HMB Research
41 peer-reviewed studies · Evidence score: 8/10
Etiology and diagnosis of heavy menstrual bleeding among adolescent and adult patients: a systematic review and meta-analysis of the literature
Comishen KJ et al. • Journal of thrombosis and haemostasis : JTH (2025)
Many diagnoses were associated with bleeding disorders and, therefore, warrant investigation when assessing a patient with HMB of unknown etiology.
- The overall prevalence of bleeding disorders was 30% (95% CI, 14-46); von Willebrand disease, 8% (95% CI, 7-10); platelet function defect, 9% (95% CI, 7-12); abnormal thyroid, 3% (95% CI, 0-6); and polycystic ovarian syndrome, 8% (95% CI, 4-12).
- Subgroup analysis showed bleeding disorders were prevalent in 16% (95% CI, -8 to 41) of adults with HMB but in 39% (95% CI 18-60) of adolescents with HMB.
- Many diagnoses were associated with bleeding disorders and, therefore, warrant investigation when assessing a patient with HMB of unknown etiology.
Quality of Life, Anxiety and Depression in Women Treated with Hysteroscopic Endometrial Resection or Ablation for Heavy Menstrual Bleeding: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Vitale SG et al. • Medicina (Kaunas, Lithuania) (2022)
However, such findings need to be confirmed by additional trials due to the high number of outdated studies and recent improvements in hysteroscopic instrumentation and techniques.
- Relative to uterine balloon therapy, amenorrhea was more common with EA/GER (relative risk 1.51 [95% CI 1.03 to 1.20] I2 = 28%), but posttreatment satisfaction was similar.
- Anxiety, depression scores and complication rates were similar between treatments.
- Conclusions: Women's perception of QoL might be seen to be less improved after hysteroscopic ER/GEA rather than hysterectomy.
Impact of oral nutritional supplement composition on healing of different chronic wounds: A systematic review
Santo ACSDE et al. • Nutrition (Burbank, Los Angeles County, Calif.) (2024)
All rights reserved.
- Primary wound types included pressure injuries (58%), diabetic foot ulcers (40%), and venous ulcers (2%).
- Two other studies investigated a combination of arginine, glutamine, and β-hydroxy-β-methylbutyrate; however, they did not yield significant results, and one study favored a hyperproteic formula instead of a hyperproteic formula with arginine.
- This review provides evidence supporting the potential of oral nutritional supplementation to enhance the healing process of chronic wounds.
β-Hydroxy-β-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: a systematic review and meta-analysis
Bear DE et al. • The American journal of clinical nutrition (2019)
HMB, and supplements containing HMB, increased muscle mass and strength in a variety of clinical conditions, although the effect size was small.
- Effect sizes were small.
- No effect on bodyweight (SMD = 0.16; 95% CI: -0.08, 0.41; z = 1.34; P = 0.18; I2 = 67%) or any other outcome was found.
- HMB, and supplements containing HMB, increased muscle mass and strength in a variety of clinical conditions, although the effect size was small.
The effects of β-hydroxy-β-methylbutyrate supplementation in patients with sarcopenia: A systematic review and meta-analysis
Gu WT et al. • Maturitas (2025)
Overall, although limited and requiring interpretation with utmost caution, current evidence indicates that HMB supplementation is beneficial for improving muscle mass and strength, but there is no evidence of a benefit on physical performance in patients with sarcopenia.
- For the overall risk of bias, no studies were graded as "high risk of bias", one (20.0 %) as "some concerns", and four (80.0 %) as "low risk of bias" according to the ROB 2.
- However, there was no evidence of a benefit on physical performance, assessed by gait speed (SMD = 0.19; 95 % CI: [-0.14, 0.53]; Z value = 1.14; P = 0.255).
- Overall, although limited and requiring interpretation with utmost caution, current evidence indicates that HMB supplementation is beneficial for improving muscle mass and strength, but there is no evidence of a benefit on physical performance in patients with sarcopenia.
Heavy menstrual bleeding and dysmenorrhea in adolescents: A systematic review of self-management strategies, quality of life, and unmet needs
Pouraliroudbaneh S et al. • International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2024)
HMB and DM have a large impact on daily living, with large areas of unmet need.
- Prevalence rates of HMB and DM were in the ranges 4%-63% and 42%-94%, respectively.
- Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea.
- Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%-65%).
Effects of HMB on Endurance Performance in a Healthy Population: A Systematic Review and Meta-Analysis
Fernández-Landa J et al. • Journal of strength and conditioning research (2024)
In conclusion, HMB (3 g·d -1 ) ingestion during 2-12 weeks significantly improves endurance performance and V̇O 2 max .Copyright © 2023 National Strength and Conditioning Association.
- The results displayed a significant improvement on endurance performance (pooled standardized mean difference [SMD] = 0.58 [0.28-0.87]) and V̇O 2 max (pooled SMD = 0.58 [0.21-0.95]) after HMB ingestion.
- Moreover, after the exclusion of the studies not evenly distributed around the base of the funnel plot, the results continued to be significantly positive in endurance performance (pooled SMD = 0.38 [0.22-0.53]) and V̇O 2 max (pooled SMD = 0.25 [0.09-0.42]).
- In conclusion, HMB (3 g·d -1 ) ingestion during 2-12 weeks significantly improves endurance performance and V̇O 2 max .Copyright © 2023 National Strength and Conditioning Association.
Nutritional interventions for treating foot ulcers in people with diabetes
Moore ZE et al. • The Cochrane database of systematic reviews (2020)
Evidence for the impact of nutritional interventions on the healing of foot ulcers in people with diabetes compared with no nutritional supplementation, or compared with a different dose of nutritional supplementation, remains uncertain, with eight studies showing no clear benefit or harm.
- It is also uncertain whether arginine, glutamine and β-hydroxy-β-methylbutyrate supplement increases the proportion of ulcers healed at 16 weeks compared with placebo (RR 1.09, 95% CI 0.85 to 1.40).
- It is uncertain whether oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements, reduces the number of deaths (RR 0.96, 95% CI 0.06 to 14.60) or amputations (RR 4.82, 95% CI 0.24 to 95.88) more than placebo.
- It is uncertain whether arginine, glutamine and β-hydroxy-β-methylbutyrate supplement increases health-related quality of life at 16 weeks more than placebo (MD -0.03, 95% CI -0.09 to 0.03).
Do "testosterone boosters" really increase serum total testosterone? A systematic review
Morgado A et al. • International journal of impotence research (2024)
The Author(s), under exclusive licence to Springer Nature Limited.
- Testosterone boosters are heavily marketed on social media and marketplaces to men with claims to significantly increase testosterone.
- Our findings indicate that most fail to increase total testosterone.
- The exceptions were β-hydroxy β-methylbutyrate and betaine, which can be considered effective for male athletes.
Ergogenic Benefits of β-Hydroxy-β-Methyl Butyrate (HMB) Supplementation on Body Composition and Muscle Strength: An Umbrella Review of Meta-Analyses
Bideshki MV et al. • Journal of cachexia, sarcopenia and muscle (2025)
HMB supplementation may benefit individuals experiencing muscular atrophy due to physiological conditions, particularly enhancing muscle mass and strength without significant changes in fat mass or body weight.
- HMB supplementation significantly increased muscle mass (ES: 0.21; 95% CI: 0.06-0.35; p = 0.004), muscle strength index (ES: 0.27; 95% CI: 0.19-0.35; p < 0.001) and FFM (ES: 0.22; 95% CI: 0.11-0.34; p < 0.001).
- No significant changes were observed in FM (ES: 0.03; 95% CI: -0.04 to 0.35; p = 0.09) or body mass (ES: 0.09; 95% CI: -0.06 to 0.24; p = 0.22).
- HMB supplementation may benefit individuals experiencing muscular atrophy due to physiological conditions, particularly enhancing muscle mass and strength without significant changes in fat mass or body weight.
Evidence-Based Supplementation Strategies for Wrestlers: A Systematic Review
Coutiño Díaz M et al. • Current nutrition reports (2025)
Overall, individual studies show some promise for several dietary supplements to alter body mass and body composition, improve exercise recovery and performance, delay fatigue, and modify serum biomarkers; nevertheless, effect sizes were often small, and results were often mixed.
- Overall, individual studies show some promise for several dietary supplements to alter body mass and body composition, improve exercise recovery and performance, delay fatigue, and modify serum biomarkers; nevertheless, effect sizes were often small, and results were often mixed.
- Published in Current nutrition reports (2025)
- Further research warranted to confirm findings
Genome-wide meta-analysis of heavy menstrual bleeding reveals 36 risk loci
Thibord F et al. • Blood (2025)
Overall, we identified 33 novel genetic loci associated with HMB, thereby significantly improving our understanding of the genetic etiology of this condition, which may provide new targets for the development of therapeutic strategies.
- Overall, we identified 33 novel genetic loci associated with HMB, thereby significantly improving our understanding of the genetic etiology of this condition, which may provide new targets for the development of therapeutic strategies.
- These genetic analyses identified 36 signals (33 novel) that were significantly associated with HMB, and gene prioritization techniques (eg, transcriptome-wide association studies, polygenic priority score) subsequently revealed likely causal genes.
- We also observed strong and significant genetic correlations with disorders of the female genital tract, including uterine fibroids, endometriosis, or ovarian cysts.
Does HMB Enhance Body Composition in Athletes? A Systematic Review and Meta-analysis
Holland BM et al. • Journal of strength and conditioning research (2022)
It is also important to consider the dosage of HMB and training parameters of athletes because these will likely influence the efficacy of supplementation.Copyright © 2019 National Strength and Conditioning Association.
- The principal finding of this analysis suggests HMB may have a small, positive impact on FFM in athletes (0.30 ± 0.13; 95% confidence interval [CI]: -0.07 to 0.68; p = 0.08), although this seems specific to when protein intake is suboptimal (<1.6 g·kg-1·d-1).
- Consistent with previous research on athletes, HMB demonstrated no significant effect on BM (-0.02 ± 0.04; 95% CI: -0.14 to 0.10; p = 0.70) and a small, nonsignificant effect on FM (-0.33 ± 0.23; 95% CI: -0.96 to 0.31; p = 0.22).
- More research is required to establish HMB's influence on FFM in athletes.
Dietary Supplementation on Physical Performance and Recovery in Active-Duty Military Personnel: A Systematic Review of Randomized and Quasi-Experimental Controlled Trials
Harlow J et al. • Nutrients (2024)
Nutrition supplementation may have small benefits on muscle performance and recovery in warfighters.
- Nutrition supplementation may have small benefits on muscle performance and recovery in warfighters.
- However, there are significant limitations in interpretation due to the largely inconsistent evidence of ingredients and comparable outcomes.
- Thus, there is inadequate practical evidence to suggest how dietary supplementation may affect field performance.
Supplementation with the Leucine Metabolite β-hydroxy-β-methylbutyrate (HMB) does not Improve Resistance Exercise-Induced Changes in Body Composition or Strength in Young Subjects: A Systematic Review and Meta-Analysis
Jakubowski JS et al. • Nutrients (2020)
Our findings do not support the use of HMB aiming at improvement of body composition or strength with RET.
- A significant effect was found on TBM.
- However, there were no significant effects for FFM, FM, or strength outcomes.
- We conclude that HMB produces a small effect on TBM gain, but this effect does not translate into significantly greater increases in FFM, strength or decreases in FM during periods of RET.
Health Benefits of β-Hydroxy-β-Methylbutyrate (HMB) Supplementation in Addition to Physical Exercise in Older Adults: A Systematic Review with Meta-Analysis
Courel-Ibáñez J et al. • Nutrients (2019)
Specifically, interventions in older adults aged 80 years or older, with cognitive impairment, frailty, or limited mobility are required.
- Results showed that HMB supplementation in addition to physical exercise has no or fairly low impact in improving body composition, muscle strength, or physical performance in adults aged 50 to 80 years, compared to exercise alone.
- There is a gap of knowledge on the beneficial effects of HMB combined with exercise to preserve cognitive functions in aging and age-related neurodegenerative diseases.
- Future RCTs are needed to refine treatment choices combining HMB and exercises for older people in particular populations, ages, and health status.
Nutritional interventions for exercise-induced muscle damage: an umbrella review of systematic reviews and meta-analyses of randomized trials
Talebi S et al. • Nutrition reviews (2024)
Supplementation with HMB, l-carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes.
- Supplementation with HMB, l-carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes.
- Published in Nutrition reviews (2024)
- Further research warranted to confirm findings
The Prevalence of Menstrual Cycle Disorders and Menstrual Cycle-Related Symptoms in Female Athletes: A Systematic Literature Review
Taim BC et al. • Sports medicine (Auckland, N.Z.) (2023)
Most studies (76.7%) in this review were graded as moderate quality.
- Based on pooled data, dysmenorrhoea (32.3%; range 7.8-85.6%) was the most prevalent MC disorder.
- MC disorders and MC-related symptoms were retrospectively assessed using self-report methods in 90.0% of studies.
- Most studies (76.7%) in this review were graded as moderate quality.
Prophylactic and therapeutic strategies for intraoperative bleeding in women with von Willebrand disease and heavy menstrual bleeding: A systematic review
Eising HP et al. • Blood reviews (2023)
VWD women often seem to experience bleeding complications during hysterectomy and all women with VWD received preprocedural hemostatic agents during EA, indicating potential under- and overdosing of current prophylactic strategies.
- Prophylaxis (Desmopressin, clotting factor concentrates or tranexamic acid) to prevent bleeding was described in 100% (30/30) of EA procedures and in 4% (24/661) of hysterectomies.
- Bleeding complications despite prophylaxis were described in 13% (3/24) of hysterectomies vs 0% (0/30) in EA.
- VWD women often seem to experience bleeding complications during hysterectomy and all women with VWD received preprocedural hemostatic agents during EA, indicating potential under- and overdosing of current prophylactic strategies.
Effects of beta-hydroxy-beta-methylbutyrate supplementation on strength and body composition in trained and competitive athletes: A meta-analysis of randomized controlled trials
Sanchez-Martinez J et al. • Journal of Science and Medicine in Sport (2018)
HMB supplementation provided modest benefits for body composition but did not significantly enhance strength in trained athletes.
- Small improvements in fat-free mass in trained athletes
- No significant effect on maximal strength in already-trained populations
- Greater benefits observed in untrained vs trained populations