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Supplements

D-ribose

What is It?
Health Benefits

Forms

Dosage Information

Guidelines for Use

General Interaction

Possible Side Effects

Cautions

References

Evidence Based Rating Scale

What Is It?

D-ribose is a monosaccharide – one of the simplest carbohydrates, consisting of one sugar. D-ribose is a building block for disaccharides such as sucrose (common sugar) and polysaccharides (such as cellulose and starch). It is sweet to taste and usually is a colorless, water-soluble, crystalline solid found in small amounts in many plant and animal foods. Ribose also is made in the body from glucose. And because it is not an essential nutrient, deficiencies do not occur.

Ribose is crucial, however, as components to two important nucleic acids known as RNA and DNA, which form and translate the body’s genetic codes. Ribose also is a component of the energy-containing substance adenosine tri-phosphate (ATP), which is critical to metabolism. Some animal and human research has shown ribose supplementation speeds up regeneration of ATP in muscle cells of the heart and elsewhere in the body when those cells have been deprived of oxygen. (1-4) D-ribose has been studied for improving heart function – particularly in coronary artery disease – and for boosting athletic performance.

Health Benefits

While D-ribose is most often hyped for its ability to speed energy recovery and increase energy reserves for enhanced athletic performance, the scientific evidence indicates D-ribose is more effective in maintaining healthy energy levels in the heart and has been shown to improve symptoms of coronary artery disease and congestive heart failure; and it also has been studied as a potentially viable treatment in chronic fatigue syndrome and fibromyalgia. 

Specifically, D-ribose may help to: 

Treat coronary artery disease (CAD). Coronary artery disease, characterized by a narrowing of the arteries that supply the heart with blood, oxygen and nutrients, impairs cardiac energy metabolism. Several studies in patients with CAD have shown the ability of ribose to stimulate ATP synthesis and improve cardiac function improving the heart’s tolerance to ischemia (decreased oxygen). In a small, randomized, placebo-controlled study published in Lancet in 1992, 20 men with severe CAD underwent treadmill exercise tests for two consecutive days then received either placebo or four 15 gm doses of ribose daily for three days. When exercise testing was repeated after treatment, the mean treadmill walking time until appearance of EKG changes (1 mm ST-segment depression) was significantly greater in the ribose than in the placebo group. In the group treated with ribose, the changes from baseline to day five in both time to ST depression and time to moderate angina were significant, but changes in the placebo group were not significant. Ribose, therefore, seemed to improve the heart’s tolerance to exercise. (5) However, few randomized, controlled studies have evaluated this use of ribose in humans. More human studies are needed in this area. 

Improve symptoms of congestive heart failure. When the heart is damaged by various conditions – such as heart attack, high blood pressure, or congenital heart defects – it may be unable to pump enough blood to meet the body’s oxygen needs. This condition is called congestive heart failure (CHF). Preliminary research indicates ribose supplementation may improve measures of cardiac function and improve quality of life in patients with CHF. In a 2003 prospective, double-blind, randomized, crossover study, 15 patients with chronic CAD and CHF who received five grams of ribose daily for three weeks showed improved measures of cardiac function and enhanced quality of life, compared to no significant changes in the placebo group. (6) 

Treat symptoms of chronic fatigue syndrome and fibromyalgia. Chronic fatigue syndrome and fibromyalgia – both characterized by low energy levels, fatigue, and pain – are often accompanied by impaired cellular energy metabolism. Although not well studied in these areas, a pilot study suggests the metabolic role of D-ribose to increase cellular energy synthesis in the heart and skeletal muscles may help to improve these symptoms of chronic fatigue syndrome and/or fibromyalgia. In this 2006 open-label uncontrolled pilot study of 41 patients with CFS and/or fibromyalgia who were treated with five grams of ribose three times a day, 66 percent of patients with either condition reported significant improvements in symptoms such as energy, pain, mental clarity, pain intensity, and well-being. (7) 

Enhance athletic performance. Although D-ribose has traditionally been used to enhance athletic performance, scientific evidence indicates supplementation does not seem to significantly increase power output or anaerobic exercise capacity  or improve muscle strength when used in a wide range of doses. However, most clinical studies have been small and of low-to-moderate quality. In one study of 11 men taking either 625 mg of ribose supplement or placebo a half hour before Wingate testing (cycle testing to determine peak anaerobic power and anaerobic capacity), supplementation did not seem to improve power output in the men. (8) Similarly, in a 2003 study of 19 athletically trained men, taking 10 grams of ribose daily did not significantly improve anaerobic exercise capacity compared to 10 grams of dextrose placebo daily during Wingate tests. (9) Several other studies also found ribose did not improve anaerobic capacity compared to placebo. (10-14) 

Forms

  • Capsule
  • Powder

Dosage Information

  • To improve exercise tolerance in patients with CAD, 15 grams four times daily has been used.
  • For chronic fatigue syndrome: 5 grams three times daily has been used.
  • For congestive heart failure: 5 grams three times daily.
  • For fibromyalgia: 5 grams three times daily has been used.

Guidelines for Use

  • D-ribose may be taken with or without food.
  • Powder forms can be mixed with water, juice, or other beverages.

General Interaction

There are no known drug or nutrient interactions associated with D-ribose.

Possible Side Effects

  • No known side effects have been reported from the use of ribose when consumed in amounts of less than 10 grams per day.
  • Larger amounts may cause gastrointestinal distress such as diarrhea, and may lower glucose levels, although it is not known whether symptoms of hypoglycemia might result.

Cautions

  • Avoid taking D-ribose if you have diabetes because it may interfere or enhance the glucose lowering effects of insulin or oral anti-hyperglycemic agents.

References

1. Zimmer HG, Ibel H, Suchner U, Schad H. Ribose intervention in the cardiac pentose phosphate pathway is not species-specific. Science. 1984;223:712-4.
2. Zimmer HG, Ibel H. Ribose accelerates the repletion of the ATP pool during recover from reversible ischemia of the rat myocardium. J Mol Cell Cardiol. 1984;16:863-6.
3. Kavazis AN, Sobota JS, Kivipelto J, et al. Ribose supplementation in maximally exercising Thoroughbreds. Equine Vet J Suppl. 2002;34:191-6.
4. Pauly DF, Pepine CJ. D-Ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther. 2000;5:249-58.
5. Pliml W, von Arnim T, Stablein A, et al. Effects of ribose on exercise-induced ischaemia in stable coronary artery disease. Lancet. 1992 Aug 29;340(8818):507-10.
6. Omran H, Illien S, MacCarter D, et al. D-Ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study. Eur J Heart Fail. 2003;5:615-9.
7. 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 Nov;12(9):857-62.
8. Peveler WW, Bishop PA, Whitehorn EJ. Effects of ribose as an ergogenic aid. J Strength Cond Res. 2006;20:519-22.
9. Kreider RB, Melton C, Greenwood M, et al. Effects of oral D-ribose supplementation on anaerobic capacity and selected metabolic markers in healthy males. Int J Sport Nutr Exerc Metab. 2003;13:76-86.
10. 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;15:653-4.
11. Berardi JM, Ziegenfuss TN. Effects of ribose supplementation on repeated sprint performance in men. J Strength Cond Res. 2003;17:47-52.
12. Dunne L, Worley S, Macknin M. Ribose versus dextrose supplementation, association with rowing performance: a double-blind study. Clin J Sport Med. 2006;16:68-71.
13. Falk DJ, Heelan KA, Thyfault JP, Koch AJ. Effects of effervescent creatine, ribose, and glutamine supplementation on muscular strength, muscular endurance, and body composition. Strength Cond Res. 2003;17:810-6.
14. Op ‘t Eijnde B, Van Leemputte M, Brouns F, et al. No effects of oral ribose supplementation on repeated maximal exercise and de novo ATP resynthesis. J Appl Physiol. 2001;91:2275-81.


Date Published: 04/22/2008
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