Fasting during Ramadan is complicated with myasthenia gravis

During the month of Ramadan, Muslims all over the world fast from dawn until sunset, meaning no food or drink for anywhere between eight and 12 hours, depending on the region. It’s the holiest month in the Islamic calendar — a time for dedication, reflection, and sharing.

But what does Ramadan mean for someone living with myasthenia gravis (MG)?

At first, it was easy.

I started fasting when I was 12, right after I got my first period, because in our culture and religion, puberty is considered the age of responsibility and the official start of adulthood. My first few years of fasting were completely manageable, mostly because Ramadan coincided with my summer break.

I spent my days sleeping and adjusted my entire schedule so that nighttime was when I ate, recharged, and lived normally.

Recommended Reading

August 27, 2024 News by Esteban Dominguez Cerezo, MS

Myasthenia gravis fatigue tied to worsening, crises, diagnosis delays

But as the years passed, Ramadan started falling during the school year, and things became tricky. At the time, I didn’t have my MG diagnosis, and no one understood why fasting was making it so hard for me to breathe.

Every year, I pushed through until I physically couldn’t do it anymore. I would fast until I reached the point of a breathing crisis, and only then would I allow myself to stop. Even though the Quran clearly states that sick people aren’t obligated to fast, it was difficult to explain my struggles to those around me.

MG adds a new challenge to fasting during Ramadan

Now that I have my diagnosis and Ramadan falls in the middle of the year, fasting has become even more difficult. I want to fast, not just because it’s a tradition, but because I’m deeply spiritual and love feeling connected to my faith.

But I also don’t want to hurt my body.

The problem is, fasting can lead to fatigue, and MG already causes extreme fatigue. The combination leads to low blood pressure, low blood sugar, and even more exhaustion — until I reach a point where I can’t breathe properly anymore.

Now, I follow a different approach. I start my day fasting, but if I feel my body weakening, I stop immediately.

This choice should be simple. Islam gives full permission for sick people to break their fast whenever needed. There are no conditions, no justifications required. If you don’t feel capable, you don’t have to do it.

Facing social pressure with an invisible illness

However, this decision has created a lot of discussion around me.

Because my illness isn’t always visible, people don’t understand why I break my fast early. They don’t see me struggling to breathe, so they assume I’m fine. Some even get upset when I stop fasting, as if I should push myself harder.

That hurts me deeply. Instead of receiving support, I feel judged. It’s frustrating to constantly justify my pain just because others can’t see it.

But here’s what gives me peace: God understands.

Islam is a religion of mercy, and I fully believe that if God had wanted fasting to be obligatory for everyone, he wouldn’t have given exemptions for sickness. The fact that he allows those who feel unwell to stop fasting — without conditions — proves that my health matters, too.

Finding peace in faith

Despite society’s expectations, I feel grateful that my religion includes me. It recognizes that not every person’s body works the same way, and it trusts us to make the best decisions for our health.

So this Ramadan, I choose faith over guilt, mercy over pressure, and health over expectation.

Because in the end, no one knows my struggles better than me — and no one understands them better than God.

Note: Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Myasthenia Gravis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to myasthenia gravis.