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:

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

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

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 includes suggestions for treatment

And a mention about “die-off” and Herx reactions when de-toxing

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

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

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.

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.

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

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.


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:

Side effects can include:

Anectdotally reported side effects also include:

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: