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I generally like writing about nutrition and alpha-1 antitrypsin deficiency (AATD), and especially the role of fasting. The goal of fasting can be complicated by any liver or other hormonal issues, so I hesitate to recommend it.

In fact, I normally don’t recommend it at all. The main goal of fasting is usually autophagy, the destruction and consumption of cell materials. This process begins in the liver, which is also where AATD begins. An interruption of any of these liver processes could be great, or it could be bad.

I think the main concern for liver damage is with the PiZZ genotype, because of the amount of protein getting stuck in the liver. I am no doctor, but I have heard that people in my support group suffer from so many liver issues.


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Therefore, my recommendation to someone with AATD who wants to try fasting is to proceed with caution. I have tried a lot of fasting and diet tricks on myself, so I would like to share some of these experiences.

I have had issues with my hormones and blood sugar for a long time, and they seem to come and go. Although I have never been one to drink much alcohol, I figured that with the infections I have had and medications I have had to take, it might be good to cleanse my liver.

I tried the Keto diet and I felt better, for about 3 months. At that point, I had lost so much weight and electrolyte balance (I had no idea how much I needed those), I ended up in the hospital. That Christmas Eve I was watching a movie with a friend and began having breathing issues that my inhaler couldn’t fix.

I was confused and had a lot of wheezing (for the first and only time in my life), and my parents had to take me home from the Emergency Room because I couldn’t drive. For a long time, I had no energy. I felt like I had hit a wall no matter what I ate.

My hormones were also out of whack and my emotions were all over the place. I learned how to remedy it but it took a while. Even now, if I don’t have enough carbohydrates in the morning, I can’t finish out the day right.

I tried intermittent fasting but soon gave up on it because I didn’t see any positive results and wondered what I was doing to myself. I just mainly felt weak and tired. Since I already felt that way in general from health issues, I found it to be very inconvenient.

I understand fasting can release toxins stored in the body, which is good. But if my friend has liver issues and wants to fast, I will always refer them to a doctor and a registered dietician for guidance. It could be a game-changer in a good way.

Read about patient education for AATD

I have heard good stories and bad, but I don’t think there is enough research to prove anything yet. The few times it was brought up in my support group for AATD, the idea was not a popular one. It’s not a matter of dislike of the idea as much as it is a lack of experience or instruction.

Perhaps if I had the time and money to research and experiment on myself, I would. I know several people who have had long-term success with the Keto diet. These people have either learned how to utilize their resources correctly or just don’t deal with the same issues I have.

I understand some people have good reasons for it. Some do it out of religious conviction, some do it out of a desire to cleanse their liver, and some do it to feel better or lose weight. These are not bad ideas, but they require someone to be healthy in certain respects.

We are all different in terms of physiological processes, especially in the liver. I have become very intuitive when it comes to finding what nutrients my body needs. I have discovered my body needs carbohydrates, protein, and fat as well as electrolytes every day.

This process comes with time. Experimenting is fun, though a doctor or dietician may need to approve it, especially if the person has issues with blood sugar.

In school, I learned that sometimes people develop a euphoric feeling that can come from strict dieting. It can give a person a feeling of control over their life, although sometimes this is deceiving. I understand this after trying the Keto diet.

We can all learn a lot from our bodies if we take the time to listen. And that does take a lot of time. I would say if a person can get past 3 months on a diet, and still be healthy, that is a great sign.

Less food is generally less money, after all. Lately, I have gravitated toward the Mediterranean diet and have had satisfactory results with it. I really like it and am grateful for how it has made me feel.

Generally, I feel better with a lower-sugar lifestyle. I am thankful for all those who have been there through the years and who helped me consider ideas and try them.

After all, everyone is amazingly designed, and we would do well to respect that. Someone once said that to be able to enjoy living right is a great gain. I’ve been thankful I have learned to enjoy right eating as much as I have.