Beta-D-ribofuranose, D-ribosa, D-ribose, Ribosa.
Ribose is a kind of sugar that is produced by the body. It is used as a medicine.
Ribose is used to improve athletic performance and the ability to exercise by boosting muscle energy. It has also been used to improve symptoms of chronic fatigue syndrome (CFS), fibromyalgia, and coronary artery disease. Ribose has been used to prevent symptoms such as cramping, pain, and stiffness after exercise in people with an inherited disorder called myoadenylate deaminase deficiency (MAD) or AMP deaminase deficiency (AMPD deficiency). Ribose has also been used to improve exercise ability in people with another inherited disorder called McArdle's disease.
Healthcare providers sometimes give ribose intravenously (by IV) as part of an imaging procedure used to measure the extent of damaged heart muscle in people with coronary artery disease. Ribose has also been used intravenously in patients with MAD to prevent symptoms such as cramping, pain, and stiffness.
How does it work?
Ribose is an energy source that the body makes from food. There is some evidence that supplemental ribose might prevent muscle fatigue in people with genetic disorders that prevent sufficient energy production by the body. It might provide extra energy to the heart during exercise in people with heart disease.
Possibly Effective for...
- Clogged heart arteries (coronary artery disease). Taking ribose by mouth seems to be effective for improving the heart's ability to manage low blood flow in people with coronary artery disease.
- Myoadenylate deaminase deficiency (MAD). Taking ribose by mouth or intravenously seems to be effective for preventing symptoms such as cramping, pain, and stiffness after exercise in people with MAD, also known as AMP deaminase deficiency (AMPD deficiency).
Possibly Ineffective for...
- Athletic performance. Research suggests that taking ribose supplements by mouth, alone or with other supplements, does not increase power or improve muscle strength in trained or untrained individuals.
Likely Ineffective for...
- McArdle's disease (a genetic metabolic disorder). Research shows that taking ribose by mouth does not improve exercise ability in people with McArdle's disease.
Insufficient Evidence to Rate Effectiveness for...
- Chronic fatigue syndrome (CFS). Early research suggests that taking a ribose supplement (CORvalen, Valen Labs) by mouth might improve energy, sleep, and sense of well-being in people with chronic fatigue syndrome.
- Mental function. Early research suggests that taking ribose by mouth for 8 days does not improve performance during tasks that cause mental fatigue.
- Congestive heart failure (CHF). Early research suggests that people with congestive heart failure who take a ribose by mouth for 3 weeks have better heart function and improved quality of life.
- Coronary artery bypass graft (CABG) surgery. Early research shows that people who take a ribose supplement by mouth immediately before surgery have better heart function after surgery.
- Fibromyalgia. Early research suggests that taking a specific ribose supplement (CORvalen, Valen Labs) by mouth can improve energy, sleep, and sense of well-being and decrease pain in people with fibromyalgia.
- A disorder that causes a strong urge to move ones legs (restless legs syndrome; RLS). Limited evidence suggests that taking ribose by mouth with meals improves symptoms in people with restless legs syndrome.
- Seizures. Early research suggests that taking ribose by mouth might improve behavior and reduce seizure frequency in people with seizures caused by a deficiency of the chemical adenylosuccinase.
- Other conditions.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Ribose seems to be LIKELY SAFE for most people when taken by mouth for short-term use or when given intravenously (by IV) by a healthcare provider. It can cause some side effects including diarrhea, stomach discomfort, nausea, headache, and low blood sugar.
There isn't enough information about the safety of long-term use.
Low blood sugar (hypoglycemia): Ribose might lower blood sugar. If you already have blood sugar that is too low, don't take ribose.
Surgery: Since ribose might lower blood sugar, there is a concern that it might interfere with blood sugar control during and after surgery. Stop taking ribose at least 2 weeks before a scheduled surgery.
InsulinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Ribose might decrease blood sugar. Insulin is also used to decrease blood sugar. Taking ribose along with insulin might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your insulin might need to be changed.
Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Ribose might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking ribose along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (Diabeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
AlcoholInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.
Alcohol might decrease your blood sugar. Ribose might also decrease your blood sugar. Taking ribose along with alcohol might cause your blood sugar to go too low.
AspirinInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.
Ribose might decrease blood sugar. Large amounts of aspirin might also decrease blood sugar. Taking ribose along with large amounts of aspirin might cause your blood sugar to go too low. But this interaction probably isn't a big concern for most people that take 81 mg of aspirin a day.
Choline magnesium trisalicylate (Trilisate)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Choline magnesium trisalicylate (Trilisate) might decrease your blood sugar. Ribose might also decrease blood sugar. Taking ribose along with choline magnesium trisalicylate (Trilisate) might cause your blood sugar to be too low. But it is not clear if this interaction is a big concern.
Propranolol (Inderal)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Propranolol (Inderal) might decrease blood sugar. Ribose might also decrease blood sugar. Taking ribose along with propranolol (Inderal) might cause your blood sugar to go too low.
Salsalate (Disalcid)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Large amounts of salsalate (Disalcid) can cause blood sugar to become low. Taking salsalate along with ribose might cause blood sugar to become too low.
IMAGESBrowse through our medical image collection to see illustrations of human anatomy and physiology See Images
The following doses have been studied in scientific research:
- To improve the ability of people with coronary artery disease to exercise: 15 grams four times daily. Beginning 1 hour before exercise until the end of the exercise session, 3 grams every 10 minutes has been used to reduce muscle stiffness and cramps caused by exercising.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Healthy Heart Resources
Health Solutions From Our Sponsors
Ataka, S., Tanaka, M., Nozaki, S., Mizuma, H., Mizuno, K., Tahara, T., Sugino, T., Shirai, T., Kajimoto, Y., Kuratsune, H., Kajimoto, O., and Watanabe, Y. Effects of oral administration of caffeine and D-ribose on mental fatigue. Nutrition 2008;24(3):233-238. View abstract.
Earnest, C. P., Morss, G. M., Wyatt, F., Jordan, A. N., Colson, S., Church, T. S., Fitzgerald, Y., Autrey, L., Jurca, R., and Lucia, A. Effects of a commercial herbal-based formula on exercise performance in cyclists. Med Sci Sports Exerc. 2004;36(3):504-509. View abstract.
Gilula, M. F. Cranial electrotherapy stimulation and fibromyalgia. Expert.Rev.Med Devices 2007;4(4):489-495. View abstract.
Gunning, M. G., Clunie, G., Bradley, J., Gupta, N. K., Bomanji, J. B., and Ell, P. J. Slow bolus injection of ribose in the identification of thallium-201 redistribution following combined adenosine/dynamic exercise stress. Eur.Heart J 1996;17(9):1438-1443. View abstract.
Hellsten, Y., Skadhauge, L., and 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.
Hendel, R. C. Single-photon perfusion imaging for the assessment of myocardial viability. J Nucl.Med 1994;35(4 Suppl):23S-31S. View abstract.
Hjiej, H., Doyen, C., Couprie, C., Kaye, K., and Contejean, Y. [Substitutive and dietetic approaches in childhood autistic disorder: interests and limits]. Encephale 2008;34(5):496-503. View abstract.
Kendler, B. S. Supplemental conditionally essential nutrients in cardiovascular disease therapy. J Cardiovasc.Nurs. 2006;21(1):9-16. View abstract.
MacCarter, D., Vijay, N., Washam, M., Shecterle, L., Sierminski, H., and St Cyr, J. A. D-ribose aids advanced ischemic heart failure patients. Int J Cardiol. 9-11-2009;137(1):79-80. View abstract.
Pauly, D. F. and Pepine, C. J. D-Ribose as a supplement for cardiac energy metabolism. J Cardiovasc.Pharmacol.Ther. 2000;5(4):249-258. View abstract.
Pauly, D. F. and Pepine, C. J. Ischemic heart disease: metabolic approaches to management. Clin.Cardiol. 2004;27(8):439-441. View abstract.
Quinlivan, R. M. and Beynon, R. J. Pharmacological and nutritional treatment trials in McArdle disease. Acta Myol. 2007;26(1):58-60. View abstract.
Salerno, C., D'Eufemia, P., Finocchiaro, R., Celli, M., Spalice, A., Iannetti, P., Crifo, C., and Giardini, O. Effect of D-ribose on purine synthesis and neurological symptoms in a patient with adenylosuccinase deficiency. Biochim.Biophys.Acta 1-6-1999;1453(1):135-140. View abstract.
Sawada, S. G., Lewis, S., Kovacs, R., Khouri, S., Gradus-Pizlo, I., St Cyr, J. A., and Feigenbaum, H. Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography: a pilot study. Cardiovasc.Ultrasound 2009;7:5. View abstract.
Shecterle, L., Kasubick, R., and St, Cyr J. D-ribose benefits restless legs syndrome. J Altern.Complement Med 2008;14(9):1165-1166. View abstract.
Wagner, S., Herrick, J., Shecterle, L. M., and St Cyr, J. A. D-ribose, a metabolic substrate for congestive heart failure. Prog.Cardiovasc.Nurs. 2009;24(2):59-60. View abstract.
Zimmer, H. G., Ibel, H., Suchner, U., and Schad, H. Ribose intervention in the cardiac pentose phosphate pathway is not species-specific. Science 2-17-1984;223(4637):712-714. View abstract.
Berardi JM, Ziegenfuss TN. Effects of ribose supplementation on repeated sprint performance in men. J Strength Cond Res 2003;17:47-52. View abstract.
Burke ER. D-Ribose What You Need To Know. Garden City Park, NY: Avery Publishing Group 1999;1-43.
Chatham JC, John Challiss RA, Radda GK, et al. Studies of the protective effect of ribose in myocardial ischaemia by using P31-nuclear-magnetic-resonance spectroscopy. Biochem Soc Trans 1985;13:885-6.
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. View abstract.
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. View abstract.
Foker JE, Einzig S, Wang T. Adenosine metabolism and myocardial preservation. Consequences of adenosine catabolism on myocardial high-energy compounds and tissue blood flow. J Thorac Cardiovasc Surg 1980;80:506-16. View abstract.
Fox IH, Kelley WN. Phosphoribosylpyrophosphate in man: biochemical and clinical significance. Ann Intern Med 1971;74:424-33. View abstract.
Geisbuhler TP, Schwager TL. Ribose-enhanced synthesis of UTP, CTP, and GTP from parent nucleosides in cardiac myocytes. J Mol Cell Cardiol 1998;30:879-87. View abstract.
Gross M, Reiter S, Zollner N. Metabolism of D-ribose administered continuously to healthy persons and to patients with myoadenylate deaminase deficiency. Klin Wochenschr 1989;67:1205-13. View abstract.
Hegewald MG, Palac RT, Angello DA, et al. Ribose infusion accelerates thallium redistribution with early imaging compared with late 24-hour imaging without ribose. J Am Coll Cardiol 1991;18:1671-81. View abstract.
Hellsten-Westing Y, Norman B, Balsom PD, et al. Decreased resting levels of adenine nucleotides in human skeletal muscle after high-intensity training. J Appl Physiol 1993;74:2523-8. View abstract.
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;15:653-64. View abstract.
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. View abstract.
Muller C, Zimmer HG, Gross M, et al. Effect of ribose on cardiac adenine nucleotides in a donor model for heart transplantation. Eur J Med Res 1998;3:554-8. View abstract.
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. View abstract.
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. View abstract.
Pasque MK, Spray TL, Pellom GL, et al. Ribose-enhanced myocardial recovery following ischemia in the isolated working rat heart. J Thorac Cardiovasc Surg 1982;83:390-8. View abstract.
Pasque MK, Wechsler AS. Metabolic intervention to affect myocardial recovery following ischemia. Ann Surg 1984;200:1-12. View abstract.
Perkowski D, Wagner S, Marcus A, St. Cyr J. Ribose enhances ventricular function following off pump coronary artery bypass surgery. J Altern Complement Med 2005;11:745.
Perlmutter NS, Wilson RA, Angello DA, et al. Ribose facilitates thallium-201 redistribution in patients with coronary artery disease. J Nucl Med 1991;32:193-200. View abstract.
Peveler WW, Bishop PA, Whitehorn EJ. Effects of ribose as an ergogenic aid. J Strength Cond Res 2006;20:519-22. View abstract.
Pliml W, von Arnim T, Stalein A, et al. Effects of ribose on excercise-induced ischaemia in stable coronary artery disease. Lancet 1992;340:507-10. View abstract.
Segal S, Foley J. The metabolism of D-ribose in man. J Clin Invest 1958;37:719-35.
St Cyr JA, Bianco RW, Schneider JR, et al. Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model. J Surg Res 1989;46:157-62. View abstract.
Stathis CG, Febbraio MA, Carey MF, et al. Influence of sprint training on human skeletal muscle purine nucleotide metabolism. J Appl Physiol 1994;76:1802-9. View abstract.
Steele IC, Patterson VH, Nicholls DP. A double blind, placebo controlled, crossover trial of D-ribose in McArdle's disease. J Neurol Sci 1996;136:174-7. View abstract.
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;12:857-62. View abstract.
Tullson PC, Bangsbo J, Hellsten Y, et al. IMP metabolism in human skeletal after exhaustive exercise. J Appl Physiol 1995;78:146-52. View abstract.
Wagner DR, Felbel J, Gresser U, et al. Muscle metabolism and red cell ATP/ADP concentration during bicycle ergometer in patients with AMPdeficiency. Klin Wochenschr 1991;69:251-5. View abstract.
Wagner DR, Gresser U, Zollner N. Effects of oral ribose on muscle metabolism during bicycle ergometer in AMPD-deficient patients. Ann Nutr Metab 1991;35:297-302. View abstract.
Ward HB, St Cyr JA, Cogordan JA. Recovery of adenine nucleotide levels after global myocardial ischemia in dogs. Surgery 1984;96:248-55. View abstract.
Zollner N, Reiter S, Gross M, et al. Myoadenylate deaminase deficiency: successful symptomatic therapy by high dose oral administration of ribose. Klin Wochenschr 1986;64:1281-90. View abstract.