Fasting causes some changes in metabolism and blood biochemistry in people who do not have health problems, but it does not cause disease. Especially those with chronic and neurological diseases should consult their doctor before intending to fast.
The blood biochemistry of each person; changes in hunger in accordance with age, gender and environmental conditions at that time. The most affected parameters are blood sugar, kidney function and blood mineral levels. These changes make themselves felt intensely during the first seven or ten days of fasting. It manifests itself as dizziness, headache, palpitation, and thirst in the patient. Then the body adapts to these changes.
Type1 and type 2 diabetes patients, hypoglycemia patients, patients with latent diabetes mellitus are adversely affected by prolonged fasting. They are more likely to experience health problems such as low blood sugar and fainting. Long hunger periods and irregularities in drug use, especially in the summer, may cause this situation. In addition, some types of diabetes medications continue to secrete insulin throughout the day, and if you skip a meal, this insulin will cause sudden sugar drops. Consuming calorie foods quickly in iftar is an event in itself that raises blood pressure and sugar.
Since the kidneys are affected by fluid and mineral imbalance, it may cause problems in patients with a background of kidney disease. Kidneys that work well and have no loss of function adapt to the decrease in fluid intake and can easily remove toxins from the body with the fluid taken within 24 hours. However, kidneys with loss of function need more fluid to remove the same amount of toxin. When this situation does not occur, the patient may be in a position to enter dialysis. Kidney sand casting, prostate disease, small kidney stones are often not adversely affected by fasting.
Diseases such as heart failure, hypertension, and coronary heart disease are diseases that often coexist and whose severity may vary according to the patient. Patients with mild dysfunction who do not use intensive medication may not be adversely affected by fasting.
In general, patients with the above-mentioned chronic diseases should be evaluated in detail by the physicians they follow before they start fasting, and it should be revealed how the disease will be affected by the current fasting conditions. It is necessary to adjust the drug doses and times used in patients who are allowed to fast, as well as to plan the diets of the patients. Fasting without communicating with their physicians, with the thought that nothing will happen, can cause serious health problems. It should be noted that; each patient’s disease is unique and they can fast if it is medically appropriate with different recommendations.
Gastrointestinal diseases are affected by starvation. Reflux disease, mild cases of gastritis, irritable bowel syndrome patients can tolerate fasting, stomach-small intestine ulcers, inflammatory bowel diseases may experience health problems. Cancer patients should not fast during treatment processes such as radiotherapy and chemotherapy. Fasting is not recommended in severe neuropsychiatric patients during pregnancy and lactation.
Headaches – MIGRAINE; Unfortunately, almost all types of headaches can be triggered by prolonged hunger. Our patients who suffer from frequent headaches can start their preventive drug treatments 4-5 months before the start of Ramadan and spend the month of Ramadan a little more comfortably. If there is not that much time; In this case, especially migraine patients can apply to a neurologist and have botox application around the head. For this, it may be appropriate to have this application done 3-4 weeks ago on average.
Stroke (stroke) disease is a condition that occurs as a result of occlusion of the cerebral vessels by a clot or bleeding in the brain. The patient may be paralyzed, partially paralyzed, or may not be able to function in whichever part of the brain there is blockage or bleeding, even if he does not have any weakness. (eg /related to vision only if in the visual field). It would not be medically appropriate to recommend long-term fasting to patients who have experienced such a vascular event. During the summer months, rapid changes can occur in the fluid and salt balance through sweating, etc. This situation is most often manifested by fluctuations in blood pressure.
Unfortunately, high blood pressure and diabetes patients are more likely to experience vascular problems such as stroke and heart attack if they fast, especially if these diseases are difficult to control. We understand this from the increase in the number of such patients who apply to our emergency departments.
Patients with chronic diseases adjust their medications as iftar and sahur. This may be appropriate for some patients and certain medications, but may be dangerous for others. If you have a blood pressure medication that should be used twice a day, it means that it should be taken every 12 hours. When the patient takes the medicine at iftar and sahur, one interval will be 6-7 hours, the other interval will be 17-18 hours. In this case, your blood pressure will rise during the day. Daily fluid loss is even more important for those who use blood pressure medication containing diuretics, and changes in fluid and salt balance in elderly patients can lead to unconsciousness and death.
It is very important for epilepsy patients not to interrupt their medication. There is no harm in fasting if patients take the drugs in a single daily dose and always at the same time, do not tire themselves excessively during Ramadan, and pay attention to their fluid intake, if their illness is mild and if their seizures are under control. If the patient needs to take the daily dose of medication in two divided parts, which is the case with most epilepsy drugs, taking the drugs in the form of iftar and sahur disrupts the daily medication regimen and the patient may have seizures.
In diseases such as MS and ALS, the situation changes regarding the severity of the disease. There is no evidence that hunger triggers MS. However, stress that increases with hunger, exposure to heat along with fluid loss can cause attacks or attack-like complaints. In this case, if the patient’s illness is mild, it may be possible to fast very carefully. For ALS, hunger does not have a significant aggravating effect on the disease. Attention should be paid to the patient’s nutritional balance and fluid intake. In both of these diseases, it is preferred that the patient does not fast. If the patient’s desire is in the direction of fulfillment, attention should be paid to the above details.
We wish you all a healthy and beautiful Ramadan month.
