D-Ribose for Fibromyalgia and Chronic Fatigue Syndrome

D-ribose is a supplement that's sometimes recommended as a treatment for people with fibromyalgia and chronic fatigue syndrome. Also called ribose or Beta-D-ribofuranose, it's a type of sugar that your body produces naturally and is readily available in supplement form.

D-ribose plays several important roles in your body, such as:

• Helping produce energy in the form of ATP (adenosine triphosphate)
• Serving as a building block of the genetic material RNA (ribonucleic acid)
• Helping increase your muscle energy

As with most supplements, we don't have enough high-quality research to draw a lot of conclusions about it as a treatment for these conditions.

We have very little research on d-ribose supplementation for either fibromyalgia or chronic fatigue syndrome. Still, some health-care providers recommend it, and some people with these conditions say it is an effective part of their treatment regimen.

One small study published in The Journal of Alternative and Complementary Medicine concluded that d-ribose supplementation significantly improved symptoms of these conditions, including:

• Increasing energy levels
• Improving sleep quality
• Improving mental clarity
• Lowering pain intensity
• Improving overall well being

However, this work is preliminary and we need considerably more research to confirm the findings, including larger studies.

It's unclear how d-ribose would accomplish the things that have been attributed to it. For example, the low energy in fibromyalgia and chronic fatigue syndrome is theorized to come from a deficiency of ATP, but we don't have any proof so far that d-ribose supplementation boosts ATP.

D-ribose has been shown to increase exercise capacity and energy following a heart attack, raising questions about whether it can help with exercise tolerance in other instances. It's been studied for increasing high-intensity exercise capacity in athletes but was found to provide no benefit. So far, we don't have evidence one way or the other whether d-ribose is effective against post-exertional malaise (a severe symptom increase after exercise), which is a key symptom of chronic fatigue syndrome.

A 2017 review of dietary modifications for chronic fatigue syndrome published in an Australian and New Zealand medical journal noted positive outcomes had been seen with d-ribose in human trials.

One extremely small study suggests that d-ribose may lessen symptoms of restless legs syndrome, which is common in people with fibromyalgia.

Again, not nearly enough research has been done, and it doesn't appear to be an area of on-going interest in the research community. Unless interest picks up, we may never really know whether d-ribose supplements are a safe and effective treatment for these conditions.

We don't yet have a standard dosing recommendation for d-ribose supplements. In the study on fibromyalgia and chronic fatigue syndrome, participants took five-gram doses three times a day.

In some studies of d-ribose for people with coronary artery disease, researchers have used doses of 15 grams four times a day.

D-ribose supplements are widely available. They are typically sold in powder form.

While some foods contain d-ribose, it's a form that your body is believed to be unable to use. That makes supplementation the typical way to increase levels.

While supplements are a "natural" treatment, they can still cause unwanted effects. Some of the side effects of d-ribose may include:

• Digestive problems, such as nausea, stomach ache, and diarrhea
• Headaches
• Lowering uric acid in urine or blood in people with kidney disorders, which raises the risk of gout or other kidney problems
• Lowering blood sugar

Because it can lower blood sugar, d-ribose is not recommended for diabetics who are on medications that lower their blood sugars.

D-ribose is generally considered safe for short-term use. So far, we don't have much safety information about long-term use or use during pregnancy and breastfeeding. 

If you're interested in d-ribose to help treat your fibromyalgia or chronic fatigue syndrome, be sure to talk to your doctor to make sure you're taking it safely.

You may also want to speak to a pharmacist about whether it could interact negatively with anything else you're taking.