It becomes evident that certain customary and religious practices may pose a challenge for individuals experiencing migraines and other headache disorders as the Jewish high holidays approach. Patient reports and medical textbooks often list fasting as a cause of headaches.
In Judaism, two days are set aside for fasting. Most readers will be familiar with Yom Kippur, also known as the Day of Atonement, which is the holiest day in the Jewish calendar. The alternate fasting day is Tish B'av, a holiday that begins on July 15 and lasts for one day. It pays tribute to the many tragedies that the Hebrew people have experienced.
In a 1995 Israeli study of hospital employees before and after a 25-hour Yom Kippur fast, it was found that subjects with a history of headaches were more likely than those without a history to experience a fasting-induced headache. The mild to moderate, non-pulsating headaches that were distributed frontally and bilaterally were described. There was a correlation between the number of reported headache attacks and the duration of fasting. The scientists noticed that withdrawal from caffeine or nicotine did not seem to have an impact on headaches.
The International Classification of Headache Disorders classifies primary and secondary headaches differently. Primary headaches, such as migraine and tension-type headaches, have no underlying medical condition or cause. Some specific causes of secondary headaches include exposure to substances like nitrites, aneurysms, and brain tumors. Most often, secondary headaches are caused by disruptions to the homeostasis, the internal system that regulates and balances our body functions. A headache during a fast is one of the most obvious signs of a homeostasis disorder.
A headache is considered to be caused by a homeostasis disorder if it initially appears in the vicinity of the disorder and then disappears or improves as the disorder recovers. If someone has a headache while fasting, it will definitely get better and hopefully go away after they eat or drink.
Fasting headaches, specifically fast-related migraine episodes, have been connected to hypoglycemia (low blood sugar). As early as 1933, the famous British neurologist MacDonald Critchley proposed that eating could help avoid migraine attacks caused by fasting and vigorous exercise. It has been suggested that the patient stick to a regular meal schedule even when on a diet to lose weight in order to avoid migraine attacks and headaches caused by fasting. If you wish to maintain your homeostasis, you should refrain from missing meals.
For people who participate in religious rituals, on the other hand, new problems arise. There are many different rules in Judaism. For instance, if someone has migraines, the ultra-Orthodox may be less strict on Tish B'av but not on Yom Kippur. The Torah's prohibition against eating anything on Yom Kippur does not apply to sick people. If a migraine could be a sign of something potentially fatal, like a stroke, then eating in moderation would be allowed (chashash sakanat nefashot). They would, of course, have to be acquainted with comparable fasting-related incidents from the past. There are guidelines that were released on
Migraine, which can be triggered by fasting, is the diagnosis made for the patient.
An aura lasts for more than an hour and comes on before a migraine actually starts.
No migraine medication, not even suppositories or sprays, can prevent a migraine attack from occurring in the first place.
These questions of philosophy are not exclusive to Judaism. Christians, and Catholics specifically, may encounter the issue during Lent. It is customary for all Catholics, beginning at age 14, to abstain from eating meat and meat products on Ash Wednesday and every Friday during Lent. Additionally, during the 40 days preceding Easter, they are expected to fast between meals. Regulations may be loosened and exceptions made for medical purposes.
What Muslims call "fasting headaches" are actually "First-of-Ramadan" (FAR) headaches caused by ritualistic fasting. Those with a history of headaches, whether they be tension or migraines, are more likely to experience a fasting headache. Hypoglycemia did not seem to be a concern for Muslims, as the majority of them seemed to eat one meal before dawn and another after dusk. However, FAR headaches may also be caused by dehydration and caffeine withdrawal from tea and coffee. Hydrating with water or a caffeinated beverage seemed to alleviate the symptoms of headaches. For a migraine sufferer who is keeping Ramadan, an abortive medication taken prior to breaking the fast may help prevent a "fasting migraine attack."
