Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Beta Hydroxybutyrate (BHB), a primary ketone body produced during states of fasting or ketogenic diets, has some scientific basis for use in supporting or treating wasting (also known as cachexia or significant loss of muscle and fat). Wasting commonly accompanies chronic illnesses such as cancer, heart failure, and HIV/AIDS. Several animal studies and limited human research suggest that BHB can serve as an alternative energy substrate when glucose availability is compromised, potentially preserving muscle mass and improving energy status. BHB may also reduce muscle protein breakdown and inflammation, both factors involved in cachexia, through signaling pathways such as inhibition of NLRP3 inflammasome and reduction of oxidative stress.

However, the clinical evidence in humans remains limited, with most studies focusing on safety, metabolism, or surrogate markers like muscle protein synthesis, rather than direct clinical endpoints such as reversal or significant slowing of wasting. Some small trials have explored exogenous ketone supplementation in cancer or elderly populations, showing modest benefits in energy status, but robust, long-term, and large-scale clinical trials are lacking. Thus, while there is a plausible scientific rationale and some preliminary supporting data, the evidence is not strong or comprehensive enough to recommend BHB as a standard treatment for wasting at this time.

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