Ribose as a therapeutic supplement
Ribose is a naturally occurring carbohydrate that plays a crucial role in the production of ATP (adenosine triphosphate), the primary energy source for cells in the human body. It is often considered for therapeutic use, particularly in relation to heart health. Some studies suggest that ribose supplementation may help restore ATP levels in the heart more quickly after oxygen deprivation, potentially benefiting individuals with conditions such as angina and congestive heart failure. However, evidence supporting its effectiveness in these areas remains preliminary and warrants further investigation.
Despite its popularity as a sports supplement, research indicates that ribose may not enhance athletic performance, especially in high-intensity exercises, as multiple studies have shown no significant benefits compared to placebo. Additionally, ribose is not an essential nutrient, and typical dietary sources do not provide sufficient amounts for therapeutic purposes, leading to recommended dosages ranging from 1 to 10 grams per day. While ribose appears to be safe for short-term use, minor side effects like gastrointestinal discomfort and headaches have been reported. Overall, ribose presents a complex profile, with potential benefits primarily focused on specific heart-related conditions rather than general athletic enhancement or performance.
Ribose as a therapeutic supplement
DEFINITION: Natural substance of the human body used as a supplement to treat specific health conditions.
- PRINCIPAL PROPOSED USES: None
- OTHER PROPOSED USES: Angina, congenital myoadenylate deaminase deficiency, congestive heart failure, enhancement of mental function
- PROBABLY NOT EFFECTIVE USES: Duchenne muscular dystrophy, McArdle’s disease, sports performance enhancement (high-intensity exercise)
Overview
Ribose is a carbohydrate vital for the body’s manufacture of ATP (adenosine triphosphate), which is the major source of energy used by the cells. Many 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 heart attack or angina, it loses much of its ATP, and its ATP levels remain low for several days, even after blood flow is resumed. Scientists have found that supplying extra ribose in the blood may help 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 best known as a sports supplement. However, evidence indicates that it is not effective for this purpose.
Requirements and Sources
Ribose is not an essential nutrient. Although it is a common sugar present in the bodies of animals and plants, food sources do not supply recommended dosages.
Therapeutic Dosages
Typical dosages of ribose recommended by sports supplement manufacturers are one to 10 grams (g) per day, which has been shown to be safe for up to eight weeks. However, researchers have used much higher dosages. 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 g of ribose four times a day for three days.
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.
Therapeutic Uses
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. One small study found evidence that ribose supplements might improve heart function in people with congestive heart failure.
Sports enthusiasts are more interested in the effects of ATP on regular muscles than in its effects on the heart muscle. Some animal studies seem to show that skeletal muscle, like heart muscle, replenishes ATP more quickly when ribose is added to the blood. In theory, this could lead to enhanced performance in high-intensity anaerobic exercise, such as sprinting. However, six small double-blind, placebo-controlled trials in humans failed to find any benefit. In one of these studies, dextrose (a form of ordinary sugar) proved effective, while ribose did not. These results were confirmed by a similar study in 2017.
In a few case reports, ribose apparently increased exercise ability in people with a rare condition involving a deficiency of the enzyme myoadenylate deaminase (AMPD). However, more research is required to confirm these findings. Overall, scientific findings for ribose's use by novice and experienced athletes to enhance performance do not support its use.
In one small double-blind study, ribose failed to effectively enhance mental function. The researchers suggest that their dose (2 g daily) may have been insufficient. Small double-blind studies have failed to find ribose effective for another rare enzyme deficiency, McArdle’s disease, or for Duchenne’s muscular dystrophy.
Scientific Evidence
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. In the study, twenty 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 three days, the men took either oral ribose (60 milligrams (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 the use of ribose supplements improved objective measures of heart function and also enhanced subjective quality of life.
Small studies in athletes concerning the role of ribose in improving performance or helping in recovery continue to be mixed. Some results indicate that fitness level impacts the role of ribose supplementation in performance enhancement. Other studies suggest the use of ribose for recovery but not performance. However, large-scale, controlled studies are needed to confirm findings, and most experts do not support ribose's use.
Safety Issues
There are no reports of lasting or damaging side effects from ribose, but formal safety studies have not been conducted. Reported minor side effects include diarrhea, gastrointestinal discomfort, nausea, and headache.
Bibliography
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