Ribose is a carbohydrate vital for the body's manufacture of ATP (adenosine triphosphate), which is the major source of energy used by our cells.
Quite a few studies have been done on ribose, mostly relating to its potential usefulness for individuals with heart disease. When the heart is starved for oxygen, as can occur with a
angina, it loses much of its ATP, and its ATP levels remain low for several days, even after blood flow is resumed.1
Scientists have found that supplying extra ribose in the blood helps restore the heart's normal ATP levels more quickly. This finding has raised hopes that ribose supplements might improve heart functioning and increase exercise capacity.
Ribose is better known as a
sports supplement. However, current evidence indicates that it is
effective for this purpose.
Ribose is not an essential nutrient. Although it is a common sugar present in the bodies of animals and plants, food sources don't supply recommended dosages.
Typical doses recommended by sports supplement manufacturers are 1 to 10 g per day. However, researchers have used much higher doses. For example, in a study focusing on coronary artery disease and exercise-induced ischemia (problems with blood supply to the heart), the participants took 15 grams of ribose 4 times a day for 3 days.2
Typically provided as a powder to be dissolved in water or in liquid form, ribose is also available commercially in capsules. The dissolved powder has a sweetish taste that some people find unpleasant.5
Ribose may be of benefit in improving exercise tolerance in people with
angina by helping the heart regenerate its ATP, but the evidence that it works remains highly preliminary.6
One small study found evidence that ribose supplements might improve heart function in people with
congestive heart failure.17
Sports enthusiasts are more interested in ATP's effects on regular muscles than on the heart muscle. At least one animal study seems to show that skeletal muscle, like heart muscle, replenishes ATP more quickly when ribose is added to the blood.7
In theory, this could lead to
in high intensity anaerobic exercise, such as sprinting. However, six small
double-blind, placebo-controlled trials in humans failed to find any benefit.14-16,18-19,21 In one of these studies, dextrose (a form of ordinary sugar) proved effective while ribose did not.20
In one small, double-blind study, ribose failed to prove effective for
enhancing mental function.22
The researchers suggest that the dose they used (2 g daily) may have been insufficient.
In a few case reports, ribose apparently has produced an increase in exercise ability in people with a rare condition involving deficiency of the enzyme myoadenylate deaminase (AMPD).8,9 However, no double-blind studies of ribose in AMPD deficiency have been conducted. Small, double-blind studies have failed to find ribose effective for another rare enzyme deficiency, called McArdle's disease,10 or for Duchenne's muscular dystrophy.11
Individuals with sufficiently severe coronary artery disease suffer reduced blood flow to the heart (ischemia) with exercise and experience
angina pain. One small study examined whether giving ribose can improve exercise tolerance for people with angina.12
In the study, 20 men with severe coronary artery disease walked on a treadmill while researchers noted how long it took for signs of ischemia to develop. For the next 3 days, the men took either oral ribose (60 mg per day) or placebo, after which they repeated the treadmill test. Results of the final test showed that those taking ribose increased the time they were able to walk before developing EKG signs of ischemia, while those taking placebo had no such improvement. This preliminary study was too small to prove anything definitively, but it certainly suggests that further investigation would be worthwhile.
Another small placebo-controlled study enrolled people with coronary artery disease and
congestive heart failure and found that use of ribose supplements improved objective measures of heart function and also enhanced subjective "quality of life."17
There are no reports of lasting or damaging side effects from ribose, but formal safety studies have not yet been conducted. Reported minor side effects include diarrhea, gastrointestinal discomfort, nausea, and headache.13
Pliml W, von Arnim T, Stablein A, et al. Effects of ribose on exercise-induced ischaemia in stable coronary artery disease.
Zollner N, Reiter S, Gross M, et al. Myoadenylate deaminase deficiency: successful symptomatic therapy by high dose oral administration of ribose.
Klin Wochenschr. 1986;64:1281-1290.
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.
Steele IC, Patterson VH, Nicholls DP. A double blind, placebo controlled, crossover trial of D-ribose in McArdle's disease.
J Neurol Sci. 1996;136:174-177.
Tullson PC, Terjung RL. Adenine nucleotide synthesis in exercising and endurance-trained skeletal muscle.
Am J Physiol. 1991;261(2 pt 1):C342-C347.
Griffiths RD, Cady EB, Edwards RH, et al. Muscle energy- metabolism in Duchenne dystrophy studied by 31P-NMR: controlled trials show no effect of allopurinol or ribose.
Muscle Nerve. 1985;8:760-767.
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;91:2275-2281.
Berardi JM, Ziegenfuss TN. Effects of ribose supplementation on repeated sprint performance in men.
J Strength Cond Res. 2003;17:47-52.
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;13:87-96.
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;5:615-619.
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. 2006;15:653-664.
Dunne L, Worley S, Macknin Mm, et al. Ribose Versus Dextrose Supplementation, Association With Rowing Performance: A Double-Blind Study.
Clin J Sport Med. 2005;16:68-71.
Dunne L, Worley S, Macknin M, et al. Ribose Versus Dextrose Supplementation, Association With Rowing Performance: A Double-Blind Study.
Clin J Sport Med. 2005;16:68-71.
Peveler WW, Bishop PA, Whitehorn EJ. Effects of ribose as an ergogenic aid.
J Strength Cond Res. 2006;20:519-522.
Ataka S, Tanaka M, Nozaki S, et al. Effects of oral administration of caffeine and D-ribose on mental fatigue.
2008 Jan 4.
Last reviewed September 2014 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.