Can D-Ribose Make You Sick?

I started taking 10mg 10g of D-Ribose daily around a year ago.

I’ve had quite a few people find my blogs about D-Ribose and reporting to me problems they’ve experienced:

  • “a definite small but significant energy boost, but also had tummy pains”
  • “a tiny energy boost, but terrible constipation and migraines by the third day”
  • “just starting d-ribose and seem to be having reflux/chest pain”
  • “started the D-ribose over a week ago, and I’ve had abdominal pain, constipation, and now increased pulse and blood pressure”
  • “when I take the D-ribose it makes me feel dizzy.”

I myself have gastric discomfort which although I had experiences before I used D-Ribose it has been persistent throughout this last year.

pic by HckySo on Flickr

pic by HckySo on Flickr

The question is can D-Ribose be causing migraine, dizziness and gastric problems for some people?

The majority of references readily available on the internet, particularly with reference to it’s use with CFS/ME and Fibromyalgia, suggest it is relatively safe and harmless.

The only “reported side effects” I found when I started taking D-Ribose were a risk of hypoglycemia and possibly loose bowels.

I don’t think that gives the whole picture!

Once other people started commenting on my blog with their side effects, particularly gastric flare ups, I did some more research.  Then today I had a comment which told me that D-Ribose can cause increased levels of uric acid.  I’ve done some more reading.

I’m not an expert.  This post is a summary of what I’ve discovered so far.

Hypoglycemia & loose stools:

D-Ribose can cause transiet hypoglycemia and loose stools  in reference to large doses (10mg or over).  Dr Teitelbaum’s recommended dose is 3 x 5mg 5g daily for the first 4 weeks, then 2 x 5mg 5g daily after that.

“The first is a transient hypoglycemia (low blood sugar) that can be eliminated by taking larger doses of ribose with other carbohydrates (such as in juice). The second side effect that may occur in some individuals is loose stools. Again, this side effect has only been reported in very large doses, greater than 10 grams.”

Herx reaction theory:

pic by coldways on flickr

pic by coldways on flickr

There are some people who say that the D-Ribose gives your body and your cells the energy they need to function more efficiently and thus fight hidden/chronic/stealth infection in the body. It fuels your mitochondria.

When fighting this/these infection(s) the theory is it is possible you may get a Herx reaction.

It’s also possible that if the D-Ribose is fuelling your body properly you may be better absorbing other suppliments/nutritional elements that are fighting the infection and thus, ironically, feeling worse.

Typically the death of these bacteria and the associated release of endotoxins occurs faster than the body can remove the toxins via the natural detoxification process performed by the kidneys and liver. It is manifested by fever, chills, headache, myalgia (muscle pain), and exacerbation of skin lesions.

From Wikipedia entry on Herxheimer_reaction

More reading on Herx reaction http://lassesen.com/cfids/herxheimer.htm includes suggestions for treatment

And a mention about “die-off” and Herx reactions when de-toxing http://www.ahummingbirdsguide.com/treatingmeantioxidants.htm

In addition to possibly promoting a Herx reaction it could in itself cause an antioxidant effect:

“Ribose may support the body’s innate antioxidant mechanisms while promoting an antioxidant effect of its own.”

From 15 May – Almost Random Research

Uric acid:
pic by lunar caustic on flickr

pic by lunar caustic on flickr

Research has found that D-Ribose can contribute to the levels of uric acid in your body.

High levels of uric acid can cause gout, a form of inflammatory arthritis which usually effects the joints.  As the uric acid forms into crystals and settles around the body the immune system then attacks the crystals which causes inflammation.

Deposits of these crystals can also develop into kidney stones.

Read more about how uric acid can cause gout pain and kidney stones.

Research has shown that D-Ribose can contribute to uric acid levels and should therefore by avoided by those with gout or exisiting high levels of uric acid.

However, I am not clear whether the D-Ribose dosing for ME/CFS (typically 10mg 10g daily) can cause levels of uric acid to become dangerously high in individuals who do not already have gout or pre-exisiting high levels of uric acid.

Also high levels of uric acid in the blood does not always mean that a person will develop gout.

“Actually most people with hyperuricemia do not develop gout. Therefore it is not necessarily the high level of uric acid causing gout but perhaps a rapid change in its level.”

From Gout Prevention & Treatment on About Arthritis

Other factors  can contribute like dehydration, injury  fever, heavy eating, heavy drinking of alcohol , recent surgery, high blood pressure, abnormal kidney function and certain medications.

So it doesn’t neccessarily follow that D-Ribose can cause gout or kidney stones but caution should be exercised and it’s sensible that any new symptoms should be discussed with a doctor.

Warnings for use of D-Ribose:

pic by stewf on Flickr

pic by stewf on Flickr

Those with gout or high levels of uric acid should avoid using D-Ribose.

Diabetics should use D-Ribose only under a doctor’s supervision.

Hypoglycemics should exercise extreme caution in the use of D-Ribose.

Pregnant and nursing mothers should avoid using D-Ribose.

“PRECAUTIONS
Pregnant women and nursing mothers should avoid supplemental D-ribose.

Supplemental D-ribose may cause hypoglycemia and elevation in uric acid levels. Those with gout should avoid supplemental D-ribose, and those with elevated uric acid levels and hypoglycemics should exercise extreme caution in its use. Those with diabetes should also exercise extreme caution in its use. And those diabetics who decide to try D-ribose must be under a physician’s supervision and have their blood glucose levels closely monitored and their antidiabetic medications appropriately adjusted, if necessary.

ADVERSE REACTIONS
Reported adverse reactions include hypoglycemia, hyperuricemia, hyperuricosuria, diarrhea, nausea and headache.”

From guidance on vitmaker D-Ribose product

Typically persons with ME/CFS are sensitive to drugs and stimulants like caffeine and alcohol.  It’s not impossible to imagine that they can also be sensitive to D-ribose.

It may be “just a simple five-carbon sugar” but it seems the possible side effects, particularly for persons with ME/CFS, can be more than reported by some suppliers.

Like any drug or suppliment caution should be used.

My experience:

I’ve been taking D-Ribose for a year.  I take two doses of 5mg 5g (one scoop) daily. I have mistakenly said I take 10mg 10g doses on my blog in the past.  It is in fact 5mg 5g doses.

pic by pckux on flickr

pic by pckux on flickr

I find D-Ribose gives me a small but beneficial energy boost.

My condition has improved in the last year but only a few percentage points of the ability scale.  My concentration has improved a great deal and my cognitive disfunction is not as big a problem.  I recover from exertions faster than before I started D-Ribose.  An exertion that used to take me 4-5 days to recover from now takes more like 1 or 2 days.

I am still ill with ME.  I am still pretty much housebound and unable to attend to routine personal care tasks on my own.  D-Ribose has not been a miracle suppliment for me.

I found taking D-Ribose in the evening (after 5pm) can cause me problem with getting to sleep.  I take 5mg in the morning and 5mg in the afternoon around 3pm.

I have had gastric problems persistently for the year I have been using D-Ribose including constipation, lots of gas, pain beneath my rib cage (possibly gas, possibly gallbladder), stomach and bowel cramping and spasms.  An IBS friendly diet and lately probiotics (Lactobacillus) seem to be helping with gastric disturbances but neither is a cure.  I did have similar bowel and stomach problems before I started D-Ribose although it feels different to before.

I have no way of knowing whether D-Ribose is responsible for any improvement or any side effect like gastric problems.

I cannot know whether these are a co-incidence, directly related to D-Ribose use, or indirectly from D-Ribose allowing an slight increase in activity promoting it’s own improvement and/or it triggering unwanted side effects.

What does alarm me slightly on a personal level about the uric acid link with D-Ribose is that I have gout and kidney stones in my immediate family.  That and there’s reasearch which suggests you can have an inherited problem with processing uric acid and thus be prone to complications.

D-Ribose is an expensive suppliment.  I think it’s worth experimenting by stopping taking it for a month or so to see what effect this has.

Summary:

I am not an expert or a doctor. This post collates information I have read on the internet.

D-Ribose hasn’t been scientifically proven to help persons with ME/CFS but research has shown persons with ME/CFS have disfunction in the cells which D-Ribose has been shown to aid.

Dr Teitelbaum conducted a survey in 2006 which found it was effective for treatment of CFS and FM but it was  not placebo controlled and was conducted on a small group.

66% of the 41 participants found the supplement helpful and it produced improvement in all the areas tested: energy, sleep, mental clarity, pain intensity and well-being

D-Ribose can have side effects especillay in large doses (10mg or over).

You should avoid taking D-Ribose if:

  • you are diabetic
  • you have gout
  • you have high levels of uric acid
  • you are pregnant or breastfeeding
  • you are hypoglycemic use only with extreme caution

Side effects can include:

  • hypoglycemia or transient hypoglycemia
  • diarrhea
  • nausea
  • headache
  • high levels of uric acid in the blood (hyperuricemia) which could possibly leading to gout
  • high levels of uric acid excreted in the urine (hyperuricosuria) which could possibly lead to kidney stone

Anectdotally reported side effects also include:

  • constipation
  • dizziness
  • migraine
  • abdominal pain
  • difficulty getting to sleep
  • increased pulse and blood pressure
  • detoxing or antioxidant reaction
  • herx reactions (fever, chills, headache, muscle pain, skin problems)
pic by -lif- on flickr

pic by -lif- on flickr

Persons with ME/CFS or FM may find D-Ribose to be beneficial.  Caution should be exercised and you should check the warnings.  If you take D-Ribose and experience any new symptoms you should consult with a doctor.

My previous posts on D-Ribose can be found here:

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26 Responses to “Can D-Ribose Make You Sick?”


  1. 1 ninacolors April 3, 2009 at 4:01 pm

    Seems like taking a month off will give you some added knowledge – expecially abt GI symptoms.

  2. 2 Renee April 4, 2009 at 1:42 am

    Wow
    I have been wondering about D-Ribose after reading about it at LymeBytes. Thanks for all the infor you gathered and shared here.It will be helpful to alot of people I am sure. Hope things start to mellow out for you.

  3. 3 Tom Anderson April 6, 2009 at 11:58 am

    I am now nearing the end of my 4th 250gm tub of D-Ribose , which I get from http://www.muscleform.co.uk/Store/Energy-$4-Fatigue/D$9RIBOSE-ATP-Fuel
    I take 3x5gm daily , mostly in strong black coffee, and have had no side-effects or recurrence of any symptoms.No noticeable energy boost but I am able to do more,more easily and life is better.
    During this period I have started taking Magnesium Mallate and vitamin D3 , both introduced separately and then increased in amounts plus taking flax seed oil.
    None of these have caused side -effects or symtom recurrence. All in all a slow steady improvement ,but not a miracle fix.
    I’m of the opinion that no supplements etc ,can help until symptoms stabilise and begin to decrease in frequency or strength , as anything you take can start everything up again , i.e you’re starting to heal,and it can’t be rushed. The old “do too much and go backwards” syndrome.
    It has taken me just over two years of Perrin Technique treatment
    to plus the recent addition of the above supplements to get to where I am now…still a long way to go..but everything is a damn sight better than what it was.

    Tom

  4. 4 ashysheela April 6, 2009 at 12:43 pm

    i have been meaning to take a break from D-ribose for ages now, and this has spurred me to seize the day! I have stopped yesterday and plan to take a 3 week break and see what happens. It took me a long time to feel the benefits of taking it (2 tubs!), so i am unsure if it is the D-ribose or not… I did have a short break from it when i ran out for about 2 weeks and noticed more aching in thigh muscles for a couple of weeks with a delayed onset (came on about a week or so after i ran out and improved again a week or so after taking it again). Well we shall see if anything changes this time…

  5. 5 cusp April 6, 2009 at 7:07 pm

    Have to say that whenever I have tried to take D-Ribose I have felt absolutely appalling very quickly — like having a combination of mild food poisoning and a hangover — so I’ve never been able to stick to it for long: hasn’t seemed worth it. I also have a strong history of gout in the family. I think the lable ME is so broad that, as with many supps., it’s trial and error and what suits one will not necessarily suit another.

  6. 6 Sue April 14, 2009 at 9:55 pm

    What an excellent, well-researched post!

    I bought some D-ribose recently but have been waiting for my Lyme disease treatment to end before I introduce something new. Just about every supplement I try – especially antioxidants, vitamins and sugars – cause worse IBS symptoms and loose bowels, despite the strong probiotics I take.

    I find it very interesting that D-ribose is known to cause hypoglycemia and it is recommended for CFS: most people with CFS develop hypoglycemia.

    Thanks so much for all your research and your informative summary!!

    Sue

  7. 7 lwilder June 13, 2009 at 3:51 am

    My father, son, and I have suffered from an undiagnosed genetic muscle disorder all our lives. I am the worst affected, have never been able to jog over 1/8 of a mile without leg muscle cramps and high heart rate. What we discovered is that we are AMP deaminase deficient. I only take 2.5 g of ribose in milk, two times a day and it has changed everything. I can now run up a flight of stairs and it is no big thing. I’m working on the concept that I may be able to exercise like a normal person. Mentally I’m surprised to find I’m very alert with great focus. All cravings for anything sweet have essentially disappeared. I’m feeling very fortunate that something as simple as D-Ribose has improved my life to this extreme.

    But folks, I’m almost completely deficient because of a genetic disorder, and I only take 5 g a day. A little goes a long way. From what I know of cellular respiration you can’t just push on one element, there’s lots of other nutrients and you need to supplement in balance unless you have a completely out of whack system like mine.

    • 8 Brice June 29, 2010 at 10:30 pm

      Lwilder,
      My wife has MyoAdenolate Deaminase Deficiency also known as AMP Deaminase deficiency. Her father has another related form of muscular dystrophy…and the Dr’s keep telling her its unrelated. She too is taking the Ribose supplement. But with her it seems to take 20mg a day, otherwise her energy level is too low and she cramps up.
      She is currently trying to contact the few researchers out there who study this deficiency to try and determine what turns the gene on/off…I’m the engineer she’s the biologist so she does better at talking about all that.
      We would really like to get in contact with you. The more people like you guys that band together to try and figure this disease out the better. If you’d like to get in contact with her, please reply, I’ll be receiving email notification if you do.

  8. 9 G TEJADA July 15, 2009 at 7:23 pm

    I took twice 5gm of D Ribose in one day and before I went to sleep my pulse was very elevated at 115 per minute. I didn’t have HB pressure or palpitations before.

  9. 10 Melanie August 12, 2009 at 12:00 am

    Hi – thanks for your thoughtful and thorough research on D-ribose. I am currently using it but my fibromyalgia chronic fatigue was pretty much gone anyway, However, I have a blog site which talks about Fibromyalgia. I have listed your blog site there and wondered if you’d be interested in listing my on your site for those who may be interested in some information about Fibromyalgia Treatment whcih has worked for me.
    Thanks
    Melanie

    • 11 Barb February 5, 2010 at 5:46 pm

      I’ve been suffering from a bad CFS/FMS flareup the past year. I started taking D-Ribose 12 days ago and have experienced the GI symptoms mentioned, in the first week, as well as elevated blood pressure, faster pulse, Herx, worsened insomnia. But the Ribose improved my energy and reduced pain almost immediately. Thank you for this blog! I didn’t know what was going on with me.

  10. 12 Kristi Ambrose February 28, 2010 at 3:51 am

    Okay, I didn’t read the whole article. BUT! I have been taking Ribose for a little over a month and just in the last 2 weeks I have been getting horrible headaches. I decided to look online and see what people are saying. So.. I guess it CAN cause them? I cant think of anything else that would be causing these. I also have Esophagitis, so I need to watch what I eat. So I know its not a food allergy or something weird like that!

  11. 13 thehamster October 19, 2010 at 1:43 am

    At the suggestion of a naturopathic physician I started taking D-ribose (5 grams 3x daily) five days ago for fibromyalgia. Have noticed some relief of aches and pains and slight increase in energy level, but the trade-off has been severe intermittent stomach pain, a lot of gas and bloating and nausea. I’m going to lay off the D-ribose for a couple of days and then try 10 grams per day and see if that produces the same side-effects.

  12. 14 Curiosity May 12, 2011 at 3:54 pm

    I’m so happy to have stumbled across your blog. I was just recently diagnosed with ME/CFS and this is EXACTLY the type of research and puzzling through things that I am prone to doing on my own. It’s great to know that maybe I won’t have to start fresh for some of this. :)

    I am hating trying to weed my way through treatments. Because my symptoms fluctuate so often, I am already having trouble knowing for sure whether a new symptom is just part of the usual morphing of my disorder, or due to a particular treatment attempt. And of course, we’re all so crazy sensitive to changes that I can’t just assume it’s unrelated and brush it off.

    Anyway, I am happy to have found your site. It’s great to read something that sounds so familiar. Many thanks, and I will be back. :)

  13. 15 Cynthia June 27, 2011 at 8:29 pm

    Thanks for your article, very interesting. I have read Dr. Titlebaum’s book about FMS/CFS and followed his suggestion of taking D-Ribose 3 times a day, the full scoop.

    I did this for about 5 days and, while I already suffer from some vertigo and dizziness, the Ribose made it so much worse that I couldn’t drive. It also made my head aches worse and also cause me nausea.

    I stopped taking it and am back to my normal level of weird dizziness. I do have an appointment with a Neurologist this week to see if maybe it’s something in my brain. The Ribose almost seemed to put my brain on overdrive. Maybe I could take a lower dose… but I’m not sure that I’ll try it.

  14. 16 Donimo July 2, 2011 at 1:29 am

    Thanks for consolidating all this info here. I’m so foggy and overwhelmed that it’s very hard for me to troll around and research. Your blog is a great source of info and a big help. I’m going to give D-Ribose a try and amp it up very slowly while supporting my system with lactobacillus etc. I’ll let you know how it goes!

  15. 17 nick fury April 26, 2012 at 5:51 pm

    Thank you for your efforts it is well received. I myself am not an alarmist type person. I do relieve some of these supplements make you worse before you get batter. I feel you search for information was well balanced. You didn’t try to frighten just to inform. Once again great JOb

  16. 18 Charles May 31, 2012 at 4:39 am

    Why would chronic infection be worsened with D-ribose taking all assumptions about that statement aside?
    Why would a genetic muscle complaint result in cramping and tachycardia?

  17. 19 Lisa Ling July 10, 2012 at 1:21 am

    I’ve tried other detoxify/cleanses before with TERRIBLE results. (Not being able to “go” for days, and having terrible pains from being so backed up.) I decided to try Lady Soma’s Detox (the one that is $74.99) after I began having issues due to taking a calcium channel blocker for migraines. I also hoped it would help get the last of the beta blocker (previous migraine treatment) out of my system. I’ve been exhausted for about 11 months due to the beta blocker. Within one day on the Lady Soma Detox, I was seeing results. Within two days I had more energy! This is an amazing product! And, unlike some similar products, you really aren’t going to be stuck in the bathroom all the time. I definitely recommend this product!!

  18. 20 Susan August 7, 2012 at 8:17 am

    I have been taking D-Ribose for a couple of months, dropping the dose to twice a day as suggested by Dr. Teitelbaum. I had a very rapid response initially, feeling on top of the world after just one week. I thought I had found the answer to my prayers. I introduced other supplements suggested for me whilst reading ‘From Fatigued To Fantastic’ which included co-enzyme Q10 which in my case is to help reduce migraines.
    I already take beta-blockers to do this but still need to resort to Imigran on frequent occasions. My husband has commented on the increased frequency since I began taking D-Ribose and we both wonder whether the cocktail of supplements is aggravating my migraines. I have more or less cut out the additional supplements but the threat of a migraine remains. Has anyone else found the D-Ribose to be the definite cause of increased attacks? I am lothe to stop taking it as it has definitely increased my energy and I can begin to consider the possibility of returning to some sort of paid employment, but not with so many migraines.

  19. 21 valerie October 25, 2012 at 1:18 pm

    have any of you heard of mthfr? It’s a very common genetic mutation where you don’t process folic acid and have to take the metabolized form of this b vitamin. It is usually the culprit behind me/cfs. You need the metabolized form of this vitamin (5 methyfolate) for every function in your body. I never heard of It till I met Dr. Stephanie Cave and tested for it (most doctors never heard of It-press them to be tested!!!) Look up mthfr under Dr. Ben Lynch or Dr. Stephanie Cave or Dr. Neil Rawlings. D ribose helped me for about 2 months and then began giving me horrible reflux too, something I thought I had left behind me. 4 grams a day. So dissapointing!!!

  20. 22 MIckey January 22, 2013 at 12:33 am

    I’m kind of in similar position as you… tried to take ribose many years ago, but had to stop because of side effects (mostly gout). Now it looks like it is necessary for me (got sth called MDD deficiency) and I just need to get rid of the side effects (which is difficult).

    About constipation… just get yourself oral antifungal… real drug, not diet or similar nonsense (although diet will work after antifungal)… it worked miracles for me… three first days after taking it was hell… diarhea and all… fungi was excreted but also digested… lot of toxins… but after that it was all good… now just got to get rid of this uric acid and I’m all good…

  21. 23 Cody March 10, 2013 at 4:10 pm

    I wish I had stumbled upon this site before I started taking D-Ribose. 3 days after I started taking ribose I ended up having a Herx reaction. I had no idea what was going on at the time. This reaction is not listed as a side effect on hardly any of the websites out there, including WebMD.

    I am so glad I know what happened now. I thought I had some kind of strange flu but it made no sense how I got it. The Herx reaction can take a while to go away. I took a smaller dose of ribose the other day after my first reaction cleared up to see if it was from ribose and I got something similar. I notice what seems like inflammation in certain areas of the body. I didn’t realize I had so much bacteria or whatever to kill off. It sure doesn’t want to go without a fight. I recommend people start out with small doses, maybe 1 gram a day, cause the Herx reaction really sucks.


  1. 1 D-Ribose « Ashy’s Blog Trackback on April 13, 2009 at 2:34 pm
  2. 2 D-Ribose Free for 10 Days « ChronicallyMe Trackback on May 9, 2009 at 11:06 am
  3. 3 My Disguise » D-Ribose and Dizziness Trackback on June 28, 2011 at 5:09 pm

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