The Connection Between Intermittent Fasting and Autoimmunity

Is intermittent fasting or time-restricted feeding a viable strategy for improving autoimmune conditions and overall immune system function? That’s the question we’ll explore today, and spoiler alert: the answer is yes. 

But I want to break down this important connection for you. 

Intermittent fasting is one of the most simple, effective, and (in my opinion) underutilized tools when it comes to improving your health, period. As Paracelsus, one of the founders of modern medicine, put so eloquently: “Fasting is the greatest remedy– the physician within”. 

So how does it work? What makes fasting so powerful, and how can you make it work for you? 

Let’s get into all of the ways intermittent fasting can improve the root causes of autoimmunity, what’s going on in your body when you take breaks from eating, and how to get started with fasting.  

The Fasting-Autoimmunity Connection

The first and arguably most important thing to understand when it comes to the fasting-autoimmunity connection is that autoimmunity is a sign that something has gone wrong with the way the body is working. 

Intermittent fasting has been shown through multiple different mechanisms to help get the body back on track. Fasting can help to: 

Reduce inflammation 

Improve metabolism and metabolic flexibility

Regulate hormones 

Balance the gut microbiome 

Stimulate cellular recycling (autophagy) 

Improve immune system function 

Regulate circadian rhythm 

Reduce oxidative stress 

All of these factors are relevant for individuals with autoimmune conditions. Imbalances and issues in these areas have been implicated in the development of autoimmune disease, and improvements in these areas have been associated with improvements in autoimmunity. 

Research into fasting as a treatment approach for autoimmune conditions is in its early stages, but researchers have seen promising results for diseases including rheumatoid arthritis, multiple sclerosis, type 1 diabetes, lupus, and psoriasis. 

For example: 

Patients with rheumatoid arthritis (RA) who practice intermittent fasting during the month-long Ramadan holiday have been found to experience rapid and sustainable improvements in symptoms. (1) 

Similar symptomatic improvements have been seen for patients with psoriasis who fast during Ramadan. (2) 

Periodic 3-day cycles of a fasting-mimicking diet have been shown to reduce inflammation, improve demyelination, and improve or even completely reverse symptoms in an animal model of multiple sclerosis (MS). (3) 

Future studies will likely see similar results for other autoimmune conditions, given their similar pathologies. 

And in my functional medicine practice, I’ve worked with countless individuals with autoimmunity who have experienced meaningful health benefits from fasting. 

So let’s take a look at some of the different ways fasting may work for those with autoimmune conditions. 

LISTEN: Gwyneth Paltrow X Dr. Will Cole: Intuitive Eating, Intermittent Fasting, Inflammation + The Future Of Functional Medicine  

Your Gut Microbiome

Alterations in the gut microbiome have been shown to play a significant role in the development of autoimmune conditions. (4) 

Intermittent fasting is one great way to help balance the gut microbiome (other ways include supplementing with a probiotic). Fasting has been shown to improve bacterial diversity and richness in the gut, and to reduce gastrointestinal inflammation. (5) 

These beneficial effects on the gut microbiome likely play an important part in why fasting helps with autoimmunity. 

A study on mice with multiple sclerosis found that intermittent fasting improved the makeup of the gut microbiome, which led to better antioxidant protection, increased ketone formation, and improved metabolism. (6) The researchers concluded that the immunomodulatory effects of intermittent fasting on MS in this study were at least in part brought on by these changes to the gut microbiome. 

Autophagy 

Autophagy is the body’s process of breaking down and recycling damaged cells, and making room for new, healthier ones. This is important all the time, but especially when our cells are experiencing accelerated damage and aging due to stress, illness, toxin exposure, or other environmental factors. 

Intermittent fasting has been shown to help promote and enhance autophagy. (7) This in turn can improve immune system regulation and autoimmunity. (8)  

Metabolic Health 

Arguably the most important thing you can do to improve your immune system function is to improve your metabolic function and flexibility, and at its core this is what intermittent fasting does. 

Intermittent fasting helps to reset our metabolism and enhance metabolic flexibility, helping to improve energy levels, reduce inflammation, and allow the body to switch more effectively between burning sugar and fat for fuel. (9)  

Inflammatory Markers

Intermittent fasting has been shown to reduce inflammation in autoimmune conditions like MS, Crohn’s, and lupus, and in several other chronic health conditions including asthma and IBS. (10, 11)

Fasting has been found to reduce levels of pro-inflammatory cytokines like interleukin 6 (IL-6), and other markers of inflammation like C-reactive protein (CRP). 

Researchers have also looked at what happens with highly inflammatory immune cells called monocytes when we fast. During periods of fasting, fewer monocytes are released, and circulating monocytes essentially go into “sleep mode”, creating less inflammation and damage than they do for those who aren’t fasting. (10) 

Fasting also increases b-hydroxybutyrate (BHB), a signaling molecule that works to reduce inflammation. 

Inflammation, of course, is generally very high for those with autoimmune conditions (and chronic illnesses in general). The ability to reduce inflammation through fasting has innumerable possible uses for improving chronic health conditions.

Learn how to reverse autoimmune symptoms, dampen inflammation, and balance your immune system with my course, Mastering Autoimmune Conditions & Inflammation with Functional Medicine. 

Your Immune System

Autoimmunity is a condition of the immune system, no matter which part (or parts) of the body it affects. Intermittent fasting has been shown to support the immune system, including by promoting the recycling of immune cells that are no longer needed (and that may be problematic). (12, 13) 

Fasting also affects immune system function through the other pathways we’ve talked about, including helping to balance the gut microbiome (the majority of the immune system lives in the gut). 

How to Get Started 

There are several different ways to practice intermittent fasting or time-restricted eating, and I firmly believe in working with your body to find the plan that feels right for you. 

If you’re completely new to IF, you might want to start with smaller or less frequent periods of fasting and work your way up. 

For most people, the easiest place to start is with establishing a schedule where you stop eating at a certain time of evening, and begin eating again at a certain time the next day. Depending on your current routine, you may want to start with 10-12 hours of overnight fasting, and increase to up to 16 hours. 

Some people like to fast this way every day, while others prefer to do it a few times a week, and/or incorporate less frequent but longer fasts into a regular routine. 

I wrote Intuitive Fasting to help you figure out the best way to incorporate intermittent fasting into your own life for optimal metabolic flexibility and wellbeing. The book takes you through a four-week plan, and it’s flexible and customizable based on your needs and your body’s responses. (There are also a lot of great recipes in the book that I personally use all the time!) 

There are a few final important things to note here. First, although we’re really talking about when you eat here, don’t forget that what you eat matters, too! Choose whole, anti-inflammatory foods during your eating windows for the best chances of success. 

And, depending on your health condition and history, you may want to consult with a trusted practitioner before you start fasting. For example, while fasting has been shown to help with type 1 diabetes, it also warrants caution as fasting influences blood sugar levels.

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The Takeaway 

Taking flexible breaks from eating to allow your body to rest and repair is a highly effective strategy for reducing inflammation, regulating metabolism, balancing the gut microbiome, stimulating autophagy, and improving autoimmunity. 

If you’re looking for more guidance on intermittent fasting and how to work it into your life, or for more comprehensive support for your autoimmune condition, consider booking a consultation with our functional medicine telehealth clinic.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.