A Woman Ate 23 Bananas After Fasting 7 Days. This Is What Happened To Her Organs.
KC is a 23 year old woman, presenting to the emergency room,
unconscious. Her mother Jane, tells the admitting nurse that KC had been
acting funny over the last week, but no one was really sure what had been happening.
KC was a fitness enthusiast. When she started college, she got in to intermittent fasting to
help regulate her diet. This is a time when people set specific times where they can and cannot eat,
to help maintain order in their diet. She noticed that sometimes, she could go a few
days without eating, and without making up for it, she’d lose a good amount of weight.
She noticed that on the days she started eating again, she’d have a
massive headache after the first meal, but she didn’t think anything of it.
Over the course of the pandemic, KC felt she had become less fit. She took it in to her own hands
to tighten the fasting periods of her eating. She saw a group of people talking about how fasting
for days at a time was a way to not only help limit intake, but also to suppress what someone
called “hunger hormones.” In her interpretation, eating more would just cause the body to release
more hunger hormone, making her hungrier after every meal, causing her to eat even more. She
believed this is what had happened to her in the year since the pandemic. So by slowly increasing
the number of days where she wouldn’t eat at all, she would be gradually pushing down
levels of hunger hormones, and prime her body to get back in to shape, she thought.
She started by not eating for a day, and then leaving an 8 hour
window the next day where she was “allowed” to eat. The next week,
she’d try for 2 days in a row without eating. And then 3 days the next.
She did lose weight, but noticed her workouts were sluggish. And the more days in between
where she didn’t eat, the more that she wouldn’t feel well when she did start eating.
KC had read online about re-feeding syndrome that can happen when someone comes out of a
fasted state too quickly. If someone fasts for too long, then their body would adapt to that state,
so eating a lot suddenly can throw everything off balance.
She thought she understood it, and knew that taken to the extreme,
eating too quickly after fasting for too long could be life threatening.
But she would NEVER take it to the extreme of course. It didn’t really matter to her. She
didn’t have any syndrome. She was OK, just didn’t feel great.
As the weeks passed, KC lengthened her fasts. It wasn’t intermittent fasting, because she would
go for almost a week in a row without eating. She noticed that she stopped getting her period. Her
biggest concern was that if she broke her fasting schedule and started eating like she had before,
then all of her work towards being the shape she was now, would be all for nothing. She
knew she eventually had to eat, and she was OK with that, so nothing seemed to be the problem.
But one day, after fasting an entire week, KC knew it was time to eat. She had never fasted
that long. She prepared beef soup which she read about online to help start refeeding,
and had done it several times with success. But it wasn’t enough. Over the next few hours,
KC developed her normal headache. She drank some water for it and started eating some
meat. And then her stomach started to swell. She went to bed feeling cold and shaking.
Over the next couple days, KC thought she was being cautious about refeeding. She kept it up but her
headache wouldn’t go away. She would feel like her stomach was swollen, but she just let it go.
KC felt her heart beating in her head. After a while she thought she was in the clear
and any risk of refeeding was over as she started eating.
She was hungry and she started eating some fruit, and she wouldn’t stop eating
until she realized she ate 10 pounds worth of bananas, and left the peels all over the kitchen counter.
Minutes after her breakfast, KC became thirsty and started drinking as much water as she could.
She felt bloated and inflated and thought that the water would help stop her headaches.
She could feel her heart skipping, as her headache started piercing in to her skull. She felt her
stomach swell up while parts of her legs started twitching, as the last thing she could remember.
Her mother Jane finds KC on the floor wheezing and sweating, without knowing
how long her daughter was like this. 911 is called. Paramedics find that KC drifts in
and out of consciousness as she’s brought to the emergency room, where we are now.
At examination, doctors notice KC’s body mass index was a little low. Her actual
body weight was lower than her Ideal Body Weight, which is a calculated and
standardized clinical measure based on height and is used for things like dosing medicines.
In this case doctors weren’t exactly sure what was happening. But what they were sure of,
was she seemed confused and would drift in and out of consciousness.
A quick test finds that KC has hypoglycemia.
Hypo meaning low. Glyce from Greek meaning sweet and referring to glucose, a name for sugar used
as energy in the human body. And -emia meaning presence in blood. Low sugar presence in blood.
Hypoglycemia can explain why KC has an altered mental status,
as doctors start her on a glucose IV, but something’s wrong. If KC had eaten
almost 30 bananas before presenting to the emergency room, and bananas are well known
to have a lot of sugar, then how could she have, low sugar presence in blood?
A blood test finds that she has vitamin deficiencies.
Doctors and her parents still dont know she ate 10 pounds of bananas after fasting for a week,
because she couldn’t tell them as she drifts in and out of consciousness.
In her hospital bed, the nurse begins to administer the vitamins to KC,
as doctors continue her IV’s, they find that she’s also dehydrated for some reason.
But very quickly, KC starts to become agitated. Her muscles start twitching and her kidneys stop
making urine. And then her blood pressure started dropping. Her heart rate would change from slow
to fast and back, while parts of her heart would skip beats.
And another blood test gives everyone some more clues as to what could be happening.
Doctors find that KC now has hyperglycemia, high sugar presence in blood. This could make sense
because they’ve been giving her sugar in her IV, but the test also shows that she has hypokalemia.
Low potassium presence in blood. But why would potassium be low in her blood? She ate a lot of
bananas and those have potassium. KC’s kidneys don’t produce any more urine, so the potassium
couldn’t have been urinated out. She hasn’t had a bowel movement in the one day she’s been in the
hospital so she didn’t lose any there either. You can’t breathe out potassium, meaning that
that potassium must have exited her blood, and entered somewhere else inside KC’s body. And if
most of the body’s potassium is already inside the cells, then it means something must have
caused even more potassium from the blood to get shoved in to the cells. And this happened during
the time that she was in the hospital because when she presented to the emergency room,
her blood potassium level, and other electrolytes, were mostly normal, so how could this happen?
The medical team takes a closer look at the blood test and find that it’s not
just potassium that’s low in KC’s blood. She also has hypocalcemia,
low calcium presence in blood, hypomagnesemia, low magnesium presence in blood, and hypophosphatemia,
low phosphate presence in blood. And if there’s been more going in to the body
rather than coming out of her body during the time she's been in the hospital, then why would all of these have low presence in blood?
You see, in a fasted state, the body becomes sensitive to insulin,
which is a hormone that’s released after you eat a meal,
and the amounts of insulin released can vary depending on the kind of food you eat.
Carbohydrates tend to spike insulin levels, while proteins and fats get a response too.
This brings us to the idea of cell signaling. Hormones are the body’s way of sending signals
inside. In the case of insulin, it’s a signal to tell the cells that new nutrients are here,
time to absorb them in and use their resource.
When the body doesn’t get a lot of new nutrients in very often, like when you’re
fasting, the cells want to be more alert for the signal when there are new nutrients available,
so they become more sensitive to insulin. In KC’s case, she knew to start eating slowly when
breaking her fast. To eat a little and build up more over time. But when she finally let up and
ate several pounds of bananas when she thought she was in the clear, the sugar rush from the fruit
signaled to her cells to shove the nutrients floating around in her blood, in to her cells.
Potassium gets pulled out from the blood and shoved in to the cells,
explaining her hypokalemia. Potassium is needed by the muscles to signal a relax,
and if there isn’t enough floating around in the blood to provide that signal,
then the muscles can’t relax explaining her twitching. Proteins from the muscles
break off into the blood stream and gunk up in her kidneys, shutting them down.
Low magnesium prevents the kidneys from reabsorbing potassium, making her hypokalemia
worse. But that’s not the only thing happened here. Even though she has low phosphate presence
in blood, her body’s stores of phosphate may have been depleted because she kept repeating
her fasts, and her actual body weight was less than 70% of her calculated ideal body weight.
So as a clinical measure, this could indicate a degree of malnutrition, especially when
The reason why phosphate is a problem here is because the body uses ATP for energy. Adenosine
Tri-Phosphate. Phosphate was depleted over time because of KC’s fasts. But also the sensitivity
of her body to insulin, caused whatever phosphate was left floating around in her blood, to pack in
to all of her cells, regardless if they needed it or not. Some cells need it more than others,
and they get extras from the blood. But when suddenly there just isn’t enough available
in the blood, then problems start to happen. And if vitamins are needed
to properly use ATP for energy, then this brings us to KC’s next problem.
Do you remember her vitamin deficiency and doctors started her on an IV of
vitamins? Well, being chronically deficient in B vitamins can
cause mental status changes, just like low blood sugar does. And unfortunately, starting her on an
IV of glucose, was absolutely the wrong thing to do in KC, given that sugar spikes insulin levels,
and KC’s body was very sensitive to insulin. The 10 pounds of bananas she ate did her in.
And because she couldn’t tell anyone, and her blood levels when she presented to
the emergency room hadn’t caught up to what was happening, things just kept getting worse for KC.
Fasting is popular now in fitness and diet circles, and there is a lot more talk about
Refeeding Syndrome now than in 2005. But the reason why doctors may not think of it right away,
is because it historically didn’t happen that often here in the United States. If it does
happen, it’s not always immediately obvious. Refeeding Syndrome you might see in people who
can’t or don’t eat for some reason. Those people might have a tumor in their mouth or neck,
or they have severe mouth sores, or they have a stomach disease, and they dont eat for several
days. Then they become critically ill for some reason, maybe or maybe not related to the fact
that they haven’t eaten for a few days. In the hospital, these people get sedated and a tube
is stuck down their throat so a machine can breathe for them. You can’t eat when
you have tube like that in your mouth, so the medical team feeds you intravenously.
If they don’t know the person hasn’t eaten for 5 days, because it might not be that obvious,
sugar and amino acids and fats are sent intravenously, causing an insulin increase,
causing everything to get shoved in to the cells in the setting of insulin sensitivity, and
causing organs to shut down because there aren’t enough nutrients in the blood for them to use.
If electrolytes in KC are low, then the answer is to replace them,
with care and constant monitoring as to not go overboard and cause
high electrolyte presence in blood, which can be just as deadly as the opposite.
This could have been avoided if KC started refeeding slowly and not eaten 10 pounds of
bananas so quickly after breaking her fast, or just not fasted in such an extreme manner. For
weight loss, fasting can be a great tool, but with every great tool always comes a safety precaution.
With careful monitoring and care, and supportive family and friends with her
afterwards, KC was able to make a full recovery.
Thanks so much for watching. Take care of yourself. And be well.