Sonam Wangchuk’s hunger strike: Can fasting become fatal? An expert explains that IV fluids are necessary when… | Today’s news
Climate activist Sonam Wangchuk is still fasting after being hospitalized after 20 days of hunger strike. He sought reform of the education system and the resignation of Education Minister Dharmendra Pradesh over alleged irregularities in the NEET examination.
Wangchuk was taken from the Jantar Mantar protest site to Safdarjung Hospital in the early hours of Saturday. The Janata Party claimed that Wangchuk was taken away “forcibly” by the Delhi Police.
Doctor Charu Bamba of Safdarjung Hospital, where Wangchuk was admitted on Saturday, said he continued to refuse oral and intravenous fluid therapy despite repeated advice from doctors. She told ANI that the activist remains conscious and clinically stable but is showing signs of dehydration.
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Prolonged fasting can lead to dehydration and dangerously high levels of ketones in the blood, which can adversely affect blood and organ function. If ketone levels exceed 3 mmol/L, medical intervention such as intravenous fluids is often required.
Sonam Wangchuk continues to refuse all forms of treatment, including IV fluids and electrolyte solutions, despite medical advice to combat dehydration and nutritional deficiencies.
Dehydration during fasting can lead to increased lactic acid production, metabolic acidosis, and potential organ dysfunction, so it is essential to monitor electrolyte levels and provide treatment if necessary.
If blood ketone levels rise above 3 mmol/L, it can lead to serious health problems including ketoacidosis, which requires force-feeding or intravenous glucose to prevent critical complications.
Intravenous fluid therapy is recommended when a fasting individual shows signs of dehydration and metabolic acidosis, which is necessary to restore hydration and electrolyte balance before serious health effects occur.
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“He is definitely showing signs of dehydration. He needs treatment. But despite our advice, he is refusing treatment. He is not accepting oral rehydration fluids, electrolyte solutions, or IV therapy,” Bamba told news agency ANI on Saturday.
Wangchuk’s wife Gitanjali J Angmo also said Wangchuk is still fasting. “The fast continues because he does not consume any sugar,” she said on Saturday.
“He’s only taking the salt water he was consuming before… I’m thankful that the government took enough care to bring him here, but we can handle the next steps ourselves; there’s no need for the government to interfere in this matter. He’s definitely weak and losing muscle – which happens with every fast – but he’s alert and very strong,” Wangchuk’s wife said.
When is fasting harmful?
While commenting on activist Sonam Wangchuk’s hunger strike, general practitioner Dr. M Wali explained the health risks of prolonged fasting and said intervention may be necessary if blood ketone levels rise dangerously.
In an interview with ANI, Dr. Wali said the formation of ketone bodies is a natural process during fasting. However, he cautioned that the benefits reverse once ketone levels exceed a certain threshold.
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He said: “Blood ketones develop after fasting. We fast monthly or in some religions for 40 days and do ‘vrat’ routinely. The practice of ‘vrat’ is very important, it stimulates a healthy metabolism which involves the formation of ketone bodies. This formation of ketone bodies is neutralized as soon as we start eating.”
“If the level of ketones is around 0.3 mmol/L, then it is not harmful. You can feel tired, exhausted and you can feel hungry. But if it is between this amount and up to 3, then it becomes very harmful to the body and various organs,” said Dr M Wali.
The doctor noted that while ketones serve as nourishment for the brain, high levels in the blood can be dangerous.
Dr. Wali said that in cases of prolonged hunger strikes, medical teams advise individuals to eat. If they refuse: “We advise them to force-feed or force-feed them.”
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“Although ketone is nutrition for the brain, it is bad for the blood. If it circulates in the blood, it is called ketonemia. In diabetics, it is called ketoacidosis. So these ketone levels, if they exceed 3, are very harmful, and in such cases we ask people who are fasting to eat and if they do not follow the command, we force or advise them,” he said.
The doctor added: “Even if they don’t feel like taking it orally, glucose can be given intravenously. Their vital signs, blood pressure, hydration, pulse, oxygenation – everything has to be monitored and that can be done in a hospital setting,” added Dr. Wali.
‘Infusion fluids become necessary when…’
Another health expert, Dr. Suranjit Chatterjee, chief consultant in internal medicine at Indraprastha Apollo Hospitals, highlighted how a “decompensated” condition can become extremely harmful to an individual.
Explaining Wangchuk’s condition, Chatterjee said the report issued indicated “compensated metabolic acidosis”.
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“Although ketone is nutrition for the brain, it is bad for the blood. If it circulates in the blood, it is called ketonemia. In diabetics, it is called ketoacidosis. So these ketone levels, if they exceed 3, are very harmful, and in such cases we ask people who are fasting to eat and if they do not follow the command, we force or advise them,” he said.
The doctor added: “Even if they don’t feel like taking it orally, glucose can be given intravenously. Their vital signs, blood pressure, hydration, pulse, oxygenation – everything has to be monitored and that can be done in a hospital setting,” added Dr. Wali.
‘Infusion fluids become necessary when…’
Another health expert, Dr. Suranjit Chatterjee, chief consultant in internal medicine at Indraprastha Apollo Hospitals, highlighted how a “decompensated” condition can become extremely harmful to an individual.
Explaining Wangchuk’s condition, Chatterjee said the report issued indicated “compensated metabolic acidosis”.
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“This clearly means that the body is affected and is suffering from dehydration. Dehydration leads to increased production of lactic acid and acidosis, which can impact kidney function. However, using the term ‘compensated’ means that the body is still fighting this condition,” he told ANI.
Chatterjee added that “compensation” only occurs when the body actively tries to restore the imbalance.
“If the condition progresses to a ‘decompensated’ state, it can become extremely harmful. Once decompensation sets in, complications such as electrolyte imbalance, loss of consciousness (which could potentially lead to coma) and liver and kidney injury or dysfunction can occur,” Chatterjee said.
“Therefore, it is crucial to address issues such as electrolyte imbalances, especially involving potassium and other substances vital to organ function at this stage. If left untreated, the damage could become irreversible and seriously harmful,” added Chatterjee.
He said that currently “we are at a stage where the body is still fighting this condition. That is why it is necessary to give IV fluids and start nutritional support. After a certain point, the situation can become critical for the patient.”
