Headaches while fasting — a common problem

Islamabad
Many people suffer mild to moderate and in some cases severe headaches while fasting in the holy month of Ramazan which according to health experts is because they do not understand the phenomenon.
In most of the cases, headaches can be avoided or controlled to a significant extent with the help of simple modifications in dietary habits and routine of daily life activities while fasting.
Apart from other factors, headaches in majority of cases is because of hypoglycaemia (lowering of blood glucose), change in sleep patterns, sweating and fatigue or reduction in blood supply to the brain.
Studies reveal that fasting may serve as a precipitating factor for headache and the onset of headache often occurs in the afternoon or evening before ‘Iftar’ while in a number of cases, it is reported after ‘Iftar’. It is witnessed that chronic patients of headache are more prone to have severe headache during fasting but some patients who experience headaches during fasting do not have any history of headaches or migraines.
Headache usually has multiple reasons in Ramazan that may be hypoglycaemia, disturbed sleep cycles, sweating, fatigue or dilutional hyponatremia, said Medical Specialist serving at Intensive Care Unit of Pakistan Institute of Medical Sciences, Islamabad Dr. Muhammad Haroon while talking to ‘The News’ on Sunday.
He added that headache among healthy persons is most commonly reported after ‘Iftar’ that is generally experienced from 30 minutes to two hours after ‘Iftar’. The reason is dilutional hyponatremia, a metabolic condition in which there is not enough sodium (salt) in the body fluids outside the cells. Low sodium levels occur when large amount of free water is taken in short time that dilutes sodium content causing typical circumferential headaches, dizziness and lethargy, he explained.
He said to avoid the condition, one should take relatively greater quantity of sodium (salty) drinks like lassi,

fresh lemonade etc and yoghurt at the time of ‘Iftar’ and after ‘Iftar’.
He added that for healthy persons who suffer headaches during fasting, it is better to take lipids containing foods like fried eggs, parathas etc as carbohydrates are used within four to six hours after ‘Sehr’, proteins are used after eight hours while lipids breakdown starts after 12 hours and it can support body’s metabolic needs for further 12 to 18 hours. “Intake of high lipids at ‘Sehr’ prevents low blood sugar in fasting and can help preventing headaches.”
He added that sleep cycles are disturbed in Ramazan as getting up early at ‘Sehr’, sleeping again and then going to work after a little sleep may disturb the metabolic process in the body. The minimum sleep time required in Ramzan per day is eight hours and the best time for sleep is after ‘travih’ and in afternoon for at least three hours-sleep.
To a query, he said the persons who have severe headache while fasting in Ramazan should consult physician and should not take the matter non-serious. Patients of high blood pressure must undergo regular check-ups particularly in case of persistent headaches during Ramazan. If one has complaints of high blood pressure, he can avoid headache only by controlling it, he added.
He informed ‘The News’ that only in the first two days of Ramazan, over 100 patients have been presented with headache as primary or secondary symptom to other diseases like acidity, stomach pain, fatigue etc at PIMS. Majority of them were given injections for pain relief, he said.
Studies reveal that the human brain is more than 75 per cent 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.
Health experts believe that dehydration is another common trigger and adequate intake of fluid between ‘Iftar’ and ‘Sehr’ and at the time of ‘Sehr’ can prevent headaches.
Dr. Haroon said that during long hours of fasting, protein breakdown starts and ammonia and other nitrogenous chemicals are released that enter brain and cause headache, drowsiness and lethargy.
He said that another reason behind headache is that when empty stomach is filled rapidly at the time of ‘Iftar’, 60 to 70 per cent of the blood supply is directed towards gastrointestinal system for digestion of the food consumed causing reduction in blood supply to the brain that results in persistent headache.
He added that people should not eat too much at the time of ‘Iftar’ and avoid stomach distention. People particularly those who experience headache while fasting should take plenty of fluids between ‘Iftar’ and ‘Sehr’.