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When Ramadan is a headache

When Ramadan is a headache

Many people who fast over Ramadan suffer mild or moderate headaches as a result of factors such as caffeine withdrawal, stress and low blood sugar. The good news, says Health24's Headache Expert, Dr Elliot Shevel, is that you can manage these headaches without breaking your fast. 

Dr Shevel, Chairman of the South African Headache Society and medical director at The Headache Clinic, has three decades' experience in the treatment and prevention of headaches, and is the most published migraine specialist in South Africa.

Says Dr Shevel: “Ramadan is a time for peace and spiritual reflection, but for many people it can also be a time beset by headaches or migraines. Most Ramadan headaches are characterised by bilateral, throbbing pain that is mild to moderate in severity.

“The headaches mainly affect the frontal (forehead and temple) region, and usually last one to two hours. 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 Ramadan headaches, but some patients with Ramadan headache have no history of headaches or migraines.

How to stave off that headache
Dr Shevel highlights caffeine withdrawal as the most common cause of Ramadan headache. Patients can often prevent headaches by reducing caffeine consumption in the weeks leading up to Ramadan month, while a cup of strong coffee just before the start of the fast for the day may prevent caffeine withdrawal headache.

Hypoglycaemia (low blood sugar) can also trigger headaches in many people. If a meal with high sugar content is taken 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.

Dehydration is another common trigger - adequate intake of fluid before the onset of the fast can often prevent headaches. Fluid retention and stress during menstruation can also contribute to Ramadan headaches. “Patients should also, as far as possible, try to avoid exposure to other triggers such as stress, fatigue and lack of sleep during Ramadan, when there is a greater tendency to headache,” says Dr Shevel. “Rest and sleep often help Ramadan headaches, and the pain often melts away when the fast is broken for the day.”

Medicinal help
Two types of medication can be used to treat Ramadan headaches: preventive, and rescue.

Preventive medication that will last for the full twelve hours of the fast includes preparations such as naproxen sodium, which is taken as a single dose of 500mg just before the fast begins.

Rescue medication can be taken in suppository form. A single diclofenac suppository can be used at the onset of the headache.

When to call your doctor
If headaches persist after Ramadan or are severe in nature, patients are advised to seek help from a medical professional. Dr Shevel says that headaches can be most successfully treated using a multidisciplinary approach, since no one medical specialisation covers all the psychological and physical dimensions that impact on and are impacted by severe headaches.


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