Researchers reviewed what we know about how fasting during Ramadan affects the liver. Ramadan fasting is different from other types of fasting because people don’t eat or drink for long periods during daylight hours. Since the liver is super important for how your body uses energy and fights inflammation, scientists wanted to understand if this type of fasting helps or hurts liver health. This review looked at studies about how Ramadan fasting affects liver function, especially for people with liver disease. The findings could help doctors give better advice to people with liver problems who want to fast during Ramadan.

The Quick Take

  • What they studied: How fasting during Ramadan (not eating or drinking from sunrise to sunset) affects liver health and function, especially in people with liver disease
  • Who participated: This was a review of existing research, not a new study with participants. Scientists looked at many previous studies about Ramadan fasting and liver health
  • Key finding: Ramadan fasting appears to affect the liver in complex ways—it may help reduce fat buildup in the liver and improve how the body handles sugar, but it also creates stress on the liver through changes in eating patterns and body rhythms
  • What it means for you: If you have liver disease and want to fast during Ramadan, talk to your doctor first. The effects depend on what type of liver disease you have and how healthy your liver is overall. One-size-fits-all advice doesn’t work here

The Research Details

This was a review article, which means scientists didn’t do a new experiment. Instead, they carefully read and summarized all the research that already exists about Ramadan fasting and liver health. They looked at studies about how fasting affects different parts of liver function, like how the liver handles sugar (insulin sensitivity), how cells clean themselves (autophagy), the bacteria in your gut, and inflammation in the body.

The researchers organized their findings by looking at different types of liver disease—from fatty liver disease (where fat builds up in liver cells) to more serious conditions like cirrhosis and liver cancer. They also looked at what happens to people who have had liver transplants and want to fast.

This type of review is valuable because it brings together information from many different studies to give a bigger picture of what we know and what we still need to learn.

The liver is like your body’s chemical factory. It processes everything you eat and drink, manages your energy, and helps fight inflammation. When you fast for long periods, your liver has to work differently. Ramadan fasting is special because it’s a dry fast (no food or water) for many hours, which is different from other types of fasting people study. Understanding how this specific type of fasting affects the liver is important because millions of people fast during Ramadan, and many of them have liver disease. Doctors need good information to help their patients make safe choices.

This is a review of existing research, not a brand-new study, so it’s only as good as the studies it reviewed. The strength of the findings depends on how many high-quality studies exist on this topic. Since this is a newer area of research, there may not be as many studies as scientists would like. The review was published in a respected medical journal, which is a good sign. However, because this summarizes other people’s work rather than doing new research, readers should know that the conclusions are based on what’s already been published, and more research is still needed.

What the Results Show

The review found that Ramadan fasting appears to affect the liver through several different pathways. First, it may help reduce the amount of fat stored in liver cells, which is good news for people with fatty liver disease. Second, fasting seems to improve how the body handles insulin and blood sugar, which could help prevent or manage diabetes-related liver problems.

However, the review also found that Ramadan fasting creates challenges for the liver. The long periods without food and water, combined with eating larger meals at night, put stress on the liver’s normal rhythms. This stress can trigger inflammation in some people, which isn’t helpful for liver health.

The review highlighted that the effects aren’t the same for everyone. People with mild liver disease might handle the fasting better than people with advanced liver disease like cirrhosis. The bacteria in your gut also seem to change during Ramadan fasting, and these changes might affect liver health in ways scientists are still trying to understand.

For people who have had liver transplants, the review suggests that fasting during Ramadan requires extra caution and medical supervision, since their livers are already dealing with the stress of being a transplanted organ.

The review found that Ramadan fasting may activate a cellular cleaning process called autophagy, where cells break down and recycle damaged parts. This could be beneficial for liver health. The fasting also appears to affect which genes are turned on or off in liver cells, which could explain some of the health effects people experience.

The review noted that the timing of meals matters a lot. When people eat large meals late at night after fasting all day, it creates a different metabolic situation than eating regular meals throughout the day. This unusual eating pattern seems to have both positive and negative effects on the liver.

This review brings together information about a specific type of fasting (Ramadan fasting) that hasn’t been studied as much as other types of intermittent fasting. Most research on intermittent fasting has looked at people who skip meals or eat during limited time windows, but Ramadan fasting is unique because it’s a dry fast with no food or water for extended periods. The review shows that Ramadan fasting might have different effects on the liver than other fasting methods because of how extreme and prolonged it is. This review fills an important gap because previous research didn’t focus specifically on how this type of fasting affects people with liver disease.

This review has several important limitations. First, it’s based on existing research, and there may not be enough high-quality studies specifically about Ramadan fasting and liver disease. Second, most studies on fasting and liver health have been done in animals or in short-term human studies, so we don’t know as much about long-term effects. Third, people’s responses to fasting vary a lot based on their genetics, overall health, diet, and other factors, so findings from one group might not apply to everyone. Fourth, the review couldn’t compare Ramadan fasting directly to other types of fasting in a controlled way because the studies weren’t designed that way. Finally, most research has been done in certain regions, so the findings might not apply equally to all populations.

The Bottom Line

If you have liver disease and want to fast during Ramadan, consult your doctor before starting (confidence: high). Your doctor can assess your specific liver condition and help you decide if fasting is safe for you. If you do fast, your doctor may recommend monitoring your liver function with blood tests (confidence: high). Staying well-hydrated during non-fasting hours and eating balanced meals when you break your fast are important (confidence: moderate). People with advanced liver disease like cirrhosis or liver cancer should be especially cautious and get medical guidance (confidence: high). If you’ve had a liver transplant, medical supervision during fasting is essential (confidence: high).

This research matters most for people who have liver disease and observe Ramadan fasting. It’s also relevant for doctors who care for Muslim patients with liver conditions. People with fatty liver disease, hepatitis, cirrhosis, or liver cancer should pay special attention. People who have had liver transplants should definitely talk to their transplant team. Healthy people without liver disease can likely fast safely during Ramadan, but this review doesn’t specifically address them. People considering intermittent fasting for weight loss or health reasons might find this information useful, but they should know this review focuses on Ramadan fasting specifically.

If fasting affects your liver, you might notice changes in how you feel within days or weeks—like changes in energy levels or digestion. However, real changes in liver function take longer to develop. If your liver is improving from fasting, blood tests might show changes within a few weeks to a few months. If fasting is causing problems, those might also take weeks to months to show up in blood tests. This is why doctors recommend getting liver function tests before and after Ramadan if you have liver disease. Don’t expect dramatic changes overnight, and remember that one month of fasting is just one factor affecting your liver health.

Want to Apply This Research?

  • Track daily energy levels (1-10 scale), any digestive symptoms, and meal composition during fasting and non-fasting periods. If you have liver disease, log any changes in appetite, nausea, or abdominal discomfort. Record the timing and size of meals when you break your fast.
  • If fasting, use the app to plan balanced meals for when you break your fast—include protein, healthy fats, and vegetables rather than heavy, fried foods. Set reminders to drink plenty of water and electrolyte-containing beverages during non-fasting hours. If you have liver disease, use the app to track appointment reminders for liver function blood tests before and after fasting periods.
  • Set up monthly check-ins to review energy levels and digestive health trends. If you have liver disease, create alerts for scheduled doctor visits and blood work. Track any changes in symptoms over the fasting month and compare to previous months. Use the app to maintain a record of conversations with your doctor about fasting safety for future reference.

This review summarizes research about how Ramadan fasting may affect liver health, but it is not medical advice. If you have liver disease of any kind—including fatty liver disease, hepatitis, cirrhosis, or liver cancer—you must talk to your doctor before fasting during Ramadan or making any changes to your eating patterns. If you have had a liver transplant, consult your transplant team before fasting. The effects of fasting on liver health vary greatly from person to person based on the type and severity of liver disease, overall health, medications, and other factors. This information is for educational purposes only and should not replace professional medical advice. Always seek guidance from a qualified healthcare provider who knows your medical history before making decisions about fasting.