Heart Failure (CHF)
Heart Failure (CHF) is a cardiovascular condition involving reduced cardiac function that can affect exercise tolerance and quality of life. It is not the same as iron deficiency: iron treatment has been studied specifically when iron deficiency is present, including in patients with HFrEF.
Start with the basics of Heart Failure (CHF), a condition categorized within cardiovascular health.
This list shows research findings, not treatments. Nothing here replaces medical care. If you have this condition, talk to a doctor.
What may help
What studies found for each option, best evidence first.
18 options:3 some evidence10 not enough evidence2 not tested in people3 no benefit found
Finnish SaunapracticeSome evidence it helpsSize of effect: Not known
Some human studies found a benefit. More research could change this.
11 of 12 studies found a benefit; 1 found none.
A pooled analysis of randomized and non-randomized human studies reported short-term improvements in cardiac biomarkers and function among people with heart failure. Reviews also reported changes in 6-minute walk distance, BNP, LVEF and NYHA class, and fewer hospitalisations with repeated far-infrared sauna therapy.
Open the Finnish Sauna pageHigh-Intensity Interval Training (HIIT)practiceSome evidence it helpsSize of effect: Not known
Some human studies found a benefit. More research could change this.
All 10 studies with a clear result found a benefit.
A 2025 meta-analysis of randomized trials found improvements in VO2peak and VO2 at VT1, but the results had high heterogeneity. Another meta-analysis reported reduced BNP/NT-proBNP with HIIT.
Open the High-Intensity Interval Training (HIIT) pageTai ChipracticeSome evidence it helpsSize of effect: Not known
Some human studies found a benefit. More research could change this.
All 3 studies with a clear result found a benefit.
Pooled analyses whose designs were not recorded reported improvements in quality of life, walking distance, and left ventricular ejection fraction when Tai Chi was added to usual care. Another pooled finding reported improvements in these outcomes along with BNP/NT-proBNP, mood, sleep, and mobility, and fewer heart failure hospitalizations; no adverse events were reported.
Open the Tai Chi pageAcupuncturepracticeNot enough evidence
Too few or too small studies to know if it works.
The one study found a benefit.
An analysis pooled 8 randomized trials in patients with confirmed heart failure, NYHA class I to III, and assessed cardiac function, walking distance, and quality of life; the evidence was rated low to very low certainty.
Open the Acupuncture pageDancepracticeNot enough evidence
Too few or too small studies to know if it works.
The one study found a benefit.
A review reported that Greek traditional dance improved health-related quality of life in male patients with heart failure II-III, with improvements comparable to aerobic and resistance exercise.
Open the Dance pagePilatespracticeNot enough evidence
Too few or too small studies to know if it works.
The one study found a benefit.
A 2019 review reported one RCT in which Pilates produced greater improvement in peak VO2 than conventional rehabilitation.
Open the Pilates pageAcceptance and Commitment Therapy (ACT)practiceNot enough evidence
Too few or too small studies to know if it works.
The one study found a benefit.
A review found that ACT processes, especially committed action, were linked to better self-care behaviors among people with cardiovascular conditions, including heart failure; the pooled analyses’ study designs were not recorded.
Open the Acceptance and Commitment Therapy (ACT) pageBreathworkpracticeNot enough evidence
Too few or too small studies to know if it works.
The one study found a benefit.
A trial in 90 participants found breathing exercises improved fatigue, dyspnea and NYHA functional class.
Open the Breathwork page
May not suit people with this condition
Supplements and practices linked to problems for people with this condition.
Hot YogapracticeUnclear
With decompensated or poorly controlled heart failure, the demands of heat-related blood-vessel widening, sweating, and sustained exertion can contribute to worsening heart failure and fluid or electrolyte shifts.
Open the Hot Yoga pageBrisk WalkingpracticeUnclear
Worsening breathlessness at rest or rapidly increasing congestion can indicate acute decompensation, when exercise is unsafe until medical stabilization. This does not apply to stable heart failure, for which appropriately prescribed exercise may be beneficial.
Open the Brisk Walking pageCalisthenicspracticeUnclear
When heart failure is decompensated, with worsening symptoms or fluid overload, exertion may be unsafe until the condition is stabilized.
Open the Calisthenics pageChelation Therapy (Non-Medical)practiceUnclear
EDTA chelation can cause rapid fluid shifts and low calcium, which may trigger arrhythmias and worsen cardiac function in people with heart failure.
Open the Chelation Therapy (Non-Medical) pageCoffee EnemapracticeUnclear
Rapid fluid and electrolyte shifts, together with caffeine-related cardiac stimulation, may worsen hemodynamic instability or arrhythmia risk in people with Heart Failure.
Open the Coffee Enema pageHot BathpracticeUnclear
With acute decompensated or unstable heart failure, immersion can shift blood toward the chest and add thermal strain to the cardiovascular system. This concern does not apply to all stable heart failure.
Open the Hot Bath pageInfrared SaunapracticeUnclear
With decompensated heart failure or current fluid overload, the heat-related increase in cardiac workload and fluid loss may be unsafe; sauna use is best avoided until the condition is clinically stable.
Open the Infrared Sauna pageIV Vitamin DrippracticeUnclear
During acute decompensated heart failure or existing fluid overload, the body may tolerate infused fluid less well, potentially worsening congestion and pulmonary edema.
Open the IV Vitamin Drip page
The expert view shows every study, dose protocol and source.
What may help
Interventions recorded as helping with this condition18 listedMost likely to help, from the evidence we have
- →PracticesFinnish SaunaCertaintyMediumSourceRCT
A pooled analysis of randomized and non-randomized human studies reported short-term improvements in cardiac biomarkers and function among people with heart failure. Reviews also reported changes in 6-minute walk distance, BNP, LVEF and NYHA class, and fewer hospitalisations with repeated far-infrared sauna therapy.
Who was studied
- Healthy people and patients
- Allergic Rhinitis
- Ankylosing Spondylitis
- Chronic Fatigue Syndrome
- Common Cold
- Copd
- Coronary Artery Disease
- +5 more
Open Finnish SaunaStudy result
Meta-analysis of infrared sauna studies in heart failure patients; cardiac biomarker and function improvements reported short-term.
- →PracticesHigh-Intensity Interval Training (HIIT)CertaintyMediumSourceRCT
A 2025 meta-analysis of randomized trials found improvements in VO2peak and VO2 at VT1, but the results had high heterogeneity. Another meta-analysis reported reduced BNP/NT-proBNP with HIIT.
Who was studied
- Healthy people and patients
- Asthma
- Cancer
- Copd
- Coronary Artery Disease
- Diabetes Type2
- Fatty Liver Nafld
- +7 more
Open High-Intensity Interval Training (HIIT)Study result
Meta-analysis of 10 RCTs showing significant improvement in VO2peak and VO2 at VT1, though with high heterogeneity.
- →PracticesTai ChiCertaintyMediumSourceRCT
Pooled analyses whose designs were not recorded reported improvements in quality of life, walking distance, and left ventricular ejection fraction when Tai Chi was added to usual care. Another pooled finding reported improvements in these outcomes along with BNP/NT-proBNP, mood, sleep, and mobility, and fewer heart failure hospitalizations; no adverse events were reported.
Who was studied
- People with a condition
Open Tai ChiStudy result
Network meta-analysis of 34 RCTs showing Tai Chi combined with usual care significantly improved MLHFQ, 6MWT, and LVEF in patients with CHF.
Low probability(12)
- →PracticesAcupunctureCertaintyLowSourceRCT
An analysis pooled 8 randomized trials in patients with confirmed heart failure, NYHA class I to III, and assessed cardiac function, walking distance, and quality of life; the evidence was rated low to very low certainty.
Who was studied
- People with a condition
- Heart Failure
Open AcupunctureStudy result
Eight RCTs in patients with confirmed heart failure, NYHA class I to III, pooled for LVEF, 6MWD, MLHFQ, LVESD and LVEDD; evidence of low to very low certainty.
- →PracticesDanceCertaintyLowSourceRCT
A review reported that Greek traditional dance improved health-related quality of life in male patients with heart failure II-III, with improvements comparable to aerobic and resistance exercise.
Who was studied
- People with a condition
Open DanceStudy result
Greek traditional dance showed significant improvements in health-related quality of life comparable to aerobic and resistance exercise in male patients with heart failure II-III
- →PracticesPilatesCertaintyLowSourceRCT
A 2019 review reported one RCT in which Pilates produced greater improvement in peak VO2 than conventional rehabilitation (p=0.02).
Who was studied
- Healthy people and patients
- Heart Failure
- Obesity
- Overweight
- Stroke
Open PilatesStudy result
One RCT (Guimarães et al., 2012) showed Pilates group had greater improvement in peak VO2 compared to conventional rehabilitation group (p=0.02)
- →PracticesAcceptance and Commitment Therapy (ACT)CertaintyLowSourceClinical
A review found that ACT processes, especially committed action, were linked to better self-care behaviors among people with cardiovascular conditions, including heart failure; the pooled analyses’ study designs were not recorded.
Who was studied
- People with a condition
- Coronary Artery Disease
- Heart Disease
- Heart Failure
- Stroke
Open Acceptance and Commitment Therapy (ACT)Study result
Al-Hammouri et al. linked ACT processes, especially committed action, to improved self-care behaviors.
- →PracticesBreathworkCertaintyLowSourceClinical
A trial in 90 participants found breathing exercises improved fatigue, dyspnea and NYHA functional class.
Who was studied
- People with a condition
Open BreathworkStudy result
RCT showing significant improvements in fatigue, dyspnea, and NYHA functional class with breathing exercises.
- →PracticesMeditationCertaintyLowSourceClinical
One pilot RCT in CHF patients with ICD/CRTD reported improved survival (88% vs 67%), less AF (p=0.045) and VT; high risk of bias.
Open MeditationWho was studied
- People with a condition
- →PracticesQigongCertaintyLowSourceClinical
A meta-analysis of 33 randomized trials found improvements in VO2peak, 6MWD, and MLHFQ when TQPs were added to routine management.
Who was studied
- People with a condition
- Heart Failure
Open QigongStudy result
Meta-analysis of 33 RCTs showing significant improvements in VO2peak, 6MWD, and MLHFQ when TQPs added to routine management.
- →PracticesTENS / EMS TherapyCertaintyLowSourceClinical
A randomized sham-controlled pilot trial of 45 people with heart failure, with 37 included in the final analysis, found that EMS improved walking distance and DASI and MLHFQ scores at discharge; DASI and MLHFQ scores remained improved versus sham at 1 month.
Who was studied
- People with a condition
- Heart Failure
Open TENS / EMS TherapyStudy result
Randomised sham-controlled pilot trial (n=45, 37 in final analysis) showing EMS significantly improved 6-MWTD, DASI and MLHFQ at discharge (p<0.05) and DASI (p=0.042) and MLHFQ (p=0.004) at 1 month vs sham.
- →PracticesHatha YogaCertaintyLowSourceReview
A 2024 narrative review described small studies reporting better quality of life and reduced inflammation in heart failure.
Open Hatha YogaStudy result
Small studies show improved quality of life and reduced inflammation; limited data.
- →PracticesYogaCertaintyLowSourceReview
A review reported improvements in peak oxygen consumption, exercise capacity, NT-proBNP, and quality of life when yoga was used as an adjunct for heart failure.
Open YogaStudy result
A meta-analysis of 11 RCTs found yoga effective as adjunct therapy for improving peak oxygen consumption, exercise capacity, NT-proBNP, and quality of life.
- →PracticesCardioCertaintyLowSourceTheoretical
In stable chronic heart failure, supervised aerobic training improves exercise capacity and quality of life and reduces hospitalizations.
- →PracticesCyclingCertaintyLowSourceTheoretical
Cycling is described as recommended for stable heart failure (NYHA Class II–III) to improve functional capacity and reduce hospitalization.
Open CyclingStudy result
Cycling is recommended in stable heart failure (NYHA Class II–III) to improve functional capacity and reduce hospitalization.
Very low probability(3)
- →PracticesStrength TrainingCertaintyVery lowSourceRCT
Studies did not support a clear improvement in Heart Failure (CHF): VO2peak improved (1.1–1.6 mL/kg/min) but not statistically significantly after 12 months, and high- or moderate-intensity exercise was not superior to guideline-based advice.
Open Strength TrainingWho was studied
- People with a condition
- →PracticesFastingCertaintyVery lowSourceClinical
The studies did not establish a benefit or contraindication: a 2026 review of observational studies found no increase in decompensation, cardiovascular events, mortality or worsening of cardiac markers with fasting in stable chronic heart failure.
Open FastingWho was studied
- People with a condition
- Heart Failure
- →PracticesGratitude JournalCertaintyVery lowSourceClinical
A pilot randomized trial in 70 people with Stage B Heart Failure (CHF) found an improvement in an inflammatory biomarker, but resting heart rate variability did not differ; the authors called for larger confirmatory studies. The findings did not support an effect on resting heart rate variability.
Open Gratitude JournalWho was studied
- People with a condition
- Heart Failure
What to avoid
Interventions recorded as making it worse11 listedHighest probability
- →PracticesHot YogaCertaintyLowSourceReference knowledge
With decompensated or poorly controlled heart failure, the demands of heat-related blood-vessel widening, sweating, and sustained exertion can contribute to worsening heart failure and fluid or electrolyte shifts.
Open Hot YogaRationale
Decompensated or poorly controlled heart failure is a state in which the cardiac output demand from heat-induced vasodilation and sweating, plus sustained exertion, can cause decompensation and fluid and electrolyte shifts.
- →PracticesBrisk WalkingCertaintyLowSourceReference knowledge
Worsening breathlessness at rest or rapidly increasing congestion can indicate acute decompensation, when exercise is unsafe until medical stabilization. This does not apply to stable heart failure, for which appropriately prescribed exercise may be beneficial.
Open Brisk WalkingRationale
Acute decompensation, such as worsening breathlessness at rest or rapidly increasing congestion, makes exercise unsafe until the person is medically stabilized; this does not apply to stable heart failure, for which appropriately prescribed exercise may be beneficial.
- →PracticesCalisthenicsCertaintyLowSourceReference knowledge
When heart failure is decompensated, with worsening symptoms or fluid overload, exertion may be unsafe until the condition is stabilized.
Open CalisthenicsRationale
Decompensated heart failure with worsening symptoms or fluid overload makes exertion unsafe until the condition is stabilized.
- →PracticesChelation Therapy (Non-Medical)CertaintyLowSourceReference knowledge
EDTA chelation can cause rapid fluid shifts and low calcium, which may trigger arrhythmias and worsen cardiac function in people with heart failure.
Open Chelation Therapy (Non-Medical)Rationale
EDTA chelation can cause rapid fluid shifts and hypocalcemia, which may precipitate arrhythmias and worsen cardiac function in heart failure patients.
- →PracticesCoffee EnemaCertaintyLowSourceReference knowledge
Rapid fluid and electrolyte shifts, together with caffeine-related cardiac stimulation, may worsen hemodynamic instability or arrhythmia risk in people with Heart Failure.
Open Coffee EnemaRationale
Rapid fluid and electrolyte shifts, together with caffeine-related cardiac stimulation, may worsen hemodynamic instability or arrhythmia risk.
- →PracticesHot BathCertaintyLowSourceReference knowledge
With acute decompensated or unstable heart failure, immersion can shift blood toward the chest and add thermal strain to the cardiovascular system. This concern does not apply to all stable heart failure.
Open Hot BathRationale
Acute decompensated or unstable heart failure can make immersion-related shifts of blood toward the chest and added thermal cardiovascular strain unsafe; this does not apply to all stable heart failure.
- →PracticesInfrared SaunaCertaintyLowSourceReference knowledge
With decompensated heart failure or current fluid overload, the heat-related increase in cardiac workload and fluid loss may be unsafe; sauna use is best avoided until the condition is clinically stable.
Open Infrared SaunaRationale
Decompensated heart failure or current volume overload can make the heat-related rise in cardiac workload and fluid loss unsafe; avoid sauna until clinically stable.
Low probability(4)
- →PracticesIV Vitamin DripCertaintyLowSourceReference knowledge
During acute decompensated heart failure or existing fluid overload, the body may tolerate infused fluid less well, potentially worsening congestion and pulmonary edema.
Open IV Vitamin DripRationale
Acute decompensated heart failure or existing volume overload reduces tolerance for infused fluid, which can worsen congestion and pulmonary edema.
- →PracticesTabata TrainingCertaintyLowSourceReference knowledge
Decompensated or symptomatic heart failure can limit the heart’s ability to meet the abrupt demand of maximal intervals. Vigorous training should wait until the condition is stabilized and a clinician has advised on exercise.
Open Tabata TrainingRationale
Decompensated or symptomatic heart failure limits the ability to meet the abrupt high cardiac demand of maximal intervals; vigorous training should wait until the condition is stabilized and a clinician has advised on exercise.
- →PracticesIce Bath / Cold PlungeCertaintyLowSourceTheoretical
Cold-induced narrowing of blood vessels increases the heart’s workload and the resistance it pumps against, which may worsen heart failure.
Open Ice Bath / Cold PlungeRationale
Cold-induced vasoconstriction increases afterload and cardiac workload, exacerbating heart failure.
How to read the evidence
Evidence tier — overall strength of the evidence for the whole compound
- StrongWell established — backed by strong, consistent human research.
- ModerateSome genuine support, but mostly from small or lower-quality studies. Promising, not proven.
- PreliminaryEarly-stage evidence — a promising hypothesis, not an established effect yet.
- LimitedVery limited evidence — treat this as a hypothesis, not proof.
- InsufficientNot enough good evidence to draw conclusions yet.
Certainty — how sure we can be that the effect is real
- Very highVery sure — strong, consistent evidence
- HighFairly sure — consistent evidence from good studies
- MediumModerately sure — new studies could change this
- LowNot sure — little or mixed evidence
- Very lowVery unsure — almost no usable evidence
Source — where the data comes from
- Meta-analysisPooled analysis of many trials — the strongest evidence
- RCTRandomized controlled trial — a strong human study design
- ClinicalA human clinical study
- Reference knowledgeFrom general health-science or pharmacology references, not a study of this exact claim
- Animal researchStudied in animals, not humans
- Community reportsAggregated user reports — anecdotal signal, not evidence
- TheoreticalMechanism-based reasoning, not yet tested
Study grade — quality of each underlying study (A best, D weakest)
- AHigh-quality — strong, consistent human trials
- BGood — solid evidence with some limitations
- CModerate — limited, small, or mixed-quality studies
- DWeak — preliminary, indirect, or animal-only
Confidence — how strongly the sources back a finding
A 0–100 score from study quality and agreement
Most supplement evidence is graded C–D. Read it as preliminary signal, not proof.
Full write-up
What is it
Heart Failure (CHF) is a cardiovascular condition involving reduced cardiac function that can affect exercise tolerance and quality of life. It is not the same as iron deficiency: iron treatment has been studied specifically when iron deficiency is present, including in patients with HFrEF. Options such as Coenzyme Q10 and Omega-3 are interventions studied in relation to the condition, not definitions of it. Medical conditions should be discussed with a clinician.
Evidence-backed options
The strongest support is for treating iron deficiency in people with HFrEF: intravenous iron was associated with fewer recurrent heart-failure hospitalizations and lower cardiovascular mortality, with the larger effect reflected in hospitalizations. This finding applies specifically to iron deficiency and HFrEF, rather than to heart failure in general. Coenzyme Q10 and taurine also have clinical trial evidence suggesting improvements in outcomes such as exercise capacity or cardiac function, but their findings should be interpreted within the populations and protocols studied.
Some options were tested in more specific settings. Astragalus was given by acupoint injection at PC6 alongside conventional standard therapy in patients with CHF described as having qi-deficiency and blood-stasis syndrome. Tai Chi was evaluated across several randomized trials, while TENS / EMS Therapy was examined in a small sham-controlled pilot study, with benefits reported at discharge and, for some measures, at 1 month. Astaxanthin was studied for 3 months in patients with heart failure and left-ventricular systolic dysfunction, with reported changes in oxidative-stress markers, cardiac contractility, and exercise tolerance.
Evidence is less definitive for Omega-3, and several other options are supported mainly by reviews, clinical evidence, or animal studies rather than direct, consistent clinical findings. For Vitamin B1 (Thiamine), standard dosing did not improve symptoms or clinical measures in mild-moderate acute heart failure patients without thiamine deficiency. Doses and durations are not specified for most options, so results cannot be assumed to apply across all forms of heart failure. A clinician can help interpret these findings in the context of the specific diagnosis and treatment plan.
What to avoid
Several flagged activities may place additional strain on circulation when heart failure is unstable. Vigorous Cycling is not appropriate during decompensated or unstable heart failure until stabilization; in stable, compensated heart failure, exercise may be beneficial when supervised. Swimming also warrants stabilization and medical clearance in this setting, because water immersion increases venous return and cardiac workload. Fluid overload can make immersion and exertion unsafe.
Coffee Enema may cause rapid fluid and electrolyte shifts. Along with caffeine-related cardiac stimulation, these changes may worsen hemodynamic instability or increase arrhythmia risk. Cigarette Smoking can add several cardiovascular stresses at once: nicotine-related vasoconstriction, carbon-monoxide hypoxemia, and increased cardiac workload. These effects may worsen ventricular strain, ischemia, and decompensation.
Ice Bath / Cold Plunge is flagged for review, but no mechanism is recorded for this contraindication, so it is not presented as a verified restriction. Because the relevance of these concerns depends on whether heart failure is stable or decompensated, any medical condition or change in exercise or exposure should be discussed with a clinician.