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The Physiology of Ramadan Fasting
Disclaimer: I am not suggesting that anyone impulsively abstain from Ramadan fasting because of the information in the following text.Since Ramadan is an obligation in our religion,any such decision needs to be made in consultation with a judicious Muslim physician who understands well both the benefits and the risks of this noble practice.
Asalamu aleykum, brothers and sisters,aunties and uncles lol.I have spent a long time thinking about why Ramadan can be so difficult at times for many individuals.It didn’t make sense to me that Allah would ordain such an ordeal as part of our religious obligations.So I began investigating.The good new is that I believe I am finally getting to an understanding of what is really happening here-even if I am not sure how to manage it.
Let me be very clear from the outset.The problem during Ramadan is not with hunger and thirst as some of the original texts- Quranic and hadith- would imply.Most people can deal quite easily with hunger and thirst and this preoccupation often more or less disappears within the first couple of days if not the first hours of the fast.So, that is not the issue.The issue is much more with symptoms like headaches and nausea and incapacitating fatigue and difficulty concentrating .Those are the issues that can prevent people from functioning during Ramadan and make them feel that it is more like an illness than the process of abstinence- which it is supposed to be.
So what is happening here? Well,when I first started examining the issue ,I looked into the two most obvious variables-dehydration, from not drinking,and hypoglycemia from not taking in calories,But neither added up.The studies I was able to find indicated that males could maintain their glycemic levels for 72 hours during continuous fasting and females for about 24 hours.No problem there.None of us are fasting continuously for that long! As to dehydration, it takes about two weeks to die from water deprivation! So being deprived for 12-17 hours should be no big deal.Those two variables-the most obvious ones-should not really be part of the problem.
Then there are the scientific types looking into this matter including two well-done studies about fasting in Saudi Arabia.(Plos One,2014;9(5):e96500 and PLos One 2017,12(4):e0174342).These studies investigate some of the standard physiological variables done in routine blood monitoring.Their findings are interesting and I will attempt to summarize here what they indicated.
1)Mean levels of GGT(one of the most sensitive liver enzyme tests) as well as total protein and albumin decreased during Ramadan.That is probably all good,indicating that the liver is under less stress because of the reduced eating
2) Morning leptin was increased and morning adiponectin was decreased.Both of these are hormones released from fat cells indicating changes probably due to the on and off eating patterns of Ramadan.Unfortunately both of these changes are indicative of insulin resistance,something at the root of problems with adult-onset diabetes,i.e. not good.
3)CRP levels and IL-1a( indicators of inflammation in the body) were lower(a good sign) but their diurnal variation was abolished(probably not good)
4)Blood glucose concentration remained within normal limits(as expected)
5) LDL(bad cholesterol)increased significantly(not good)
6) increased glucocorticoids,the stress hormone was increased(not good)
So what we see here is a mixed picture- some variables improving others worsening.The troubling, but not unexpected feature, however, that the studies indicate is that there is an increased incidence of cardiometabolic disorders and type -2 diabetes.Not unexpected as I have witnessed several crises of a medical and psychiatric nature as a doctor-from migraines to kidney stones to intractable depression.Each of these was manageable although sometimes the only way to manage them was to stop fasting-which we are permitted to do for medical reasons.
As I have said,none of this was surprising and none of it was troubling-at least to me.There may be a small but relatively predictable worsening of certain medical conditions during Ramadan.Some of them require sound medical advice.But overall,this increased risk is a small price to pay for obedience to our Lord and all the benefits pursuant to that.Let us remember that doing hajj also involves a low level of risk as does breaking our sleep cycle to pray tahhajjud.All well-worth the effort in terms of our relationship with our Creator.,no doubt.
As usual,whenever I consult with the official scientific publications,I still felt that my questions were not really answered and I remained unsatisfied.Then came the’tajalli’! the ‘ilham’! -the insight if you wish..The real problem is none of the above-mentioned! The real problem is that we are all toxic in the modern world-to various degrees.You see, the people at the time of the Prophetsaws and right up to early in the twentieth century had no mercury in their mouths from amalgam fillings.they had no lead in their system from lead pipes and additives to petroleum and lead in paints.They had no aluminum from vaccines and Teflon,non-stick cookware.They had no exposure to pesticides and herbicides and fungicides in their food.They were not surrounded by formaldehyde-(in glues and fillers) laden construction materials and on and on.But all of us in the modern world have these exposures.These substances are found in umbilical cord blood and breast milk.
So we are all toxic!And fasting becomes a detoxification process! And that is where most of the symptoms come from.
This may all sound discouraging at this point.And it is troubling.And it definitely has to be managed appropriately.But there is an upside to all of this.If Ramadan is really a detox program, there may well be benefits to it.I am hoping to test out this hypothesis in the next few years inshallah.If it turns out to be the case, I will have attained the Holy Grail of Islamic Medical Research lol-proving that Ramadan is beneficial to our health .Anyone interested in participating in this research is more than welcome to contact me.I,myself intend to do a pre- and post-Ramadan hair analysis for heavy metals to see if there are any changes to be found.I am also looking for a lab that can do Urinary Glyphosate(a marker for all pesticide exposures)in a cheap and simple way. To be continued…Salaams,Ibrahim
The Mueller Report-The Obsessive vs. the Psychopath
The Mueller Report is out today..Fascinating politics and gamesmanship! Two major points;1) As I stated in my original article”The Modern Institution as Obsessional Personality”(soon to be published in my new book) the Obsessional Personality(Mueller in this case) systematically gets it wrong! His obsessive preoccupation with details regularly leads him to” mistake the forest for the trees” and miss the big picture.Theory proved once again!
2) Trump owes us another book entitled: “The Psychopath’s Guide to Doing Wrong without Getting Criminally Prosecuted”. I’m sure it will be a big hit in the prisons and simultaneously in the Boardrooms of American Corporations including of course the Banks and Wall Street.Way to go,Donald.You are truly the incarnation of the American dream,for some, and the American nightmare for many others!
The Notre Dame Fire-An Alternative Reaction
After the terrible fire at the Notre Dame cathedral in Paris the chorus of voices in reaction came out in unison:”Oh mon Dieu(good start lol) C’est une tragédie.How are we going to rebuild?”and condolences and sympathies were offered from around the world.Politicians and journalists oblige,of course.
Let’s try another approach.What if the French instead said:”This is a sign from our Lord.What have we done wrong?” Maybe this is about our treatment of North Africans in our country.Maybe this is about how we are treating the refugees showing up at our shores from around the world and us not showing them enough compassion.Maybe God is not happy about us abandoning our own religion.Or maybe we should be putting more energy and value into being God-fearing instead of putting so much store in hedonism and pleasure-seeking? Wouldn’t that be amazing?! And isn’t that what we should be doing,not only the French but all of us?!
It is interesting to observe that individuals,often enough but by no means always ,do exactly that! It is called ‘tauba’ in our tradition(turning back to God, repentance).But nations seem to be incapable of such a gesture.Why is that? The individuals in the collective seem to be reinforcing the illusion and supporting the lie instead of the Truth(remember Nazi Germany and the Serbian massacres and the Burmese persecution of the Rohingya just to mention a few relatively recent events) .Collectivities appear to be even more perverse than individuals.So beware of the social influences around you.They are more likely to be corrupting than salutary.
All that being said,my sympathies go out to the French nation.They are so intelligent in their heedlessness lol Salaams,Ibrahim
What’s Wrong with Medicine?
One day, driving along in my car and listening to a documentary on CBC, I came across a professor from the University of Toronto talking about”What’s wrong with physics”. The thing I remember best is him stating that, according to his analysis,neither Albert Einstein nor Niels Bohr, arguably the greatest physicists of the last couple of centuries ,would have been admitted to the U.of Toronto post-graduate program in physics at his University! Wow! That says a lot, doesn’t it.
So it got me reflecting on the parallel question in my field:”What’s Wrong with Medicine?” As I watch some videos of Alternative medicine and see people like Dietrich Klinghart and Dale Breseden and think about the now deceased William Rea from the American Environmental medicine field,I am struck by how intelligent and creative and curious these people are.I have the same sense when I read about historical figures in psychiatry like Emil Kraepelin and Eugen Bleuler and figures in medicine like Galen and more recently William Osler.
However,this is not what I see with the vast majority of modern doctors even those in research.. At first,this may seem counter-intuitive.Aren’t these the smartest and the brightest from all our educational systems? Aren’t the ones who get into medical school often the top of their class-“la crème de la créme”?There are several important caveats to consider here.
First is the selection process.The medical schools are mostly screening for high-performance students on standardized testing.Even when they look at extra-curricular activities-like charitable work or even sports-these criteria are usually easy to manipulate and the ambitious parents of these students are often very savvy in how to manipulate the system.Do some work at the local homeless shelter or get involved in your local environmental issues or become a regular leader at the Scouts or Guides and you’re good to go! And everyone knows that.When you add into the mix,interviewers who are not particularly good observers themselves(may have been selected as well for those very same conformist qualities) you have” a perfect storm” of mediocrity.
Bottom line,what I am saying here is that medical students are being screened for mechanical intelligence(the kind that shows up on standardized testing,obedience(they always follow the rules-saw that when I was teaching them at McGill) and ultimately for conformity and ,mediocrity.At the end of the day,you don’t really have doctors-you have medical bureaucrats-people who are very good at memorizing facts whether they come from textbooks,conferences or the latest scientific journals and following algorithms but not good at all at listening to people or developing creative solutions to problems.
On top of this we have regulatory bodies like State Medical Boards who are uniformly pushing conformity in the name of science-something I call “Scientific Fascism”. Almost every doctor I know or have seen who is good at creative solutions has had a problem with these regulatory bodies and some have been harassed out of practice or pushed to nervous breakdowns and even death by these Orwellian governing bodies and the pharmaceutical and insurance companies who are subsidizing them-all in the name of science! But more accurately representing money and power more than knowledge and efficacy.
So next time you go to your doctor,don’t be surprised.Perhaps the best approach is to consider them like civil service functionnaries. Get what you can from the real knowledge and technology they have and figure out how to manage your health on your own.Salaams,Ibrahim
The Cause of Most Modern Woes-The European Intellect!
As I am rereading parts of Sigmund Freud ‘s “The Interpretation of Dreams” for the next book on Dream Interpretation,I realize how convoluted the Germanic mind is.And Freud is by no means the worst.If you want a more intense version, you can try Schopenhauer and Kant and Hegel! Then there are the French and their love of ideas and abstractions(“Je pense, donc je suis”). Yes ,the same ones who claimed they could cure schizophrenia by analyzing the delusions and thus chased me away from psychiatry on my first time around.! And the British with their obsessional style of accumulating facts and details and developing classifications and taxonomies.(It’s called Empiricism and it haunts us every day whether we realize it or not!)
Let’s not forget their ancient predecessors, the Greeks, who we were taught to idealize in Elementary school! Remember-the Golden Age of Athens.!They developed all sorts of philosophical systems from which to think about reality without actually seeing it for what it is.
I realized, in doing my reading, that I have been gravitating more and more towards a totally different approach which involves the more simple thinking of the Semites(Judaism and Islam-no, not Christianity which is actually a Europeanized Semitic tradition) combined with the subtlety of the Farther East traditions of Vedanta,Buddhism and Taoism that help us subtelize our awareness of consciousness. With this combo I manage to find both right guidance,knowing the difference between right and wrong,and inner peace which comes through distancing oneself from the mind rather than embracing it.This combo protects us from the obfuscations of the European intellect and the angst that it necessarily generates. Long Live the East-Middle and Far!
Podcast – Sheikh-Murid Relationship
How Can They Possibly Get It Right?!
How can they possibly get it right?!(Directed to the majority of humanity lol)
1) They have no basirat (inner sight)
2) They have no trust in the real people of basirat
3) Their emotional reactions of attachment and aversion make it so that they cannot even properly register the facts that could allow them to perform a rational analysis and
4)no one has taught them the proper art of dream interpretation
How can they possibly get it right?! It would veritably be a miracle!
Salaams,Ibrahim
The New Sheikh
Asalamu aleykum,brothers and sisters.In the early 2000’s I met with one of the great Shuyukh of Islam – Sheikh Mahshur al Haddad r.a.- the sheikh of Sheikh Omar Ibn Hafiz and Sheikh Ali Jeffri ,in Jeddah shortly before his passing.
Although in a weakened state ,he managed to tell us, through his interpreter, that the days of tariqat, as we knew it, were over as people were no longer able to bear the rigour of the sheikh/murid relationship
At the time,I believed he was only referring to his own tariqat, but over the years I have been able to see the general applicability of his statement!
We are no longer in the era of the Insan al Kamil( the perfect man) and the murid with total surrender and perfect adab( if ever that actually existed in reality!).The new sheikh has to be ready to “mix it up”. He has to be ready to be challenged and to be able to assert what is True and to step back if he is in error.And he has to have some understanding of the psychological dynamics in any relationship- including his relationship with his students! Welcome.to the modern world! We should not lament the changes but rather should embrace them.There is something salutary in all of this as there was something problematic in the previous formalism that existed.Long live the Truth.
Salaams,Ibrahim