D-Ribose

Ribose · D-Ribofuranose

Snapshot

Indications	Contraindications
Cardiac energy metabolism¹ Myocardial ischemia tolerance¹ Exercise-induced angina¹ Fatigue²

D-ribose is a five-carbon sugar that forms the backbone of adenosine triphosphate (ATP), the cell's energy currency.¹ Supplementation aims to support ATP resynthesis in tissues that lose nucleotides under stress, a rationale first developed for the heart under ischemic conditions. The uses that follow are cardiac energy support, including in heart failure, and fatigue or low energy in otherwise healthy middle-aged adults, where it has been tested combined with nicotinamide.

In stable coronary artery disease, a 2000 review described improved time to exercise-induced angina¹. A 2021 narrative review in heart failure with preserved ejection fraction described D-ribose as supporting mitochondrial ATP production and cited a completed trial reporting improved ejection fraction³. About 620 products listing D-ribose are on the market, mostly powders with fewer capsules and liquids; see Form comparison.

In an equine study, long-term supplementation did not raise glycated plasma proteins, and no human glycation data accompany it⁴.

Last updated October 15, 2026. Read how we make monographs.

In the full monograph

29 sources, 10 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources