Does fasting heal vitiligo?

Last Updated on 11th February 2024 by Caroline Haye

Does detox work? And is fasting the way to do it?

Following the dietary excesses of the festive season, many of us have been cleaning up our act this month. We may even be going through a detox of some description to kick-start a healthier new year. So, with this in mind, I put the search term “does fasting heal vitiligo?” into Google. And what I got was 2,620,000 links in just 0.52 seconds.

It still amazes me that technology has enabled each one of us to ask questions like this and receive as many potential answers as we have time and patience to wade through. At the touch of a screen, we have access to everything from cutting-edge medical research to individual personal stories. But this means that fact, fiction, differing opinions, opposing theories, biased advertising and downright misinformation all jostle for our attention. So, of course, we end up having to sift, scrutinise and fact-check all of these, as best we can, in order to get to the truth.

Add to this the knowledge that even our most qualified vitiligo experts still only know a fraction of what there is to learn about the condition, and it’s little wonder that online searches of this kind generate more questions than answers. So, to spare you the frustration and “internet fatigue” of researching the subject yourself, here’s what I have managed to discover about whether or not fasting and “detoxing” might improve vitiligo. It has been a confusing journey of discovery that has led me up the proverbial garden path and back again several times over… Which is why this post is longer than usual. But, if you prefer to cut to the chase, just scroll down to My Conclusions at the bottom of the page for a summary.

What is a detox? And what constitutes a fast?

For the purposes of this post, I’ll define a detox as any programme or process that aims to remove toxins (or any damaging substances) from the body. Most of us probably associate the term with rehab for drug or alcohol abuse more than anything else. But it also applies to popular diet culture, complementary therapies and even mental and spiritual well-being. (And let’s not forget that most modern usage of all – the “digital detox”.)

A fast can be defined as completely abstaining from food intake for certain periods of time. These might simply be overnight (hence we “break-fast” in the morning). Or it might range from several hours a day, a few days or even weeks. So there can be different lengths of fast. And the effects of such intermittent fasting vary depending on the length and frequency of fast and on how food is re-introduced. Plus there are numerous other factors involved, not least the individual’s metabolism and state of health.

So, these two terms – fasting and detoxing – encompass a range of practices and variables… All of which make it that much harder to find a straightforward answer to our question. After all, how can anyone draw clear-cut conclusions when there are so many different ways of fasting and detoxing? And how do you identify all the risks and benefits when there are so many individual human systems, organs and medical conditions to consider? I suspect it would take a lot more research than anyone is currently willing to pay for.

One thing is for sure, though. There is no shortage of controversy on the subject. But there is a lot of evidence to be found and evaluated if you are willing to search long and hard enough. So, undaunted, let’s look at the question from both sides.

Anti-fasting

Detoxifying, whether by fasting or any other “dietary manipulation”, is viewed by some as a pointless – maybe even harmful – health fad… A trendy marketing ploy, pushed by celebrities, bloggers, health gurus and diet books like Eat Stop Eat. And there is no question that it is indeed big business. In fact, the global detox product market has been valued at well over $50 billion US.

Many of these products are marketed as part of calorie-restricted or cleansing diets or as an aid to fasting. But, despite their popularity in some quarters, the concept of restricting food intake drastically for significant periods of time has plenty of critics. If you aren’t careful about which programme you follow and how you go about it, you could seriously damage your health. Or, at least, end up out of pocket, as the author of this article entitled Diets, Detox, and Other Delusions points out.

What most doctors seem to think

On the whole, the medical profession are sceptical of the whole fasting-detox trend. For example, Dr Toni Brayer from the Sutter Pacific Medical Foundation says, “There are no scientific studies that indicate any benefit to efforts to detoxify the body. Many of these product promotions are really scams.” And her colleague Dr Tom Hopkins points out, “A fast longer than a day or two can deplete vitamins, minerals and electrolytes… Fasts can actually deplete the liver of proteins needed to deal with potentially carcinogenic substances.”

Professor Edzard Ernst, an eminent scientist and expert on complementary and alternative medicine, agrees, stating that, “the principles of AD [Alternative Detox] make no sense from a scientific perspective and there is no clinical evidence to support them. The promotion of AD treatments provides income for some entrepreneurs but has the potential to cause harm to patients and consumers. In alternative medicine, simplistic but incorrect concepts such as AD abound.” And he goes on to say, “DETOX IS BUNK! Save your hard-earned money for stuff that is proven to work.”

Mainstream medicine rarely recommends fasting

In common with Professor Ernst and countless other medical experts, many authority sites and academic publications broadly agree that the whole detox industry is built on misconceptions about what toxins actually are… And the erroneous idea that they need removing from our body by some external intervention. For example, this article entitled The Truth About Toxins debunks some of the popular myths surrounding detoxification, pointing out that our physiology is designed to self-cleanse without any interference on our part.

In light of this, it’s not surprising that mainstream medical professionals rarely recommend the practice… Unless it is under medical supervision or specifically for substance abuse. But, just because there is a general scepticism among doctors does not mean that no scientific basis for fasting exists. [To jump straight to the science click here.] So, before we draw any conclusions, let’s look at the other side of the coin.

Pro-fasting

Anecdotal evidence

Unplanned intermittent fasting was once a natural consequence of the feast and famine existence of our early forebears… Which is one reason to believe that periods of surviving without food may be written into our DNA.

Legions of devotees around the world claim to have improved their health and well-being, or even to have cured diseases, by undergoing a detox. And there is no shortage of praise for the alleged health benefits of fasting among individuals and companies who sell commercial detox products either… Which is no surprise. Of course, the fact that “they would say that, wouldn’t they” doesn’t necessarily mean all their recommendations are worthless. As the saying goes, absence of proof is not proof of absence.

The news story of how one young woman experienced re-pigmentation after cutting out sugar, wheat and dairy is impressive… As is a scientific report of a case of rapid repigmentation after cutting out gluten. (But I am not sure that these relate to fasting, as such. They, and many similar examples shared online, are more about permanently removing certain triggers from the diet, rather than going without food for periods of time. And they probably don’t even qualify for the term “detox” either.) So, let’s move on…

Ayurveda

There is a long history of therapeutic fasting in eastern traditional practices, in particular Ayurveda. Ayurvedic medicine recommends regular detoxes as a means of re-balancing the body. As do numerous other ancient, holistic forms of alternative medicine. And, although the language and philosophy of this tradition lack scientific credibility from a western viewpoint, it strikes me that the practice has another kind of credibility. Surely, over the three plus millennia since its development, it must have had a high success rate. Otherwise, why would it have survived?

The trouble with this scenario, though, is that anecdotal success carries very little weight in the context of modern western scientific research. Western medicine demands rigorous and repeated testing under very specific conditions before it deems any kind of therapy proven. This is exactly as it should be in a discipline that requires certainties and absolutes. But it does leave traditional medicine at a distinct disadvantage. In our science-driven world, drugs that go through extensive research and development, clinical trials and certification are considered superior and more trustworthy. (Even though they are only ever partially effective and come with side effects.) So this leaves ancient remedies that have stood the test of time and worked well for generations of patients in second place.

Scientific evidence

While most mainstream doctors are sceptics, Dr Amy Myers highly recommends the practice. She especially recommends it for autoimmune diseases (having suffered from one herself). And, whether the majority of doctors are aware of this or not, there is in fact a significant amount of scientific evidence to suggest that intermittent fasting has some important health benefits. These include improved blood sugar control, decreased inflammation, improved heart health, and weight loss. A restricted calorie diet (including periodic fasting) has also been associated with extended longevity. And also with improvements in neurological diseases, including multiple sclerosis.

A number of studies into intermittent fasting point to increased protection against cancers, neurodegenerative disorders and autoimmune conditions. (Which, presumably, might include vitiligo). But the specifics of how fasting is carried out are crucially important. For example, this research into the effects of fasting on inflammatory immune disorders found that “Dietary interventions have profound effects on immune responses through metabolic rewiring. Fasting has been shown to enhance immune memory and suppress inflammation”. Yet, on the other hand, “dietary interventions of different types, durations, and timings can have opposite effects on health and disease.”

How you fast is important

So it is clearly not the case that you can just give up food on a whim, then start eating any foods again at random and expect this to have the desired effect on your health. There is a lot more to it than that. And it seems like scientists are really only beginning to discover these secrets. For example, recent research into the effects of periodic fasting on patients with COVID-19 suggests the practice leads to a lower risk of hospitalisation or mortality. In fact, the authors conclude, “Fasting may be a complementary therapy to vaccination that could provide immune support and hyperinflammation control during and beyond the pandemic.”

There are many more scientific papers I could quote. But perhaps the most balanced article I found on the whole subject is called Intermittent fasting: the science of going without, which explains some of the science behind the practice, while also warning against the risks of blindly jumping on the fasting bandwagon. It gives some credible data on the reasons why intermittent fasting appears to have some general health and weight loss benefits. However, it makes no mention at all of vitiligo or any other skin condition. So I decided to do a bit more digging… [Keep going – we’re nearly there!]

Potential relevance to vitiligo

In the course of my search, I stumbled on an article that was potentially relevant to vitiligo. It was some research from 2019 into the effects of autophagy on skin cells (including melanocytes). Autophagy is a stress-induced survival state that kicks in when the body is deprived of food for a limited period of time. And it has a rejuvenating and correcting effect at a cellular level. The article focusses on skin ageing and makes no direct mention of either fasting or vitiligo. However, it does state that melanocytes need autophagy in order to slow down the ageing process and keep working effectively. So, that would suggest that intermittent fasting might help to “reset” damaged or ageing pigment cells. (Let’s hope that there will be further research into the potential application of induced autophagy in the context of vitiligo.)

I also found another paper that specifically relates to the role of autophagy in vitiligo. This confirms that melanocytes rely on autophagy for their survival but that in vitiligo this process is defective, meaning that our pigment cells are more sensitive to oxidative stress. Unfortunately though, the paper does not refer to fasting, as such, nor give any clue as to whether fasting would help fix the defective autophagy process in vitiligo. Or perhaps even make it worse.

A “living laboratory”

Scientific articles proving the dermatological benefits of fasting were hard to find. This one, highlighting the potential of the Islamic month of Ramadan as a “living laboratory” for studying the health benefits of fasting, is fascinating. And, so far, using this approach has produced some promising data on numerous conditions, including psoriasis. There is some research suggesting that a detoxification program combining fasting with fluid therapy may be helpful for stubborn cases of severe atopic dermatitis. And multiple articles point to fast-induced improvements in the gut microbiome as being a key factor in alleviating chronic inflammatory skin conditions. So all of this sounds positive, as far as it goes. But what can we conclude from all of this?

My conclusions

Researching this topic has been a learning curve and I have changed my viewpoint several times in the course of my reading. But, after sifting through a mountain of web pages in search of an answer to the question, “Does fasting heal vitilligo?”, here is a summary of my conclusions…

• A clear answer to the question is hard to find because there are so many variables to allow for in either proving or disproving the proposition. (e.g. Some of the health claims attributed to fasting may be due to other dietary factors, like reducing empty calories, improving nutritional intake or avoiding gluten or other triggers.)
• The western medical community is very sceptical of commercial detox products and of the need to detoxify (except in cases of substance abuse). In many ways, they are right to be sceptical. Detox diets are big business and not always safe, effective or appropriate.
• Most family doctors would probably warn against intermittent fasting, being more aware of the potential risks in getting it wrong than of the mounting scientific evidence of its health benefits.
• There is a large amount of anecdotal evidence that intermittent fasting can improve a wide range of health issues. And numerous research articles strongly support this view. Among the many apparent benefits are some that may relate to vitiligo, for example improvements in the gut microbiome, autoimmune diseases and chronic inflammatory skin conditions.
• On balance, I agree with those who advise caution when it comes to commercial detox products and fad fasts. But I think there is far too much evidence (both anecdotal and scientific) showing the benefits of responsible intermittent fasting to dismiss it out of hand.

Will I be fasting from now on?

My own experience of reversing vitiligo did not involve fasting or dieting at all. However, it did rely on nutritional manipulation in the form of supplementation. So I do know first-hand that a nutritional approach can work.

Since my initial recovery, I have also learned that taking probiotics and eating a low carb, clean diet always has a hugely positive impact on my general health. In addition, I have learned the hard way that cutting out trigger foods (in my case, gluten) is hugely important. And, having researched the subject, I now suspect that some form of intermittent fasting would be another good way of achieving the same improved digestion and all the knock-on benefits that come with it.

Intermittent fasting made easy

So, am I going to go without food for days or weeks at a time? Heck, no! If I were to do anything as drastic as that I would only do it under expert supervision. But there are other, safe ways to try out intermittent fasting. And, much to my surprise, it turns out they don’t necessarily require massive willpower or significant lifestyle changes either. Abstaining from food for 12 hours a day is a recognised and effective form of intermittent fasting. And it is simple to do, just by eating your evening meal a little earlier and not snacking until breakfast.

On that basis, I will certainly be giving it a try. I do not see fasting as any kind of compensation for a bad diet (so I won’t be binging for the other 12 hours!). And neither do I expect it to take the place of the nutritional protocol that I use to control my vitiligo. But if abstaining from food for twelve hours out of every 24 has the potential, as part of a healthy lifestyle, to optimise my health and maybe improve my skin further, why would I not at least give it a go?