Fasting for Pruritis

This may only be anecdotal and perhaps coincidental but I wanted to post about my experience with trying an extended fast (it was over 30 hours), to see if allowing autophagy to take place, would alleviate my horrible pruritis. Autophagy and short bouts of fasting do have other benefits so I was apt to try. I drank water, tea and had a little soy milk (unsweetened) in coffee. The idea is not to eat and definitely avoid sugar.

I just did this, so I will have to report back to let you know if the relief is sustained beyond the day and/or for how long, but while yesterday evening (at or around the 24 hr mark) I was still very itchy but this morning, it was pretty much negligeable. I did have a half cup of rice at the 24 hrs mark or so to take my ursodial but that is it. I pretty much fasted about 36 hrs (and remarkably, I wasn’t hungry).

The pruritis has been absolutely horrible for me for the last 4-6 weeks again, after a prior bout around April, after which I took antibiotics (to alleviate these symptoms and to get my bili and ALP down as a prophylaxis to prevent infection). I don’t take the antibiotics thing lightly as it destroys the gut bacteria but it was intolerable. My skin is bruised, raw and was bloodied and scarred.

This brief article explains what autophagy is: Autophagy: Definition, Diet, Fasting, Cancer, Benefits, and More. It basically is a process where the body ‘eats itself’ to get rid of bad cells and the like. The body enters this mode after/during a fast. It really kicks in after 24-30 hours.

This is a medical article but it is very scientific and may be only understable to those who study in the field - (PDF) The Therapeutic and Pathogenic Role of Autophagy in Autoimmune Diseases

In any case, I have so far experienced substantial relief and will post updates.

Warning - if you do decide to try it, don’t do it longer than that 36 hr or so, and you may want to try some intermittent fasting to start if you don’t think you can fast. If you do have to eat a small amount, you can still continue on the fast and it should have some benefits. Depending on your condition, you may wish to consult a doctor.

For background, I am vegan and on a strictly plant-based diet (trying to minimize processed foods as well but heck, I ain’t perfect :slight_smile:

Thanks for sharing this Birdy. Of course we want to remind our member patients that they should not take on such a prolonged fast without first consulting with their physician. I do hope you get some positive results though.

Have you ever tried the prescription medication Rifampin for your itching? You might ask your doctor about it. I was on 300 mg twice a day and it pretty much eliminated my terrible itching.


Thanks Mark.

I am on the Cilofexor trial so I can’t take other medications while on the trial…at least not that one or anything steroidal. Cholestrymine was it and it had no positive impact.

There is a decent amount of work on short term fasting. I had done intermittent fasting before (bit not for or during pruitis). This was the first over 24 hrs (not abnormal in history as we didn’t always have access to food). Historically (not too long ago :grinning:) we didn’t eat from 6 or 7 pm until morning which is a shorter intermittent fast.

Probably not advisable for those that are underweight but when the itching is so bad and you can’t function…

3 -5 day fasts are a different story…medical baseline and checks…most definitely! And as you note, for any fast, the safety is highly dependent on the individual and the state of their PSC. I have probably had to fast that long basically to prepare for colonscopies and my biopsies.

Anyway, happy to say, still no severe itching this evening. If this relief lasts, I will do it again. The body benefits regardless and personally seaking, if I can avoid drugs, I will always opt for that if there are lifestyle alternatives that are just as effective.

Something people may wish to explore with their specialists.

Glad this seemed to help! I am fortunate not to experience pruritis so far but have found relief from liver pain and nausea from short fasts (from skipping a meal to 24-30 hrs). I’m also in the Cilofexor trial.

I found this same thing on my own. When I would fast for Christian reasons, my inflammation and arthritis would disappear. I never new the reason. I do not have itching yet in my stage of psc, but glad to have this knowledge ready.
Thank you!

Thank you Cody for sharing your experience!

I am pretty amazed with how it worked after one fast.

I went from an 8-9 level itchiness to about a 1-2 and the frequency during the day has also reduced.

It will now be a weekly thing for me.

Glad you don’t have pruritis yet. Mine just started this year, almost 4 years exactly from my first attack which led to my PSC diagnosis

How far along are you on the trial? I have just over 6 months left. Did the PK substudy too.

Thank you for sharing Mark.

I usually fast yearly for 25 hrs for religious/traditional reasons but it is a full fast without liquids.

This was my first longer proper fast after reading a lot about it to understand what happens and why it works at a physiological

Pretty interesting

Thanks for your reply. Yes fasting as a sacrifice probably has more benefits in return then we know…

With the lack of appetite common with PSC, a 30 hour fast would not be too much of a stretch. Yes, that was a cheeky comment, so no flames, please.
But the loss of nutrition would be a concern too.

No cheeky comment :slight_smile:

I have found that the only time my appetite is reduced is when I have URQ pain and nausea. Otherwise…I still have a huge appetite…sigh.

It is strange (perhaps not uncommon?) But I find that I now seldom now have pain but it has been replaced with pruritis. I would take the former over the latter but my body (not my mind) seems to be making all the decisions

I will post my update on fasting after doing it for a few more weeks.