Over-the-counter remedies for Ramadan

What is Ramadan?

Ramadan is the 9th month of the Islamic calendar whereby millions of Muslims all over the world observe this holy month by fasting. The fast is from sunrise (Suhur) to sunset (Iftar) and the month typically lasts for 29 to 30 days due to the lunar cycle. Times of fasting can vary from different areas within the UK and countries across the world. Observers are required to abstain from food, drink, smoking and conjugal relationships during the time of fasting (1). This period is to aid detoxification, purification and mindfulness (2).

What happens to the body during Ramadan?

Low blood sugar

Your body undergoes various physical changes during fasting. Due to the decreased amount of eating times, low blood sugar (glucose) is common. Once the glucose stores (glycogen) from breakfast are used up, the body compensates by inducing the breakdown of fat to convert to glucose to keep bodily functions working. The level of blood sugar in the blood is generally lower than normal at this point.

- Dizziness and headaches are a common side effect of low blood sugar. To treat this while fasting, during the dark hours it is important to consume as much water as possible in order to keep hydrated and keep your blood pressure at an adequate level. For headaches, foods which contain prolonged-released carbohydrates are advised; this will ensure slow release of glucose into the bloodstream reducing headaches.

Over-the-counter treatment options:

- Paracetamol and Ibuprofen: paracetamol and Ibuprofen can also be used during the non-fasting hours to compensate for short-term pain and discomfort from headaches.

- 4Head® - a topical headache treatment can also be used for short-term relief.

Dehydration

Dehydration can be a huge issue during the month of Ramadan as only a finite amount of water can be consumed. It is a good idea to keep a large bottle of water with you, during the dark hours. Side effects experienced from dehydration can include headaches and muscle cramps. Muscle cramps and stiffness are a common side effect of fasting; this is due to the low levels of salts and electrolytes in the body.

Over-the-counter treatment options:

- Oral rehydration salts (eg Dioralyte®): - replenishing the low salt and electrolytes like potassium in the body is important for repair and reduction in cramping. A sachet in the morning pre-sunrise meal (Suhur) and in the evening post-sunrise (Iftar) will reduce cramps and frequency of cramps.

- Bananas and tomatoes are fantastic sources of potassium to replenish the electrolyte imbalance and reduce cramping. So try to incorporate these in your diet.

Acid reflux and heartburn

The fast duration can range significantly geographically due to the seasons, but it typically can range from 9-19 hours. As a result food is consumed early in the morning and late in the evening. Traditionally, large amounts of fried, spicy foods are consumed in the evening; this can give rise to acid reflux and heartburn.

Over-the-counter treatment options:

- Omeprazole, pantoprazole, esomeprazole (Nexium®) are tablets/capsules for acid reflux. They work by blocking the receptor which produces acid in the stomach and reducing over-production and the discomfort felt when reflux occurs (3).

- Gaviscon® is known as a rafting agent. It works by producing a cool foam (protective layer) on top of the stomach acid and keeping the contents within the stomach, reducing the painful symptoms that can be felt up the food pipe.

- Rennie®: this works by neutralising excess stomach acid reducing the heartburn feeling.

Supplements

Additional supplementations with vitamins is a good way to help replenish those which are normally consumed within the day.

- Ensure drinks: these are nutritional supplements to aid eating - especially good in the morning for the pre-sunrise meal for those who cannot eat a lot of food. There are a good source of vitamins, minerals and protein and provide balanced nutrition (3).

- Multivitamins : additional vitamins are a good way to ensure a balanced vitamin intake throughout the month of Ramadan.

Disclaimer: prior to following any of the advice above please consult a healthcare professional to ensure the products are right for you and your condition.


Yasmin Karsan is a UK registered pharmacist who has a pharmacy-related blog, Ask a Pharmacist, and an Ask a Pharmacist YouTube channel. Follow @YasminKarsan on twitter or Askapharmacist on Instagram.

References:

(1) Ziaee, V., et al. "The changes of metabolic profile and weight during Ramadan fasting." Singapore medical journal 47.5 (2006): 409.

(2) Roy, Anindita Singha, and Amit Bandyopadhyay. "Effect of Ramadan intermittent fasting on selective fitness profile parameters in young untrained Muslim men." BMJ Open Sport & Exercise Medicine 1.1 (2015): e000020.

(3) Joint Formulary Committee, and Royal Pharmaceutical Society of Great Britain. British national formulary. Vol. 64. Pharmaceutical Press, 2012.