Who Should Not Fast: Contraindications Explained Plainly

The essentials

• Buchinger therapeutic fasting is well possible for many people; during pregnancy and breastfeeding, and with anorexia and other eating disorders, it is not suitable.
• For advanced liver or kidney insufficiency, decompensated hyperthyroidism and pronounced malnutrition, the Guidelines on Fasting Therapy (ÄGHE) advise against fasting.
• People on long-term medication should not fast without medical accompaniment, because many drugs need to be re-adjusted during fasting.
• At Tannerhof a telephone medical pre-consultation is available on request before arrival; the actual clarification follows in the medical intake consultation on the first fasting day.
• What matters for a fasting week are your own will and readiness to fast — everything else is discussed together with the medical team.

Who should not fast?

Buchinger therapeutic fasting is the conscious, time-limited abstention from solid food and stimulants. Human metabolism has strong strategies for bridging a limited fasting period, and so fasting is well possible for many people. But there are situations where therapeutic fasting is not the right path. These limits are well described in fasting medicine, and naming them openly belongs to the care of a house that has offered medically guided therapeutic fasting for over 70 years.

For guests interested in a medically guided fasting programme, Body Detox is the relevant programme page; the methodology itself is described on the Buchinger Method page.

The Guidelines on Fasting Therapy from the German Medical Society for Therapeutic Fasting and Nutrition (ÄGHE) list a manageable set of contraindications. The large observational study by Wilhelmi de Toledo and colleagues with more than 1,400 fasters, published in PLOS One in 2019, used the same conditions in advance as exclusion criteria — and documented a very favourable safety profile in the remaining participants.

Pregnancy and breastfeeding

During pregnancy and breastfeeding, therapeutic fasting is not suitable. Nutrient needs are particularly high in this time, because not only the woman but also the child must be reliably supplied. Both the Guidelines on Fasting Therapy and the PLOS One investigation list pregnancy and breastfeeding as a clear contraindication.

This does not mean that a conscious, lighter nutrition during this life phase is excluded — the time-limited abstention from solid food in the sense of Buchinger fasting, however, does not belong here. People thinking about a later fasting week in this phase best clarify the right timing with their own trusted physician.

Anorexia and other eating disorders

With anorexia and other eating disorders, therapeutic fasting is not suitable. Here it is not about a time-limited, voluntary caesura but a disturbed relationship to food that would be reinforced rather than clarified by fasting. The ÄGHE Guidelines explicitly name anorexia nervosa and pronounced malnutrition as contraindications; in the PLOS One investigation, anorexia nervosa and cachexia belonged to the pre-defined exclusion criteria.

Therapeutic fasting requires a stable relationship to food, to which one consciously returns after the fasting time. Exactly this relationship is in treatment with an eating disorder. So the meeting with oneself that fasting can be is not the right path in this situation.

Chronic conditions and ongoing medication

Beyond the points named, the Guidelines on Fasting Therapy describe further conditions where fasting is advised against or particularly careful medical accompaniment is needed:

• Advanced liver or kidney insufficiency, because metabolism is additionally challenged during fasting.
• Decompensated hyperthyroidism, which should first be stabilised.
• Advanced dementia or pronounced cognitive limitations.
• Pronounced malnutrition and cachexia, that is a state of wasting.

Ongoing medication plays its own role. During fasting, metabolism changes, and many drugs — for example for blood pressure, blood sugar or coagulation — must then be adjusted medically. The ÄGHE puts it clearly: people taking medication should not fast without medical accompaniment. This is not an exclusion but a reason to put fasting in expert hands. That is exactly what medically guided fasting is for.

Here too the data picture helps with classification: in the PLOS One investigation of over 1,400 people who fasted under expert guidance for four to 21 days, adverse effects occurred in fewer than one percent of participants, and serious events remained the rare exception. The condition was always that the named contraindications were excluded beforehand. Exactly this prior clarification is the task of medical accompaniment.

What medical clarification at Tannerhof provides

At Naturhotel Tannerhof, therapeutic fasting is always medically guided — this is the stance of the house, grown across three generations of physicians. The doctors at Tannerhof are fasting experts, and exactly therefore the clarification of whether fasting fits in an individual case is well placed with them. Where this text makes a medical statement, it is either supported by the Guidelines and studies on fasting therapy available at the ÄGHE, or it describes the medically guided practice at Tannerhof.

For doubts before arrival — for example with a chronic condition, ongoing medication or simply uncertainty — a telephone medical pre-consultation can be arranged on request. So the most important question is clarified before the journey begins.

The actual, detailed clarification follows in the medical intake consultation on the first fasting day. This consultation is holistically arranged and includes:

• medical history-taking,
• physical examination including bioimpedance analysis, a measurement of body composition,
• medication review,
• and beyond that the questions of why you are fasting, what is happening in your life right now, and what fasting experience you bring.

The length of stay is already booked before arrival; in the intake consultation the course can be agreed within this frame together with the medical team, and adjusted as needed. Every person is different, and the individual stands at the centre.

What carries therapeutic fasting at Tannerhof

If the medical clarification supports it, a fasting week begins that is more than abstention from solid food. Buchinger therapeutic fasting is more than a diet and not a primary weight-loss method — it is a therapeutic method, a cleansing on several levels, and a meeting with oneself. The body works on two levels at once: it shifts to fat burning, and it begins autophagy, the body's own recycling and cleansing processes at the cellular level.

The accompanying treatments are deliberately broad and tailored directly to fasting: medical history-taking and examination, follow-up and closing consultation, bioimpedance analysis and depending on the programme IHHT altitude training, Kneipp alternating affusion, hay flower and aromatic wraps, mud and warm packs, magnesium-rich detoxifying baths, fasting massage, detoxifying massage with king's oil or acidosis massage, lymphatic drainage, breathing therapy and sauna. Plus yoga, Feldenkrais, Tai Chi and Theraband training; mental accompaniment such as psychotherapeutic coaching, nature coaching and art therapy; and where medically suitable ozone autohaemotherapy.

Movement stays part of fasting, only measured: moderate aerobic and moderate strength training, a walk at a pace that fits the fast. Above all lies the place: Bayrischzell, the alpine meadow, the mountain stream, clear pure mountain air and the view to the Wendelstein. My hideaway in the mountains is the quiet frame in which fasting and medical guidance multiply each other.

What matters in the end is your own will and readiness to fast. If both are there and the medical clarification supports it, the right frame and the right duration are found together with the medical team. An overview at the Therapeutic Fasting and Schlanke Tanne hub.