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Fasting For Ramadan? Here's How To Do It Safely

Nina Ghamrawi, MS, RD, CDE
March 20, 2023
March 27, 2023

The holy month of Ramadan is a time for spiritual reflection and discipline, but we fast from dawn until sunset. It is extremely physically exhausting! For patients with chronic diseases, you must be cautious. Here is what you need to know to make an informed decision about whether or not you can fast during Ramadan, and how to adjust your medications.

When Should You Be Cautious?

For some people with chronic diseases, fasting during Ramadan may not be safe. Here are some conditions that require caution:

  1. Uncontrolled Diabetes: If you have uncontrolled diabetes, fasting can be dangerous because it can lead to extremely high or low blood sugar levels, and cause complications like diabetic ketoacidosis or even diabetic coma. Ensure that you have good blood sugar control before considering fasting.
  2. Controlled Diabetes: If your diabetes is well-controlled and you have no other underlying health conditions, fasting during Ramadan may be safe depending on your individual circumstances. Your doctor may need to adjust your medications or diet plan during the fasting period to ensure that your blood sugar levels remain stable. Also, check your blood sugar levels more often during the fast, and to break your fast immediately if your blood sugar levels become too low or too high.
  3. Advanced Kidney Disease: If you have advanced kidney disease, fasting can be dangerous because it can lead to dehydration and an increase in waste products in your blood. It's important to speak to your doctor or healthcare provider about whether fasting is safe for you.
  4. Cardiovascular Disease: If you have cardiovascular disease, fasting can be dangerous because it can lead to dehydration, low blood pressure, and irregular heart rhythms. It's important to speak to your doctor or healthcare provider about whether fasting is safe for you.
  5. Pregnant or Breastfeeding Women: Pregnant or breastfeeding women with chronic diseases should not fast during Ramadan because it can affect the health of the mother and the baby.

How To Fast Safely During Ramadan

For many people with chronic diseases, fasting during Ramadan can be safe if certain precautions are taken. Here are some general guidelines to follow:

  1. Consult your Doctor: If you have any chronic disease such as diabetes, heart disease, kidney disease or any other chronic illness, it's important to speak to your doctor or healthcare provider about fasting. They can help you determine whether fasting is safe for you and give you advice on how to manage your medications and condition during the fast.
  2. Adjust your medication and diet plan: If your doctor approves fasting, you may need to adjust your medication and diet plan accordingly. For example, if you have diabetes, you may need to adjust the timing or dosage of your insulin injections or oral medications to avoid hypoglycemia (low blood sugar). You may also need to change the types of foods you eat during the pre-dawn and sunset meals (suhoor and iftar) to maintain stable blood sugar levels.
  3. Stay Hydrated: Staying hydrated is crucial during Ramadan, especially for people with chronic diseases. It's important to drink plenty of water during the pre-dawn and sunset meals to prevent dehydration, especially in hot weather. If you have kidney disease, you may need to limit your fluid intake, so speak to your doctor or healthcare provider about how much water you should drink.
  4. Keep monitoring: it is important to always check your vitals, especially when there is no food onboard. Medications can act for long periods, but without food  in your system, your body may respond differently, so keep monitoring.
  5. Check your blood pressure 3 times per day- morning, mid-day, and in the evening after maghrib and iftar (the evening time after you are permitted to eat);
  6. If you monitor blood sugars, get 2 paired readings , and a mid-dady check- check when you first wake up, before suhoor (the morning meal time), and 2 hours after your suhoor. Check any time you feel symptoms of low glucose during the day, and also check before and 2 hours after iftar

What Should You Do If You Feel Uncomfortable Symptoms?

It's important to prioritize your health and safety, and not to push yourself beyond your limits. If you feel unwell or experience symptoms, there are different ways to handle them:

  • Dizziness, weakness, or dehydration--> Stop fasting and seek medical attention.
  • Unbearable exhaustion in the afternoons--> Re-evaluate your morning suhoor ad iftar: did you have enough fiber and protein to give you a slow release of energy throughout the day? Did you drink enough water? Check your blood sugars to make sure they aren’t going low. If glucose is low, stop fasting and talk to your doctor about temporarily adjusting medications.
  • Muscular cramping--> you may be dehydrated or be missing valuable minerals; drink water in small amounts, and more frequently throughout the night, and/or add a fruit and vegetable smoothie to increase mineral intake to the recommended 2-4 servings of fruit and 3-5 servings vegetables per day.
  • Burning on urination--> you may be getting a urinary tract infection; drink water in small amounts and more frequently throughout the night, and try adding an electrolyte drink to your evening or morning routine, such as a coconut water.

Takeaways

In conclusion, fasting during Ramadan can be safe for patients with chronic diseases if certain precautions are taken. It's important to consult your doctor or healthcare provider before fasting to determine whether it's safe for you. If your doctor approves fasting, you may need to adjust your medication and diet plan accordingly and stay hydrated during the fast. For patients with certain conditions, caution should be taken, and fasting may not be safe. Remember that the health and safety of yourself and your family should always come first.

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