Can D-Ribose Cause Heart Palpitations?

In this article, we will take a close look at D-ribose, a naturally occurring pentose carbohydrate, and its effects on heart palpitations. We will evaluate its role in energy metabolism and its potential benefits in conditions like ischemia and heart failure.
Jakub Gwiazdecki

Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

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Can D-Ribose Cause Heart Palpitations?

No. According to the literature, there is no present evidence that d-ribose can cause any disturbance in heart rhythm. There is no direct link between D-ribose and heart palpitations.

D-ribose is a crucial element that plays key roles in all cells in the body. It takes part in the production of ATP, adenosine triphosphate, a direct source of energy on the cellular level [1, 2]. An increase in this sugar in the body is linked with higher energy levels and improvements in heart function after ischemic events [1, 3]. Thanks to this property, it works against possible disturbances in the heart rhythm and heart palpitations.

Even ingesting 20 grams of D-ribose daily for two weeks does not cause any changes in the biochemical picture of the blood [4]. While this does not directly exclude any possible heart problems, it indicates that there are no changes in the environment in which the heart is working. Biochemical changes in the surrounding of cardiomyocytes are one of the potential causes of dysrhythmias, which are often experienced as heart palpitations.

Most research indicates only the benefits of D-ribose. It shows a beneficial influence on the cardiovascular system, with no suggestion for heart palpitations.

What is D-Ribose?

D-ribose is a naturally occurring sugar that is found in all living cells. As its core consists of five carbon atoms, it belongs to the pentose group. Many vital biomolecules contain this sugar in their structures. It is found in RNA, nucleotides, or riboflavin. All these play a key role in many fundamental processes in the body [2].

After being digested, D-ribose undergoes phosphorylation and becomes ribose-5-phosphate. This is an important molecule that serves two life-sustaining processes. First of all, it takes part in the ATP synthesis. This end product is the source of energy for most of the energy-requiring biochemical reactions in the cells. The second process D-ribose participates in is the synthesis of nucleotides. They are the bricks of the genetic information used to synthesize proteins [2].

D-ribose is used therapeutically to enhance cardiac function. It is given to patients with heart failure and as a remedy for post-exercise fatigue. However, recent studies have indicated a potential link between D-ribose metabolic disturbances and type 2 diabetes mellitus [2]. This correlation can cause a significant change in D-ribose supplementation, as diabetes is a risk factor for cardiovascular disease.

What does D-ribose do to the heart?

In normal conditions, d-ribose serves the heart as a key in cell metabolism. However, in heart disease, such as myocardial ischemia, the cell metabolism changes. The heart cells have less oxygen and nutrients. This significantly lowers the ATP levels available to the cell, impeding its normal function. In such cases, higher levels of d-ribose have been shown to increase the energy levels and improve the function of the affected cells [1, 5, 6].

Additionally, D-ribose is also beneficial in ischemic-caused cardiomyopathy, a condition where, due to the ischemia, the structure of the heart is changed. In this condition, pentose improved the contractile response of the myocardium to treatment with dobutamine [7].

In heart failure, D-ribose has been found to enhance cardiac function. This can be explained by the simple increases in ATP production and, thus, the higher amounts of energy available for the cardiac muscle [2]. D-ribose supplementation also resulted in improved diastolic functional parameters, thus relieving the symptoms of a failing heart [8].

What are the cardiovascular risks of D-ribose?

Despite all the heart benefits of D-ribose, the cardiovascular impact is not completely flawless.

There is one potential risk associated with D-ribose arising from its property as a sugar. It is contributing to the formation of advanced glycation end products (AGEs). Those compounds that accumulate in the body over time are linked with many health conditions, which include cardiovascular disease. For instance, in diabetic patients, D-ribose-induced glycation of low-density lipoprotein (LDL) can contribute to the creation of atherosclerosis [9].

In addition, D-ribose has been associated with metabolic disturbances. Those can potentially be linked to type 2 diabetes mellitus. In that way, d-ribose can cause an indirect risk to the cardiovascular system [2].

When is supplementation with D-ribose beneficial for the heart?

D-ribose supplementation can be beneficial for the heart in several specific circumstances.

For example, in patients with chronic coronary heart disease who suffer from heart failure, D-ribose supplementation improves cardiac hemodynamics and relieves the symptoms. It enhances the diastolic filling of the left ventricle as well as limits the left atrial size. Thanks to those changes, the heart's effective output increases and the heart fails less [8, 10].

Also, in the already-mentioned ischemic heart diseases, D-ribose has potential benefits. It increases the energy level in the heart and also improves the function of the myocardium after an ischemic event [1, 6].

However, D-ribose can also be beneficial in the case of patients with a high risk of myocardial infarction (ischemic events). In patients with stable angina, the heart tolerance for ischemia was found to be greater after d-ribose supplementation. Already 3 days were sufficient to bring visible changes during the exercise ECG [11].

However, because some studies indicate a possible cytotoxic effect of the d-ribose supplementation, more research is needed for the evaluation of the long-term side effects [12]. Individuals with preexisting diseases should not overload themselves with this sugar without proper control and consultation.

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Jakub Gwiazdecki

Jakub Gwiazdecki

Jakub is in his fifth year as a medical student at Comenius University in Bratislava, Slovakia. He has special interested in cardiology and in patient-centered medicine. His love for heart health isn't just book-smarts; he wants to know how it works, what it means for our feelings, and how key it is for health and happiness. Jakub thinks real good health care comes from always putting the patient at the centre, treating each person as a whole.