D-Ribose for Fibromyalgia & Chronic Fatigue Syndrome

A Type of Sugar

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D-ribose is a supplement that's sometimes recommended for people with fibromyalgia and chronic fatigue syndrome. Also called ribose or Beta-D-ribofuranose, it is a type of sugar that your body produces naturally. It plays several important roles in your body:

  • it helps produce energy in the form of ATP (adenosine triphosphate)
  • it's a building block of the genetic material RNA (ribonucleic acid)
  • it help increase your muscle energy
  • it improves exercise capacity and energy following a heart attack

D-ribose has been studied for increasing high-intensity exercise capacity in athletes but was found to provide no benefit. As with most supplements, we don't have enough high-quality research to draw a lot of conclusions about it.

D-Ribose for Fibromyalgia & Chronic Fatigue Syndrome

We have very little research on d-ribose supplementation for either fibromyalgia or chronic fatigue syndrome. Still, some health-care providers recommend it, and some people with these conditions say it is an effective part of their treatment regimen.

One small study concluded that d-ribose supplementation significantly improved symptoms of these conditions, including:

  • increasing energy levels
  • improving sleep quality
  • improving mental clarity
  • lowering pain intensity
  • improving overall well being

However, this work is preliminary and we need more research to confirm the findings.

Some research suggests that fibromyalgia and chronic fatigue syndrome both involve deficiencies in ATP, but d-ribose supplementation has not been proven effective at boosting ATP in these conditions.

So far, we don't have evidence one way or the other whether d-ribose is effective against post-exertional malaise (a severe symptom increase after exercise), which is a key symptom of chronic fatigue syndrome.

A 2017 review of dietary modifications for chronic fatigue syndrome published in an Australian and New Zealand medical journal noted positive outcomes had been seen with d-ribose in human trials.

One extremely small study suggests that d-ribose may lessen symptoms of restless legs syndrome, which is common in people with fibromyalgia.

Again, not nearly enough research has been done, and it doesn't appear to be an area of on-going interest in the research community. Unless interest picks up, we may never have firm evidence on whether  before we really know whether d-ribose supplements can help us or how much.

D-Ribose Dosage

We don't yet have a standard dosing recommendation for d-ribose supplements. In the study on fibromyalgia and chronic fatigue syndrome, participants took five-gram doses three times a day.

In some studies of d-ribose for people with coronary artery disease, researchers have used doses of 15 grams four times a day.

D-ribose supplements are widely available. They are typically sold in powder form.

D-Ribose in Your Diet

Foods don't actually contain d-ribose in a form that your body can use, so supplementation is the typical way to increase levels.

Your body uses vitamin B-12 to produce d-ribose, so a B-12 deficiency could contribute to a d-ribose deficiency.

B-12 is also widely available as a supplement. Foods rich in B-12 include:

  • beef liver and other organ meats
  • shellfish
  • meat and poultry
  • eggs
  • milk and other dairy products
  • fortified breakfast cereals
  • nutritional yeast

If you're not deficient in B-12, eating these foods may not help your body increase natural d-ribose levels. Your doctor can do a blood test to see if you're deficient in any major vitamins.

Side Effects of D-Ribose

While supplements are a "natural" treatment, they can still cause unwanted effects. Some of these side effects may include:

  • digestive problems, such as nausea, stomach ache and diarrhea
  • headache
  • lowering uric acid in urine or blood in people with kidney disorders, which raises risk of gout or other kidney problems
  • lowering blood sugar

Because it can lower blood sugar, d-ribose is not recommended for diabetics who are on medications that lower their blood sugars.

D-ribose is generally considered safe for short-term use. So far, we don't have much safety information about long-term use or use during pregnancy and breast feeding.

Is D-Ribose Right for You?

If you're interested in d-ribose to help treat your fibromyalgia or chronic fatigue syndrome, be sure to talk to your doctor to make sure you're taking it safely.

You may also want to speak to a pharmacist about whether it could interact negatively with anything else you're taking.

Sources:

Gerdle B, Forsgren MF, Bengtsson A, et al. Decreased muscle concentrations of ATP and PCR in the quadriceps muscle of fibromyalgia patients--a 31P-MRS study. European journal of pain. 2013 Sep;17(8):1205-15.

Jones K, Probst Y. Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review. Australian and New Zealand journal of public health. 2017 Jun 14. doi: 10.1111/1753-6405.12670.

Myhill S, Booth NE, McLaren-Howard J. Targeting mitochondrial dysfuction in the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) - a clinical audit. International journal of clinical and experimental medicine. 2013;6(1):1-15.

Shecterle L, Kasubick R, St Cyr J. D-ribose benefits restless legs syndrome Journal of Alternative and Complementary Medicine. 2008 Nov;14(9):1165-6.

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