A Simple Sugar Vital for Energy Production

Also known as 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)—the source of energy in your cells.

Ribose 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

Your body uses ribose to make ATP. ATP is 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.

Your muscles can store only so much ATP at a time, and your body continuously makes more ATP to replace what is being used. Theoretically, the more ribose you have in your body, the more ATP you can produce, and the more energy you will have.

The potential uses of ribose include:

Despite ribose’s potential benefits, there is limited scientific evidence to support its use for any health condition or 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 evidence does not back up this use. Research shows 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. Also, the sample sizes are often small, which means the results may not translate into the general population.

A small study of 21 untrained male college students showed that taking 15 grams (g) of D-ribose an hour before and after jumping exercises, along with intervals of 12, 24, and 36 hours afterward, reduced muscle soreness compared to a placebo. D-ribose also seemed to improve muscle recovery.

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.

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 diet and polyunsaturated fatty acids (PUFAs) were recommended. Some nutritional deficiencies and conditions, like iron-deficiency anemia, were associated with 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. However, more robust research is needed to verify these results.

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, D-ribose may be a helpful addition to standard treatments for this type of 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.

Sources of D-Ribose and 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

No foods contain high amounts of D-ribose. Ribose is found in riboflavin (vitamin B2). This vitamin is the one of the main food sources of ribose.

Foods high in riboflavin include:

• Oats
• Yogurt
• 2% milk
• Beef
• Clams
• Almonds
• Swiss cheese
• Mushrooms
• Chicken
• Eggs
• Quinoa
• Salmon

Cooking likely decreases the amount of ribose available in foods.

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:

Side Effects of Ribose Supplements

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.

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

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.

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.

High concentrations of D-ribose can be bad for the kidneys and may increase the likelihood of other conditions. D-ribose activates processes in the body that increase oxidative stress and inflammation. These negative effects are linked to not only kidney disease, but also diabetes, Alzheimer’s disease, and cataracts.

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.

Insulin products include but aren’t limited to the following examples:

• Humalog
• Humulin R
• Lantus
• Levemir
• Basaglar
• Apidra

If you have diabetes, speak with a healthcare provider about taking D-ribose. Scientific evidence suggests people with diabetes have higher levels of not only glucose, but also D-ribose, which can be associated with diabetic nephropathy and diabetic encephalopathy.

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:

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

Research modestly supports the following supplements for heart failure:

Summary 

Ribose, or D-ribose is a sugar molecule your body needs to make and store energy. Although limited, research suggests D-ribose may be useful for heart failure, chronic fatigue syndrome, and fibromyalgia. It may even help raise energy, stamina, and endurance levels.

Although foods contain ribose, they only contain small amounts. Ribose supplements are also available. However, they are not recommended for people who are pregnant or breastfeeding or for children.

Talk to a healthcare provider before taking ribose to make sure it’s right for you. People with diabetes who take medications to lower blood sugar may want to avoid this supplement.