Research and Literature


June 21, 2018   /




Contributed by Elaine M. Koontz, RD, LD/N

Reviewed and updated by Anne Danahy, MS, RDN, LDN


Ribose is a sugar produced by the body, and the energy-producing substrate for ATP, the form of energy that all cells in the body use. Ribose is also used as a medication and supplement (as D-ribose). Clinically, it is used by people with the genetic muscle condition myoadenylate deaminase deficiency (MAD) to improve their symptoms of cramping, pain, and stiffness after exercise. There is also research that supports its use to improve cardiac function in patients with heart failure.


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In addition, some evidence suggests that D-Ribose may improve symptoms of chronic fatigue syndrome, fibromyalgia, restless legs syndrome, and coronary artery disease. Some athletes take D-ribose to improve athletic performance. However, research on these uses for D-ribose shows mixed results.


Research on cardiovascular disease

When a person has a heart attack, their levels of adenosine triphosphate (ATP) decrease sharply and rapidly. This reduction in ATP is the major culprit in long-term heart damage following a heart attack. It is known as ischemia-reperfusion injury. The faster the heart muscle cells recover, the less risk for long-term damage to the heart. D-ribose has been shown to increase ATP levels after a heart attack in animal studies, but human studies are limited and those who appear to benefit the most from D-ribose are patients with heart failure and myocardial ischemia.

In a small pilot study on patients with congestive heart failure and ischemic heart disease, researchers determined that after 6 weeks of oral supplementation with D-ribose (5g 3 times each day), there was an improvement in cardiac function in 64% of patients. The improvement was also maintained at a week-9 follow-up.1

D-ribose also improved ventilation efficiency in patients with advanced heart failure who complained of shortness of breath. After 8 weeks of supplementation with 5g D-ribose 3 times/day, all 16 study subjects demonstrated improvements in breathing and ventilation efficiency after an exercise test.2

During some heart surgeries, a cardiac arrest is induced. This can cause rapid deterioration of heart muscle function and delay recovery. Experimentally, hearts demonstrate a 50% reduction in myocardial ATP levels following ischemia while on cardiopulmonary bypass. With reperfusion, it can take 9 to 10 days for complete recovery. In an animal study when scientists administered a solution containing D-ribose to the heart during surgery, the supplemented experimental group demonstrated significant improvement in heart muscle function, when compared with controls.3

Reported side effects of ribose include diarrhea, stomach discomfort and nausea, headache, and low blood sugar. Use of ribose is cautioned for people with diabetes or hypoglycemia, those who are having surgery, and pregnant or breastfeeding women. D-ribose supplements are often $30 to $50/month.


References and recommended readings

  1. Bayram M, St. Cyr JA, Abraham WT. D-ribose aids heart failure patients with preserved ejection fraction and diastolic dysfunction: a pilot study. Ther Adv Cardiovasc Dis. 2015;9(3):56-65.
  2. MacCarter D, Vijay N, Washam M, Shecterle L, Sierminski H, Cyr JS. D-ribose aids advanced ischemic heart failure patients. Int J Cardiol. 2009;137(1):79-80.
  3. Wyatt DA, Ely SW, Lasley RD, Walsh R, Mainwaring R, Berne RM, Mentzer JR. Purine-enriched asanguineous cardioplegia retards adenosine triphosphate degradation during ischemia and improves postischemic ventricular function. J Thoraci Cardiovasc Surg. 1989;97(5):771-778.
  4. Mahoney DE, Hiebert JB, Thimmesch A, Pierce JT, Vacek JL, Clancy RL, Sauer AJ, Pierce JD. Understanding D-Ribose and Mitochondrial Function. Adv Biosci Clin Med. 2018;6(1):1-5.
  5. Pauly DF, Pepine CJ. D-Ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther. 2000;5(4):249-58.
  6. Shecterle LM, Cyr JA. A potential role of D-ribose for myocardial diastolic dysfunction. J Card Ther. 2014;1(1).


Current review date: 6/21/18

Previous review date: 2/27/18