Supplement
D-ribose is a sugar your cells use to rebuild ATP, the molecule that powers muscles and the heart. People mostly look at it for heart failure and cardiomyopathy, where the evidence is moderate, and in one small group with heart failure, angina improved. Still, the studies were small, and in exercise trials ribose showed no clear difference in aerobic performance.
Sources: PMID 14607200
- Updated
- How we grade
- 14 studies cited
- Best evidence
- Grade C
- Conditions studied
- 11
- Outcomes
- 78
- Graded outcomes
- 0073
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| ATP Regeneration Small Increase | Improves (the measure goes up) | Small effect | 2 studies | 28 people | ||
| Ammonia No effect | NoneNo effect | 20 people | ||||
| Power Output | Improves (the measure goes up) | 3 studies | 46 people | |||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 2 studies | 28 people | |||
Studies that measured oxidative stress biomarkers | ||||||
| Blood glucose | Improves (the measure goes down) | 1 study | 26 people | |||
Studies that measured blood glucose | ||||||
| Blood Lactate (Exercise) | Changes; see studies | 20 people | ||||
| Blood Urea Nitrogen | Improves (the measure goes up) | 26 people | ||||
| Creatine Kinase | Changes; see studies | 47 people | ||||
| Cycling Performance | Improves (the measure goes up) | 8 people | ||||
| Glutathione (GSH) | Improves (the measure goes up) | 7 people | ||||
| Lactate Dehydrogenase | Improves (the measure goes up) | 21 people | ||||
| Maximal isometric voluntary contraction | Improves (the measure goes up) | 20 people | ||||
| Muscle Soreness | Improves (the measure goes down) | 21 people | ||||
| Muscle Strength | Improves (the measure goes up) | 21 people | ||||
| Myoglobin | Improves (the measure goes up) | 21 people | ||||
| Rating of Perceived Exertion | Improves (the measure goes up) | 26 people | ||||
| Uric Acid | Improves (the measure goes down) | 7 people | ||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Angina Small Improvement | Improves (the measure goes up) | Small effect | 20 people | |||
| ATP Regeneration | Improves (the measure goes up) | 2 studies | 15 people | |||
| Exercise Capacity | Improves (the measure goes up) | 2 studies | 251 people | |||
| Atrial Contribution To Left Ventricular Filling | Improves (the measure goes up) | 15 people | ||||
| Brain Natriuretic Peptide | Improves (the measure goes up) | 216 people | ||||
| E wave deceleration time | Improves (the measure goes up) | 15 people | ||||
| End-Systolic Volume | Improves (the measure goes up) | 15 people | ||||
| Exercise Tolerance | Improves (the measure goes up) | 35 people | ||||
| Glycogen Resynthesis | Improves (the measure goes up) | 15 people | ||||
| Left Atrial Dimension | Improves (the measure goes up) | 15 people | ||||
| Left Ventricular Diastolic Dimension | Improves (the measure goes up) | 15 people | ||||
| Left Ventricular Ejection Fraction | Improves (the measure goes up) | 231 people | ||||
| Quality of Life | Improves (the measure goes up) | 231 people | ||||
| Vigor/Activity | Improves (the measure goes up) | 216 people | ||||
Coronary Artery Disease (CAD)
- Angina: improves
- ATP Regeneration: improves
- Exercise Capacity: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Angina Small Improvement | Improves (the measure goes up) | Small effect | 20 people | |||
| ATP Regeneration | Improves (the measure goes up) | 2 studies | 15 people | |||
| Exercise Capacity | Improves (the measure goes up) | 2 studies | 35 people | |||
| Atrial Contribution To Left Ventricular Filling | Improves (the measure goes up) | 15 people | ||||
| E wave deceleration time | Improves (the measure goes up) | 15 people | ||||
| End-Systolic Volume | Improves (the measure goes up) | 15 people | ||||
| Exercise Tolerance | Improves (the measure goes up) | 35 people | ||||
| Left Atrial Dimension | Improves (the measure goes up) | 15 people | ||||
| Left Ventricular Diastolic Dimension | Improves (the measure goes up) | 15 people | ||||
| Left Ventricular Ejection Fraction | Improves (the measure goes up) | 15 people | ||||
| Quality of Life | Improves (the measure goes up) | 15 people | ||||
Fibromyalgia
- Fatigue Symptoms: improves
- Subjective Well-Being: improves
- Fibromyalgia Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Fatigue Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 36 people | |||
| Subjective Well-Being | Improves (the measure goes up) | 1 study | 36 people | |||
Studies that measured subjective well-being | ||||||
| Fibromyalgia Symptoms | Improves (the measure goes down) | 36 people | ||||
Myalgic Encephalomyelitis (Chronic Fatigue Syndrome)
- Fatigue Symptoms: improves
- Subjective Well-Being: improves
- Fibromyalgia Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Fatigue Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 36 people | |||
| Subjective Well-Being | Improves (the measure goes up) | 1 study | 36 people | |||
Studies that measured subjective well-being | ||||||
| Fibromyalgia Symptoms | Improves (the measure goes down) | 36 people | ||||
Muscle Size Strength
- Creatine Kinase: improves
- Oxidative Stress Biomarkers: improves
- Lactate Dehydrogenase: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Creatine Kinase Small Decrease | Improves (the measure goes down) | Small effect | 21 people | |||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 2 studies | 21 people | |||
Studies that measured oxidative stress biomarkers | ||||||
| Lactate Dehydrogenase | Improves (the measure goes up) | 21 people | ||||
| Muscle Soreness | Improves (the measure goes down) | 21 people | ||||
| Muscle Strength | Improves (the measure goes up) | 21 people | ||||
| Myoglobin | Improves (the measure goes up) | 21 people | ||||
Muscle Size & Strength
- Creatine Kinase: improves
- Oxidative Stress Biomarkers: changes; see studies
- Lactate Dehydrogenase: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Creatine Kinase Small Decrease | Improves (the measure goes down) | Small effect | 21 people | |||
| Oxidative Stress Biomarkers | Changes; see studies | 2 studies | 21 people | |||
Studies that measured oxidative stress biomarkers | ||||||
| Lactate Dehydrogenase | Improves (the measure goes up) | 21 people | ||||
| Muscle Soreness | Changes; see studies | 21 people | ||||
| Muscle Strength | Improves (the measure goes up) | 21 people | ||||
| Myoglobin | Improves (the measure goes up) | 21 people | ||||
Aerobic Exercise Performance
- Aerobic Exercise Metrics
- Power Output: improves
- ATP Regeneration: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Aerobic Exercise Metrics No effect | NoneNo effect | 1 study | 31 people | |||
Studies that measured aerobic exercise metrics | ||||||
| Power Output | Improves (the measure goes up) | 3 studies | 26 people | |||
| ATP Regeneration | Improves (the measure goes up) | 2 studies | 8 people | |||
| Blood glucose | Improves (the measure goes down) | 1 study | 26 people | |||
Studies that measured blood glucose | ||||||
| Blood Urea Nitrogen | Improves (the measure goes up) | 26 people | ||||
| Creatine Kinase | Changes; see studies | 26 people | ||||
| Cycling Performance | Improves (the measure goes up) | 8 people | ||||
| Rating of Perceived Exertion | Improves (the measure goes up) | 26 people | ||||
Anaerobic Exercise Performance
- Ammonia
- Power Output: improves
- ATP Regeneration: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Ammonia No effect | NoneNo effect | 51 people | ||||
| Power Output | Improves (the measure goes up) | 3 studies | 28 people | |||
| ATP Regeneration | Improves (the measure goes up) | 2 studies | 20 people | |||
| Peak power output (PPO) | Improves (the measure goes up) | 2 studies | 39 people | |||
| Blood glucose | Improves (the measure goes down) | 1 study | 31 people | |||
Studies that measured blood glucose | ||||||
| Blood Lactate (Exercise) | Changes; see studies | 51 people | ||||
| Maximal isometric voluntary contraction | Improves (the measure goes up) | 20 people | ||||
| Uric Acid | Improves (the measure goes down) | 19 people | ||||
Type 1 Diabetes
- Blood glucose: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose | Improves (the measure goes down) | 1 study | 34 people | |||
Studies that measured blood glucose | ||||||
Type 2 Diabetes
- Blood glucose: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose | Improves (the measure goes down) | 1 study | 34 people | |||
Studies that measured blood glucose | ||||||
Key findings
- ATP RegenerationImproves (the measure goes up)
- AnginaImproves (the measure goes up)
- Fatigue SymptomsImproves (the measure goes down)
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- Grade C
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Studies cited
14 studies from PubMed
- No effects of oral ribose supplementation on repeated maximal exercise and de novo ATP resynthesis
- The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study
- D-Ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study
- Effects of ribose on exercise-induced ischaemia in stable coronary artery disease.
- Effects of Ubiquinol and/or D-ribose in Patients With Heart Failure With Preserved Ejection Fraction.
- Ribose versus dextrose supplementation, association with rowing performance: a double-blind study
- The influence of D-ribose ingestion and fitness level on performance and recovery
- Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans
- Effects of ribose supplementation on repeated sprint performance in men
- Effects of oral D-ribose supplementation on anaerobic capacity and selected metabolic markers in healthy males
- Effects of ribose supplementation prior to and during intense exercise on anaerobic capacity and metabolic markers
- The role of ribose on oxidative stress during hypoxic exercise: a pilot study
- Effect of D-ribose supplementation on delayed onset muscle soreness induced by plyometric exercise in college students.
- Oral administration of D-ribose in diabetes mellitus.