D-Ribose—A Very Powerful and Natural Body Energizer
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(Used with permission from the book "From Fatigued to Fantastic!" Avery/Penguin, October 2007)
In looking at energy production, it helps to look at the "energy molecules" such as ATP, NADH, and FADH. These represent the energy currency in your body, and are like the paper that money is printed on. You can have all the fuel you want, but if it cannot be converted to these molecules, it is useless!
For years, I talked about the importance of B vitamins, which are a key component of these molecules. These helped to a degree, but it was clear that a key component was missing. In looking at the biochemistry of these energy molecules, they are also made of 2 other key components—adenine and Ribose. Adenine is plentiful in the body and supplementing with adenine did not help CFS. We then turned our attention to Ribose. Ribose is made in your body in a slow, laborious process and cannot be found in food. We knew that CFS/FMS causes your body to dump other key energy molecules like Acetyl-L-Carnitine. We then found that the body did the same with Ribose, making it hard to get your furnaces working again even after the other problems were treated.
This was like one of those "Eureka!" moments where things came together. Not having Ribose would be like trying to build a fire without kindling-nothing would happen. We wondered if giving Ribose to people with CFS would jump-start their energy furnaces. The answer was a resounding yes!
Our recently published study (see the study abstract in Appendix B) showed an average 44.7% increase in energy after only 3 weeks (improvement began at 12 days) and an average overall improvement in quality of life of 30%. Two thirds of the CFS/FMS patients felt they had improved.19 Usually a 10% improvement for a single nutrient is considered excellent. A 44.7% increase left us amazed, and I am now recommending Ribose for all of my CFS/FMS patients, for athletes, and any one with pain, fatigue or heart problems. Ribose recently became available (over the counter) to physicians, and is one of the few natural products actually starting with physicians and then moving out into health food stores.
It is critical to use the proper dose for the first 3 weeks, which is 5 grams (5000 mg) three times a day. It can then be dropped to twice a day. I recommend the Corvalen form of Ribose as it is the least expensive and highest quality and is packaged with a 5 gm dosing scoop in it. One 280 gm container will be enough to tell you if it will work. Corvalen M (which has Ribose plus magnesium and malic acid) is also available, but if you are also taking the Energy Revitalization System vitamin powder (see chapter X), you are already getting the magnesium and malic acid, and the regular Corvalen is a better deal financially. Bioenergy, which makes Corvalen, also conducts almost all of the research on Ribose, knows the most about it, and has outstanding customer service in case you have any questions. Because of its importance, it's worth looking at energy production and Ribose in greater detail. Having had the chance to explore the research and speak with a number of the researchers, below is what I've learned from them.
D-Ribose Accelerates Energy Recovery
D-Ribose (which is what I am referring to when I say Ribose) is a simple, five-carbon sugar (known as a pentose by biochemists) that is found naturally in our bodies. But Ribose is not like any other sugar. Sugars we are all familiar with, such as table sugar (sucrose), corn sugar (glucose), milk sugar (lactose), honey (predominantly fructose), and others are used by the body as fuel. These sugars are consumed and, with the help of the oxygen we breathe, are "burned" by the body to recycle energy. Because they are used excessively, they can also be toxic, as we've discussed earlier. Ribose, on the other hand, is special. When we consume Ribose, the body recognizes that it is different from other sugars and preserves it for the vital work of actually making the energy molecule that powers our hearts, muscles, brains, and every other tissue in the body.
A key molecule, called adenosine triphosphate (or ATP for short), is known as the energy currency of the cell because the amount of ATP we have in our tissues determines whether we will be fatigued, or will have the energy we need to live vital, active lives. Ribose provides the key building block of ATP, and the presence of Ribose in the cell stimulates the metabolic pathway our bodies use to actually make this vital compound. If the cell does not have enough Ribose, it cannot make ATP. So, when cells and tissues become energy starved, the availability of Ribose is critical to energy recovery.
Normal, healthy heart and muscle tissue has the capacity to make all the Ribose it needs. When normal tissue is stressed by overexertion, several days of rest will usually allow it to fully recover. The muscle may be sore during recovery, as we frequently see for the three or four days after a hard day of yard work or after a weekend pick up football game, but eventually energy levels will be restored and the soreness will disappear. But when the muscle is chronically stressed by disease or conditions that affect tissue energy metabolism, the cells and tissues simply cannot make enough Ribose quickly enough to recover. Hearts and muscles just don't have the metabolic machinery they need to make Ribose very efficiently. The result is chronic, persistent pain, stiffness, soreness, and overwhelming fatigue that may never go away.
The Link between Ribose, Energy, and Fatigue
Clinical and scientific research has repeatedly shown that giving Ribose to energy deficient hearts and muscles stimulates energy recovery. One important study involved healthy athletes participating in high-intensity, endurance exercise over the course of one week. After exercise the energy level in the athlete's muscle was reduced by almost 30%. Giving 10 grams of Ribose per day for three days following exercise restored muscle energy levels to normal, while treatment with placebo provided virtually no effect.20 This study clearly showed that Ribose stimulated the energy recovery pathways in the body, helping the muscle rebuild its energy supply quickly and completely. Even after three days of rest, muscle that was not treated with Ribose remained energy starved and fatigued.
Two very interesting studies in animals showed how dramatic the effect of Ribose could be on energy recovery in fatigued muscle. These studies were conducted by Dr. Ron Terjung, one of the top muscle physiologists in the U.S. In their research, Dr. Terjung and his co-investigators found that Ribose administration in fatigued muscle increased the rate of energy recovery by 340% to 430%, depending on which type of muscle was tested.21 He also found that even very small amounts of Ribose had the effect of helping the muscle cell preserve energy, a process known as energy salvage, and the higher the Ribose dose, the more dramatic the effect on energy preservation.22 Although this groundbreaking research was done in animals it was instrumental in defining the biochemistry and physiology associated with the use of Ribose in overcoming heart and muscle fatigue. But most of us with CFS and FMS are neither top athletes nor animals, so the question remains, "How will Ribose affect me?"
Research in Ribose and CFS/FMS began with a case study that was published in the prestigious journal Pharmacotherapy in 2004.23 This case study told the story of a veterinary surgeon diagnosed with fibromyalgia. For months, this dedicated doctor found herself becoming more and more fatigued, with pain becoming so profound she was finally unable to stand during surgery. As a result, she was forced to all but give up the practice she loved.
Upon hearing that a clinical study on Ribose in congestive heart failure was underway in the university where she worked, she asked if she could try the Ribose to see if it might help her overcome the mind-numbing fatigue she experienced from her disease. After three weeks of Ribose therapy she was back in the operating room, practicing normally with no muscle pain or stiffness, and without the fatigue that had kept her bedridden for many months.
Being a doctor, she was skeptical, not believing that a simple sugar could have such a dramatic effect on her condition. Within two weeks of stopping the Ribose therapy, however, she was out of the operating room and back in bed. So, to again test the theory, she began Ribose therapy a second time. The result was similar to her first experience, and she was back doing surgery in days. After yet a third round of stopping (with the return of symptoms) and starting (with the reduction of symptoms) the Ribose therapy, she was convinced, and has been on Ribose therapy since that time.
Several of the patients participating in the study have contacted me regarding the relief they found with Ribose therapy. Most importantly, they speak to the profound joy they feel when they are able to begin living normal, active lives after sometimes years of fatigue, pain, and suffering. Here is a sample of what one patient, Julie (Minnesota), an elementary teacher, wrote: "I had so much pain and fatigue I thought I was going to have to quit teaching. When I take [Ribose], I feel like a huge weight is being lifted from my chest, and I'm ready to take on those kids again!" The relief patients feel with Ribose therapy is heartwarming, and goes directly to the dramatic impact Ribose has on increasing energy, overcoming fatigue, enhancing exercise tolerance, and raising the patient's quality of life.
I found this report intriguing and decided to design the larger study in patients with fibromyalgia or chronic fatigue syndrome which I began to discuss earlier. Along with two research collaborators, I recently published a scientific paper describing the results of this research. The study we designed was intended to determine whether or not Ribose would be effective in relieving the overwhelming fatigue, pain, soreness, and stiffness suffered by patients having this debilitating condition. Our study included41 patients with a diagnosis of fibromyalgia or chronic fatigue syndrome who were given Ribose at a dose of 5 grams three times per day for an average of three weeks. We found the Ribose treatment led to significant improvement in energy levels, sleep patterns, mental clarity, pain intensity, and well being. Of the patients participating in the study, 65.7 % experienced significant improvement while on Ribose, with an average increase in energy of 44.7% and overall well being of 30%—remarkable results from a single nutrient!19 The only significant side effects were that 2 people felt too energized and hyper/anxious on the Ribose. This is simply dealt with by lowering the dose and/or taking it with food.
To further validate these findings, we are currently conducting a much larger placebo controlled study, and hope to have the results published in the coming year. Interestingly, one of our study patients had an abnormal heart rhythm called atrial fibrillation. Ribose is outstanding in the treatment of heart disease as well, because it restores energy production in the heart muscle. Because of this, it was not surprising that this man's atrial fibrillation also went away on the Ribose and he was able to stop his heart medications as well! Because of its importance and the research showing marked heart muscle dysfunction (because of low energy) in CFS, let's look at Ribose and the heart in more detail.
Ribose and the Fatigue Associated with Heart Disease
Decades of research have shown that Ribose has a profound effect on heart function in patients with congestive heart failure, coronary artery disease, and cardiomyopathy (a weakened heart muscle). Like the muscles in patients with fibromyalgia, sick hearts are energy starved.24 This energy deprivation keeps the heart from relaxing between heartbeats, making it impossible for the heart to completely fill with blood25 (it surprisingly takes more energy for the heart muscle to relax than contract). Because the heart does not fill completely, less blood is pumped to the body with each heartbeat. The heart then gets stiff and it strains to contract. Ultimately, the heart becomes enlarged, a condition known as hypertrophy, and it is unable to pump normally.
You can compare this to the effect of weight training on the muscles in the bicep of the upper arm. Over time, weight training against more and more weight makes the muscle larger and harder. Similarly, when the heart becomes stiff it is forced to contract against more and more pressure, making the heart muscle grow. While in the case of the bicep this may be a desirable outcome, in the heart it can be deadly. In contrast to the biceps muscle, hearts must remain supple so they can fill properly and empty fully with each contraction. If hearts cannot pump normal volumes of blood, muscles of the arms and legs and brain tissue become oxygen starved. The result is fatigue, pain on standing or walking, loss of interest in, or the ability to perform any physical activity, brain fog, and depression. In the end, the heart cannot pump enough blood to even supply itself with life-giving oxygen and a heart attack can be the result.
Using Ribose to restore the energy level in the heart allows it to fully relax, fill, and empty completely to circulate blood to the outer reaches of the body.26 Circulating more blood means muscles in the arms and legs, and the tissues of the brain, get the oxygen they need to function normally. This result was made evident in several important studies in patients with congestive heart failure and angina.
In one study conducted at the University of Bonn in Germany, patients with congestive heart failure were treated with either 10 grams of Ribose or a sugar placebo every day for three weeks.27 They were then tested for heart function, exercise tolerance (a measure of fatigue), and quality of life using a questionnaire designed for this purpose. In this study, Ribose therapy had a significant effect on all measures of diastolic heart function, showing that increased energy in the heart allowed the heart to relax, fill, and pump more normally. Patients in the study were also much more tolerant to exercise when they were on Ribose, and, through their responses to the questionnaire, showed they had a higher quality of life as a result.
Two additional studies went on to help explain how Ribose therapy in congestive heart failure may affect fatigue and exercise tolerance.28,29 These studies showed that Ribose treatment increased ventilatory and oxygen utilization efficiency, a medical way of saying that the patients were able to breathe better and use the oxygen they inhaled more efficiently. Improving the patient's ability to use oxygen means more oxygen is available to go into the blood and out to the tissues. Having more oxygen available allows the muscle to burn fuel more efficiently, helping it keep pace with its energy demand. The result is less fatigue, a greater ability to tolerate exercise, and a higher quality of life. An added benefit to improving ventilatory efficiency is that ventilatory efficiency is a dominant predictor of mortality in congestive heart failure. Increasing ventilatory efficiency with Ribose therapy is, therefore, a direct correlate to prolonging life in this patient population.
There are very few nutritional therapies that can legitimately boast of having this profound of an effect on the tissues they target. None, other than Ribose, can claim such an effect in cell or tissue energy metabolism. Ribose is a unique and powerful addition to our complement of metabolic therapies in that it is completely safe, proven by strong, well designed clinical and scientific evidence, natural, and fundamental to a vital metabolic process in the body.30-34 I have added a few more study references for those who would like more information about Ribose.35-56
corvalen-d-ribose Ribose regulates how much energy we have in our bodies, and for those suffering from fatigue, muscle soreness, stiffness, and a host of related medical complications, the relief found in energy restoration can be life changing. This is why I recommend that all CFS/FMS patients begin with D-Ribose 5 grams (1 scoop of Corvalen) 3x day for 2-3 weeks then twice a day. It is critical to take the 3 scoops a day for the first few weeks to see the optimal effects. Although many of the treatments in this book take 6-12 weeks to start working, most people feel the difference by the end of a single 280 gm container. For the few who don't, retry it again once you are 12-16 weeks into the other treatments well discuss. You'll be glad you did!
Although Ribose is the most promising energy nutrient, others are also worth looking at as well. Most of these only need to be taken for 4-9 months, though some people choose to take them longer (I take my Ribose every day even though I feel great. It makes me feel even better!). You will know by how you feel on them. (Buy Corvalen Ribose best lowest price free shipping)
Footnotes:
19. Teitelbaum JE, JA St.Cyr, C Johnson. The use of D-Ribose in chronic fatigue syndrome and fibromyalgia: a pilot study. J Alternative and Complementary Medicine 2006;12(9):857-862.
20. Hellsten Y, Skadgauge L, Bangsbo J. Effect of Ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. American Journal of Physiology 2004; 286(1): R182-R188.
21. Tullson PC, Terjung RL. Adenine nucleotide synthesis in exercising and endurance-trained skeletal muscle. American Journal of Physiology 1991; 261: C342-C347.
22. Brault JJ, Terjung RL. Purine salvage to adenine nucleotides in different skeletal muscle fiber types. Journal of Applied Physiology 2001; 91: 231-238.
23. Gebhart B, JA Jorgenson. Benefit of Ribose in a patient with fibromyalgia. Pharmacotherapy 2004;24(11):1146-1648.
24. 22. Ingwall JS. ATP and the Heart. Kluwer Academic Publishers, Boston, Massachusetts.
25. Reibel D, Rovetto M. Myocardial ATP Synthesis and Mechanical Function Following Oxygen Deficiency. American Journal of Physiology 1978; 234(5): H620-H624.
26. Zimmer HG, Ibel H, Suchner U. Ribose Intervention in the Cardiac Pentose Phosphate Pathway is Not Species-Specific. Science 1984; 223: 712-714.
27. Omran H, S Illien, D MacCarter, JA St. Cyr, B Luderitz. D-Ribose improves diastolic function and quality of life in congestive heart failure patients: A prospective feasibility study. European Journal of Heart Failure 2003;5:615-619.
28. Vijay N, D MacCarter, M Washam, J St.Cyr. Ventilatory efficiency improves with d-Ribose in congestive Heart Failure patients. Journal of Molecular and Cellular Cardiology 2005;38(5):820.
29. Carter O, D MacCarter, S Mannebach, J Biskupiak, G Stoddard, EM Gilbert, MA Munger. D-Ribose improves peak exercise capacity and ventilatory efficiency in heart failure patients. Journal of the American College of Cardiology 2005;45(3 Suppl A):185A.
30. Griffiths JC, JF Borzelleca, J St.Cyr. Lack of oral embryotoxicity/teratogenicity with D-Ribose in Wistar rats. Journal of Food and Chemical Toxicology 2007;45(3):388-395.
31. Griffiths JC, JF Borzelleca, J St. Cyr. Sub-chronic (13-week) oral toxicity study with D-Ribose in Wistar rats. Journal of Food and Chemical Toxicology 2007:45(1):144-152.
32. Gross M, Dormann B, Zollner N. Ribose administration during exercise: effects on substrates and products of energy metabolism in healthy subjects and a patient with myoadenylate deaminase deficiency. Klin Wochenschr 1991; 69: 151-155.
33. Wagner DR, Gresser U, Zollner N. Effects of oral Ribose on muscle metabolism during bicycle ergometer in AMPD-deficient patients. Annals of Nutrition and Metabolism 1991; 35: 297-302.
34.Gross M, S Reiter, N Zollner. Metabolism of D-Ribose administered to healthy persons and to patients with myoadenylate deaminase deficiency. Klin Wochenschr 1989; 67: 1205-1213.
35. Guymer EK, KJ Clauw. Treatment of fatigue in fibromyalgia. Rheum Dis Clin North Am 2002;28(2):67-78.
36.Rooks DS, CB Silverman, FG Kantrowitz. The effects of progressive strength training and aerobic exercise on muscle strength and cardiovascular fitness in women with fibromyalgia: a pilot study. Arthritis Rheum 2002;47(1):22-28.
37.Geenen R, JW Jacobs, JW Bijlsma. Evaluation and management of endocrine dysfunction in fibromyalgia. Rheum Dis Clin North Am 2002;28(2):389-404.
38.Schachter CL, AJ Busch, PM Peloso, MS Shepard. Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: a randomized controlled trial. Phys Ther 2003;83(4):340-358.
39.Williamson DL, PM Gallagher, MP Goddard, SW Trappe. Effects of Ribose supplementation on adenine nucleotide concentration in skeletal muscle following high-intensity exercise. Med Sci Sport Exc 2001; 33(5 suppl).
40.Zollner N, Reiter S, Gross M, Pongratz D, Reimers CD, Gerbitz K, Paetzke I, Deufel T, Hubner G. Myoadenylate deaminase deficiency: successful symptomatic therapy by high dose oral administration of Ribose. Klin Wochenschr 1986; 64: 1281-1290.
41.Patton BM. Beneficial effect of D-Ribose in patients with myoadenylate deaminase deficiency. Lancet May 1982; 1701.
42.Salerno C, D'Eufermia P, Finocchiaro R, Celli M, Spalice A, Crifo C, Giardini O. Effect of D-Ribose on purine synthesis and neurological symptoms in a patient with adenylsuccinase deficiency. Biochim Biophys Acta 1999; 1453: 135-140.
43.Salerno C, M Celli, R Finocchiaro, P D'Eufemia, P Iannetti, C Crifo, O Giardini. Effect of D-Ribose administration to a patient with inherited defect of adenylosuccinase. Purine Metabolism in Man IX. Plenum Press, New York, 1998.
44.Pauly D, C Pepine. D-Ribose as a supplement for cardiac energy metabolism. J Cardiovasc Pharmacol Ther 2000;5(4):249-258.
45.Pauly D, C Johnson, JA St. Cyr. The benefits of Ribose in cardiovascular disease. Med Hypoth 2003;60(2):149-151.
46.Pauly DF, CJ Pepine. Ischemic heart disease: Metabolic approaches to management. Clin Cardiol 2004;27(8):439-441.
47.Dodd SL, CA Johnson, K Fernholz, JA St.Cyr. The role of Ribose in human skeletal muscle metabolism. Med Hypoth 2004;62(5):819-824.
48. Zarzeczny R, JJ Brault, KA Abraham, CR Hancock, RL Terjung. Influence of Ribose on adenine salvage after intense muscle contractions. J Appl Physiol 2001;91:1775-1781.
49.Wallen JW, MP Belanger, C Wittnich. Preischemic administration of Ribose to delay the onset of irreversible ischemic injury and improve function: studies in normal and hypertrophied hearts. Can J Physiol Pharmacol 2003;81:40-47.
50. Wilson R, D MacCarter, J St. Cyr. D-Ribose enhances the identification of hibernating myocardium. Heart Drug 2003:3:61-62.
51.Van Gammeren D, D Faulk, J Antonio. 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. Curr Ther Res 2002;63(8):486-495.
52.Sharma R, M Munger, S Litwin, O Vardeny, D MacCarter, JA St. Cyr. D-Ribose improves Doppler TEI myocardial performance index and maximal exercise capacity in stage C heart failure. J Mol Cell Cardiol 2005;38(5):853.
53. Pliml W, T von Arnim, A Stablein, H Hofmann, HG Zimmer, E Erdmann. Effects of Ribose on exercise-induced ischaemia in stable coronary artery disease. Lancet 1992;340:507-510.
54. Perkowski D, S Wagner, A Marcus, J St. Cyr. D-Ribose improves cardiac indices in patients undergoing "off" pump coronary arterial revascularization. J Surg Res 2007;173(2):295.
55. Muller C, H Zimmer, M Gross, U Gresser, I Brotsack, M Wehling, W Pliml. Effect of Ribose on cardiac adenine nucleotides in a donor model for heart transplantation. Eur J Med Res 1998;3:554-558.
56. Grant GF, RW Gracey. Therapeutic nutraceutical treatments for osteoarthritis and ischemia. Exp Opin Ther Patents 2000;10(1): 1-10.
Monday, June 2, 2008
Sunday, June 1, 2008
The Use of D-Ribose in Chronic Fatigue Syndrome
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THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE
Volume 12, Number 9, 2006, pp. 857–862, © Mary Ann Liebert, Inc.
The Use of D-Ribose in Chronic Fatigue Syndrome and Fibromyalgia: A Pilot Study
JACOB E. TEITELBAUM, M.D.,1 CLARENCE JOHNSON, M.S.,2 and JOHN ST. CYR, M.D., Ph.D.2
ABSTRACT
Objectives: Fibromyalgia (FMS) and chronic fatigue syndrome (CFS) are debilitating syndromes that are often associated with impaired cellular energy metabolism. As D-ribose has been shown to increase cellular energy synthesis in heart and skeletal muscle, this open-label uncontrolled pilot study was done to evaluate if D-ribose could improve symptoms in fibromyalgia and/or chronic fatigue syndrome patients.
Design: Forty-one (41) patients with a diagnosis of FMS and/or CFS were given D-ribose, a naturally occurring pentose carbohydrate, at a dose of 5 g t.i.d. for a total of 280 g. All patients completed questionnaires containing discrete visual analog scales and a global assessment pre– and post–D-ribose administration.
Results: D-ribose, which was well-tolerated, resulted in a significant improvement in all five visual analog scale (VAS) categories: energy; sleep; mental clarity; pain intensity; and well-being, as well as an improvement in patients’ global assessment. Approximately 66% of patients experienced significant improvement while on D-ribose, with an average increase in energy on the VAS of 45% and an average improvement in overall well-being of 30% (p 0.0001).
Conclusions: D-ribose significantly reduced clinical symptoms in patients suffering from fibromyalgia and chronic fatigue syndrome. 857
INTRODUCTION
Fibromyalgia (FMS), which currently affects an estimated 3 to 6 million Americans,1,2 and chronic fatigue syndrome (CFS) are disabling syndromes that often coexist. Patients suffering with these syndromes commonly report severe persistent fatigue, diffuse migratory pain, cognitive dysfunction, and disordered sleep. Many of the clinical symptoms found in FMS/CFS may be related to a decrease in tissue energy levels with altered energy metabolism. Previous reports claim that abnormal muscular energy metabolism frequently can be reflected in pain because of chronic muscle shortening,3 postexertional fatigue, and low exercise tolerance associated with decreased cardiac output and stroke volumes.4 In addition, it has been postulated that decreased energy production in these syndromes also may result in hypothalamic dysfunction, which can be reflected clinically as disordered sleep, hormonal imbalances, and autonomic dysfunctions.5 Causes and mechanisms for this mitochondrial dysfunction are unknown; however, an alteration in muscle adenine nucleotide
metabolism is found, mainly in lower adenosine triphosphate (ATP) levels and depleted energy reserves.6,7
D-Ribose, a naturally occurring pentose carbohydrate, is a key structural component in the DNA, RNA, ATP, FADH, coenzyme-A, and NADH needed by the mitochondria to maintain cellular energy homeostasis. Supplemental doses of D-ribose in patients with congestive heart failure and ischemic heart disease have shown a significant improvement in diastolic dysfunction, physical function, exercise tolerance, and quality of life.8 D-Ribose has also been reported to be effective in restoring tissue energy levels following intense exercise9 and in an isolated case report of a patient with FMS.10 Because of the known energy and functional 1Fibromyalgia and Fatigue Centers, Dallas, TX. 2Valen Labs, Minneapolis, MN. benefits of D-ribose, an open-label uncontrolled pilot study was performed to assess whether D-ribose would decrease symptoms in patients suffering from FMS and CFS.
MATERIALS AND METHODS
Patient enrollment
Forty-one (41) adult patients, diagnosed by their physicians as having FMS (by ACR Criteria) and/or CFS (by CDC criteria), were found eligible for this study. In addition, patients also had to be without known severe medication or nutrient sensitivities, and not have taken D-ribose in the past. Recruitment of patients was through the FMS and CFS e-mail newsletter associated with the Annapolis Research Center and the www.Vitality101.com web site. Readers with an established diagnosis of FMS or CFS were informed about the nature of the study and were invited to participate if they satisfied the entrance criteria. All patients were thoroughly
informed about D-ribose, its potential benefits, and possible adverse side-effects and gave informed consent. The protocol is consistent with the principles of the Declaration of Helsinki. Except for a free container of D-ribose, patients received no compensation.
Design of study
A 280-g container of D-ribose (CORvalen, Valen Labs, Minneapolis, MN) and a questionnaire (outcome measures) were mailed to each subject once the patient was enrolled. Each patient was instructed to take one scoop (5-g) of D-ribose three times per day (t.i.d.) mixed with food, water, or another beverage until the container was empty and then to return the container and questionnaires in a prepaid envelope. They were instructed to stay on their current treatment
regimen and not change dosing or add or delete any treatments during the study.
Outcome measures
Subjective outcome measures were assessed using discrete Visual Analog Scale questions (DVAS) pre- and postintervention. Measured DVAS parameters were energy levels,
sleep disturbances, mental clarity, pain, and an overall sense of well-being. Patients were asked to individually rate each of these five areas on a 1 to 10 scale as shown below:
A. How is your energy?
1 2 3 4 5 6 7 8 9 10
1 near dead and 10 excellent
B. How is your sleep?
1 2 3 4 5 6 7 8 9 10
1 no sleep and 10 8 hours of sleep a night without waking
C. How is your mental clarity?
1 2 3 4 5 6 7 8 9 10
1 brain dead and 10 good clarity
D. How bad is your pain?
1 2 3 4 5 6 7 8 9 10
1 very severe pain and 10 pain free
E. How is your overall sense of well-being?
1 3 4 5 6 7 8 9 10
1 near dead and 10 excellent
Compliance was addressed in each patient by asking how many doses were missed and noting how long it took to finish the 280-g container, as well as by weighing the received container at the completion of the study. Each patient was asked if any adverse side effects occurred while on D-ribose. Finally, each patient commented on his or her overall subjective feeling while taking D-ribose: much better, somewhat better, no change, somewhat worse, or much worse.
RESULTS
Of the 41 patients enrolled in the study, five patients were considered noncompliant; therefore, they were excluded from the study and final analysis. Noncompliance was defined as having consumed half or less of the provided D-ribose during the study. Of the 36 remaining patients, the average age was 48 years, 78% were female. Patients had been ill with CFS/FMS for an average of 7.15 years. Further demographics are summarized in Table 1. The average length
of time on D-ribose was 25 days (range, 17 to 35 days). Subjectively, significant improvements were found in energy levels (p 0.0001), sleep patterns (p 0.0001), mental clarity (p 0.003), pain threshold (p 0.026), and the patient’s state of well-being (p 0.0001) when comparing
questionnaires at enrollment and at the completion of the study in all of the patients (Table 2). Table 3 denotes the pre- and postribose assessments in patient categories for each separate syndrome. At the completion of the study, patients also felt a positive subjective improvement while taking D-ribose (Table 4). Twenty-three (23) of the 35 patients (65.7%) completing
the assessment experienced improvement during the course of the study (somewhat better to much better) while taking D-ribose. The responses were compared to the null 858 TEITELBAUM ET AL.
TABLE 1. PATIENT DEMOGRAPHICS
Patient demographics
Sex Female: 28 (78%)
Average age 48 years (21–62)
Previous diagnosis: FMS 75%
Previous diagnosis: CFS 58%
Average duration CORvalen therapya 28 days (17–35)
FMS, fibromyalgia; CFS, chronic fatigue syndrome.
aValen Labs, Minneapolis, MN. response of “No Change” in a one-sample nonparametric
sign test and signed rank test. Both tests resulted in statistical
significance (p 0.0001).
The following subgroup analyses were also performed: gender, age, CFS, and FMS. Gender was at least a marginally significant predictor of measured outcomes: energy levels (p 0.02), sleep patterns (p 0.001), mental clarity (p 0.002), pain threshold (p 0.06), state of well-being
(p 0.03), and total score (p 0.001). Age was not associated with any of the outcome parameters: energy levels (p 0.80), sleep patterns (p 0.32), mental clarity (p 0.97), pain threshold (p 0.50), a state of well-being (p 0.45), and total score (p 0.58). A prior diagnosis of CFS was not associated with any of the outcomes: energy levels (p 0.59), sleep patterns (p 0.28), mental clarity (p 0.33), pain threshold (p 0.39), state of well-being (p 0.39), and total score (p 0.27). Likewise, a prior diagnosis of FMS was not associated with any of the measured outcomes: energy levels (p 0.58), sleep patterns (p 0.29), mental clarity (p 0.20), pain threshold (p 0.43), state of well-being (p 0.33), and total score (p 0.24). Of the five patients that were found to be noncompliant,
three stopped taking D-ribose because of a hyperanxious feeling (one patient), lightheadedness (one patient), and increased appetite (one patient). Two others changed their mind and simply did not begin the study. Of the remaining 36 patients who completed the study, one patient experienced transient nausea and another felt mild anxiety. Both of these reactions were reversed by simply lowering the dose of D-ribose.
DISCUSSION
Fibromyalgia and CFS are common, nonarticular, debilitating syndromes that affect approximately 2%–4% of the population worldwide. Patients with FMS and/or CFS generally
demonstrate reduced sustained exercise capacity, with lack of muscular contractile force and endurance.11,12 Similar conditions are frequently associated with abnormal metabolism. Therefore, many FMS and/or CFS studies have investigated potential alterations in muscle metabolism. 6,13,14–19
D-RIBOSE FOR CFS AND FMS 859
TABLE 2. PRE- AND POSTRIBOSE ASSESSMENTS: ALL PATIENTS
Pre Post Difference
Category N mean (std) mean (std) (95% CI) p-Value
Energy level 36 3.8 (1.1) 5.5 (1.5) 1.7 0.0001
(1.1, 2.2)
Sleep 36 4.8 (1.6) 6.0 (1.9) 1.2 0.0001
(0.6, 1.7)
Mental clarity 36 4.9 (1.5) 5.7 (1.7) 0.8 0.003
(0.3, 1.3)
Pain 36 4.9 (2.3) 5.6 (2.2) 0.7 0.026
(0.1, 1.3)
Well-being 36 4.3 (1.3) 5.6 (1.5) 1.3 0.0001
(0.8, 1.9)
CI, confidence interval.
TABLE 3. PRE- AND POSTRIBOSE ASSESSMENTS PER DIAGNOSIS
FMS CFS Both FMS/CFS
(N 15) (N 9) (N 12)
Pre mean Post mean Improvement Pre mean Post mean Improvement Pre mean Post mean Improvement
Category (std) (std) (%) (std) (std) (%) (std) (std) (%)
Energy 3.7 5.5 1.8 4.2 6.1 1.9 3.7 4.9 1.2
(1.0) (1.5) (48%) (1.4) (1.5) (45%) (1.2) (1.4) (32%)
Sleep 4.4 5.9 1.5 5.6 7.2 1.6 4.8 5.2 0.4
(1.2) (1.6) (34%) (1.7) (1.7) (29%) (1.9) (2.2) (8%)
Mental clarity (14..07) (15..87) (211.%0 ) (25..02) (16..76) (217.%4 ) (15..71) (15..31) 0
Pain (24..35) (25..05) (212.%0 ) (62..73) (71..86) (116.%1 ) (41..16) (41..12) 0
Well-being 4.1 5.7 1.6 4.6 6.3 1.7 4.3 5.0 0.7
(1.0) (1.5) (39%) (1.7) (1.2) (37%) (1.3) (1.5) (16%)
FMS, fibromyalgia; CFS, chronic fatigue syndrome. Adenosine triphosphate (ATP) is the primary energy source of all living cells. In tissues subjected to metabolic stress, such as hypoxia, ischemia, or known conditions of mitochondrial dysfunction, ATP is catabolized with compromised metabolic recovery. With ATP catabolism, adenosine diphosphate (ADP) levels accumulate, forcing the cell to try to balance ATP/ADP ratios in order to maintain energy
stasis. However, these reactions ultimately lead to an increased intracellular concentration of adenosine monophosphate (AMP). In an effort to try to control energy balance, the cell catabolizes AMP, ultimately forming inosine, hypoxanthine, and adenine. These catabolic end products are washed out of the cell, resulting in a net loss of purines and an ultimate reduction in the total pool of adenine nucleotides. Potentially, up to 90% of these produced catabolites can be biochemically salvaged and recycled. 9,20,21
The rate of recovery of these energy substrates in metabolically stressed cells is important for functional recovery of the cell, including muscle.20,21–23 Therapeutic solutions that could
try to maintain a cell’s energy stasis include either blocking the degradation of adenine nucleotides or providing metabolic supplementation to enhance nucleotide recovery via the salvage or de novo pathways of purine synthesis. The availability of 5-phosphoribosyl-L-pyrophosphate (PRPP) is rate limiting in adenine nucleotide de novo synthesis and salvage pathways, which is necessary to preserve or rebuild cellular energy stores.9,20,21 5-Phosphoribosyl-Lpyrophasphate is formed through pyrophosphorylation of ribose-
5-phosphate that is, itself, synthesized from glucose via the pentose phosphate pathway (PPP; or hexose monophosphate shunt). The rate-limiting enzymes in the PPP, glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase, are poorly expressed in heart and muscle cells. As such, in skeletal muscle the PPP is suppressed, limiting ribose availability as a substrate to drive the purine nucleotide pathway and retarding purine nucleotide synthesis
during or following a metabolic insult. The energy reserve, phosphorylation potential (PP), and
the ability to use oxygen (total oxidative capacity or Vmax) have been determined using P-31 MRS in both normal and fibromyalgic muscle.16 Both mean PP and Vmax values are found to be significantly reduced in FMS.16 These findings are consistent with reduced oxidative phosphorylation and ATP synthesis, which translate clinically to muscle fatigue, soreness, and stiffness.24 Impairment in mitochondrial oxidative phosphorylation and potentially diminished glucose metabolism impact ATP turnover, suggesting that the muscles of fibromyalgia patients are energy starved. Further, decreased ATP concentrations with accompanying changes in
energy metabolism have been found in the red blood cells of fibromyalgia patients,25 suggesting that this energy deficiency may be systemic.
Muscular metabolic abnormalities in fibromyalgia have been proposed.6 Dysfunctional metabolism has been shown to lead to cellular abnormalities6 that impact cellular function,
producing clinical symptoms. Muscle biopsies have shown that levels of phosphocreatine (PCr) and ATP are significantly reduced (21% and 17%, respectively) in muscle tissues of fibromyalgia patients and the synthesis of PCr, an important store of cellular high-energy phosphates, is deficient. Magnetic imaging of skeletal muscle has shown that resting levels of ATP are 15% lower in fibromyalgia patients than in normal controls and during exercise PCr and ATP levels remain significantly low.14,16,19 During exercise there is an increase in metabolic breakdown products of ATP (phosphodiesters) in fibromyalgic skeletal muscle groups, indicating abnormal adenine nucleotide metabolism and disruption of cell membranes, which are common in other muscular diseases. There has been speculation that these findings may be similar in patients afflicted with CFS.16 It also has been shown that there are a decreased numbers of capillaries within fibromyalgic muscle fibers, which can reduce the oxidative capacity, leading to limited energy turnover, purine pool depletion, and increased pain.24,26 Thickening of the capillary endothelium also contributes to restricted oxygen transport or delivery, further lowering oxygen tension in the muscle, affecting energy metabolism and contributing to functional fatigue and weakness. In general, the fibromyalgic muscle has lower ATP concentrations than normal muscle. Further, these factors can alter calcium and cellular ion stasis, which, clinically can produce muscle soreness, stiffness, fatigue, and diminished exercise capacity. Patients with FMS and/or CFS may therefore have an alteration in muscular energy use and metabolism. Fibromyalgic muscle reaches anaerobic threshold earlier in exercise, thereby potentially using less available energy-rich phosphate metabolites at maximal work capacity. Patients with FMS may have abnormal high-energy phosphate metabolism with significantly lower levels of ATP and ADP in affected muscles as compared to normal controls.24
The findings in this pilot study, using daily D-ribose, revealed an increased improvement in the quality of life in patients afflicted with FMS/CFS. However, there are several limitations noted in this study. A major limitation centers on a lack of a placebo group. This was, however, meant as
an initial pilot study with each patient acting as their own control. A follow-up RCT is, of course, critical and currently 860 TEITELBAUM ET AL.
TABLE 4. GLOBAL SUBJECTIVE FEELING RATING
Response N (%)
Much better 5 (14.3%)
Somewhat better 17 (48.6%)
Somewhat better/no change 1 (2.9%)
No change 9 (25.7%)
No change/somewhat worse 1 (2.9%)
Somewhat worse 2 (5.7%)
Much worse 0 (0%)
under way using information (and impetus) gained from this pilot study. In addition, as patients were not seen in a clinic, initial assessment of each patient relied on their own personal physician providing an accurate clinical diagnosis of FMS/CFS. This pilot assessment was designed as a clinically focused, community-based study, and this reflects what occurs in most patients’ cases.
Subjective outcome measures were only assessed in this study. The diagnoses and effectiveness of therapies of FMS and CFS are largely based on subjective symptoms. As no accepted diagnostic laboratory tests are available to confirm the diagnoses of and monitor progress in these syndromes, it is reasonable to rely on subjective outcome measurements in this clinical setting. Also, patients did not eliminate other stable treatment modalities they had been on during the study. However, patients were instructed not to make any changes in their treatment regimen during the study. D-Ribose produced a subjective beneficial outcome in these patients;
therefore, the addition of D-ribose may offer an added benefit to their concurrent therapies.
CONCLUSIONS
This pilot study suggests that D-ribose may provide subjective benefits in patients with FMS and/or CFS. Given the biochemical benefits of D-ribose on increasing muscular energy pools and reducing metabolic strain in affected muscles, the use of this supplement may offer a valuable option for improving quality of life in patients afflicted with FMS and/or CFS.
ACKNOWLEDGMENTS
The authors thank Valen Labs, Inc. (Minneapolis, MN) for providing the oral D-ribose. Dr. Teitelbaum has no financial conflict of interest and his payment for doing the study was donated to charity. Dr. St. Cyr is a consultant for Valen Labs, and Mr. Johnson is on staff at Valen Labs.
REFERENCES
1. Goldenberg DL. Fibromyalgia syndrome—an emerging but controversial condition. JAMA 1987;257:2782–2787.
2. Wolfe F, Ross K, Anderson J, et al. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheumatol 1995;38:19–28.
3. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual, vol. 1. Baltimore: Williams & Wilkins, 1983.
4. Peckerman A, LaMancha JJ, Dahl KA, et al. Abnormal impedance cardiography predicts symptom severity in chronic fatigue syndrome. Am J Med Sci 2003;26:55–60.
5. Teitelbaum JE, Bird B, Greenfield RM, et al. Effective treatment of CFS and FMS: A randomized, double-blind placebo controlled study. J Chronic Fatigue Syndrome 2001;8:3–24.
6. Bengtson A, Heriksson KG, Larsson J. Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia. Arthritis Rheumatol 1986;29:817–821.
7. Eisinger J, Plantamura A, Ayavou T. Glycolysis abnormalities in fibromyalgia. J Am Coll Nutr 1994;13:144–148.
8. Omran H, Illien S, MacCarter D, et al. D-Ribose improves diastolic function and quality of life in congestive heart failure patients: A prospective feasibility study. Eur J Heart Failure
2003;5:615–619.
9. Hellsten Y, Skadgauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol 2004;286:
R182–R188.
10. Gebhart B, Jorgenson J. Benefit of ribose in a patient with fibromyalgia. Pharmacotherapy 2004;24:1646–1648.
11. Lund N, Bengtsson A, Thorborg P. Muscle tissue oxygen in primary fibromyalgia. Scan J Rheumatol 1986;15:165–173.
12. Schachter CL, Busch AL, Peloso PM, Shepard MS. Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: A randomized controlled trial. Phys Ther 2003;83:340–358.
13. 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;32:138–145.
14. Strobl ES, Krapf M, Suckfull M, et al. Tissue oxygen measurement and 31P magnetic resonance spectroscopy in patients with muscle tension and fibromyalgia. Rheumatol Int
1997;16:175–180.
15. Krapf MW, Muller S, Mennet P, et al. Recording muscle spasms in the erector spinae using in vivo 31P magnetic resonance spectroscopy in patients with chronic lumbalgia and generalized tendomyopathies. Z Rheumatol 1992;51:229–237.
16. Park JH, Phothimat P, Oates CT, et al. Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia. Arthritis Rheumatol
1998;41:406–413.
17. Jacobsen S, Jensen KE, Thomsen C, et al. Magnetic resonance spectroscopy in fibromyalgia. A study of phosphate-31 spectra from skeletal muscles during rest and after exercise. Ugeskr
Laeger 1994;156:6841–6844.
18. Kushmerick MJ. Muscle energy metabolism, nuclear magnetic resonance spectroscopy and their potential in the study of fibromyalgia. J Rheumatol 1989;(Suppl 19):40–46.
19. Sprott H, Rzanny R, Reichenbach JR, et al. 31P magnetic resonance spectroscopy in fibromyalgic muscle. Rheumatology (Oxford) 2000;39:1121–1125.
20. Brault JJ, Terjung RL. Purine salvage to adenine nucleotides in different skeletal muscle fiber types. J Appl Physiol 2001;91:231–238.
21. Tullson PC, Terjung RL. Adenine nucleotide synthesis in exercising and endurance-trained skeletal muscle. Am J Physiol 1991;261:C342–C347.
22. Reibel D, Rovetto M. Myocardial ATP synthesis and mechanical function following oxygen deficiency. Am J Physiol. 1978;234:H620–H624. D-RIBOSE FOR CFS AND FMS 861
23. Williamson DL, Gallagher PM, Goddard MP, Trappe SW. Effects of ribose supplementation on adenine nucleotide concentration in skeletal muscle following high-intensity exercise.
Med Sci Sport Exc 2001;33(5 suppl):5166.
24. Olson NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci 1998;315:351–358.
25. Eisinger J, Bagneres D, Arroyo P, et al. Effects of magnesium, high-energy phosphates, piracetam and thiamin on erythrocyte transketolase. Magnet Res 1994;7:59–61.
26. Bengtsson A, Henriksson KG. The muscle in fibromyalgia—a review of Swedish studies. J Rheumatol Suppl 1989;19:144–149.
Address reprint requests to:
Jacob E. Teitelbaum, M.D.
76-6326 Kaheiau Street
Kailua-Kona, HI 96740
E-mail: Endfatigue@aol.com
862 TEITELBAUM ET AL.
THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE
Volume 12, Number 9, 2006, pp. 857–862, © Mary Ann Liebert, Inc.
The Use of D-Ribose in Chronic Fatigue Syndrome and Fibromyalgia: A Pilot Study
JACOB E. TEITELBAUM, M.D.,1 CLARENCE JOHNSON, M.S.,2 and JOHN ST. CYR, M.D., Ph.D.2
ABSTRACT
Objectives: Fibromyalgia (FMS) and chronic fatigue syndrome (CFS) are debilitating syndromes that are often associated with impaired cellular energy metabolism. As D-ribose has been shown to increase cellular energy synthesis in heart and skeletal muscle, this open-label uncontrolled pilot study was done to evaluate if D-ribose could improve symptoms in fibromyalgia and/or chronic fatigue syndrome patients.
Design: Forty-one (41) patients with a diagnosis of FMS and/or CFS were given D-ribose, a naturally occurring pentose carbohydrate, at a dose of 5 g t.i.d. for a total of 280 g. All patients completed questionnaires containing discrete visual analog scales and a global assessment pre– and post–D-ribose administration.
Results: D-ribose, which was well-tolerated, resulted in a significant improvement in all five visual analog scale (VAS) categories: energy; sleep; mental clarity; pain intensity; and well-being, as well as an improvement in patients’ global assessment. Approximately 66% of patients experienced significant improvement while on D-ribose, with an average increase in energy on the VAS of 45% and an average improvement in overall well-being of 30% (p 0.0001).
Conclusions: D-ribose significantly reduced clinical symptoms in patients suffering from fibromyalgia and chronic fatigue syndrome. 857
INTRODUCTION
Fibromyalgia (FMS), which currently affects an estimated 3 to 6 million Americans,1,2 and chronic fatigue syndrome (CFS) are disabling syndromes that often coexist. Patients suffering with these syndromes commonly report severe persistent fatigue, diffuse migratory pain, cognitive dysfunction, and disordered sleep. Many of the clinical symptoms found in FMS/CFS may be related to a decrease in tissue energy levels with altered energy metabolism. Previous reports claim that abnormal muscular energy metabolism frequently can be reflected in pain because of chronic muscle shortening,3 postexertional fatigue, and low exercise tolerance associated with decreased cardiac output and stroke volumes.4 In addition, it has been postulated that decreased energy production in these syndromes also may result in hypothalamic dysfunction, which can be reflected clinically as disordered sleep, hormonal imbalances, and autonomic dysfunctions.5 Causes and mechanisms for this mitochondrial dysfunction are unknown; however, an alteration in muscle adenine nucleotide
metabolism is found, mainly in lower adenosine triphosphate (ATP) levels and depleted energy reserves.6,7
D-Ribose, a naturally occurring pentose carbohydrate, is a key structural component in the DNA, RNA, ATP, FADH, coenzyme-A, and NADH needed by the mitochondria to maintain cellular energy homeostasis. Supplemental doses of D-ribose in patients with congestive heart failure and ischemic heart disease have shown a significant improvement in diastolic dysfunction, physical function, exercise tolerance, and quality of life.8 D-Ribose has also been reported to be effective in restoring tissue energy levels following intense exercise9 and in an isolated case report of a patient with FMS.10 Because of the known energy and functional 1Fibromyalgia and Fatigue Centers, Dallas, TX. 2Valen Labs, Minneapolis, MN. benefits of D-ribose, an open-label uncontrolled pilot study was performed to assess whether D-ribose would decrease symptoms in patients suffering from FMS and CFS.
MATERIALS AND METHODS
Patient enrollment
Forty-one (41) adult patients, diagnosed by their physicians as having FMS (by ACR Criteria) and/or CFS (by CDC criteria), were found eligible for this study. In addition, patients also had to be without known severe medication or nutrient sensitivities, and not have taken D-ribose in the past. Recruitment of patients was through the FMS and CFS e-mail newsletter associated with the Annapolis Research Center and the www.Vitality101.com web site. Readers with an established diagnosis of FMS or CFS were informed about the nature of the study and were invited to participate if they satisfied the entrance criteria. All patients were thoroughly
informed about D-ribose, its potential benefits, and possible adverse side-effects and gave informed consent. The protocol is consistent with the principles of the Declaration of Helsinki. Except for a free container of D-ribose, patients received no compensation.
Design of study
A 280-g container of D-ribose (CORvalen, Valen Labs, Minneapolis, MN) and a questionnaire (outcome measures) were mailed to each subject once the patient was enrolled. Each patient was instructed to take one scoop (5-g) of D-ribose three times per day (t.i.d.) mixed with food, water, or another beverage until the container was empty and then to return the container and questionnaires in a prepaid envelope. They were instructed to stay on their current treatment
regimen and not change dosing or add or delete any treatments during the study.
Outcome measures
Subjective outcome measures were assessed using discrete Visual Analog Scale questions (DVAS) pre- and postintervention. Measured DVAS parameters were energy levels,
sleep disturbances, mental clarity, pain, and an overall sense of well-being. Patients were asked to individually rate each of these five areas on a 1 to 10 scale as shown below:
A. How is your energy?
1 2 3 4 5 6 7 8 9 10
1 near dead and 10 excellent
B. How is your sleep?
1 2 3 4 5 6 7 8 9 10
1 no sleep and 10 8 hours of sleep a night without waking
C. How is your mental clarity?
1 2 3 4 5 6 7 8 9 10
1 brain dead and 10 good clarity
D. How bad is your pain?
1 2 3 4 5 6 7 8 9 10
1 very severe pain and 10 pain free
E. How is your overall sense of well-being?
1 3 4 5 6 7 8 9 10
1 near dead and 10 excellent
Compliance was addressed in each patient by asking how many doses were missed and noting how long it took to finish the 280-g container, as well as by weighing the received container at the completion of the study. Each patient was asked if any adverse side effects occurred while on D-ribose. Finally, each patient commented on his or her overall subjective feeling while taking D-ribose: much better, somewhat better, no change, somewhat worse, or much worse.
RESULTS
Of the 41 patients enrolled in the study, five patients were considered noncompliant; therefore, they were excluded from the study and final analysis. Noncompliance was defined as having consumed half or less of the provided D-ribose during the study. Of the 36 remaining patients, the average age was 48 years, 78% were female. Patients had been ill with CFS/FMS for an average of 7.15 years. Further demographics are summarized in Table 1. The average length
of time on D-ribose was 25 days (range, 17 to 35 days). Subjectively, significant improvements were found in energy levels (p 0.0001), sleep patterns (p 0.0001), mental clarity (p 0.003), pain threshold (p 0.026), and the patient’s state of well-being (p 0.0001) when comparing
questionnaires at enrollment and at the completion of the study in all of the patients (Table 2). Table 3 denotes the pre- and postribose assessments in patient categories for each separate syndrome. At the completion of the study, patients also felt a positive subjective improvement while taking D-ribose (Table 4). Twenty-three (23) of the 35 patients (65.7%) completing
the assessment experienced improvement during the course of the study (somewhat better to much better) while taking D-ribose. The responses were compared to the null 858 TEITELBAUM ET AL.
TABLE 1. PATIENT DEMOGRAPHICS
Patient demographics
Sex Female: 28 (78%)
Average age 48 years (21–62)
Previous diagnosis: FMS 75%
Previous diagnosis: CFS 58%
Average duration CORvalen therapya 28 days (17–35)
FMS, fibromyalgia; CFS, chronic fatigue syndrome.
aValen Labs, Minneapolis, MN. response of “No Change” in a one-sample nonparametric
sign test and signed rank test. Both tests resulted in statistical
significance (p 0.0001).
The following subgroup analyses were also performed: gender, age, CFS, and FMS. Gender was at least a marginally significant predictor of measured outcomes: energy levels (p 0.02), sleep patterns (p 0.001), mental clarity (p 0.002), pain threshold (p 0.06), state of well-being
(p 0.03), and total score (p 0.001). Age was not associated with any of the outcome parameters: energy levels (p 0.80), sleep patterns (p 0.32), mental clarity (p 0.97), pain threshold (p 0.50), a state of well-being (p 0.45), and total score (p 0.58). A prior diagnosis of CFS was not associated with any of the outcomes: energy levels (p 0.59), sleep patterns (p 0.28), mental clarity (p 0.33), pain threshold (p 0.39), state of well-being (p 0.39), and total score (p 0.27). Likewise, a prior diagnosis of FMS was not associated with any of the measured outcomes: energy levels (p 0.58), sleep patterns (p 0.29), mental clarity (p 0.20), pain threshold (p 0.43), state of well-being (p 0.33), and total score (p 0.24). Of the five patients that were found to be noncompliant,
three stopped taking D-ribose because of a hyperanxious feeling (one patient), lightheadedness (one patient), and increased appetite (one patient). Two others changed their mind and simply did not begin the study. Of the remaining 36 patients who completed the study, one patient experienced transient nausea and another felt mild anxiety. Both of these reactions were reversed by simply lowering the dose of D-ribose.
DISCUSSION
Fibromyalgia and CFS are common, nonarticular, debilitating syndromes that affect approximately 2%–4% of the population worldwide. Patients with FMS and/or CFS generally
demonstrate reduced sustained exercise capacity, with lack of muscular contractile force and endurance.11,12 Similar conditions are frequently associated with abnormal metabolism. Therefore, many FMS and/or CFS studies have investigated potential alterations in muscle metabolism. 6,13,14–19
D-RIBOSE FOR CFS AND FMS 859
TABLE 2. PRE- AND POSTRIBOSE ASSESSMENTS: ALL PATIENTS
Pre Post Difference
Category N mean (std) mean (std) (95% CI) p-Value
Energy level 36 3.8 (1.1) 5.5 (1.5) 1.7 0.0001
(1.1, 2.2)
Sleep 36 4.8 (1.6) 6.0 (1.9) 1.2 0.0001
(0.6, 1.7)
Mental clarity 36 4.9 (1.5) 5.7 (1.7) 0.8 0.003
(0.3, 1.3)
Pain 36 4.9 (2.3) 5.6 (2.2) 0.7 0.026
(0.1, 1.3)
Well-being 36 4.3 (1.3) 5.6 (1.5) 1.3 0.0001
(0.8, 1.9)
CI, confidence interval.
TABLE 3. PRE- AND POSTRIBOSE ASSESSMENTS PER DIAGNOSIS
FMS CFS Both FMS/CFS
(N 15) (N 9) (N 12)
Pre mean Post mean Improvement Pre mean Post mean Improvement Pre mean Post mean Improvement
Category (std) (std) (%) (std) (std) (%) (std) (std) (%)
Energy 3.7 5.5 1.8 4.2 6.1 1.9 3.7 4.9 1.2
(1.0) (1.5) (48%) (1.4) (1.5) (45%) (1.2) (1.4) (32%)
Sleep 4.4 5.9 1.5 5.6 7.2 1.6 4.8 5.2 0.4
(1.2) (1.6) (34%) (1.7) (1.7) (29%) (1.9) (2.2) (8%)
Mental clarity (14..07) (15..87) (211.%0 ) (25..02) (16..76) (217.%4 ) (15..71) (15..31) 0
Pain (24..35) (25..05) (212.%0 ) (62..73) (71..86) (116.%1 ) (41..16) (41..12) 0
Well-being 4.1 5.7 1.6 4.6 6.3 1.7 4.3 5.0 0.7
(1.0) (1.5) (39%) (1.7) (1.2) (37%) (1.3) (1.5) (16%)
FMS, fibromyalgia; CFS, chronic fatigue syndrome. Adenosine triphosphate (ATP) is the primary energy source of all living cells. In tissues subjected to metabolic stress, such as hypoxia, ischemia, or known conditions of mitochondrial dysfunction, ATP is catabolized with compromised metabolic recovery. With ATP catabolism, adenosine diphosphate (ADP) levels accumulate, forcing the cell to try to balance ATP/ADP ratios in order to maintain energy
stasis. However, these reactions ultimately lead to an increased intracellular concentration of adenosine monophosphate (AMP). In an effort to try to control energy balance, the cell catabolizes AMP, ultimately forming inosine, hypoxanthine, and adenine. These catabolic end products are washed out of the cell, resulting in a net loss of purines and an ultimate reduction in the total pool of adenine nucleotides. Potentially, up to 90% of these produced catabolites can be biochemically salvaged and recycled. 9,20,21
The rate of recovery of these energy substrates in metabolically stressed cells is important for functional recovery of the cell, including muscle.20,21–23 Therapeutic solutions that could
try to maintain a cell’s energy stasis include either blocking the degradation of adenine nucleotides or providing metabolic supplementation to enhance nucleotide recovery via the salvage or de novo pathways of purine synthesis. The availability of 5-phosphoribosyl-L-pyrophosphate (PRPP) is rate limiting in adenine nucleotide de novo synthesis and salvage pathways, which is necessary to preserve or rebuild cellular energy stores.9,20,21 5-Phosphoribosyl-Lpyrophasphate is formed through pyrophosphorylation of ribose-
5-phosphate that is, itself, synthesized from glucose via the pentose phosphate pathway (PPP; or hexose monophosphate shunt). The rate-limiting enzymes in the PPP, glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase, are poorly expressed in heart and muscle cells. As such, in skeletal muscle the PPP is suppressed, limiting ribose availability as a substrate to drive the purine nucleotide pathway and retarding purine nucleotide synthesis
during or following a metabolic insult. The energy reserve, phosphorylation potential (PP), and
the ability to use oxygen (total oxidative capacity or Vmax) have been determined using P-31 MRS in both normal and fibromyalgic muscle.16 Both mean PP and Vmax values are found to be significantly reduced in FMS.16 These findings are consistent with reduced oxidative phosphorylation and ATP synthesis, which translate clinically to muscle fatigue, soreness, and stiffness.24 Impairment in mitochondrial oxidative phosphorylation and potentially diminished glucose metabolism impact ATP turnover, suggesting that the muscles of fibromyalgia patients are energy starved. Further, decreased ATP concentrations with accompanying changes in
energy metabolism have been found in the red blood cells of fibromyalgia patients,25 suggesting that this energy deficiency may be systemic.
Muscular metabolic abnormalities in fibromyalgia have been proposed.6 Dysfunctional metabolism has been shown to lead to cellular abnormalities6 that impact cellular function,
producing clinical symptoms. Muscle biopsies have shown that levels of phosphocreatine (PCr) and ATP are significantly reduced (21% and 17%, respectively) in muscle tissues of fibromyalgia patients and the synthesis of PCr, an important store of cellular high-energy phosphates, is deficient. Magnetic imaging of skeletal muscle has shown that resting levels of ATP are 15% lower in fibromyalgia patients than in normal controls and during exercise PCr and ATP levels remain significantly low.14,16,19 During exercise there is an increase in metabolic breakdown products of ATP (phosphodiesters) in fibromyalgic skeletal muscle groups, indicating abnormal adenine nucleotide metabolism and disruption of cell membranes, which are common in other muscular diseases. There has been speculation that these findings may be similar in patients afflicted with CFS.16 It also has been shown that there are a decreased numbers of capillaries within fibromyalgic muscle fibers, which can reduce the oxidative capacity, leading to limited energy turnover, purine pool depletion, and increased pain.24,26 Thickening of the capillary endothelium also contributes to restricted oxygen transport or delivery, further lowering oxygen tension in the muscle, affecting energy metabolism and contributing to functional fatigue and weakness. In general, the fibromyalgic muscle has lower ATP concentrations than normal muscle. Further, these factors can alter calcium and cellular ion stasis, which, clinically can produce muscle soreness, stiffness, fatigue, and diminished exercise capacity. Patients with FMS and/or CFS may therefore have an alteration in muscular energy use and metabolism. Fibromyalgic muscle reaches anaerobic threshold earlier in exercise, thereby potentially using less available energy-rich phosphate metabolites at maximal work capacity. Patients with FMS may have abnormal high-energy phosphate metabolism with significantly lower levels of ATP and ADP in affected muscles as compared to normal controls.24
The findings in this pilot study, using daily D-ribose, revealed an increased improvement in the quality of life in patients afflicted with FMS/CFS. However, there are several limitations noted in this study. A major limitation centers on a lack of a placebo group. This was, however, meant as
an initial pilot study with each patient acting as their own control. A follow-up RCT is, of course, critical and currently 860 TEITELBAUM ET AL.
TABLE 4. GLOBAL SUBJECTIVE FEELING RATING
Response N (%)
Much better 5 (14.3%)
Somewhat better 17 (48.6%)
Somewhat better/no change 1 (2.9%)
No change 9 (25.7%)
No change/somewhat worse 1 (2.9%)
Somewhat worse 2 (5.7%)
Much worse 0 (0%)
under way using information (and impetus) gained from this pilot study. In addition, as patients were not seen in a clinic, initial assessment of each patient relied on their own personal physician providing an accurate clinical diagnosis of FMS/CFS. This pilot assessment was designed as a clinically focused, community-based study, and this reflects what occurs in most patients’ cases.
Subjective outcome measures were only assessed in this study. The diagnoses and effectiveness of therapies of FMS and CFS are largely based on subjective symptoms. As no accepted diagnostic laboratory tests are available to confirm the diagnoses of and monitor progress in these syndromes, it is reasonable to rely on subjective outcome measurements in this clinical setting. Also, patients did not eliminate other stable treatment modalities they had been on during the study. However, patients were instructed not to make any changes in their treatment regimen during the study. D-Ribose produced a subjective beneficial outcome in these patients;
therefore, the addition of D-ribose may offer an added benefit to their concurrent therapies.
CONCLUSIONS
This pilot study suggests that D-ribose may provide subjective benefits in patients with FMS and/or CFS. Given the biochemical benefits of D-ribose on increasing muscular energy pools and reducing metabolic strain in affected muscles, the use of this supplement may offer a valuable option for improving quality of life in patients afflicted with FMS and/or CFS.
ACKNOWLEDGMENTS
The authors thank Valen Labs, Inc. (Minneapolis, MN) for providing the oral D-ribose. Dr. Teitelbaum has no financial conflict of interest and his payment for doing the study was donated to charity. Dr. St. Cyr is a consultant for Valen Labs, and Mr. Johnson is on staff at Valen Labs.
REFERENCES
1. Goldenberg DL. Fibromyalgia syndrome—an emerging but controversial condition. JAMA 1987;257:2782–2787.
2. Wolfe F, Ross K, Anderson J, et al. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheumatol 1995;38:19–28.
3. Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual, vol. 1. Baltimore: Williams & Wilkins, 1983.
4. Peckerman A, LaMancha JJ, Dahl KA, et al. Abnormal impedance cardiography predicts symptom severity in chronic fatigue syndrome. Am J Med Sci 2003;26:55–60.
5. Teitelbaum JE, Bird B, Greenfield RM, et al. Effective treatment of CFS and FMS: A randomized, double-blind placebo controlled study. J Chronic Fatigue Syndrome 2001;8:3–24.
6. Bengtson A, Heriksson KG, Larsson J. Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia. Arthritis Rheumatol 1986;29:817–821.
7. Eisinger J, Plantamura A, Ayavou T. Glycolysis abnormalities in fibromyalgia. J Am Coll Nutr 1994;13:144–148.
8. Omran H, Illien S, MacCarter D, et al. D-Ribose improves diastolic function and quality of life in congestive heart failure patients: A prospective feasibility study. Eur J Heart Failure
2003;5:615–619.
9. Hellsten Y, Skadgauge L, Bangsbo J. Effect of ribose supplementation on resynthesis of adenine nucleotides after intense intermittent training in humans. Am J Physiol 2004;286:
R182–R188.
10. Gebhart B, Jorgenson J. Benefit of ribose in a patient with fibromyalgia. Pharmacotherapy 2004;24:1646–1648.
11. Lund N, Bengtsson A, Thorborg P. Muscle tissue oxygen in primary fibromyalgia. Scan J Rheumatol 1986;15:165–173.
12. Schachter CL, Busch AL, Peloso PM, Shepard MS. Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: A randomized controlled trial. Phys Ther 2003;83:340–358.
13. 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;32:138–145.
14. Strobl ES, Krapf M, Suckfull M, et al. Tissue oxygen measurement and 31P magnetic resonance spectroscopy in patients with muscle tension and fibromyalgia. Rheumatol Int
1997;16:175–180.
15. Krapf MW, Muller S, Mennet P, et al. Recording muscle spasms in the erector spinae using in vivo 31P magnetic resonance spectroscopy in patients with chronic lumbalgia and generalized tendomyopathies. Z Rheumatol 1992;51:229–237.
16. Park JH, Phothimat P, Oates CT, et al. Use of P-31 magnetic resonance spectroscopy to detect metabolic abnormalities in muscles of patients with fibromyalgia. Arthritis Rheumatol
1998;41:406–413.
17. Jacobsen S, Jensen KE, Thomsen C, et al. Magnetic resonance spectroscopy in fibromyalgia. A study of phosphate-31 spectra from skeletal muscles during rest and after exercise. Ugeskr
Laeger 1994;156:6841–6844.
18. Kushmerick MJ. Muscle energy metabolism, nuclear magnetic resonance spectroscopy and their potential in the study of fibromyalgia. J Rheumatol 1989;(Suppl 19):40–46.
19. Sprott H, Rzanny R, Reichenbach JR, et al. 31P magnetic resonance spectroscopy in fibromyalgic muscle. Rheumatology (Oxford) 2000;39:1121–1125.
20. Brault JJ, Terjung RL. Purine salvage to adenine nucleotides in different skeletal muscle fiber types. J Appl Physiol 2001;91:231–238.
21. Tullson PC, Terjung RL. Adenine nucleotide synthesis in exercising and endurance-trained skeletal muscle. Am J Physiol 1991;261:C342–C347.
22. Reibel D, Rovetto M. Myocardial ATP synthesis and mechanical function following oxygen deficiency. Am J Physiol. 1978;234:H620–H624. D-RIBOSE FOR CFS AND FMS 861
23. Williamson DL, Gallagher PM, Goddard MP, Trappe SW. Effects of ribose supplementation on adenine nucleotide concentration in skeletal muscle following high-intensity exercise.
Med Sci Sport Exc 2001;33(5 suppl):5166.
24. Olson NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci 1998;315:351–358.
25. Eisinger J, Bagneres D, Arroyo P, et al. Effects of magnesium, high-energy phosphates, piracetam and thiamin on erythrocyte transketolase. Magnet Res 1994;7:59–61.
26. Bengtsson A, Henriksson KG. The muscle in fibromyalgia—a review of Swedish studies. J Rheumatol Suppl 1989;19:144–149.
Address reprint requests to:
Jacob E. Teitelbaum, M.D.
76-6326 Kaheiau Street
Kailua-Kona, HI 96740
E-mail: Endfatigue@aol.com
862 TEITELBAUM ET AL.
Friday, May 9, 2008
Natural Treatment for Fibromyalgia
Natural Treatment Protocol for Fibromyalgia
CorvalenM (1 scoop 2X/day in water with food (Take 1 scoop 3X/day for the first 3 weeks) and then decrease to 2X/day). CORvalenM contains pure Bioenergy RIBOSE to help your cells and tissues make the energy they need to stay healthy. It also provides magnesium and malate, vital ingredients your body needs to use energy efficiently. Ribose has been gaining a lot of attention because it has been clinically proven to be critical in rebuilding cellular energy. The result of energy restoration leaves people feeling less pain with more energy. This unique, safe, and clinically proven combination of ingredients accelerates your body's own natural process of energy synthesis and utilization. Ribose is a five-carbon monosaccharide that is vital for the cellular synthesis of ATP (adenosine triphosphate). Adenosine triphosphate is the energy of life and ribose is one of the fundamental building blocks of ATP. Supplemental ribose has been proven to effectively speed energy recovery in cells, represented in improved cardiac function, muscle recovery and overall quality of life.
Metagenics COQ10 ST-100 (1 gel cap 2X/day with meals) Important in energy production, enhances immune function, decrease the frequency of migraine headaches, assist weight loss when dieting, improve exercise tolerance in sedentary people, decrease allergies.
Metagenics EPA/DHA Extra Strength 720 (2 gel caps 2X/day with meal (fat). Fish oil levels are low in CFS/FMS patients. Decrease anger, anxiety, depression, increase vigor, improve attention, cognition, physiological functions and mood. Decreases dry eyes.
Metagenics Myocalm (2 tablets up to 3 tabletsAs needed for muscle tightness). Natural muscle relaxer, tension, anxiety. Supplies important minerals involved in muscular contraction and relaxation responses. May help relieve minor muscle pain associated with stress or physical exertion, and may prevent nocturnal leg muscle cramps.
Metagenics Fibroplex or Fibroplex Plus
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. (2-4 tablets 2X/day (pain & energy) Take up to 8 tablets a day to find your correct dose)
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.
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 proteinbreakdown. 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. These studies also used magnesium supplements, due to the fact that magnesium is often low in FM patients. 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 MyocalmPM (3 tablets 60 minutes before bedtime) Useful as a sleep aid, muscle and tension relief. Promotes a feeling of calm.
Metagenics Tran-Q (relax muscles, ease tension) 6-8 tablets/day in divided doses if muscles still tense/tight with Myocalm. Helps to promote relaxation and sense of well being.
Metagenics UltraInflamX
See UltraInflamXModified Step Program for directions. May lower inflammatory response by modulating the pro-inflammatory “cascade”, supporting the anti-inflammatory “pathways”, and quenching the excessive free-radical production that may be associated with increased inflammation. Important in all chronic inflammatory conditions. Useful in fibromyalgia.
CorvalenM (1 scoop 2X/day in water with food (Take 1 scoop 3X/day for the first 3 weeks) and then decrease to 2X/day). CORvalenM contains pure Bioenergy RIBOSE to help your cells and tissues make the energy they need to stay healthy. It also provides magnesium and malate, vital ingredients your body needs to use energy efficiently. Ribose has been gaining a lot of attention because it has been clinically proven to be critical in rebuilding cellular energy. The result of energy restoration leaves people feeling less pain with more energy. This unique, safe, and clinically proven combination of ingredients accelerates your body's own natural process of energy synthesis and utilization. Ribose is a five-carbon monosaccharide that is vital for the cellular synthesis of ATP (adenosine triphosphate). Adenosine triphosphate is the energy of life and ribose is one of the fundamental building blocks of ATP. Supplemental ribose has been proven to effectively speed energy recovery in cells, represented in improved cardiac function, muscle recovery and overall quality of life.
Metagenics COQ10 ST-100 (1 gel cap 2X/day with meals) Important in energy production, enhances immune function, decrease the frequency of migraine headaches, assist weight loss when dieting, improve exercise tolerance in sedentary people, decrease allergies.
Metagenics EPA/DHA Extra Strength 720 (2 gel caps 2X/day with meal (fat). Fish oil levels are low in CFS/FMS patients. Decrease anger, anxiety, depression, increase vigor, improve attention, cognition, physiological functions and mood. Decreases dry eyes.
Metagenics Myocalm (2 tablets up to 3 tabletsAs needed for muscle tightness). Natural muscle relaxer, tension, anxiety. Supplies important minerals involved in muscular contraction and relaxation responses. May help relieve minor muscle pain associated with stress or physical exertion, and may prevent nocturnal leg muscle cramps.
Metagenics Fibroplex or Fibroplex Plus
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. (2-4 tablets 2X/day (pain & energy) Take up to 8 tablets a day to find your correct dose)
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.
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 proteinbreakdown. 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. These studies also used magnesium supplements, due to the fact that magnesium is often low in FM patients. 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 MyocalmPM (3 tablets 60 minutes before bedtime) Useful as a sleep aid, muscle and tension relief. Promotes a feeling of calm.
Metagenics Tran-Q (relax muscles, ease tension) 6-8 tablets/day in divided doses if muscles still tense/tight with Myocalm. Helps to promote relaxation and sense of well being.
Metagenics UltraInflamX
See UltraInflamXModified Step Program for directions. May lower inflammatory response by modulating the pro-inflammatory “cascade”, supporting the anti-inflammatory “pathways”, and quenching the excessive free-radical production that may be associated with increased inflammation. Important in all chronic inflammatory conditions. Useful in fibromyalgia.
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.
Tuesday, February 26, 2008
NaturalNews.com printable articleOriginally published February 25 2008
Brenda Cobb: 4 Reasons People Get Sick and Healing Through Thoughts by Kevin Gianni (see all articles by this author)
(NaturalNews) This is an excerpt from Brenda Cobb's interview for the Raw Summit, a complete interview encyclopedia of cutting edge living and raw food knowledge. You can find the complete transcripts and audios at (http://www.rawsummitarchives.com/). In this interview, Brenda Cobb, author and founder of The Living Foods Institute in Atlanta, GA, gives the 4 reasons why she feels people get sick and the emotional component to healing.
Raw Food World Summit Interview Excerpt with Brenda Cobb, Kevin Gianni: When you talk about illness and you talk about people who have disease and who can heal themselves, it's more than just food, correct?
Brenda Cobb: It really is. I believe that it's much more than the food. I think that's one of the reasons that the program that I use now, developed over the nine years of having been doing this, is so effective to the health of people - because we look beyond the food. Now, we certainly do use a 100% organic, the raw food and the living food.The way we describe raw food and living food is raw food, we believe, is fruits, vegetables and not seeds that have not been cooked. We believe a living food is a sprouted food, something that's growing when you eat it; among them bean and lentil sprout and sun flower, and buckwheat sprout. And so, that certainly is a part of the program.
But we believe there are really four main reasons that people get sick. The number one reason we believe is because of how people think, we think it's more important than what we're eating; and part of that number one reason is emotional stuff because most everybody, and you can hardly avoid it if you go through the human experience on the planet earth, is going to have emotional stuff sometimes that has been buried so deep that they don't even really it's there. And so it's good to work on the emotional stuff and clear that out, there is sometimes issues with forgiveness - forgiving yourself or things or somebody else who has maybe done you wrong and really letting go of those things. And then another part of that number one reason is stress because the world we are living in is stressful. It's never what happens to you, it's always you're reaction to what happens to you and you can stress yourself out or you can learn how to deal with stress so that it becomes constructive rather than destructive. So that's the first area we help people with.
The number two area we help people with is toxicity because there's toxins that have built up over years of breathing the air, drinking water that is not pure, of eating processed foods with additive colors, chemicals, dyes, maybe foods that have been genetically modified, hybridized, taking prescription and over-the-counter medications, drinking alcohols, smoking cigarettes, whatever it might be. Toxic relationship, toxic job contributes to toxicity in the body. So, we believe you have to get all the toxins that are already in there out so the body can do what it was created to do in that field itself.
The third reason we think people are getting sick is because of their decisions and we are believing that a lot are deficient in vitamins, minerals, and enzymes. Now, we are doing our best to get these through good nutrition, but also realize that the soil today is not what it was in great, great granddaddy's day and that there is not as much of the mineralization and so forth in the soil. So, there are some super foods and algae and some products that we used that helped to boost that along with the good nutrition. But we do believe that you cannot take a product in place of good nutrition. You've got to have good nutrition as your foundation and then if you want to do any supplementation, I like the supplement only with food sources, you know, a raw food powder or an algae and we also use herbs and essential oils to help the body to cleanse and detox and nourish. We found that to be very effective.
And then the fourth thing that we found make people sick is the dirty, toxic impacted colon. So our program also focuses on cleansing the colon, getting out the impacted waste, mucoid plaque, worm, parasites. You know, from years of eating maybe foods made with flour and water that makes a glue or a paste and people get that gunk and that sticky stuff inside of their colon and it sticks in there and sometimes it can become really hard and there's a barrier between the good nutrition, even if you're eating good food. You've changed your ways and now you're eating raw and living food. If you got a lot of plaque built up in the colon, you can't really assimilate the nutrients as well. So, we like to simultaneously be putting in the good food while we are also getting out the bad stuff and then when we do all of it together, we really feel that, that's supporting the body, the mind, the spirit, the mental, the emotional, the physical, the spiritual, and that the body can bounce back from most anything.
Kevin: Let's talk about number one. How are some of the ways that someone can deal with the way that they're thinking or not even deal but free themselves of some of the stress and some of the emotional issues that they have?
Brenda: Well, first thing is a lot of times we are thinking thoughts that we don't really even realize are negative. Many people, if you talk to them about negative thinking or negative speaking and you ask them, "Do you speak or think in a negative way?" Most people will say, "No, I don't." But then when you really kind of get down to how they are talking to themselves, you will see that the way that they're talking is not really positive, that they are meaning to say something positive but they're saying it in a negative way.
So that's the first thing, it's really just kind of teaching people to unprogram themselves; you know, it's kind of like when you were a child and you're sad, you're told, "Don't speak unless spoken to," you know or "Don't talk to strangers," and then you grow up and you're in a job, you're in a sales position, you've got to speak and you've got to talk to strangers. So, now what are you going to do? So, it comes just as a part of reprogramming some of those old tapes that we have heard and how to talk about ourselves positively.
One way we do it is to teach people some very simple affirmations; even though they may sound very simple, almost too simple and people will say, "Gosh, it seems so easy, how can it work if it's so simple?"Well you know, anytime you say the words, "I am" and then you feel that blanking with another word, you're saying the most possible, positive or powerful three words that you can say. So if you say, "I am healed" then you're going to create the energy of healing. But if you say "I am sick" you're going to continue to create the energy around sickness. So, that's one thing, really being careful when you say "I am". You know, let's say you work really hard all day and you're tired, so you're saying "I am so tired". Well, the more you say it, the more tired that you get.
Instead, if you go out and take a little walk around the block and say, "I am energized, I am enthusiastic, I am excited to be alive," you begin talking to yourself in that way, breathing the fresh air, getting the body moving a little bit, you'll see that at the end of that 20 or 30 minutes, you are actually feeling better. So, that's one thing.
Now, as far as emotional stuff, really we like to help people to understand what are the emotional components that are related to the disease or symptom that they've manifested. I used a couple of books that I really like for that. I used a book called Feeling Buried Alive Never Die by Karol Truman and I used a book that a lot of people have heard of called You Can Heal Your Life by Louise Hay and then I used a book called Radical Forgiveness by Colin Tipping and we really study those levels of "okay, first let's get real about what is that emotional component and does it ring true for you and sometimes people will say, 'Wow, I cannot believe how much that is like me, what you're telling me, this emotional thing.'"All the times people will even be in denial more and they'll say, "Well no, I don't think that's it, I don't see how that could be causing my problem." So we just gently and lovingly work with people to get them more aware.
We have specific exercises that we do in our emotional healing classes to help people to be able to see within themselves and, you know we get them to face some of the things, you know, asking them questions like "what is it about yourself that you would like to see change" and "you know, how do you think that the way you've thought in the past has impacted you and do you think that you are fulfilling your mission in life" and just get people dialoguing and thinking, you know when you start talking among yourselves, you can even create a wonderful mastermind group and all of the sudden just from hearing what other people are saying, many times we get our own answers. We're not looking to somebody else to figure it out for us, you know we can figure it out our self but it helps to be able to discuss it with others.And so that is also a part of the way that we help people through emotional healing. Now, with stress, we are doing breathing exercises, relaxation exercises, stretching, yoga, you know helping people to learn how to relieve stress that gets impacted in their self and in their organs, in their glands. Most people don't breathe to their full capacity, that shallow breathing, and they find that when they really use more of their lungs and breathe in deeply, that itself can relax.We talk and teach about meditation and how just to be free of thought for a little bit, don't even think about anything and, you know something Kevin, that's more challenging than it sounds. So, just not focus on thinking about a particular thing and to rest the mind and I think all of those things put together can really impact the person in a positive way.
To read the rest of this interview please visit (http://www.rawsummitarchives.com/) . This is just an excerpt of over 14 hours of cutting edge living food, raw food or health information revealed during the Raw Food World Summit.
About the authorKevin Gianni is a health advocate, author and speaker. He has helped thousands of people in over 85 countries learn how to take control of their health--and keep it. To view commentary on natural health issues, vegan and raw food diets, holistic nutrition and more click here.His book, "The Busy Person's Fitness Solution," is a step-by-step guide to optimum health for the time and energy-strapped.To find out more about abundance, optimum health and self motivation click here... or you're interested in the vegan and raw food diet and cutting edge holistic nutrition click here.For access to free interviews, downloads and a complete bodyweight exercise archive visit www.LiveAwesome.com.
Brenda Cobb: 4 Reasons People Get Sick and Healing Through Thoughts by Kevin Gianni (see all articles by this author)
(NaturalNews) This is an excerpt from Brenda Cobb's interview for the Raw Summit, a complete interview encyclopedia of cutting edge living and raw food knowledge. You can find the complete transcripts and audios at (http://www.rawsummitarchives.com/). In this interview, Brenda Cobb, author and founder of The Living Foods Institute in Atlanta, GA, gives the 4 reasons why she feels people get sick and the emotional component to healing.
Raw Food World Summit Interview Excerpt with Brenda Cobb, Kevin Gianni: When you talk about illness and you talk about people who have disease and who can heal themselves, it's more than just food, correct?
Brenda Cobb: It really is. I believe that it's much more than the food. I think that's one of the reasons that the program that I use now, developed over the nine years of having been doing this, is so effective to the health of people - because we look beyond the food. Now, we certainly do use a 100% organic, the raw food and the living food.The way we describe raw food and living food is raw food, we believe, is fruits, vegetables and not seeds that have not been cooked. We believe a living food is a sprouted food, something that's growing when you eat it; among them bean and lentil sprout and sun flower, and buckwheat sprout. And so, that certainly is a part of the program.
But we believe there are really four main reasons that people get sick. The number one reason we believe is because of how people think, we think it's more important than what we're eating; and part of that number one reason is emotional stuff because most everybody, and you can hardly avoid it if you go through the human experience on the planet earth, is going to have emotional stuff sometimes that has been buried so deep that they don't even really it's there. And so it's good to work on the emotional stuff and clear that out, there is sometimes issues with forgiveness - forgiving yourself or things or somebody else who has maybe done you wrong and really letting go of those things. And then another part of that number one reason is stress because the world we are living in is stressful. It's never what happens to you, it's always you're reaction to what happens to you and you can stress yourself out or you can learn how to deal with stress so that it becomes constructive rather than destructive. So that's the first area we help people with.
The number two area we help people with is toxicity because there's toxins that have built up over years of breathing the air, drinking water that is not pure, of eating processed foods with additive colors, chemicals, dyes, maybe foods that have been genetically modified, hybridized, taking prescription and over-the-counter medications, drinking alcohols, smoking cigarettes, whatever it might be. Toxic relationship, toxic job contributes to toxicity in the body. So, we believe you have to get all the toxins that are already in there out so the body can do what it was created to do in that field itself.
The third reason we think people are getting sick is because of their decisions and we are believing that a lot are deficient in vitamins, minerals, and enzymes. Now, we are doing our best to get these through good nutrition, but also realize that the soil today is not what it was in great, great granddaddy's day and that there is not as much of the mineralization and so forth in the soil. So, there are some super foods and algae and some products that we used that helped to boost that along with the good nutrition. But we do believe that you cannot take a product in place of good nutrition. You've got to have good nutrition as your foundation and then if you want to do any supplementation, I like the supplement only with food sources, you know, a raw food powder or an algae and we also use herbs and essential oils to help the body to cleanse and detox and nourish. We found that to be very effective.
And then the fourth thing that we found make people sick is the dirty, toxic impacted colon. So our program also focuses on cleansing the colon, getting out the impacted waste, mucoid plaque, worm, parasites. You know, from years of eating maybe foods made with flour and water that makes a glue or a paste and people get that gunk and that sticky stuff inside of their colon and it sticks in there and sometimes it can become really hard and there's a barrier between the good nutrition, even if you're eating good food. You've changed your ways and now you're eating raw and living food. If you got a lot of plaque built up in the colon, you can't really assimilate the nutrients as well. So, we like to simultaneously be putting in the good food while we are also getting out the bad stuff and then when we do all of it together, we really feel that, that's supporting the body, the mind, the spirit, the mental, the emotional, the physical, the spiritual, and that the body can bounce back from most anything.
Kevin: Let's talk about number one. How are some of the ways that someone can deal with the way that they're thinking or not even deal but free themselves of some of the stress and some of the emotional issues that they have?
Brenda: Well, first thing is a lot of times we are thinking thoughts that we don't really even realize are negative. Many people, if you talk to them about negative thinking or negative speaking and you ask them, "Do you speak or think in a negative way?" Most people will say, "No, I don't." But then when you really kind of get down to how they are talking to themselves, you will see that the way that they're talking is not really positive, that they are meaning to say something positive but they're saying it in a negative way.
So that's the first thing, it's really just kind of teaching people to unprogram themselves; you know, it's kind of like when you were a child and you're sad, you're told, "Don't speak unless spoken to," you know or "Don't talk to strangers," and then you grow up and you're in a job, you're in a sales position, you've got to speak and you've got to talk to strangers. So, now what are you going to do? So, it comes just as a part of reprogramming some of those old tapes that we have heard and how to talk about ourselves positively.
One way we do it is to teach people some very simple affirmations; even though they may sound very simple, almost too simple and people will say, "Gosh, it seems so easy, how can it work if it's so simple?"Well you know, anytime you say the words, "I am" and then you feel that blanking with another word, you're saying the most possible, positive or powerful three words that you can say. So if you say, "I am healed" then you're going to create the energy of healing. But if you say "I am sick" you're going to continue to create the energy around sickness. So, that's one thing, really being careful when you say "I am". You know, let's say you work really hard all day and you're tired, so you're saying "I am so tired". Well, the more you say it, the more tired that you get.
Instead, if you go out and take a little walk around the block and say, "I am energized, I am enthusiastic, I am excited to be alive," you begin talking to yourself in that way, breathing the fresh air, getting the body moving a little bit, you'll see that at the end of that 20 or 30 minutes, you are actually feeling better. So, that's one thing.
Now, as far as emotional stuff, really we like to help people to understand what are the emotional components that are related to the disease or symptom that they've manifested. I used a couple of books that I really like for that. I used a book called Feeling Buried Alive Never Die by Karol Truman and I used a book that a lot of people have heard of called You Can Heal Your Life by Louise Hay and then I used a book called Radical Forgiveness by Colin Tipping and we really study those levels of "okay, first let's get real about what is that emotional component and does it ring true for you and sometimes people will say, 'Wow, I cannot believe how much that is like me, what you're telling me, this emotional thing.'"All the times people will even be in denial more and they'll say, "Well no, I don't think that's it, I don't see how that could be causing my problem." So we just gently and lovingly work with people to get them more aware.
We have specific exercises that we do in our emotional healing classes to help people to be able to see within themselves and, you know we get them to face some of the things, you know, asking them questions like "what is it about yourself that you would like to see change" and "you know, how do you think that the way you've thought in the past has impacted you and do you think that you are fulfilling your mission in life" and just get people dialoguing and thinking, you know when you start talking among yourselves, you can even create a wonderful mastermind group and all of the sudden just from hearing what other people are saying, many times we get our own answers. We're not looking to somebody else to figure it out for us, you know we can figure it out our self but it helps to be able to discuss it with others.And so that is also a part of the way that we help people through emotional healing. Now, with stress, we are doing breathing exercises, relaxation exercises, stretching, yoga, you know helping people to learn how to relieve stress that gets impacted in their self and in their organs, in their glands. Most people don't breathe to their full capacity, that shallow breathing, and they find that when they really use more of their lungs and breathe in deeply, that itself can relax.We talk and teach about meditation and how just to be free of thought for a little bit, don't even think about anything and, you know something Kevin, that's more challenging than it sounds. So, just not focus on thinking about a particular thing and to rest the mind and I think all of those things put together can really impact the person in a positive way.
To read the rest of this interview please visit (http://www.rawsummitarchives.com/) . This is just an excerpt of over 14 hours of cutting edge living food, raw food or health information revealed during the Raw Food World Summit.
About the authorKevin Gianni is a health advocate, author and speaker. He has helped thousands of people in over 85 countries learn how to take control of their health--and keep it. To view commentary on natural health issues, vegan and raw food diets, holistic nutrition and more click here.His book, "The Busy Person's Fitness Solution," is a step-by-step guide to optimum health for the time and energy-strapped.To find out more about abundance, optimum health and self motivation click here... or you're interested in the vegan and raw food diet and cutting edge holistic nutrition click here.For access to free interviews, downloads and a complete bodyweight exercise archive visit www.LiveAwesome.com.
Wednesday, February 6, 2008
Rhodiola Herbal Extract Found to Fight Off Depression
Rhodiola Herbal Extract Found to Fight Off Depression
by Michael Jolliffe
(NaturalNews) A new clinical trial has found that an extract of the herb Rhodiola could be a useful treatment for cases of mild to moderate depression.
The study, published in the Nordic Journal of Psychiatry, involved 80 participants, aged between 18 and 70, who were divided into three groups. The first received 340mg of Rhodiola extract daily, the second twice as much, and the third two capsules containing a placebo.
The results revealed that only the groups taking Rhodiola had found benefit, with particularly significant improvements in insomnia and emotional instability, and no adverse effects.
Rhodiola is thought to work against depression in two ways. Firstly, researchers believe the herb blocks the enzyme monoamine oxidase in a manner similar to the early drug anti-depressants such as amitriptyline, which helps the brain to retain levels of 'feel good' neurotransmitters such as serotonin and norepinephrine. Rhodiola is also believed to calm a part of the brain known as the HPA axis, which connects the brain to the adrenal glands. High levels of adrenal stress hormones have consistently been found in individuals suffering from depression, but Rhodiola may address this imbalance and help to restore normal levels.
The plant has a long history of traditional usage associated with improving strength, motivation and resistance to stress and fatigue. Early records suggest that civilisations as old as the Vikings have prized and cultivated Rhodiola. It was equally prized by Soviet researchers during the Cold War, who successfully tested its application with both athletes and astronauts.
Experts have commented on the promise that this latest research holds for the treatment of depression. Dr. Richard Brown, associate professor of clinical psychiatry at Columbia University College of Physicians & Surgeons, and one of the world's leading experts on Rhodiola, called for additional studies 'to explore and establish the potential applications of the herb', but stated his belief that both sufferers and researchers should be 'encouraged' by the results.
About the author
Michael Jolliffe is a health writer, and an expert on nutritional and environmental influences on health and disease. He is a member of the British Association for Nutritional Therapy, International Society for Orthomolecular Medicine and the Life Extension Foundation.
by Michael Jolliffe
(NaturalNews) A new clinical trial has found that an extract of the herb Rhodiola could be a useful treatment for cases of mild to moderate depression.
The study, published in the Nordic Journal of Psychiatry, involved 80 participants, aged between 18 and 70, who were divided into three groups. The first received 340mg of Rhodiola extract daily, the second twice as much, and the third two capsules containing a placebo.
The results revealed that only the groups taking Rhodiola had found benefit, with particularly significant improvements in insomnia and emotional instability, and no adverse effects.
Rhodiola is thought to work against depression in two ways. Firstly, researchers believe the herb blocks the enzyme monoamine oxidase in a manner similar to the early drug anti-depressants such as amitriptyline, which helps the brain to retain levels of 'feel good' neurotransmitters such as serotonin and norepinephrine. Rhodiola is also believed to calm a part of the brain known as the HPA axis, which connects the brain to the adrenal glands. High levels of adrenal stress hormones have consistently been found in individuals suffering from depression, but Rhodiola may address this imbalance and help to restore normal levels.
The plant has a long history of traditional usage associated with improving strength, motivation and resistance to stress and fatigue. Early records suggest that civilisations as old as the Vikings have prized and cultivated Rhodiola. It was equally prized by Soviet researchers during the Cold War, who successfully tested its application with both athletes and astronauts.
Experts have commented on the promise that this latest research holds for the treatment of depression. Dr. Richard Brown, associate professor of clinical psychiatry at Columbia University College of Physicians & Surgeons, and one of the world's leading experts on Rhodiola, called for additional studies 'to explore and establish the potential applications of the herb', but stated his belief that both sufferers and researchers should be 'encouraged' by the results.
About the author
Michael Jolliffe is a health writer, and an expert on nutritional and environmental influences on health and disease. He is a member of the British Association for Nutritional Therapy, International Society for Orthomolecular Medicine and the Life Extension Foundation.
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