Aduh mak, this sounds really tough, anemia + mild asthma + GERD during puasa is memang a lot for your body to handle lah. A few of my mum friends yang pregnant and anemia during Ramadan also struggled similarly, some even decided tak puasa sebab doctor advised against it, especially kalau ada shortness of breath and vomiting involved. Since you're 18 weeks and dah rasa macam ni, better you check with your doctor or OB-GYN sebab pregnancy + puasa + these conditions memang kena balance carefully, dehydration, not eating enough, dapat trigger semua ni lagi teruk. Try discussing dengan dia if you should continue, atau maybe puasa yang boleh flexible lang (like just certain days or shorter fasting hours) yang won't risk you or baby. Jangan force yourself ye, health comes first!