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Therapeutic fasting according to Nikolayev
Medical expert of the article
Last reviewed: 04.07.2025

In the first part of his book, which sets out the theoretical foundations of the RTD method, Yu. S. Nikolaev cites the statement of the ancient Greek philosopher and healer Hippocrates: "Wisdom consists in knowing everything that has been done by nature." This is precisely what the teaching on therapeutic fasting, set out by Nikolaev, is based on.
From the point of view of Yu. S. Nikolaev, "there is only one "disease" - the result of ignoring or not knowing the laws of nature, in this case - the laws of nutrition and fasting, this single, dialectically interconnected process. This leads to toxemia, or clogging with poisons and slags of metabolic origin." In order to fight the disease, it is necessary first of all to thoroughly cleanse the body. And we are talking not only about cleansing the blood, intestines or other organs (they talk about this now no less than about diets for weight loss), but also about cleansing various tissues of the body, which is simply impossible to do with external methods. Only the body itself can carry out such a radical cleansing, switching from exogenous (external) to endogenous (internal) nutrition at the expense of the body's resources.
Previously, it was believed that the body's resources were extremely poor (some nutritionists and doctors still adhere to this point of view), but the practice of wartime and modern research within the framework of the theory of unloading-dietary therapy have shown that this is not so. Our body is much more resilient and, if appropriate conditions are created, can independently cope with many diseases, including difficult-to-treat ones.
According to Yu. S. Nikolaev, dosed therapeutic fasting can be used both for therapeutic purposes (alone or as part of a treatment plan developed for a specific disease) and for the prevention of diseases or their relapses. By the way, Nikolaev himself, who not only proclaimed the idea of fasting treatment, but also put it into practice based on his own experience, lived a long active life and left this world at the age of 93.
This is as far as theory is concerned. In practice, the RTD method has been used in our country for several years in various medical centers. Dosed fasting according to Nikolaev is a scientifically and practically substantiated treatment system designed for hospital conditions. At home, a person can try a short-term 1-3-day scheme, but subject to a preliminary full examination and the absence of contraindications to the appointment of therapeutic fasting.
Preparation for therapeutic fasting according to Nikolaev includes a review of eating behavior. Most patients who are prescribed fasting treatment are overweight and accustomed to the feeling of satiety, so a sharp refusal to eat food can become a serious stress for many, which entails breakdowns. To prevent such an outcome, a week before starting fasting, it is recommended to switch to a rational healthy diet, which involves giving up fatty and fried foods, smoked products, coffee, chocolate.
At the same time, you need to think about bad habits. Doctors strongly recommend giving up smoking and drinking alcohol. Some clinics even ask patients to sign a receipt stating that they are familiar with the possible consequences of tobacco and alcohol on the body during fasting.
According to Nikolaev's method, fasting should begin with cleansing procedures, which are then carried out regularly during the fasting period (daily or 2-3 times a week). On the first day of fasting, you need to drink a saline laxative in the morning (usually Glauber's salt or magnesium sulfate, known to many as magnesia) at a rate of 0.5 g per 1 kg of the patient's weight.
If, for various reasons, the patient's intestines are excessively stretched, repeated rinsing of the rectum with the same Glauber's salt or chamomile infusion will be more relevant. In a hospital setting, such an effect is achieved by hydrocolonotherapy, which is prescribed 1 or 2 times a week.
It should be noted that cleansing the intestines, even during fasting, is one of the necessary daily procedures. Despite the fact that food does not enter the body from the outside, waste accumulates in it every day. When switching to endogenous nutrition, waste products should be considered as waste products of the processing of one's own reserves with the formation of a substance resembling the original feces of newborns.
As for the duration of fasting according to Nikolaev, it may vary depending on the diagnosis, age and condition of the patient. A short course of dry or wet fasting is 1-3 days. Fasting for more than 3 days involves drinking water. If a person adheres to dry (absolute) therapeutic fasting for more than 3 days, then this can only be done under the supervision of a doctor.
Yu. S. Nikolaev preferred wet fasting, which better corresponds to the physiological needs of the body, although in most cases it requires a longer course of treatment with fasting. Courses of complete therapeutic fasting can be short (1-3 days), medium (5-21 days) and long (more than 3 weeks) duration. Short-term courses usually do not have much therapeutic or health value, so they are rarely used (usually as a warm-up or preparation for a longer refusal of food).
It should be said that to achieve good results, it is desirable that the fasting period be at least 7-9 days, because it is during this period that, with complete fasting, a transition to the compensated acidosis stage is observed, i.e. the body is already completely switching to endogenous nutrition. Nikolaev believed that the most optimal fasting period is a 21-day course. Thus, after the acidotic crisis, the body has another 2 weeks left for complete cleansing and the beginning of regenerative processes.
According to Nikolaev, therapeutic fasting for 21 days or more (for example, up to 30 days) will not cause harm to the body, since the loss of 12-18% of the total body weight does not lead to irreversible changes in the body. If you keep calm and minimize energy consumption (do not engage in vigorous activities), then a person can easily withstand fasting even for 2 weeks.
The problem is that it is very difficult to create suitable conditions at home, unless the person is lonely and lives independently. Otherwise, sympathetic glances from relatives, persuasion to eat at least a small piece and temptations in the form of food that smells appetizing and entices with its appearance cannot be avoided. In addition, it is very difficult to determine the line when fasting should be stopped according to indications, which are critical conditions and the inability of organs to cope with the function assigned to them (the kidneys and liver, which work as filters, suffer especially during fasting).
The most suitable conditions for fasting are created in hospitals, where the patient is under medical supervision during the entire unloading period and some part of the recovery period, vital organs are regularly monitored, and psychological assistance is available. At the same time, only those who practice therapeutic fasting are in the ward, which eliminates temptations in the form of food. Patients are protected from both the sight of food and smells, which reduces the likelihood of a breakdown.
Moreover, RDT in clinics practicing the method of Yu.S. Nikolaev includes not only abstinence from food, but also some procedures, in particular:
- Physical therapy (daily walking for at least 2.5 hours a day and an individually selected set of exercises),
- bowel cleansing (enemas, colonic dialysis or colon hydrotherapy with or without sorbent),
- general and local massage, manual therapy, acupuncture,
- water treatments: swimming pool, sauna, bath, Charcot shower, medicinal baths, etc.,
- physiotherapy (UHF, diathermy, etc.),
- psychological relief sessions.
Let's consider how treatment with fasting according to Nikolaev (complete therapeutic fasting) is carried out. The morning of the first and subsequent days of fasting begins with cleansing procedures, followed by a bath (shower) and massage (special pressing and warming). Only after this can the patient go to breakfast.
It would seem, what kind of breakfast does a fasting person have? However, the peculiarity of Nikolaev's system is the use of rosehip infusion in addition to water. This is what patients take for breakfast, and then for dinner. At lunch, the patient can drink plain water, mineral water like "Borjomi" or the same rosehip infusion.
After breakfast, there is a half-hour rest, followed by a walk. The walk usually lasts until lunch. During it, patients are allowed to drink water in unlimited quantities. But usually it is limited to the standard 1.5-2 liters per day.
After lunch and a daytime rest (about 1 hour), patients are prescribed various physical procedures every other day (as indicated). In their free time, they walk, do feasible work, play board games, read, do creative work and handicrafts. In the evenings, as usual, they watch TV, and those who are younger and more resilient can even dance.
Before going to bed, patients drink water, gargle and brush their teeth, which are considered mandatory procedures during fasting. Active cleansing occurs throughout the body, so there may be an unpleasant smell from the mouth, plaque on the tongue and teeth, which must be removed daily through hygiene procedures.
Special attention is also paid to the conditions of the patients' night rest, which should maximally restore the strength spent during the day. Therefore, the wards have good ventilation and access to fresh air. To prevent patients from freezing, they are covered warmly, and towards the end of the fast, when the chilliness increases, a heating pad is added under the blanket.
The fasting period initially set by the doctor may change somewhat later. Patients do not suffer from hunger after 3-4 days, their appetite decreases, food reflexes fade, but it is usually not possible to completely get rid of thoughts about food. Therefore, at some point, when the body is completely cleansed and the endogenous food reserves are noticeably depleted, patients regain their appetite.
The appearance of appetite in combination with some other signs (disappearance of tongue coating and bad breath, fresh complexion, almost complete absence of feces after the cleansing procedure) is an indicator that fasting can be completed. However, often due to a number of reasons the fasting period has to be completed ahead of schedule, which, however, does not greatly reduce the effectiveness of therapeutic fasting.
The exit from fasting, according to the RDT method, should be carried out in accordance with the existing pathology. So, in case of stomach ulcer and some gastrointestinal diseases, the patient exits fasting on vegetable broths and mashed, and then thoroughly chewed viscous porridges. In other cases, a juice diet may be prescribed. Subsequently, the diet includes mashed baked vegetables and fruits (apples), soups, borscht, compotes, boiled fish, omelets, beef meatballs and much more.