p<0.0001) from 37.8 to 18.2. Similarly, the number of Long Covid Symptoms decreased from 20.5 to 12.2, a decrease of 40.6% (p<0.0001). No major adverse safety events were recorded although there was one overnight hospitalization. Both intermittent fasting interventions (6 weeks of TRE and 4 weeks of once per week fasting) decreased symptoms over the 10-week trial but the more intense weekly fasting regimen was significantly better.
Figure 6. All participants were ranked by percent decrease in LC-Score from best responders to worst responders. Q1 is the top quartile of responders over the 10-week trial duration including the 2-week baseline run-in, and completion of either the Fasting then TRE arm or the TRE then Fasting arm. The average change in LC-Score during each of the given trial phases is plotted here. Note, for half of participants, the order in which they did the treatments was different (TRE then Fasting) then that chosen for the plot.
Resolution of individual symptoms during the 10-week trial varied considerably (Figure 6). Eleven of 28 common symptoms resolved about 51% of the time (46-56%) while another eleven symptoms resolved about 40% of the time (35-44%). Meanwhile, brain fog, blurry vision, tinnitus, fatigue and PEM resolved in only about 21% (19-23%) of participants. Frequencies of the less-common 32 symptoms also decreased 40% overall.
Safety precautions
Not everyone can safely do intermittent fasting. Diabetics and pregnant women should not fast. Those with a history of eating disorders should not fast.
Consult with your health professionals if you have medications or health conditions that might be negatively impacted by fasting for a night-day-night or about 40 hours.
RISKS
Water fasting for 40 hours may temporarily increase the severity of some of your Long COVID symptoms. For example, if you have a rapid heart rate, it may increase for 1-2 days. If you have anxiety, it may noticeably increase in severity for 1-2 days. After their first water fast, about 10 percent of long haulers may experience a significant flare-up of their symptoms that lasts about 2-4 days.
There are known risks associated with longer duration water fasts, primarily hypoglycemia or low blood sugar if you are diabetic and electrolyte imbalances that may trigger serious adverse symptoms upon re-feeding and these adverse effects could result in serious complications or even death.
Caution: Your first water fast should be from supper to supper, about 21-23 hours in length. See how your Long COVID symptoms respond. If this causes a long flare-up, do not attempt longer fasts.
Time-restricted eating
Everyone in the trial started with two weeks of limiting their eating to a 10 hour window each day. I suggest that you aim for a 9 hour eating window. Avoiding sugars and bread (fast carbs) was recommended. Many long-haulers skip breakfast. Those participants did not respond as well as those that ate breakfast before 10 am. A daily good eating window seems to be 8 am till 4 pm or 9 am till 5 pm. This likely encourages healthy day/night rhythms and better hormonal regulation in your body.
Fasting Guidelines:
- Purchase Morton Lite Salt and a 200 mg Magnesium Glycinate oral supplement in advance of your water fasting.
- Always start your water fast in the evening or late afternoon. Aim for “night – day – night” for 38-40 hours. Fasting longer (for another day and night) did not help reduce symptoms.
- For water fasting, DO DRINK water! Black tea or green tea is fine also. Try to avoid coffee.
- During your water fast, prepare and drink a saltwater solution twice daily for electrolytes. Also take your Magnesium Glycinate oral supplement twice daily by mouth. Instructions:
Dissolve ½ tsp of Morton Lite Salt in 10 ounces of luke-warm water and drink twice a day (Lite Salt replaces half the sodium with potassium). Take 200 mg Magnesium Glycinate oral supplement by mouth twice a day
- Once you have completed your night-day-night water fast of about 38 to 40 hours, resume eating in the morning with a smaller meal that starts with steamed vegetables and try to include an egg. Avoid simple carbs like bread and boxed cereals.
- REMEMBER: many with long covid may experience a temporary increase in their long covid symptoms either during a water fast or, more likely, following a water fast. This is to be expected and typically lasts for 4 to 10 hours. Sometimes the flare-up may last for 2 – 3 days or even longer.
The trial protocol
The trial duration was 10 weeks.
2 weeks: No added sugars diet, eat in a 10 to 12 hour window daily. Only eating in a regular daily time window is called Time-Restricted Eating or TRE. This two (2) week period is considered the “Baseline” period. You will be prompted by email to complete 3 Symptom Surveys during this time period.
4 weeks: No added sugars diet, eat in an 8-9 hour window daily, once weekly 36-40 hour fasts
4 weeks: No added sugars diet, eat in a 9-10 hour window daily.
Supplements and medications
Participants had to stop all supplements other than a standard daily multivitamin.
Fasting for Long COVID and Long Vax, a 12 week Protocol