Is it safe to fast after having a stroke?
You may wish to fast for personal or religious reasons. The most common religious reason is the 30-day celebration of Ramadan, during which Muslims fast from dawn until dusk.
Muslims are not required to fast if they are ill or if their medical condition could get worse by fasting. This may include some stroke survivors, who may then honour Ramadan in different ways.
But how do you know if it is safe for you to fast? There are a number of factors to consider.
Medication
Many medications need to be taken at certain times of the day. Others need to be taken before or with food. This can make it difficult to take medication while fasting.
In Islam, taking some medication is breaking the fast of Ramadan. This includes tablets. Many people therefore will choose either to not fast or to change their medication schedule.
But changing your medication schedule is not always safe. Many conditions can be negatively affected if medication is not taken as prescribed.
You should speak with your pharmacist, GP or specialist about whether it is safe to change your medication schedule during your fast. They may be able to help you adapt your medication. Or they may advise against doing so.
Dehydration
Dehydration is when you do not drink enough fluids to replace the ones you lose through breathing, sweating, going to the toilet, etc. Fasting for any period can increase the risk of dehydration.
Being dehydrated can affect the flow of blood in your body, increasing the risk of blood clots. Being dehydrated while taking certain blood pressure medications can also damage your kidneys. A study also found that people who were dehydrated at the time of their stroke were more likely to have worse outcomes.
It may not be safe for you to continue fasting if you are unable to remain hydrated. Drinking enough of the right kinds of fluid before and after your fast is essential.
Specific medical conditions
There are some medical conditions that need extra consideration when deciding whether to fast. This is not a complete list.
Diabetes
Some people find it difficult to manage their diabetes during a fast. You should always speak with your GP or specialist team before the start of your fast.
There are a few things they will need to consider:
What kind of diabetes do you have? Fasting is particularly difficult with insulin-dependent diabetes.
Are you able to keep your blood sugar in a healthy range?
Do you have any complications that could be made worse through fasting?
Do the tablets need to be taken at specific times?
You can read more about fasting with diabetes on the Diabetes UK website.
Atrial fibrillation
Atrial fibrillation (AF) can be negatively affected by changes to your sleeping and eating routines. It is important to take oral anticoagulants at the correct time of day so they protect you from stroke.
If you have AF, you should speak with your GP or specialist before starting a fast.
High blood pressure
Fasting may lead to a reduction in blood pressure. This may lead to you feeling symptoms like dizziness. In contrast, missing tablets will lead to an increase in blood pressure.
As with any chronic medical condition, you should speak with your GP or specialist before fasting.
Can I still exercise or do my physiotherapy?
It is certainly possible to exercise during a period of fasting, but you may want to change which activities you do. If you sweat too much during your exercise, you could become dehydrated. That is why many people switch to gentler exercises like walking and yoga during Ramadan.
If you are undertaking regular physiotherapy, you should speak with your physiotherapist before fasting. They may pause your therapy or suggest changes to it depending on how strenuous it is or if your medication schedule has changed.
Tips for healthy eating during Ramadan
If you decide that it is safe for you to celebrate Ramadan through fasting, it is important that you choose the right foods and drinks both before (suhoor) and after (iftar) you fast.
Try to include things like fruit, vegetables, lean protein, oats, bulghur wheat, wholegrain bread or brown rice. These kinds of food give you energy that is released slowly over several hours.
Stay hydrated using plenty of sugar-free drinks. If you don't like water, try adding a little sugar-free squash.
Avoid salt and salty foods. These can make you more dehydrated and are not good for your blood pressure.
Try baking or grilling your food instead of frying it.
Avoid fatty and sugary foods.