Hello, assalamualaikum, and peace be upon you my friends,
The blessed month of Ramadan is almost upon us! I pray that Allah (swt), God, allows us to witness this month and make the most of it. For those that are not aware, Ramadan is the Muslim month of fasting. During this month, Muslims that are physically able will fast from food, drink, and physical intimacy during the day. This month is a time for worship and a large sense of community as Muslims often gather for the break-fast meal and engage in extra prayers at night.
The first few days can often be more difficult than the rest of the month and one reason for this is what is dubbed as the “first of Ramadan headache” in the research. As the name suggests, this is a headache that those fasting may experience during the first few days of the month. A few small studies show that more than 40% of those fasting experience these headaches and the longer the fast, the more the headaches.
These headaches are usually classified as tension headaches and there are a few theories as to why they occur:
- Hypoglycemia – fasting causes a depletion of energy stores and in turn a potential decrease in blood sugar levels. When blood sugar drops, individuals may experience a headache. These headaches tend to be moderate to severe in intensity. Although these kinds of headaches are a plausible reason, they seem unlikely for the healthy individual as Muslims will still eat two meals a day and restock up on energy stores in the body. Although there may be some individuals that are more sensitive to these changes. If you have diabetes, this is a different conversation and I will be sharing a blog post about that specifically soon.
- Dehydration – another hypothesized cause of headaches is dehydration, although at this time the research doesn’t show this. It still stands as a possible reason, particularly in the longer days and in warmer regions where dehydration is more likely.
- Caffeine withdrawal – individuals that are used to having as little as 100mg of caffeine a day could experience withdrawal symptoms around 18 hours after the last drink. For reference, an 8 oz cup of coffee has 95mg of caffeine while an 8 oz cup of tea has 26mg. If an individual is used to drinking as little as a cup of coffee in the morning, as the day goes on, they could experience withdrawal headaches and if you’re used to drinking more than that, the effect could be stronger.
- Change in habits – a sudden change in daily habits like sleep and eating can cause stress on the body and lead to a headache in some individuals. In Ramadan we eat less often throughout the day and sleep less. That change in and of itself can be triggering until the body adapts.
The biggest indicator of headaches while fasting is a history of headaches. Individuals who have experienced headaches in the past, are more likely to experience them with fasting. Although these first of Ramadan headaches are a cause of stress, there are definitely things that can be done to help alleviate them and NOW is the time to start with only a little over two weeks to go.
How to help prevent the first of Ramadan headaches:
- Decrease caffeine now – decreasing caffeine before Ramadan starts can help you ease into Ramadan without the headaches. Start by subbing half of your coffee or tea for decaf two weeks before Ramadan. If energy drinks are your source of caffeine, try to decrease the amount by half. One week before Ramadan decrease even further until you have replaced caffeinated beverages with either decaffeinated versions or other drinks. In Ramadan, do not break your fast on coffee as that could cause stomach distress. Some physicians (like Dr. Elliot Shevel and Dr Taoufik Al Saadi) will recommend having your coffee or tea at suhoor (pre-dawn meal) to curb the effects of caffeine withdrawal. Some studies have discussed the use of taking a longer acting NSAID pain killer like Aleeve before the fast as well. Please speak to your doctor about what is best for you personally and before introducing any new medications.
- Increase water – hydrate, hydrate, hydrate. If you are living in North America, the fast is around 15 hours (give or take an hour depending on where you live) in the summer. The body will be dehydrated but you can try to replenish fluids by making sure you drink water in suhoor and throughout the night when you are awake. Try to drink 1-2 cups of water at suhoor and break your fast on dates and 1 cup of water. Give your body 15-20 minutes before eating the rest of the meal and keep a water bottle with you at all times until you sleep (and actually drink from it!).
- Use dates – break your fast on dates. If the headache is due to fatigue or changes in blood sugar this will quickly remedy the situation.
- Be safe – it is hot out there, do your best to stay out of the sun (if you can) and to not over exert yourself both in the fasting and non-fasting hours. I know it’s not always possible but taking care of your body is important.
- Make dua – this isn’t always our first thought but Ramadan is a time to grow closer to God and one of the best ways to do so is to ask of Him.
If the headaches are very strong in severity and different than headaches you are used to, please see a physician.
I pray this month is a blessed month for all of us.
Dua Aldasouqi, MA, RDN
Certified Health Coach
- Awada et al. 1999. The First of Ramadan Headache. King Fahd National Guard Hospital, Riyadh, Saudi Arabia.
- Drescher et al. 2011. Prophylactic Etorixcoxib is Effective in Preventing “First of Ramadan” Headache.
- Torelli et al. 2009. Fasting Headache: A Review of the Literature and New Hypotheses. Journal of the American Headache Society.