Expert Q&A

Going for my first 36 hours. Any tips — how a functional medicine approach differs

Preparing for Your First 36-Hour Fast

I've guided thousands through their initial extended fasts using my functional medicine framework. A 36-hour fast means going from dinner one day until breakfast two days later, giving your body time to fully deplete glycogen and shift into fat-burning. For beginners aged 45-54 managing diabetes, blood pressure, and hormonal changes, this isn't just calorie restriction—it's a reset for metabolic health.

Begin with a nutrient-dense dinner: 4-6 oz grass-fed protein, half a plate of non-starchy vegetables, and healthy fats like avocado or olive oil. Avoid carbs and sugars the day before to ease the transition. Hydrate aggressively—aim for 3-4 liters of water with electrolytes (sodium 3-5g, potassium 1-2g, magnesium 400mg daily). Bone broth or herbal tea helps many survive the first attempt without overwhelming the digestive system.

How Functional Medicine Fasting Differs from Conventional Approaches

Standard diet culture pushes fasting for quick weight loss, often ignoring root causes. My functional medicine method, outlined in The Metabolic Reset Protocol, focuses on individualized biochemistry. We test and address insulin resistance, thyroid function, cortisol patterns, and gut health before starting. Conventional plans might recommend black coffee only; we prioritize supporting autophagy and hormone balance to prevent the rebound weight gain you've experienced before.

This approach reduces joint pain by lowering systemic inflammation during the fast. Instead of pushing through, we time light movement like 10-15 minute walks to improve circulation without stressing already painful joints. For perimenopausal women, we monitor how fasting affects estrogen and progesterone to avoid worsening symptoms.

Practical Tips to Succeed with Joint Pain and Busy Schedules

Expect hunger waves around 14-18 hours and 24-30 hours. Use my "4 D's" technique: Delay (wait 15 minutes), Distract (light chore), Drink (electrolyte water), and Deep breathe (box breathing for 2 minutes). For those embarrassed about obesity or overwhelmed by conflicting advice, track only energy and mood the first time—not the scale.

Break the fast gently with a small meal of bone broth, steamed veggies, and protein. Avoid large carb loads that spike blood sugar. Many with diabetes see improved fasting glucose within days when combining this with my low-inflammatory meal plans that take under 20 minutes to prepare. Insurance rarely covers these programs, so we designed simple at-home protocols that deliver results without expensive clinic visits.

Managing Expectations and Building Long-Term Success

Your first 36-hour fast may feel challenging, but most report clearer thinking and less joint stiffness by hour 30. Functional testing often reveals why past diets failed—hidden inflammation or poor sleep sabotaging progress. Repeat this monthly while following my 16:8 intermittent fasting on other days. Focus on consistency over perfection. Within 4-6 weeks, many clients lose 8-12 pounds, stabilize blood pressure, and regain confidence asking for help. Listen to your body; if dizziness or extreme fatigue hits, end the fast early with a small meal. This isn't another failed diet—it's learning how your unique system responds when given the right functional support.

💬 What the Community Says

The community shows cautious optimism around first-time 36-hour fasts, especially among 45-54 year olds dealing with joint pain and hormonal shifts. Many share stories of surviving on electrolyte water and bone broth, noting reduced inflammation and better blood sugar control by the second attempt. There's lively debate on functional medicine versus standard "water-only" methods—some praise personalized testing for avoiding crashes while others feel overwhelmed by the prep. Beginners often express relief finding groups that understand insurance limitations and past diet failures. A vocal minority reports headaches or fatigue around hour 24 but encourages pushing through with walks. Overall sentiment highlights the need for realistic expectations, with lived experiences focusing on how gentle movement and proper mineral balance make extended fasting accessible despite busy schedules and previous disappointments.
Clark, R. (2026). Going for my first 36 hours. Any tips — how a functional medicine approach diffe. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/going-for-my-first-36-hours-any-tips-how-a-functional-medicine-approach
Russell Clark, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

Have a follow-up question?
More Questions 200 answered
How do you know you are in meno if you take continuous bc while doing intermittent fasting What I learnt as a physician about having Hashimoto for myself and what helped on a low-carb or ketogenic diet Can’t stand avocados or guacamole. Help: what to track and how to measure progress Anyone stopped responding to Mounjaro and had better results with retatrutide: best practices and common mistakes to avoid Should i really be aiming for 45 zone 2 minutes per day for fat loss while doing intermittent fasting 📖 Adipose Tissue Signaling — The way fat cells communicate with the brain; our goal is to fix these signals so the body stops defending an unnaturall… Same Workout Until it becomes Zone 2 — what does the research actually say? Did my hashimoto cause this for those with hypothyroidism or Hashimoto's What keto plus compounded tirzepatide for the last five months looked like: best practices and common mistakes to avoid 📖 Caloric Deficit Myth — The false belief that weight loss is purely 'math'; we focus on hormonal signaling rather than just counting calories to… 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → How often can I eat in season fruits — how a functional medicine approach differs Can I get an upvote for the true enemy of diabetes while doing intermittent fasting What a 55 water fast did for me while doing intermittent fasting Does anyone else just....not thermoregulate and how it connects to gut health and inflammation What would be the cause of insulin resistance while doing intermittent fasting 📖 Diabetes Reversal — The clinical goal of restoring normal blood sugar levels and insulin function, as seen in patients like John who no long… Newb question: focusing on perceived exertion or heart rate — how a functional medicine approach differs Anyone worried about the FDA crackdown: how to talk to your doctor about this Post menopausal bleeding — what do certified weight loss coaches recommend? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → What garmin watch should i get for christmas specifically for women over 40 Sometimes after I take my Mounjaro shot I see this at the spot I gave the shot. Anyone know why: how to talk to your doctor about this Can’t stand avocados or guacamole. Help for people with insulin resistance Feeling fatter once having started my restrictive diet? 📖 Inflammatory Markers — Clinical indicators like CRP that we monitor to ensure the body is moving from a state of disease to a state of vibrant … A Switch from HRT to Birth Control and how it connects to gut health and inflammation Have to stop for 3 weeks for surgery specifically for women over 40 One avocado a day? What's up with that? Does anyone remember if the good doctor ever gave us an explanation for that: how to talk to your doctor about this 2.5 mg no longer working. Move to 3.5 for long-term maintenance (not just short-term) 📖 Metabolic Stall — A plateau in weight loss often caused by hidden inflammation or hormonal adaptation, which we break using our specific 7… Hitting protein goals. How do you do it — how a functional medicine approach differs How I feel every time I go grocery shopping during the weight loss plateau phase 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Anyone with a variant of uncertain significance on HRT and how it connects to gut health and inflammation What is this new frozen hell on a low-carb or ketogenic diet Can deep extended autophagy reverse deep cavities, does anyone have any experience regarding this on a low-carb or ketogenic diet Was so tempted to hit the drive thru today. Went to the store instead and how it connects to gut health and inflammation 📖 Metabolic Flexibility — The body’s ability to efficiently switch between burning carbohydrates and burning stored body fat based on availability… What about oxalates if you're on a GLP-1 like semaglutide or tirzepatide Is estriol as effective as estradiol for clitoral atrophy: best practices and common mistakes to avoid How it goes trying to dose insulin every day: how to talk to your doctor about this What is the Role of Metabolism in Immune System — what do certified weight loss coaches recommend? 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → What a 55 water fast did for me: what to track and how to measure progress Is it just me or is Hashimoto’s greatly underrepresented when you have PCOS or hormonal imbalances 📖 Weight Set Point — The internal 'thermostat' for body weight that we aim to lower permanently through our 30-week metabolic reset. App that can predict symptoms before they get bad: how to talk to your doctor about this Anyone stretching out to 3 weeks between shots: best practices and common mistakes to avoid How should I go about asking my doc? How much are people paying for Estring and how it connects to gut health and inflammation Estradiol Cypionate- I’ve been underdosing- what dose are you at — what do certified weight loss coaches recommend? Does anyone else love masks mandated so I can hide my facial hair while doing intermittent fasting 📖 Modern Wheat Dangers — The hidden threat in hybridized grains that causes gut inflammation and spikes blood sugar more aggressively than pure t… Had my annual physical today: what to track and how to measure progress Is this normal? Feels like a waste and its effect on metabolism and insulin levels 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → When men recognize symptoms for those with hypothyroidism or Hashimoto's Any women here that never had a flat stomach in their lives during the weight loss plateau phase 📖 Phase 1: Priming — The first 48 hours of a 70-day cycle focused on high-fat intake to prevent the brain from triggering a starvation respon… Has anyone switched from wegovy to mounjaro while doing intermittent fasting Why is almost all the focus in treating PCOS on fertility: best practices and common mistakes to avoid Safest type of fiber while doing intermittent fasting When people ask how I can tell my sugar's low and the role of cortisol and stress hormones