What Is D-Ribose?

Ribose is a sugar molecule that occurs naturally in the body and is made from blood glucose. It is a vital part of adenosine triphosphate (ATP)—a molecule that helps store and release energy. ATP also supports muscle contraction (the tightening, shortening, and lengthening of muscles) and your body's nerve signals. Also known as D-ribose, it is marketed as a nutritional supplement to reduce fatigue and improve athletic performance. It's also been studied for people with heart failure.

This article discusses the potential uses and benefits of D-ribose, along with some facts to keep in mind if you decide to add it to your medicine cabinet.

Uses of D-Ribose

Ribose has been studied as a treatment for people with heart failure or energy deficits, such as chronic fatigue syndrome and fibromyalgia. It's also popular among athletes looking to increase energy, boost stamina, and enhance athletic performance.

Despite ribose's potential benefits, there is limited scientific evidence to support its use for any health condition or as for performance enhancement. Here's a look at some key findings from the research on ribose supplements.

Athletic Performance

Although ribose supplements are widely touted as a natural remedy for enhancing exercise endurance, the National Institutes of Health (NIH) maintains that this supplement has little or no effect on adults' exercise capacity, either for seasoned athletes or novices.

Clinical trials are few and far between, and only a few show any benefit of D-ribose on athletic performance.

A small study of 21 untrained college students assigned male at birth showed that people who took 15 grams (g) of D-ribose an hour before and after jumping exercises, along with intervals of 12, 24, and 36 hours afterward, had less muscle soreness than those who took a placebo. D-ribose also seemed to improve muscle recovery. This trial had a small sample size, and because it was only performed in young adults assigned male at birth, the results may not translate into the general population.

In another small trial comparing the effects of D-ribose in people who regularly exercised to those who did not, 26 people were given 10 g a day of either D-ribose or a placebo for five days. The results differed depending on fitness level. People who did not exercise regularly showed performance improvement and experienced a lower perceived rate of exertion after taking D-ribose. Those with higher levels of fitness did not show improvement. Again, this study was limited by a small sample size.

There is not enough evidence to recommend D-ribose as an athletic performance booster.

Heart Failure Recovery

Ribose supplements may be of some benefit to people with heart failure, though the evidence is limited. The 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (a combined effort of the American Heart Association, American College of Cardiology, and the Heart Failure Society of America) suggests not all nutritional supplements may be effective at treating heart failure.

A low-sodium DASH (Dietary Approaches to Stop Hypertension) diet and polyunsaturated fatty acids (PUFAs) were recommended. Some nutritional deficiencies and conditions, like iron-deficiency anemia, were associated with heart failure. An RD or a registered dietitian nutritionist (RDN) may be required to evaluate heart failure. Speak with your healthcare provider. Please don't delay the evaluation and treatment of heart failure.

In one study, researchers gave a small sample of people with congestive heart failure (CHF) 5 g of D-ribose daily for six weeks. Heart function measurements improved in 64% of subjects. Those improvements were sustained in follow-up assessments three weeks after ceasing supplementation. Only 11 people were enrolled in this trial, so the level of evidence is weak. Also, there was no placebo control to compare against the results of the D-ribose treatment.

A randomized controlled trial of 216 people with heart failure with preserved ejection fraction (HFpEF) showed supplementing with 15 g of D-ribose per day decreased heart failure symptoms and increased ejection fraction (a measure of the heart's strength). While more information is needed, the researchers suggested D-ribose may be a helpful addition to standard treatments for this type of heart failure.

More research is needed to determine D-ribose's effects on people with heart failure.

Additional Uses

In addition to the potential health benefits listed above, some people use D-ribose to support:

• Fibromyalgia (a chronic disorder causing pain and tenderness throughout the body, in addition to fatigue and sleep problems)
• Chronic fatigue syndrome (a serious, long-term condition of extreme tiredness)

There is no evidence to recommend D-ribose for these uses.

What Are the Side Effects of D-Ribose?

Your provider may recommend you take D-ribose for heart health or for another reason. However, be aware that consuming any supplement, including D-ribose, may have potential side effects. These side effects may be common or severe.

Common Side Effects

Side effects of D-ribose at normal doses for short periods seem to be rare but may include:

• Diarrhea
• Stomach discomfort
• Nausea

Taking D-ribose with meals (particularly high-fat and high-carbohydrate meals) seemed to decrease its absorption. D-ribose has caused a temporary drop in blood sugar, which may cause hypoglycemia (low blood sugar) symptoms.

Severe Side Effects

Severe side effects have not been reported with D-ribose, but safety data is limited.

Precautions

There is not enough evidence to support D-ribose's safety during pregnancy and breastfeeding, and it is not recommended for use at those times. It's also not suggested for children, as there's not enough data on its safety.

Dosage: How Much D-Ribose Should I Take? 

There is no standard recommended dosage of D-ribose. The most common doses, and those used in scientific studies, are typically between 5 g and 15 g per day.

What Happens If I Take Too Much D-Ribose?

D-ribose is considered relatively safe for short-term use. In a survey of human studies, short-term hypoglycemia was noted in just one study participant who took one 10 g dose of D-ribose.

Long-term safety studies for this supplement in humans are lacking, but one mouse study using D-ribose for six months showed evidence of anxiety and memory loss. However, it's challenging to interpret whether it may affect humans similarly. Discuss any concerns you have with your healthcare provider.

Interactions

People with diabetes who are taking medications to lower blood sugar, such as insulin or sulfonylureas, and people with hypoglycemia may need to avoid supplementing with D-ribose, as it may lower blood sugar. Examples of insulin products include but aren't limited to Humalog, Humulin R, Lantus, Levemir, Basaglar, and Apidra. More information about how different types of insulin work may be found here.

It is essential to carefully read a supplement's ingredients list and nutrition facts panel to learn which ingredients are in the product and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.

How to Store D-Ribose

Store D-ribose in a cool, dry place, away from children and pets. Discard after one year or as indicated on the packaging.

Similar Supplements

Other popular supplements marketed to alleviate fatigue or to improve athletic performance, often without evidence, include:

• Arginine
• Caffeine
• Creatine
• DHEA (dehydroepiandrosterone)
• Ginseng
• Glutamine
• Iron
• Protein
• Quercetin

The following supplements have been suggested to help people with heart failure in the past. However, there's mixed evidence for their use:

• Coenzyme Q10 (CoQ10)
  
• Vitamin D

Research modestly supports the following supplements for heart failure:

• Iron
  
• Polyunsaturated fatty acids (PUFAs)

Sources of D-Ribose & What to Look For 

Some foods contain low amounts of D-ribose. It's also available as a dietary supplement in most health food stores, pharmacies, and online.

Food Sources of D-Ribose

Low levels of D-ribose are consumed in the diet. D-ribose is found in meats like beef and chicken, though amounts vary. Cooking likely decreases the amount of ribose available.

D-Ribose Supplements

D-ribose is sold as capsules, tablets, and a powder that can be mixed with a non-carbonated beverage. It is a naturally occurring sugar and tastes sweet.

When selecting a brand of supplements, look for products that have been certified by one or more of these organizations:

• ConsumerLab
• USP
• NSF
  

Summary 

Due to the limited research, it's too soon to recommend D-ribose supplements for any condition. It's also important to note that self-treating a condition and avoiding or delaying standard care may have serious consequences. If you're considering using D-ribose supplements to treat any chronic condition, talk to your healthcare provider before starting the supplement.