Empirical Validation of Lunar Timing for Hijama: A Cross-Sectional Study of Hemostatic and Immune Biomarkers from Yemen
Article Sidebar
Hijama,
Immune Function,
Lunar Chronobiology,
Prophetic Medicine
Main Article Content
Radfan Saleh Abdullah
Ibrahim Ahmed
Othman Mohammed
Akram Jamal
Fawaz Ahmed
Bushra Dahan
Alawy Adel
Tofaha Abdullah
Mother Saleh
Shadia Hamid
Naif Mohammed
Khawla Mohammed
Yaqoub Khalid
Sabran Nabil
Abdulmajeed Abdulkareem
Abdulkareem Mohammed Abdulkareem
Mohammed Ali
Abstract
Background: Prophetic Medicine (Al-Tibb al-Nabawi) recommends performing Hijama (wet cupping) on specific mid-lunar days (17th, 19th, and 21st of the Hijri month). This recommendation has lacked empirical validation until now.
Objectives: This study aims to empirically validate whether these lunar phases are associated with measurable variations in hemostatic and immunological parameters relevant to Hijama's therapeutic mechanisms.
Methods: 258 healthy persons between the ages of 18 and 50 participated in a cross-sectional study conducted in Yemen's Ad'Dla Governorate. Automated systems were used to analyse blood samples taken during the new moon (1st–5th Hijri days) and mid-lunar phase (17th–21st Hijri days) for full blood counts and coagulation profiles. Paired t-tests, two-way ANOVA, bootstrapping, and Bayesian analysis were used to assess the data.
Results: Significant improvements in hemostatic and immunological measures, such as higher platelet, monocyte, neutrophil, and eosinophil counts and a shorter clotting time, were linked to the mid-lunar phase (all p < 0.05). ANCOVA verified that these changes were independent of environmental influences (p-phase < 0.001; p-temp > 0.05), and all values stayed within normal clinical ranges.
Conclusion: This work supports a fundamental idea in prophetic medicine and the foundation of lunar chronotherapy by offering the first empirical proof that mid-Hijri lunar days are linked to enhanced hemostatic and immunological responses. To verify their clinical usefulness after Hijama, more randomised controlled trials are required.
Article Details
Copyright (c) 2026 Naif Ali, Radfan Saleh Abdullah, Ibrahim Ahmed, Othman Mohammed, Akram Jamal, Fawaz Ahmed, Bushra Dahan, Alawy Adel, Tofaha Abdullah, Mother Saleh, Shadia Hamid, Naif Mohammed, Khawla Mohammed, Yaqoub Khalid, Sabran Nabil, Abdulmajeed Abdulkareem, Abdulkareem Mohammed Abdulkareem, Mohammed Ali
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Aboushanab, T. S., & Alsanad, S. (2018). Cupping Therapy : An Overview from a Modern Medicine Perspective. Journal of Acupuncture and Meridian Studies, 11(3), 83–87. https://doi.org/10.1016/j.jams.2018.02.001
Ali, N. T., Abdullah, R. S., Ahmed, I., Mohammed, O., Jamal, A., Ahmed, F., Dahan, B., Adel, A., Abdullah, T., Saleh, M., Hamid, S., Mohammed, N., Mohammed, K., Khalid, Y., Nabil, S., & Abdualkareem, A. (2026). Lunar Synchronization of Hemostasis and Immunity Validates Prophetic Timing of Hijama Therapy : A Multicenter Study from Yemen. Journal of Taibah University Medical Sciences, 21(1), 33–40. https://doi.org/10.1016/j.jtumed.2025.12.004
Ali, W., Saba, Z., Hussain, S., Zahra, S., Irshad, M., Ramzan, M. S., Zakariya, B., Technology, I., Khan, R. Y., Sciences, H., & Ali, W. (2024). Revealing Melatonin’s Mysteries : Receptors, Signaling Pathways , and Therapeutics Applications. Thieme, 56(06). https://doi.org/10.1055/a-2226-3971
Alrawi, S. N., Khidir, A., Elnashar, M. S., Abdelrahim, H. A., Killawi, A. K., Hammoud, M. M., & Fetters, M. D. (2017). Traditional Arabic & Islamic Medicine: Validation and Empirical Assessment of A Conceptual Model in Qatar. BMC Complementary and Alternative Medicine, 17(157), 1–10. https://doi.org/10.1186/s12906-017-1639-x
Andreatta, G., & Tessmar-raible, K. (2020). The Still Dark Side of the Moon : Molecular Mechanisms of Lunar-Controlled Rhythms and Clocks. Journal of Molecular Biology, 432(12), 3525–3546. https://doi.org/10.1016/j.jmb.2020.03.009
Bernardi, F., & Mariani, G. (2021). Biochemical, Molecular and Clinical Aspects Of Coagulation Factor VII and its Role in Hemostasis and Thrombosis. Haematologica, 106(2). https://doi.org/10.3324/haematol.2020.248542
Boutin, J. A., Kennaway, D. J., & Jockers, R. (2023). Melatonin : Facts, Extrapolations and Clinical Trials. Biomolecules, 13(6), 1–26. https://doi.org/10.3390/biom13060943
Calvo, J. R., & Maldonado, M. D. (2024). Immunoregulatory Properties of Melatonin in the Humoral Immune System : A Narrative Review. Immunology Letters, 269(June), 106901. https://doi.org/10.1016/j.imlet.2024.106901
Enax-krumova, E. K., Baron, R., Treede, R., & Vollert, J. (2021). Contralateral Sensitisation is Not Specific for Complex Regional Pain Syndrome. Comment on Br J Anaesth 2021 ; 127 : e1 e 3. British Journal of Anaesthesia, 127(5), e173–e176. https://doi.org/10.1016/j.bja.2021.07.019
Häfker, N. S., Andreatta, G., Manzotti, A., Falciatore, A., Raible, F., & Tessmar-raible, K. (2023). Rhythms and Clocks in Marine Organisms. Annual Review OfMarine Science, 15, 509–538. https://doi.org/10.1146/annurev-marine-030422- 113038
He, F., Wu, X., Zhang, Q., Li, Y., Ye, Y., Li, P., Chen, S., Peng, Y., Hardeland, R., & Xia, Y. (2021). Bacteriostatic Potential of Melatonin: Therapeutic Standing and Mechanistic Insights. Frontiers in Immunology, 12(May), 1–15. https://doi.org/10.3389/fimmu.2021.683879
Helfrich-förster, C., & Wehr, T. A. (2026). Evolutionary and Physiological Arguments for the Existence of A Circalunar Clock in Humans. BMC Ecology and Evolution, 8(26), 55. https://doi.org/10.1186/s12862-026-02550-8
Hempen, C., & Hummelsberger, J. (2020). Traditionelle Chinesische Medizin (TCM) – vom Mythos zur Evidenz. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 63(April), 570–576. https://doi.org/10.1007/s00103-020-03132-9
Ibrahim, Z., Murphy, R. P., Cornelissen, G., Arya, R., & Goswami, N. (2026). Circadian Clock Regulation of Hemostasis: A Systematic Review of Molecular Pathways. Research and Practice in Thrombosis and Haemostasis, 10(4), 106642. https://doi.org/10.1016/j.rpth.2026.106642
Ii, W. H. W., Walton, J. C., Devries, A. C., & Nelson, R. J. (2020). Circadian Rhythm Disruption and Mental Health. Translational Psychiatry, 10(28). https://doi.org/10.1038/s41398-020-0694-0
Jackson, J. A., Stewart, A., & Cable, J. (2024). Lunar-Linked Biological Rhythms in the Immune System of Freshwater Three-Spined Stickleback. Discovery Immunology, 3(1). https://doi.org/10.1093/discim/kyae007
Kim, J. Y., Min, K., Paik, H. Y., & Lee, S. K. (2026). Sex Omission and Male Bias Are Still Widespread in Cell Experiments. American Journal of Physiology, 320(5). https://doi.org/10.1152/ajpcell.00358.2020
Kruschke, J. K., & Liddell, T. M. (2018). Bayesian Data Analysis for Newcomers. Psychon Bull Rev, 25, 155–177. https://doi.org/10.3758/s13423-017-1272-1
Kumar, G., Ph, D., Kumar, Y., Ph, D., Kumar, G., Ph, D., & Tahlan, A. K. (2023). Characterization of Uropathogenic E. Coli from Various Geographical Locations in India. Journal of Taibah University Medical Sciences, 18(6), 1527–1535. https://doi.org/10.1016/j.jtumed.2023.07.003
Laabdi, M., & Elbittioui, A. (2024). From Aslamat al-Macrifa to Al-Tak¯amul al-Macrif¯ı: A Study of the Shift from Islamization to Integration of Knowledge. Religions, 15(3). https://doi.org/10.3390/ rel15030342
Lansiaux, E., Jain, N., Chodnekar, S. Y., Siddiq, A., Ibrahim, M., Yèche, M., & Kantane, I. (2024). Understanding the Complexities of Space Anaemia in Extended Space Missions: Revelations from Microgravitational Odyssey. Frontiers in Psychology, 15(March), 1–6. https://doi.org/10.3389/fphys.2024.1321468
Lee, C. M., Kim, M., Kang, C. K., Choe, P. G., Kim, N. J., Bang, H., Cho, T., Shin, H. M., Kim, H.-R., Park, W. B., & Oh, M. (2023). Different Degree of Cytokinemia and T-Cell Activation According to Serum IL-6 Levels in Critical. Frontiers in Immunology, 14(April), 1–8. https://doi.org/10.3389/fimmu.2023.1110874
Lee, Y., Field, J. M., & Sehgal, A. (2021). Circadian Rhythms , Disease and Chronotherapy. Journal of Biological Rhythms, 36(6), 503–531. https://doi.org/10.1177/07487304211044301
Lévi, F. A., Okyar, A., Hadadi, E., Innominato, P. F., & Ballesta, A. (2024). Circadian Regulation of Drug Responses : Toward Sex-Specific and Personalized Chronotherapy. Annual Review OfPharmacology and Toxicology, 89–114. https://doi.org/10.1146/annurev-pharmtox-051920- 095416
Liu, Z., Liang, Q., Ren, Y., Guo, C., Ge, X., Wang, L., Cheng, Q., Luo, P., Zhang, Y., & Han, X. (2023). Immunosenescence: Molecular Mechanisms and Diseases. Signal Transduction and Targeted Therapy, 8(200). https://doi.org/10.1038/s41392-023-01451-2
Markus, R. P., Sousa, K. S., Cruz-machado, S. S., Fernandes, P. A., & Ferreira, Z. S. (2021). Possible Role of Pineal and Extra-Pineal Melatonin in Surveillance, Immunity, and First-Line Defense. International Journal of Molecular Sciences, 22(22). https://doi.org/10.3390/ijms222212143
Mogharbel, G. H., Badawi, A. S., Zaman, A. Y., Elmoniem, M. M. A., Abdel-Rahman, I. M., Alenazi, M. E., Shah, F. A., Aly, M. A., Imam, S. N., Alenazi, N. E., & Sayed, S. M. E. S. (2023). Therapeutic Benefits of Prophetic Medicine Remedies in Treating Hematological Diseases (A Review Article). American Journal of Blood Research, 13(4), 130–142. https://pmc.ncbi.nlm.nih.gov/articles/PMC10509466/
Moon, E., Partonen, T., Beaulieu, S., & Linnaranta, O. (2022). Melatonergic Agents in Fl Uence the Sleep-Wake and Circadian Rhythms in Healthy and Psychiatric Participants: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. American College of Neuropsychopharmacology, 47(January). https://doi.org/10.1038/s41386-022-01278-5
Okhota, S., Melnikov, I., Avtaeva, Y., Kozlov, S., & Gabbasov, Z. (2020). Shear Stress-Induced Activation of von Willebrand Factor and Cardiovascular Pathology. International Journal of Molecular Sciences, 21(20). https://doi.org/10.3390/ijms21207804
Padmaningtyas, D. A., Ammalia, S. A., & Lukman, S. (2024). Cupping and Female Reproductive Problems : A Narrative Review. International Journal of Islamic and Complementary Medicine, 5(2), 136–148. https://doi.org/10.55116/IJICM.V5I2.89
Park, S., & Park, J. K. (2024). Back to Basics: the Coagulation Pathway. Blood Research, 59(35). https://doi.org/10.1007/s44313-024-00040-8
Rana, S., Prabhu, S. D., & Young, M. E. (2020). Chronobiological Influence Over Cardiovascular Function The Good, the Bad, and the Ugly. Circulation Research, 126(2), 258–279. https://doi.org/10.1161/CIRCRESAHA.119.313349
Rashid, N. (2024). Prophetic Medicine (Twibb Nabbawi) Principles in Clinical Practice: Experiences from Uganda. International Journal of Human and Health Sciences, 08(03), 241–248. https://doi.org/10.31344/ijhhs.v8i3.718
Reda, S., Morimont, L., & Rühl, H. (2020). Can We Measure the Individual Prothrombotic or Prohemorrhagic Tendency by Global Coagulation Tests? Hämostaseologie, 40(03), 364–378. https://doi.org/10.1055/a-1153-5824
Rudolph, J. E., Zhong, Y., Duggal, P., Mehta, S. H., & Lau, B. (2023). Defining Representativeness of Study Samples in Medical and Population Health Research. BMJ Medicine, 2(1). https://doi.org/10.1136/bmjmed-2022-000399
Swope, C. B., Rong, S., Campanella, C., Phillips, A. J. K., Cain, S. W., Mcglashan, E. M., Swope, C. B., Rong, S., & Campanella, C. (2023). Factors Associated with Variability in the Melatonin Suppression Response to Light : A Narrative Review. Chronobiology International, 40(4), 542–556. https://doi.org/10.1080/07420528.2023.2188091
Treml, B., Wallner, B., Blank, C., & Fries, D. (2022). The Influence of Environmental Hypoxia on Hemostasis — A Systematic Review. Frontiers in Cardiovascular Medicine, 9(February), 1–13. https://doi.org/10.3389/fcvm.2022.813550
Zambetta, R. M., & Signini, É. D. F. (2024). Effects of Weightlessness on the Cardiovascular System: A Systematic Review and Meta-Analysis. Frontiers in Physiology, 15(July). https://doi.org/10.3389/fphys.2024.1438089
Zhai, Y., Hui, Y., Jiang, Z., Ding, L., Cheng, J., Xing, T., Zhai, H., & Zhang, H. (2024). Efficacy and Safety of Wet Cupping in the Treatment of Neurodermatitis: A Systematic Review and Meta-Analysis. Frontiers in Medicine, 11(December). https://doi.org/10.3389/fmed.2024.1478073