Refeeding Syndrome: What is it, and what you need to know. 

It is possible for someone who has been undernourished to develop refeeding syndrome when they begin to eat again. In this case, the reintroduction of glucose (sugar) causes sudden shifts in electrolytes, which leads to several problems. 


Refeeding syndrome can be triggered by as little as five consecutive days of starvation. Doctors may be able to prevent the illness if they discover symptoms early.

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Refeeding Syndrome Causes


Refeeding syndrome, whether enteral or parenteral, is induced by fast refeeding, which causes metabolic and hormonal abnormalities. Starvation causes the body to convert from relying on carbohydrates for energy to relying on fats and proteins. This also reduced basal metabolic rate by up to 20% to 25%. 


During long-term starvation, hormones and metabolic processes adjust to prevent protein and muscle degradation. 


The usage of ketone bodies in muscle and other tissues decreases, and fatty acids become the primary energy source. If you boost your ketone body levels in your bloodstream, your brain will be stimulated into using ketone bodies as its primary energy source. 


In addition, the liver reduces the rate of gluconeogenesis, which prevents muscle protein. Several intracellular minerals are substantially reduced over a prolonged period of fasting. However, serum concentrations of certain minerals (such as phosphate) may remain within the normal range. That’s because these minerals are mainly in the intracellular compartment, which contracts during long-term fasting. Additionally, renal excretion is reduced. 


Effects of Refeeding Syndrome on the Heart


A study conducted on 36 volunteers who lost weight during World War II shows that when they were received, their smaller hearts (due to starvation) were unable to manage the rise in blood volume.


That’s why healthcare personnel closely examine the cardiovascular system throughout the first several weeks of refeeding. 


The heart mass can return to normal if one gains the correct weight. Phosphorus deficiency has been shown to cause anomalies in heart muscle contraction. 

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Effects of Refeeding on the Endocrine System (Hormonal System)

In many cases, the effects of refeeding lead to: 


  • The loss of their monthly cycles in females
  • Infertility 
  • Low blood sugar levels are quite dangerous. 
  • Bone atrophy 
  • Fractures 
  • Stunted growth. That’s because of the slow body metabolism and energy generation. 


Effects of Refeeding on the Digestive System


Constipation, delayed stomach emptying, reduced colonic transit time, and potential hepatitis are all slowing down the gastrointestinal system. If purging habits are taking place, there may be further difficulties. 


Overusing laxatives can affect colonic muscles, resulting in a “lazy colon” that can induce severe constipation and even bowel blockage. 


The Pulmonary System’s Response to Refeeding Syndrome

Muscle atrophy and reduced pulmonary capacity occur. In addition, red blood cells, white blood cells, and platelet production are also reduced. Besides cognitive decline, peripheral neuropathy, and possibly convulsions, the brain diminishes in size (cerebral atrophy). 


The Renal System’s Response to Refeeding Syndrome


Dehydration and overconsumption of water can harm kidney function. Muscle loss happens on a systemic level. The skin dries out, and the hue of the skin shifts. Also, it results in balding on the head.


What Is the Best Way to Deal with Refeeding Syndrome?


Before you begin refeeding, your doctors will do a blood test. Your electrolyte levels will be checked to see if there are any imbalances. Then, they’ll add the missing micronutrients to your dietary plan. The aim is to start with the micronutrients that you’re lacking. Doing this will help your body better break down food and use carbs. 


In addition, electrolyte deficits may not always be detected in the initial blood test. Until you start refeeding, your body doesn’t realize it needs those electrolytes. Because of this, some shortcomings may not become apparent until after the refeeding process has started. 


Keep an eye out for any changes in your health. Regularly monitor your electrolyte levels. Within the first five days of refeeding, a condition known as refeeding syndrome is common. Your healthcare team will slow down refeeding if you show signs of illness. You’ll get nutrients through an intravenous (IV) line if necessary.




A condition known as the “refeeding syndrome” occurs when food is provided to an animal or human being too soon after starvation. This is because of a sudden shift in electrolytes and hormones. 


Heart failure and comas can occur as a result of electrolyte imbalances. In some situations, the refeeding syndrome can lead to death. 


Malnourished individuals are particularly vulnerable to refeeding syndrome. Those with anorexia nervosa or a long-term alcohol abuse problem may be more susceptible to developing the disease. 


Electrolyte infusions and a slower refeeding schedule can help reduce the complications of refeeding syndrome. Treatments are more likely to be successful if started early in the disease process. 


The next steps in improving the prognosis are raising awareness and using screening programs to identify persons at risk of refeeding syndrome. It’s always to seek a reputable doctor who is experienced and can advise you on the best possible routes.