Brief Answer:
No, there is no dangerous effects on your health if you keep fasting.

Detailed Answer:
Wa-alaikum-assalaam Wa-Rahmatullahi-wa-Barakatuhu-Wa-Maghfirat Uhu.

RAMADAN KAREEM!

Dr. Hanif warmly Welcomes you Mr. XXXX!

Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can realize your health worries. Being your physician, I will take care all of your medical concerns according to the latest guidelines in the field of medicine.

I really appreciate your patience for so long fasting (2:04 to 21:56) and your devotion towards guidance of Allah-Subhan-Allah-Taala. May He bestow His countless blessings upon you and your family.

Now coming to your health issues one by one. There is a multidisciplinary approach when treating a patient with Vit. B.12 deficiency especially when he is on fasting too. Fasting itself has no effects on the status of the B.12 deficiency. But as we are advancing in the month of Ramadan XXXXXXX water depletion in body and nerves goes on to its peak levels especially in last Ashra of Ramadan XXXXXXX

Our brain, nerves and muscles, all need a good supply of water and nutrients for them to work properly. When you fast, they start working suboptimally and sometimes we feel dizziness, a little weakness, and pounding sensations or sticking in peripheral parts of the body (like hands & feet) and head especially on the backside.

It is also due to the lack of glucose in circulation as the day advances. Muscles are selfish in that they don't share their stored glucose. Brain and nerves utilize only glucose for their proper function. That is why you feel all the symptoms during the day. But as soon as you take Iftar, Alhamdulillah you feel very better. It is not due solely to your taking the tablets, because tablets take hours to dissolve and become bioavailable for the body nerves and that effects takes even days or weeks to kick in and maintain the effect on nerves. After Iftar, your betterment is due to energy drinks and all that meal that goes in, bringing water and glucose levels to normal Mr. XXXXXXX That is the point, you feel revitalized and feel much better Alhamdulillah.

Now I want to come to Vit. B12 deficiency. At this young age it's alarming to me that you got deficient in it. Are you a true vegetarian? Because, Vit. B12 deficiency is usually due to a food deficient in enough B.12. Or if there is some problem with gastrointestinal tract for example stomach lining goes so thin, or some gastric surgery, or small intestinal disease, or due to pernicious anemia, or long term usage of acid reducing medications.

If there is long term B12 deficiency it may lead to a blood disorder called B.12 Deficiency anemia. Your physician may run a blood test on you to rule it out.

B12 is needed for making our blood cells and DNA. That's why deficiency of B12 may lead to some neurological symptoms. I want to clear your doubts on your symptoms which you are feeling. The most important symptom of B12 deficiency anemia is fatigue,weakness and tiredness. But this may also be due to lack of sleep.

Probably you don't have other symptoms of B12 deficiency anemia, like weight loss, sore tongue, constipation, diarrhea, nausea vomiting, abdominal bloating, rapid heart rate and fast breathing.

But Mr. XXXXXXX you have tingling/sticking sensations in hands and feet and they are one of the signs of peripheral neuropathy due to B12. deficiency.

Now I want to address your Pilonidal Sinus. It previously (in MAY) was 8 cm but now it is 6 cm. It means the wound is getting healed up and this is a good sign. Please take a very good care of the wound. Avoid direct contact with water when taking a shower that may stay inside it including the soap and shampoo. Apply surgical bandage to make the area water proof and remove bandage after the shower.

Consult a Surgeon on a regular basis for complete care of the wound and early healing. I want to assure you that fasting has no side effects on healing of the wound.

Now I want to discuss your attached report. It is totally normal. A little variation of systolic blood pressure and systolic vascular resistance, but that is insignificant and not a big clinical issue. But remember, if you have a family history of cardiovascular diseases and high blood pressure, then you are warned that someday you may end up in high blood pressure. What is the remedy? Increase your physical activity. 10,000 Steps on a healthy pace every second day is your goal. Your weight is pretty good, but it will be perfect if you take it at 75Kgs.

RECOMMENDED DIETS AND MEDICATIONS:-
Take Meat, milk, cheese, eggs, poultry, seafood. Keep taking B12 medications, and try to eat cereal in Sehri that is fortified with B12. After Ramadan it should be part of your breakfast. Do a heavy Sehri (breakfast) and light Iftar (dinner). Take Nature Made Digestive Probiotic Advanced capsules (1 pair daily).

Have a wonderful time ahead. Hope I answered all of your questions. Let me know if you have any further clinical concerns. I will be happy to get back to you shortly. If satisfied here, please give a five star rating and don't forget to close the discussion.

Regards!
DR. XXXXXXX HANIF
USA

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Brief Answer:
Keep taking a healthy diet, consult a surgeon for pilonidal sinus wound

Detailed Answer:
I appreciate your follow-up query and welcome you back Mr. XXXX!


You are doing really great that you are eating everything. A healthy diet is great for you. Don't overcook the food, and don't barbecue the meat or chicken. It destroys vitamins and micronutrients in food. Preferred way is to steam cook the food and don't use microwave Ovens too.

Pilonidal Sinus bleed has depleted Red blood cells in your body and you are already deficient of B12 vitamin. B12 as I said earlier is needed for Blood cells formation. All of this combined scenario makes more chances for B12 deficiency anemia.

That's why I suggested you to take care of the wound surgically. Please Consult a Surgeon on regular basis for the same.

After Iftar, your condition gets better due to nutritious meals you take plus the Vit B 12 medications and this is a really great deal of recovery. So it shows that Ramadan has no bad effects on your health and body. It's all temporary and reversible loss of fluids, nutrients and glucose which comes back after Iftar.

Whenever you consult your physician (your next In-clinic visit) please ask him to do your complete metabolic profile and also B12 levels to see the progress of treatment. It is because, if oral medications are not able to take B12 to normal limits, we need to put you on Injectable B12 which is more potent and effective way to treat. Also If someone has pernicious anemia, in that case too, we put patient on injectable B12 instead of the Oral medications.



Respected Mr. XXXXXXX Hope I answered all of your health concerns . If you have further questions, feel free to contact me anytime. Always write my name in start of your question in future, and I will get back to you in no time. If satisfied, please give a five Star rating and don't forget to Close the discussion.

Have a wonderful time ahead.
 

Best Regards!

DR. XXXXXXX M. HANIF

USA

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Brief Answer:
No Rush! You may do it when your doctor is back.

Detailed Answer:
Dr. Hanif warmly Welcomes you!

Thanks for a follow-up question Mr. XXXX!

Your compliments are my strength, to help the ailing humanity even with more devotion.

There is no hurry. Vitamin deficiencies take longer times to develope and same for recovery. Wait for your primary care physician and when he is back, you may go and consult him. Stay blessed and healthy.

Hope I answered all of your health concerns . If you have further questions, feel free to contact me anytime.

Mr. XXXX! In future too, always ask me a direct question as you did right now, for any health issues with you or any other family member, and I will get back to you in no time.

If satisfied, please give me a five Star rating and don't forget to Close this discussion.

Have a wonderful time ahead.
 

Best Regards!

DR. XXXXXXX M. HANIF

USA

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