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D-Ribose for Heart, Fibromyalgia, Chronic Fatigue

Mitochondria are important cellular organelles involved in cellular energy production.

With many pathologic conditions and aging, mitochondrial function declines, and there is a reduction in the production of the energy molecule, adenosine triphosphate (ATP). When mitochondria are dysfunctional people can experience extreme fatigue and other symptoms experienced with heart failure.

D-ribose, a naturally occurring 5-carbon sugar found in the cells and particularly in the mitochondria, is essential in energy production. Without sufficient energy, cells cannot maintain integrity and function. Supplemental D-ribose has been shown to improve cellular processes when there is mitochondrial dysfunction. When individuals take supplemental D-ribose, it can assist the body to produce D-ribose-5-phosphate for the production of energy. [source]

D-ribose has been used both orally and intravenously in patients for many different pathologic conditions such as chronic fatigue syndrome, fibromyalgia, and myocardial dysfunction. It is often used to improve athletic performance and reduce symptoms of cramping, pain, and stiffness following exercise. [source

I have a copy of this book, Mitochondria and the Future of Medicine by Lee Know, ND. The book is a bit technical, but it has some great info on this topic.

The book goes into a lot of detail. Below I share info from the book.

It seems like dysfunctional mitochondria might be at the heart of these conditions. D-ribose is natural and used to make cellular energy. ATP is the currency of energy in the body. It is made of three major chemical groups: adenine, D-ribose (a 5-carbon sugar) and three phosphate groups.

Apparently the body can make D-ribose, but the process is slow. You want to have a large energy pool to help in times of need, to minimize the the damage caused by oxygen deprivation (like during a heart attack or stroke). This is a supply and demand issue. The cells can’t supply enough energy to keep up with demand. D-ribose is considered beneficial for heart conditions. The late Stephen Sinatra, MD and cardiologist, recommended that all heart patients take daily D-ribose supplements.

Other health conditions with decreased mitochondrial energy production can benefit too including chronic fatigue and fibromyalgia.

Chronic fatigue syndrome, Myalgic encephalomyelitis and Fibromyalgia are often discussed together because of the overlapping symptoms that are common to all three: fatigue, cognitive dysfunction, headaches and sleep disturbances. The demand for energy in these conditions can outstrip the body’s supply. One root cause is mitochondria dysfunction. To understand this more deeply, consider the book by Sarah Mayhill, Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis, 2nd ed.: It’s Mitochondria, Not Hypochondria

Study: The use of D-ribose in chronic fatigue syndrome and fibromyalgia

Study objectives: “Fibromyalgia (FMS) and chronic fatigue syndrome (CFS) are debilitating syndromes that are often associated with impaired cellular energy metabolism. As D-ribose has been shown to increase cellular energy synthesis in heart and skeletal muscle, this open-label uncontrolled pilot study was done to evaluate if D-ribose could improve symptoms in fibromyalgia and/or chronic fatigue syndrome patients.”

Study results: “D-ribose, which was well-tolerated, resulted in a significant improvement in all five visual analog scale (VAS) categories: energy; sleep; mental clarity; pain intensity; and well-being, as well as an improvement in patients’ global assessment. Approximately 66% of patients experienced significant improvement while on D-ribose, with an average increase in energy on the VAS of 45% and an average improvement in overall well-being of 30% (p < 0.0001).”

Conclusions: D-ribose significantly reduced clinical symptoms in patients suffering from fibromyalgia and chronic fatigue syndrome. [source]


In this condition the lining of the capillaries become thickened, oxygen can’t cross adequately to supply the tissues, there’s an energy drain and it affects muscles. Lactic acid builds up, there’s pain, muscle stiffness, soreness and fatigue.

D-ribose supplementation helps patients rebuild the cellular energy pool, managing the calcium and potassium—reducing pain, relaxing muscles. “Many fibromyalgia patients who use D-ribose to support cellular bioenergetics report that they are able to become involved in the normal activities of daily life again” writes Dr. Know.

“While there is technically no such thing as a “D-ribose deficiency” there is a deficiency relative to the demand or speed at which we need it to be available.”

When D-ribose is given, the energy pool can return to normal within two days.

Best Food Sources of D-Ribose

  • Beef
  • Lamb Liver
  • Salmon
  • Pork
  • Poutry
  • Eggs
  • Sardines, Anchovies, Herring
  • Cheddar cheese, cream cheese, yogurt

Supplementing D-Ribose

Doses as low as 500mg can be beneficial, but standard dosages range from 3 – 5 grams per day in divided doses.

For those with chronic health conditions, an adequate dose will usually result in symptom improvement, typically within a few days.

D-ribose is considered safe for short-term use. This supplement can lower blood sugar levels, so check with your provider before taking D-ribose with medication for diabetes.

Ecological Formulas. D-RIBOSE is a naturally occurring five carbon sugar which is used by the body to synthesize nucleic acid, glycogen and other metabolic products. This physiologic agent is integral to ATP replenishment and has a direct effect on heart and skeletal muscle. 

Take one (1) gram (1/4 tsp) three (3) times daily in water, preferably before meals, or as directed by a physician.

Serving Size: 1 Scoop (approx. 1/4 tsp) = 1 gram

Amount Per Serving
Total Carbohydrate
 … 1 g
Sugars … 1 g
D-Ribose … 1000 mg 

Protocol for Life Balance. D-Ribose Powder

  • 100% Pure
  • Supports Energy Production and Storage*
  • Muscle Recovery*
  • Vegetarian Product

Ribose is a pentose (5-carbon) sugar essential for the production of DNA and RNA.  Ribose is also a fundamental building block of adenosine triphosphate (ATP), the preferential source of energy skeletal muscle and heart tissue.

As a dietary supplement, take 1 tsp two to three times daily in water about 30 minutes before meals or as directed by a healthcare professional.

Serving Size: 1 tsp = 2.5 grams D-Ribose Powder (Bioenergy RIBOSE™)

Cautions with D-Ribose Supplementation

D-ribose is considered safe for short-term use. This supplement can lower blood sugar levels, so check with your provider before taking D-ribose with medication for diabetes.

D-Ribose may relieve discomfort in patients but it is important to know that ribose supplementation may promote glycation. Proteins in the body are susceptible to glycation by ribose and generate Advanced Glycation End Products (AGEs) that lead to cell dysfunction and cell death. [source] [source]

There is a balance between benefits and side effects that the patient must consider along with their physician. I do not recommend healthy individuals take a ribose supplement with the idea that they want more energy.