Adrenal Support Formula with 14 researched nutrients
Our product developers were assigned the task of developing the most advanced adrenal support product based on published research. After a thorough review of the literature, they formulated Energy Multi-Plex™ --- the total energy formula. A favorite among doctors and patients, Energy Multi-Plex™ is a reasonably priced answer to many people's dreams of more energy.
“I have improved energy after supplementing with NT Factor Energy and Energy Multi-Plex. Especially notable are the increased maximal sudden power, endurance, and ability to recover during exercise and also for the next day events - for example in distance bicycling on hilly roads and weight lifting and aerobic exercising at the Y. These two Researched Nutritionals products were added to a thorough treatment program for a longer-term fatigue illness from tick borne infection complex illness in the later, more recent stages of therapy. I think the products address some of what we know about mitochondrial damage in the longer-term fatigue- like syndromes and look forward to discussing this further with others interested in increased energy. I have no conflicts of interest in my dialogues regarding Researched Nutritionals products.” --- H. Smith MD
Each bottle provides a one month supply of the following complexes and health benefits:
Energymax™ Complex: Targeted blend of D-ribose, panax ginseng which
• promotes healthy energy levels by raising the level of the body’s energy fuel, ATP
• supports healthy cognitive performance
MuscularEnergy™ Complex: Combination of malic acid and rhodiola rosea which
• plays a key role in energy producing Kreb’s Cycle
• has an adaptogenic affect to support physical activity
Mitrochondria Energizer™ Complex: Powerful duo of acetyl-L-carnitine and alpha lipoic acid which
• acts as a catalyst for ATP production in mitochondria
• improves mitochondrial function while promoting healthy cognitive function
Metabolism Plus™ Complex: Natural, non-stimulation blend of pyruvic acid and 7-Keto DHEA which
• naturally increases, without artificial stimulation, resting metabolism
• multiple studies show increased fat utilization (fat loss) as an energy source
• promotes fat loss through thermogenesis
HeartStrong™ Complex: Hight potency Co Q10 and L-Taurine which
• is used by the body to transform food into adenosine triphosphate (ATP), the energy on which the body runs
• promotes healthy heart and gum tissue
• modulates the immune system
• promotes healthy heart beat and cell wall stability
Key Nutrient Blend: pantothenic acid, vitamin B-12, magnesium and potassium which
• are essential nutrients involved in producing, transporting and releasing energy from fat
• promotes healthy neuromuscular function and muscle contractions
Suggested Use
As a dietary supplement, take three capsules per day (at one time or throughout the day) or as directed by your healthcare professional.
Buy Researched Nutritionals
Showing posts with label ribose. Show all posts
Showing posts with label ribose. Show all posts
Monday, May 24, 2010
Medical Food with Ribose, l-Carnitine, Acetyl l-Carnitine, Malic Acid & Magnesium
Medical Food with Ribose, l-Carnitine, Acetyl l-Carnitine, Malic Acid & Magnesium
RibosCardio™ has been designed to support serious energy needs of patients. The product has been formulated with CardioPerform™, a potent blend of L-carnitine (transports fuel into the heart to be burned as energy) and Acetyl L-carnitine (improves heart & brain health, protecting against oxidative damage), plus the patented form of D-Ribose, malic acid and magnesium gluconate to optimize energy production and synthesis.
Published research shows our patented form of D-ribose may be an effective adjunct in promoting cardiovascular, skeletal muscle, and neurological health. With heart patients, D-ribose has been found effective in restoring energy, improving ventilatory efficiency, oxygen uptake, stroke volume, diastolic function, physical performance, and quality of life. In neuromuscular disease, D-ribose helps to reduce pain, overcome fatigue, increase exercise tolerance, and help patients live more normal, active lives.
RibosCardio™'s magnesium gluconate and malic acid help your body use energy more efficiently. Your cells use magnesium in over 300 enzyme reactions, and it distributes energy evenly throughout the cell so it is available when and where it is needed. Malic Acid helps your mitochondria recycle the energy you have, maximizing cellular energy output.
D-Ribose Research Highlights
Cardiovascular Function: Scientific and clinical studies have repeatedly shown that our patented D-Ribose can restore energy and improve function in ischemic, hypoxic, and failing hearts. Oxygen deprivation causes hearts to use energy faster than it can be replaced through normal processes of tissue energy turnover. The result is a depletion of cellular energy reserves translating to a loss of heart function.
Mid-study results of an ongoing double blind, crossover trial with congestive heart failure patients were recently reported. Results showed conclusively that when patients were given ribose (15 grams per day for three weeks) they had improved diastolic heart function, increased physical function score and enhanced quality of life score. Echocardiographic studies of these patients showed that ribose administration enhanced relaxation of the left ventricle and improved the efficiency of filling from the left atrium. No such improvements were found during placebo administration (3).
RibosCardio™ increases cardiac energy to help fuel the heart. For patients, this can mean more energy and a higher quality of life.
Sports Nutrition: In skeletal muscle, high-intensity exercise can lead to a loss of up to 26% of cellular adenosine triphosphate, or ATP. One consequence of this energy drain is an increase in free radicals in affected muscle. Free radicals attack cell and mitochondrial membranes and can destroy the genetic material that helps muscle tissues synthesize proteins.
RibosCardio™ helps in three ways. First, if enough ribose is present in the cell or the circulating blood, energy compounds can be saved, or salvaged, before they wash out of the cell and are lost. Second, ribose accelerates energy synthesis, so if energy compounds are lost, they can be quickly replaced. Finally, by keeping the energy compounds in the cell, RibosCardio™ reduces free radical formation and preserves the energy the tissue needs to make proteins essential for maintaining muscle health and performance. This energy improvement has been shown to increased performance over time. A study published in the journal, Current Therapeutic Research, showed that male recreational bodybuilders experienced a significant improvement in both muscular endurance (20% increase over the four weeks versus a 12%for the placebo group) and muscular endurance (3.2% increase over the four weeks versus a 1.7% for the placebo group) following 28 days of our patented D-Ribose supplementation(1).
Fibromyalgia & Chronic Fatigue Syndrome: The muscle in patients with FMS and CFS is generally severely energy starved. This lack of energy leads to a number of physiological reactions within the muscle cell, ending in debilitating fatigue, muscle pain, soreness, and stiffness. By increasing the energy level in affected muscle, our patented D-Ribose helps patients overcome fatigue, and lessens the pain associated with their conditions.
RibosCardio™ has been designed to support serious energy needs of patients. The product has been formulated with CardioPerform™, a potent blend of L-carnitine (transports fuel into the heart to be burned as energy) and Acetyl L-carnitine (improves heart & brain health, protecting against oxidative damage), plus the patented form of D-Ribose, malic acid and magnesium gluconate to optimize energy production and synthesis.
Published research shows our patented form of D-ribose may be an effective adjunct in promoting cardiovascular, skeletal muscle, and neurological health. With heart patients, D-ribose has been found effective in restoring energy, improving ventilatory efficiency, oxygen uptake, stroke volume, diastolic function, physical performance, and quality of life. In neuromuscular disease, D-ribose helps to reduce pain, overcome fatigue, increase exercise tolerance, and help patients live more normal, active lives.
RibosCardio™'s magnesium gluconate and malic acid help your body use energy more efficiently. Your cells use magnesium in over 300 enzyme reactions, and it distributes energy evenly throughout the cell so it is available when and where it is needed. Malic Acid helps your mitochondria recycle the energy you have, maximizing cellular energy output.
D-Ribose Research Highlights
Cardiovascular Function: Scientific and clinical studies have repeatedly shown that our patented D-Ribose can restore energy and improve function in ischemic, hypoxic, and failing hearts. Oxygen deprivation causes hearts to use energy faster than it can be replaced through normal processes of tissue energy turnover. The result is a depletion of cellular energy reserves translating to a loss of heart function.
Mid-study results of an ongoing double blind, crossover trial with congestive heart failure patients were recently reported. Results showed conclusively that when patients were given ribose (15 grams per day for three weeks) they had improved diastolic heart function, increased physical function score and enhanced quality of life score. Echocardiographic studies of these patients showed that ribose administration enhanced relaxation of the left ventricle and improved the efficiency of filling from the left atrium. No such improvements were found during placebo administration (3).
RibosCardio™ increases cardiac energy to help fuel the heart. For patients, this can mean more energy and a higher quality of life.
Sports Nutrition: In skeletal muscle, high-intensity exercise can lead to a loss of up to 26% of cellular adenosine triphosphate, or ATP. One consequence of this energy drain is an increase in free radicals in affected muscle. Free radicals attack cell and mitochondrial membranes and can destroy the genetic material that helps muscle tissues synthesize proteins.
RibosCardio™ helps in three ways. First, if enough ribose is present in the cell or the circulating blood, energy compounds can be saved, or salvaged, before they wash out of the cell and are lost. Second, ribose accelerates energy synthesis, so if energy compounds are lost, they can be quickly replaced. Finally, by keeping the energy compounds in the cell, RibosCardio™ reduces free radical formation and preserves the energy the tissue needs to make proteins essential for maintaining muscle health and performance. This energy improvement has been shown to increased performance over time. A study published in the journal, Current Therapeutic Research, showed that male recreational bodybuilders experienced a significant improvement in both muscular endurance (20% increase over the four weeks versus a 12%for the placebo group) and muscular endurance (3.2% increase over the four weeks versus a 1.7% for the placebo group) following 28 days of our patented D-Ribose supplementation(1).
Fibromyalgia & Chronic Fatigue Syndrome: The muscle in patients with FMS and CFS is generally severely energy starved. This lack of energy leads to a number of physiological reactions within the muscle cell, ending in debilitating fatigue, muscle pain, soreness, and stiffness. By increasing the energy level in affected muscle, our patented D-Ribose helps patients overcome fatigue, and lessens the pain associated with their conditions.
Monday, March 9, 2009
What is the difference between CORvalen and CorvalenM?
What is the difference between CORvalen and CorvalenM? Both products recommend 5 grams per serving, and both have the same number of servings of D-ribose the principal active ingredient. In addition, CorvalenM contains magnesium and malate, both shown to improve muscle metabolism and relaxation.
How do I know which is best for me? As a general rule, CORvalen is recommended for heart patients and athletic applications. CorvalenM is used more for muscle aches, pain, soreness, and stiffness. But there are many exceptions with each. Ask yourself, Does my diet need additional magnesium? Magnesium is important for over 200 chemical reactions in the body. Some say the American diet contains less and less natural magnesium because more of our food is processed and we drink more bottled water and beverages than a couple of generations ago.
Conversely, too much magnesium leads to loose stools and diarrhea. You can pick up magnesium from several sources vitamin pills and other supplements.
What are the ingredients for each product? CORvalen is 100% D-ribose. Each serving contains 5g of D-ribose. CORvalen M contains D-ribose, malate and magnesium. For each serving of CORvalen M, there is 5g D-ribose, 240mg Malate (or malic acid) and 800mg magnesium gluconate (the same as 40mg elemental magnesium). CORvalen Chewable Wafers each contain 1.67 grams D-ribose. Other ingredients include inulin, cocoa bean powder, mannitol, modified cellulose, safflower oil, coconut powder, stearic acid, silicon dioxide and natural flavors.
What is ribose? D-Ribose is a simple, 5-carbon monosaccharide, or pentose sugar. It is used by all the cells of the body and is an essential compound in energy metabolism. Ribose is also the carbohydrate backbone of genetic material, DNA and RNA, certain vitamins and other important cellular compounds.
Who needs CORvalen? Ribose is an essential ingredient in stimulating natural energy production. Research has shown that ribose promotes cardiovascular health, reduces cardiac stress associated with strenuous activity and helps athletes extend their exercise tolerance and accelerates recovery. Ribose helps hearts and muscles maximize energy recovery. Whether you are a trained athlete, a weekend warrior or are concerned about your cardiovascular health, ribose may help give the energy boost your body needs.
How is ribose made in the body? Most compounds necessary for life are made in the body through a series of complicated pathways. Ribose is no different. In the body, ribose is made from glucose (a simple 6-carbon sugar) through a pathway called the Pentose Phosphate Pathway (PPP). Eventually, adenosine triphosphate (ATP) is produced. ATP is the primary energy molecule in your body’s cells. Though your body makes ribose and ATP naturally, it produces it slowly. As a result, your heart and muscle tissues use their energy faster than they can restore it and the energy pools become depleted.
How does the body derive cellular energy from ribose? The physiologically functional form of ribose, called 5-phosphoribosyl-1-pyrophosphate (PRPP), regulates the metabolic pathway that synthesizes energy compounds in all living tissue. If this compound is not available in sufficient quantity, energy synthesis slows.
How does taking supplemental CORvalen aid in increasing cellular energy? If the cellular energy pool is depleted by disease or exercise, it must be replaced. PRPP is required to turn on the metabolic pathway used by the body to replenish these energy pools. Supplemental ribose bypasses the slow and rate-limiting enzymes in the Pentose Phosphate Pathway, forms PRPP, and quickly begins the process of energy synthesis.
What will CORvalen do for someone concerned about cardiovascular health? Numerous medical studies have shown that energy levels in the heart can be dramatically lowered by exercise or decreased blood flow associated with certain cardiac diseases. Depleted cardiac energy pools may be associated with increased cardiac stress, altered cardiac function, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
What is the recommended daily dosage of CORvalen? Usual dosage: 5g serving twice daily, taken with meals. A third serving may be added with a midday meal as needed.
Alternative dosage: 5g just before and just after exercise or physical activity.
Serving measurement: 5g of CORvalen powder is a rounded teaspoonful. A single dose measuring scoop is provided with each jar.
CORvalen may be dissolved in 2 oz. or more of juice, tea, or coffee or sprinkled over foods of choice (such as hot oatmeal, yogurt, cold cereal). CorvalenM has a more citrus flavor so it is best in juice, water or yogurt. CORvalen and CorvalenM should NOT be mixed into carbonated beverages.
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. CORvalen (D-ribose) should be taken just before and just after exercise or activity. For extended exercise, an additional 1 to 2 grams per hour of exercise or activity may be helpful.
When can I expect to feel results/benefits from taking CORvalen? Individual response varies widely, but relief from fatigue is often felt within the first 10 days of consistent use.
What can I mix with CORvalen? CORvalen may be mixed with water, juice, coffee, tea or sprinkled on cereal or fruit. It has a mild pleasant sweet taste and is very flexible.
Are there any side effects associated with taking ribose? CORvalen may lower blood sugar for 60 to 90 minutes after ingestion. This may cause one to feel very hungry or lightheaded. This can be avoided by taking with meals or with some form of a carbohydrate such as a juice.
What will ribose do for someone who exercises on a regular basis? Scientific research shows that three or four workouts per week may not allow enough rest time between sessions for heart and muscle energy pools to return to normal levels. Taking CORvalen (D-ribose) shortens the time needed by heart and muscle tissue to replace energy that is lost through vigorous exercise. Keeping energy pools full helps to keep hearts and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise manages free radical formation and lowers cardiac stress associated with hypoxia.
Does CORvalen conflict with any medications? There are no known interactions with drugs or other supplements.
Does ribose work with creatine or other supplements? Ribose can increase the effect of creatine and other energy supplements by keeping the energy pool at full capacity. Creatine works by recycling energy that is already present in the tissue. Another supplement, carnitine, aids in fatty acid metabolism. A third, pyruvate, also helps to recycle energy. Only ribose performs this important metabolic function. Without adequate levels of energy to work with, no other supplement can be fully effective.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
How do I know which is best for me? As a general rule, CORvalen is recommended for heart patients and athletic applications. CorvalenM is used more for muscle aches, pain, soreness, and stiffness. But there are many exceptions with each. Ask yourself, Does my diet need additional magnesium? Magnesium is important for over 200 chemical reactions in the body. Some say the American diet contains less and less natural magnesium because more of our food is processed and we drink more bottled water and beverages than a couple of generations ago.
Conversely, too much magnesium leads to loose stools and diarrhea. You can pick up magnesium from several sources vitamin pills and other supplements.
What are the ingredients for each product? CORvalen is 100% D-ribose. Each serving contains 5g of D-ribose. CORvalen M contains D-ribose, malate and magnesium. For each serving of CORvalen M, there is 5g D-ribose, 240mg Malate (or malic acid) and 800mg magnesium gluconate (the same as 40mg elemental magnesium). CORvalen Chewable Wafers each contain 1.67 grams D-ribose. Other ingredients include inulin, cocoa bean powder, mannitol, modified cellulose, safflower oil, coconut powder, stearic acid, silicon dioxide and natural flavors.
What is ribose? D-Ribose is a simple, 5-carbon monosaccharide, or pentose sugar. It is used by all the cells of the body and is an essential compound in energy metabolism. Ribose is also the carbohydrate backbone of genetic material, DNA and RNA, certain vitamins and other important cellular compounds.
Who needs CORvalen? Ribose is an essential ingredient in stimulating natural energy production. Research has shown that ribose promotes cardiovascular health, reduces cardiac stress associated with strenuous activity and helps athletes extend their exercise tolerance and accelerates recovery. Ribose helps hearts and muscles maximize energy recovery. Whether you are a trained athlete, a weekend warrior or are concerned about your cardiovascular health, ribose may help give the energy boost your body needs.
How is ribose made in the body? Most compounds necessary for life are made in the body through a series of complicated pathways. Ribose is no different. In the body, ribose is made from glucose (a simple 6-carbon sugar) through a pathway called the Pentose Phosphate Pathway (PPP). Eventually, adenosine triphosphate (ATP) is produced. ATP is the primary energy molecule in your body’s cells. Though your body makes ribose and ATP naturally, it produces it slowly. As a result, your heart and muscle tissues use their energy faster than they can restore it and the energy pools become depleted.
How does the body derive cellular energy from ribose? The physiologically functional form of ribose, called 5-phosphoribosyl-1-pyrophosphate (PRPP), regulates the metabolic pathway that synthesizes energy compounds in all living tissue. If this compound is not available in sufficient quantity, energy synthesis slows.
How does taking supplemental CORvalen aid in increasing cellular energy? If the cellular energy pool is depleted by disease or exercise, it must be replaced. PRPP is required to turn on the metabolic pathway used by the body to replenish these energy pools. Supplemental ribose bypasses the slow and rate-limiting enzymes in the Pentose Phosphate Pathway, forms PRPP, and quickly begins the process of energy synthesis.
What will CORvalen do for someone concerned about cardiovascular health? Numerous medical studies have shown that energy levels in the heart can be dramatically lowered by exercise or decreased blood flow associated with certain cardiac diseases. Depleted cardiac energy pools may be associated with increased cardiac stress, altered cardiac function, fatigue and decreased exercise tolerance. Ribose is the key nutrient for quickly restoring cardiac energy stores.
What is the recommended daily dosage of CORvalen? Usual dosage: 5g serving twice daily, taken with meals. A third serving may be added with a midday meal as needed.
Alternative dosage: 5g just before and just after exercise or physical activity.
Serving measurement: 5g of CORvalen powder is a rounded teaspoonful. A single dose measuring scoop is provided with each jar.
CORvalen may be dissolved in 2 oz. or more of juice, tea, or coffee or sprinkled over foods of choice (such as hot oatmeal, yogurt, cold cereal). CorvalenM has a more citrus flavor so it is best in juice, water or yogurt. CORvalen and CorvalenM should NOT be mixed into carbonated beverages.
To maximize athletic performance, or to keep energy pools high during strenuous activity, slightly larger doses may be required. CORvalen (D-ribose) should be taken just before and just after exercise or activity. For extended exercise, an additional 1 to 2 grams per hour of exercise or activity may be helpful.
When can I expect to feel results/benefits from taking CORvalen? Individual response varies widely, but relief from fatigue is often felt within the first 10 days of consistent use.
What can I mix with CORvalen? CORvalen may be mixed with water, juice, coffee, tea or sprinkled on cereal or fruit. It has a mild pleasant sweet taste and is very flexible.
Are there any side effects associated with taking ribose? CORvalen may lower blood sugar for 60 to 90 minutes after ingestion. This may cause one to feel very hungry or lightheaded. This can be avoided by taking with meals or with some form of a carbohydrate such as a juice.
What will ribose do for someone who exercises on a regular basis? Scientific research shows that three or four workouts per week may not allow enough rest time between sessions for heart and muscle energy pools to return to normal levels. Taking CORvalen (D-ribose) shortens the time needed by heart and muscle tissue to replace energy that is lost through vigorous exercise. Keeping energy pools full helps to keep hearts and muscles in good physiological condition, increase power and endurance, and reduce fatigue. Recent research has also shown that ribose supplementation during exercise manages free radical formation and lowers cardiac stress associated with hypoxia.
Does CORvalen conflict with any medications? There are no known interactions with drugs or other supplements.
Does ribose work with creatine or other supplements? Ribose can increase the effect of creatine and other energy supplements by keeping the energy pool at full capacity. Creatine works by recycling energy that is already present in the tissue. Another supplement, carnitine, aids in fatty acid metabolism. A third, pyruvate, also helps to recycle energy. Only ribose performs this important metabolic function. Without adequate levels of energy to work with, no other supplement can be fully effective.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Saturday, April 19, 2008
Fibromyalgia, Pain Relief & Energy with Malic Acid
Malic Acid, Energy, & Fibromyalgia
Improvement in pain observed within 48 hours of supplementation with 1200-2400 mg. of malic acid per day. Buy Metagenics Fibroplex with magnesium and malic acid at a discount
Combine Bioenergy Corvalen Ribose with Metagenics Fibroplex for muscle pains and energy - Corvalen Lowest Price with Free Shipping
Primary fibromyalgia (FM) is a condition affecting principally middle-aged women, characterized by a syndrome of generalized musculoskeletal pain, aches, stiffness, and tenderness at specific anatomical sites. This condition is considered primary when there are no obvious causes. Since it was first described, FM has become recognized as a fairly common rheumatic complaint with a clinical prevalence of 6 to 20 percent. Additionally, FM has been associated with irritable bowel syndrome, tension headache, mitral valve prolapse, and chronic fatigue syndrome. Numerous treatment modalities have been attempted to treat patients with FM, but unfortunately the results have usually been poor. The primary reason for this lack of success was undoubtedly due to our lack of understanding FMs etiology.
In recent years, evidence has accumulated to suggest that FM is the result of local hypoxia in the muscles. For instance, patients with FM have low muscle-tissue oxygen pressure in affected muscles, and to a lesser degree the same was found in other tissues. Muscle biopsies from affected areas showed muscle tissue breakdown and mitochondrial damage. Additionally, low levels of the high energy phosphates ATP, ADP, and phosphocreatine were found. It has been hypothesized that in hypoxic muscle tissues glycolysis is inhibited, reducing ATP synthesis. This stimulates the process of gluconeogenesis, which results in the breakdown of muscle proteins to amino acids that can be utilized as substrates for ATP synthesis. This muscle tissue breakdown, which has been observed in muscle biopsies taken from FM patients, is hypothesized to result in the muscle pain characteristic of FM.
Malic acid is both derived from food sources and synthesized in the body through the citric acid (Krebs) cycle. Its importance to the production of energy in the body during both aerobic and anaerobic conditions is well established. Under aerobic conditions, the oxidation of malate to oxaloacetate provides reducing equivalents to the mitochondria through the malate-aspartate redox shuttle. During anaerobic conditions, where a buildup of excess of reducing equivalents inhibits glycolysis, malic acids simultaneous reduction to succinate and oxidation to oxaloacetate is capable of removing the accumulating reducing equivalents. This allows malic acid to reverse hypoxias inhibition of glycolysis and energy production. This may allow malic acid to improve energy production in FM, reversing the negative effect of the relative hypoxia that has been found in these patients.
Because of its obvious relationship to energy depletion during exercise, malic acid may be of benefit to healthy individuals interested in maximizing their energy production, as well as those with FM. In the rat it has been found that only tissue malate is depleted following exhaustive physical activity. Other key metabolites from the citric acid cycle needed for energy production were found to be unchanged. Because of this, a deficiency of malic acid has been hypothesized to be a major cause of physical exhaustion. The administration of malic acid to rats has been shown to elevate mitochondrial malate and increase mitochondrial respiration and energy production. Surprisingly, relatively small amounts of exogenous malic acid were required to increase mitochondrial energy production and ATP formation. Under hypoxic conditions there is an increased demand and utilization of malic acid, and this demand is normally met by increasing the synthesis of malic acid through gluconeogenesis and muscle protein
breakdown. This ultimately results in muscle breakdown and damage.
In a study on the effect of the oral administration of malic acid to rats, a significant increase in anaerobic endurance was found. Interestingly, the improvement in endurance was not accompanied by an increase in carbohydrate and oxygen utilization, suggesting that malic acid has carbohydrate and oxygen-sparing effects. In addition, malic acid is the only metabolite of the citric acid cycle positively correlated with physical activity. It has also been demonstrated that exercise-induced mitochondrial respiration is associated with an accumulation of malic acid. In humans, endurance training is associated with a significant increase in the enzymes involved with malic acid metabolism.
Because of the compelling evidence that malic acid plays a central role in energy production, especially during hypoxic conditions, malic acid supplements have been examined for their effects on FM. Subjective improvement in pain was observed within 48 hours of supplementation with 1200 - 2400 milligrams of malic acid, and this improvement was lost following the discontinuation of malic acid for 48 hours. While these studies also used magnesium supplements, due to the fact that magnesium is often low in FM patients, the rapid improvement following malic acid, as well as the rapid deterioration after discontinuation, suggests that malic acid is the most important component. This interesting theory of localized hypoxia in FM, and the ability of malic acid to overcome the block in energy production that this causes, should provide hope for those afflicted with FM. The potential for malic acid supplements, however, reaches much farther than FM. In light of malic acids ability to improve animal exercise performance, its potential for human athletes is particularly exciting.
Additionally, many hypoxia related conditions, such as respiratory and circulatory insufficiency, are associated with deficient energy production. Therefore, malic acid supplements may be of benefit in these conditions. Chronic Fatigue Syndrome has also been found to be associated with FM, and malic acid supplementation may be of use in improving energy production in this condition as well. Lastly, malic acid may be of use as a general supplement aimed at ensuring an optimal level of malic acid within the cells, and thus, maintaining an optimal level of energy production.
Metagenics Fibroplex has: Thiamin (as thiamin mononitrate) 50 mgVitamin B6 (as pyridoxine HCl) 50 mgMagnesium (as magnesium bis-glycinate†) 150 mgManganese (as manganese glycinate†) 5 mgMalic Acid 600 mg
Metagenics Fibroplex® Plus - Support for Muscle Tenderness and Discomfort
Fibroplex® Plus provides targeted nutritional support for soft tissues in those with muscle tenderness and discomfort. Featuring a blend of specific vitamins, minerals, and amino acids in an easy-to-use delivery form, this specialized formula works by supporting cellular energy production and muscular and nervous system function.
Improvement in pain observed within 48 hours of supplementation with 1200-2400 mg. of malic acid per day. Buy Metagenics Fibroplex with magnesium and malic acid at a discount
Combine Bioenergy Corvalen Ribose with Metagenics Fibroplex for muscle pains and energy - Corvalen Lowest Price with Free Shipping
Primary fibromyalgia (FM) is a condition affecting principally middle-aged women, characterized by a syndrome of generalized musculoskeletal pain, aches, stiffness, and tenderness at specific anatomical sites. This condition is considered primary when there are no obvious causes. Since it was first described, FM has become recognized as a fairly common rheumatic complaint with a clinical prevalence of 6 to 20 percent. Additionally, FM has been associated with irritable bowel syndrome, tension headache, mitral valve prolapse, and chronic fatigue syndrome. Numerous treatment modalities have been attempted to treat patients with FM, but unfortunately the results have usually been poor. The primary reason for this lack of success was undoubtedly due to our lack of understanding FMs etiology.
In recent years, evidence has accumulated to suggest that FM is the result of local hypoxia in the muscles. For instance, patients with FM have low muscle-tissue oxygen pressure in affected muscles, and to a lesser degree the same was found in other tissues. Muscle biopsies from affected areas showed muscle tissue breakdown and mitochondrial damage. Additionally, low levels of the high energy phosphates ATP, ADP, and phosphocreatine were found. It has been hypothesized that in hypoxic muscle tissues glycolysis is inhibited, reducing ATP synthesis. This stimulates the process of gluconeogenesis, which results in the breakdown of muscle proteins to amino acids that can be utilized as substrates for ATP synthesis. This muscle tissue breakdown, which has been observed in muscle biopsies taken from FM patients, is hypothesized to result in the muscle pain characteristic of FM.
Malic acid is both derived from food sources and synthesized in the body through the citric acid (Krebs) cycle. Its importance to the production of energy in the body during both aerobic and anaerobic conditions is well established. Under aerobic conditions, the oxidation of malate to oxaloacetate provides reducing equivalents to the mitochondria through the malate-aspartate redox shuttle. During anaerobic conditions, where a buildup of excess of reducing equivalents inhibits glycolysis, malic acids simultaneous reduction to succinate and oxidation to oxaloacetate is capable of removing the accumulating reducing equivalents. This allows malic acid to reverse hypoxias inhibition of glycolysis and energy production. This may allow malic acid to improve energy production in FM, reversing the negative effect of the relative hypoxia that has been found in these patients.
Because of its obvious relationship to energy depletion during exercise, malic acid may be of benefit to healthy individuals interested in maximizing their energy production, as well as those with FM. In the rat it has been found that only tissue malate is depleted following exhaustive physical activity. Other key metabolites from the citric acid cycle needed for energy production were found to be unchanged. Because of this, a deficiency of malic acid has been hypothesized to be a major cause of physical exhaustion. The administration of malic acid to rats has been shown to elevate mitochondrial malate and increase mitochondrial respiration and energy production. Surprisingly, relatively small amounts of exogenous malic acid were required to increase mitochondrial energy production and ATP formation. Under hypoxic conditions there is an increased demand and utilization of malic acid, and this demand is normally met by increasing the synthesis of malic acid through gluconeogenesis and muscle protein
breakdown. This ultimately results in muscle breakdown and damage.
In a study on the effect of the oral administration of malic acid to rats, a significant increase in anaerobic endurance was found. Interestingly, the improvement in endurance was not accompanied by an increase in carbohydrate and oxygen utilization, suggesting that malic acid has carbohydrate and oxygen-sparing effects. In addition, malic acid is the only metabolite of the citric acid cycle positively correlated with physical activity. It has also been demonstrated that exercise-induced mitochondrial respiration is associated with an accumulation of malic acid. In humans, endurance training is associated with a significant increase in the enzymes involved with malic acid metabolism.
Because of the compelling evidence that malic acid plays a central role in energy production, especially during hypoxic conditions, malic acid supplements have been examined for their effects on FM. Subjective improvement in pain was observed within 48 hours of supplementation with 1200 - 2400 milligrams of malic acid, and this improvement was lost following the discontinuation of malic acid for 48 hours. While these studies also used magnesium supplements, due to the fact that magnesium is often low in FM patients, the rapid improvement following malic acid, as well as the rapid deterioration after discontinuation, suggests that malic acid is the most important component. This interesting theory of localized hypoxia in FM, and the ability of malic acid to overcome the block in energy production that this causes, should provide hope for those afflicted with FM. The potential for malic acid supplements, however, reaches much farther than FM. In light of malic acids ability to improve animal exercise performance, its potential for human athletes is particularly exciting.
Additionally, many hypoxia related conditions, such as respiratory and circulatory insufficiency, are associated with deficient energy production. Therefore, malic acid supplements may be of benefit in these conditions. Chronic Fatigue Syndrome has also been found to be associated with FM, and malic acid supplementation may be of use in improving energy production in this condition as well. Lastly, malic acid may be of use as a general supplement aimed at ensuring an optimal level of malic acid within the cells, and thus, maintaining an optimal level of energy production.
Metagenics Fibroplex has: Thiamin (as thiamin mononitrate) 50 mgVitamin B6 (as pyridoxine HCl) 50 mgMagnesium (as magnesium bis-glycinate†) 150 mgManganese (as manganese glycinate†) 5 mgMalic Acid 600 mg
Metagenics Fibroplex® Plus - Support for Muscle Tenderness and Discomfort
Fibroplex® Plus provides targeted nutritional support for soft tissues in those with muscle tenderness and discomfort. Featuring a blend of specific vitamins, minerals, and amino acids in an easy-to-use delivery form, this specialized formula works by supporting cellular energy production and muscular and nervous system function.
- Provides targeted nutrition for soft tissue in those with muscle tenderness and discomfort.
- Provides targeted support for energy metabolism and neuromuscular function.
- Supports cellular energy production and mitochondrial function.
- Provides magnesium in the form of an amino acid chelate designed to be easily absorbed.
Friday, March 21, 2008
Special Report: Condition Specific Nutrition CORvalenM
Buy CorvalenM or Corvalen at the lowest price with FREE Shipping
by John St. Cyr, M.D.
CORvalenM™ is the common denominator for all individuals needing to restore cellular energy. As a product extension of CORvalen, a medical food for heart disease patients, it was created to help those suffering from myalgia and chronic fatigue. However, because of the benefits CORvalenM provided to its users, it was also discovered that active individuals could reap the benefits of this natural supplement.
The Ingredients
A variety of conditions can leave people constantly fatigued, short of breath, stiff and sore, making it impossible to face life’s daily activities. Over exertion of or exercise weaken muscles and drain energy reserves, leaving people tired and achy. Often, this fatigue, shortness of breath, soreness, stiffness, and general lack of well-being are associated with depleted energy from the cells and tissues. CORvalenM, with D-ribose, magnesium and malic acid (three substances found naturally in your body) has been clinically proven to be critical in rebuilding cellular energy. The results are dramatic, with people feeling less pain and more energy. D-ribose, the main ingredient in CORvalenM, is a fivecarbon monosaccharide that is vital for the cellular synthesis of ATP (adenosine triphosphate). ATP is the energy of life, and ribose is the fundamental building block of ATP. Without ribose, the process of energy synthesis slows dramatically. Ribose has been clinically proven to effectively speed energy recovery in cells and to improve cardiac function, muscle recovery, and overall quality of life.
The Benefits
Whether suffering from myalgia or chronic fatigue, or needing to recover faster during endurance training, CORvalenM is the perfect natural supplement. When hard work, strenuous exercise, or certain medical conditions stress cells, cellular energy is burned faster than it can be restored. The result is pain, soreness, stiffness, and fatigue. Healthy cells often can rebuild these energy levels eventually, but the process is slow. And chronically energy-starved cells may never fully recover. CORvalenM accelerates this recovery. From endurance athletes to active people who like to run or take a long walk, high energy levels are important to everyone. But energy is especially critical to people who suffer from debilitating myalgia, soreness, stiffness, and fatigue. By taking CORvalenM, normal energy levels are restored and the whole body feels more energetic. More importantly, people taking CORvalenM report an increased sense of well-being and an improved quality of life. CORvalenM is proven safe, effective and beneficial to those needing to restore energy, minimize fatigue and alleviate muscle pain, soreness and stiffness.
by John St. Cyr, M.D.
CORvalenM™ is the common denominator for all individuals needing to restore cellular energy. As a product extension of CORvalen, a medical food for heart disease patients, it was created to help those suffering from myalgia and chronic fatigue. However, because of the benefits CORvalenM provided to its users, it was also discovered that active individuals could reap the benefits of this natural supplement.
The Ingredients
A variety of conditions can leave people constantly fatigued, short of breath, stiff and sore, making it impossible to face life’s daily activities. Over exertion of or exercise weaken muscles and drain energy reserves, leaving people tired and achy. Often, this fatigue, shortness of breath, soreness, stiffness, and general lack of well-being are associated with depleted energy from the cells and tissues. CORvalenM, with D-ribose, magnesium and malic acid (three substances found naturally in your body) has been clinically proven to be critical in rebuilding cellular energy. The results are dramatic, with people feeling less pain and more energy. D-ribose, the main ingredient in CORvalenM, is a fivecarbon monosaccharide that is vital for the cellular synthesis of ATP (adenosine triphosphate). ATP is the energy of life, and ribose is the fundamental building block of ATP. Without ribose, the process of energy synthesis slows dramatically. Ribose has been clinically proven to effectively speed energy recovery in cells and to improve cardiac function, muscle recovery, and overall quality of life.
The Benefits
Whether suffering from myalgia or chronic fatigue, or needing to recover faster during endurance training, CORvalenM is the perfect natural supplement. When hard work, strenuous exercise, or certain medical conditions stress cells, cellular energy is burned faster than it can be restored. The result is pain, soreness, stiffness, and fatigue. Healthy cells often can rebuild these energy levels eventually, but the process is slow. And chronically energy-starved cells may never fully recover. CORvalenM accelerates this recovery. From endurance athletes to active people who like to run or take a long walk, high energy levels are important to everyone. But energy is especially critical to people who suffer from debilitating myalgia, soreness, stiffness, and fatigue. By taking CORvalenM, normal energy levels are restored and the whole body feels more energetic. More importantly, people taking CORvalenM report an increased sense of well-being and an improved quality of life. CORvalenM is proven safe, effective and beneficial to those needing to restore energy, minimize fatigue and alleviate muscle pain, soreness and stiffness.
Thursday, November 29, 2007
Research: Benefit of Ribose in a Patient With Fibromyalgia
01-31-2005 Journal: Pharmacotherapy
Benjamin Gebhart, Pharm.D.; James A. Jorgenson, M.S., FASHP
Abstract and Introduction
Abstract
Ribose was added to the existing treatment regimen of a woman with fibromyalgia, resulting in a decrease in symptoms. It has been postulated that patients with fibromyalgia may have an alteration in muscle adenine nucleotide metabolism, leading to depleted energy reserves and an imbalance in cellular adenosine-triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge. As a key component in adenine nucleotide synthesis, ribose supplementation may be useful in such patients.
Introduction
Fibromyalgia is a syndrome that is manifested by generalized muscle pain and additional systemic symptoms of fatigue, tenderness and stiffness in multiple joints, sleep disturbance, and alterations in bowel activity.
The specific etiology is unknown; however, changes in muscle histology, energy metabolism, oxygen utilization, and the neuroendocrine stress-response system have been postulated to play a role in the development and persistence of this disorder.[1] Low levels of muscle adenine nucleotides, reflected in depleted energy reserves and an imbalance in cellular adenosine 5'-triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge, have been reported.[2-4] The unknown cause and varying presenting symptoms make fibromyalgia a therapeutic challenge for practitioners.[5-7]
The management of patients with fibromyalgia requires the integration of both pharmacologic and nonpharmacologic approaches. Pharmacologic options have included tricyclic antidepressants, selective serotonin receptor antagonists, analgesics, benzodiazepines, antiinflammatory agents, and corticosteroids.[5, 6, 8]
Routine daily exercise programs, dietary modifications, alternative therapies such as biofeedback and hypnotherapy, and nutraceuticals such as S-adenosyl-L-methionine (SAMe) have also been explored.[9] Unfortunately, less than 50% of patients achieve any meaningful relief of their symptoms with use of those therapies.[5]
We describe the case of a patient with fibromyalgia who had symptomatic relief when ribose was added to her existing treatment regimen. There have been anecdotal reports on the benefits of ribose in patients with fibromyalgia in whom conventional therapies have failed; however, to our knowledge, this is the first published case of use of ribose for this syndrome.
Case Report
A 37-year-old woman had daily episodes of intense musculoskeletal pain and stiffness, mental "cloudiness," bouts of diarrhea, and sleep disturbance. As she was a surgeon, these symptoms compromised the skills necessary to perform her daily duties in the operating room. She was diagnosed with fibromyalgia by exclusion of other diseases and syndromes and in accordance with the American College of Rheumatology criteria.[10]
The patient was treated with ibuprofen 800 mg twice/day, valdecoxib 10 mg once/day, diphenhydramine 50 mg-acetaminophen 1000 mg at bedtime, and physical therapy once/day. She stated that this therapeutic regimen had limited benefit and that the adverse effects from these drugs further impaired her ability to perform her operative duties.
Approximately 7 months later, in addition to her regular drug therapy, the patient began taking CORvalen (Bioenergy, Inc., Ham Lake, MN), a ribose-based product. She took 5 g of CORvalen mixed in water twice/day. She experienced no adverse effects, and after 14 days she reported a decrease in her symptoms. Specifically, she noted an improvement in sleep, mental alertness, a marked decrease in joint pain, and normal stools. This trend continued, and after an additional month of CORvalen therapy she reported near-normal functioning with a major reduction in her symptoms.
After another month of taking CORvalen and feeling "normal," the patient elected to discontinue the drug. Within 7 days, she regressed to her initial fibromyalgia state, as reflected in joint pain, sleep disturbance, morning stiffness, trigger-point flares, and diarrhea. She resumed taking CORvalen, at the same dosage as before, and a major reduction in her symptoms again occurred within 14 days. She noted continual benefit for the next month while taking CORvalen. She stopped taking the drug for a second time after this additional 30-day period, and once again she experienced a reemergence of symptoms. When CORvalen was restarted for a third time, the patient's symptoms again subsided.
At the time of this writing, the patient was continuing to take CORvalen and was satisfied that her symptoms had abated.
Discussion
Ribose is a simple carbohydrate that plays a role in high-energy phosphate and nucleic acid synthesis. After ischemia or hypoxia, myocytes have decreased levels of ATP and total adenine nucleotides. Several days are required for their recovery once normoxia has been reestablished.[11-13] In patients with chronic hypoxic conditions, the cellular energy charge may never be fully regained.[14]
These cells have the capacity to regenerate ATP; however, the pentose phosphate pathway of glucose metabolism utilized in the formation of the ribose that is needed to drive the regenerative process is slow in both heart and skeletal muscle cells due to poor expression of specific rate-limiting enzymes. Supplemental ribose has been shown to enhance the synthesis of adenine nucleotides, rebuilding depressed energy pools in both the heart and skeletal muscle after an ischemic or hypoxic insult.[11, 12] Ribose bypasses the rate-limiting enzymatic steps of the pentose phosphate pathway and accelerates the formation of ATP and subsequent tissue recovery.[15]
Supplemental ribose is initially converted to ribose-5-phosphate, subsequently forming 5-phosphoribosyl-1-pyrophosphate, a molecule key to the synthesis of ATP through the de novo purine nucleotide pathway. The safety of ribose has been investigated in standard laboratory and animal toxicology models and in human studies both subjectively and objectively. Investigators have concluded that ribose is well tolerated at dosages of up to 60 g/day, with no significant adverse effects.[16]
Ribose has been shown to improve the energy recovery time in skeletal muscle and to relieve fatigue, soreness, and stiffness after intense exercise.[12, 13, 17] It also has been reported to have a beneficial effect after high-intensity exercise in sports medicine.
One study concluded that ribose accelerated the replenishment of ATP after intense muscle contractions,[18] and bodybuilders and sprinters have reported subjective and objective benefits during exercise after the administration of ribose.[18-20] However, other reports have shown inconsistent results for ribose in relation to improving short-term anaerobic exercise performance, muscle strength, endurance, or body composition during cycling or resistance training.[20, 21]
Ribose has also been investigated for its potential medical efficacy in both animal studies and human clinical trials. To date, the most promising data have been reported in connection with the application of ribose in cardiovascular disease. Both short-term and long-term animal studies found that the use of ribose after myocardial ischemia resulted in enhanced recovery of ATP along with improved diastolic functional parameters.[22, 23]
Clinical benefits have also been observed. Patients with coronary artery disease or heart failure have decreased myocardial ATP levels. Daily supplemental ribose has been shown to improve cardiac function, increase exercise tolerance, and enhance quality of life in this population.[24]
Patients with fibromyalgia may experience an alteration in physiologic muscle metabolism. It has been found that they reach the anaerobic threshold in their muscles earlier, thereby using less of the available energy-rich phosphate metabolites at maximal work capacity.[25] In another study, patients with fibromyalgia were reported to have a potential abnormality in high-energy phosphate metabolism, as evidenced by significantly lower levels of ATP and ADP in affected muscles as compared with patients without the disease.[2]
Theoretically, the effect of ribose on increasing the muscle energy pool could reduce the metabolic strain in affected muscles and allow patients to assume a more active lifestyle. Considering the known musculoskeletal symptomatology in this syndrome and the reported benefits of ribose in skeletal muscle metabolism and physiology, supplemental ribose appears to have aided our patient in improving her quality of life.
Conclusion
Fibromyalgia presents a continuing therapeutic challenge. Ribose is a naturally occurring carbohydrate with documented medical benefits in patients with cardiovascular disease. To our knowledge, this is the first report to suggest its potential benefit in a patient with fibromyalgia, who had had suboptimal results with conventional therapies. We are designing a trial using objective outcome measures to further evaluate the effectiveness of this product in patients with fibromyalgia
Pharmacotherapy 24(11):1646-1648, 2004. © 2004 Pharmacotherapy Publications
References:
1. Olson NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci 1998;315:351-8.
2. Bengtsson A, Henriksson KG, Larsson J. Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia. Arthritis Rheum 1986;29:817-21.
3. Eisinger J, Plantamura A, Ayavou T. Glycolysis abnormalities in fibromyalgia. J Am Coll Nutr 1994;13:144-8.
4. Park JH, Phothimat P, Oates CT, Hernaz-Schulman M, Olsen NJ. Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia. Arthritis Rheum 1998;41:406-13.
5. Leventhal LJ. Management of fibromyalgia. Ann Intern Med 1999;131:850-7.
6. Friedberg F, Jason LA. Chronic fatigue syndrome and fibromyalgia: clinical assessment and treatment. J Clin Psychol 2001;57:433-55. Lash AA, Ehrlich-Jones L, McCoy D. Fibromyalgia: evolving concepts and management in primary care settings. Medsurg Nurs 2003;12:145-59, 190.
7. Briley M, Moret C. Fibromyalgia syndrome: an overview of potential drug targets. Drugs 2003;6:668-73.
8. Holdcraft LC, Assefi N, Buchwald D. Complementary and alternative medicine in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol 2003;17:667-83.
9. Wolfe F, for the American College of Rheumatology. Criteria for the classification of fibromyalgia: report of the multi-center criteria committee. Arthritis Rheum 1990;33:160-72.
10. St Cyr J, Bianco R, Schneider J, et al. Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model. J Surg Res 1989;42:157-62.
11. Hellsten Y, Skadhauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol Integr Comp Physiol 2004;286:R182-8.
12. Williamson DL, Gallagher PM, Goddard MP, Witter J, Trappe S. Effects of ribose supplementation on adenine nucleotide concentration in skeletal muscle following high-intensity exercise [abstr]. Med Sci Sport Exer 2001;33(5 suppl).
13. Ingwall JS. ATP and the heart. Boston: Kluwer Academic, 2002:55-95.
14. Pauly DF, Pepine CJ. D-ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther 2000;5: 249-58.
15. Pliml W, von Arnim T, Stablein A, Hoffman H, Zimmer HG, Erdmann E. Effects of ribose on exercise-induced ischaemia in stable coronary artery disease. Lancet 1992;340:507-10.
16. Butler T, St Cyr J. Use of ribose to prevent cramps and soreness in muscles. U.S. patent 6159943. December 12, 2000.
17. Zarzeczny R, Brault JJ, Abraham KA, Hancock C, Terjung R. Influence of ribose on adenine salvage after intense muscle contractions. J Appl Physiol 2001;91:1775-81.
18. Van Gammeren D, Antonio J, Falk D. The effects of four weeks of ribose supplementation on body composition and exercise performance in healthy, young, male recreational bodybuilders: a double-blind, placebo controlled trial. Cur Therapeut Res 2002;63:486-95.
19. Berandi JM, Ziegenfuss TN. Effects of ribose supplementation on repeated sprint performance in men. J Strength Cond Res 2003;17:47-52.
20. Falk DJ, Heelan KA, Thyfault JP, Koch AJ. Effects of effervescent creatine, ribose, and glutamine supplementation on muscular strength, muscular endurance, and body composition. J Strength Cond Res 2003;17:810-16.
21. Schneider J, St Cyr J, Mahoney J, Bianco R, Ring W, Foker J. Recovery of ATP and return of function after global ischemia [abstr]. Circulation 1985;72(4 pt 2):III-298.
22. Zimmer HG. Normalization of depressed heart function in rats by ribose. Science 1983;220:81-2.
23. Omran H, Illien S, MacCarter D, St Cyr J, Luderitz B. D-ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study. Eur J Heart Failure 2003;5:615-19.
24. Lund E, Kendall SA, Janerot-Sjoberg B, Bengtsson A. Muscle metabolism in fibromyalgia studied by P-31 magnetic resonance spectroscopy during aerobic and anaerobic exercise. Scand J Rheumatol 2003;32:138-45.
Source: MedScape
Benjamin Gebhart, Pharm.D.; James A. Jorgenson, M.S., FASHP
Abstract and Introduction
Abstract
Ribose was added to the existing treatment regimen of a woman with fibromyalgia, resulting in a decrease in symptoms. It has been postulated that patients with fibromyalgia may have an alteration in muscle adenine nucleotide metabolism, leading to depleted energy reserves and an imbalance in cellular adenosine-triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge. As a key component in adenine nucleotide synthesis, ribose supplementation may be useful in such patients.
Introduction
Fibromyalgia is a syndrome that is manifested by generalized muscle pain and additional systemic symptoms of fatigue, tenderness and stiffness in multiple joints, sleep disturbance, and alterations in bowel activity.
The specific etiology is unknown; however, changes in muscle histology, energy metabolism, oxygen utilization, and the neuroendocrine stress-response system have been postulated to play a role in the development and persistence of this disorder.[1] Low levels of muscle adenine nucleotides, reflected in depleted energy reserves and an imbalance in cellular adenosine 5'-triphosphate:adenosine 5'-diphosphate:adenosine 5'-monophosphate (ATP:ADP:AMP) ratios with an abnormal energy charge, have been reported.[2-4] The unknown cause and varying presenting symptoms make fibromyalgia a therapeutic challenge for practitioners.[5-7]
The management of patients with fibromyalgia requires the integration of both pharmacologic and nonpharmacologic approaches. Pharmacologic options have included tricyclic antidepressants, selective serotonin receptor antagonists, analgesics, benzodiazepines, antiinflammatory agents, and corticosteroids.[5, 6, 8]
Routine daily exercise programs, dietary modifications, alternative therapies such as biofeedback and hypnotherapy, and nutraceuticals such as S-adenosyl-L-methionine (SAMe) have also been explored.[9] Unfortunately, less than 50% of patients achieve any meaningful relief of their symptoms with use of those therapies.[5]
We describe the case of a patient with fibromyalgia who had symptomatic relief when ribose was added to her existing treatment regimen. There have been anecdotal reports on the benefits of ribose in patients with fibromyalgia in whom conventional therapies have failed; however, to our knowledge, this is the first published case of use of ribose for this syndrome.
Case Report
A 37-year-old woman had daily episodes of intense musculoskeletal pain and stiffness, mental "cloudiness," bouts of diarrhea, and sleep disturbance. As she was a surgeon, these symptoms compromised the skills necessary to perform her daily duties in the operating room. She was diagnosed with fibromyalgia by exclusion of other diseases and syndromes and in accordance with the American College of Rheumatology criteria.[10]
The patient was treated with ibuprofen 800 mg twice/day, valdecoxib 10 mg once/day, diphenhydramine 50 mg-acetaminophen 1000 mg at bedtime, and physical therapy once/day. She stated that this therapeutic regimen had limited benefit and that the adverse effects from these drugs further impaired her ability to perform her operative duties.
Approximately 7 months later, in addition to her regular drug therapy, the patient began taking CORvalen (Bioenergy, Inc., Ham Lake, MN), a ribose-based product. She took 5 g of CORvalen mixed in water twice/day. She experienced no adverse effects, and after 14 days she reported a decrease in her symptoms. Specifically, she noted an improvement in sleep, mental alertness, a marked decrease in joint pain, and normal stools. This trend continued, and after an additional month of CORvalen therapy she reported near-normal functioning with a major reduction in her symptoms.
After another month of taking CORvalen and feeling "normal," the patient elected to discontinue the drug. Within 7 days, she regressed to her initial fibromyalgia state, as reflected in joint pain, sleep disturbance, morning stiffness, trigger-point flares, and diarrhea. She resumed taking CORvalen, at the same dosage as before, and a major reduction in her symptoms again occurred within 14 days. She noted continual benefit for the next month while taking CORvalen. She stopped taking the drug for a second time after this additional 30-day period, and once again she experienced a reemergence of symptoms. When CORvalen was restarted for a third time, the patient's symptoms again subsided.
At the time of this writing, the patient was continuing to take CORvalen and was satisfied that her symptoms had abated.
Discussion
Ribose is a simple carbohydrate that plays a role in high-energy phosphate and nucleic acid synthesis. After ischemia or hypoxia, myocytes have decreased levels of ATP and total adenine nucleotides. Several days are required for their recovery once normoxia has been reestablished.[11-13] In patients with chronic hypoxic conditions, the cellular energy charge may never be fully regained.[14]
These cells have the capacity to regenerate ATP; however, the pentose phosphate pathway of glucose metabolism utilized in the formation of the ribose that is needed to drive the regenerative process is slow in both heart and skeletal muscle cells due to poor expression of specific rate-limiting enzymes. Supplemental ribose has been shown to enhance the synthesis of adenine nucleotides, rebuilding depressed energy pools in both the heart and skeletal muscle after an ischemic or hypoxic insult.[11, 12] Ribose bypasses the rate-limiting enzymatic steps of the pentose phosphate pathway and accelerates the formation of ATP and subsequent tissue recovery.[15]
Supplemental ribose is initially converted to ribose-5-phosphate, subsequently forming 5-phosphoribosyl-1-pyrophosphate, a molecule key to the synthesis of ATP through the de novo purine nucleotide pathway. The safety of ribose has been investigated in standard laboratory and animal toxicology models and in human studies both subjectively and objectively. Investigators have concluded that ribose is well tolerated at dosages of up to 60 g/day, with no significant adverse effects.[16]
Ribose has been shown to improve the energy recovery time in skeletal muscle and to relieve fatigue, soreness, and stiffness after intense exercise.[12, 13, 17] It also has been reported to have a beneficial effect after high-intensity exercise in sports medicine.
One study concluded that ribose accelerated the replenishment of ATP after intense muscle contractions,[18] and bodybuilders and sprinters have reported subjective and objective benefits during exercise after the administration of ribose.[18-20] However, other reports have shown inconsistent results for ribose in relation to improving short-term anaerobic exercise performance, muscle strength, endurance, or body composition during cycling or resistance training.[20, 21]
Ribose has also been investigated for its potential medical efficacy in both animal studies and human clinical trials. To date, the most promising data have been reported in connection with the application of ribose in cardiovascular disease. Both short-term and long-term animal studies found that the use of ribose after myocardial ischemia resulted in enhanced recovery of ATP along with improved diastolic functional parameters.[22, 23]
Clinical benefits have also been observed. Patients with coronary artery disease or heart failure have decreased myocardial ATP levels. Daily supplemental ribose has been shown to improve cardiac function, increase exercise tolerance, and enhance quality of life in this population.[24]
Patients with fibromyalgia may experience an alteration in physiologic muscle metabolism. It has been found that they reach the anaerobic threshold in their muscles earlier, thereby using less of the available energy-rich phosphate metabolites at maximal work capacity.[25] In another study, patients with fibromyalgia were reported to have a potential abnormality in high-energy phosphate metabolism, as evidenced by significantly lower levels of ATP and ADP in affected muscles as compared with patients without the disease.[2]
Theoretically, the effect of ribose on increasing the muscle energy pool could reduce the metabolic strain in affected muscles and allow patients to assume a more active lifestyle. Considering the known musculoskeletal symptomatology in this syndrome and the reported benefits of ribose in skeletal muscle metabolism and physiology, supplemental ribose appears to have aided our patient in improving her quality of life.
Conclusion
Fibromyalgia presents a continuing therapeutic challenge. Ribose is a naturally occurring carbohydrate with documented medical benefits in patients with cardiovascular disease. To our knowledge, this is the first report to suggest its potential benefit in a patient with fibromyalgia, who had had suboptimal results with conventional therapies. We are designing a trial using objective outcome measures to further evaluate the effectiveness of this product in patients with fibromyalgia
Pharmacotherapy 24(11):1646-1648, 2004. © 2004 Pharmacotherapy Publications
References:
1. Olson NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci 1998;315:351-8.
2. Bengtsson A, Henriksson KG, Larsson J. Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia. Arthritis Rheum 1986;29:817-21.
3. Eisinger J, Plantamura A, Ayavou T. Glycolysis abnormalities in fibromyalgia. J Am Coll Nutr 1994;13:144-8.
4. Park JH, Phothimat P, Oates CT, Hernaz-Schulman M, Olsen NJ. Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia. Arthritis Rheum 1998;41:406-13.
5. Leventhal LJ. Management of fibromyalgia. Ann Intern Med 1999;131:850-7.
6. Friedberg F, Jason LA. Chronic fatigue syndrome and fibromyalgia: clinical assessment and treatment. J Clin Psychol 2001;57:433-55. Lash AA, Ehrlich-Jones L, McCoy D. Fibromyalgia: evolving concepts and management in primary care settings. Medsurg Nurs 2003;12:145-59, 190.
7. Briley M, Moret C. Fibromyalgia syndrome: an overview of potential drug targets. Drugs 2003;6:668-73.
8. Holdcraft LC, Assefi N, Buchwald D. Complementary and alternative medicine in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol 2003;17:667-83.
9. Wolfe F, for the American College of Rheumatology. Criteria for the classification of fibromyalgia: report of the multi-center criteria committee. Arthritis Rheum 1990;33:160-72.
10. St Cyr J, Bianco R, Schneider J, et al. Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model. J Surg Res 1989;42:157-62.
11. Hellsten Y, Skadhauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol Integr Comp Physiol 2004;286:R182-8.
12. Williamson DL, Gallagher PM, Goddard MP, Witter J, Trappe S. Effects of ribose supplementation on adenine nucleotide concentration in skeletal muscle following high-intensity exercise [abstr]. Med Sci Sport Exer 2001;33(5 suppl).
13. Ingwall JS. ATP and the heart. Boston: Kluwer Academic, 2002:55-95.
14. Pauly DF, Pepine CJ. D-ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther 2000;5: 249-58.
15. Pliml W, von Arnim T, Stablein A, Hoffman H, Zimmer HG, Erdmann E. Effects of ribose on exercise-induced ischaemia in stable coronary artery disease. Lancet 1992;340:507-10.
16. Butler T, St Cyr J. Use of ribose to prevent cramps and soreness in muscles. U.S. patent 6159943. December 12, 2000.
17. Zarzeczny R, Brault JJ, Abraham KA, Hancock C, Terjung R. Influence of ribose on adenine salvage after intense muscle contractions. J Appl Physiol 2001;91:1775-81.
18. Van Gammeren D, Antonio J, Falk D. The effects of four weeks of ribose supplementation on body composition and exercise performance in healthy, young, male recreational bodybuilders: a double-blind, placebo controlled trial. Cur Therapeut Res 2002;63:486-95.
19. Berandi JM, Ziegenfuss TN. Effects of ribose supplementation on repeated sprint performance in men. J Strength Cond Res 2003;17:47-52.
20. Falk DJ, Heelan KA, Thyfault JP, Koch AJ. Effects of effervescent creatine, ribose, and glutamine supplementation on muscular strength, muscular endurance, and body composition. J Strength Cond Res 2003;17:810-16.
21. Schneider J, St Cyr J, Mahoney J, Bianco R, Ring W, Foker J. Recovery of ATP and return of function after global ischemia [abstr]. Circulation 1985;72(4 pt 2):III-298.
22. Zimmer HG. Normalization of depressed heart function in rats by ribose. Science 1983;220:81-2.
23. Omran H, Illien S, MacCarter D, St Cyr J, Luderitz B. D-ribose improves diastolic function and quality of life in congestive heart failure patients: a prospective feasibility study. Eur J Heart Failure 2003;5:615-19.
24. Lund E, Kendall SA, Janerot-Sjoberg B, Bengtsson A. Muscle metabolism in fibromyalgia studied by P-31 magnetic resonance spectroscopy during aerobic and anaerobic exercise. Scand J Rheumatol 2003;32:138-45.
Source: MedScape
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