Everything I Know About Fasting and Going Keto

“Cancer..” she dropped while her eyes betrayed that she shouldn’t have.

“She didn’t.” I thought.

“Cancer!?” I bit back. “Uhm, nope, thank you. I’m just here for a pap smear.” I tried staring her out.

But beneath my gaze, I noticed that I was holding my breath. I hoped she wouldn’t. Or maybe that she would.

I needed this to end. Couldn’t have her elaborate on her threat. Thus, I toned down, “Please, stop. You’re scaring me. I’m just here for a pap smear.”

·

A month earlier, I had done a health screening. I was visiting my parents in Sarajevo, and my mom insisted on the checkup.

Everything was fine, I was told, except for that infection and inflammation down under.

Mild problem, though. It would likely go away with a round of antibiotics. To be sure, I was advised to follow up once I finished the dose.

And so here I was, back in Singapore, translating the results of my first pap smear to Dr. Chan, and asking for a second one.

Dr. Chan, in return, began our conversation by asking me why I didn’t have any kids, being 32 and married. It was a bad start, and soon we were arguing about what my previous results meant.

She thought I needed extra tests. When I declined, out of distrust, it looked like her last sales pitch was cancer.

In the end, I got my pap smear and got out. I then bought a bowl of cut fruits, my equivalent of the old sugar drug, and devoured it.

Dr. Chan turned out to be right. I did need further tests. The second pap smear showed that the inflammation was still there, and moreover, that atypical cells were present.

Soon after, I did a biopsy. The results ruled out cancer. However, I did have precancerous cells lining up my cervix, which were in a pretty shitty stage, CIN III.

If I didn’t do anything about it, these precancerous cells would likely develop into cancerous ones. Cut them out was the option at hand. And I was okay with that until I wasn’t.

The complications didn’t seem trivial.

A sentence that I remembered reading kept hovering in my mind:

If you don’t have cancer and you do therapeutic fast 1 to 3 times a year, you could purge any precancerous cells that may be living in your body. –Dom D’Agostino, Tools of Titans

If there was a chance that my body could heal itself, how could I not try?

Twelve weeks later, the Friday before Christmas, I was waiting for a take-out order, when out of boredom, I called back an unknown number. It was nurse Khwan.

“I’m trying to email you the results right now,” she said, “It’s CIN I.”

“CIN I?” I urged.

“Yes, CIN I.” she confirmed.

I gasped, “CIN I, CIN I. It worked…”

“Yes. We were all a bit skeptical,” nurse Khwan confessed, “But yes, whatever you did, it worked.”

What I Did

Calorie-restricted ketogenic diet
I ate around 1550 kcal per day and followed a strict ketogenic diet: 20-25 grams of net carbs, 50-55 grams of protein, and the rest of my calories came from fat.

Intermittent Fasting
I ate only once a day within a 4-hour window.

Fasting
I did three 5-day water fasts, one every month.

I rigorously complied with this plan for three months. After that, I continued with the ketogenic diet and intermittent fasting. I stopped restricting calories, though, and eased on the water fasts.


Note I

I followed the above regime in an attempt to avoid surgery. It was a metabolic therapy first and foremost, not a diet for losing weight.

If you have a history of eating disorders or disordered eating, you shouldn’t be doing any intermittent fasting or fasting. If you decide to ignore this warning, then at the very least, you should find a nutritionist who’s familiar with fasting and the keto diet and is willing to guide you, knowing your history.

Friends and other people I talked to, who battled eating disorders in the past, told me that any type of fasting would be too dangerous for them. Someone close to me discovered that she suffers from an eating disorder after trying intermittent fasting and the keto diet.

Fasting and measuring my food intake for three months, clearly scarred my eating habits. It took me months to stop obsessing about food and eating times, and to restore a more balanced relationship with food.

Thus, please, be careful with yourself. You don’t have to do things my way. Do plenty of research, and I’m sure that you’ll discover options that work even better for you.

·

Note II

Both my general practitioner and gynaecologist agreed to give my experiment a go for three months. Even though they didn’t believe it would work, it was still essential to have them on board since I needed them to monitor my body’s responses to the diet. I’d do blood tests every four weeks in the first three months, and then every six weeks. If you’re going to do this, you need to do tests. The doctors can help you with this. 


Timeline of My Lab Results

In December 2018, three months into the regime I implemented, my second biopsy showed that the cells had gone from CIN III to CIN I.

In October 2019, about one year after I found out I had CIN III, the lab results showed that the cells had gone back to normal.

 

Lab Results

Date Pap Smear Class Cervical Biopsy
2018, August ASC-H 2
2018, August CIN III
2018, December* ASCUS 2 CIN I
2019, March ASCUS 2
2019, July ASCUS 2
2019, October Normal 1

*In December 2018, I did both a pap smear and a biopsy.

 

Classification of Cervical Pap Smear**

Description CIN Grade The Bethesda System (2001) Papanicolau Classes (closest equivalent)
Normal Normal Negative for intraepithelial lesion or malignancy Class I
Atypical Atypia ASC-US/ASC-H/AGUS/AGUS-N Class II
HPV HPV LSIL Class II
Mild dysplasia CIN I LSIL Class II
Moderate dysplasia/CIS CIN II HSIL Class III
Severe dysplasia/CIS CIN III/CIS HSIL Class III
CIS, can’t rule out invasion CIS, can’t rule out invasion HSIL, can’t rule out invasion/AIS Class IV
Invasive carcinoma Invasive carcinoma Invasive carcinoma Class V

**From Quest Laboratories in Singapore

What Made It Easy

  • G’s support. Not only did G support my decision, but he also switched to the keto diet with me, and spent a lot of time researching and reading up on metabolic therapies.
  • My parents.
  • The friends who cheered me on, and believed perhaps even more than I did, that our bodies can heal through food.
  • The existing research by the doctors, scientists, and other people who went before me.

The Hard Parts

  • The doubt.
  • The continuous research. About everything. And the amount of contradicting and often plain wrong sources.
  • The Keto Flu. I had all the symptoms.
  • People telling me to have the surgery.
  • Seeing my friends and family struggle with their health, yet being unable to persuade them to give up sugar and processed foods (at the very least).

The Silver Lining

  • Food tastes so much better with added fat.
  • I’m more aware of the quality of the foods I eat and buy.
  • All the knowledge I gained about health and disease prevention will be available to me for the rest of my life.

Some Advice

  • Do a lot of research.
  • Doing research takes time; however, you don’t want to wait until you know everything. Just start and refine as you go.
  • Include podcasts and audiobooks in your research. They will help you learn quicker.
  • Google your health concern in combination with the keywords fasting and ketogenic diet.
  • Make sure to have plenty of bone broth, eat avocados, top up your electrolytes, and increase your salt intake.

Resources

Apps

📋 Cronometer · An app that can help you track your macros. It has good support for the ketogenic diet and also syncs with the Apple Health app.

Zero · Cool fasting tracker app

Books

Documentaries

The Magic Pill – Recommended to me by Inou, friend and web developer without a web presence

Podcasts

Tim Ferriss adapted the chapters that I listed under books from his podcast interviews: Dom D’Agostino on Fasting, Ketosis, and the End of Cancer and Dr. Peter Attia on Life-Extension, Drinking Jet Fuel, Ultra-Endurance, Human Foie Gras, and More. You can listen to these for free.

Tools

🏋🏻‍♀️ Hario V60 Drip Scale · To weigh your foods (and coffee beans)

🌡 Keto-Mojo · The device that I use to measure my glucose and ketone levels

Websites

🍳 DietDoctor · For keto recipes that don’t look disgusting

Foods & Supplements

Below you’ll find a list of foods & supplements which I use and have researched. When possible, I’ve linked to a product’s page on iHerb since they ship worldwide (non-affiliated).

Foods

When it comes to oils, you can use any brand that’s organic and cold-pressed and tastes good. I use coconut oil, ghee, and pork fat for cooking. Avocado oil and olive oil for salads and greens.

I stopped using sweeteners altogether about one year into keto. If they’re helping you, however, to comply with the therapy, I think that stevia (Now Foods) and erythritol are your best choices for now.

I used to cook with shirataki noodles for some time, but I don’t anymore. My intuition tells me that it’s not a product that I want to use for a long time. Again though, they can help you transition with giving up pasta and noodles.

I don’t drink milk, nor do I consume dairy products that contain less than 35% fat–except for some cheeses.

·

Apple cider vinegar, CoralTree – 🍒 Cheeky fact: I stopped using Bragg’s vinegar (which is widely available) after I discovered a fishy on their label. I really don’t need a splash of religious proliferation with every salad, thank you very much.

Almond butter, Fixx & Fogg – Their peanut butter is delicious too, but I don’t eat it often since peanuts are considered legumes and not nuts.

Almond meal, Absolute Organic

Avocado oil, Grove

Butter, salted and unsalted, Kerrygold or Anchor

Cacao powder, Navitas

Chocolate 90%, Lindt – The 95% bar is good too, but much harder to find.

Coconut butter, Nativa

Coconut flakes, Edward & Sons + Shredded coconut, Edwards & Sons

Coconut flour, Absolute Organic

Coconut milk, Aroy-D

Coconut oil, Garden of Life

Coconut yogurt, Coyo

Cream cheese + heavy cream (35% fat), Emborg

Flaxseed (ground), Ceres

Ghee, Organic Valley

Granola, Pecan Coconut, The Whole Kitchen

Hemp seed hearts, Now Foods

Mayonnaise, Undivided Food Co. · I’ve also used Avocado Oil Mayonnaise by Primal Kitchen but found the avocado oil taste too present at times.

Olive Oil, Cobram Estate · Why I use Cobram Estate Olive Oil

Pork fat, Epic Bar

Pork rinds, Epic Bar

Psyllium husks, Absolute Organic · I use psyllium husks to make these coconut flatbreads.

Sea salt flakes, Maldon

Seaweed snack, SeaSnax

Seed crackers, Ben Banter

Stocks and broths, The Stock Merchant

Vanilla Extract, Simply Organic

Other foods that are a staple in our house: avocado, berries (blueberries, raspberries, strawberries), cheese (buffalo mozzarella, gruyere, halloumi, mascarpone, parmesan, white cheddar), chia seeds, eggs, fish (salmon), meat (grass-fed beef), olives, mushrooms (enoki makes for a delicious faux pasta), nuts (almonds, brazil nuts, hazelnuts, macadamias, pecans, walnuts), veggies (asparagus, broccoli, brussels sprouts, cauliflower, kale, spinach).

Supplements

Beef gelatine, Vital Proteins

Brain octane oil (MCT Oil), Bulletproof 

Calcium citrate, Now Foods

Collagen peptides, Vital Proteins

L-Lysine, Now Foods

Magnesium drink supplement, Natural Vitality

Magnesium oil, Sunfood

MCT oil powder, Perfect Keto

Methyl folate, Now Foods

Omega 3 fish oil, Sports Research

Questions I Received

“Oh Heavens!” all you readers of both sexes will cry out, “oh Heavens above! But what a wretch the Professor is! Here in a single word he forbids us everything we most love, those little white rolls … and those cookies … and a hundred other things made with flour and butter, with flour and sugar, with flour and sugar and eggs! He doesn’t even leave us potatoes, or macaroni! Who would have thought this of a lover of good food who seemed so pleasant?” “What’s this I hear?” I exclaim, putting on my severest face, which I do perhaps once a year. “Very well then; eat! Get fat! Become ugly, and thick, and asthmatic, and finally die in your own melted grease: I shall be there to watch it.” –Jean Anthelme Brillat-Savarin, 1825, via Why We Get Fat by Gary Taubes

Most questions I get are about the ketogenic diet, and specifically, about which foods are allowed on the diet. In regards to using the keto diet as a metabolic therapy, my take on it is this: be as rigorous as you can.

1. Can I drink coffee on keto? I’m asking because my main concern for doing it would be low levels of energy due to fasting and low carb consumption.

> Yeah, coffee is okay. That’s coffee without milk, though, since milk has too many carbs.

On a side note, you may want to try bulletproof coffee, which comes down to blending a cup of coffee with 15 grams of (grass-fed) butter or ghee, and 15 grams of MCT oil. Blending is non-negotiable; it’s what makes the beverage frothy and creamy.

Here’s the original bulletproof coffee recipe.

2. Is intermittent fasting + keto suitable with a day job? I don’t mind being hungry, but if I’m going to feel low and drained for a few weeks, I might have to postpone or cancel some work projects.

> I went on keto and started fasting the same month that I began my first job as a web developer. The situation wasn’t ideal. What made it easier, however, is that I was able to work from home most of the time.

Working from home allowed me to cook my meals and eat whenever I wanted. I also didn’t have to worry about feeling weak or lightheaded in public.

Your body will most certainly go through a transition period. But I can’t tell you how it will respond to the changes you make to your diet. You may feel low for some days, or even weeks (like I did), but you might as well feel fine (like G did).

Taking it a bit slower, though, can’t hurt. You can use that extra time to take better care of yourself, but also for research.

3. Is the transition from a carb-based diet to keto easy? I’m not eating a lot of carbs but probably at least 100 grams/day. And I think you said that you were sick for the first weeks or so if I remember?

> It depends. G’s transition was quite smooth. Mine was not. I had all the keto flu symptoms. Heart palpitations, headaches, hair loss, cramps, brain fog, insatiable thirst, dry mouth, and an irregular period. Knowing that my transition was hard can help you prepare for the worst, but it doesn’t mean yours will be the same.

4. Do you always need to be in keto? Or can you be in and out without altering the “power” of the diet, especially for medical purposes?

> For me, getting out of ketosis was never an option that I entertained, knowing that staying in ketosis was the one thing that could help starve the pre-cancerous cells in my body.

If you’re using keto as a metabolic therapy, stay in ketosis long enough to either see a positive or negative trend in your desired results or blood tests. Then, based on those new results, do more research and take it from there.

5. Can you drink alcohol while on keto? Like one or two glasses of wine or a beer once in a while.

> One bottle of beer has about 12.5 grams of net carbs. One glass of red wine (175ml) has about 4.5 grams of net carbs.

If you’re going to follow a strict ketogenic diet (like I did), you can have 20 grams of net carbs a day. That, then, comes down to two bottles of beer or four glasses of red wine–and no other food that contains carbs, which is pretty much all food.

Now you decide how much of your daily allowed grams of net carbs you want to waste on beer or wine.

My advice. Get healthy first. But if you’re still craving that drink, skip the beer and have a wine. Better yet, go for a spirit like a high-quality gin or tequila, which don’t have any carbs.

All alcoholic beverages, however, do contain calories. Thus, you’ll still need to keep an eye on those if you’re following a calorie-restricted diet on top of the ketogenic diet.

6. What’s your take on stevia chocolate?

I stopped eating artificial sweeteners altogether, but I think they can serve as a transition solution for some time.