Hydroxymethyl Butyrate (HMB)


Hydroxymethyl butyrate (HMB) is a compound made by the body that breaks down amino acids. It has been used to improve athletic performance. HMB has also been used to lower blood pressure and cholesterol. It can be taken as a pill or powder.


There are no advised doses for hydroxymethyl butyrate.

What Research Shows

May Be Effective

  • Cancer support—may increase lean body mass when taken with arginine and glutamine by people who have advanced solid tumors; may prevent radiation dermatitis in people with head and neck cancer C1, C2
  • Diabetic foot ulcer—may improve healing when used with arginine and glutamine D1
  • Hip fractures—may improve muscle mass and function and prevent sarcopenia when taken with other supplements by older adults F1, F2
  • Muscle loss —may preserve muscle mass in older adults G1

May Not Be Effective

  • Lung cancer support—may not improve lean body mass when taken with arginine and glutamine by people who have advanced lung cancer C
  • Wound complications—may not be reduced when taken with arginine and glutamine by people having open surgery H1

Unlikely to Be Effective

Not Enough Data to Assess

  • Bronchiectasis B1
  • Hemodialysis support E1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

It is likely safe to take hydroxymethyl butyrate in small doses for a short time. Not enough studies have been done to say whether it is safe to use for a long period. It is also not known whether it is safe to take by women who are pregnant or breastfeeding.


Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.


A. Athletic Performance

A1. Sanchez-Martinez J, Santos-Lozano A, et al. Effects of beta-hydroxy-beta-methylbutyrate supplementation on strength and body composition in trained and competitive athletes: A meta-analysis of randomized controlled trials. J Sci Med Sport. 2018 Jul;21(7):727-735.

B. Bronchiectasis

B1. Olveira G, Olveira C, et al. Oral supplement enriched in HMB combined with pulmonary rehabilitation improves body composition and health related quality of life in patients with bronchiectasis (Prospective, Randomised Study). Clin Nutr. 2016 Oct;35(5):1015-1022.

C. Cancer Support

C1. Imai T, Matsuura K, et al. Effect of HMB/Arg/Gln on the prevention of radiation dermatitis in head and neck cancer patients treated with concurrent chemoradiotherapy. Jpn J Clin Oncol. 2014 May;44(5):422-427.

C2. Mochamat, Cuhls H, et al. A systematic review on the role of vitamins, minerals, proteins, and other supplements for the treatment of cachexia in cancer: a European Palliative Care Research Centre cachexia project. J Cachexia Sarcopenia Muscle. 2017 Feb;8(1):25-39.

D. Diabetic Foot Ulcer

D1. Armstrong DG, Hanft JR, et al. Effect of oral nutritional supplementation on wound healing in diabetic foot ulcers: a prospective randomized controlled trial. Diabet Med. 2014 Sep;31(9):1069-1077.

E. Hemodialysis Support

E1. Fitschen PJ, Biruete A, et al. Efficacy of beta-hydroxy-beta-methylbutyrate supplementation in maintenance hemodialysis patients. Hemodial Int. 2017 Jan;21(1):107-116.

F. Hip Fracture

F1. Ekinci O, Yanık S, et al. Effect of Calcium β-Hydroxy-β-Methylbutyrate (CaHMB), Vitamin D, and Protein Supplementation on Postoperative Immobilization in Malnourished Older Adult Patients With Hip Fracture: A Randomized Controlled Study. Nutr Clin Pract. 2016 Dec;31(6):829-835.

F2. Malafarina V, Uriz-Otano F, et al. Effectiveness of nutritional supplementation on sarcopenia and recovery in hip fracture patients. A multi-centre randomized trial. Maturitas. 2017 Jul;101:42-50.

G. Muscle Loss in Older Adults

G1. Wu H, Xia Y, et al. Effect of beta-hydroxy-beta-methylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2015 Sep-Oct;61(2):168-175.

H. Wound Complications

H1. Wada N, Kurokawa Y, et al. Perioperative Nutritional Support With Beta-hydroxy-beta-methylbutyrate, Arginine, and Glutamine in Surgery for Abdominal Malignancies. Wounds. 2018 Sep;30(9):251-256.

Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 5/27/2020

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