The thermoregulatory responses to graded cooling were measured in 11 healthy male subjects after a 12 h fast and after a 48 h fast. The cooling stimulus was produced by changing the temperature of the skin of the trunk and legs with a water-perfused suit. Five levels of skin temperature from 35.5 to 24 degrees C were applied on each occasion. After a 12 h fast, core temperature was maintained during cooling. This maintenance of core temperature was associated with an increase in metabolic rate and a reduction in blood flow to the hand and to the forearm. After 48 h of fasting, the subjects could not maintain core temperature during cooling, and a decrease of 0.36 +/- 0.05 degrees C occurred as the suit temperature was reduced from 35.9 to 24 degrees C. Metabolic rate was slightly higher after the 48 h fast than after the 12 h fast, but similar increases in metabolic rate were observed during cooling. Vasoconstriction in the hand was initially less after a 48 h fast than after a 12 h fast, but at the lowest suit temperature, hand blood flow was similar, and low, on both occasions. After 48 h of fasting, forearm blood flow was elevated at all suit temperatures, being approximately twice the level recorded after the 12 h fast. Venous plasma noradrenaline levels did not change during cooling after the 12 h fast, whilst after 48 h of fasting a significant increase in noradrenaline level was observed at the lowest suit temperature. The results of this study provide further evidence that fasting induces an impairment of autonomic reflex mechanisms, but it is not clear whether this is due to a suppression of sympathetic nervous activity.