13: Nausea, Hashimoto’s, Keto Rash, Autophagy, Normal Weight, Calories Out, Fiber

13: Nausea, Hashimoto’s, Keto Rash, Autophagy, Normal Weight, Calories Out, Fiber


Veteran health podcaster, blogger, international speaker, and bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” teams up with Toronto, Ontario Canada-based nephrologist Dr. Jason Fung from IntensiveDietaryManagement.com and Dr. Fung’s Clinical Director at his Intensive Dietary Management Program clinic Megan Ramos on this podcast dedicated to answering YOUR questions about intermittent, alternate day, and extended fasting. Jimmy and Dr. Fung are the coauthors of the 2016 international bestseller The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting and, along with Megan, are happy to provide this podcast as an additional resource for anyone curious about going on a fast to improve their health. We love hearing from our listeners with new questions–send an email to Jimmy at livinlowcarbman@charter.net. And if you’re not already subscribed to the podcast on iTunes, then you can do that and leave a review HERE. Listen in today as Jimmy, Megan, and special guest Nadia C. Brito Pateguana, ND  bring you the latest information and answer your questions all about fasting in Episode 13.


SPECIAL GUEST: Nadia C. Brito Pateguana, ND

I am a mother, a wife, a daughter, a friend, but I am also a Naturopathic Doctor. This means that I look at patients, and health, from a holistic point of view. I don’t see organs, I don’t see illnesses, I see people.

I graduated from The Canadian College of Naturopathic Medicine (www.ccnm.edu) in 2004. I have a Degree in Honours Biology from McMaster University (2000). My interest has always been how to heal the human body. In search for my own wellness I discovered Naturopathic Medicine. We believe in the Healing Power of Nature; the body’s ability to heal thyself. Our first and foremost Principle is “To Do No Harm”, and I try to follow this to the best of my capacity at all times. With a strong science-based approach, CCNM‘s 4 year program includes TCM (Traditional Chinese Medicine) and Acupuncture, Homeopathy, Nutrition, Counselling, and all the other Medical Sciences.  My focus has always been on Nutrition. Mostly, I use FOOD as my medicine!

KEY QUOTE: “Most people can master fasting, it’s the diet they have trouble with. Fasting and starving are not the same thing. When it’s time to eat, EAT.” – Nadia C. Brito Pateguana, ND

Here’s what Jimmy, Megan, and Dr. Pateguana talked about in Episode 13:


Hello Jimmy and Megan,

I think I know why people say that women cannot fast. I used to be a woman who struggled with fasting but it was because I was making one major mistake that is more common among women and less common among men. Women are much more likely to under-eat by a significant amount of calories, then they overtrain in their workouts, and on top of that try to incorporate fasting into their health strategy. When you under-eat and also fast, the body thinks you are starving and I have heard Dr. Fung speak about this inducing starvation mode. Would you please underscore to your female listeners in particular that if you eat an adequate number of calories when you are feeding that fasting is not only fine but it can actually help to reset your circadian rhythm and other bodily functions? It has helped my body balance my hormones in a way that even nutritional ketosis could not on its own. I would love to start a women’s fasting group on Facebook and I hope I can invite you all to join. Thanks again for this great podcast.

Most sincerely,

Airia (aka Keto Sister)


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1. Why did I get extreme nausea in the midst of my extended fast?

Hi Jimmy and Megan,

I’m a 56-year old woman who started fasting with a goal of lowering my blood sugar and losing weight. I just finished a 24-day water and black coffee fast and ended my goal of 30 days because of extreme nausea. By Day 8, I started to drag a bit and so I began drinking some homemade bone broth. But then I became nauseous from drinking the broth a couple of days later and ditched that. A few days after that the coffee I was drinking made me nauseous, too. By Day 15, I was only drinking water and pushed my way to Day 24 before ending it. Why did I have such extreme nausea while fasting?

Thank you for helping me with this!


KEY QUOTE: “Some people that have more damaged metabolism have a harder time getting into ketosis, and that can cause nausea. ” – Megan Ramos

2. Does fasting make the symptoms of the autoimmune disease Hashimoto’s better or worse?

Hi Jimmy and Megan,

From what I read about fasting, it seems to be a potential therapy for autoimmune conditions. But thyroid specialist and neurologist Dr. Datis Kharrazian says that one of the 10 mistakes that Hashimoto’s patients make is the following:

“When blood sugar gets too low it raises the inflammatory messenger IL-6 and promotes autoimmune flare-ups. Symptoms of low blood sugar are most noticeable between meals or if you skip meals and include shakiness, blurred vision, crankiness and irritability, and loss of function. If you feel a jump in your function and energy after eating it confirms your blood sugar was low—when your blood sugar is stable the only thing you should feel after eating is not hungry. Constantly skipping breakfast and missing meals will aggravate your autoimmune response and promote autoimmune flare-ups.”

I know Dr. Fung has said there is no impact to the thyroid when fasting. But do we know what impact fasting has on Hashimoto’s? It seems the autoimmune disease is made worse by fasting, not better. I am under the care of a functional medicine doctor and have adopted all of his proposed lifestyle changes to heal my Hashimoto’s. I tried a two-day fast and saw ketones rise to 7.7 mmol and blood glucose drop to 58 before I broke the fast. It was a water-only fast with sea salt and occasional bone broth. Two days later, I didn’t feel great and developed a sore throat with excessive sleeping. Did I have a flare up of my Hashimoto’s from fasting?



3. Does fasting lead to the development of the “keto rash?”

Hi Jimmy and Megan,

I have been in nutritional ketosis for over two years and have successfully trained for and ran in two marathons over the past year in a fasted state. I have read The Complete Guide To Fasting and have undertaken my first extended fast which lasted four days. During the fast I had a recurrence of what appears to be a so-called “keto rash” which I have had on and off since I’ve been eating ketogenic. I am wondering if Dr. Fung has seen this in his fasting and ketogenic patients and what could be causing this. Is this something to be concerned about when fasting?

Kind regards,

Melissa in Australia



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4. What is the shortest fasting time for getting the autophagic benefits of fasting and do adding in nutrients negatively impact autophagy?

Hey guys,

I was afraid of dealing with hunger and stressful work situations at the same time if I fasted. But hearing Jimmy talk about drinking kombucha and bone broth during his fast was my “aha” moment! And I have now lost 14 pounds in 6 days doing intermittent fasting for 24 hour while enjoying coffee with cream and Perrier eating only one low-carb meal a day.

But I am interested in getting the benefits of autophagy with my fasting. So I have a few questions about this:

1) What’s the shortest fasting window to still trigger significant autophagy?
2) Do MCT oil, small amounts of heavy cream, coffee, bone both or sparkling water negatively impact autophagy?

Thanks guys!


5. Is it advisable for someone who is not overweight to engage in a fast?

Hi Jimmy and Megan,

Fasting seems to be most helpful for obesity and diabetes control. But there are so many other benefits of fasting that are extremely crucial for all of us, not just those with weight and blood sugar issues. I am in the minority and feel like a minority because I am not overweight and I have pretty much have been the same weight forever. What kind of fasting if any would be advised for someone like me who is not dealing with excess weight but would like to get the other benefits of fasting such us immune system reset? It seems to me our ancestors, who were not overweight, were fasting without any major negative impact on their health. Is fasting just for overweight people?

Thank you for all you do,


KEY QUOTE: “When you’re losing fat from fasting, it’s not that you’ve reduced calories, it’s the fact that you’ve reduced insulin and the fat can be released.” – Jimmy Moore

6. Isn’t the half-pound of body fat you lose daily while fasting simply “calories out?”

Hey Jimmy and Megan,

Dr. Fung has thoroughly debunked the calories in, calories out model numerous times. But when he talks about the two compartment model, he notes that the fact that a pound of fat contains about 3500 calories of energy. So while fasting you can lose about half a pound of body fat a day. So my question to you is this: Wouldn’t that be considered “calories out?” If so, then is the “calories out” equation different from the “calories in” one?




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7. Is it okay to use a fiber supplement while engaged in fasting?

Hey guys,

I greatly enjoyed reading The Complete Guide to Fasting and I love this new podcast. My question for you guys is regarding the use of fiber while fasting. What is your opinion about taking fiber-based supplement powders that are devoid of any sugar or artificial sweeteners? I typically take a combination of different kinds of fibers like inulin, acacia, glucomannan, psyllium, and flax. I did not see this addressed in your book.

Thank you for your input,


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Jimmy Moore from “Livin’ La Vida Low-Carb”
Dr. Jason Fung from Intensive Dietary Management
Megan Ramos from Intensive Dietary Management
– Nadia C. Brito Pateguana, ND bio 
The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting
– Get the full audiobook read by Jimmy on Audible
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