D-ribose is a sugar involved in producing energy in the body and is also the structural basis of DNA and RNA. As a supplement, it is commonly used to help with heart disease and chronic fatigue syndrome. Read on to see how this sugar may be an effective treatment for these conditions and others.
What Is D-Ribose?
D-ribose is a naturally occurring sugar present in all living cells. It is a key component in many biological pathways but is most active in glycation (bonding between a sugar and a protein or fat molecule) .
D-ribose, together with adenine, makes the adenosine molecule of adenosine triphosphate (ATP), the main storage and transportation unit of energy .
D-ribose is also used to make nicotinamide adenine dinucleotide (NAD) and flavin adenine dinucleotide (FAD), two important molecules involved in cellular respiration.
D-ribose is also the key structural basis of RNA and DNA [3, 4, 5].
Health Benefits of D-Ribose Supplementation
There are many commercial D-ribose supplements, especially to increase athletic performance. However, the FDA hasn’t approved them for any conditions due to the lack of solid clinical research. Regulations set manufacturing standards for supplements but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing with D-ribose.
Insufficient Evidence for:
1) Athletic Performance
D-ribose may enhance the recovery of energy reserves following inadequate blood supply to organs and tissues after high-intensity exercise .
In a study of 24 bodybuilders 10 grams/day of D-ribose for 4 weeks significantly increased bench press strength .
In another trial on 26 healthy people, the same amount of D-ribose improved power output while reducing perceived exertion and creatine kinase level (which are normally high after strenuous exercise) .
A multi-herbal supplement with D-ribose failed to improve performance in a small trial on 17 cyclists, but it supplied a much lower dose (2.4 – 4.8 grams/day of a blend also containing other ingredients) .
Despite its widespread use to increase athletic performance, only 2 small clinical trials back it up. The evidence to support this use is insufficient until larger, more robust clinical trials are conducted.
2) Heart Disease
Several studies found that D-ribose increases ATP levels in heart cells and improves heart function [10, 11, 12].
Congestive heart failure is a condition in which heart muscles don’t pump blood as well as they should. In a clinical trial of 15 congestive heart failure patients, D-ribose improved heart function .
D-ribose helped 20 men with stable heart disease to exercise longer without developing chest pains (angina) or ECG changes in another trial .
In mice, D-ribose and L-cysteine supplementation lowered blood LDL and other oxidized fat. It also reduced oxidative stress in the aorta, the main artery that carries blood from the heart .
However, D-ribose showed no benefits in treating chronic heart failure in healthy mice or in mice with elevated myocardial creatine .
The results are promising, but the evidence is insufficient to claim that D-ribose helps with heart disease. Further clinical research is needed.
3) Fibromyalgia and Chronic Fatigue Syndrome
A pilot study of 41 patients with fibromyalgia or chronic fatigue syndrome found that 5 grams of D-ribose daily improved energy, sleep, mental clarity, pain intensity, and well-being .
A case study found that 5 grams of D-ribose taken twice daily with other medications reduced fibromyalgia symptoms, which returned after one week of stopping D-ribose supplementation .
A single clinical trial and a case study are clearly insufficient evidence to support the benefits of D-ribose in people with fibromyalgia and chronic fatigue syndrome. More clinical trials on larger populations are required.
Case Studies (Very Low to Lacking Evidence)
A few case studies document improvement of the following conditions with D-ribose supplementation:
- Restless leg syndrome 
- A rare genetic disorder with severe dexterity and motor retardation (adenylosuccinase deficiency) [20, 21]
- Another genetic disorder in which the muscles cannot process the energy molecule ATP (myoadenylate deaminase deficiency) [22, 23]
Case studies can only be considered anecdotes with a much lower level of evidence than any clinical studies. Additionally, two of these conditions failed to respond to D-ribose therapy in some cases [24, 25].
Animal Studies (Lack of Evidence)
No clinical evidence supports the use of D-ribose for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies listed should not be interpreted as supportive of any health benefit.
D-ribose reduced kidney dysfunction and tissue damage caused by the chemotherapy drug Cisplatin in mice .
D-ribose also reduced kidney damage caused by lack of blood supply and decreased neutrophil activation in rats .
D-ribose prevents the activation of pro-apoptotic (programmed cell death) genes in the hippocampus, demonstrating a neuroprotective effect in mice with irregular heartbeat .
D-ribose increased gut motility in mice and increased energy expenditure, which decreases body weight .
Testicular Toxicity Caused by Aluminum
D-ribose (in combination with L-cysteine) reduced aluminum-induced testicular toxicity in rats .
The opinions expressed in this section are solely those of D-ribose users, who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.
Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare providers because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.
Most users reported taking D-ribose supplements for increasing their energy levels and athletic performance. A few took it to improve heart palpitations and muscle pain. Many of the users were happy with the results and reported less fatigue.
Dissatisfied users mainly reported that the supplement was less effective than they had expected or didn’t work at all. Others complained about its high price. A diabetic user reported experiencing adverse effects similar to those of sugar spikes and suspected these were due to D-ribose being obtained from corn sugar.
D-Ribose Dosage, Side Effects, Supplements
Because D-ribose supplements are not approved by the FDA for any conditions, there is no official dose. Users and supplement manufacturers have established unofficial doses based on trial and error.
Clinical studies have used between 5 – 15 g daily. When supplementing with 15 g it is advised to separate into three 5 g doses.
Keep in mind that the safety profile of D-ribose is relatively unknown given the lack of well-designed clinical studies. The list of side effects below is not a definite one, and you should consult your doctor about other potential side effects based on your health condition and possible drug or supplement interactions. Seek medical attention if you notice any severe or mild, persistent adverse effects after supplementing with D-ribose.
By inducing protein aggregation and rapidly producing AGEs (advanced glycation end products), D-ribose may be involved in cell dysfunction and cognitive impairments [31, 32].
Long-term oral administration of D-Ribose induced memory loss with anxiety-like behavior and also elevated Aβ-like deposition and Tau hyperphosphorylation associated with Alzheimer’s in mice .