Ribose

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • ADP-ribose, aldose, C5H10O5, Corvalen®, deoxyribose, monosaccharide, nucleic acids, nucleotides, pentose sugar, ribose-5-phosphate.

Background

  • Ribose has many important roles in physiology. Ribose and its related compound deoxyribose are the building blocks of the nucleic acids ribonucleic acid (RNA) and deoxyribonucleic acid (DNA), respectively. Ribose phosphates are used by microorganisms to make the amino acid histidine, one of the 22 amino acids commonly found in animal proteins. Ribose is the sugar that begins the metabolic process for production of adenosine triphosphate (ATP), the major source of energy used by cells.

  • Use of ribose by athletes and bodybuilders is based on the theory that ribose supplies muscle cells with a continuous supply of ATP. It is also sometimes combined with creatine, another substance that helps keep the muscles supplied with ATP, in formulations marketed to professional bodybuilders. While there is an abundance of anecdotal evidence from bodybuilders and other athletes concerning the positive effects of ribose, clinical research in this area suggests that ribose may not have effects on exercise performance.

  • Research has shown that ribose may help speed recovery of the heart muscle after a heart attack and improve blood flow to the heart in those affected by inadequate oxygen. Ribose supplementation has been used to support heart function and rejuvenate heart tissue after both heart attacks and heart surgery. Research has also shown that ribose may improve symptoms associated with fibromyalgia (muscle and connective tissue pain). However, research is preliminary, and firm conclusions cannot be drawn at this time.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Heart disease

Some evidence suggests that ribose may be beneficial to individuals with heart disease. Further research is needed in this field.

Fibromyalgia

Limited evidence suggests that ribose may be beneficial to individuals with fibromyalgia. Additional research is needed before a conclusion can be drawn.

McArdle’s disease

Early evidence suggests that ribose may be beneficial to individuals with McArdle’s disease. Further research is needed in this field.

Mental health (fatigue)

Evidence supporting the use of ribose in fatigue-inducing mental tasks is lacking. Additional research is needed before a conclusion can be drawn.

Muscle mass / body mass

Evidence supporting the use of ribose for an effect on muscle or body mass is lacking. Further research is needed in this field.

Restless leg syndrome

Limited evidence suggests that ribose may be beneficial to individuals with restless leg syndrome. Additional research is needed before a conclusion can be drawn.

Seizures (adenylosuccinase deficiency)

Limited evidence suggests that ribose may have a role in reducing seizure frequency. Further research is needed in this field.

Exercise performance enhancement

Evidence supporting the use of ribose for exercise performance enhancement is currently unavailable. Additional research is needed before a conclusion can be drawn.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Autism, diabetes, Huntington’s chorea/disease.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • For exercise performance enhancement, 10 milligrams of ribose has been taken by mouth daily for up to eight weeks. A single dose of 625 milligrams of ribose has been taken by mouth. Two hundred milligrams of ribose per kilogram of body weight has been taken by mouth three times daily for three days. Four doses of eight grams of ribose have been taken by mouth over 36 hours. Four doses of four grams of ribose have been taken by mouth daily for six days.

  • For fibromyalgia, five grams of D-ribose has been taken by mouth three times daily, up to a total of 280 grams (duration not specified).

  • For heart disease, according to available clinical trials, doses were not taken specifically following a coronary event, but rather in people with documented heart disease. D-ribose has been taken by mouth for three weeks (dose unspecified). Sixty grams of ribose has been taken by mouth daily in four doses by mouth for five days.

  • For McArdle’s disease, 60 grams of D-ribose has been taken by mouth daily for five days.

  • For mental fatigue, two grams of ribose has been taken by mouth daily for eight days.

  • For restless leg syndrome, five grams of D-ribose has been taken by mouth daily at different trial stages; each stage lasted three weeks, with a two-week washout period between stages. The initial stage involved a single five-gram dose of D-ribose consumed at breakfast. Throughout the second stage, D-ribose was taken at breakfast and lunch. In the third stage, D-ribose was taken at all meals (breakfast, lunch, and dinner).

  • For seizures (adenylosuccinase deficiency), 10 millimoles of D-ribose per kilogram of body weight has been taken by mouth daily in one patient (duration unclear).

Children (under 18 years old)

  • There is no proven safe or effective dose for ribose in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to ribose.

Side Effects and Warnings

  • Ribose may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Use cautiously in people with kidney disorders, as ribose may raise uric acid levels in the blood or urine.

  • Use cautiously in people with gastrointestinal disorders, as diarrhea and nausea have been reported.

  • Use cautiously in people prone to headaches, as ribose may cause headaches.

  • Ribose is not recommended in pregnant or breastfeeding women, due to a lack of available scientific evidence

  • Avoid with known allergy or hypersensitivity to ribose.

Pregnancy and Breastfeeding

  • Ribose is not recommended in pregnant or breastfeeding women, due to a lack of available scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Ribose may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Those taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Ribose may interact with agents used for the heart and agents that affect seizure threshold.

Interactions with Herbs and Dietary Supplements

  • Ribose may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Ribose may interact with herbs and supplements used for the heart and herbs and supplements that affect seizure threshold.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Ataka S, Tanaka M, Nozaki S, et al. Effects of oral administration of caffeine and D-ribose on mental fatigue. Nutrition 2008;24(3):233-238. View Abstract
  2. Dunne L, Worley S, Macknin M. Ribose versus dextrose supplementation, association with rowing performance: a double-blind study. Clin J Sport Med 2006;16(1):68-71. View Abstract
  3. Gebhart B, Jorgenson JA. Benefit of ribose in a patient with fibromyalgia. Pharmacotherapy 2004;24(11):1646-1648. View Abstract
  4. Gilula MF. Cranial electrotherapy stimulation and fibromyalgia. Expert Rev Med Devices 2007;4(4):489-495. View Abstract
  5. Hellsten Y, Skadhauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol Regul Integr Comp Physiol 2004;286(1):R182-R188. View Abstract
  6. Hjiej H, Doyen C, Couprie C, et al. [Substitutive and dietetic approaches in childhood autistic disorder: interests and limits]. Encephale 2008;34(5):496-503. View Abstract
  7. Kendler BS. Supplemental conditionally essential nutrients in cardiovascular disease therapy. J Cardiovasc Nurs 2006;21(1):9-16. View Abstract
  8. Kerksick C, Rasmussen C, Bowden R, et al. Effects of ribose supplementation prior to and during intense exercise on anaerobic capacity and metabolic markers. Int J Sport Nutr Exerc Metab 2005;15(6):653-664. View Abstract
  9. MacCarter D, Vijay N, Washam M, et al. D-ribose aids advanced ischemic heart failure patients. Int J Cardiol 2009;137(1):79-80. View Abstract
  10. Quinlivan RM, Beynon RJ. Pharmacological and nutritional treatment trials in McArdle disease. Acta Myol 2007;26(1):58-60. View Abstract
  11. Sawada SG, Lewis S, Kovacs R, et al. Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography: a pilot study. Cardiovasc Ultrasound 2009;7:5View Abstract
  12. Shecterle L, Kasubick R, St. Cyr J. D-ribose benefits restless legs syndrome. J Altern.Complement Med 2008;14(9):1165-1166. View Abstract
  13. Steele IC, Patterson VH, Nicholls DP. A double blind, placebo controlled, crossover trial of D-ribose in McArdle’s disease. J Neurol Sci 1996;136(1-2):174-177. View Abstract
  14. Teitelbaum JE, Johnson C, St Cyr J. The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study. J Altern Complement Med 2006;12(9):857-862. View Abstract
  15. Wagner S, Herrick J, Shecterle LM, et al. D-ribose, a metabolic substrate for congestive heart failure. Prog Cardiovasc Nurs 2009;24(2):59-60. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical a