.png)
Fasting during Ramadan is an important spiritual practice for millions of Muslims around the world. However, for individuals with long-term lung conditions such as pulmonary fibrosis, fasting may present unique health challenges, particularly in taking medication, hydration, and managing symptoms.
Researchers have recently looked at how Ramadan fasting affects people with lung diseases and shared helpful advice to healthcare professionals to support safe fasting. They looked at evidence from different studies to create guidance. Although there were no studies looking at the effects of fasting for people with pulmonary fibrosis, insights from research on other chronic lung diseases helped to guide appropriate clinical advice.
How does Ramadan fasting affect people with pulmonary fibrosis?
During Ramadan, Muslims fast from dawn to sunset, not eating food, drinking water, or taking oral medications. While fasting itself isn’t necessarily harmful, it can affect people living with pulmonary fibrosis in several ways:
- Medication timing – Many medications need to be taken at specific times, including antifibrotics (nintedanib and pirfenidone). It’s important to change when you take your medications to work with your fasting hours. Otherwise, the medication might not work properly.
- Hydration levels – Long hours without water can lead to dehydration. This can make mucus in the lungs thicker and breathing more difficult.
- Symptom control – Changes in routine, sleep patterns, and diet can sometimes make your symptoms worse.
Can I fast?
Healthcare professionals play a crucial role in guiding people living with pulmonary fibrosis on whether fasting is appropriate. A pre-Ramadan consultation should include a comprehensive risk assessment.
It’s important to speak to your healthcare team before deciding to fast. There may be different recommendations based on your health:
- If you have mild or stable disease with no recent exacerbations, and your symptoms are well controlled, you may be able to fast.
- If you take antifibrotic medication or immunomodulatory therapy that cannot be adjusted to fit in with the fasting schedule, or you take other certain medication, you may be considered high risk and advised not to fast.
- If you have severe disease and need an increase in how often you eat or drink, you may be considered high risk for fasting and it may not be advisable.
- If you have a lot of severe symptoms, your lung function is very low, you have oxygen therapy or you have had a recent exacerbation in the last 3 months, you may be considered very high risk for fasting.
Your healthcare team will consider this when guiding you about the safety of fasting.
If you cannot fast for Ramadan, you can still observe this holy month in other ways. There are other ways to participate in Ramadan.
Expert Recommendations for a Healthy Ramadan
The study provided practical advice for people with lung conditions who are able to fast:
- Talk to your healthcare team before Ramadan – A healthcare provider can assess your condition, adjust medications if needed, and help decide if fasting is safe for you.
- Follow your prescribed treatment plan – If fasting is safe for you, your doctor may recommend a change to your treatment or medication timing
- Stay hydrated during non-fasting hours – Drink plenty of water between iftar (sunset meal) and suhoor (pre-dawn meal) to prevent dehydration.
- Try to eat a balanced diet – Avoid salty, fried, and sugary foods that can cause dehydration. Eating well during non-fasting hours helps you to maintain a healthy weight, gives you the energy you need and keeps the immune system working.
- Monitor your symptoms closely – If your symptoms get worse, contact your healthcare team, as you may be advised to stop fasting to keep you safe.
- Review your Ramadan experience – If you have fasted, it is important to review how things went with your healthcare team, and share your experience. This will help to identify any challenges that may be supported in subsequent years, and also help doctors to be able to support other people who wish to fast during Ramadhan.
Fasting during Ramadan is a deeply significant spiritual practice for millions of Muslims, but for individuals with pulmonary fibrosis, it can present unique challenges. Through our systematic review and consensus recommendations, we aimed to provide clear, expert-driven guidance to support healthcare professionals in advising patients on fasting while prioritising their health.
While research specifically on pulmonary fibrosis and fasting remains limited, our recommendations emphasise the importance of individualised pre-Ramadan consultations, comprehensive risk assessments - including previous fasting experiences, symptom burden and disease severity - and tailored patient education, along with medication adjustments where possible.
We hope this works equips healthcare professionals to guide their patients safely and confidently through Ramadan.
Dr Fasihul Khan - Consultant Respiratory Physician, University Hospitals of Leicester NHS Trust, and Lead Researcher on the project
For people who are unable to fast due to health risks, alternate ways to observe Ramadan include:
- Charitable giving (Fidya) – providing meals for those in need as an alternative to fasting.
- Increased worship and reflection – engaging in prayer, recitation of the Quran, and spiritual activities.
- Community involvement – supporting local initiatives and spending time with family and friends in meaningful ways.
With proper planning and medical supervision, many people with pulmonary fibrosis can navigate Ramadan safely. Healthcare professionals play a vital role in providing safe guidance, ensuring there is a balance of religious observance with health needs. By working together and making small changes, it’s possible for people with pulmonary fibrosis to balance health needs with the religious observance, when it’s safe for you to do so.
Future research is needed to understand the impact of pulmonary fibrosis and refine clinical recommendations.
Further Information
Muslim Council of Britain: 2025 Ramadan guide
British Nutrition Foundation: A healthy Ramadan
The Action for Pulmonary Fibrosis support line is open 9am-5pm Monday to Friday throughout Ramadan if you need advice or support.
Ramadan Mubarak!
This article is for general information only. Ask your healthcare team what to do if your symptoms get worse and always follow their advice. Information provided by Action for Pulmonary Fibrosis (APF) is not a substitute for professional medical advice. It’s intended as general information only. APF is not responsible for any errors or omissions or for any loss or damage suffered by users resulting from the information published on actionpf.org.