As the Jewish high holidays draw near, it becomes clear that some traditional and religious practices might be problematic for those who suffer from migraines and other headache disorders. Fasting is frequently mentioned as a headache trigger in patient reports and medical textbooks.
There are two days of fasting observed throughout Judaism. The holiest day in the Jewish calendar is Yom Kippur (the Day of Atonement), which most readers will be familiar with. Tish B'av, a holiday that starts the night of July 15 and lasts for one day, is the alternate fasting day. It honors the numerous tragedies that have befallen the Hebrew people.
It was discovered that subjects with a history of headaches were more likely to experience a fasting-induced headache than those without a history of headaches in a 1995 Israeli study of hospital employees before and after a 25-hour Yom Kippur fast. The frontally and bilaterally distributed, mild to moderate, non-pulsating headaches were described. The length of fasting was correlated with the number of reported headache attacks. The scientists observed that headaches did not appear to be affected by caffeine or nicotine withdrawal.
Primary and secondary headaches are categorized differently in the International Classification of Headache Disorders. There is no underlying condition or cause for primary headaches, which include migraine and tension-type headaches. A brain tumor, an aneurysm, or exposure to a substance like nitrites are just a few examples of specific causes of secondary headaches. The internal system that controls and stabilizes our bodily functions, known as homeostasis, is the most common cause of secondary headaches. An easily recognizable manifestation of a homeostasis disorder would be a headache during a fast.
If a headache develops for the first time near a homeostasis disorder and goes away or gets better once the disorder gets better, the headache is thought to be caused by the disorder. After the victim of a fasting headache consumes food or liquids, it will undoubtedly get better and hopefully go away.
Fasting headaches, particularly migraine attacks linked to fasting, have been linked to hypoglycemia (low blood sugar levels). The renowned British neurologist MacDonald Critchley suggested that eating could prevent migraine attacks brought on by fasting and strenuous exercise as early as 1933. It has been advised that even when dieting for weight loss, the patient should maintain a regular meal schedule to prevent fasting headaches and those migraine attacks linked to fasting. You should avoid skipping meals if you want to keep your homeostasis.
However, a fresh set of issues surfaces for those who follow religious rituals. Judaism has a variety of rules; for example, the ultra-Orthodox may be less strict on Tish B'av but not on Yom Kippur if the person has migraines. A person who is ill is not exempt from the Torah's prohibition against eating anything on Yom Kippur. Eating in moderation would be permitted if a migraine could be the precursor to a life-threatening event, such as a stroke (chashash sakanat nefashot). Of course, they would need to be familiar with similar fasting-related incidents from the past. There are rules, which were published on
The patient has a diagnosis of migraine, which can be brought on by fasting.
An aura precedes the onset of a migraine, and the aura lasts for more than an hour.
No migraine treatments (such as suppositories or sprays) can stop a migraine attack before it starts.
These philosophical conundrums are not unique to Judaism. During the Lenten season, Christians, and Catholics in particular, may experience the problem. All Catholics from the age of 14 until their death are expected to abstain from eating meat and meat products on Ash Wednesday and every Friday during Lent, as well as from eating between meals for the 40 days leading up to Easter. For medical reasons, regulations can be relaxed and exceptions can be made.
The "First-of-Ramadan" (FAR) headaches, which are brought on by ritualistic fasting, are what Muslims refer to as fasting headaches. A fasting headache is more likely to occur in people who have a history of headaches, whether they were migraines or tension headaches. Since most Muslims appeared to eat one meal before dawn and another after dusk, hypoglycemia did not appear to be a concern for this religious group. Dehydration and caffeine withdrawal from coffee and tea, however, might also contribute to FAR headaches. Drinking water or a caffeinated beverage appeared to ease headache symptoms. An abortive medication taken before breaking the fast may help a migraine sufferer who is observing Ramadan avoid a "fasting migraine attack."