Therapeutic Ketosis for Heart Failure
Therapeutic Ketosis for Heart Failure By: Marc Lobliner, IFBB Pro A recent state‑of‑the‑art review published in the Journal of Cardiac Failure (Kodur et al., 2025) shows that failing hearts naturally increase ketone oxidation as a survival mechanism for energy production. Small clinical trials have demonstrated that supplementing with ketones like beta-hydroxybutyrate (BHB) can improve heart function in patients with heart failure. The review highlights promising results for exogenous ketones in boosting cardiac output, stroke volume, and ejection fraction—metrics directly tied to heart performance. Key Insights from the Review Failing hearts suffer from an energy crisis. Normally, the heart burns glucose and fatty acids. But in heart failure, those pathways become inefficient. As a result, the heart shifts toward burning ketones, which are a more efficient and clean fuel. The most accessible and impactful ketone for this purpose is beta-hydroxybutyrate (BHB). Studies now show that even in the most compromised hearts, infusions of BHB lead to immediate improvements in pumping capacity,