title: The short-term effects of fasting on the neuroendocrine system in patients with chronic pain syndromes.
abstract: It is commonly reported that short term fasting leads to mood enhancement and emotional harmonisation. We investigated psychosocial well-being and the neuroendocrine response, assessed by nightly urinary excretion of cortisol and catecholamines, in 28 inpatients with chronic pain syndromes during and after a one-week modified fast. Twenty-two of the patients (51.4 +/- 2.7 years, BMI 26.8 +/- 1.0 kg/m2) participated in a 7-day fast with daily intake of 300 kcal/day, six control patients (47.5 +/- 4.0 years; BMI 22.9 +/- 1.1 kg/m2) received a vegetarian-based diet. With fasting significant increases of the urinary concentration of noradrenaline (17.8 +/- 3.0-27.8 +/- 3.8 microg/ml), adrenaline (1.5 +/- 0.2-3.4 +/- 0.7 microg/ml) and cortisol (26.1 +/- 3.7-40.7 +/- 6.1 microg/ml) were observed, whereas controls showed no significant endocrine changes. The neuroendocrine response to fasting was pronounced in younger subjects (age <50 years) and in the presence of a BMI >25 kg/m2, moreover the increase in cortisol excretion was significantly higher in subjects with lower baseline cortisol levels. Mood and well-being increased non-significantly in both groups. Fasting was well tolerated, and regarded as beneficial by most fasting patients. Our results show that short-term fasting leads to neuroendocrine activation and may suggest that the extent of this response is dependent on the individual metabolic and endocrine state at baseline.
authors.affiliation: Department of Internal Medicine V and Integrative Medicine, Kliniken Essen Mitte, Am Deimelsberg 34 a, 45276 Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Michalsen
authors.forename: S
authors.initials: S
authors.lastname: Schneider
authors.forename: A
authors.initials: A
authors.lastname: Rodenbeck
authors.forename: R
authors.initials: R
authors.lastname: Lüdtke
authors.forename: G
authors.initials: G
authors.lastname: Huether
authors.forename: G J
authors.initials: GJ
authors.lastname: Dobos
mesh_terms: D000339:Affect; D000375:Aging; D015992:Body Mass Index; D001835:Body Weight; D002908:Chronic Disease; D004032:Diet; D014676:Diet, Vegetarian; D004837:Epinephrine / Q000652:urine; D005215:Fasting / Q000502:physiology*; D005260:Female; D006261:Headache / Q000453:epidemiology; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008297:Male; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000503:physiopathology*; D009638:Norepinephrine / Q000652:urine; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D015431:Weight Loss
chemical_list: D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine