Fasting Nearly Doubled Migraine Attacks in a Ramadan Study: What the Research Shows

Fasting Nearly Doubled Migraine Attacks in a Ramadan Study: What the Research Shows

Medical disclaimer: This article summarises published research for informational purposes only. It is not medical advice and is not a substitute for guidance from a qualified health professional. Always consult your doctor before starting any fasting protocol, especially if you have an existing health condition or take medication.

Study at a Glance

What This Study Looked At

Researchers wanted to know what happens to people with existing migraine when they take on a month of daily dawn-to-dusk fasting — the pattern observed during Ramadan. This is a form of time-restricted eating, typically involving 12–16 hours without food or water each day for a full month, making it a useful natural experiment for studying fasting and headache disorders. The study compared migraine patients who chose to fast throughout Ramadan against migraine patients who did not fast, tracking attack frequency and severity before and during the fasting month. For general background on fasting and headaches, see our overview of fasting and chronic headaches.

Who Was Studied

Participant profile: Adults with a pre-existing diagnosis of migraine (with and without aura) attending a headache clinic; mixed sex, broadly representative of a general headache-clinic population.

How the fasting protocol worked in this study: Participants in the fasting group abstained from all food and water from dawn until sunset each day for the full lunar month of Ramadan, then ate and drank normally during the night-time hours — a daily fasting window of roughly 12 to 16 hours depending on the time of year.

What the Researchers Found

Migraine attack frequency

• The fasting group showed a significant increase in migraine attack frequency during the fasting month compared with their own pre-Ramadan baseline.
• The non-fasting comparison group, tracked over the same calendar period, did not show a comparable increase — pointing to the fasting pattern itself, rather than the time of year, as the relevant factor.
• Several fasting participants also reported changes in attack characteristics, including altered duration and intensity of individual migraine episodes.

What Did Not Change

• Migraine diagnosis type (with vs. without aura) did not appear to predict who worsened during fasting.
• The non-fasting control group's headache patterns remained broadly stable across the study period.

What the Researchers Concluded

The authors concluded that Ramadan-style fasting was associated with a clinically meaningful worsening of migraine frequency and severity in people with a pre-existing migraine disorder, and suggested that known migraine triggers common during fasting — dehydration, skipped caffeine, delayed meals, and disrupted sleep patterns — likely played a role.

What This Means If You Fast

• Migraine history changes the calculus. If you already have a diagnosed migraine disorder, this study suggests fasting protocols — even culturally established ones like Ramadan — carry a real risk of increasing attack frequency, not just occasional headache discomfort.
• Hydration timing likely matters a lot. Because Ramadan fasting restricts water as well as food, dehydration is a plausible driver of the increase; a fasting protocol that allows water (as most intermittent fasting approaches do) may carry a different risk profile. See our guide on why drinking water is the most important rule of fasting.
• Caffeine withdrawal is a known trigger. Abruptly cutting daytime coffee or tea during a long fasting window can itself provoke headache in caffeine-dependent people, independent of the fast itself.
• Electrolyte balance is worth attention. Sodium, magnesium, and potassium shifts during fasting can contribute to headache; see our breakdown of electrolytes women need during intermittent fasting for practical guidance that applies broadly.
• Track your own response before assuming fasting is safe for you. If you have a migraine history, start with a much shorter fasting window than you might otherwise consider, and stop if attack frequency increases.
• This doesn't mean all fasting is off-limits. The Ramadan protocol studied here is unusually strict — no water for 12–16 hours daily, for a full month. Shorter, water-permitted fasting windows have not been shown to carry the same risk in this population.

Study Limitations

• Relatively small sample size (76 total participants, 41 in the fasting arm).
• Participants were not randomized to fasting vs. non-fasting groups — people who chose to fast may differ systematically from those who didn't (self-selection bias).
• Attack frequency and severity relied on patient self-report and recall, which can introduce reporting bias.
• Single-center study conducted in one regional population, limiting generalizability to other groups or fasting protocols.
• The Ramadan protocol restricts water as well as food, so findings may not generalize to intermittent fasting approaches that permit water and non-caloric beverages.
• No data provided on medication use, caffeine intake changes, or sleep disruption as separate contributing variables.

Source

Abu-Salameh, I., Plakht, Y., & Ifergane, G. (2010). Migraine exacerbation during Ramadan fasting. The Journal of Headache and Pain, 11(6), 513–517. PMID: 20857160

Frequently Asked Questions

Does intermittent fasting cause migraines?

This study found that fasting was associated with a significant increase in migraine attack frequency specifically in people who already had a diagnosed migraine disorder. It did not study whether fasting can trigger migraines in people without a prior history.

Is Ramadan fasting the same as intermittent fasting for headache risk?

Not exactly. Ramadan fasting restricts both food and water for 12–16 hours daily, while most intermittent fasting protocols (like 16:8) permit water and non-caloric drinks throughout the fast, which may reduce the dehydration-related headache risk seen in this study.

Why would fasting trigger a migraine?

Likely contributors include dehydration, low blood sugar, caffeine withdrawal, delayed meal timing, and disrupted sleep — all recognized migraine triggers that can occur together during an extended fast.

Should people with migraines avoid intermittent fasting altogether?

Not necessarily, but this research suggests caution. People with a migraine history should start with shorter fasting windows, maintain hydration and electrolytes, and stop or shorten the fast if attack frequency increases.

How much did migraine frequency increase in this study?

The fasting group's average migraine attacks rose from roughly 1.2 per month at baseline to roughly 2.3 per month during the fasting period, while the non-fasting comparison group showed no significant change.

Related Research and Articles

• Can Fasting Help Chronic Headaches? What History and Science Both Say
• Intermittent Fasting and Headaches in Women
• Why Drinking Water Is the Most Important Rule of Fasting
• Electrolytes Women Need During Intermittent Fasting
• Who Should NOT Fast: Clear Contraindications and Cautions
• Is Fasting Dangerous? Separating Fear from Fact
• 12-Hour vs 16-Hour vs 24-Hour Fasting: What Happens at Each Stage

Want the complete guide to fasting? Get Intermittent Fasting in Practice on Amazon — and claim 3 months free on our fasting app at fastinginpractice.com/redeem.