Research Group for ME/CFS, Chronic Disease, Aging and Cancer

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Ian Nicolades (IBD, completed fast)
« on: June 15, 2021, 08:10:39 AM »
Background:
I was diagnosed with IBD/IBS in the summer of last year. My primary symptoms were bloody stool and severe bloating after meals. I don't recall the exact diagnosis because after months of going back and forth with specialists and getting a colonoscopy done, they told me "here, use this suppository enema thing every night, and it might help alleviate some of your symptoms... What's that? No, it won't cure or fix anything haha, we haven't a clue how to do that, this is your life now - anyways, good luck and be on your merry way!". Pre-cancerous polyps were also removed during the colonoscopy, so that was fun.

I have an extensive background in medical research in the field of cancer. Bodybuilding has been a hobby of mine for a long time, and I am extremely knowledgeable about training, nutrition, and supplementation. This made it easier to track what worked and what didn't via exhaustive logging, but more difficult because there was no low-hanging fruit to go after, so to speak, as my normal diet is already macronutritionally appropriate and micronutritionally complete. I exhausted pretty much every other intervention I could think of to try to cure my condition - unfortunately, stress is one of the main triggers of my flare-ups, and my life has been necessarily immersed in stress for several years. The only dietary intervention which helped, to some extent, was prolonged water fasting (~5 day stints), which resulted in temporary reduction of symptoms. A low-fat diet also helped. Other than that, there seemed to be very little rhyme or reason - casein and dairy seemed like candidates for provoking a stronger immediate reaction of bloating, but during especially bad flareups, literally any food would cause it.

I performed a ton of bloodwork and diagnostic testing under Josh's guidance. My bloodwork has historically shown low HDL and high LDL, despite total cholesterol being within range. My blood pressure has also been troublesome, generally stubbornly sticking around 125-135 systolic, even with herculean quantities of potassium and extremely little sodium. Both of these points have vexed me as nutritionally, there is not much more I can improve upon, and I'd much rather address the underlying condition then band-aid it with pharmacological solutions. Doubly annoying is that by modern medicine's standards of care, both my lipids and my BP are not enough to warrant a concern - unfortunately, according to my doctors they're considered good compared to the average American. ;) But from a health and longevity perspective, there was lots of room to improve, and I definitely wanted to min/max them before they do become a problem.

I tested negative for the usual suspects described in the paper, with the exception of HHV6. Also of note, I had a fecal study done as well - to no surprise, its results were generally in the range from "mediocre" to "really poor". Importantly, I did not test positive for c.diff. I had lyme disease as a kid - unfortunately I could not find any medical records of it, but I do recall being put on some heavy duty meds that kept me almost bedridden for a month.

Current status:
I completed a 9-day enhanced water fast exactly as described in Josh's paper, and then went straight into Phase 2. So far, it's been an overwhelming success! I'll let the before and after pictures speak for themselves. But, do note that I am definitely one of the milder cases here - chatting with some of the lovely folks who've found their way here already, my life has been fairly normal - even during my worst flareups, I could still work, train, and generally live a fairly functional life. I have nothing but love and respect for the brave souls having to cope with far worse on a daily basis - and I can only hope that my little point of data will help that journey along in some small way. What follows is a crosspost of the daily logs I kept during mine.

Before/after pictures:




« Last Edit: June 21, 2021, 09:52:19 AM by Ian Nicolades »


Re: Ian Nicolades (IBD, completed fast)
« Reply #1 on: June 15, 2021, 08:43:15 AM »
Daily enhanced fasting logs, starting from 6/1/2021

IMPORTANT NOTE: In this log, I do take some risks, such as going out to stores, walking around cities and such. This is dangerous. During the enhanced fasting protocol, energy must be managed - and if a crash happens for whatever reason, the only rescue is succinic acid. I did so because I had 1-2 people with me every time, who were fully informed of the protocol, had the contact info for Josh and others who would know what to do, and had plenty of properly-dosed succinic acid on hand with us at all times. Please do not take any unnecessary risks!

Day 1: It sucks. But I'm committed to pushing through and in a supportive environment. It's going to be the least-worst time to get it done for work too. The biggest symptoms I had were vague nausea and malaise - it's much more intense than the usual "I'm starting a fast and switching off the food intake for now" phase.

Day 2: Seesawing between "hey, this is less worse than expected!" and "oh god back to having been run over by a truck, nap time". Went for a half hour stroll outside, which was nice. The diarrhea began at around the 36hr mark for me, but nothing too major.

Day 3: Still on the seesaw. Generally feeling slightly better than yesterday. Had a solid bowel movement middle of the day, which is weird - possibly my gut is so screwed up that it just took that long to finally pass.
Took another stroll around the neighborhood, then later an IKEA because about all I'm mentally capable of right now is organizing supplements. GF drove me, don't worry!

Day 4. Feeling better overall throughout the day, got some work done in the morning and took a short walk, napped, meandered about on the treadmill for about 2 miles, took a 15 minute nap and felt great. Been organizing work stuff while playing DND, feel more and more like my old self - we'll see if the trend continues tomorrow. :D

Day 5. Still generally improving - we went to the mall of America and walked around for a few hours before I started feeling crappy again. Went back home, I slept for a couple hours, then went for a short walk outside. Activity level is up, waves of sickness are down, everything seems to be moving in the right direction. Took 10mg CBD isolate powder sublingually, either that or the general recovery process seems to have increased libido - usually it's completely zero deep into a fast. ;)

Day 6. I'm fairly confident I'm now happily in the "piles of energy" phase that Josh reported. Been up for 15hrs getting stuff done now, feels like when I'm on a perfectly dialed in supplementation protocol and piles of noots, but without the vague uneasiness of "this perfect balance of productivity is fragile and fleeting".
Only downside now is the diahrea. I'm strongly considering getting some adult diapers. We keep it real here in the trenches of this blog. :D
I'm going to see how well this goes with a full normal workday tomorrow (which is 16hrs of writing some of the most complicated code possible while herding cats)

Day 7. Nothing major to report, skin continues to heal at an amazing rate, generally feeling good. Walked a lot, did some light BW training, everything's peachy. :)

Day 8. Anhedonia in the afternoon related to work, but 100mg sublingual phenylpiracetam as per Josh's suggestion seemed to fix it up. Watched a movie with GF and spent 2hrs walking on a treadmill, 13 degree incline at 1.5-1.7mph, estimated another 1/3lb of fat burnes through just from that.

Day 9. Was going well until I overexerted myself with BW training and fast walking at max incline on the treadmill - zero energy the rest of the day, muscles ached and twitched, felt like they were burning up and desperate for aminos. I toughed it out (read: alternated sprawling out on the couch and bed, like a beached whale, regretting my poor life choices) until just past midnight, ~6hrs past my last sip of the EGCG mix. Even with melatonin, there was no chance I'd be able to sleep as I was still wide awake, acutely aware of how terrible I was feeling, and unable to think of anything but food.

So I took 50mg succinic acid to be safe and officially broke my fast, ended up eating through just about an entire day's worth of the diet plan. :)
That's about 218 hours of fasting completed by my count - nearly double my previous record of only 5 days!

Lessons learned:
- First day is actually easier than anticipated, all things considered - consider things like caffeine to tough out the hunger signalling as your body slowly accepts that it's going to have to do without food for a little while.

- The next few days were miserable as the process began in earnest. Give yourself time and accept that this is necessary, temporary, and worth it.

    "I must not fear.
    Fear is the mind-killer.
    Fear is the little-death that brings total obliteration.
    I will face my fear.
    I will permit it to pass over me and through me.
    And when it has gone past, I will turn the inner eye to see its path.
    Where the fear has gone there will be nothing. Only I will remain."

-fear, +cells with disregulated metabolisms ;)

- At some point, the clouds will part, the sun will break through, and you'll feel like "hey, this is great, I could probably do this forever!". Just keep expectations in line and don't push yourself too hard. Like I did. :D
- Enjoy the healing and recovery process - it was fun to watch old skin wounds heal in near real time.

Just took my first dose of the maintenance stack with some coffee and a few handfuls of plain popcorn - going to make some oats with berries soon and see what the next phase has in store. :)


Re: Ian Nicolades (IBD, completed fast)
« Reply #2 on: June 15, 2021, 08:57:33 AM »
Phase 2 logs/notes/updates
I officially ended my fast on 6/10/2021. Collected here are some of the more interesting details of what happens next.

Day 1 of Phase 2 complete (and hey, doesn't that sound cool!)

Feeling awesome, like I just leveled up and hit a huge power spike with a bunch of shiny new toys unlocked. I have extensive experience with water fasts (I've forgotten how many I've completed, I routinely do so every couple of months/as needed), and this is significantly different from the sensation of improvement after them, and certainly not a "wow eating again is amazing compared to not eating" placebo.

I've had no issues with the supplementation protocol or the diet model; no bloating to be found, which is honestly amazing - I can't remember the last time I've been able to eat until I'm full and not stand up to find myself a bloated disaster. Only one potential sign of immune activity, a mildly itchy/sore throat later in the day, which could have been from eating more popcorn, especially after having not eaten anything for so long. Note that when I say "popcorn" I mean "plain homemade air popped popcorn" - not anything with butter/oil/etc that's objectively awful.

Back to the gym for the first time in almost 2 weeks, did a full body session with 10+ rep range @ 8-9 RPE. Was surprisingly strong, don't seem to have lost much strength if any. Protein + carbs crept over the suggested ratios as I'm generally very much in tune with what my body is craving and just gave it what it wanted, and I'm sure my activity level warranted it.

Another thing to note - my BP has never been this good before. 102/72 today, zero meds. I may need to start increasing sodium at this rate, which is absolutely unreal to me. :D


Day 3 - we had a party and I spent the evening making sushi for everyone. The sushi I make myself is also quite in line with the dietary model - I use allulose instead of sugar to season the sushi rice vinegar, sushi nori is an incredible food, and high quality fish + veggies are perfect! The only things not in line with the dietary model are the quantity of it that I can eat (which is nearly infinite) and the inevitable creeping up of sodium - I use potassium and other equivalents where possible, but even low-sodium soy sauce has a frightening amount of sodium in it. I considered this the first test of what happens when I eat 1) a larger quantity of food and 2) a larger quantity of sodium.

Success on both counts - no bloat, and next morning's BP was 105/70, despite consuming some unknown, incalculable, and vast quantity of sodium. :D

Day 4+ I started noticing a pattern where every time I ate wheat germ, I would get a mildly scratching throat and/or a runny nose. Obviously, I started piling on absolutely silly quantities to see how much of an immune response I could trigger. My current high score is about 1/3rd of a bag of wheat germ (~8 servings), 2 servings of oats+oat bran, 8x the starting dose of lion's mane, and 2x the dose of the beta glucan caps... All I got from that by then was a sniffle. ;)

On the subject of heart rate, my RHR during the day has dropped by about 10-20 BPM - e.g. before when I'd get up and move around, it'd jump to around 90. Now, doing so only gets it to around 70.

I've continued to increase workload in the gym, slowly getting back to my old levels of weight, intensity and session duration, and session frequency over the week. So far I'm still keeping frequency light to favor recovery, but weight and intensity are nearly up to my old levels - I don't seem to have lost any strength at all over the last few weeks. Worthwhile to note is that for the month preceeding this experiment, I had been traveling for work, and then moving across the country, so training and nutrition were suboptimal for a time.


Re: Ian Nicolades (IBD, completed fast)
« Reply #3 on: June 19, 2021, 05:07:37 PM »
that's an example of a log bro

holy shit that bloat, doesn't even look like the same person xD

nothing like being free to eat all that food again, i miss eating granola or plain rice without getting instant diarrhea

like you I've only found "temporary cures"
e.g metformin, telmisartan/candesartan, 5day fasts, though reishi/oat seems the most incredible

you're running this management phase for almost 10 days now right, how long you intend to keep it??


Thanks for sharing your journey.



Re: Ian Nicolades (IBD, completed fast)
« Reply #4 on: June 20, 2021, 09:50:22 AM »
wow thats amazing, a lot of people with chronic fatigue syndrome have various stomach related problems,  I had acute lactose intolerance / gastroparesis once when I was really ill,  then I was fine for years,  after a change in life circumstances last year I started having some strange new symptoms, terrible sore throats and nausea,  then in the winter I had started having really odd behaviour of the stomach,  
at times when I felt like I had almost no energy or I was trying to use more than I had ( on the verge of what we call a 'crash' ),  my stomach would start feeling different and I would need to go to the toilet suddenly / many times, or I would just produce ridiculous amounts of methane somehow, which would continue into the next day.  I haven't experienced this symptom while on the protocol even though I was quite ill before starting the protocol.  I had a little bit of it last night but thats because a few days ago I intentionally deviated from the diet to test Joshuas hypothesis. 


Re: Ian Nicolades (IBD, completed fast)
« Reply #5 on: June 21, 2021, 05:48:52 AM »
that's an example of a log bro

holy shit that bloat, doesn't even look like the same person xD

nothing like being free to eat all that food again, i miss eating granola or plain rice without getting instant diarrhea

like you I've only found "temporary cures"
e.g metformin, telmisartan/candesartan, 5day fasts, though reishi/oat seems the most incredible

you're running this management phase for almost 10 days now right, how long you intend to keep it??


Thanks for sharing your journey.
You're welcome! I intend to stay on the management supplementation indefinitely. The diet will be/already has been tweaked a bit to fit my current needs, but very minorly so - the building blocks are the same as my usual diet, just in different proportions. ;)


Re: Ian Nicolades (IBD, completed fast)
« Reply #6 on: June 21, 2021, 05:53:15 AM »
wow thats amazing, a lot of people with chronic fatigue syndrome have various stomach related problems,  I had acute lactose intolerance / gastroparesis once when I was really ill,  then I was fine for years,  after a change in life circumstances last year I started having some strange new symptoms, terrible sore throats and nausea,  then in the winter I had started having really odd behaviour of the stomach, 
at times when I felt like I had almost no energy or I was trying to use more than I had ( on the verge of what we call a 'crash' ),  my stomach would start feeling different and I would need to go to the toilet suddenly / many times, or I would just produce ridiculous amounts of methane somehow, which would continue into the next day.  I haven't experienced this symptom while on the protocol even though I was quite ill before starting the protocol.  I had a little bit of it last night but thats because a few days ago I intentionally deviated from the diet to test Joshuas hypothesis.
Interesting - I can usually tell ahead of time if something is going to cause severe gastrointenstinal upset based on how it subjectively makes my stomach 'feel'. Which is annoyingly unscientific, but it helped me eventually trial and error my way into a diet model that was mostly compatible with my condition for a long period of time. Josh hypothesized that that is why my symptoms were so much more manageable than others' with similar prognoses - my preexisting diet and lifestyle helped minimize any exacerbation of the underlying problem.

I can't imagine what I would have looked like if I had been on a Standard American Diet. :P


Re: Ian Nicolades (IBD, completed fast)
« Reply #7 on: June 21, 2021, 06:10:41 AM »
I've been in the maintenance phase for 10 days now. In that time I've moved ahead way quicker in my excitement to test out my amazing new superpower of "being able to eat food again". ;D

First, physique update:

I'm back up to my usual training volume and intensity. I should probably describe what that entails for context - a minimum of two hours in the gym every day, the meat of training being three different supersets of three muscle groups. E.g. the first group is shoulder press -> bench press -> tricep cable pushdown; 4 sets of each, each work set taken to failure (= "I can no longer perform another rep without compromising form"), last set of each taken to failure++ (e.g. 2-3 dropsets of progressively lighter weight). Then again with shoulder lateral raises -> decline bench -> floor press. That session is bookended with cardio / mobility / prehab work. So far I seem to be recovering better than I have previously - hopefully all the cellular energy that had been going to viral replication is now going to muscle protein synthesis. ;)

I was able to induce a minor amount of bloating this weekend. I did so by finding the tastiest middle eastern restaurant around (Holy Land in Minneapolis - cannot recommend it enough!), ordering appetizers, a main course, and their Chef's Special, their description of which enthusiastically stressed that it "makes a great sharable feast for 3-4 adults". I then proceeded to eat all of it by myself, while also stealing a decent amount of everything the others I was with had. And then we went to an ice cream shop.

I regret nothing. 8)

Current plan is to spend the weekdays cutting with just potatoes/oats for carbs around training sessions, sip EAAs all day, stay on the maintenance schedule, and resume eating my way through the city on the weekends. GF will be out of town for a bit for a big family event while I need to stay here for work, so I'm going to go through the enhanced fast again with her when she returns.

Oh... and guess what my BP was the morning after the cheat day to end all cheat days? 116/68. ;D Previously, after eating out anywhere, I'd be lucky to keep it under 140 systolic.
« Last Edit: June 21, 2021, 08:16:01 AM by Ian Nicolades »


Re: Ian Nicolades (IBD, completed fast)
« Reply #8 on: June 23, 2021, 09:11:33 AM »
Yesterday's experiment was to double my last personal record of beta-glucan content per meal. The last time I did this, at roughly half of these doses, I got a little bit of a sniffle. This time, I got mayyybe 1/3rd to 1/2 of a sniffle.

I think I'm pretty close to maxing out the benefits seen from 80% of the day's calories coming from oats and wheat germ. 8)

« Last Edit: June 23, 2021, 03:21:08 PM by Ian Nicolades »


Re: Ian Nicolades (IBD, completed fast)
« Reply #9 on: June 23, 2021, 10:22:56 AM »

I think I'm pretty close to maxing out the benefits seen from 80% of the day's calories coming from oats and wheat germ. 8)
holy shit man

we vegan now

pics not loading here


Re: Ian Nicolades (IBD, completed fast)
« Reply #10 on: June 23, 2021, 03:26:57 PM »
Moved pics to imgur. :)

Josh and I recommend (ab)using glycine to make that much wheat germ taste more... enjoyable. I am personally a fan of allulose as a non-nutritive sweetener, which also helps with that - even silly amounts of it never seemed to affect my IBD, pre or post protocol.

And make sure it's not dry or you may find yourself choking on sawdust - I made the mistake of using it as a topping on some protein bread, and had a near death experience as a result. :D


Re: Ian Nicolades (IBD, completed fast)
« Reply #11 on: June 27, 2021, 09:24:59 PM »
I had some more fun this week.

First, I saved the receipt this time - we ordered 39 maki rolls. I estimate that I ate at least 2/3rds of them myself. Random picture... But only one, because I was too busy eating after that.

Then, ice cream. There's a local shop that makes their own, and has a 12 scoop challenge - finish it all by yourself, get your picture on the wall.



I now have my picture on their wall. ;)


In more productive news, I started another enhanced fast two days ago. Feeling great on it this time around - I expect because I was on reishi up until the day before starting it, so any remaining viral activity will still be silenced for ~5 days.


Re: Ian Nicolades (IBD, completed fast)
« Reply #12 on: June 28, 2021, 07:03:12 AM »
Day 3 of the enhanced fast, and trialing some bolt-ons for enhanced lipolysis - 100mg hesperidin, 5mg forskolin. The first dose felt like the equivalent of chugging 2-3 energy drinks, so I'd subjectively wager it's doing something productive. ;)

Averaging about 20k steps a day, but avoiding any physical activity more strenuous than walking.


Re: Ian Nicolades (IBD, completed fast)
« Reply #13 on: June 28, 2021, 09:17:51 PM »
I definitely noted the intense kick from this combo when I fasted. This is what had me very cautious about ROS and issues for CFS/ME people. ???
NB. I am NOT a doctor and all information provided is for educational purposes only.

Please consult your physician before attempting anything you read here.


Re: Ian Nicolades (IBD, completed fast)
« Reply #14 on: June 29, 2021, 07:08:26 AM »
Did 100mg hesperidin and 5mg forskolin 3x yesterday, each right before some LISS. Tolerance seemed to build and/or I got used to the effect, so this morning I tried 10mg forskolin. Still seems good to go.

Fat loss subjectively seems greater with the combo, but it's difficult to draw any firm conclusions from a single, unreliable data point.

I'm planning on this being the last day of this fast, so only 4 days. Tomorrow I'll start eating in the morning, get a full body workout in, refeed in the evening, and go straight back into fasting. I'm going to be guiding someone else here through the fast and I want us to be on the same schedule.

The gym here has one of these: https://fit3d.com/
I used it last Wednesday, right before going on another sushi and ice cream bender. It claimed just under 17% body fat, which seems not terribly inaccurate. For fun, I showed one of the personal trainers its results and asked how long he thought it would take for me to get "ridiculously beach-ready shredded" - after some pressing, he said "well, if you're really really strict on your diet, I'd say 12 weeks, maaaybe 10 weeks". I thanked him and told him I'd see him around... Then texted him videos of my sushi and ice cream adventures, of course.

I'd estimate somewhere around 10-20lbs of fat to lose to get there, so 3-4 more 5 day enhanced fasts should get that done in short order. Then after I've spent a few days refilling glycogen and training hard again, I'll call him up again and blow his mind. ;D