The Influence of Ramadan Fasting on Endocrine Regulation and Metabolic Health: A Comprehensive Review

Ramadan fasting, a form of intermittent fasting practiced worldwide, has complex effects on endocrine regulation and metabolic health. This review synthesizes current literature on hormonal changes during Ramadan, including alterations in thyroid, adrenal, gonadal, and pancreatic hormones, along with their circadian and immune-related dynamics. It additionally examines metabolic outcomes such as lipid profile improvements, glycemic control in diabetic patients, and changes in body composition, highlighting hormonal contributions to appetite and satiety regulation. At the cellular level, fasting influences key signaling pathways, receptor regulation, oxidative stress responses, and gene expression, which collectively mediate endocrine adaptations. Clinical implications for endocrine disorder management during Ramadan are explored, emphasizing the importance of personalized approaches considering age, sex, autoimmunity, and comorbidities. The review identifies substantial knowledge gaps, particularly regarding long-term effects and vulnerable populations, underscoring the need for further research to optimize therapeutic strategies and health outcomes associated with Ramadan fasting.