Fasting, in one form or another, has always been an important and often necessary part of religious life, discipline and experience in every faith, including among others: Christianity and the sacrifices of Lent; Greek Orthodox Christianity and the fasting periods of the Nativity Fast, Lent and the Assumption; the Muslim holy month of Ramadan; Judaism, which mandates penitential fasting on Yom Kippur along with fasting on sad days such as Tishah B'Av, as well as fasting on certain other days of the year which mark sad events.
Fasting is not just a religious activity. People also fast for political or health and wellbeing reasons.
On this page:
- I have asthma. Is it safe to fast?
- I'm fasting for Ramadan - will asthma medicine break my fast?
- Can I adjust my asthma medicine to suit my fast?
- Look after your asthma when you fast
- Our top tips to stay safe during your fast
- More advice...
It's especially important for Muslim people from South Asian communities to look after their asthma during Ramadan. Statistics tell us that people from South Asian communities are generally three times more likely than white people to have an emergency hospital admission for their asthma, despite the fact that the incidence of asthma in South Asian communities is actually lower than in the white population.
There is little to suggest that fasting causes problems if you have asthma. But if when you're fasting you choose not to take your medicines exactly as prescribed for example, if you stop using your inhaler(s) because you believe that using an inhaler would break your fast or you use them at different times to the prescribed times, this can cause your symptoms to get worse. In fact, stopping your medicines can cause your asthma symptoms to return and increase your risk of a life-threatening asthma attack. Speak to your GP or asthma nurse before you stop taking your medicines.
If you are not allowed to drink liquids during your fast, be aware that dehydration can dry the airways and may make your asthma worse. This could be particularly true if your asthma is triggered by exercise.
In Ramadan fasting is the complete abstinence from food and drink between dawn and dusk. All those who are ill or frail, pregnant or menstruating women, breastfeeding mothers and travellers don't need to fast during Ramadan.
Although Islamic rules state that people with long-term conditions such as asthma are permitted not to fast, some Muslims with asthma still choose to fast during Ramadan and many may consider using an inhaler to be breaking their fast.
Many religious leaders agree that if you have a long-term health condition such as asthma, you should carry on taking your medicine when you're fasting. Also, its generally agreed by many religious leaders that asthma medicines taken in inhaler form do not break a fast because the medicine is inhaled directly into the lungs. Very little medicine is absorbed into the stomach.
However, the decision to fast is up to you. You can speak to your Imam for advice about whether or not to use your asthma medicine when you fast.
You should discuss your plans for fasting with your doctor or asthma nurse before making any decisions to change the way you take your asthma medicines. Don't stop taking your asthma medicine without speaking to your doctor first.
Your GP or asthma nurse can tell you whether or not its possible to adjust your medicine to suit your plans during the period you fast for example, to change your prescription to a long-acting preventer medicine, or to change the times when you take your medicines so you don't need to take them during daylight hours.
If you have adjusted your medicines for fasting and you begin to feel worse, please see your doctor or asthma nurse as soon as you can.
To help make sure your asthma is well managed while you fast, you should have a written asthma action plan which you fill out with your doctor or asthma nurse. This plan can include details of what to do when fasting, such as:
- when and how much of your asthma medicine to take
- how to know when your asthma is getting worse and what to do if it does
- what to do if you have an asthma attack
- If you're not taking your asthma medicines or you have adjusted your medicines during your fast and you notice that your asthma symptoms are getting worse seek medical help straight away.
- Even if you don't plan to use your inhalers during the fasting period, always carry your reliever inhaler (usually blue) with you at all times in case of an emergency. If you do have an asthma attack it could save your life. Most religious leaders agree that using an inhaler does not break your fast.
- If you're due an annual asthma review when you're fasting, don't just skip it. Book one before you fast (or if this is not possible, soon after you stop fasting) so that your GP or asthma nurse can see how you're doing.
- Speak to your religious leader (e.g. Imam, Priest, Rabbi, therapist etc) for advice - if you choose not to use your inhalers in daylight hours it may be okay to take your preventer inhaler before sunrise and after sunset.
Mohammed Zubair Butt, Islamic scholar from Muslim Council of Britain, says:
"Oral inhalers will invalidate your fast because the medicine reaches the throat [cavity of consequence] (and possibly further down the digestive tract) via the mouth [orifice of consequence]. In addition nebulisers also invalidate your fast because the mist inhaled is a mixture of gas and liquid particles in the form of small aerosol droplets which reach the throat [cavity of consequence] via the mouth [orifice of consequence]. Those wishing to fast during Ramadan should consult their GP as to whether it is safe for them to do so or whether it is safe and reasonable to adjust their medicines in line with Asthma UK's advice. If it is not, the guidance is that you make such fasts up later if possible, such as in the smaller days of winter. Otherwise you should pay the appropriate compensation for each fast."
Rabbi Michael Laitner, assistant rabbi at Finchley United Synagogue and coordinator of United Synagogue 'Living Learning' department notes that:
"Yom Kippur, a day when we fast so we can focus on spiritual matters over physical ones, along with Tisha B'Av, when we fast to express sadness, are the principal fasts in the Jewish calendar. Fasting is not primarily about physical privation. If you have any health concerns related to fasting, such as taking medicine or if you are diabetic, asthmatic or pregnant, for example, you must consult with your doctor and a rabbi in advance of a fast for advice as to whether you are obligated to fast or not."
Sonia Munde, Head of Helpline at Asthma UK, offers the following advice for people with asthma who are fasting:
"If you're fasting speak to your religious leader or fast advisor for advice - if you choose not to use your preventer inhaler in daylight hours it is usually quite reasonable to alter the time of your medicines as long as you discuss it with your doctor. If you have adjusted your medicines for your fast and you begin to feel worse, please see your doctor or asthma nurse as soon as you can. Even then, it won't necessarily mean breaking your fast as long as you explain your needs to your doctor."
For more advice speak to:
- Your GP or asthma nurse at your local surgery
- An asthma nurse specialist on our Helpline: 0300 222 5800 (9am - 5pm, Monday to Friday)
- Your religious leader or fast advisor, eg, your Imam, Priest, Rabbi, therapist etc.
Last updated August 2016
Next review due August 2019