Research & Education

D-Ribose to Promote Cardiac Function and Exercise Recovery

What is D-Ribose? 

D-ribose is often referred to as “molecular currency,” as it plays a critical role in supporting energy production. Every cell in the body requires energy as adenosine triphosphate (ATP) to properly function. However, ATP production may become depleted during heightened energy demands, such as high-intensity exercises, or with certain conditions, such as cardiovascular disease. Impaired ATP production may result in muscle fatigue or prolonged recovery periods, and the body may rely on alternative metabolic pathways to create cellular energy. This is where D-ribose comes into play. D-ribose has a unique role in its ability to “bypass” a rate-limiting enzyme (glucose-6-phosphate dehydrogenase) in the pentose phosphate pathway required for ATP production, which may promote proper energy production during high energy demands. D-ribose is also essential in building various compounds in the body, such as nucleotides, coenzymes, and nucleic acids. Clinical studies also suggest that D-ribose may attenuate the effects of oxidative stress in the body, especially during exercise. D-ribose is produced endogenously and can be obtained through supplements. 

D-Ribose and Exercise Recovery 

Research suggests it may take days for muscle ATP status to return to normal after prolonged or high-intensity exercise. For athletes, this may result in excessive muscle fatigue, cramping, pain, and stiffness, or an inability to sufficiently recover in the subsequent days after playing sports or exercising. D-ribose has been shown in human studies to promote proper ATP production during and after exercise, which may support muscle performance, recovery, and exercise metabolism. 

A double-blind, crossover study of healthy adults (n = 26) compared the effects of 10 g per day of D-ribose supplementation to a control while undergoing 1 hour of high-intensity interval exercise. The adults receiving D-ribose exhibited improved exercise performance and significantly lower rates of perceived exercise and creatine kinase. While there are conflicting results, previous human studies have demonstrated that athletes administered D-ribose supplementation before sports play or exercise exhibited increased power output, muscular power assessment in weightlifting, and overall muscular strength.

D-Ribose and Cardiac Function 

It is understood that proper cardiac function requires healthy ATP production. Ingwall and Weiss proposed that a “failing heart is energy starved.” Myocardial ischemia (or decreased blood flow and oxygen to the heart muscle) is commonly found in those with atherosclerosis and is often an underlying condition of cardiovascular disease. Research suggests that cardiac ischemia is associated with insufficient ATP status. For this reason, pre-clinical and pilot clinical studies have investigated and concluded that D-ribose may be clinically beneficial for those with cardiac dysfunction. However, more clinical research is needed before major conclusions can be drawn.

In various human studies, patients with congestive heart failure who were administered D-ribose supplementation exhibited improved diastolic function, ventilatory efficiency, and subjective quality of life and physical function as part of an overall healthy lifestyle. Research also suggests that D-ribose may improve mitochondrial function, potentially increasing ATP production and promoting cardiac performance. Mitochondria produce 99% of the ATP in the body.

Proper ATP status is crucial in supporting heart health and athletic performance. Due to the unique role of D-ribose in energy production, it may promote cardiac function and exercise recovery. 

By Danielle Moyer, MS, CNS, LDN