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Hypertensive or Cardiac Patients: Those who have mild to moderate high blood pressure along with being overweight should be encouraged to fast, since fasting may help to lower their blood pressure. They should see their physician to adjust medicines. For example, the dose of water pill (diuretic) should be reduced for fear of dehydration and long acting agents like Inderal LA or Tenormin can be given once a day before Suhur. Those with severe hypertension or heart diseases should not fast at all.

Those with Migraine Headache: Even in tension headache, dehydration, or low blood sugar will aggravate the symptoms, but in migraine during fasting, there is an increase in blood free fatty acids, which will directly affect the severity or precipitation of migraine through release of catecholamines. Patients with migraines are advised not to fast.

Pregnant Women (Normal Pregnancy): This is not an easy situation. Pregnancy is not a medical illness, therefore, the same exemption does not apply. There is no mention of such exemption in Qur'an. However, the Prophet (sallallahu alaihi wassalam) said the pregnant nursing women do not fast. This is in line with God not wanting anyone, even a small fetus, to suffer. There is no way of knowing, the damage to the unborn child until the delivery, and that might be too late. In my humble opinion, during the first and third trimester (three months) women should not fast. If however, Ramadan happens to come during the second trimester (4th - 6th months) of pregnancy, a woman may elect to fast provided that:

1. her own health is good and
2. it is done with the permission of her obstetrician and under close supervision

The possible damage to the fetus may not be from malnutrition provided the Iftar and Suhur are adequate, but from dehydration, from prolonged (10 - 14 hours) abstinence from water.

Therefore it is recommended that Muslim patients if they do fast, do so under medical supervision.

References

1. Bistrian, B.R., "Semi-starvation Diet Recent Development", Diabetic Care, November 1978
2. Blackburn, G.L., et al, "Metabolic Changes on PSMF diet" Diabetes, June 1976
3. Cott, A., "Fasting Is A Way Of Life", New York: Bantam Books, 1977
4. Hirsch, Jules, "Hypothalamic Control of Appetite" Hospital Practices, February 1984
5. Khurane, R.C., "Modified Ketogenic Diet For Obesity", Cancer Monthly Digest, July 1973
6. Hussaini, N.M., Journal of Islamic Medical Association, October 1982
7. Athar, S., "Therapeutic Benefits Of Ramadan Fasting", Islamic Horizons, May 1984
8. Soliman, N., "Effects Of Fasting During Ramadan", Journal of Islamic Medical Association, November, 1987
9. F. Azizi et al, "Evaluation of Certain Hormones And Blood Constituents During Islamic Fasting Month", Journal of Islamic Medical Association, November 1987
10. Athar, S., "Fasting For Medical Patients - Suggested Guide-line", Islamic Horizons, May 1985

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(This article was taken from a booklet provided by Muslim Aid Australia. We would like to thank them for this wonderful booklet)

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