Question:

I am a sister who is anemic, and fasting is pretty difficult for me. Sometimes, I have a tough time getting out of bed, and I often feel dizzy when I get up. I think I have low blood pressure too, and I feel weak and light-headed sometimes. I want to keep fasting, and don’t feel like my condition is that extreme to break my fast. Do you have any tips for how I can have a healthy Ramadan this year?

Answer:

Many sisters face the additional challenges of anemia and low blood pressure when observing the fast of Ramadan. It is important to differentiate anemia and low blood pressure, although the symptoms can be the same and both can be exacerbated by fasting.

Anemia is low red blood cells or hemoglobin, the oxygen-carrying “metalloprotein” of our blood. Our body needs oxygen as a fuel, so if we are anemic, our blood has difficulty delivering oxygen. With low oxygen, we can feel weak and light-headed. Menstruating women are more at risk for having anemia. Other issues such as low iron in the diet, genetic conditions, or other diseases can also cause anemia.

Low blood pressure means that the blood is flowing through our body at a less than ideal pressure. Therefore, not only does oxygen transport suffer, but so do the transportation of nutrients and organ function as well.

Thus, both anemia and low blood pressure can make us feel weak. Both conditions are exacerbated by fasting, since dehydration and low blood sugar also affect how well our bodies and brains function.

It is important to stay very well hydrated and drink plenty of fluids—mostly simple water. Remember, caffeinated products like tea and coffee can act as diuretics, which actually promote fluid loss. Some people who drink caffeinated products regularly can have rebound headaches, which may be worsened by anemia and low blood pressure. It is best to wean off caffeinated products one to two weeks before fasting.

Avoid simple sugars, which cause rapid fluctuations in blood sugar. Always eat a pre-fast meal (suhoor) with protein, healthy fats, and complex carbohydrates.

In some cases, anemia may be a medical reason not to fast. Your physician or medical provider can help you to make that decision. It is not the intention of the fast to cause or worsen illness.

The Qur’an says: “…So whoever sights [the new moon of] the month, let him fast it; and whoever is ill or on a journey – then an equal number of other days. Allah intends for you ease and does not intend for you hardship and [wants] for you to complete the period and to glorify Allah for that [to] which He has guided you; and perhaps you will be grateful.” (2:185)

Dr. Nisha AbdulCader is a pediatrician in San Luis Obispo, California.  She is the medical director for Child Abuse Services for San Luis Obispo County and was one of the founders of the UMMA Community Clinic.

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