D-Ribose, a sugar sold as a dietary supplement, is promoted to help strained heart and muscle refill energy stores. Heart failure symptoms show the most consistent benefit; other uses rest on small studies or ones without comparison groups, and beyond exercise recovery in the less trained, nothing shows benefit for healthy people or aging. The main dependable risk is a short-lived drop in blood sugar; long-term safety is unresolved. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Fasting glucose | 75–90 mg/dL | Hypoglycemia baseline |
| Post-dose glucose | ≥70 mg/dL at 30–60 min | Detects dose-related dips |
| HbA1c | 4.8–5.3% | Glycation load |
| Uric acid | 3.5–5.5 mg/dL | Purine load |
| BNP or NT-proBNP | No established functional target; track change from own baseline | Heart strain response |
| Ejection fraction | No established functional target; track change from own baseline | Pumping response |
Cadence: Baseline panel before starting; fingerstick glucose 30–60 minutes after doses during weeks 1–2 with glucose-lowering drugs; symptom ratings weekly for 12 weeks; fasting glucose, HbA1c and uric acid at 12 weeks, then every 6–12 months; heart failure markers on the cardiologist's schedule