More Useful Stuff
Nearly half of Muslims experience increased headaches during the month of fasting
The good news? You can manage these headaches without breaking your fast, says Dr Elliot Shevel, chairman of the South African Headache Society.
The fasting month of Ramadan is an annual religious practice of Muslims prior to the “Eid ul-Fitr” celebration. During the one-month period, Muslims fast from sunrise to sunset (abstain from eating, drinking and smoking for 29 to 30 days). Many people who fast over Ramadan suffer mild or moderate headaches as a result of factors such as hypoglycaemia, caffeine withdrawal, change in sleep patterns and the stress of fasting itself.
The University of Malaya carried out a study over four months: two months before, the month of Ramadan and one month after. Eighty-three subjects were given headache diaries over this time and at the end of each month the severity of headache was quantified using the Chronic Pain Grade. They found that the pain intensity increased in 48% of the subjects. They concluded that fasting over Ramadan was a significant precipitating factor for headache.
Headache onset often occurs in the afternoon or evening just before the fast is broken. Headache frequency typically increases over the duration of fasting. Those prone to headaches at other times of the year are most likely to get headaches, but some patients that experience headaches during this time have no history of headaches or migraines.
How to eliminate headaches during Ramadan:
1. Adjust your coffee intake
Dr Shevel highlights caffeine withdrawal as the most common cause of headache while fasting. Patients can often prevent headaches by reducing caffeine consumption in the weeks leading up to Ramadan month, so bear that in mind for next year’s fast. For now, try a strong cup of coffee just before the start of the fast for the day – it may help ease the caffeine withdrawal headache later in the day.
2. Avoid a sugar crash
Hypoglycaemia (low blood sugar) can also trigger headaches in many people. If you eat a breakfast with high sugar content before the day’s fast begins, it can cause a rapid rise in blood sugar levels followed by a fast drop that may trigger a headache. Eating a meal with low sugar content before the fast may prevent the onset of a headache during the day. For a list of foods which have a low glycemic index to be sent to you, contact The Headache Clinic on 0861 678 911.
3. Don’t forget to drink
Dehydration is another common headache trigger. Adequate intake of water before the onset of the fast can often prevent headaches. The human brain is more than 75% water, and it is very sensitive to the amount of water available to it. When the brain detects that the water supply is too low, it begins to produce histamines. This is essentially a process of water rationing and conservation, in order to safeguard the brain in case the water shortage continues for a long period of time. The histamines directly cause pain and fatigue, in other words a headache and the low energy that usually accompanies it. So drink at least a litre of water with your morning meal to help your body and brain stay hydrated until you break fast in the evening.
4. Get enough good quality sleep
“Headache sufferers should also, as far as possible, try to avoid exposure to other triggers such as fluid retention, stress, fatigue and lack of sleep during Ramadan, when there is a greater tendency to experience headache,” says Dr Shevel. “Rest and sleep often help to prevent being subjected to headaches and the pain often melts away when the fast is broken for the day.”
Preventive medication that will last for the full daylight hours of the fast includes preparations such as the tablet Naproxen sodium, which is taken as a single dose of 500mg just before the fast begins. These tablets are sold over-the-counter at your pharmacy.
When to call your doctor
“If headaches are interfering with your fast during Ramadan, contact The Headache Clinic on 0861 678 911 as we have a number of techniques to relieve you of your pain. You should be able to continue your fast without breaking any of the principles of Ramadan,” added Dr Shevel. If your headaches persist after Ramadan or are severe in nature, patients are advised to seek help from a medical professional. Dr Shevel explains that headaches can be most successfully treated using a multidisciplinary approach, since no one medical specialisation covers all the psychological and physical dimensions of severe headaches.