Expert offers advice on managing migraines during Ramadan
CLEVELAND, March 21: Dehydration, poor sleep, and caffeine and nicotine withdrawal are among the factors that can trigger headaches while fasting during Ramadan, but there are simple solutions that can help address these issues, says a headache specialist from global health system Cleveland Clinic.
“During Ramadan, individuals who are predisposed to frequent headaches or migraines should take steps to avoid known triggers,but also implement positive habits such as exercising and improving sleep hygieneto help prevent headaches and support fasting,” says Emad Estemalik MD, MBA, Section Head for Headache and Facial Pain at Cleveland Clinic’s Neurological Institute.
Dr. Estemalik says that around 16-20% of women and 6-8% of mensuffer from migraines on a regular basis. For these individuals in particular, it is important to avoid food triggers when breaking their fast.
“Foods that are known to trigger migraines include meals containing monosodium glutamate (MSG) – often found in fast food, instant noodles and snacks, for example –as well as nitric oxide, commonly found in chocolate, processed meat, certain leafy green vegetables, and other foods,”says Dr. Estemalik. “Individuals will normally know which specific foods trigger their migraines and the portions they can tolerate, but it is advisable for them to avoid these foods completely at a time when they are already coping with other potential migraine triggers such as prolonged periods of not eating.”
Caffeine
Dehydration can also trigger headaches, and everyone who fasts should ensure that they get plenty of fluids between iftar and suhoor, even more so when temperatures are high, says Dr. Estemalik. He adds that water is always the best choice, but that individuals should pay attention to their caffeine intake too.
“Reducing the amount caffeine a person normally consumes in the form of coffee, tea or sodacan lead to withdrawal symptoms that include headaches. The right amount of caffeine can be protective against migraines too. However, excessive caffeine can actually trigger headaches and migraines,” explains Dr. Estemalik. “We generally advise people to aim for 100mg of caffeine a day, which is around one mug of coffee, and not to exceed this amount.”
Another factor that can trigger headaches while fasting is nicotine withdrawal. “Ramadan providesan ideal opportunity to quit smoking completely, or to start reducing the number of cigarettes a person smokes daily so they can stop smoking gradually,” says Dr. Estemalik. “In addition to the wellknown health benefits of quitting, smoking is also associated with cluster headaches, so smoking cessation couldhelp reduce their headaches in general.”
Positive steps that individuals can take to prevent headaches while fasting include exercising regularly to maintain an active metabolism, says Dr. Estemalik. He suggests taking a walk or performing aerobic or any other exercise around two hours after iftar. In addition, he advises people to break their fast gradually, rather than with a heavy meal, and also to ensure that they are getting adequate sleep during Ramadan.
Lastly, says Dr. Estemalik, if individuals do get headaches, they might take pain pills after breaking their fast, but excessive use could also be a trigger. “If people takeoverthe-counter pain medications more than two to three times per week, they run the risk of developing medication-overuse headaches, also known as rebound headaches. So, if individuals have frequent headaches or migraines, it is best to consult a healthcare provider to find the preventative strategies that will suit them best.”