Fasting and Arthritis

Fasting has a long history particularly for religious reasons and is common to all religions including Islam, Judaism, Buddhism, Hinduism, Christianity and the Mormon faith. Many people have also explored fasting for health benefits. In this page, we look at whether fasting may be helpful for those with arthritis.

People with chronic health conditions may be excused from fasting on religious grounds, however many will still want to participate completely or partially, and may have concerns that their medicines or their condition may be affected.

Ramadan

During Ramadan, even drinking water counts as breaking a fast, however medicines that need to be taken twice daily with food can safely be taken before sunrise and after dusk.

Use of arthritis medications during Ramadan:

Certain medications especially non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen or naproxen must be taken with food, to help prevent harmful effects on the stomach, so if this cannot be done, these medicines should be avoided or can be switched to a once or twice daily version that can be taken once the fast is broken.

Certain medications, for example antibiotics, usually need to be taken 3 times daily, however it is possible to switch to a different type that can be taken twice daily instead.

Disease-modifying medicines such as methotrexate are also usually taken with food to reduce the risk of nausea but as this is only taken once weekly this is not such a big issue.

Weekly medication for osteoporosis, for example alendronic acid, must be taken on an empty stomach with a glass of water with nothing to eat for 30 minutes afterwards, so timing of this dose may need to be adjusted according to fasting and eating hours.

Fasting for Health Benefits

Intermittent fasting may have some benefits for weight management, mood, sleep and even arthritis activity. Two of the most popular methods of intermittent fasting are:

• Fasting for health is becoming increasingly common as part of weight-control measures, for example the 5:2 diet popularised by Dr Michael Moseley.
• Intermittent fasting for 14 hours daily and limiting food intake to a 10-hour window is also becoming more popular and has been shown to improve mood, hunger and sleep, possibly by effects on the gut microbiome.

Is Fasting Beneficial for Arthritis?

Although a Cochrane review in 2009 did not show any benefits for intermittent fasting in rheumatoid arthritis, fasting is known to reduce inflammatory markers and a more recent review has shown a possible short-term benefit on the symptoms of rheumatoid arthritis. Intermittent fasting may even improve disease activity in psoriatic arthritis.

Studies have shown that arthritis symptoms, for people with stable rheumatoid arthritis, does not increase during prolonged fasting and that fasting is safe.

Tips for fasting safely

• If you have any concerns about fasting and your medical condition or medication and side effects related to fasting, you should speak to your GP or pharmacist.
• During periods of fasting, it is sensible to avoid dehydration and drink plenty of water if possible, and to avoid too much strenuous exercise, especially in the heat, however gentle exercise is fine.
• Certain medications that need to be taken with food can become more, or less effective during fasting and side effects may happen if medicines are not taken with food, so it is important to be careful with medication during prolonged fasts.
• Blood pressure medications can cause a drop in blood pressure, often mid-morning and this can be more dramatic if water is also avoided.
• Whilst intermittent fasting is safe for the majority of people, people with certain health conditions especially diabetes should be very cautious as during fasting blood sugar levels will drop and staying hydrated is very important.