A year ago, i was diagnosed with having migraines most likely due to hormonal changes.

I am prescribed 2 types of medication. One is longer acting and is taken daily to decrease the amount of headaches I have overall. The other medication is a very quick acting medication that is taken at the first signs of a "breakthrough" migraine. If I wait too long after the first signs, the medication becomes almost useless.

As for migraines during fasting, in this last year when I have fasted and these migraines have come on, I have powered through them all the way to Iftar, which I usually open with some tea, medication, and a date until I am able to eat.

My question is, I know that fasting when you are sick is impermissible. and I know that these migraines are a type of illness, but what I need to know is, how do I determine if I should break my fast due to the migraine or not?

I am in no way looking for a way out of offering my fasts as even though not fasting is permissible under certain circumstances, the Quran rightly says.."and that you fast is better for you if you know", so clearly the best outcome is to complete as many days of fasting as possible, in sha Allah.

You have to break your fast when you are sick and the pain becomes unbearable. If you know you will have pain or a doctor recommends you don’t fast you would be excused from fasting. However if the pain is bearable, you should try to fast and if it becomes too difficult You can break your fast. If you break the fast you would have to give the fidya, which is 3/4 if a kilo of food to the poor for each day (that is if you were not able to make it up within one year).

My advice is to practice the fast before the month of Ramadan. As in train your body to fast in rajab and Sha’baan. You have to try to wake up for suhur, have your tea or coffeee and maybe even take the pill. I know people who had this problem and they treat it this way by eating at suhur and starting the fast before the first day of Ramadan.